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Metal free ceramics /lingual orthodontics courses

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Indian Dental Academy: will be one of the most relevant and exciting training

center with best faculty and flexible training programs for dental

professionals who wish to advance in their dental practice,Offers certified

courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,

Prosthetic Dentistry, Periodontics and General Dentistry.

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  • 1. 1 METAL FREE CERAMICSMETAL FREE CERAMICS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. 2 Introduction : Ceramics in dentistry is a recent phenomenon, theCeramics in dentistry is a recent phenomenon, the desire for a durable and esthetic material isdesire for a durable and esthetic material is ancient. Although metals have manyancient. Although metals have many characteristics that make them useful in dentistrycharacteristics that make them useful in dentistry they do not look like natural teeth. In contrast athey do not look like natural teeth. In contrast a superb esthetic and biocompatible result can besuperb esthetic and biocompatible result can be achieved with ALL CERAMICS’s.achieved with ALL CERAMICS’s. Ceramic is the most natural appearing prostheticCeramic is the most natural appearing prosthetic restorative material for missing tooth substance.restorative material for missing tooth substance. www.indiandentalacademy.com
  • 3. 3 Dental porcelain play an important role in theDental porcelain play an important role in the fabrication of the most esthetic fixed partialfabrication of the most esthetic fixed partial dentures. Translucency, light transmission,dentures. Translucency, light transmission, and biocompatibility give dental ceramicsand biocompatibility give dental ceramics highly desirable esthetic properties.highly desirable esthetic properties. However, the brittle nature of dentalHowever, the brittle nature of dental porcelains, which are basicallyporcelains, which are basically noncrystalline glasses composed ofnoncrystalline glasses composed of structural units of silicon and oxygen (SiOstructural units of silicon and oxygen (SiO44 tetrahedra) limit the use of this material.tetrahedra) limit the use of this material. www.indiandentalacademy.com
  • 4. 4 Selection :  The primary advantage of using metal freeThe primary advantage of using metal free ceramic system is to increase the depth ofceramic system is to increase the depth of translucency and light transmission in thetranslucency and light transmission in the crown either deep into the crown or acrosscrown either deep into the crown or across the entire crown.the entire crown.  Esthetic results vary from system to system,Esthetic results vary from system to system, and in a laboratory setting several factorsand in a laboratory setting several factors influence the choice one crown system overinfluence the choice one crown system over another….another…. www.indiandentalacademy.com
  • 5. 5 Factors influence the selection of crown system :  Strength.Strength.  Simplicity of fabrication.Simplicity of fabrication.  Potential for high volume production.Potential for high volume production.  Marginal and internal fit.Marginal and internal fit.  Cost-benefit analysis.Cost-benefit analysis.  Personal experience.Personal experience.  Esthetic performance.Esthetic performance. www.indiandentalacademy.com
  • 6. 6 Indications : The fracture resistance of all-ceramic crown isThe fracture resistance of all-ceramic crown is based on adequate support by thebased on adequate support by the preparation, proper patient selection,preparation, proper patient selection, strength of crown material and type ofstrength of crown material and type of luting cement.luting cement. Indications include….Indications include…. ♣ All anterior teeth where esthetics is ofAll anterior teeth where esthetics is of prime factor.prime factor. www.indiandentalacademy.com
  • 7. 7 ♣ Conservation of tooth structure andConservation of tooth structure and maintenance of periodontal health.maintenance of periodontal health. ♣ Lower incisors where space is available.Lower incisors where space is available. ♣ Limited use on the premolar teeth where theLimited use on the premolar teeth where the occlusion allows some protection of theocclusion allows some protection of the buccal shearing cusps.buccal shearing cusps. www.indiandentalacademy.com
  • 8. 8 Contra-indications:  In the cases of parafunctional activity of theIn the cases of parafunctional activity of the mandible,e.g. bruxism. Or any deflectivemandible,e.g. bruxism. Or any deflective malocclusions remain uncorrected.malocclusions remain uncorrected.  Where occlusal clearance after after toothWhere occlusal clearance after after tooth preparation is less than 0.8 mm, e.g. very thinpreparation is less than 0.8 mm, e.g. very thin teeth, deep incisal over jets with lingual wearteeth, deep incisal over jets with lingual wear facets.facets.  Insufficient tooth support or where the preparationInsufficient tooth support or where the preparation design causes sudden changes of thickness in thedesign causes sudden changes of thickness in the porcelain.porcelain.  Molar teeth.Molar teeth. www.indiandentalacademy.com
  • 9. 9 Aluminous Porcelain Vs Metal Ceramics www.indiandentalacademy.com
  • 10. 10 Aluminous porcelain : Advantages :Advantages : 1.1. Good esthetics is easily obtained if theGood esthetics is easily obtained if the core porcelain is placed correctly.core porcelain is placed correctly. 2.2. Full lingual core porcelains protect theFull lingual core porcelains protect the crown against opposing incisors.crown against opposing incisors. 3.3. The resistance to pyroplastic flow orThe resistance to pyroplastic flow or slump of the core porcelain can produceslump of the core porcelain can produce better fits than regular porcelains.better fits than regular porcelains. 4.4. Greater depth of translucency obtained.Greater depth of translucency obtained.www.indiandentalacademy.com
  • 11. 11 Aluminous Porcelain : Disadvantages :Disadvantages : 1.1. Cannot be used in posterior regions.Cannot be used in posterior regions. 2.2. Parafunctional movements.Parafunctional movements. 3.3. Long span bridges.Long span bridges. 4.4. Tooth preparation is even more.Tooth preparation is even more. www.indiandentalacademy.com
  • 12. 12 Metal Ceramics : Advantages :Advantages : 1.1. Very high strength due to prevention ofVery high strength due to prevention of crack propagation.crack propagation. 2.2. Improved fit.Improved fit. 3.3. Long span bridges.Long span bridges. 4.4. Availability.Availability. 5.5. Economical.Economical. www.indiandentalacademy.com
  • 13. 13 Disadvantages :Disadvantages :  Increased opacity and light reflectivity.Increased opacity and light reflectivity.  Risk of over contouring – metal .5 mm and theRisk of over contouring – metal .5 mm and the rest is ceramic material.rest is ceramic material.  Metal margin exposure.Metal margin exposure.  The fit of long span bridges may be affected byThe fit of long span bridges may be affected by the creep of the metal during successive bakes ofthe creep of the metal during successive bakes of porcelain.porcelain.  Difficult to obtain good esthetics.Difficult to obtain good esthetics.  Porcelains used in the metal-ceramic techniquePorcelains used in the metal-ceramic technique are more liable to devitrify which can produceare more liable to devitrify which can produce cloudiness.cloudiness. www.indiandentalacademy.com
  • 14. 14 Constituents of Dental Porcelain : Silicon dioxide – SiO2 – Glass forming matrix,Silicon dioxide – SiO2 – Glass forming matrix, glass formers.glass formers. Boric oxide –B2O3 – (Glass modifiers /Flux)Boric oxide –B2O3 – (Glass modifiers /Flux) Lowers the softening point, lower viscosity,Lowers the softening point, lower viscosity, higher expansion.higher expansion. Oxides of potassium, Sodium, calcium, lithium,Oxides of potassium, Sodium, calcium, lithium, magnesium (Glass modifiers).magnesium (Glass modifiers). Aluminum oxide – Al2O3 – (intermediate oxides)Aluminum oxide – Al2O3 – (intermediate oxides) reduces viscosity, lowers firing temperature.reduces viscosity, lowers firing temperature. Phosphorus pentoxide – P2O5 – opalescence,Phosphorus pentoxide – P2O5 – opalescence, glass forming oxide.glass forming oxide.www.indiandentalacademy.com
  • 15. 15 Properties of Dental Porcelain :  Low fusing temperature.Low fusing temperature.  High viscosity.High viscosity.  Resistance to devitrification.Resistance to devitrification.  Translucent.Translucent. www.indiandentalacademy.com
  • 16. 16 Strength of All Ceramic Crowns : The objective of fabricating all ceramic crown is toThe objective of fabricating all ceramic crown is to provide the patient with lasting esthetic restorations.provide the patient with lasting esthetic restorations. New materials are been advocated as replacementNew materials are been advocated as replacement for metal ceramic restoration.for metal ceramic restoration. The strength of ceramic is greatly influenced by theThe strength of ceramic is greatly influenced by the presence of surface flaws acting as stress initiatorspresence of surface flaws acting as stress initiators and causing widening and propagation ofand causing widening and propagation of microcracks through the material from the surface.microcracks through the material from the surface. Therefore dental porcelain is much weaker inTherefore dental porcelain is much weaker in tension than in compression and is prone to brittletension than in compression and is prone to brittle fracture.fracture. www.indiandentalacademy.com
  • 17. 17 Dental porcelain is also susceptible to “staticDental porcelain is also susceptible to “static Fatigue”which is generally caused by aFatigue”which is generally caused by a stress dependent chemical reaction betweenstress dependent chemical reaction between water vapor and the surface flaws in thewater vapor and the surface flaws in the restoration. This causes flaws to grow torestoration. This causes flaws to grow to critical dimensions, allowing spontaneouscritical dimensions, allowing spontaneous crack propagation, resulting in a fracturecrack propagation, resulting in a fracture with comparatively little occlusal loading,with comparatively little occlusal loading, particularly over long periods.particularly over long periods. www.indiandentalacademy.com
  • 18. 18 Surface Flaws : A high strength ceramic with a badly flawed surfaceA high strength ceramic with a badly flawed surface may perform worse in a clinical situation than amay perform worse in a clinical situation than a weaker ceramic with comparatively flaw-freeweaker ceramic with comparatively flaw-free surface.surface. The fracture pattern of cast glass ceramic, aluminousThe fracture pattern of cast glass ceramic, aluminous porcelains is always initiated at the surfaces andporcelains is always initiated at the surfaces and usually at the locations involving porosities.usually at the locations involving porosities. Kelley et al classified porcelain defects intoKelley et al classified porcelain defects into Processing defects – Machining scratches, porosities,Processing defects – Machining scratches, porosities, and impurity inclusions.and impurity inclusions. Inherent material defects – large grains, residualInherent material defects – large grains, residual stresses and microcracks.stresses and microcracks.www.indiandentalacademy.com
  • 19. 19 Core Thickness : The rigidity and thickness of the ceramic core playThe rigidity and thickness of the ceramic core play an essential role in the flexural strength of thean essential role in the flexural strength of the whole restoration.sections less than 1mm shouldwhole restoration.sections less than 1mm should be avoided, and ideally dentist should aim forbe avoided, and ideally dentist should aim for cross sections of 1.5 mm.cross sections of 1.5 mm. The ideal aluminous porcelain coping for incisorsThe ideal aluminous porcelain coping for incisors should exhibit: * a lingual surface atleast 1 mmshould exhibit: * a lingual surface atleast 1 mm thick: *a lingual collar extended proximally,thick: *a lingual collar extended proximally, similar to a metal coping: *the incisal labial areasimilar to a metal coping: *the incisal labial area thinned to 0.3 mm for esthetics.thinned to 0.3 mm for esthetics. www.indiandentalacademy.com
  • 20. 20 Strengthening Mechanisms : Crack-tip interactions :Crack-tip interactions : Dispersion strengthening with Alumina,Dispersion strengthening with Alumina, Leucite, Zirconia and MagnesiumLeucite, Zirconia and Magnesium aluminum oxide spinell crystals. Obstaclesaluminum oxide spinell crystals. Obstacles in the microstructure impede crackin the microstructure impede crack propagation by reorienting and deflectingpropagation by reorienting and deflecting the plane of fracture.the plane of fracture. www.indiandentalacademy.com
  • 21. 21 Crack-tip Shielding :Crack-tip Shielding : Events triggered by the high stresses in the crack tipEvents triggered by the high stresses in the crack tip region act to reduce the stresses.region act to reduce the stresses. Dispersion strengthening by Glass Infusion of slipDispersion strengthening by Glass Infusion of slip cast alumina ceramics, (Micro-crack toughening).cast alumina ceramics, (Micro-crack toughening). Dispersion strengthening of PSZ ceramics,Dispersion strengthening of PSZ ceramics, (Transformation toughening).(Transformation toughening). www.indiandentalacademy.com
  • 22. 22 Crack Bridging : The second phase crystalline structure acts asThe second phase crystalline structure acts as a “bandage”to prevent crack from openinga “bandage”to prevent crack from opening further.Crystallization of Glasses byfurther.Crystallization of Glasses by Ceramming.Ceramming. www.indiandentalacademy.com
  • 23. 23 Crystalline dispersion Strengthening : StrengtheningStrengthening methodmethod Clinical systemClinical system CharacteristicsCharacteristics Fused AluminaFused Alumina sintered into asintered into a matched expansionmatched expansion glass.glass. Hi – CeramHi – Ceram (Vident)(Vident) Alumina reinforcedAlumina reinforced ceramicsceramics Leucite crystalsLeucite crystals dispersed throughdispersed through the body of thethe body of the crowncrown Optec(Jeneric/PentOptec(Jeneric/Pent ron)ron) IPS EmpressIPS Empress (ivoclar)(ivoclar) Leucite reinforcedLeucite reinforced Heat pressedHeat pressed leucite-reinforcedleucite-reinforced CrystallizedCrystallized magnesiunmagnesiun aluminum oxedealuminum oxede spinellspinell Al-Ceram (InnotekAl-Ceram (Innotek Dental Corp.)Dental Corp.) formerly Cerestore.formerly Cerestore. Shrik-freeShrik-free aluminaalumina ceramic.ceramic. www.indiandentalacademy.com
  • 24. 24 Glass infiltration strengthening : ReinforcingReinforcing crystalscrystals Clinical SystemClinical System CharestresticsCharestrestics AluminaAlumina In-CeramIn-Ceram Alumina (Vita)Alumina (Vita) High aluminaHigh alumina coping infused withcoping infused with a low fusing glassa low fusing glass ZirconiaZirconia In-CeramIn-Ceram Zirconia (Vita)Zirconia (Vita) High ZirconiaHigh Zirconia coping infused withcoping infused with a low fusing glassa low fusing glass MagnesiumMagnesium oxide spinelloxide spinell In-CeramIn-Ceram Spinell (Vita)Spinell (Vita) High SpinellHigh Spinell coping infused withcoping infused with a low fusing glassa low fusing glasswww.indiandentalacademy.com
  • 25. 25 Crystallization of Glasses : StrengtheningStrengthening methodmethod Clinical systemClinical system CharacteristicsCharacteristics Conversion byConversion by “Ceramming”“Ceramming” DicorDicor (Dentsply)(Dentsply) Castable glassCastable glass ceramic withceramic with tetrasilic fluormicatetrasilic fluormica crystalscrystals Conversion byConversion by “Crystallization”“Crystallization” CerapearlCerapearl (Kyocera(Kyocera america Inc.)america Inc.) Castable apatiteCastable apatite ceramicceramic www.indiandentalacademy.com
  • 26. 26 Classification of Dental Porcelain A lu m in a M ag n esiu n sp in ell Z ircon iu m L eu cite Z irconia W h iskers H ig h A lu m in a R ein forcin g M aterial P ow d er slu rry C astab le P ressab le In filtrated M achin ab le G en aral S ystem H ihg F usin g M ed iu m F u sin g L ow F u sin g F irin g Tem p eratu re A L L -C E R A M IC S Summarywww.indiandentalacademy.com
  • 27. 27 Firing Temperature : High Fusing : 1290`C – 1370`CHigh Fusing : 1290`C – 1370`C These are used for the manufacture ofThese are used for the manufacture of porcelain teeth.porcelain teeth. Composed of Feldspar=70%-90%, Quart=Composed of Feldspar=70%-90%, Quart= 11%-18%, Kaolin= 1%-10%.11%-18%, Kaolin= 1%-10%. www.indiandentalacademy.com
  • 28. 28 Low / Medium Fusing Porcelains Low and medium fusing porcelains areLow and medium fusing porcelains are manufactured by a process called Fritting.manufactured by a process called Fritting. www.indiandentalacademy.com
  • 29. 29 General ClassificationGeneral Classification 1.Conventional powder ceramics 2.Castable ceramics 3.Pressable ceramics 4.Infiltrated ceramics 5.Machinable ceramics www.indiandentalacademy.com
