Beruflich Dokumente
Kultur Dokumente
aesthetic restorations
Associate Prof. Paulo Francisco Cesar
University of So Paulo
School of Dentistry
Department of Biomaterials and Oral Biology
Collaborators:
Prof. Lucas Hian da Silva
Prof. Susana Salazar-Marocho
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paulofc@usp.br
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Universidade de So Paulo
Faculdade de Odontologia
Departamento de Biomateriais e Biologia Oral
Outline:
1. Ceramics
2. Surface treatments
3. Cements
1. Ceramics
1.1. What are the options?
1. Ceramics
1.1. What are the options?
1. Ceramics
1.1. What are the options?
Brands
Porcelains
Glass-ceramics
Glass-infiltrated composites
Polycrystalline ceramics
1. Ceramics
1.1. What are the options?
Porcelains
Glass-ceramics
Glass-infiltrated composites
Polycrystalline ceramics
Porcelains
Borba, 2010
Porcelains
1
Alberto Calazans
Gonzaga, 2007
Glass-infiltrated composite
Polycrystalline
Alumina
Y-TZP
Borba, 2010
1. Ceramic
a) Leque de opes
1.2. Material of choice
b) O material de escolha
c) Novas perspectivas
1. Ceramics
1.2. Material of choice
Veneers
Inlays /Onlays
Crowns
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Veneers
Porcelains or Glass-ceramics
Porcelains
Inlay/Onlay
1
Porcelains or Glass-ceramics
2
Glass-ceramics
1
2
3
Crowns
High translucency:
coping+veneering ceramic
Glass-ceramics (monolithic)
Glass-ceramic (monolithic)
Glass-ceramic (monolithic)
Crowns
Low translucency
1
Y-TZP
Y-TZP
Cercon/Dentstply
Abutments
Y-TZP
Metal
Debonding
Fractures
Veneers/Inlay/Onlay/Crowns
Due to the posterior location of the restorations, these timedependent degradation processes were not of concern clinically
and were only observed by the examiners.
Debonding
Evaluation of tensile retention of Y-TZP crowns after long-term aging: effect of the core
substrate and crown surface conditioning.
Amaral R, Rippe M, Oliveira BG, Cesar PF, Bottino MA, Valandro LF.
Oper Dent. 2014 Nov-Dec;39(6):619-26.
Evaluation of Tensile Retention of Y-TZP Crowns Cemented on Resin Composite Cores: Effect
of the Cement and Y-TZP Surface Conditioning.
debonding
Inlay/Onlay/Crown
Defects on the cementation surface
Inlay/Onlay/Crowns
Marginal defects
Cesar, 2012
Cesar, 2012
Inlay/Onlay/Crown
Inlay/Onlay/Crown
Fardim, 2013
Inlay/Onlay/Crown
Fardim, 2013
Inlay/Onlay/Crown
Fardim, 2013
Inlay/Onlay/Crown
Fardim, 2013
Inlay/Onlay/Crowns
Inlay/Onlay/Crown
In vivo
In vitro
Inlay/Onlay/Crown
Chipping
Inlay/Onlay/Crown
Chipping
compression curl
Compression
curl
2 blunt contacts
2009 Jun;5(5):1668-77
Chipping/incisal edge
Fracture
Chipping/cervical area
Multiple cracks
Gender: female;
No parafunctional habits;
Metal post;
(Mesial)
Arrest lines
Multiple
damage.
areas
of
occlusal
Origin
Conclusion
Origin on occlusal surface;
Relationship with cumulative damage on glaze layer;
Delamination was observed;
Problem with coping design.
Fracture rates (%) of the venering porcelain applied over Y-TZP in clinical trials
Continued...
Study
Larsson
Rinke
Zembic
Ortorp
Vigolo
Lops
Burke
Sailer
Schmitter
Schmitt
Molin
Sagirkaya
Pelaez
Salido
Year
2013
2013
2012
2012
2012
2013
2013
2007
2012
2012
2008
2012
2012
2012
%Fracture
88.9
28.8
0
3
7.7
10.8
24.2
15
26.7
28
0
0.9
10
29.1
Beuer
Tinschert
Rinke
Sailer
Edelhoff
Beuer
Schmitt
Papaspyridakos
Raigrodski
Pospiech
Esquivel-Upshaw
Tsumita
Cehreli
Ohlmann
Bornemann
Ohlmann
Larsson
2010
2008
2013
2009
2008
2009
2010
2012
2006
2003
2013
2010
2009
2012
2003
2008
2006
7.4
6
5.8
33.4
9.5
0
5.9
31.3
25
2.6
16.7
14.3
0
20
3.3
13
54
grade 1 = small chip that does not demand any action, except polishing.
