Hybrid ceramic (PICN) for tooth wear treatment using the One-step No-prep technique

Polymer-infiltrated ceramic network (PICN), commonly referred to as “hybrid ceramic,” represents a unique class of materials that integrate glass-ceramic and polymer. Vita Enamic is the only PICN material available on the market, benefiting from over a decade of clinical use and research. It offers a balance between pure ceramics and direct and CAD/CAM composites, leveraging their advantages while minimizing their disadvantages in the context of severe tooth wear (TW) treatment. PICN exhibits properties that closely mimic tooth tissue, particularly its wear behavior and stiffness, while polymer promotes the material’s ability to dampen occlusal stress. The introduction of PICN prompted the One-step No-prep technique for treating severe TW. This noninvasive and straightforward method provides a cost-effective alternative to traditional indirect approaches. The present article reviews the properties of PICN and compares them with other materials used in TW treatment. Clinical cases illustrate the One-step No-prep technique for generalized severe TW and the orthodontic-assisted One-step No-prep technique for localized cases, which is an evolution of the Dahl concept. The clinical and scientific background of PICN as used in the One-step No-prep technique are discussed and the excellent clinical outcomes from various perspectives are highlighted. The article also addresses the limitations of PICN such as the tendency for chipping at thin occlusal borders of posterior restorations and a lower gloss on occlusal surfaces compared with pure ceramics. These limitations do not affect patient satisfaction but could be improved upon. Despite these drawbacks, PICN appears to be suitable for managing TW in a noninvasive way. Keywords: CAD/CAM, composites, Dahl, minimally invasive dentistry, occlusion, orthodontics