  • 30. 30 Castable Ceramics : These products are supplied as solid ceramic ingots,These products are supplied as solid ceramic ingots, which are used for fabrication of cores or fullwhich are used for fabrication of cores or full contour restorations using a lost wax andcontour restorations using a lost wax and centrifugal casting technique. Generally, onecentrifugal casting technique. Generally, one shade of material is available. Which is coveredshade of material is available. Which is covered by conventional feldspathic porcelain or is stainedby conventional feldspathic porcelain or is stained to obtain proper shading and characterization ofto obtain proper shading and characterization of the final restoration.the final restoration. e.g. DICOR (Corning glass, Dentsply).e.g. DICOR (Corning glass, Dentsply). CERAPEARL (Bioceram, Kyocera)CERAPEARL (Bioceram, Kyocera) www.indiandentalacademy.com
  • 31. 31 Powder Slurry Ceramics : These products are supplied as powders to which theThese products are supplied as powders to which the technician adds distilled water to produce a slurry,technician adds distilled water to produce a slurry, which is build up in layers on a die material towhich is build up in layers on a die material to form the contours of the restoration. The powdersform the contours of the restoration. The powders are available in different shades andare available in different shades and translucencies, and are supplied withtranslucencies, and are supplied with characterizing stains and glazes.characterizing stains and glazes. e.g. OPTEC H.S.P (Jeneric/Pentron)e.g. OPTEC H.S.P (Jeneric/Pentron) DUCERAM L.F.C (Ducera Inc)DUCERAM L.F.C (Ducera Inc) Vita Hi-Ceram (Vita Zahnfabrik)Vita Hi-Ceram (Vita Zahnfabrik)www.indiandentalacademy.com
  • 32. 32 Pressable Ceramics : These are also supplied as ingots, these product areThese are also supplied as ingots, these product are melted at higher temperatures and pressed into amelted at higher temperatures and pressed into a mould using a lost wax technique. These pressedmould using a lost wax technique. These pressed form can be made into full contour, or can be usedform can be made into full contour, or can be used as a substrate for conventional feldspathicas a substrate for conventional feldspathic porcelain buildup, or can be built up by layeringporcelain buildup, or can be built up by layering technique.technique. e.g. IPS Empress I, II (Ivoclar vivadent)e.g. IPS Empress I, II (Ivoclar vivadent) OPC (Optec Pressable Ceramic)OPC (Optec Pressable Ceramic) ALCERAM (Cerestore, Innotek dental corp)ALCERAM (Cerestore, Innotek dental corp) www.indiandentalacademy.com
  • 33. 33 Infiltrated Ceramics : These are glass infiltrated core ceramics. ThisThese are glass infiltrated core ceramics. This involves slipcasting technique for makinginvolves slipcasting technique for making the core, and the contours of the restorationthe core, and the contours of the restoration are obtained by individual layering andare obtained by individual layering and staining techniques.staining techniques. e.g. In-CERAM (Vita Zahnfabrik)e.g. In-CERAM (Vita Zahnfabrik) AluminaAlumina ZirconiaZirconia SpinellSpinell www.indiandentalacademy.com
  • 34. 34 Machinable Ceramics These products are supplied as ingots in variousThese products are supplied as ingots in various shades and are milled into desired form. Theseshades and are milled into desired form. These machined restorations can be stained and glazed tomachined restorations can be stained and glazed to obtain desired characterization. They are of twoobtain desired characterization. They are of two types :types : CAD-CAM =CAD-CAM = Computer Aided Designing – ComputerComputer Aided Designing – Computer Aided MillingAided Milling. e.g. CEREC (Sirona). e.g. CEREC (Sirona) Ivoclar ProCAD (Ivoclar, Spring)Ivoclar ProCAD (Ivoclar, Spring) Dicor M.G.C (Dentsply)Dicor M.G.C (Dentsply) Copy Milling = CELAY (Mikrona Technologies)Copy Milling = CELAY (Mikrona Technologies)www.indiandentalacademy.com
  • 35. 35 Preparations for All-Ceramic Crowns : The role of the tooth preparation for aThe role of the tooth preparation for a porcelain jacket crown is to provide supportporcelain jacket crown is to provide support for the prosthesis with uniform porcelainfor the prosthesis with uniform porcelain thickness. It was recognized that the mostthickness. It was recognized that the most frequent cause of JC failure was improperfrequent cause of JC failure was improper tooth preparation.tooth preparation. www.indiandentalacademy.com
  • 36. 36 The Design : The design of an ideal all-ceramic crown preparation is toThe design of an ideal all-ceramic crown preparation is to provide maximum strength of the crown by establishing flatprovide maximum strength of the crown by establishing flat planes at right angles to the forces of mastication andplanes at right angles to the forces of mastication and avoiding sharp line angles. A shoulder margin is alsoavoiding sharp line angles. A shoulder margin is also required because it offers superior strength as compared torequired because it offers superior strength as compared to chamfer.chamfer. www.indiandentalacademy.com
  • 37. 37 Length of the preparation : When a load is applied from a lingual direction, the labialWhen a load is applied from a lingual direction, the labial shoulder is placed under compression and only the lengthshoulder is placed under compression and only the length of the preparation at the incisal lingual aspect providesof the preparation at the incisal lingual aspect provides significant resistance to this force.short preparations causesignificant resistance to this force.short preparations cause considerable stresses and may lead to fracture.considerable stresses and may lead to fracture.www.indiandentalacademy.com
  • 38. 38 Length of the preparation : The ideal incisal reduction 2 mm and must not exceed moreThe ideal incisal reduction 2 mm and must not exceed more than 1/3than 1/3rdrd of the anatomical crown . If the incisal reductionof the anatomical crown . If the incisal reduction is too thin, it should be thickened and placed at a rightis too thin, it should be thickened and placed at a right angle to the direction of stress by reducing the preparationangle to the direction of stress by reducing the preparation to a length of 2/3to a length of 2/3rdrd of the anatomical crown.of the anatomical crown.www.indiandentalacademy.com
  • 39. 39 Shoulder : A well defined shoulder with adequate width improves theA well defined shoulder with adequate width improves the fracture resistance of the crown because it providesfracture resistance of the crown because it provides additional bulk at the margins that is placed at right anglesadditional bulk at the margins that is placed at right angles to the direction of stressesto the direction of stresses The more the intimate the contact between the preparationThe more the intimate the contact between the preparation and the ceramic crown higher the resistance to fracture onand the ceramic crown higher the resistance to fracture on occlusal loading.occlusal loading.www.indiandentalacademy.com
  • 40. 40 Shoulder / Chamfer : When the shoulder angle of the preparation to theWhen the shoulder angle of the preparation to the longitudinal axis of the tooth is greater than 90`,longitudinal axis of the tooth is greater than 90`, the risk if porcelain fracture increases.the risk if porcelain fracture increases. The internal shoulder angle should be rounded toThe internal shoulder angle should be rounded to reduce the stress concentration factor up to 50%reduce the stress concentration factor up to 50% and because sharp internal line angles cannot beand because sharp internal line angles cannot be easily reproduced with porcelain. Similarly , theeasily reproduced with porcelain. Similarly , the internal rounded shoulder is recommended for theinternal rounded shoulder is recommended for the In-Ceram* crown to facilitate the adaptation of theIn-Ceram* crown to facilitate the adaptation of the aluminous oxide slip on the die.aluminous oxide slip on the die. www.indiandentalacademy.com
  • 41. 41 Shoulder / Chamfer : A chamfer is conservative and simpler toA chamfer is conservative and simpler to execute and has been described as an optionexecute and has been described as an option for cast glass ceramic restorations.for cast glass ceramic restorations. www.indiandentalacademy.com
  • 42. 42 Shoulder width : A shoulder of uniform thickness may roundA shoulder of uniform thickness may round the preparation excessively and compromisethe preparation excessively and compromise resistance form. For a maxillary centralresistance form. For a maxillary central incisor, the lingual and facial shoulderincisor, the lingual and facial shoulder width should be I mm with a minimum ofwidth should be I mm with a minimum of 0.8 mm, and the interproximal width should0.8 mm, and the interproximal width should be 0.5 mm because the proximal walls ofbe 0.5 mm because the proximal walls of the crown flare out and provide sufficientthe crown flare out and provide sufficient strength in the proximal areastrength in the proximal area www.indiandentalacademy.com
  • 43. 43 Shoulder width : These specifications for a shoulder of non uniformThese specifications for a shoulder of non uniform width provide for conservatism, support, andwidth provide for conservatism, support, and resistance of the preparation to stresses.resistance of the preparation to stresses. www.indiandentalacademy.com
  • 44. 44 Shoulder curvature (interproximally) : The finish lines should follow a smooth curvatureThe finish lines should follow a smooth curvature that it is not too steep inter-proximally to avoid athat it is not too steep inter-proximally to avoid a potential v shaped notch that could split the labialpotential v shaped notch that could split the labial off the lingual aspect of the crown.off the lingual aspect of the crown.www.indiandentalacademy.com
  • 45. 45 Facial & Lingual reduction : The minimal acceptable facial thickness of porcelainThe minimal acceptable facial thickness of porcelain from an esthetic standpoint is 1.0mm, and thefrom an esthetic standpoint is 1.0mm, and the ideal depth of reduction on the midfacial aspect ofideal depth of reduction on the midfacial aspect of a typical maxillary central incisor for ana typical maxillary central incisor for an aluminous porcelain jacket crown should be 1.3aluminous porcelain jacket crown should be 1.3 mm. Facial depths of reduction up to 1.5mm havemm. Facial depths of reduction up to 1.5mm have also been recommended for molded, castable, andalso been recommended for molded, castable, and slip-cast ceramics. Lingual thickness values of 1.5slip-cast ceramics. Lingual thickness values of 1.5 mm are ideal but are difficult to achieve routinely.mm are ideal but are difficult to achieve routinely. www.indiandentalacademy.com
  • 46. 46 Facial & Lingual reduction : Practically lingual thickness should be in thePractically lingual thickness should be in the 1 – 1.3 mm range, and the absolute1 – 1.3 mm range, and the absolute minimum should be 0.8 mm. The lingualminimum should be 0.8 mm. The lingual aspect of the preparation should be shapedaspect of the preparation should be shaped to avoid uneven sections of the crowns andto avoid uneven sections of the crowns and sharp line angles must be avoided.sharp line angles must be avoided. www.indiandentalacademy.com
  • 47. 47 Taper :Minimal taper is recommended for maximum surfaceMinimal taper is recommended for maximum surface area and support of the preparation. Excessivearea and support of the preparation. Excessive taper of the preparation correlates with a reductiontaper of the preparation correlates with a reduction in breaking strength and increase in stressin breaking strength and increase in stress concentration in the area where support is lacking.concentration in the area where support is lacking. A 5`taper is ideal and would ensure maximumA 5`taper is ideal and would ensure maximum resistance form with only one path of insertion ofresistance form with only one path of insertion of the crown but it is also difficult to achieve withoutthe crown but it is also difficult to achieve without producing undercuts.producing undercuts. The safest and most practical convergence angle ofThe safest and most practical convergence angle of all-ceramic preparations is 10`taper, whichall-ceramic preparations is 10`taper, which represents an acceptable compromise betweenrepresents an acceptable compromise between taper and strength.taper and strength. www.indiandentalacademy.com
  • 48. 48 Taper : Excessive porcelain bulk has an adverse effect onExcessive porcelain bulk has an adverse effect on strength. It is not the bulk that gives the strength tostrength. It is not the bulk that gives the strength to the crown, it is the resistance to flexure providedthe crown, it is the resistance to flexure provided by the support from the preparation and theby the support from the preparation and the accuracy of the fit.accuracy of the fit.www.indiandentalacademy.com
  • 49. 49 CASTABLE CERAMICS DICOR*DICOR* CERAPEARL*CERAPEARL* Summary www.indiandentalacademy.com
  • 50. 50 DICOR The castable glass ceramic system  HistoryHistory MaterialMaterial Advantages & DisadvantagesAdvantages & Disadvantages Indications & ContraindicationsIndications & Contraindications Clinical proceduresClinical procedures Laboratory proceduresLaboratory procedures www.indiandentalacademy.com
  • 51. 51 History :  The DICOR castable glass ceramic is one of theThe DICOR castable glass ceramic is one of the pyoceram ceramics manufactured by Corningpyoceram ceramics manufactured by Corning glass ware.glass ware.  Founded in the year 1978, after 6 years ofFounded in the year 1978, after 6 years of intensive research this ceramic system wasintensive research this ceramic system was introduced to dentistry.introduced to dentistry.  The present system represents the cumulativeThe present system represents the cumulative efforts of Peter.J.Adair of BIOCOR Inc., Davidefforts of Peter.J.Adair of BIOCOR Inc., David Grossman Ph.D of the Corning Glass ware &Grossman Ph.D of the Corning Glass ware & Dentsply International.Dentsply International. www.indiandentalacademy.com
  • 52. 52 Composition  Consists of three crystalline forms,Consists of three crystalline forms, SiOSiO22, = 45% -70% (w/w), = 45% -70% (w/w) KK22O, = 20% (w/w)O, = 20% (w/w) MgO, = 3% - 13% (w/w)MgO, = 3% - 13% (w/w) MgFMgF22 == 4% - 9%4% - 9% (w/w)(Fluoride as a nucleating(w/w)(Fluoride as a nucleating agent forming nucleation sites to aid the crystal growthagent forming nucleation sites to aid the crystal growth during the process of ceramming, ;eading to a growth ofduring the process of ceramming, ;eading to a growth of approx 1 micron small tetrasilicic crystals).approx 1 micron small tetrasilicic crystals). Small amounts of AlOSmall amounts of AlO33, ZrO, ZrO22,BaO,BaO Fluorescing agents.Fluorescing agents. www.indiandentalacademy.com
  • 53. 53 Material :  Technically described as Tetrasilicic fluoromicaTechnically described as Tetrasilicic fluoromica glass ceramic.glass ceramic.  Tetrasilicic fluoromica crystalsTetrasilicic fluoromica crystals 55% vol55% vol GlassGlass 45% vol45% vol  These miniscule crystals lie interlaced within theThese miniscule crystals lie interlaced within the glass phase in the direction of the casting. On theglass phase in the direction of the casting. On the surface of the cerammed glass are Enstatitesurface of the cerammed glass are Enstatite crystals of thickness microns. These occur throughcrystals of thickness microns. These occur through fluorine depletion which occurs through thefluorine depletion which occurs through the interaction with the embedment material neededinteraction with the embedment material needed for the ceramming process. These crystals are infor the ceramming process. These crystals are in orthogonal in direction to the surface and areorthogonal in direction to the surface and are whitish and opaque.whitish and opaque.www.indiandentalacademy.com
  • 54. 54 Advantages :  Strength -Strength -  Feldspathic porcelains and some all porcelains, areFeldspathic porcelains and some all porcelains, are glasses, and they are subject to the inherentglasses, and they are subject to the inherent frailties of glass (super cooled liquids).frailties of glass (super cooled liquids).  The tetrasilicic mica crystals(KThe tetrasilicic mica crystals(K22MgMg55SiSi88OO2020FF44) are) are similar to mica.similar to mica.  These crystals stop the propagation Griffith flaws.These crystals stop the propagation Griffith flaws. www.indiandentalacademy.com
  • 55. 55 Marginal adaptation :  Dicor casting are statistically more consistent inDicor casting are statistically more consistent in terms of “fit”than were the gold crowns.terms of “fit”than were the gold crowns.  The thermal expansion of coefficient of cast glassThe thermal expansion of coefficient of cast glass ceramic is close to that of natural enamel. Thisceramic is close to that of natural enamel. This means expansion and contraction during normalmeans expansion and contraction during normal temperature fluctuations, thus maintaining a goodtemperature fluctuations, thus maintaining a good marginal seal.marginal seal. www.indiandentalacademy.com
  • 56. 56 Biocompatibility :  Lesser plaque accumulation.Lesser plaque accumulation.  good marginal fit.good marginal fit.  Fluoride content inhibits bacterialFluoride content inhibits bacterial colonization.colonization.  The surface of the restoration is smooth andThe surface of the restoration is smooth and non porous.non porous. www.indiandentalacademy.com
  • 57. 57 Wear Potential :  This system has a microhardness closely matchedThis system has a microhardness closely matched to enamel, while the microhardness of feldspathicto enamel, while the microhardness of feldspathic porcelains is one third greater.porcelains is one third greater.  Cast Ceramic (KHN) = 362.Cast Ceramic (KHN) = 362.  EnamelEnamel (KHN) = 343.(KHN) = 343. contd…. www.indiandentalacademy.com
