Introduction

Aesthetics in contemporary dentistry is partly defined by the

patients desires for naturalness and harmony. However, it is among the
tasks of the dentist to translate the patients wishes to reality providing the
ideal restoration and one such restoration can be ceramic restoration.
The word CEA!"C# is derived from $reek word %EA!&'#
which means ()*T 'T)++#. Ceramic is an earthen material usually of
silicate nature.
!odern techni,ues in restorative dentistry include the use of
ceramic materials for -acket crowns, laminates, inlays and onlays. These
restorations not only look natural but also have a very good periodontal
response when placed properly. Considering the above factors, let us go
into details of ceramics.
History
Ceramics were probably the first material, to be significantly made
by human beings. The $reek word .%eramos/. 0ottery or burnt stuff of fire
has been known to man for about 1,22,222 years. At the same time during
this period the 3
st
burnt stuff would have been accidentally produced. Early
fabrication of ceramic articles has been found and dated as far back as
3
4,222 years. The earliest glassing techni,ue was a 'umerian invention
made famous about 1,222 (.C. Historically 4 basic type of ceramic
materials were developed.
1. Earthern ware:
"t fired at low temperature and is relatively porous.
2. Stone ware:
5hich appeared in China in about 322 (.C. and is fired at a higher
temperature than earthern ware, which results in both higher strength and
renders the material impervious to water.
3. Porcelain:
5hich was obtained by flu6ing white China clay with China stone#
to produce a white translucent stone ware. This was developed in %ing7te7
tehing in China in about 3,222 A.8.
This material was strongest than the stone ware and earthern ware.
The development of the art and science of dental ceramic in many
way parallels the historical development of industrial revolution.
3991: A +rench apothecary named Ale6is 8uchateau noticed that ceramic
utensils that he used every day for mi6ing and grinding his various
;
chemicals resisted staining with the relatively non7porous surface and were
also resistant to abrasion. "t would appear that these were the circumstances
which gave birth to the idea of using porcelain as a dental restorative
material.
He succeded in making the first partial denture.
3<22: *icholas 8iu = Chemant of 0aris in collaboration with Ale6is
improved the method of fabrication and wedge wood supplied the paste for
porcelain.
These were all white and opa,ue as other pottery materials.
3<24: +oucous reported and highlighted the shortcomings in color and
translucency of early porcelain materials.
3<2>: +on?i and "talian dentist produced the first terro metallic teeth# i.e.
porcelain with metal.
He also developed teeth with platinum brackets, backed into
porcelain and were subse,uently soldered with gold to patient denture
bases. 0orcelain was the parian chinar type with e6treme translucency = ;
types: !att, Cmooth = 8entistry. This has feldspar as its principal
constituent under proper firing control can develop a self gla?ing surface
without loss of detail.
4
3<4<: Elias 5ildman formulated a much more translucent and attached to
teeth by fusing the porcelain to the patient post.
3<<>73<@2: The first porcelain inlay was produced in 0hiladelphia 0C in
3@22 the development of the small electric furnace added impetus to the
making of these inlays.
3<<>: 0orcelain A C = Band of 8etroit.
3<<@: 8r. Charley Holand of 8etroit filed the first patient for the
construction of 0AC.
3@32: !echanic props. 0ublished.
3@3<: Chemical analysis of porcelain.
3@;4: +irst casting of dental porcelain.
3@12: Cacuum firing of dental porcelain.
3@1;: +luoroscent porcelains.
3@D>: 0orcelain fused to gold systems to improve strength.
3@>;: 8evelopment of much improved gold alloys as a porcelain fused to
metal system.
3@>D: 8evelopment of dental aluminous porcelain by !cBean and Hugh.
1
3@>9: estriction of uranium to 3E by 5t.
3@><: +irst use of a glass ceramic by !cCulloch.
3@92: 8evelopment of porcelain fused to base metals.
3@91: 0orcelain fused to noble metals.
3@<2: 8evelopment of non7shrink# aluminous direct moulding core for
crowns.
3@<4: 8evelopment of high e6pansion core material by &/(rien F8C*AG.
3@<1: "ntroduction of glass7ceramic system. +irst international standard
published.
3@<1: for dental ceramic powders by Corning $lass Company. "'& ><9;7
3@<1 FEG.
3@<D: &rganic li,uid binder instead of H
;
& was developed by 'anderson.
3@@3: epair of porcelain by alph using hydrofluoric acid etching silane.
