3 main options for intracoronal esthetic posterior restorations

Direct composite Indirect composite Indirect ceramic

Indirect composite
Less technique sensitive Significantly lower fracture rates with flexural and compressive strength >140MPa

Less wear of opposing tooth structure and

excellent abrasion resistance of opposing dentition Excellent marginal adaptation Ease of adjustment with excellent polishability Cost effective

 Importantly, indirect composites are superior to direct composites because :

the bulk of polymerization shrinkage takes place outside
the mouth consequently there is less stress at the tooth-restoration margin and as a result there is: Less microleakage Less marginal breakdown Less post-operative sensitivity Less marginal staining.

Preparation
Which design to use? Divergent, non retentive preparation Resistance form may be incorporated with rounded proximal boxes No grooves! Resistance and retention adhesion Walls and floors smooth, even

 Rounded internal angles to enhance adaptation of the restorative material Occlusal reduction should be anatomic and uniform Minimum of 2 mm for strength No bevels In case of estehetics use a long chamfer instead of butt joint

Preparation
The main feature of such restorations is the use of butt joint margins.

Why butt joint margin

Thin bevelled margins can break off easily during

seating
Bevelled margins are more likely to fracture under occlusal forces Bevelled margins are more difficult to prepare Bevelled margins are more difficult to finish in the laboratory Bevelled margins tend to remove more tooth structure