Reliability and strength of all-ceramic dental restorations fabricated by direct ceramic machining (DCM).

All-ceramic dental bridges for the molar region are not yet available at reasonable costs. The novel direct ceramic machining (DCM) process allows an easy, reliable and rapid fabrication for all-ceramic dental restorations with high mechanical strength and good biocompatibility. In DCM, an enlarged framework is easily milled out of a pre-fabricated porous ceramic blank made of zirconia. After sintering to full density, no further time-consuming hard machining with diamond tools is needed. For individual esthetical requirements, the framework is coated with a veneer porcelain. Compared to the commercially available In-Ceram Alumina and IPS Empress2 restorations, the mechanical strength of zirconia frameworks is twice as high, allowing the restorations to bear the high mastication forces in the molar region. In terms of reliability, zirconia bridges fabricated by the DCM process are also superior to In-Ceram Alumina and IPS Empress2. A clinical study of three-unit dental bridges in the molar region found no problems after the first year of observation.