3@@4: !onsenego (urdaicon studied the effect of fluorescence in ceramics
and showed the effect of cementing media on fluorescence of ceramics.
D
INDICATIONS OF CERAMICS:
3. Aesthetic alternative for discoloured teeth.
;. (adly or grossly carious teeth.
4. Traumatic fracture of incisal angles or buccal cusps
of teeth.
1. Congenital abnormalities.
D. Ceneers.
>. "nlays or onlays.
9. abutment retainers.
<. 8enture as tooth material.
@. 'plinting of mobile teeth with metal backing.
32. &cclusal corrections and improvement of alignment
or function.
Advantages:
7 E6cellent biocompatibility.
7 Chemically inert.
7 E6cellent esthetics due to:
Translucency.
$ood color stability.
Capability of being pigmented.
>
'tain resistance.
Disadvantages:
7 0oor mechanical properties as the tensile strength is low,
brittle and easy to fracture.
7 High shrinkage on fusing conventional ones.
7 Techni,ue sensitive.
7 Bengthy procedure.
Definition:
Ceramic is a compound of metallic and non7metallic elements
usually &; F(y $ilman 3@>9G.
Dental Ceraic !as given in S"inners#
A compound of metals FAl, Ca, Bi, !g, %, *a, 'n, T, and HG and
non7metals F'i, (, +, &
;
G that may be used as a single structural component
Fas used in CA87CA! inlayG or as one of the several layers that are used
in the fabrication of ceramic7based prosthesis.
C$aracteristics of Ceraics:
3. Chemical inertness.
;. Hardness.
4. 'usceptibility to brittle fracture.
9
1. efractory nature.
D. Appearance similar to natural tooth.
>. "nsulating properties:
a. Bow thermal conductivity.
b. Bow electrical conductivity.
c. Bow thermal diffusivity.
C%ASSIFICATION:
I& 'ased on ty(e:
aG +eldspathic.
bG Beucite reinforced.
cG Aluminous porcelain.
dG Alumina.
eG $lass7infiltrated alumina.
fG 'pinel glass infiltrated.
gG $lass ceramic.
II& 'y use:
aG 8enture teeth.
bG !etal ceramic veneers.
cG "nlays, crowns and bridges.
<
III& 'y (rocessing et$od:
aG 'intering.
bG Casting.
cG !achining.
I)& 'y su*structure aterial:
aG Cast metal.
bG 'waged metal.
cG $lass ceramic.
dG CA87CA! porcelain.
eG 'intered ceramic core.
)& 'ased on firing te(erature
aG High fusing = 3422IC.
bG !edium = 332373422IC.
cG Bow = <D273322IC.
dG )ltra low 7 J<D2IC.
)I& According to a((lication:
aG Core porcelain.
bG (ody K dentine 0.
cG Enamel 0.
)II& Met$od of fusing !Mclean#
aG At atm pressure.
@
bG At decreased pressure FvacuumG.
cG $as fusing.
Met$ods of fa*ricating ceraic restorations:
7 Condensation and sintering.
7 0ressure molding and sintering.
7 Casting and ceramming.
7 'lip and casting.
7 'intering and glass infiltration.
7 !illing by computer control.
Co(osition:
3G 'ilica.
;G 0otash feldspar K soda feldspar FrefractoryG.
4G %aolin binder.
1G 0igments = control fusion temperature, sintering temperature,
thermal contraction coefficient and solubility..
DG &pacifiers.
>G $lasses Flow fusing which act as flu6esG.
Silica four fors:
7 Crystalline ,uart?.
7 Crystalline cristabolite.
7 Crystalline tridymite.
7 Crystalline fused silica.
32
9G $lass modifiers:
7 "ncreased fluidity.
7 8ecreased softening temperature.
7 "ncreased thermal e6pansion.
7 L!edium and high fusing = denture teeth.
7 Bow and ultra low = crown and bridge construction ultra
low: Titanium and Titanium alloy. Fbecause of low
contraction coefficient and low firing temperatures decrease
risk for growth of metal o6ide layerM.
Modifiers + Sodiu, -, Ca, H.O/
+eldspar: % K *a feldspar which comprise of :
7 0otash.
7 'oda.
7 Alumina.
7 'ilica.
0ro(erties:
3G +orms a glass phase that will soften and flow slightly
coalescing of porcelain powder particles Fprocess is %a li,uid
phase sinteringG. 8riving force for sintering is reduced energy
because of decrease surface area.
33
;G Tendency to form crystalline mineral leucite when its melted.
