Key Takeaways & Executive Findings
- •• Machinable resin-ceramic composites combine resin and ceramic properties, offering elastic modulus close to dentin and good fatigue resistance, making them suitable for onlay restorations. • CAD/CAM technology enables efficient chairside fabrication of resin-ceramic onlays, reducing patient visits and improving precision. • Onlay restorations with resin-ceramic composites preserve more tooth structure compared to full crowns or post-core crowns, aligning with minimally invasive dentistry. • Strict patient selection and adherence to preparation guidelines are crucial for high success rates, though complications like fracture and debonding remain challenges.
Abstract
BACKGROUND: Resin-ceramic composites have gradually become an important choice for onlay restoration materials due to their advantages such as good aesthetics, elastic modulus close to that of dental tissues, excellent repair performance, and high efficiency in manufacturing processes. OBJECTIVE: To review the performance of computer-aided design and computer-aided manufacturing (CAD/CAM) milled resin-ceramic composite materials and their current application in minimally invasive onlay restorations. METHODS: Using "machinable resin ceramic material, nano resin ceramic, resin-infiltrated ceramic, onlay" as Chinese keywords and "CAD/CAM resin ceramic, resin nano ceramic, polymer-infiltrated ceramic network, onlay" as English keywords, a systematic search was conducted in the CNKI and PubMed databases. The search covered relevant literature published from January 2020 to August 2025, with a small number of earlier publications also included. The titles and abstracts of the retrieved literature were initially screened, and the full texts of the selected literature were thoroughly reviewed. Studies with low relevance, incomplete data, or duplicate research were excluded, and 76 articles were finally included for review. RESULTS AND CONCLUSION: Machinable resin-ceramic composites are a class of chairside restorative materials composed of resin and inorganic ceramics, mainly divided into nano resin ceramics and resin-infiltrated ceramics. Existing research data and clinical applications indicate that the mechanical properties of machinable resin-ceramic composites are close to those of traditional glass ceramics, with elastic modulus matching dentin, good fatigue resistance and wear resistance, and significantly improved bonding strength to dentin after targeted surface treatment, showing stable performance in complex oral environments. When applied to onlay restorations, strict selection of indications, avoidance of high-risk factors, and adherence to minimally invasive preparation principles can achieve high restoration success and survival rates, as well as high patient satisfaction. Currently, there are still complications such as fracture and debonding in clinical applications, requiring more research to further improve material properties and optimize clinical outcomes.
1. Introduction
Root canal-treated premolars and molars often present with substantial tooth defects, and the main clinical restoration methods include full crowns, post-core crowns, and onlays. Full crown restoration is widely used, but it requires significant tooth reduction, and the preparation may further weaken the cervical tooth structure [1]. For large defects after root canal treatment, post-core crowns have been conventionally used to restore tooth morphology and function; however, the post space preparation may induce stress concentration and microcracks in the root canal wall, leading to poor prognosis [2]. Onlays, which evolved from inlays, cover part or all of the cusps and can be used for large defect restorations with less tooth preparation than full crowns or post-core crowns, while preserving the original proximal contacts. With the growing concept of minimally invasive dentistry, clinicians prefer to restore large defects with minimal tooth reduction and high efficiency.
With the advent of digital technology, computer-aided design and computer-aided manufacturing (CAD/CAM) has been integrated into prosthodontics. CAD/CAM technology enables the design and fabrication of restorations chairside in a single visit through digital scanning, design, and milling, reducing the number of patient visits and offering greater efficiency, precision, and comfort compared to traditional impression techniques [3]. Technological advances have driven the development of materials, and numerous CAD/CAM materials have emerged. Resin-ceramic composites are a new class of composites composed of resin and inorganic ceramics, combining the toughness of composite resin with the high strength of ceramics. With CAD/CAM digital technology, they can meet the demands of minimally invasive restorations, high-precision chairside operations, and aesthetics, and have attracted considerable attention in prosthodontics due to their unique properties and advantages. CAD/CAM machinable resin-ceramic onlay minimally invasive restorations will bring a new prospect for large defects after root canal treatment.
This article reviews the application of machinable resin-ceramic composites in minimally invasive onlay restorations, aiming to provide clinical references.
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Huang Rongjie, Bao Xuemei (2026). Properties of machinable resin-ceramic composites and their application in onlay restorations. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21596
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Frequently Asked Questions
What are machinable resin-ceramic composites?
Machinable resin-ceramic composites are chairside restorative materials composed of resin and inorganic ceramics, available in two main types: nano resin ceramics and resin-infiltrated ceramics. They combine the toughness of resin with the strength of ceramics, offering elastic modulus close to dentin and good fatigue resistance.
How do resin-ceramic composites compare to traditional glass ceramics?
Resin-ceramic composites have mechanical properties close to traditional glass ceramics, but with a lower elastic modulus that better matches dentin, reducing stress on the tooth structure. They also exhibit good fatigue resistance and wear resistance, and can achieve high bonding strength to dentin after surface treatment.
What are the advantages of using onlays for large tooth defects?
Onlays preserve more tooth structure compared to full crowns or post-core crowns, as they require less tooth preparation. They cover the cusps and extend to the proximal or axial surfaces, restoring occlusal function and morphology while protecting remaining tooth tissue, aligning with minimally invasive dentistry principles.
What complications can occur with resin-ceramic onlays?
Potential complications include fracture of the restoration, debonding from the tooth, and wear of the opposing dentition. These can be minimized by strict patient selection, proper case design, and adherence to preparation and bonding protocols.
What is the role of CAD/CAM in resin-ceramic onlay restorations?
CAD/CAM technology enables digital scanning, design, and milling of resin-ceramic onlays chairside in a single visit, improving efficiency, precision, and patient comfort. It allows for minimally invasive preparations and high-quality restorations with reduced turnaround time.
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