Bonded restorations for the prevention and treatment of the cracked-tooth syndrome

Several reports revealed that the cracked-tooth syndrome is a common proble m in dental practice, which often results in extraction of the affected inc ompletely fractured teeth. Predominantly restored teeth suffer from these i ncomplete fractures. Therefore, it is of outstanding importance to stabiliz e teeth weakened due to cavity preparation. Besides full cuspal coverage by partial or full crowns, bonded restorations have been proposed for interna l splinting of restored teeth. Although contradictory data have been publis hed, there is evidence that bonded amalgam or resin-based composite restora tions (RBC) do not increase fracture resistance of teeth with wide occlusal -proximal cavities to values similar to sound, unrestored controls. Indirec tly fabricated RBC inlays and various ceramic inlays, however, increased fr acture strength to levels as high as those of sound caries-free teeth. Ther efore, it is recommended that weakened teeth with wide cavities be strength ened by fun cuspal coverage with cast or ceramic restorations, by bonded ce ramic inlays, or by indirectly-fabricated bonded RBC composite inlays.