Beucite is a potassium aluminium silicate mineral with a
large coefficient of thermal e6pansion.
Advantages: in the manufacture of porcelain for metal bonding.
<G &ther Additives:
3. a. !etal o6ides: (oric o6ide:
7 Acts as a modifier.
7 8ecreased viscosity.
7 8ecreased softening temperature.
7 +orms its own glass network.
*/ Aluina
;. 0igmenting o6ides:
7 "ron K*i o6ide 7 (rown.
7 Cu& = $reen.
7 Ti& = yellowish brown.
7 !n& = Bavendar.
7 Co& = (lue.
4. &pacifiers
7 Cerium o6ide.
7 Hirconium o6ide.
3;
7 Titanium o6ide.
7 'n&
Are added to obtain various shades needed to simulate natural teeth.
Advantages:
aG $ood aesthetic ,ualities.
bG High hardness and compressive strength.
cG $ood chemical durability.
dG E6cellent biocompatibility.
Disadvantages:
aG (rittleness.
bG 8ecreased fracture toughness.
cG 8ecreased tensile strength.
METHOD OF STREN1THENIN1 CERAMICS:
Two methods to overcome the above mentioned deficiencies:
a) Method to strengthen brittle materials.
i. 8evelopment of residual compressive stresses within the
surface of the material.
ii. "nterruption of crack propagation through the material.
34
b) Methods of designing components to minimize stress
concentration and tensile stresses.
2# Develo(ent of residual co(ressive stresses *y:
"on e6change K chemical tampering.
Thermal tampering.
Thermal compatibility.
i. "on e6change : % replaces *aN
= %
;
*&
4
contains 4DE more of potassium.
= )sed on internal surface of crown and bridge inlay
because this surface is protected by grinding and
e6posure to acids.
= "ncraesed C stresses of app. 922!pa are introduced.
ii. Thermal Tampering.
7 !ost common method.
7 )sed in automobile windows, windshields, sliding glass
doors, diving masks.
7 'tresses are created by rapidly cooling K ,uenching the
surface when its hot and in softened state. This produce an
31
outer rigid layer surrounding a molten core which when
solidifies, it shrinks and creates residual tensile stresses in
core and residual compressive stresses within outer surface.
apid cooling is accompanied by -ets of air directed at the
molten glass surface.
+or dental application = Hot glass phase ceramic is ,uenched in
silicone oil K other special li,uids, rather than using air -ets as
they do not cool the surface uniformly.
iii. Thermal compatibility:
"nvolves mismatch in coefficient of thermal
contraction of metal to ceramic when cooled to room
temperature after firing. F)sed by corning glass works to
manufacture dinnerwareG.
!etal has increased thermal contraction coefficient.
.# Interru(tion of crac" (ro(ogation:
a# Dis(ersion of crystalline ($ases
7 )nder stress the crystal absorbs energy from the crack Fsuch
as: aG Alumina, bG 8icor $. Ceramic use of mica crystallineG.
3D
e,uired close match between thermal C of 777777777 of glass
material and crystalline materialG.
*# Transforation toug$ening:
7 "t relies on toughness of the particle to absorb energy from
crack and deplete its driving force for propagation.
7 Crystalline material such as 0'H is added which undergoes
change in crystal structure when placed under stress. Energy
re,uired for transformation is taken from energy which
allows the crack to propagate.
Disadvantages of 0S3 !0artially Sta*ili4ed 3ircona#:
efractive inde6 not same as that of glass matri6. Thus particle of
0'H scatter light producing an opacifying effect that may not be
aesthetically pleasing.
b) Designs of dental restoration:
7 Avoid e6posure to increased T.'.
7 Avoid stress concentration at sharp angles or marked changes
in thickness.
iG To minimi?e tensile stress:
3>
7 )se of ductile metal coping.
7 )se of bonded pt foil 0AC.
7 )se of swaged Au alloy foil techni,ue.
iiG educing stress raisers:
7 'tress raisers are discontinues in brittle materials F'a
ceramicsG that cause stress concentration.
7 Avoid abrupt changes in shape and thickness in ceramic
contour.
Stress raisers in 05C:
7 Creases K folds of pt foil substrate = form notches.
7 'harp line angles.
7 Barge changes in porcelain thickness.
7 'mall particle of porcelain along internal porcelain margin of
crown.
7 'tray particle fused within internal porcelain.
0+! = occlusion ad-usted properly.
7 8ecreased contact points.