  • 58. 58 Wear potential…..  The surface can be polished to a veryThe surface can be polished to a very smooth non porous finish smoother thansmooth non porous finish smoother than glazed feldspathic porcelain.glazed feldspathic porcelain.  Lingual contours that represent aLingual contours that represent a physiologic anterior guidance are also aphysiologic anterior guidance are also a crucial factor in minimizing wear.crucial factor in minimizing wear. www.indiandentalacademy.com
  • 59. 59 Thermal conductivity :  Low thermal conductivity that insulates theLow thermal conductivity that insulates the underlying tooth from temperature changes.underlying tooth from temperature changes. SimplicitySimplicity www.indiandentalacademy.com
  • 60. 60 Esthetics : There is a close match in translucency between theThere is a close match in translucency between the cast ceramic material and enamel.cast ceramic material and enamel.  The numerous, small mica crystals that constituteThe numerous, small mica crystals that constitute the structure of the castable ceramic are looselythe structure of the castable ceramic are loosely matched in the index of refraction to thematched in the index of refraction to the surrounding glass phase that bonds the material.surrounding glass phase that bonds the material. Thus the intensity of light scattering at each glassThus the intensity of light scattering at each glass crystal interface is less, that is more suitable.crystal interface is less, that is more suitable. Increase in crystalinity ensures more scattering.Increase in crystalinity ensures more scattering.  Veneering porcelains also can be used to modifyVeneering porcelains also can be used to modify translucency and better color depth.translucency and better color depth.  This material is capable of producing chameleonThis material is capable of producing chameleon effect, where part of the color of the restoration iseffect, where part of the color of the restoration is picked up from the adjacent teeth as well as thepicked up from the adjacent teeth as well as thewww.indiandentalacademy.com
  • 61. 61 Disadvantages :  Special equipment and cost.Special equipment and cost.  Moderate strength.Moderate strength.  No fixed partial denture application.No fixed partial denture application.  High failure rate in posterior regions of theHigh failure rate in posterior regions of the mouth, as well as recent developments ofmouth, as well as recent developments of other materials, led to the phasing of thisother materials, led to the phasing of this product.product. www.indiandentalacademy.com
  • 62. 62 Indications :  Anterior PJC.Anterior PJC.  Inlays, onlays, three quarter crowns.Inlays, onlays, three quarter crowns.  Partial veneers, especially in periodontallyPartial veneers, especially in periodontally compromised teethcompromised teeth www.indiandentalacademy.com
  • 63. 63 Contraindications :  Clinical crown length is short.Clinical crown length is short.  FPD.FPD. www.indiandentalacademy.com
  • 64. 64 Clinical Procedure :  The tooth structure is sufficiently removedThe tooth structure is sufficiently removed to allow an adequate thickness of theto allow an adequate thickness of the material for strength and color saturation.material for strength and color saturation.  For castable ceramics, the tooth reductionFor castable ceramics, the tooth reduction on all surfaces must be no less than 1.2mm.on all surfaces must be no less than 1.2mm.  Heavy chamfer (135`)`or shoulder margin.Heavy chamfer (135`)`or shoulder margin.  6`- 8`taper and all line angles rounded.6`- 8`taper and all line angles rounded.  Standard impression procedures areStandard impression procedures are followed.followed. www.indiandentalacademy.com
  • 65. 65 Tooth preparation :  Incisal or occlusal - 1.5 mm- 2.0 mm.Incisal or occlusal - 1.5 mm- 2.0 mm.  Facial or lingual - 1.0 mm – 1.5 mm.Facial or lingual - 1.0 mm – 1.5 mm.www.indiandentalacademy.com
  • 66. 66 Laboratory Procedures :  Die preparation.Die preparation.  Waxing & Spruing.Waxing & Spruing.  Investing & Mold conditioning.Investing & Mold conditioning.  Casting.Casting.  Divesting.Divesting.  Sprue removal.Sprue removal.  Embedding.Embedding.  Ceramming & post ceram divesting.Ceramming & post ceram divesting.  Finishing, coloring.Finishing, coloring.www.indiandentalacademy.com
  • 67. 67 Die Preparation : Casts shoulb free of 0cclusal artifacts,air bubbles andCasts shoulb free of 0cclusal artifacts,air bubbles and other inaccuracies.other inaccuracies. Dies must be prepared with proper indexing. TheDies must be prepared with proper indexing. The dies should be sectioned, trimmed and refineddies should be sectioned, trimmed and refined with care.with care. Any existing undercuts must bu blocked out toAny existing undercuts must bu blocked out to ensure wax pattern removal without distortion.ensure wax pattern removal without distortion. Die sealant should be used.Die sealant should be used. A die spacer of appropriate shade is applied onA die spacer of appropriate shade is applied on evenly to the die to within 1 mm of margin.evenly to the die to within 1 mm of margin.www.indiandentalacademy.com
  • 68. 68 Prepared Die : www.indiandentalacademy.com
  • 69. 69 Waxing :  Die lubricant is applied over the die spacer toDie lubricant is applied over the die spacer to prevent adherence of the wax to the die.prevent adherence of the wax to the die.  All contours of the wax crown should have aAll contours of the wax crown should have a minimum thickness of at least 1mm to ensureminimum thickness of at least 1mm to ensure adequate strength of the crown.adequate strength of the crown.  A smooth and completely formed internal surfaceA smooth and completely formed internal surface of the waxed crown is necessary.of the waxed crown is necessary.  A wild-Leitz stereomicroscope with fibre opticA wild-Leitz stereomicroscope with fibre optic light can be used to avoid any over extensions inlight can be used to avoid any over extensions in the margins.the margins. www.indiandentalacademy.com
  • 70. 70 Wax Pattern : www.indiandentalacademy.com
  • 71. 71 Spruing :  One 8 or 10 gauge wax sprue, attached to theOne 8 or 10 gauge wax sprue, attached to the incisal surface of the anterior patterns, provides anincisal surface of the anterior patterns, provides an adequate gate for the ingress of the ceramicadequate gate for the ingress of the ceramic material.material.  Posterior patterns are usually require 10 gaugePosterior patterns are usually require 10 gauge sprues attached to the lingual and buccal cusp tips.sprues attached to the lingual and buccal cusp tips.  Sprue placement on molar patterns should beSprue placement on molar patterns should be diagonally opposed for more uniform flow of thediagonally opposed for more uniform flow of the fluid ceramic.fluid ceramic.  A sprue design incorporating a perpendicularA sprue design incorporating a perpendicular reservoir has also produced adequate casting.reservoir has also produced adequate casting.www.indiandentalacademy.com
  • 72. 72 Spruing :  Length must be approx 3 – 4 mm.Length must be approx 3 – 4 mm.  The pattern should be located so that itsThe pattern should be located so that its most distal point is approx 6 – 7 mm frommost distal point is approx 6 – 7 mm from the open end of the casting ring to allowthe open end of the casting ring to allow adequate diffusion of the mold glassadequate diffusion of the mold glass through the investment.through the investment. www.indiandentalacademy.com
  • 73. 73 Spruing : www.indiandentalacademy.com
  • 74. 74 Investment :  Wax pattern must be cleansed with a debublizingWax pattern must be cleansed with a debublizing agent, any excess must be removed.agent, any excess must be removed.  Non-corroding casting rings that are resistant toNon-corroding casting rings that are resistant to oxidation at high temperature must be used.oxidation at high temperature must be used.  2 layers of Kaoliner* a ring liner material (an2 layers of Kaoliner* a ring liner material (an asbestos liner)is placed inside the ring,to permitasbestos liner)is placed inside the ring,to permit suffficient expansion.suffficient expansion.  The ring liner is saturated eith water for about 10The ring liner is saturated eith water for about 10 sec before ceating the ring on to the cruciblesec before ceating the ring on to the crucible former.former.  A special phosphate bonded investment is usedA special phosphate bonded investment is usedwww.indiandentalacademy.com
  • 75. 75 Castable ceramic investment* : www.indiandentalacademy.com
  • 76. 76 Investment :  This material exhibits no setting expansion butThis material exhibits no setting expansion but produces approx 1.5% thermal expansion at highproduces approx 1.5% thermal expansion at high temperatures.temperatures.  8 ml of distilled water must be mixed with 60 gm8 ml of distilled water must be mixed with 60 gm of investment powder for 30 sec under vacuumof investment powder for 30 sec under vacuum with power spatulation.with power spatulation.  After spatulation additional vibration underAfter spatulation additional vibration under vacuum is carried for 20 – 30 sec.vacuum is carried for 20 – 30 sec.  The mixed investment should be carefully appliedThe mixed investment should be carefully applied on to the wax pattern with a camel’s hair brush.on to the wax pattern with a camel’s hair brush.www.indiandentalacademy.com
  • 77. 77 Investment :  After the wax pettern is carefully filled andAfter the wax pettern is carefully filled and coated, the remaining material should becoated, the remaining material should be vibrated into the ring allowing an excess tovibrated into the ring allowing an excess to remain above the open ends of the ring.remain above the open ends of the ring.  After bench setting for 1 hr the excessAfter bench setting for 1 hr the excess material should be trimmed even with thematerial should be trimmed even with the top of the casting flask.top of the casting flask. www.indiandentalacademy.com
  • 78. 78 Investment : www.indiandentalacademy.com
  • 79. 79 Mold conditioning :  A two stage mold conditioning is employed.A two stage mold conditioning is employed.  The invested pattern is placed in a cold furnace,The invested pattern is placed in a cold furnace, the temperature is raised to 249`C, and maintainedthe temperature is raised to 249`C, and maintained for 30 min (heat soak), 10 min of additional timefor 30 min (heat soak), 10 min of additional time for each ring should be added if more than threefor each ring should be added if more than three rings are placed at a time.rings are placed at a time.  The temperature is raised to 899`C, andThe temperature is raised to 899`C, and maintained for 2 hrs (heat soak), similarly 10 minmaintained for 2 hrs (heat soak), similarly 10 min added for each ring.added for each ring. www.indiandentalacademy.com
  • 80. 80 Casting : A 4 gm ceramic ingot is loaded in the ceramicA 4 gm ceramic ingot is loaded in the ceramic crucible.crucible. The amount of ceramic material required toThe amount of ceramic material required to make a good casting can be determinedmake a good casting can be determined when multiplied by a conversion factor ofwhen multiplied by a conversion factor of 2.6, the weight of the wax pattern, sprues2.6, the weight of the wax pattern, sprues and button should not exceed 4gm .and button should not exceed 4gm . Two patterns can be cast into one flask.Two patterns can be cast into one flask. www.indiandentalacademy.com
  • 81. 81 Ceramic ingot; Ceramic crucible: www.indiandentalacademy.com
  • 82. 82 Casting Machine :  The Dentsply DICOR casting machineThe Dentsply DICOR casting machine features a platinum electric resistance-typefeatures a platinum electric resistance-type muffle mounted on a electrically drivenmuffle mounted on a electrically driven straight centrifugal casting arm.straight centrifugal casting arm.  The machine is fitted with a specialThe machine is fitted with a special receptacle to hold the Dicor crucible.receptacle to hold the Dicor crucible. www.indiandentalacademy.com
  • 83. 83 Dentsply DICOR Casting Machine : www.indiandentalacademy.com
  • 84. 84 Dentsply DICOR Casting Machine : www.indiandentalacademy.com
  • 85. 85 Casting Procedure :  An ideal temperature of 1100`C is maintained forAn ideal temperature of 1100`C is maintained for 10 min to stabilize the muffle.10 min to stabilize the muffle.  The crucible containing the ceramic ingot isThe crucible containing the ceramic ingot is inserted through the rear muffle door.inserted through the rear muffle door.  The crucible is properly positioned in the muffleThe crucible is properly positioned in the muffle for melting the glass by the help if a special tool.for melting the glass by the help if a special tool.  The rear door is closed, the melting temperature isThe rear door is closed, the melting temperature is adjusted to 1360`C, and the melt switch is turnedadjusted to 1360`C, and the melt switch is turned on.on.  After reaching the determined temperature, thisAfter reaching the determined temperature, this will be maintained for 6 min.will be maintained for 6 min.www.indiandentalacademy.com
  • 86. 86 Casting Procedure :  The rear muffle door is opened .The rear muffle door is opened .  The casting ring is removed from the burnoutThe casting ring is removed from the burnout furnace and placed in the cradle with the cruciblefurnace and placed in the cradle with the crucible and gate facing the muffle.and gate facing the muffle.  The front muffle door is opened and the muffleThe front muffle door is opened and the muffle assembly is slid forward towards the casting ringassembly is slid forward towards the casting ring until it is seated.until it is seated.  The casting machine cover is shut and the castingThe casting machine cover is shut and the casting switch is turned on. The casting arm spinsswitch is turned on. The casting arm spins automatically for 4 ½ min and then stops. By theautomatically for 4 ½ min and then stops. By the end of the spin cycle the casting will cool downend of the spin cycle the casting will cool downwww.indiandentalacademy.com
  • 87. 87 Casting Procedure :  The casting ring is removed form theThe casting ring is removed form the machine and allowed to dool for 45 minmachine and allowed to dool for 45 min before divesting.before divesting. Divesting : •After cooling, the investment is removed from arround the edges of the casting ring to a depth of approx 6 –8 mm. The investment mass can be forced out of the retaining ring by pushing with the fingers. www.indiandentalacademy.com
  • 88. 88 Divesting :  The bulk of the investment material can be brokenThe bulk of the investment material can be broken away from the casting with finger pressure.away from the casting with finger pressure.  The remaining casting should be removed with anThe remaining casting should be removed with an air abrasive tool using 25 micron aluminum oxideair abrasive tool using 25 micron aluminum oxide at 40 p.s.I.at 40 p.s.I.  The margin areas should be protected by coveringThe margin areas should be protected by covering with the finger to prevent chipping.with the finger to prevent chipping. www.indiandentalacademy.com
  • 89. 89 Sprue removal :  The cast crown is cut off at the junction ofThe cast crown is cut off at the junction of sprue and button using a suitable single orsprue and button using a suitable single or double side diamond disc.double side diamond disc.  The sprue is cut near the glass button toThe sprue is cut near the glass button to avoid chipping.avoid chipping.  The remaining button must be dicsarde andThe remaining button must be dicsarde and cannot be reused because the glass is alteredcannot be reused because the glass is altered during melting cycle.during melting cycle.  The casting at this stage is non-crystalline.The casting at this stage is non-crystalline. www.indiandentalacademy.com
  • 90. 90 Casting : www.indiandentalacademy.com
  • 91. 91 Embedding :  The casting is embedded in the ceramicThe casting is embedded in the ceramic embedment material, so that the cerammingembedment material, so that the ceramming process can take place.process can take place.  During this ceramming procedure the glass isDuring this ceramming procedure the glass is concerted into a 55% crystalline form.concerted into a 55% crystalline form.  The glass casting is embedded in a mixture of 18The glass casting is embedded in a mixture of 18 ml distilled water and 50gm of embedmentml distilled water and 50gm of embedment powder. Hand mixing is sufficient.powder. Hand mixing is sufficient.  The inside of the crown is carefully filled with theThe inside of the crown is carefully filled with the embedment mix and then it is placed on a trayembedment mix and then it is placed on a tray with a concave receptacle in which additionalwith a concave receptacle in which additional material is placed.material is placed.www.indiandentalacademy.com
  • 92. 92 Embedding :  Additional embedment is used to cover andAdditional embedment is used to cover and protect the glass crown. The material should beprotect the glass crown. The material should be allowed to set for 45 – 60 min.allowed to set for 45 – 60 min. www.indiandentalacademy.com
