A critical scoping review of fractographic studies on clinically fractured all-ceramic fixed dental prostheses
Pilecco RO, Pereira GKR, Bacchi A, Tribst JPM, Dal Piva AMdO, Kleverlaan CJ, Valandro LF, Cesar PF, Lohbauer U, Scherrer SS (2026)
Publication Type: Journal article, Review article
Publication year: 2026
Journal
DOI: 10.1016/j.dental.2026.07.008
Abstract
Objectives: Fractures in all-ceramic restorations remain a relevant clinical complication despite advances in materials and manufacturing. This study aimed to map and critically appraise the available evidence on fractographic analyses of clinically failed all-ceramic prostheses, focusing on fracture origins and reporting quality. Methods: This scoping review followed JBI guidelines and was registered in the Open Science Framework. Two trained independent reviewers searched LILACS, MEDLINE, EMBASE, Web of Science and Scopus databases. Studies published in English reporting fractographic analyses of clinically failed prostheses were included. Data extraction covered fractographic methods, restoration type, ceramic material, fracture type, and origin location. Results: Fracture origins were strongly influenced by restoration design and support conditions. In tooth-supported bilayered alumina single crowns, fracture occurred predominantly at the cervical margins, followed by veneer chipping. In tooth-supported bilayered zirconia FDPs, fractures originated mainly at the gingival side of connectors, followed by veneer chipping. In implant-supported zirconia veneered single crowns, fracture origins were identified at screw access holes or at internal angles of the abutment. In bilayered zirconia implant-supported FDPs, veneer chipping was the most frequent fracture type. Significant variability was identified in the quality of published fractographic analyses. Significance: Despite advances in materials and manufacturing, fractures in all-ceramic restorations remain a clinical challenge, often associated with design or processing factors. The variability in fracture-prone regions highlights the complexity of restoration biomechanics. Improved adherence to fractographic guidelines and closer collaboration with trained fractographers should be included in future studies to enhance the quality and interpretability of fracture analysis.
Authors with CRIS profile
Involved external institutions
Universidade Federal do Rio Grande do Sul (UFRGS)
Brazil (BR)
Federal University of Santa Maria / Universidade Federal de Santa Maria (UFSM)
Brazil (BR)
Academisch Centrum Tandheelkunde Amsterdam
Netherlands (NL)
University of São Paulo / Universidade de São Paulo (USP)
Brazil (BR)
University of Geneva / Université de Genève (UNIGE)
Switzerland (CH)
Brazil (BR)
Federal University of Santa Maria / Universidade Federal de Santa Maria (UFSM)
Brazil (BR)
Academisch Centrum Tandheelkunde Amsterdam
Netherlands (NL)
University of São Paulo / Universidade de São Paulo (USP)
Brazil (BR)
University of Geneva / Université de Genève (UNIGE)
Switzerland (CH)
How to cite
APA:
Pilecco, R.O., Pereira, G.K.R., Bacchi, A., Tribst, J.P.M., Dal Piva, A.M.d.O., Kleverlaan, C.J.,... Scherrer, S.S. (2026). A critical scoping review of fractographic studies on clinically fractured all-ceramic fixed dental prostheses. Dental Materials. https://doi.org/10.1016/j.dental.2026.07.008
MLA:
Pilecco, Rafaela Oliveira, et al. "A critical scoping review of fractographic studies on clinically fractured all-ceramic fixed dental prostheses." Dental Materials (2026).
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