39
DE)E%O0MENTS OF DENTA% 0ORCE%AINS:
) PS! DE"E#$PME%!S
3. ir firing : prior to early 3@>2s, porcelain powders
used had large particles si?e, to avoid opacity but resulted in porosities
FinternalG. (ut aesthetic of these materials was e6cellent F!clean 3@9@G.
;. "ac&&m firing: The introduction of vacuum fired
porcelains reduced the internal porosities and further increased the
aesthetics.
4. Porcelain f&sed to metal: 'ince the introduction of
the first successful porcelain7fused to metal systems in early 3@>2s
there has been increasing demands for ceramic restorative materials.
0orcelain was fused to metal substrate to increase its resistance to
fracture which occurred due to:
i. elatively low tensile strength.
ii. (rittleness of porcelain.
Disadvantages of (orcelain fused6to6etal:
3. !etal base can affect the aesthetic of porcelain by
reducing light transmission through the porcelain by creating metal
ion discoloration.
3<
;. 0atients might have allergic reaction or sensitivity to
metal.
4. !aterial and labor costs for its fabrication.
These drawbacks of 0+! have prompted the development of new
all7ceramic restorations.
1. l&mino&s porcelains : Aluminous porcelain used
in 0AC/s is composed of a similar composition as that of feldspathic
dental porcelain with increased amounts of aluminium o6ide FAl
;
&
4
G by
D2 wtE.
7 Ceramics employed in conventional porcelain -acket crown
are high fusing feldspathic porcelain#.
7 8ue to relatively low strength of this type of porcelain
!clean and Hughes in 3@>D# developed alumina reinforced
porcelain core material for fabrication of 0AC/s.
Manufacture:
The alumina reinforced porcelain described above are produced by
prefitting the crystalline component with the glassy matri6.
These can be used as a cores to replace the substructure used in
ceramo7metal constructions. They are veneered with conventional
feldspathic porcelain to reproduce contour and shade of a natural tooth.
3@
Advantages:
3G "mproved aesthetics.
;G "ncreased fle6ural strength Fbecause of higher crystalline
contentG.
4G Enhanced fracture toughness.
Disadvantages:
3G Bow translucency Fdue to presence of second phase in glassy
matri6G.
;G "ncreased sintering shrinkage.
4G 'trength is inade,uate for use in posterior teeth.
1G +it is poor as compared to 0+!.
DG High clinical fracture.
>G Techni,ue sensitive
Indications:
+or restoration of anterior crown when aesthetic is prime concern.
E6amples: Hi7ceram.
;2
7/ Magnesia core:
7 A high thermal e6pansion core porcelain has been described
by &/(rien in 3@<D.
7 !agnesia crystals were used to reinforce a high e6pansion
coefficient glass, resulting in a core porcelain with a modulus
of elasticity same as alumina = reinforced porcelain7343
!pa.
Indications:
3. )sed with body porcelain normally used to veneer
metallo7ceramic restorations !agnesia reinforced material is
thermally compatible with body porcelain because of its high thermal
e6pansion coefficient.
Advantages:
3. "mproved shade matching
when used with veneers.
;. +le6ural strength is
doubled = this is due to treating of surface of magnesia core
porcelain with a suitable glass.
;3
T8o ec$aniss 8ere suggested for i(roved strengt$:
aG The gla?e was thought to penetrate the open pores, effectively
reducing the number of surface flaws.
bG $la?e may have replaced the surface layer in compression.
Disadvantages:
3. 8ue to high e6pansion magnesia core porcelain is more liable
to thermal shock on cooling.
9/ 'onded (latinu foil co(ing:
This techni,ue uses bonding of porcelain to metal by use of tin
o6ide coatings on platinum foil.
O*:ective:
3G "mproves aesthetic by replacing thicker metal coping
with a thin platinum foil thus providing more space for porcelain.
0rocedure: Aluminous porcelain is bonded to pt foil copings, attachment
of porcelain in secured by electroplating the foil with a thin layer of tin and
then it is o6idi?ed in a furnace to provide a continuous film of tin o6ide for
porcelain bonding.
Rationale:
;;
(onded foil acts as an inner skin on the fit surfaces to reduce
subsurface porosity and formation of microcracks in the porcelain thus
increasing its fracture resistance of the unit.
'/ RECENT 0ORCE%AINS:
9. ll 'eramic S(stem: The evolution of porcelain
materials has been a battle for the ideal strength7aesthetic combinations.
8ue to the inherent drawbacks related to 0+!, as stated earlier, all
ceramic crowns were introduced into dentistry.
The first all7ceramic crowns were introduced by .BA*8/ in 3@24.