  • 93. 93 Ceramming :  This process is accomplished by a preciselyThis process is accomplished by a precisely controlled ceramming furnace.controlled ceramming furnace.  The furnace temperature is gradually increased toThe furnace temperature is gradually increased to 1075`C for 3 ½ hrs, this temperature should be1075`C for 3 ½ hrs, this temperature should be maintained for 6 hrs. the furnace is cooled tomaintained for 6 hrs. the furnace is cooled to 200`C and the embedment tray is removed.200`C and the embedment tray is removed.  The ceramming process involves a two-stage heatThe ceramming process involves a two-stage heat treatment. The first heat treatment is carried at thetreatment. The first heat treatment is carried at the temperature for maximum nucleation of crystals,temperature for maximum nucleation of crystals, so maximum no: of crystals are formed. Theso maximum no: of crystals are formed. The temperature is held for some time for the crystaltemperature is held for some time for the crystal growth to take place, to attain the maximum size.growth to take place, to attain the maximum size.www.indiandentalacademy.com
  • 94. 94 DICOR Ceramming Furnace : www.indiandentalacademy.com
  • 95. 95 Ceramming tray : www.indiandentalacademy.com
  • 96. 96 DICOR Ceramming Furnace : www.indiandentalacademy.com
  • 97. 97 Ceramming  The proper ceram cycle is verified by the use of aThe proper ceram cycle is verified by the use of a pyrometric cone.pyrometric cone.  The characteristic droop will provide verificationThe characteristic droop will provide verification that proper time and temperature has allowed thethat proper time and temperature has allowed the development of the desired crystalline propertiesdevelopment of the desired crystalline properties in the casting.in the casting. www.indiandentalacademy.com
  • 98. 98 Ceramming verification : www.indiandentalacademy.com
  • 99. 99 Postceram divesting :  The tray is allowed to cool to roomThe tray is allowed to cool to room temperature.temperature.  The embedment is broken.The embedment is broken.  The crown is cleaned by air-blasting withThe crown is cleaned by air-blasting with 25 micron aluminum oxide at 40 p.s.I at a25 micron aluminum oxide at 40 p.s.I at a distance of approx 6inches.distance of approx 6inches.  The margins should be protected fromThe margins should be protected from chipping during air-blasting.chipping during air-blasting. www.indiandentalacademy.com
  • 100. 100 Wax pattern – Glass form - crystalline form - finished crown www.indiandentalacademy.com
  • 101. 101 Crown finishing :  Crystalline glass crown is inspected for internalCrystalline glass crown is inspected for internal nodules or irregularities, which may interfere withnodules or irregularities, which may interfere with seating of the casting on the die. Theseseating of the casting on the die. These irregularities csn be removed with extrafineirregularities csn be removed with extrafine diamond points.diamond points.  The crows is seated on to the die and examined forThe crows is seated on to the die and examined for marginal overextensions. If any, must be removedmarginal overextensions. If any, must be removed with fine white point or rubber wheel rotating atwith fine white point or rubber wheel rotating at low speed.low speed.  The remaining sprue is removed with a doubleThe remaining sprue is removed with a double sided diamond disc rotating at slow speed.sided diamond disc rotating at slow speed. www.indiandentalacademy.com
  • 102. 102 Crown finishing :  The fine opaque white skin covering the crownThe fine opaque white skin covering the crown must be removed. The sprue is finished and themust be removed. The sprue is finished and the skin is lightly removed with a fine rubber abrasiveskin is lightly removed with a fine rubber abrasive wheel.wheel.  After removal of the skin the crown is air blastedAfter removal of the skin the crown is air blasted with 25 microns aluminum oxide at 40 psi.with 25 microns aluminum oxide at 40 psi.  The primary and secondary occlusal anatomy canThe primary and secondary occlusal anatomy can be defined with small round and inverted cone T.Cbe defined with small round and inverted cone T.C burs.burs.  Corrections can be done with an add-on material.Corrections can be done with an add-on material. The casting is dried in front of the open muffle atThe casting is dried in front of the open muffle at 593`C and introduced into muffle under vacuum593`C and introduced into muffle under vacuum to a temperature of 968`C for 1 min and can beto a temperature of 968`C for 1 min and can be shaped and adjusted to desired contours.shaped and adjusted to desired contours. www.indiandentalacademy.com
  • 103. 103 Characterization & Glazing :  After the ceramming process the casring isAfter the ceramming process the casring is achromatic, the desired hue is decided by theachromatic, the desired hue is decided by the shading porcelains.shading porcelains.  The blending of enamel and body colors mustThe blending of enamel and body colors must occur while they are wet.occur while they are wet.  The first and the second shading porcelains shouldThe first and the second shading porcelains should be fired at a slightly lower temperature to preventbe fired at a slightly lower temperature to prevent over glazing and glassy appearance of the crown.over glazing and glassy appearance of the crown.  Castable ceramics can be fired repeatedly in aCastable ceramics can be fired repeatedly in a conventional glazing oven without affecting theconventional glazing oven without affecting the physical properties or marginal integrity of thephysical properties or marginal integrity of the materialmaterial www.indiandentalacademy.com
  • 104. 104 Characterization & Glazing : www.indiandentalacademy.com
  • 105. 105 Unglazed & Glazed crowns : www.indiandentalacademy.com
  • 106. 106 Completed crown : www.indiandentalacademy.com
  • 107. 107 Cementation :  The color value is modified by a series odThe color value is modified by a series od dentsply shaded cements.these cements are colordentsply shaded cements.these cements are color coordinated with the die spacers that are earliercoordinated with the die spacers that are earlier used.used.  If a natural colored tooth preparation exists, aIf a natural colored tooth preparation exists, a translucent glass ionomer cement is indicated. Intranslucent glass ionomer cement is indicated. In those cases the tooth structure or a metal core isthose cases the tooth structure or a metal core is present, the use of properly colored cement can bepresent, the use of properly colored cement can be of good esthetic value.of good esthetic value.  During cementation process, controlled, positiveDuring cementation process, controlled, positive finger pressure should be used to seat the crownfinger pressure should be used to seat the crown onto the prepared tooth. Excess cement isonto the prepared tooth. Excess cement is completely removed after the setting is complete.completely removed after the setting is complete.www.indiandentalacademy.com
  • 108. 108 Dicor shaded cements : www.indiandentalacademy.com
  • 109. 109 CERAPEARL :  IntroductionIntroduction  CompositionComposition  PropertiesProperties  Lab techniqueLab technique www.indiandentalacademy.com
  • 110. 110 Introduction :  Bioceram group have developed castableBioceram group have developed castable ceramic material (Hobo & Kyocera) whichceramic material (Hobo & Kyocera) which may be classified as CaO.Pmay be classified as CaO.P22OO55.MgO.SiO.MgO.SiO22 glass ceramic.glass ceramic.  Its crystalline structure is similar to that ofIts crystalline structure is similar to that of enamel.enamel.  Biocompatible and is indicated for crownsBiocompatible and is indicated for crowns and inlays.and inlays. www.indiandentalacademy.com
  • 111. 111 Composition :  It is composed of CaO.PIt is composed of CaO.P22OO55.MgO.SiO.MgO.SiO22 plusplus traces of other elements.traces of other elements.  CaO.PCaO.P22OO55 - are the main ingredients and aid- are the main ingredients and aid in glass formation. Essential to formin glass formation. Essential to form hydroxyapatite crystals.hydroxyapatite crystals.  Mg O. CaO – decrease the viscosity.Mg O. CaO – decrease the viscosity.  SiOSiO22 in combination with Pin combination with P22OO55 – form the– form the matrix.matrix. www.indiandentalacademy.com
  • 112. 112 Properties :  Melts at 1460`C and can be cast. TheMelts at 1460`C and can be cast. The casting has an amorphous microstructurecasting has an amorphous microstructure and when it is reheated at 870`C for 1 hr, itand when it is reheated at 870`C for 1 hr, it forms crystalline oxyapatite. This apatite isforms crystalline oxyapatite. This apatite is clinically unstable and when exposed toclinically unstable and when exposed to moisture becomes crystalline hydro-moisture becomes crystalline hydro- oxyapatite.oxyapatite.  It has similar crystalline arrangement asIt has similar crystalline arrangement as enamel but the crystals are irregularenamel but the crystals are irregular providing superior mechanical strength.providing superior mechanical strength.www.indiandentalacademy.com
  • 113. 113 Lab Technique :  Casts are poured in type IV dental stone.Casts are poured in type IV dental stone.  After the die sealant,spacer and separator isAfter the die sealant,spacer and separator is applied, the wax up is done and sprue isapplied, the wax up is done and sprue is attached.attached.  Invested in phosphate bonded investment in aInvested in phosphate bonded investment in a silicone mold.silicone mold.  After seraration of the silicone mold 60 minAfter seraration of the silicone mold 60 min later, it is dried in an oven at temperature lesslater, it is dried in an oven at temperature less than 100`C for 30 min.than 100`C for 30 min.  Then the temperature is raised to 500`C and thenThen the temperature is raised to 500`C and then to 800`C for 30 min.to 800`C for 30 min.www.indiandentalacademy.com
  • 114. 114 Lab Technique :  The investment mold is transferred to a high heatThe investment mold is transferred to a high heat processor specially developed for this system.processor specially developed for this system.  8 – 10 gm of new Cerapearl is placed in the8 – 10 gm of new Cerapearl is placed in the ceramic crucible and melted under vacuum atceramic crucible and melted under vacuum at 1400`C and cast into a mold.1400`C and cast into a mold.  Upon completion of casting the ring is transferredUpon completion of casting the ring is transferred to crystallization mold. The process by which theto crystallization mold. The process by which the casting is re-heated under appropriate conditionscasting is re-heated under appropriate conditions to develop the micro-crystals of apatite is termedto develop the micro-crystals of apatite is termed crystallization.crystallization.  It makes the casting highly dense, strong, hard andIt makes the casting highly dense, strong, hard and chemically stable.chemically stable. www.indiandentalacademy.com
  • 115. 115 Lab Technique :  The crystalization starts at 750`C thenThe crystalization starts at 750`C then maintained for 15 min =, then reached atmaintained for 15 min =, then reached at 870`C for 1 hr.870`C for 1 hr.  Translucency is similar to enamel.Translucency is similar to enamel.  External stains can also be given afterExternal stains can also be given after cooling.cooling. www.indiandentalacademy.com
  • 116. 116 Conventional POWDER SLURRY CERAMICS Vita Hi-Ceram*Vita Hi-Ceram* Optec HSP*Optec HSP* Duceram LFC*Duceram LFC* Summary www.indiandentalacademy.com
  • 117. 117 VITA Hi-Ceram :  Material propertiesMaterial properties  Laboratory procedures.Laboratory procedures. www.indiandentalacademy.com
  • 118. 118 Material :  This is a aluminum oxide reinforced hardThis is a aluminum oxide reinforced hard core porcelain.core porcelain.  Alumina reinforced core consists of 50% ofAlumina reinforced core consists of 50% of aluminous crystals in a matrix of low fusingaluminous crystals in a matrix of low fusing glass of matching thermal expansion.glass of matching thermal expansion.  Aluminous core porcelains are twiceAluminous core porcelains are twice stronger than regular porcelains.stronger than regular porcelains. www.indiandentalacademy.com
  • 119. 119 A comparision of the bending strengths of vita Hi-Ceram and Vitadur-N core porcelains www.indiandentalacademy.com
  • 120. 120 Merits :  Highly accurate margins.Highly accurate margins.  Higher melting points and greater stability.Higher melting points and greater stability.  For both anterior and posterior crowns,For both anterior and posterior crowns, veneers.veneers. www.indiandentalacademy.com
  • 121. 121 Clinical Procedures :  Heavy chamfer or shoulder with internalHeavy chamfer or shoulder with internal angles rounded.angles rounded.  Regular impression procedures.Regular impression procedures. www.indiandentalacademy.com
  • 122. 122 Lab Procedures :  Preparing the refractory die.Preparing the refractory die.  Hard core porcelain framework.Hard core porcelain framework.  Crown buildup.Crown buildup. www.indiandentalacademy.com
  • 123. 123 Refractory Die :  Prepared die on thePrepared die on the master model.master model. www.indiandentalacademy.com
  • 124. 124  To create theTo create the necessarynecessary space for thespace for the cement,cement, apply Vitaapply Vita interspaceinterspace varnish on tovarnish on to the die in 2the die in 2 or 3 coatings.or 3 coatings. www.indiandentalacademy.com
  • 125. 125  Apply aApply a coat of thincoat of thin insulatinginsulating grease ontogrease onto thethe duplicatingduplicating base andbase and ring, fix thering, fix the die into thedie into the duplicatingduplicating base andbase and then placethen place the ringthe ring intointo position.position. www.indiandentalacademy.com
  • 126. 126  The hi-ceramThe hi-ceram duplicatingduplicating paste consistspaste consists of paste, liquidof paste, liquid and catalyst,and catalyst, should beshould be stirred quicklystirred quickly to obtain ato obtain a homogenoushomogenous mix. NOTE :mix. NOTE : first mix thefirst mix the paste and liquidpaste and liquid together andtogether and then stir in thethen stir in the catalyst.catalyst. www.indiandentalacademy.com
  • 127. 127  To avoidTo avoid any creatingany creating bubbles, fillbubbles, fill the mold bythe mold by pouring inpouring in the mixturethe mixture in a finein a fine stream.stream. WorkingWorking time approxtime approx 2 ½ min.2 ½ min. Setting timeSetting time – 20 – 30– 20 – 30 min.min. www.indiandentalacademy.com
  • 128. 128  Remove theRemove the die from thedie from the solidifiedsolidified cast ofcast of duplicatingduplicating paste, andpaste, and clean off theclean off the interspaceinterspace varnishvarnish using theusing the interspaceinterspace varnishvarnish thinner.thinner. www.indiandentalacademy.com
  • 129. 129  Mix theMix the refractory Hi-refractory Hi- Ceram dieCeram die material togethermaterial together with the diewith the die material liquid:material liquid: for this, thefor this, the liquid should beliquid should be drawn into thedrawn into the dosing syringedosing syringe to the 3 ml mark,to the 3 ml mark, for one 15 gmfor one 15 gm sachet ofsachet of powder. *Stirpowder. *Stir the two materialsthe two materials for at least 1for at least 1 min.min. www.indiandentalacademy.com
  • 130. 130  On a vibratorOn a vibrator without anywithout any bubbles fill thebubbles fill the mold that is tomold that is to be duplicated.be duplicated. While it is stillWhile it is still soft, set asoft, set a porcelainporcelain retaining pinretaining pin into the dieinto the die material, so asmaterial, so as to later be ableto later be able to safely fix theto safely fix the die onto adie onto a porcelain firingporcelain firing tray.tray. www.indiandentalacademy.com
  • 131. 131  The setting timeThe setting time for Hi-Ceramfor Hi-Ceram die materialdie material varies betweenvaries between 1 ½ - 2 hrs,1 ½ - 2 hrs, depending ondepending on the roomthe room temperature.temperature. After no moreAfter no more than 6 hrs thethan 6 hrs the die is removeddie is removed from the mold.from the mold. www.indiandentalacademy.com
  • 132. 132  The die should be set onThe die should be set on a porcelain tray for thea porcelain tray for the refractory material torefractory material to harden. Pre dry the dieharden. Pre dry the die in the VITA Vacumatin the VITA Vacumat 200 /100 : with the200 /100 : with the furnace on standby(orfurnace on standby(or prog A), lower the firingprog A), lower the firing tray by manual controltray by manual control key and the place thekey and the place the die onto it. Only whendie onto it. Only when the die material hasthe die material has turned light green theturned light green the following prog isfollowing prog is initiated ……….initiated ………. www.indiandentalacademy.com
  • 133. 133  In theIn the VitaVita Vacumat 200Vacumat 200 :: prog 5.5, endprog 5.5, end temp 1,000`C,temp 1,000`C, pre-drying timepre-drying time 10 min, heating10 min, heating time 10 min, holdtime 10 min, hold time 3 min. In thetime 3 min. In the Vita VacumatVita Vacumat 100100 : prog 5, end: prog 5, end temp 1000`C, pre-temp 1000`C, pre- drying time 10drying time 10 min, heating timemin, heating time 10 min, hold time10 min, hold time 3 min.3 min. www.indiandentalacademy.com
  • 134. 134 Constructing the hard core porcelain www.indiandentalacademy.com
  • 135. 135  The Hi-Ceram hardThe Hi-Ceram hard core porcelain has tocore porcelain has to be applied and firedbe applied and fired in three layersin three layers altogether : 1. Thealtogether : 1. The wash firing.; 2. Halfwash firing.; 2. Half of the requiredof the required thickness withthickness with protuberances forprotuberances for later checking on thelater checking on the thickness of thethickness of the porcelain.; 3. Fullporcelain.; 3. Full build-up as a smallerbuild-up as a smaller version of the crownversion of the crown it is to become.it is to become. Minimum thickness-Minimum thickness- 0.5mm.0.5mm. www.indiandentalacademy.com