CAD-on system
http://sayakaattitude.blogspot.com/2011/07/emax-zirpress-2.html
Sintered
Flexural strength
(MPa)
51.3 4.9c
Sintered
+
Fibers
65.2 4.4b
Hot-pressed
67.1 7.9b
Hot-pressed
+
Fibers
76.5 11.0a
Sintered
Sintered + Fibers
Hot-Pressed
Hot-Pressed + Fibers
POROSITY (%)
CAD-on system
Source: www.ivoclar.com
http://www.vita-zahnfabrik.com/
http://www.vita-zahnfabrik.com/
http://www.vita-zahnfabrik.com/
Fractures
FPDs
Fractures
FPDs
CC
HL
Borba, 2010
1. Ceramics
1.3. The future
1. Ceramics
1.3. The future
Monolithic zirconia
Lithium silicate with zirconia particles
CONTROL
AGED
Source: Vita
Monolithic Y-TZP
2. Surface treatments
Acid etching
Silanes
Ceramic primers
HF)
Cesar, 2002
Silane
Bi-functional molecule (bonds to silica and resin composites)
It is used in association with HF or Tribo-chemical treatment
Brands: Monobond-s (Ivoclar Vivadent), Prosil (FGM), Silane (Ultradent).
Silane
Bond strength between resin cement and porcelain
Bond strength (MPa)
25
20
15
10
Control
Sem
TC
Aged
Com
TC
HFHF
com
withsilano
silane
Control
Sem
TC
AgedTC
Com
sem silano
HFHF
without
silane
Parameters:
Particle size: 50 to 150 m
Pressure: 2.8 bar
Time: 10 s
Distance :10 mm
Compression layer
3M ESPE
Zhang et al., 2006
3M ESPE
30
25
20
15
10
5
0
Control
controle
Aged
envelhecido
Sandblasting
Jateamento
Control
controle
Aged
envelhecido
Alumina
+ silica
Silicatizao
6
5
4
3
2
1
0
Control
Sem
TC
Aged
Com
TC
MZ Primer + Multilink
Y-TZP-after Cojet
48
51
35
35
Silane
SILANO
Silane
+ MDP
SILANO+MDP
CONTROLE
Control
Silane
SILANO
Silane
+ MDP
SILANO+MDP
ENVELHECIDO
Aged
2. Surface treatments
2.2. Treatment of choice
HF + Silane
Time
Porcelains
1 to 2 min
Glass-ceramics
(leucite)
1 min
Glass-ceramics
(lithium disilicate)
20 to 30 s
Cojet + silane/primers
Courtesy: FGM
2. Surface treaments
2.3. The future
glaze spray
glaze powder/liquid
HF etching
3. Cements
3.1. What are the options?
Zinc phosphate
Conventional glass-ionomer cements (GIC)
Conventional
Conventional + self-etching primer
Self-adhesives
Resin Cements
Conventional
acid +
primer + bond
cement
Conventional +
Self etching primer
Self-adhesive
Self-etching primer
cement
cement
Resin cements
Conventional
Conventional +
Self etching primer
Self-adhesive
Photo-activated
Dual
Dual
Chemically
Chemically
activated
activated
Dual
Resin Cements
Conventional
acid +
primer + bond
cement
Conventional +
Self etching primer
Self-adhesive
Self-etching primer
cement
cement
Anusavice, 2009
Resin Cements
Conventional
acid +
primer + bond
cement
Conventional +
Self etching primer
Self-adhesive
Self-etching primer
cement
cement
MDP:
10-methacryloxydecyl dihydrogen phosphate (MDP)
MDP
Y-TZP
Resin
composite
Dentin/
Enamel
Resin Cements
Conventional
acid +
primer + bond
cement
Conventional +
Self etching primer
Self-adhesive
Self-etching primer
cement
cement
Self-adhesive cements
Dual
One step, less technique sensitive.
Brands: U200 (3M ESPE), SmartCem 2 (Dentsply) and Panavia SA (Kuraray)
Unicem (3M ESPE)
3. Cements
3.2. Material of choice
Metal cores
Resin composites (fiber posts)
Tooth substrate
3. Cimentos
3.2. O material de escolha
Metal
Resin composites
Tooth
Glass-ceramic crowns
Polycrystalline crowns
Polycrystalline crowns
Metal cores
Glass-ceramic crown
Self-adhesive
Conventional resin cement+
Self-etching primer (MDP)
Chemical bond to metallic oxides of the post
Good hybrid layer on remaining dentin tissue
Self-adhesive
Easy to use
Less technique sensitive
Metal cores
Polycrystalline crown
Cojet
Synergic effect of Cojet+ silane + MDP
Chemical bonding to metallic oxides
activated only.
porcelain or glass-ceramic
0
Rely X ARC
Variolink II
DUAL
Filtek Flow
S FOTO only.
Photo-cured
FLOW
Y-TZP
Silane
MDP
1. Cojet
2. Silane application
3. Ceramic primer
Y-TZP
Y-TZP
3. Cements
3.3. The future
Universal adhesives
Universal adhesives
Dual resin cement+ Universal adhesive
Indicated for all materials
3
RelyX Ultimate
Cojet
Scotchbond Universal
Source: 3M
Multilink Automix
Panavia F2.0
RelyX Ultimate
Burgess et al, Retention of zirconia crowns bonded with adhesive resin cements, AADR 2012, Abstract 156376
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