These materials were:
aG elatively weak.
bG Had limited clinical use.
Thus, in 3@>D, !clean and Hughes formulated aluminous porcelains
composition which form the basic composition of these All7ceramic
crowns.
7 These aluminous porcelains had increased rate of fracture.
7 !ore recently, newer types of all7ceramic restoration have
been developed that may prove to have a lower incidence of
clinical fracture:
;4
This may be due to:
aG All7ceramic restorations today consists of
stronger materials and involve better fabricating techni,ues.
bG These restorations can be etched and bonded to
the underlying tooth structure with the new dentin adhesives.
cG 5ith greater tooth reduction than what was
previously used for 0AC/s, clinicians now provide lab technicians
with enough room to create thicker and stronger restoration.
FI)E CATE1ORIES OF A%%6CERAMIC S;STEM INC%<DE:
3G Conventional Fpowder7slurryG ceramics.
;G Castable ceramics.
4G 0ressable ceramics.
1G "nfiltrated ceramics.
DG !achinable ceramics.
)* 'on+entional Powder sl&rr( ceramics:
These are supplied as powder which the technician adds water to
produce a slurry, which is built up in layers on die material to form the
contours of the restorations.
0o8ders:
;1
7 Available in various shades and translucencies.
7 'upplied with characteri?ing stains and gla?es.
;D
This system includes:
aG &ptec H'0 FAeneric 0entronG.
bG 8uceram B+C.
a) $ptec ,SP: -lso .nown as le&cite/reinforced porcelain):
&ptec H'0 is a leucite7reinforced feldspathic porcelain that is
condensed and sintered like aluminous porcelain and traditional
feldspathic porcelain. Beucite = a reaction product of potassium
feldspar and glass.
Advantages:
3. Back of metal or opa,ue
substructure.
;. $ood translucency
FuniformG.
4. !oderate fle6ural strength
= 31>!pa.
1. 'pecial lab e,uipments not
re,uired.
Disadvantages:
3. 0otential marginal inaccuracy caused by porcelain
sintering shrinkage.
;. 0otential to fracture in posterior teeth.
;>
4. +it of crowns not as good as that of 0+! crowns
with metal margins.
1. "ncreased leucite content increases in vitro wear of
opposing teeth.
Indications:
7 "nlays.
7 &nlays.
7 Bow stress crown and veneers.
Features:
3G !ore translucent than alumina core crown K glass infiltrated
alumina core crowns because has only a moderately opa,ue
core.
;G 'trength of optec H'0 is increased than feldspathic porcelain
used for porcelain fused to metal because of its leucite
crystals.
7 The shrinkage on condensation and sintering occurs when
fired because of volumetric reduction caused by sintering.
7 &nly body and incisal porcelain are used because the opacity
provided by the leucite crystals does not re,uire the use of
core porcelain.
;9
7 'andblasting recommended to achieve bonding with resin
cement.
;<
b) D&ceram #0' -Deg&ssa)
This is a relatively new category of restorative material, referred to
as hydrothermal low7fusing ceramics.
7 Composed of an amorphous glass containing hydro6yl ions.
Indications:
3. "nlays.
;. Ceneers.
4. +ull contour crowns.
Advantages:
3. $reater density.
;. Higher fle6ural strength
F332!paG..
4. $reater fracture resistant.
1. Bower hardness Fthan
feldspathic porcelainG.
D. *o special e,uipment
re,uired for fabrication.
7 Higher fle6ural strength is due to an ion7e6change
mechanism of hydro6yl ions.
7 Bower hardness is due to absence of leucite crystals in this
material.
;@
Difference *et8een %FC and O0TEC HS0
%FC O(tec
3G Contains &H
7
ion in
matri6.
;G )ses a metal 8uceram
ceramic as a core.
4G Bess abrasion of
opposing tooth.
7 Contain leucite
crystals in matri6.
7 *o core material.
7 !ore abrasion of
opposing tooth.
The restoration is made in two layers:
i. (ase layer: is a 8uceram metal
ceramic Fa leucite containing porcelainG. This is placed on a
refractory die using standard powder7slurry techni,ue and then
baked at @42IC.
ii. 8uceram B+C = This is applied
over the base layer using a powder slurry techni,ue and baked at a
relatively low temperature of >>2IC.
The material is supplied in a variety of shades and can be surface7
characteri?ed with compatible stains and modifier.