  • 136. 136  Prior toPrior to each neweach new applicationapplication of Hi-Ceramof Hi-Ceram hard corehard core porcelain,porcelain, the diethe die should firstshould first be allowedbe allowed to cool andto cool and then left tothen left to soak insoak in water untilwater until no moreno more bubbles arebubbles are beingbeing emitted.emitted. www.indiandentalacademy.com
  • 137. 137  Excess waterExcess water should beshould be soaked up. Next,soaked up. Next, Hi-Ceram hardHi-Ceram hard core porcelaincore porcelain powder is mixedpowder is mixed together withtogether with Vita modelingVita modeling liquid “P” to aliquid “P” to a thin, creamythin, creamy consistency.consistency. This is thenThis is then applied as a thinapplied as a thin wash onto thewash onto the die.die. www.indiandentalacademy.com
  • 138. 138  Pre dry thePre dry the die on thedie on the loweredlowered firing trayfiring tray of theof the furnacefurnace until it hasuntil it has againagain turned lightturned light green, andgreen, and then fire asthen fire as follows,follows, using ausing a standbystandby temperaturetemperature of 600`C :of 600`C : www.indiandentalacademy.com
  • 139. 139  In the Vita vacumat 200:In the Vita vacumat 200: programme 6.6, end temperature 1170`C,programme 6.6, end temperature 1170`C, pre-drying time 6 min, heating time 10 min,pre-drying time 6 min, heating time 10 min, hold time 0 min, vacuum firing time 10hold time 0 min, vacuum firing time 10 min.min.  In the Vita vacumat 100:In the Vita vacumat 100: programme 6, end temperature 1170`C, pre-programme 6, end temperature 1170`C, pre- drying time 6 min, heating time 10 min,drying time 6 min, heating time 10 min, hold time 0 min, vacuum firing time 10hold time 0 min, vacuum firing time 10 min.min. www.indiandentalacademy.com
  • 140. 140  Soak the die in waterSoak the die in water again, and then applyagain, and then apply the hard core porcelainthe hard core porcelain for second firing. Tofor second firing. To make sure of having themake sure of having the correct thickness of Hi-correct thickness of Hi- Ceram hard coreCeram hard core porcelain,porcelain, protuberances or pointsprotuberances or points can be constructed forcan be constructed for control purposes. Thecontrol purposes. The firing instructions arefiring instructions are the same as for the 1the same as for the 1stst hard core porcelainhard core porcelain firing.firing. www.indiandentalacademy.com
  • 141. 141  The fully built up hard core porcelain in itsThe fully built up hard core porcelain in its final form before the third firing.final form before the third firing. For this, fire fire as follows, using a standby temperature of 600`C www.indiandentalacademy.com
  • 142. 142  In the Vita vacumat 200:In the Vita vacumat 200: Programme 6.7, end temperature 1170`C, pre-Programme 6.7, end temperature 1170`C, pre- drying tome 6 min, heating up tome 6 min,drying tome 6 min, heating up tome 6 min, hold time 3 min, vacuum firing time 10hold time 3 min, vacuum firing time 10 min.min.  In the Vita vacumat 100:In the Vita vacumat 100: Programme 6, end temperature 1170`C, pre-Programme 6, end temperature 1170`C, pre- drying time 6min, heating up tome 10 min,drying time 6min, heating up tome 10 min, hold time 3 min, vacuum firing time 10hold time 3 min, vacuum firing time 10 min.min. www.indiandentalacademy.com
  • 143. 143  The thickness of hard core porcelainThe thickness of hard core porcelain framework should not be less than 0.5 mm.framework should not be less than 0.5 mm.  For additional stability, a collar in Hi-For additional stability, a collar in Hi- Ceram hard core porcelain can be addedCeram hard core porcelain can be added palatally or lingually.palatally or lingually. www.indiandentalacademy.com
  • 144. 144  Just as with VitaJust as with Vita VMK metal-ceramicVMK metal-ceramic porcelain, Hi-Ceramporcelain, Hi-Ceram hard core porcelainshard core porcelains can also be shadedcan also be shaded individually using theindividually using the Hi-Ceram COLORHi-Ceram COLOR hard-core porcelains,hard-core porcelains, e.g. ti reinforce thee.g. ti reinforce the shade from within inshade from within in cases where thecases where the thickness of the dentinthickness of the dentin porcelain is thinnerporcelain is thinner than normal.than normal. www.indiandentalacademy.com
  • 145. 145  TheThe refractoryrefractory die shoulddie should be blastedbe blasted away usingaway using glass beadsglass beads at aat a pressure ofpressure of 1- 2 bar.1- 2 bar. www.indiandentalacademy.com
  • 146. 146  The finished Hi-The finished Hi- Ceram hard coreCeram hard core frame work onframe work on the stone die.the stone die. Any areas ofAny areas of interface orinterface or feathered edgesfeathered edges should beshould be carefully groundcarefully ground down ordown or removed using aremoved using a fine-grainedfine-grained diamond.diamond. www.indiandentalacademy.com
  • 147. 147  As the Hi-Ceram hard core framework has notAs the Hi-Ceram hard core framework has not been constructed on the model, any areas that arebeen constructed on the model, any areas that are now found to have been built up too high or toonow found to have been built up too high or too thick can be corrected using a fie grainedthick can be corrected using a fie grained diamond.diamond. www.indiandentalacademy.com
  • 148. 148 The build up of the crown : www.indiandentalacademy.com
  • 149. 149  The crown shouldThe crown should be built up to itsbe built up to its desired shape usingdesired shape using Vitadur-N dentinVitadur-N dentin porcelain, althoughporcelain, although to compensate firingto compensate firing shrinkage it must beshrinkage it must be built longerbuilt longer incisally. The cervixincisally. The cervix of the hard coreof the hard core framework can beframework can be coated before handcoated before hand using Vitadur-Nusing Vitadur-N opacous porcelain.opacous porcelain. www.indiandentalacademy.com
  • 150. 150  A little Vitadur-NA little Vitadur-N opacous dentin canopacous dentin can also be appliedalso be applied palatally, so thatpalatally, so that even in caseseven in cases where there is awhere there is a deeper than normaldeeper than normal bite by thebite by the occluding teeth,occluding teeth, any shiningany shining through of the Hi-through of the Hi- Ceram hard coreCeram hard core porcelain will beporcelain will be completelycompletely avoided.avoided. www.indiandentalacademy.com
  • 151. 151  To create theTo create the necessary spacenecessary space for the enamelfor the enamel porcelain, theporcelain, the dentin should havedentin should have a crescent carveda crescent carved away incisally andaway incisally and for the smoothfor the smooth transition betweentransition between the dentin andthe dentin and enamel, then alsoenamel, then also be smoothenedbe smoothened using a flattenedusing a flattened brush.brush. www.indiandentalacademy.com
  • 152. 152  For individualFor individual shading andshading and characterizatiocharacterizatio n, there are 5n, there are 5 Vitadur-NVitadur-N opacousopacous dentin, 6dentin, 6 dentin effect,dentin effect, 2 enamel2 enamel effect and 7effect and 7 COLORCOLOR porcelainsporcelains available.available. www.indiandentalacademy.com
  • 153. 153  The shape of theThe shape of the crown is nowcrown is now built up inbuilt up in Vitadur-NVitadur-N enamelenamel porcelain. Itporcelain. It should beshould be somewhat oversomewhat over dimensioned todimensioned to compensatecompensate firing shrinkage.firing shrinkage. www.indiandentalacademy.com
  • 154. 154  The crown is firedThe crown is fired as follows: either byas follows: either by placing it onto aplacing it onto a fibrous pad firingfibrous pad firing support (in whichsupport (in which case raise thecase raise the temperature bytemperature by 10`C), or by10`C), or by wrapping a normalwrapping a normal crown stand in thecrown stand in the fibrous pad materialfibrous pad material and then placing theand then placing the crown loosely ontocrown loosely onto it:it: www.indiandentalacademy.com
  • 155. 155  In the Vita vacumat 200:In the Vita vacumat 200: Programme 6.4, end temperature 960`C, pre-Programme 6.4, end temperature 960`C, pre- drying time 6 min, heating up time 6 min,drying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min.hold time 1 min, vacuum firing time 6 min.  In the Vita vacumat :In the Vita vacumat : Programme 6, end temperature 960`C, pre-Programme 6, end temperature 960`C, pre- drying time 6 min, heating up time 6 min,drying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min.hold time 1 min, vacuum firing time 6 min. www.indiandentalacademy.com
  • 156. 156  The fired Hi-Ceram crown should be groundThe fired Hi-Ceram crown should be ground all over in the normal way, using a diamondall over in the normal way, using a diamond or a green silicon carbide bur. Foror a green silicon carbide bur. For corrections, clean without using anycorrections, clean without using any cleansing agent but with a clean brush undercleansing agent but with a clean brush under running water, or a steam jet blaster.running water, or a steam jet blaster. Then reapply the appropriate porcelain and fire as for the main vacuum firing, except with the temperature reduced by 10`C. www.indiandentalacademy.com
  • 157. 157  Before each firing, it is also possible toBefore each firing, it is also possible to improve the accuracy of fit and esthetics ofimprove the accuracy of fit and esthetics of the cervical margin: the stone die shouldthe cervical margin: the stone die should first be insulated using one drop thin bodiedfirst be insulated using one drop thin bodied super glue. This sealing of the surface willsuper glue. This sealing of the surface will prevent the die from soaking up anyprevent the die from soaking up any moisture from the porcelain. Next, tomoisture from the porcelain. Next, to prevent to prevent the modeled porcelainprevent to prevent the modeled porcelain from sticking to the die, the chamfer shouldfrom sticking to the die, the chamfer should be thinly coated with Hi-Ceram die releasebe thinly coated with Hi-Ceram die release before applying the cervical porcelain.before applying the cervical porcelain. www.indiandentalacademy.com
  • 158. 158  The cervicalThe cervical porcelain should beporcelain should be mixed with Vitamixed with Vita modeling liquid,modeling liquid, applied onto theapplied onto the cervical margin,cervical margin, condensed and thencondensed and then bottled. Excessbottled. Excess cervical porcelainscervical porcelains should then beshould then be removed usingremoved using either a clean fingereither a clean finger or a dry brush.or a dry brush. www.indiandentalacademy.com
  • 159. 159  Without beingWithout being tilted, the crowntilted, the crown should beshould be removed andremoved and fired as ……fired as …… www.indiandentalacademy.com
  • 160. 160 Cervical porcelain firing in the Vita vacumat 200Cervical porcelain firing in the Vita vacumat 200 programme 6.8, end temperature 940`C, pre-programme 6.8, end temperature 940`C, pre- drying time 6 min, heating up time 6 min, holddrying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min.time 1 min, vacuum firing time 6 min. Cervical porcelain firing in the Vita vacumat 100Cervical porcelain firing in the Vita vacumat 100 programme 6, end temperature 940`C, pre-programme 6, end temperature 940`C, pre- drying time 6 min, heating up time 6 min, holddrying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min.time 1 min, vacuum firing time 6 min. www.indiandentalacademy.com
  • 161. 161 Glaze firing :  Applying theApplying the Vitachrom ”L”Vitachrom ”L” glaze No. 725glaze No. 725 allows theallows the temperature fortemperature for the glaze firingthe glaze firing to be lowered,to be lowered, therebythereby guarantyingguarantying that the cervicalthat the cervical margins retainmargins retain its accurate fit.its accurate fit.www.indiandentalacademy.com
  • 162. 162  Glaze firing in the Vita vacumat 200:Glaze firing in the Vita vacumat 200: Programme 5.4, end temperature 920`C, pre-Programme 5.4, end temperature 920`C, pre- drying time 4 min, heating up time 3 min,drying time 4 min, heating up time 3 min, hold time 1 min.hold time 1 min.  Glaze firing in the Vita vacumat 100:Glaze firing in the Vita vacumat 100: Programme 5, end temperature 920`C, pre-Programme 5, end temperature 920`C, pre- drying time 4 min, heating up time 3 min,drying time 4 min, heating up time 3 min, hold time 1 min.hold time 1 min. www.indiandentalacademy.com
  • 163. 163 Finished Vita Hi-ceram crowns www.indiandentalacademy.com
  • 164. 164 Optec HSP www.indiandentalacademy.com
  • 165. 165 Introduction: Optec HSP(Jeneric / Pentron) is a Leucite-Optec HSP(Jeneric / Pentron) is a Leucite- reinforced feldspathic porcelain that isreinforced feldspathic porcelain that is condensed and sintered like aluminouscondensed and sintered like aluminous porcelain and traditional porcelain. Hasporcelain and traditional porcelain. Has greater strength than traditional feldspathicgreater strength than traditional feldspathic porcelains due to increased amount ofporcelains due to increased amount of leucite. The manufacturer disperses theleucite. The manufacturer disperses the leucite crystals in a glassy matrix byleucite crystals in a glassy matrix by controlling their nucleation crystal growthcontrolling their nucleation crystal growth during the initial production of theduring the initial production of the porcelain powder.porcelain powder.www.indiandentalacademy.com
  • 166. 166  Because of its increased strength, Optec HSP*Because of its increased strength, Optec HSP* does not require a core when used to fabricate alldoes not require a core when used to fabricate all ceramic restorations, as is necessary withceramic restorations, as is necessary with aluminous PJC’s. the body and incisal porcelainsaluminous PJC’s. the body and incisal porcelains are pigmented to provide the desired shade andare pigmented to provide the desired shade and translucency. The leucite and glass componentstranslucency. The leucite and glass components are fused together during the baking processare fused together during the baking process (1020`C). The buildup and contouring of the(1020`C). The buildup and contouring of the crown is done on a special semi-permeable diecrown is done on a special semi-permeable die material. It has a moderately opaque corematerial. It has a moderately opaque core compared with a metal or an aluminous porcelaincompared with a metal or an aluminous porcelain core, it is more translucent than alumina-corecore, it is more translucent than alumina-core crowns and glass infiltrated alumina core crowns.crowns and glass infiltrated alumina core crowns. www.indiandentalacademy.com
  • 167. 167 Advantages:  Lack of metal or opaque substructure.Lack of metal or opaque substructure.  Good translucency.Good translucency.  Moderate flexural strength.Moderate flexural strength.  No special laboratory equipments needed.No special laboratory equipments needed. www.indiandentalacademy.com
  • 168. 168 Disadvantages:  Potential marginal inaccuracy caused byPotential marginal inaccuracy caused by porcelain sintering shrinkage.porcelain sintering shrinkage.  Potential to fracture in posterior teeth.Potential to fracture in posterior teeth. Leucite reinforced porcelain that is condensedLeucite reinforced porcelain that is condensed and sintered shrinks when fired because ofand sintered shrinks when fired because of the volumetric decrease caused by sintering,the volumetric decrease caused by sintering, and the fit of the crowns made from thisand the fit of the crowns made from this ceramic is not as good as that of PFMceramic is not as good as that of PFM crowns with metal margins.crowns with metal margins. www.indiandentalacademy.com
  • 169. 169 Duceram LFC: www.indiandentalacademy.com
  • 170. 170 Introduction:  The development of very low fusingThe development of very low fusing ceramics(fusing temperature 660`C) meantceramics(fusing temperature 660`C) meant that a simple and accurate technique forthat a simple and accurate technique for building up and firing all-ceramicbuilding up and firing all-ceramic restorations.restorations. www.indiandentalacademy.com
  • 171. 171 Method of Fabrication: Tooth preparation.Tooth preparation. Die preparation.Die preparation. Ceramic core.Ceramic core. Ceramic buildup.Ceramic buildup. www.indiandentalacademy.com
  • 172. 172 Tooth preparation: Preparation for a CJC with a peripheral shoulder.www.indiandentalacademy.com
  • 173. 173 Ceramic coping preparation :  Refractory die.Refractory die.  Initial ceramic connector layer.Initial ceramic connector layer.  Ceramic core buildup.Ceramic core buildup. www.indiandentalacademy.com
  • 174. 174 A fine layer of initial ceramic over the refractory die the refractory die (Ducera-lay) is fired at 980`C. This connector layer should be bright and even Ceramic connector: www.indiandentalacademy.com
  • 175. 175 Ceramic Core: Lamination in Duceram ceramic directly on the refractory die to produce a ceramic coping of 0.3 mm thickness www.indiandentalacademy.com
  • 176. 176 Lamination in Duceram ceramic directly on the refractory die to produce a ceramic coping of 0.3 mm thickness www.indiandentalacademy.com
