Clinical Management of Ceramic Fractures: An Evidence- and Substrate-Driven Algorithm

Fracture of ceramic restorations remains one of the most frequent technical complications in contemporary esthetic dentistry. Despite the growing emphasis on minimally invasive strategies, clinical decision-making and repair protocols remain inconsistent, particularly in hybrid scenarios where ceramic, enamel, dentin, and composite substrates coexist.

This lecture introduces an evidence- and substrate-driven clinical algorithm designed to standardize diagnostic assessment, guide material identification, and optimize restorative outcomes. Special emphasis is placed on hybrid substrates, cross-contamination risks, and the critical role of selective surface treatment during substrate-specific pretreatment procedures.

Each decision node is translated into structured, clinically executable sequences and illustrated through representative clinical case presentations that demonstrate the algorithm’s application of in both common and complex fracture scenarios. The objective is to enhance predictability, preserve tooth structure, and provide clinicians with a reproducible framework for the minimally invasive management of fractured ceramic restorations.

1. Apply a substrate-driven, evidence-based clinical algorithm to manage different ceramic fracture scenarios.
2. Recognize when a fractured ceramic restoration should be polished, repaired, or replaced based on clinical evaluation and risk assessment.
3. Select and implement appropriate material- and substrate-dependent surface treatment protocols to optimize adhesion and longevity.

Presenter

Rui Falacho, DMD, MSci, PgD, PhD

Rui Falacho is an Associate Professor at the University of Mallorca (UMAC) and an Adjunct Assistant Professor at the University of Pennsylvania School of Dental Medicine. He serves as Section Editor for Digital Dentistry for the Journal of Esthetic and Restorative Dentistry. He is currently the President of the European Academy of Digital Dentistry (EADD, https://eadigitaldentistry.org/), and the Portuguese Society of Prosthodontics and Esthetic Dentistry (SPPED). He serves as the Director of the Master’s Program in Advanced Adhesive Restorative Dentistry at UMAC.

Dr. Falacho has authored more than 20 peer-reviewed publications in leading journals, holds one registered patent, and has received multiple awards. He maintains a private practice focused on prosthodontics, adhesive dentistry, biomechanics, and digital workflows.