42
II& Casta*le Ceraic Systes
These products are supplied as solid ceramic ingots, which are used
for fabrication of cores or full contour restoration using a lost wa6 and
centrifugal casting techni,ue.
Also referred to as $lass ceramic crown#.
7 "ntroduced in dentistry by !ac Culloch in 3@><.
7 0reviously used a glass molding process to produce denture
teeth.
7 Bater crowns and inlays were fabricated using centrifugal
casting of molten glass.
Definition:
A glass ceramic is a material that is formed into a desired shape as a
glass, then sub-ected to a heat treatment to induce partial divetrification
Fi.e. loss of glassy structure by crystalli?ation of glassG.
FIRST COMMERCIA%%; A)AI%A'%E CASTA'%E CERAMIC
MATERIA% =AS DICOR !develo(ed *y corning glass 8or"s
ar"eted *y Dents(ly#
43
Dicor: This is a polycrystalline glass, ceramic material initially formed as a
glass and subse,uently heat treated under controlled crystalli?ation
conditions to produce a glass7ceramic material.
Indications:
aG "nlays.
bG Ceneers.
cG +ull crowns.
0rocedure:
A full7contour transparent glass crown is cast at 34D2IC then is heat
treated at 329DIC for 32 hours. This heat treatment causes microscopic
plate like crystals of mica to grow within the glass matri6.
The crystal nucleation and crystal growth process is known as
CEA!!"*$#.
These crystals:
3G Create a relatively opa,ue material.
;G "ncrease the fracture resistance.
4G "ncreases the strength.
1G Also they are less abrase to opposing tooth structure.
After this glass is fitted on a die and coated with veneered porcelain
to match the shape and appearance of ad-acent tooth.
4;
To achieve the shade, the colored stains are baked on the surface of
glass ceramic material.
Advantages:
3. High fle6ural strength = 3D;!0a.
;. Abrasiveness same as that of tooth.
4. Accurate fit of crown.
Disadvantages:
3. 'pecial investment and casting e,uipment re,uired.
;. 'urface stains may be lost due to abrasion, routine
oral prophyla6is or application of acidulated fluoride gels.
To overcome this problems dentsply introduced another glass
ceramic material:
7 8icor plus = this is a shaded feldspathic porcelain veneer
applied to 8icor substrate.
7 8icor plus is more abrasive than dicor to the teeth.
7 These are more resistant to dissolution.
III& Mac$ina*le Ceraics:
44
These products are supplied as ceramic ingots in various shades and
are used in computer7aided design, Computer7aided manufacturing or
CA87CA! procedures.
The machined restoration can be stained and gla?ed to obtain the
desired characteri?ation.
The ingots used do not re,uire further high temperature processing.
They are placed in machining apparatus to produce the desired contours.
The internal surface of restoration are ground with diamond disks or
other instruments to the dimensions obtained from a scanned image of the
preparation. This is followed by occlusal ad-ustment, polishing, etching
and bonding the restoration to the prepared tooth.
Early pioneers of CA87CA! system: (ruce Altschuler
7 &riginated in 3@12s in )nited 'tates.
Advantages:
3. *egligible porosity.
;. "mpression not re,uired.
4. educe assistant time associated with impression
procedures.
1. 'ingle appointment procedure.
41
D. $ood patients acceptance.
Disadvantages:
3. *eed for e6pensive
e,uipment.
;. Back of computer
controlled processing support for occlusal ad-ustment.
4. Techni,ue sensitive nature
of surface imaging re,uired for the prepared tooth.
The different types of ceramic ingots used in the process are:
a) 'erec +itabloc.s mar. )
This is the feldspathic porcelain which was the first composition
used with the cerec systems.
7 'imilar to feldspathic porcelain in composition, strength,
wear properties.
7 +le6ural strength = @4!0a.
7 !illing of a ceramic ingot is done from a digiti?ed optical
scan.
4D
b) 'erec +itabloc.s mar. ))
This is a feldspathic porcelain of:
7 "ncreased strength, has finer grain si?e than the mark "
compositions.
7 +le6ural strength 3D; !0a.
7 This is less abrasive than cerec !ark " and is similar to that
of enamel.
7 "ngot is milled in a digiti?ed optical scan.
c) Dicor M1' -Dentspl():
Co(osition:
>DE fluorosilicic mica crystals in 4DE glass matri6.
Features:
3G "mproved fle6ural strength than castable 8icor = ;3>!0a.
;G 'ofter than conventional feldspathic porcelain.
4G 0roduces less abrasive wear of opposing tooth structures than cerec
!ark " but more than C!% "".