  • 177. 177 Lamination in Duceram ceramic directly on the refractory die to produce a ceramic coping of 0.3 mm thickness www.indiandentalacademy.com
  • 178. 178 The coping is fired at 940`C. Various shades can be introduced at this stage. www.indiandentalacademy.com
  • 179. 179 After firing the coping is gently sandblasted off the refractory material using 50 micron aluminum oxide powder.www.indiandentalacademy.com
  • 180. 180 Prepared coping www.indiandentalacademy.com
  • 181. 181 Ceramic Buildup: The coping is replaced on the plaster cast.The coping is replaced on the plaster cast. Lamination can the be completed using aLamination can the be completed using a low-fusing ceramic, which will be fired atlow-fusing ceramic, which will be fired at 660`C in a vacuum.660`C in a vacuum.www.indiandentalacademy.com
  • 182. 182 Completed Duceram-LFC Crown: Facial view ^ www.indiandentalacademy.com
  • 183. 183 Completed Duceram-LFC Crown: Lingual view (Courtesy : Marc Cristou)www.indiandentalacademy.com
  • 184. 184 Properties:  Flexural strength – 110 Mpa.Flexural strength – 110 Mpa.  Hardness is close to that of natural toothHardness is close to that of natural tooth due to absence of leucite.mdue to absence of leucite.m  Opalescence of the natural tooth can beOpalescence of the natural tooth can be reproduced.reproduced.  Fluorescence of LFC is very close to that ofFluorescence of LFC is very close to that of natural tooth.natural tooth. www.indiandentalacademy.com
  • 185. 185 Fluorescence:  ComparisonComparison ofof fluorescencefluorescence of naturalof natural teeth(green),teeth(green), DuceramDuceram LFC(blue),LFC(blue), www.indiandentalacademy.com
  • 186. 186 Fluorescence: LFC (circle left); traditional ceramic material (circleLFC (circle left); traditional ceramic material (circle right); natural tooth (middle).right); natural tooth (middle). www.indiandentalacademy.com
  • 187. 187 Advantages:  Excellent marginal adaptation.Excellent marginal adaptation.  Use of plaster master cast.Use of plaster master cast.  No special equipment required.No special equipment required.  Allows for modification by repeated firings.Allows for modification by repeated firings.  Abrasion rate close to that of natural tooth.Abrasion rate close to that of natural tooth.  Good visual qualities, including bestGood visual qualities, including best reproduction of opalescence of natural teeth.reproduction of opalescence of natural teeth. www.indiandentalacademy.com
  • 188. 188 Indications:  Laminate veneers.Laminate veneers.  Jacket crowns.Jacket crowns.  Inlays.Inlays.  Onlays.Onlays.  If high transparency ceramic is required.If high transparency ceramic is required. www.indiandentalacademy.com
  • 189. 189 Contraindications:  Masking grossly discolored tooth.Masking grossly discolored tooth.  When aiming for high fracture resistance.When aiming for high fracture resistance.  All other common contraindications.All other common contraindications. www.indiandentalacademy.com
  • 190. 190 MACHINABLE CERAMICS Summary www.indiandentalacademy.com
  • 191. 191 Classification: a ceramic restoration fabricated by use of a computer aided design - computer aided milling a process of milling a structure using a device that traces the surface of a metal, ceramic or a polymer pattern and transfers the traced spatial positions to a cutting station. C A D -C A M C e r a m ic s C o p y -M il l e d C e r a m ic s M ac h in able C er a m ic s www.indiandentalacademy.com
  • 192. 192 CAD – CAM Ceramics CERECCEREC CEREC SCANCEREC SCAN CEREC 2CEREC 2 CEREC InLABCEREC InLAB CEREC 3CEREC 3 PROCERAPROCERA www.indiandentalacademy.com
  • 193. 193 Introduction: The introduction of Computer-Aided-Designing &The introduction of Computer-Aided-Designing & Computer-Aided-Milling(CAD-CAM) systems toComputer-Aided-Milling(CAD-CAM) systems to prosthetic dentistry represents a majorprosthetic dentistry represents a major technological breakthrough. It is now possible totechnological breakthrough. It is now possible to design and fabricate ceramic restorations at adesign and fabricate ceramic restorations at a single appointment, as opposed to the traditionalsingle appointment, as opposed to the traditional method of making impressions, fabricating ofmethod of making impressions, fabricating of provisional prosthesis, and using a lab forprovisional prosthesis, and using a lab for development of the restoration. These restorationsdevelopment of the restoration. These restorations save dentists and patients time, provide an estheticsave dentists and patients time, provide an esthetic restoration, and have the potential for wearrestoration, and have the potential for wear resistance.resistance. www.indiandentalacademy.com
  • 194. 194 History: Optical scanning and computer generation ofOptical scanning and computer generation of restorations were attempted as early as 1971restorations were attempted as early as 1971 (Altschuler, 1971/1973) but the continued(Altschuler, 1971/1973) but the continued improvement in technology, a number ofimprovement in technology, a number of systems are currently being investigated atsystems are currently being investigated at this time………this time……… Duret & PrestonDuret & Preston 19811981 Brendestini et alBrendestini et al 19851985 RekowRekow 19871987 WilliamsWilliams 19871987 Duret et alDuret et al 19881988www.indiandentalacademy.com
  • 195. 195 Objectives:  To eliminate traditional impression methods.To eliminate traditional impression methods.  To design, the future restoration inTo design, the future restoration in accordance with the preparation, the functionaccordance with the preparation, the function and natural anatomy,e.g. with the use ofand natural anatomy,e.g. with the use of computer.computer.  To produce the restoration chair side.To produce the restoration chair side.  To improve the restoration qualities,To improve the restoration qualities, mechanical resistance, marginal fit, surfacemechanical resistance, marginal fit, surface quality and esthetics.quality and esthetics.www.indiandentalacademy.com
  • 196. 196 Types of CAD – CAM Devices:  DIRECT:DIRECT: Fully integrated CAD – CAM devices forFully integrated CAD – CAM devices for chair side restorative approach. CAD &chair side restorative approach. CAD & CAM stations are located at the dentalCAM stations are located at the dental office.office.  INDIRECT:INDIRECT: System that consists of several modules withSystem that consists of several modules with at least, distinctive CAD & CAM stations.at least, distinctive CAD & CAM stations. www.indiandentalacademy.com
  • 197. 197 Indirect Method:  The optical impression is taken in the dentalThe optical impression is taken in the dental office, where CAD is done; data areoffice, where CAD is done; data are transmitted to CAM station for restorationtransmitted to CAM station for restoration fabrication.fabrication.  The optical impression is taken in the dentalThe optical impression is taken in the dental office; collected information is thenoffice; collected information is then transmitted to a central station, where CADtransmitted to a central station, where CAD & CAM modules operate.& CAM modules operate. www.indiandentalacademy.com
  • 198. 198 Indirect Method:  Because of the overall dimensions and the cost ofBecause of the overall dimensions and the cost of the indirect CAD – CAM devices, they are usuallythe indirect CAD – CAM devices, they are usually not located in the dental office, but more likely innot located in the dental office, but more likely in a central laboratory where data is collected froma central laboratory where data is collected from different treatment places. E.g. ….different treatment places. E.g. ….  Duret system*.Duret system*.  Procera system* (Noble Bio-Care).Procera system* (Noble Bio-Care).  Cicero system* (Elephant Industries).Cicero system* (Elephant Industries).  President system* (DCS Dental).President system* (DCS Dental).  CEREC SCAN* & CEREC InLAB* (SironaCEREC SCAN* & CEREC InLAB* (Sirona Dental company)Dental company) www.indiandentalacademy.com
  • 199. 199 Direct CAD - CAM CEREC, CEREC 2, CEREC 3CEREC, CEREC 2, CEREC 3 www.indiandentalacademy.com
  • 200. 200 C E R E C S Y S T Ewww.indiandentalacademy.com
  • 201. 201 CEREC Systems: The CEREC system, developed in Zurich,The CEREC system, developed in Zurich, Switzerland has been marketed for severalSwitzerland has been marketed for several years with the improvised CEREC 2years with the improvised CEREC 2 introduced in mid 1990’s, upgraded tointroduced in mid 1990’s, upgraded to CEREC 3 in the year 2000.CEREC 3 in the year 2000. www.indiandentalacademy.com
  • 202. 202 The equipment consists of a computerThe equipment consists of a computer integrated imaging and milling system, withintegrated imaging and milling system, with the restorations designed on the computerthe restorations designed on the computer screenscreen www.indiandentalacademy.com
  • 203. 203 Materials used with CEREC’s:  Dicor MGC*(Dicor MGC*(Machinable Glass CeramicMachinable Glass Ceramic)(Dentsply):)(Dentsply): This is a mica based machinable glass ceramicThis is a mica based machinable glass ceramic containing 70% vol of crystalline phase. Thecontaining 70% vol of crystalline phase. The unique “House of Cards” microstructureunique “House of Cards” microstructure found in Dicor MGC is due to the interfound in Dicor MGC is due to the inter locking of the small platelet shaped mica-locking of the small platelet shaped mica- crystals with an average size of 1 – 2crystals with an average size of 1 – 2 microns. This particular structure leads tomicrons. This particular structure leads to multiple crack deflections and ensuresmultiple crack deflections and ensures greater strength than leucite containinggreater strength than leucite containing ceramics.ceramics. www.indiandentalacademy.com
  • 204. 204 Materials used with CEREC’s:  Vita Mark II (Vident):Vita Mark II (Vident): These contain sanidine (KALSiThese contain sanidine (KALSi33OO88) as a major) as a major crystalline phase within a glassy matrix.crystalline phase within a glassy matrix. www.indiandentalacademy.com
  • 205. 205 Materials used with CEREC’s:  ProCad (Ivoclar):ProCad (Ivoclar): Like Ivoclar's popularLike Ivoclar's popular Empress™ material,Empress™ material, ProCAD is reinforcedProCAD is reinforced with tiny leucite particles,with tiny leucite particles, and has been referred toand has been referred to as: "Empress on a stick".as: "Empress on a stick". Shade cross-reference: 100 = A1, A2, B1, B2, C1 200 = A3, A3.5 300 = B3, B4 400 = C2, D2, D3 500 = A4, C3, C4, D4 www.indiandentalacademy.com
  • 206. 206 Materials used with CEREC’s:  Vita IN-Ceram Blanks (Vita Zhanfabrik):Vita IN-Ceram Blanks (Vita Zhanfabrik): These are third generation blanks from Vita.These are third generation blanks from Vita.  The Spinell MgAlThe Spinell MgAl22OO44..  The Alumina AlThe Alumina Al22OO33..  The Zirconia ZrOThe Zirconia ZrO2.2. www.indiandentalacademy.com
  • 207. 207 The Spinell Blanks:  The fine chemical and mechanicalThe fine chemical and mechanical properties of the highly pure syntheticproperties of the highly pure synthetic spinell are used with the aim to obtain anspinell are used with the aim to obtain an esthetically appealing, translucent ceramicesthetically appealing, translucent ceramic structures.structures. www.indiandentalacademy.com
  • 208. 208 The Alumina Blanks:  These uses the advantages of the syntheticThese uses the advantages of the synthetic corundum that is prepared from bauxitecorundum that is prepared from bauxite prepared in electric melting furnace. Theprepared in electric melting furnace. The result is a dental all ceramic system withresult is a dental all ceramic system with convincing mechanical properties.convincing mechanical properties. www.indiandentalacademy.com
  • 209. 209 The Zirconia Blanks:  This combines the fracture toughness of theThis combines the fracture toughness of the meta-stable tetragonal zirconium oxidemeta-stable tetragonal zirconium oxide which is also referred to as “ceramic steel”.which is also referred to as “ceramic steel”. www.indiandentalacademy.com
  • 210. 210 Clinical Procedure: Preparation design.Preparation design. Optical impression.Optical impression. Computer generated restoration design.Computer generated restoration design. Milling procedure.Milling procedure. www.indiandentalacademy.com
  • 211. 211 Tooth Preparation Design:  Tooth preparation follows typical all-Tooth preparation follows typical all- ceramic guidelines.ceramic guidelines. Chamfer Shoulderwww.indiandentalacademy.com
  • 212. 212 Optical impression  The surface of the prepared teeth often lacksThe surface of the prepared teeth often lacks sufficient reflectivity or it may have facets that givesufficient reflectivity or it may have facets that give an uneven glaze to the computer screen.an uneven glaze to the computer screen.  It is therefore necessary to coat the preparation withIt is therefore necessary to coat the preparation with a special powder (titanium dioxide) that has propera special powder (titanium dioxide) that has proper light reflectivity.light reflectivity.  Rubber dam must be placed to prevent fogging ofRubber dam must be placed to prevent fogging of the camera lens and to aid in isolation.the camera lens and to aid in isolation.  Cerec is the first system that makes intra-oralCerec is the first system that makes intra-oral scanned impressions a reality. This is done throughscanned impressions a reality. This is done through a small hand held camera. The camera, whicha small hand held camera. The camera, which resembles a wand, illuminates the prepared toothresembles a wand, illuminates the prepared tooth and the 2 adjacent teeth with its light source andand the 2 adjacent teeth with its light source and processes the image with the 3-D measuringprocesses the image with the 3-D measuringwww.indiandentalacademy.com
  • 213. 213  The operator actually feels the wandThe operator actually feels the wand vibrate as the camera oscillates to scan thevibrate as the camera oscillates to scan the teeth at slightly different angles. The Cerecteeth at slightly different angles. The Cerec software then blends these images to createsoftware then blends these images to create its 3D map of the topography. This opticalits 3D map of the topography. This optical scanning system could well be the precursorscanning system could well be the precursor of much expanded use of optical scanningof much expanded use of optical scanning in dentistry. However, the inability to scanin dentistry. However, the inability to scan sub gingival margin areas and somesub gingival margin areas and some interproximal areas must (but probably will)interproximal areas must (but probably will) be overcome before optical scanningbe overcome before optical scanning becomes mainstream.becomes mainstream.www.indiandentalacademy.com
  • 214. 214 Optical impression: www.indiandentalacademy.com
  • 215. 215www.indiandentalacademy.com
  • 216. 216 Design Phase:  With theWith the help of thehelp of the CEREC 3CEREC 3 Software weSoftware we can choosecan choose the basisthe basis software forsoftware for thethe designing ofdesigning of inlays/onlayinlays/onlay s or crownss or crowns or veneers.or veneers. www.indiandentalacademy.com
  • 217. 217 Shaping of the surfaces: 1.1. FunctionFunction 2.2. CorrelationCorrelation 3.3. ExtrapolationExtrapolation www.indiandentalacademy.com
  • 218. 218  Function:Function: This design programme takes design of theThis design programme takes design of the antagonist.antagonist.  CorrelationCorrelation This design programme allows to copy intactThis design programme allows to copy intact occlusal surfaces.occlusal surfaces.  ExtrapolationExtrapolation This programme calculates the dimensions ofThis programme calculates the dimensions of the restoration with reference to a tooththe restoration with reference to a tooth database and as well as with the adjacentdatabase and as well as with the adjacent teeth.teeth. www.indiandentalacademy.com
  • 219. 219  With usingWith using all theall the programmesprogrammes the operatorthe operator can digitallycan digitally design thedesign the restorationrestoration by movingby moving the cursorthe cursor along thealong the boundaries.boundaries. www.indiandentalacademy.com
  • 220. 220  The procedure can be stopped at any timeThe procedure can be stopped at any time and can override the computer and allowand can override the computer and allow the operator to correct, the digitallythe operator to correct, the digitally generated features.generated features.  Once the restoration has been designed, theOnce the restoration has been designed, the computer develops a 3-D model on thecomputer develops a 3-D model on the screen.screen.  All the information is stored.All the information is stored.  The design phase usually takes 2 – 8 min.The design phase usually takes 2 – 8 min. www.indiandentalacademy.com
  • 221. 221 Milling Phase:  After all the data has been supplied, theAfter all the data has been supplied, the computer selects the size of the ceramiccomputer selects the size of the ceramic block to be used in the milling process.block to be used in the milling process.  There are wide range :There are wide range :  Composition.Composition.  Shade.Shade.  Size.Size. www.indiandentalacademy.com
