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Avaliação de desgaste dentário em reabilitações cerâmicas : abordagens clínicas e laboratoriais
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Resumo(s)
A introdução de novos materiais cerâmicos na medicina dentária revolucionou a reabilitação oral, proporcionando estética superior e maior semelhança com dentes
naturais, especialmente na região anterior. Nas últimas três décadas, a preferência por restaurações livres de metal cresceu, motivada pela busca por soluções estéticas,
biocompatíveis e duráveis. Dentre os materiais desenvolvidos, destacam-se os sistemas de silicato e vidro, usados em facetas e núcleos, e as cerâmicas de alta resistência, como o óxido de zircónia e a alumina, indicadas para coroas e próteses em regiões de alta carga. Apesar das vantagens, a abrasividade desses materiais contra o esmalte
antagonista ainda representa um desafio clínico. Embora falhas sejam raras, a compreensão dos mecanismos de desgaste é fundamental para melhorar a durabilidade
das restaurações cerâmicas. Esta revisão narrativa visa analisar qualitativamente os mecanismos de desgaste em próteses cerâmicas, focando na progressão microestrutural
dos danos e suas implicações clínicas. A pesquisa bibliográfica incluiu artigos publicados entre 2005 e 2025 nas bases PubMed, Scielo, Google Scholar e Cochrane,
em português, inglês e espanhol. As coroas metalocerâmicas possuem alta durabilidade, com sobrevivência superior a 90% em até 25 anos, porém apresentam limitações
estéticas. Cerâmicas como feldspática, dissilicato de lítio e zircónia são alternativas que equilibram estética, resistência e biocompatibilidade. A feldspática é indicada para áreas de baixa carga devido à baixa resistência, enquanto o dissilicato oferece melhor equilíbrio entre estética e resistência. A zircónia monolítica polida (Y-TZP) destaca-se
por alta resistência e baixa abrasividade ao esmalte antagonista, sendo ideal para regiões de alta carga. Estudos mostram que a zircónia polida causa menos desgaste ao esmalte do que outras cerâmicas, graças à sua microestrutura e acabamento. A escolha correta do material, associada a polimento adequado e monitorização do desgaste, é
fundamental para a longevidade e função das reabilitações protéticas.
The introduction of new ceramic materials in dentistry has revolutionized oral rehabilitation by providing superior aesthetics and greater similarity to natural teeth, especially in the anterior region. Over the past three decades, the preference for metal-free restorations has increased, driven by the demand for aesthetic, biocompatible, and durable solutions. Among the developed materials, silicate and glass systems stand out, used in veneers and cores, as well as high-strength ceramics like zirconia oxide and alumina, which are indicated for crowns and prostheses in high-load areas. Despite their advantages, the abrasiveness of these materials against the opposing enamel still poses a clinical challenge. Although failures are rare, understanding the wear mechanisms is essential to improve the durability of ceramic restorations. This narrative review aims to qualitatively analyze the wear mechanisms in ceramic prostheses, focusing on the microstructural progression of damage and its clinical implications. The literature search included articles published between 2005 and 2025 in PubMed, Scielo, Google Scholar, and Cochrane databases, in Portuguese, English, and Spanish. Metal-ceramic crowns have high durability, with survival rates above 90% up to 25 years, but they present aesthetic limitations. Ceramics such as feldspathic, lithium disilicate, and zirconia are alternatives that balance aesthetics, strength, and biocompatibility. Feldspathic ceramics are recommended for low-load areas due to their low strength, while lithium disilicate offers a better balance between aesthetics and strength. Polished monolithic zirconia (Y-TZP) stands out for its high strength and low abrasiveness to opposing enamel, making it ideal for high-load regions. Studies show that polished zirconia causes less enamel wear than other ceramics, thanks to its microstructure and surface finish. The correct choice of material, combined with proper polishing and wear monitoring, is fundamental for the longevity and function of prosthetic rehabilitations.
The introduction of new ceramic materials in dentistry has revolutionized oral rehabilitation by providing superior aesthetics and greater similarity to natural teeth, especially in the anterior region. Over the past three decades, the preference for metal-free restorations has increased, driven by the demand for aesthetic, biocompatible, and durable solutions. Among the developed materials, silicate and glass systems stand out, used in veneers and cores, as well as high-strength ceramics like zirconia oxide and alumina, which are indicated for crowns and prostheses in high-load areas. Despite their advantages, the abrasiveness of these materials against the opposing enamel still poses a clinical challenge. Although failures are rare, understanding the wear mechanisms is essential to improve the durability of ceramic restorations. This narrative review aims to qualitatively analyze the wear mechanisms in ceramic prostheses, focusing on the microstructural progression of damage and its clinical implications. The literature search included articles published between 2005 and 2025 in PubMed, Scielo, Google Scholar, and Cochrane databases, in Portuguese, English, and Spanish. Metal-ceramic crowns have high durability, with survival rates above 90% up to 25 years, but they present aesthetic limitations. Ceramics such as feldspathic, lithium disilicate, and zirconia are alternatives that balance aesthetics, strength, and biocompatibility. Feldspathic ceramics are recommended for low-load areas due to their low strength, while lithium disilicate offers a better balance between aesthetics and strength. Polished monolithic zirconia (Y-TZP) stands out for its high strength and low abrasiveness to opposing enamel, making it ideal for high-load regions. Studies show that polished zirconia causes less enamel wear than other ceramics, thanks to its microstructure and surface finish. The correct choice of material, combined with proper polishing and wear monitoring, is fundamental for the longevity and function of prosthetic rehabilitations.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Cerâmica Desgaste dentário Medicina dentária Reabilitação oral