1G +ormed by milling process.
4>
d) 'ela(:
This can be used for CA87CA! produced restoration or in copy
milling techni,ue:
7 "t is a fine grained feldspathic porcelain that reduces the wear
of antagonist tooth structure.
!anufactures claim that composition of celay is same as cerec
vitablock mark "" thus properties are also same.
49
Ot$er c$aracteristics of CAD6CAM syste:
3G All these ceramic ingots can be characteri?ed with surface
stains which may be lost by abrasion.
;G The gap between tooth and the restoration is wider in CA87
CA! produced inlay than other all7ceramic restoration. 5ear
of cement in this gap may be of clinical significance.
4G They are etchable for bonding to tooth structure.
I)& 0RESSA'%E CERAMICS
Also known as in-ection molded glass ceramics.
7 'upplied as ceramic ingots.
7 These products are melted at high temperature and in-ected
under pressure and high temperature into the mold created by
using lost7wa6 techni,ue.
7 The processed form can be made to full contour or can be
used as a substrate.
The two systems under this category are:
aG "0' Empress.
bG &ptec pressable ceramic.
4<
I0S EM0RESS
7 "t contains increased concentration of leucite crystals that
increase the resistance to crack propagation.
7 !aterial is in-ection molded over a 1D minute period at high
temperature to produce ceramic substructure.
7 The crown forms can either by stained or gla?ed or build up
using a conventional layering techni,ue.
Advantages:
3G Back of metal K opa,ue ceramic core.
;G !oderate fle6ural strength =3;>!0a initially after heat treatment
3>273<;.
4G E6cellent fit.
1G E6cellent esthetics.
Disadvantages:
3G 0otential to fracture in posterior areas.
;G *eed for special laboratory e,uipment.
4@
O(tec 0ressa*le Ceraic !O0C#:
7 &0C is a type of feldspathic porcelain with increased leucite
content processed by molding under pressure and heat.
Indications:
3G "nlay.
;G Ceneer.
4G +ull crowns.
1G Core material for feldspathic porcelain.
High abrasiveness than tooth structure.
+le6ural strength = 3>D!0a.
(oth &ptec and "0' Empress produce strong, translucent, dense and
etchable ceramic restorations.
12
)& INFI%TRATED CERAMIC !glass infiltrated aluina core ceraic C#/
These products are supplied as two components:
0owder = Al
;
&
4
K spinel = Fporous substrateG.
$lass = "nfiltrated into porous substrate at high temperature.
"t is veneered using conventional feldspathic techni,ue.
Commercially available as "*7CEA! FC"8E*TG.
Advantages:
3G Back of metal.
;G "ncreased fle6ural strength F1D2!0aG.
4G E6cellent fit because of less shrinkage.
Disadvantages:
3. &pacity of the core.
;. )nsuitability for conventional acid etching.
4. *eed for speciali?ed e,uipment.
Indications:
3G 'ingle anterior and posterior crown.
;G Anterior three unit bridge.
Ste(s for fa*ricating in6cera (rost$esis:
3G 0repare teeth with heavy circumferential chamfer FO 3mmG.
13
;G !ake impression and pour two dies or duplicate on die in refractory
die material.
4G Apply Al
;
&
4
on duplicate die using the slip cast method.
1G 'inter coping for 32 hours at 3322IC.
DG Apply slurry of glass infiltration material.
>G +ire for 47D hours at 33;2IC to allow infiltration of glass.
9G Trim e6cess glass from coping with diamond burs.
<G (uild up core with enamel and dentine porcelain Fvitadur alphaG.
@G +ire in the oven, grind in anatomy and occlusion finish and gla?e
before delivery.
Sli( cast et$od:
This involves the placement of a low7viscosity slurry of the powder
onto a porous refractory die that draws water from the slurry, thus
depositing a layer of solid Al
;
&
4
on the die. The capillary action of die
continues as other layers are added. Heat the die and material at 3;2IC for
; hours to dry the Al
;
&
4
.
1;
Foration of in6cera:
The slightly sintered aluminous porcelain core is infiltrated with
glass at 3322IC for 1 hours to eliminate porosity and strengthen the slip
cast core. This initial sintering process causes minimal volume decrease
because temperature and time are sufficient only to cause bonding between
particles. This increased marginal fit because of decreased shrinkage.
ecently an alternative to in7ceram, a more translucent ceramic
called in7ceram spinell is introduced.
7 8ecreased fle6ural strength.
7 "ncreased translucency = increased aesthetics where ad-acent
teeth or restoration are more translucent.