  • 222. 222  These blanks are factory fabricated and thusThese blanks are factory fabricated and thus are more homogenous and less porous thanare more homogenous and less porous than materials that are made in the lab.materials that are made in the lab.  These materials also produce “chameleonThese materials also produce “chameleon effect”.effect”.  The material is mounted on the metal stud,The material is mounted on the metal stud, which allows it to be inserted in to thewhich allows it to be inserted in to the milling hub.milling hub.  Once the material is inserted. The windowOnce the material is inserted. The window is closed an the milling process is activated.is closed an the milling process is activated. www.indiandentalacademy.com
  • 223. 223 Milling process - - - - - - - - - - - Completed ceramic core www.indiandentalacademy.com
  • 224. 224 Limitations of CEREC:  The CEREC system was acceptable withThe CEREC system was acceptable with regard to the longevity of adhesivelyregard to the longevity of adhesively bonded restorations, but the amount ofbonded restorations, but the amount of manual corrections to make the restorationmanual corrections to make the restoration fit was too high. Hence it was important tofit was too high. Hence it was important to improve the accuracy and fit.improve the accuracy and fit.  Diamond disc was only tool for cutting.Diamond disc was only tool for cutting. Hence it was important to incorporate anHence it was important to incorporate an additional diamond cutting instrument.additional diamond cutting instrument.  Dentist’s required intensive training forDentist’s required intensive training for CAD. So it was important to achieve easy,CAD. So it was important to achieve easy, and user friendly software for CAD.and user friendly software for CAD.www.indiandentalacademy.com
  • 225. 225 Improvisation’s in CEREC 2:  The new camera provides more date with greaterThe new camera provides more date with greater accuracy with a resolution from 25 microns to 50accuracy with a resolution from 25 microns to 50 microns.microns.  The new technology has an on board 32 bitThe new technology has an on board 32 bit processor which increases the resolution of theprocessor which increases the resolution of the monitor and a a added color screen.monitor and a a added color screen.  The mew machine has two cutting heads insteadThe mew machine has two cutting heads instead of one, with 12`degree of freedom along 6 axis.of one, with 12`degree of freedom along 6 axis. www.indiandentalacademy.com
  • 226. 226 New Technology CEREC 3:  Software still easy and user friendly whichSoftware still easy and user friendly which uses windows as operating system.uses windows as operating system.  Two compatible cameras available-Two compatible cameras available- SIROCAM 2 / SIDEXIS.SIROCAM 2 / SIDEXIS.  Precise restorations.Precise restorations.  Extra-oral and intra-oral measuring.Extra-oral and intra-oral measuring.  Rapid production.Rapid production.  The imaging unit and the milling unit canThe imaging unit and the milling unit can be linked via cable, IRD port, networked.be linked via cable, IRD port, networked.  Supported with online help and design.Supported with online help and design.www.indiandentalacademy.com
  • 227. 227 Advantages of CEREC System:  One or two appointments.One or two appointments.  Optical impression, max time required is 5Optical impression, max time required is 5 sec.sec.  Wear hardness similar to enamel.Wear hardness similar to enamel.  Less fracture due to single homogenousLess fracture due to single homogenous block.block.  Excellent polish.Excellent polish.  Improved esthetics.Improved esthetics.  Time saving.Time saving.  Good occlusal morphology in relation toGood occlusal morphology in relation to antagonist.antagonist. www.indiandentalacademy.com
  • 228. 228 Indirect CAD - CAM CEREC* SCAN,CEREC* SCAN, CEREC* In-LABCEREC* In-LAB PROCERA* SYSTEMPROCERA* SYSTEM www.indiandentalacademy.com
  • 229. 229 CEREC SCAN:  Tooth preparation.Tooth preparation.  Conventional impressions.Conventional impressions.  Die preparation.Die preparation.  Controlled by one of the practice pc’s.Controlled by one of the practice pc’s.  Can be upgrade to CEREC 3.Can be upgrade to CEREC 3.  Works upon CEREC 3 software.Works upon CEREC 3 software.  Intra oral scanning device is not present.Intra oral scanning device is not present. www.indiandentalacademy.com
  • 230. 230 CEREC SCAN (inclusive of both scanningCEREC SCAN (inclusive of both scanning and milling device)with lap top(imagingand milling device)with lap top(imaging device).device). www.indiandentalacademy.com
  • 231. 231  ScanningScanning device.device. www.indiandentalacademy.com
  • 232. 232 CEREC In-LAB: www.indiandentalacademy.com
  • 233. 233 Controlled Scanning:  Consists of a compact milling unit with aConsists of a compact milling unit with a in-built scanner.in-built scanner.  This consists of non contact scanning forThis consists of non contact scanning for utmost precision.utmost precision.  Software runs on Windows* 98.Software runs on Windows* 98. www.indiandentalacademy.com
  • 234. 234 Scanning device www.indiandentalacademy.com
  • 235. 235 Controlled Design:  Offers a complete spectrum of designOffers a complete spectrum of design options for crowns and bridge framework.options for crowns and bridge framework.  All relevant parameters can be adjustedAll relevant parameters can be adjusted individually …for example, the occlusalindividually …for example, the occlusal and radial wall thickness and the crossand radial wall thickness and the cross sectional area of the bridge connectors.sectional area of the bridge connectors.  This system gives a visual thickness ifThis system gives a visual thickness if operator falls short of the minimum materialoperator falls short of the minimum material specific wall thickness.specific wall thickness.  Thus the operator exerts complete controlThus the operator exerts complete control over the design process ay all times.over the design process ay all times. www.indiandentalacademy.com
  • 236. 236 Controlled shaping of spacer. Overall design. Constant monitoring of connector cross section. Pontic shaping www.indiandentalacademy.com
  • 237. 237 Controlled milling: Prior to each milling jib CEREC In-LabPrior to each milling jib CEREC In-Lab automatically checks the dimensionalautomatically checks the dimensional accuracy of the milling tools.accuracy of the milling tools. The integrated soft touch control monitors theThe integrated soft touch control monitors the calibration of the tools throughout thecalibration of the tools throughout the milling process and compensates for anymilling process and compensates for any wear-related inaccuracies.wear-related inaccuracies. www.indiandentalacademy.com
  • 238. 238 Parallel milling with two tools: www.indiandentalacademy.com
  • 239. 239 High speed milling of copings and bridge frame work. www.indiandentalacademy.com
  • 240. 240 Processing times: Process stepProcess step CopingCoping BridgeBridge frameworkframework ScanningScanning (automatic)(automatic) Approx. 10 minApprox. 10 min Approx. 20minApprox. 20min DesignDesign Approx. 2 minApprox. 2 min Approx. 6 minApprox. 6 min MillingMilling (automatic)(automatic) Approx. 15 minApprox. 15 min Approx. 50 minApprox. 50 min www.indiandentalacademy.com
  • 241. 241 Completed bridge framework www.indiandentalacademy.com
  • 242. 242 I n di c at io n s of C E R E C www.indiandentalacademy.com
  • 243. 243 Procera* All-Ceram www.indiandentalacademy.com
  • 244. 244 Introduction:  The Procera® System developed by Dr.The Procera® System developed by Dr. Matts Andersson for Nobel BiocareMatts Andersson for Nobel Biocare embraces the concept of computer assistedembraces the concept of computer assisted design and computer assisted machiningdesign and computer assisted machining and is a method that appears to satisfy theseand is a method that appears to satisfy these needs. With the Procera® System theneeds. With the Procera® System the technician can design a coping for a fulltechnician can design a coping for a full crown restoration controlling the thickness,crown restoration controlling the thickness, emergence profile, and precision of fit. Theemergence profile, and precision of fit. The design data can be forwarded to thedesign data can be forwarded to the manufacturing facility and the copingmanufacturing facility and the coping produced in various materials.produced in various materials.www.indiandentalacademy.com
  • 245. 245  The Procera® AllCeram Crown involves aThe Procera® AllCeram Crown involves a densely sintered high-purity alumina coredensely sintered high-purity alumina core combined with a low fusing veneeringcombined with a low fusing veneering porcelain fabricated by the pressed powderporcelain fabricated by the pressed powder technology.technology. Material: www.indiandentalacademy.com
  • 246. 246 Advantages:  The finished crown has a translucense veryThe finished crown has a translucense very similar to the natural tooth.similar to the natural tooth.  Aluminum oxide is a highly biocompatibleAluminum oxide is a highly biocompatible material, comparable to titanium.material, comparable to titanium.  The coping is made of dense-sinteredThe coping is made of dense-sintered aluminum oxide to maximize strength.aluminum oxide to maximize strength.  The Procera® technique guarantees highThe Procera® technique guarantees high precision for optimal fit.precision for optimal fit. www.indiandentalacademy.com
  • 247. 247 Fabrication Procedures:  Tooth preparation.Tooth preparation.  Die preparation.Die preparation.  Scanning.Scanning.  Data transfer.Data transfer.  Central milling.Central milling.  Application of conventional porcelains.Application of conventional porcelains. www.indiandentalacademy.com
  • 248. 248 Tooth preparation:  Since the scanner'sSince the scanner's tip is rounded, thetip is rounded, the finish line shouldfinish line should be a chamfer placedbe a chamfer placed sub-gingivally atsub-gingivally at 0.5 mm to 0.7mm.0.5 mm to 0.7mm. A rounded shoulderA rounded shoulder may be also anmay be also an appropriate design.appropriate design. www.indiandentalacademy.com
  • 249. 249 Tooth preparation:  A relatively levelA relatively level topographytopography should beshould be accomplishedaccomplished during preparationduring preparation of the occlusalof the occlusal surface ofsurface of posteriorposterior dentition.dentition. www.indiandentalacademy.com
  • 250. 250 Tooth preparation:  The occlusal surface ofThe occlusal surface of a posterior tooth isa posterior tooth is shaped, eliminatingshaped, eliminating undercuts and sharpundercuts and sharp edges. Steep slopesedges. Steep slopes and sharp groves areand sharp groves are avoided to enable theavoided to enable the scanner to recognizescanner to recognize all of the informationall of the information through the tip.through the tip. www.indiandentalacademy.com
  • 251. 251 Tooth preparation:  For anteriorFor anterior dentition,dentition, preparation ofpreparation of the lingualthe lingual surface requiressurface requires shaping withshaping with diamond bur todiamond bur to eliminate debris.eliminate debris. www.indiandentalacademy.com
  • 252. 252 Tooth preparation:  Fine finish lines onFine finish lines on the prepared tooththe prepared tooth enable the scannerenable the scanner to precisely registerto precisely register all aspects of theall aspects of the die models, directlydie models, directly affecting theaffecting the marginal fit of themarginal fit of the definitivedefinitive restoration.restoration. www.indiandentalacademy.com
  • 253. 253 Tooth preparation:  PreparationPreparation depths shoulddepths should be between 1.0be between 1.0 mm and 1.5mm and 1.5 mm, while themm, while the occlusalocclusal reductionreduction should be atshould be at least 2.0 mm.least 2.0 mm. www.indiandentalacademy.com
  • 254. 254 Lab Procedures:  The cast is made in the conventional way,The cast is made in the conventional way, the die is ditched to make the margin easierthe die is ditched to make the margin easier to identify during scanning.to identify during scanning.  The die is then taken to the PROCERA*The die is then taken to the PROCERA* design station for scanning and designing.design station for scanning and designing. www.indiandentalacademy.com
  • 255. 255  A technician using the special Procera designA technician using the special Procera design station scans the die and designs the coping tostation scans the die and designs the coping to be fabricated. This station consists of a computer,be fabricated. This station consists of a computer, a modem and the Procera scanner. Oncea modem and the Procera scanner. Once positioned on the scanner, a probe lightly touchespositioned on the scanner, a probe lightly touches the die as it is rotated. A 3D map is producedthe die as it is rotated. A 3D map is produced from this "tactile scan" that consists offrom this "tactile scan" that consists of approximately 50,000 data points from aroundapproximately 50,000 data points from around the die. The technician then marks the margin orthe die. The technician then marks the margin or finish line and selects an emergence profile forfinish line and selects an emergence profile for the coping, using the computer and its’ Procerathe coping, using the computer and its’ Procera design software. This information is thendesign software. This information is then modemed to the manufacturing facility inmodemed to the manufacturing facility in Fairlawn, New Jersey. In about 4 days theFairlawn, New Jersey. In about 4 days the Procera coping is returned to the laboratory forProcera coping is returned to the laboratory for further veneering.further veneering. www.indiandentalacademy.com
  • 256. 256  The production starts with milling anThe production starts with milling an enlarged die to compensate for the sinteringenlarged die to compensate for the sintering shrinkage.shrinkage.  An enlarged high-alumina coping is milledAn enlarged high-alumina coping is milled that shrinks to the desired shape afterthat shrinks to the desired shape after sintering.sintering.  The coping is returned to the laboratory,The coping is returned to the laboratory, and body and incisal porcelains are added inand body and incisal porcelains are added in the conventional manner.the conventional manner. www.indiandentalacademy.com
  • 257. 257 COPY MILLED RESTORATIONS CELAY* SystemCELAY* System Mikrona TechnologiesMikrona Technologies Switzerland.Switzerland. www.indiandentalacademy.com
  • 258. 258 Introduction:  The Celay* is a well hand operated systemThe Celay* is a well hand operated system that represents an interesting alternative tothat represents an interesting alternative to CAD – CAM system for the dentalCAD – CAM system for the dental laboratory.laboratory.  It is an innovative system developed byIt is an innovative system developed by Dr.Stefan I. Eidenbenz at the university ofDr.Stefan I. Eidenbenz at the university of Zurich in 1994.Zurich in 1994. www.indiandentalacademy.com
  • 259. 259 Ceramic Blanks: www.indiandentalacademy.com
  • 260. 260 Procedure:  Preparation:Preparation: shoulder withshoulder with rounded axio-rounded axio- cervical linecervical line angle.angle. www.indiandentalacademy.com
  • 261. 261 Resin coping:  A prototypeA prototype composite resincomposite resin coping is modeledcoping is modeled on the die.on the die. www.indiandentalacademy.com
  • 262. 262  The resin coping modeled with CELAY –The resin coping modeled with CELAY – TECH is transferred on to the scanning /TECH is transferred on to the scanning / milling platform.milling platform. www.indiandentalacademy.com
  • 263. 263www.indiandentalacademy.com
  • 264. 264  Scanning of the prototype resin withScanning of the prototype resin with simultaneous of the copy milled crownsimultaneous of the copy milled crown substructure.substructure. www.indiandentalacademy.com
  • 265. 265  Copy milledCopy milled substructure prior tosubstructure prior to finishing.finishing. www.indiandentalacademy.com
  • 266. 266  The finishedThe finished sinteredsintered substructure aftersubstructure after firing onto the die.firing onto the die. www.indiandentalacademy.com
  • 267. 267 Advantages:  Precisely fitting ceramic restorations can bePrecisely fitting ceramic restorations can be developed without a lab technician in highdeveloped without a lab technician in high grade factory fired porcelain, in a very shortgrade factory fired porcelain, in a very short time in one session.time in one session.  The grains are finer than conventional In-The grains are finer than conventional In- Ceram, therefore the strength is more thanCeram, therefore the strength is more than conventional.conventional. www.indiandentalacademy.com
  • 268. 268 GLASS INFILTRATED CERAMICS In-Ceram* AluminaIn-Ceram* Alumina In-Ceram* SpinellIn-Ceram* Spinell In-Ceram* ZirconiaIn-Ceram* ZirconiaSummary www.indiandentalacademy.com
  • 269. 269 History:  In 1985 a new ceramic material wasIn 1985 a new ceramic material was introduced. This system evolved from theintroduced. This system evolved from the research of Dr. Mickael Sadoun in 1985 inresearch of Dr. Mickael Sadoun in 1985 in France at a research laboratory forFrance at a research laboratory for biomaterials at the university of Pram V.biomaterials at the university of Pram V.  It is manufactured and marketed by VITAIt is manufactured and marketed by VITA Zahnfabrik, Germany.Zahnfabrik, Germany. www.indiandentalacademy.com
