Posterior Mini-Invasive Restorations: The Dilemma of Material Choice

Introduction: Minimally invasive dentistry prioritizes preserving tooth structure while restoring function and esthetics. For posterior restorations, choosing among various ceramic and hybrid ceramic materials presents a significant dilemma. The present work discusses the critical factors influencing the selection of these indirect materials, highlighting their properties, indications, and the challenges in optimizing clinical outcomes.

Methods: The material classes considered include feldspathic porcelain, leucite-reinforced ceramics, lithium disilicate, zirconia (monolithic and layered), and resin–ceramic hybrid materials. Evaluation criteria encompass mechanical properties (flexural strength, fracture toughness, wear resistance), esthetics, bondability, biocompatibility, and their ability to facilitate conservative tooth preparation. Clinical scenarios and patient-specific factors like occlusal load, esthetic demands, and opposing dentition are also addressed.

Results: For posterior mini-invasive restorations, lithium disilicate is a common choice, offering excellent esthetics and good mechanical properties for inlays, onlays, and crowns. Zirconia, particularly in monolithic forms, is preferred for high-occlusal-load situations due to its superior strength, though esthetics may vary with opacity. Newer translucent zirconias balance esthetics and strength. Resin–ceramic hybrid materials combine polymer resilience with ceramic wear resistance, offering shock absorption and ease of repair for specific minimally invasive applications. The dilemma often involves balancing strength, esthetics, and conservative preparation, as material properties directly influence required preparation dimensions. Patient factors like bruxism or limited interocclusal space further complicate the decision.

Conclusions: Selecting indirect ceramic or hybrid ceramic materials for posterior minimally invasive restorations in prosthodontics is a complex decision. While lithium disilicate and zirconia offer robust options for strength and esthetics, resin–ceramic hybrids provide unique advantages. The ultimate choice hinges on a thorough clinical assessment, aiming to resolve this material dilemma for optimal long-term success of conservative restorations.