7 Core of in7ceram spinell is !gAl
;
&
1
infiltrated with glass.
CERAMIC )ENEERS:
7 )sed since 3@<3 due to acid etching of porcelain.
Advantages:
3. !ore conservative approach than 0AC.
;. E6cellent aesthetics.
14
Disadvantages:
3. Techni,ue sensitive = as a
conventional acid7base K resin based luting cements play a role in
appearance.
;. esin bonded veneers
have been reported with recurrent caries.
4. E6pensive.
1. !ight abrade opposing
tooth structure if not polished.
Acid used hydrofluoric acid Ffor etchingG.
Indications:
3G 'tained K hypoplastic anterior teeth.
S$rin" free ceraics:
8ue to ill fit of aluminous 0AC/s 'o?io and iley 3@<4 described the
use of shrink free ceramic coping which is formed on epo6y die by a
transfer moulding process.
Co(osition:
Alumina.
11
!agnesia.
Aluminosilicate glass frit.
5a6.
'ilicone resin plastici?er.
The moulded core is sub-ected to a lengthy heat treatment during
which time some of the alumina reacts with magnesium o6ide to form
magnesium aluminate spinel crystals. The reaction is accompanied with
increase in volume which offsets the sintering shrinkage.
The so7called crestore coping is veneered with aesthetic porcelains.
+le6ural strength for cevestore core = 31D!0a.
7 Compressive strength same as conventional alumina
reinforced material.
7 +racture toughness is also same.
7 !arginal fit not accurate.
7 8ue to limitations of cresetore systems a new shrink free
ceramic was developed ABCEA!.
Casta*le A(atite cro8ns:
'ynthetic hydro6yapatite may be used for replacement of lost tooth
structure.
1D
7 This cannot be fabricated directly.
7 An indirect techni,ue involves conversion of calcium
phosphate glass to a partially crystalline apatite glass
ceramic. This is known as CEA0EAB.
7 The procedure for its production is similar to that of 8icor
glass ceramic system.
7 The calcium phosphate based glass is transformed to a
partially crystalline body by a controlled heat treatment is
then tinted by the application of coloured gla?es.
C$aracteristics/
Tensile strength is increased 4 fold.
efractive inde6, density, hardness, thermal e6pansion,
thermal conductivity similar to natural enamel.
Renaissance cro8n:
The enaissance ceraphatin or ceplater crown is similar to the
platinum bonded type of restoration in that a thin metal substructure is used
to protect the fit surface of crown.
7 8escribed by 'chossow 3@<1.
1>
7 The techni,ue utili?es a gold7coated foil matri6 which is
folded like an umbrella which is burnished onto the die and
heated.
Foil consists of four layers:
7 &uter most layer = pure Au.
7 *e6t layer = Alloy of Au, 0t, 0d.
7 Third layer = 322E 0d.
7 "nner most layer = Au, 0t, 0d.
The gold coating melts and acts as a solder which secures the folds
in a place, thus creating a stable coping. The crown is then build up with
metal bonding porcelain.
7 Compressive strength is inferior to conventional aluminium
0AC.
7 +it was accurate.
H;'RID CERAMICS : !ESTENIA#:
Combination of ceramic and composite material.
Has @; wtE filler loading.
0article si?e 2.2;Pm7;Pm.
19
)ndications 7 Aacket crown.
7 "nlay.
7 &nlay.
7 Crown and bridge.
0hysical properties are much higher the conventional porcelain.
Advantages:
7 E6cellent aesthetics.
7 8urability.
7 Ease of use.
Conclusion:
Although, the all7ceramic restorations being more precise, tedious,
time consuming and re,uire a elaborate e,uipmentation, it gives a better
esthetics and better marginal fit.
1<
References:
3. 8ental caries = An update = C. 0iddock, and A.A.E.
Qualthough, A 8ent 3@@2R 14: ;;97;D4.
;. A review of all ceramic restoration. !arc A. osen
(lum. AA8A Col. 3;<, !arch 3@@9R ;@97429.
4. A clinical performance of CA87CA! generated
inlay, onlay. AA8A, vol. 3;9: August 3@@>.
1. 'cience of dental materials = %enneth A. Anusavice,
Tenth edition, dental ceramics.
1@
RECENT AD)ANCES IN 0ORCE%AIN MATERIA%S
CONTENTS
"ntroduction
History
8efinition
Classification
Composition
!ethods of strengthening ceramics
8evelopment of dental porcelains
D2