  • 270. 270 Introduction:  This system use a slip casting(a procedureThis system use a slip casting(a procedure by which a fine particle ceramic, dispersedby which a fine particle ceramic, dispersed in an aqueous liquid medium (low viscosityin an aqueous liquid medium (low viscosity slurry) is applied on to a porous mold,slurry) is applied on to a porous mold, which rapidly extracts the liquid causing thewhich rapidly extracts the liquid causing the formation of a close packed but a waekformation of a close packed but a waek ceramic particle structure.) procedure. Thenceramic particle structure.) procedure. Then the slip-casting is sinter fired.the slip-casting is sinter fired.  The combination of these procedures givesThe combination of these procedures gives the material its outstanding properties.the material its outstanding properties.www.indiandentalacademy.com
  • 271. 271 Classification: ReinforcingReinforcing crystalscrystals Clinical SystemClinical System CharestresticsCharestrestics AluminaAlumina In-CeramIn-Ceram Alumina (Vita)Alumina (Vita) High aluminaHigh alumina coping infused withcoping infused with a low fusing glassa low fusing glass ZirconiaZirconia In-CeramIn-Ceram Zirconia (Vita)Zirconia (Vita) High ZirconiaHigh Zirconia coping infused withcoping infused with a low fusing glassa low fusing glass MagnesiumMagnesium oxide spinelloxide spinell In-CeramIn-Ceram Spinell (Vita)Spinell (Vita) High SpinellHigh Spinell coping infused withcoping infused with a low fusing glassa low fusing glass www.indiandentalacademy.com
  • 272. 272 Properties:  Higher flexuralHigher flexural strengths, at least 3strengths, at least 3 times than the oldertimes than the older systems.systems.  In-Ceram Z = 700 MpaIn-Ceram Z = 700 Mpa  In-Ceram A = 500 MpaIn-Ceram A = 500 Mpa  In-Ceram S = 350 MPaIn-Ceram S = 350 MPa www.indiandentalacademy.com
  • 273. 273  Fracture toughness(inFracture toughness(in Mpa x m),Mpa x m),  In-Ceram Z = 6.8In-Ceram Z = 6.8  In-Ceram A = 4.7In-Ceram A = 4.7  In-Ceram S = 2.7In-Ceram S = 2.7 www.indiandentalacademy.com
  • 274. 274 Alumina:  Aluminum oxide, also known by itsAluminum oxide, also known by its mineralogical name corundum(in Tamil:mineralogical name corundum(in Tamil: Korundum) occurs in nature in severa;Korundum) occurs in nature in severa; different varieties. The most well known isdifferent varieties. The most well known is the ruby followed by sapphire. With athe ruby followed by sapphire. With a Moh’s hardness of 9, corundum is the nextMoh’s hardness of 9, corundum is the next hardest natural mineral to diamond.hardest natural mineral to diamond. www.indiandentalacademy.com
  • 275. 275  Natural corundum crystallizesNatural corundum crystallizes trigonally and frequently into barreltrigonally and frequently into barrel shaped crystals.shaped crystals.www.indiandentalacademy.com
  • 276. 276  Can be manufactured synthetically usingCan be manufactured synthetically using the Vernuil process. Its melting point isthe Vernuil process. Its melting point is 2054`C.2054`C.  Good insulation, abrasion resistance, andGood insulation, abrasion resistance, and biocompatible.biocompatible.  The In-Ceram Alumina makes use of theseThe In-Ceram Alumina makes use of these advantages of colorless corundum.advantages of colorless corundum. www.indiandentalacademy.com
  • 277. 277 In this system a bimodalIn this system a bimodal grain distribution withgrain distribution with a medium grain sizea medium grain size of approx. 3 micronsof approx. 3 microns is used. At ais used. At a temperature oftemperature of 1120`C, far below the1120`C, far below the melting point ofmelting point of corundum, a sinteringcorundum, a sintering process takes place inprocess takes place in which the Alwhich the Al22OO33 particles, by means ofparticles, by means of processes at theprocesses at the surface, form a bondsurface, form a bond with their contactwith their contact points.points. ^ Scanning electro micrograph of porously sintered VITA In- Ceram Alumina. The structure thereby obtained has a chalky consistency and is still easy to process. www.indiandentalacademy.com
  • 278. 278  For the glassFor the glass infiltration a specialinfiltration a special glass is used whichglass is used which has an excellenthas an excellent wetting power towetting power to corundum and has acorundum and has a very low viscosityvery low viscosity at the infiltrationat the infiltration temperature oftemperature of 1100`C, in order to1100`C, in order to fill the freefill the free porosities betweenporosities between the Althe Al22OO33 particles.particles. ^ Scanning electron micrograph showing transverse section of glass infiltrated VITA In-Ceram Alumina www.indiandentalacademy.com
  • 279. 279  Only after the glass infiltration, that theOnly after the glass infiltration, that the high strength, typical tooth color andhigh strength, typical tooth color and translucency if VITA In-Ceram Alumina istranslucency if VITA In-Ceram Alumina is obtained.obtained. www.indiandentalacademy.com
  • 280. 280  The ceramic materials for substructures ofThe ceramic materials for substructures of jacket crows have been enriched up to 60%jacket crows have been enriched up to 60% weight with aluminum oxide crystals with aweight with aluminum oxide crystals with a grain size of 10 – 30 microns.grain size of 10 – 30 microns.  Due to the large difference in the refractionDue to the large difference in the refraction index (feldspar = 1.53; corundum = 1.76)index (feldspar = 1.53; corundum = 1.76) intense refraction of light occurs at theintense refraction of light occurs at the aluminum oxide crystals on the feldsparaluminum oxide crystals on the feldspar which results in the opaque effect of suchwhich results in the opaque effect of such aluminum oxide enriched ceramicaluminum oxide enriched ceramic materials. Therefore they are only suitablematerials. Therefore they are only suitable for making crown frames with subsequentfor making crown frames with subsequent veneering.veneering. www.indiandentalacademy.com
  • 281. 281  Synthetically produced corundum with aSynthetically produced corundum with a grain size of 2 – 5 microns is used in In-grain size of 2 – 5 microns is used in In- Ceram Alumina.Ceram Alumina.  Bridges made with In-Ceram which areBridges made with In-Ceram which are subsequently coated with VITADURsubsequently coated with VITADUR ALPHA feature considerably increasedALPHA feature considerably increased stability values:stability values: www.indiandentalacademy.com
  • 282. 282 Spinell:  Spinell (MgAl2O4) is a matural mineralSpinell (MgAl2O4) is a matural mineral that is mainly found together with limestonethat is mainly found together with limestone and dolomite, sometimes also with graniteand dolomite, sometimes also with granite or as loose sediment in sand.or as loose sediment in sand.  Spinell crystals are colorless or colored,Spinell crystals are colorless or colored, glassy, transparent or even opaque crystalsglassy, transparent or even opaque crystals with a cubic geometry which often revealswith a cubic geometry which often reveals the tendency of twin formation.the tendency of twin formation. www.indiandentalacademy.com
  • 283. 283  If the metal ions (MgIf the metal ions (Mg 2+2+ , Al, Al 3+3+ ) in a highly) in a highly pure, colorless spinell are replaced by otherpure, colorless spinell are replaced by other metal ions, striking color change can bemetal ions, striking color change can be observed.observed.  Originally, Magnesium oxide andOriginally, Magnesium oxide and aluminum oxide were mixed in a ratio of 1 :aluminum oxide were mixed in a ratio of 1 : 1 and transformed to spinell at temperatures1 and transformed to spinell at temperatures above 1600`C. since this was a trickyabove 1600`C. since this was a tricky process due to high temperatures, nowadaysprocess due to high temperatures, nowadays by thermal decomposition of salt mixturesby thermal decomposition of salt mixtures or by evaporation or by decomposition ofor by evaporation or by decomposition of nitrides spinell is synthesized.nitrides spinell is synthesized. www.indiandentalacademy.com
  • 284. 284  This material acts as an excellent thermalThis material acts as an excellent thermal insulator, excellent stability even at highinsulator, excellent stability even at high temperatures. This is even acid resistant,temperatures. This is even acid resistant, chemical stability, low electric conductivity,chemical stability, low electric conductivity, high translucency and biocompatible.high translucency and biocompatible. Structure of sintered , non- infiltrated spinell: basis for the core. Spinell structure after infiltration with In-Ceram Spinell glass. www.indiandentalacademy.com
  • 285. 285 Zirconia:  Principle of strengthening by thePrinciple of strengthening by the incorporation of a crystalline material that isincorporation of a crystalline material that is capable of undergoing a change in crystalcapable of undergoing a change in crystal structure when placed under stresses.structure when placed under stresses.  This crystalline material is usually termedThis crystalline material is usually termed as Partially Stabilized Zirconia(PSZ).as Partially Stabilized Zirconia(PSZ).  The energy required for the transformationThe energy required for the transformation of PSZ is taken from the energy that allowsof PSZ is taken from the energy that allows the crack to propagate.the crack to propagate.  One drawback of PSZ is that its refractiveOne drawback of PSZ is that its refractive index is much higher than that of theindex is much higher than that of the surrounding glass matrix.surrounding glass matrix.www.indiandentalacademy.com
  • 286. 286  Principle ofPrinciple of transitiontransition strengthening(lefstrengthening(lef t) and a scanningt) and a scanning electronelectron micrographmicrograph photo of a crackphoto of a crack (next to the red(next to the red line) that isline) that is running throughrunning through the infiltrationthe infiltration glass of theglass of the substructuresubstructure material andmaterial and stopped (head ofstopped (head of the arrow) by athe arrow) by a zirconium oxidezirconium oxide grain (whitgrain (whit color).color). www.indiandentalacademy.com
  • 287. 287  Transition electron microscope photo of theTransition electron microscope photo of the infiltrated In-Ceram Zirconia substructure.infiltrated In-Ceram Zirconia substructure. X-ray diffraction studies of the zirconiumX-ray diffraction studies of the zirconium oxide particle in the center of the photooxide particle in the center of the photo show that it features the desired tetragonalshow that it features the desired tetragonal form.form. www.indiandentalacademy.com
  • 288. 288  Scanning electron microscope photos of In-Scanning electron microscope photos of In- Ceram Zirconia / VITADUR ALPHA. TheCeram Zirconia / VITADUR ALPHA. The small picture in the upper right cornersmall picture in the upper right corner shows the cervical area of a In-Ceramshows the cervical area of a In-Ceram Zirconia crown veneered with VITADURZirconia crown veneered with VITADUR ALPHA porcelain.ALPHA porcelain.www.indiandentalacademy.com
  • 289. 289  As a result, the the particles of PSZ scatterAs a result, the the particles of PSZ scatter light as it passes through the bulk of thelight as it passes through the bulk of the porcelain, and this scattering produces anporcelain, and this scattering produces an opacifying effect that may not be esthetic inopacifying effect that may not be esthetic in most dental restorations.most dental restorations. Comparison of fracture toughness and flexural strengthwww.indiandentalacademy.com
  • 290. 290 Advantages:  Higher Flexural strength:Higher Flexural strength: Flexural strength of In-Ceram is at least 3Flexural strength of In-Ceram is at least 3 times that of the older system.times that of the older system.  Better precision:Better precision: Marginal fit is achieved during the first firingMarginal fit is achieved during the first firing stage and despite repeated firings, it isstage and despite repeated firings, it is retained throughout the entire procedure.retained throughout the entire procedure.  Lesser working time:Lesser working time: Faster than metal ceramic systems.Faster than metal ceramic systems. www.indiandentalacademy.com
  • 291. 291  HigherHigher modulus of elasticitymodulus of elasticity than regularthan regular feldspathic porcelain.feldspathic porcelain.  Double theDouble the compressive strengthcompressive strength as that ofas that of regular feldspathic porcelains.regular feldspathic porcelains.  ExcellentExcellent estheticsesthetics, as they can transmit, as they can transmit light better than ceramo-metal restorations.light better than ceramo-metal restorations.  Biocompatibility:Biocompatibility:  Glazed porcelains produce a non porousGlazed porcelains produce a non porous surface, which is the most biocompatible ofsurface, which is the most biocompatible of all restorative materials and potential metalall restorative materials and potential metal allergies or toxicity reactions are avoided.allergies or toxicity reactions are avoided. www.indiandentalacademy.com
  • 292. 292  Development of localized residual stressDevelopment of localized residual stress fields during cooling, has been implicated asfields during cooling, has been implicated as a mechanism to improvea mechanism to improve toughnesstoughness of theof the material. In-Ceram has been proved to havematerial. In-Ceram has been proved to have greater fracture toughness than most of thegreater fracture toughness than most of the dental ceramics used today.dental ceramics used today.  TheThe dimensional stabilitydimensional stability of the In-Ceramof the In-Ceram substructure during the porcelain firing andsubstructure during the porcelain firing and glazing process is highly satisfactory and theglazing process is highly satisfactory and the marginal fit is seen to be better inmarginal fit is seen to be better in 50`preparations than in 90`preparations.50`preparations than in 90`preparations.  Easy roughening by ceramic acid etching orEasy roughening by ceramic acid etching or aluminum oxide blasting. Allowingaluminum oxide blasting. Allowing optimum bondingoptimum bonding to enamel or dentin.to enamel or dentin.www.indiandentalacademy.com
  • 293. 293  Low weight.Low weight.  High acceptance.High acceptance.  Perio-prosthodontic value:Perio-prosthodontic value:  Good biocompatibility.Good biocompatibility.  Diminished plaque accumulation.Diminished plaque accumulation.  High fitting accuracy.High fitting accuracy.  No metal-ceramic junction.No metal-ceramic junction.  Good chemical / biological stability.Good chemical / biological stability. www.indiandentalacademy.com
  • 294. 294 Disadvantages:  Expensive:Expensive: Use of specialized equipment and techniquesUse of specialized equipment and techniques results in added cost of fabrication.results in added cost of fabrication.  The porous, uninfiltrated coping matrix isThe porous, uninfiltrated coping matrix is weak. Thus care must be taken in handlingweak. Thus care must be taken in handling and contouring ay this stage, to avoidand contouring ay this stage, to avoid chipping at margins and cracking of thechipping at margins and cracking of the material.material. CracksCracks may be initiated at thismay be initiated at this stage leading to an weakened restoration.stage leading to an weakened restoration.  Preparation leads to reduced tooth substance.Preparation leads to reduced tooth substance.www.indiandentalacademy.com
  • 295. 295  Wearing of opposing teeth:Wearing of opposing teeth: Abrasion is the byproduct of the leucite crystalAbrasion is the byproduct of the leucite crystal within these materials affecting the opposingwithin these materials affecting the opposing natural tooth.natural tooth.  Mismatches between theMismatches between the thermal expansionthermal expansion coefficientcoefficient of the crystalline phase and theof the crystalline phase and the glassy matrix can create boundary stressesglassy matrix can create boundary stresses during cooling.during cooling.  Necessity of bonding for optimum strength.Necessity of bonding for optimum strength.  Difficulty in removing both crown andDifficulty in removing both crown and cementing medium when replacement iscementing medium when replacement is necessary.necessary. www.indiandentalacademy.com
  • 296. 296 Indications: •Patient allergic to metal alloys. •Optimum esthetic result. •Patient requirement.www.indiandentalacademy.com
  • 297. 297 Contraindications:  Heavy occlusion or bruxism.Heavy occlusion or bruxism.  Patients requiring splinting of teeth.Patients requiring splinting of teeth.  Patients with short clinical crowns.Patients with short clinical crowns.  Cost factor.Cost factor.  Long span bridges.Long span bridges. www.indiandentalacademy.com
  • 298. 298 Clinical procedures In-Ceram*In-Ceram* www.indiandentalacademy.com
  • 299. 299 Armamentarium: www.indiandentalacademy.com
  • 300. 300 Armamentarium: www.indiandentalacademy.com
  • 301. 301  Divide the unprepared labial surface if theDivide the unprepared labial surface if the tooth crown into three equal thirds.tooth crown into three equal thirds.www.indiandentalacademy.com
  • 302. 302  Prepare two depth orientation grooves onPrepare two depth orientation grooves on the labial surface of the tooth with a dual-the labial surface of the tooth with a dual- guided groove cutter.guided groove cutter.www.indiandentalacademy.com
  • 303. 303  Prepare palatal depth orientation grooves.Prepare palatal depth orientation grooves. www.indiandentalacademy.com
  • 304. 304  Prepare two incisal depth orientationPrepare two incisal depth orientation grooves.grooves. www.indiandentalacademy.com
  • 305. 305  Condition after milling of all depthCondition after milling of all depth orientation grooves.orientation grooves. www.indiandentalacademy.com
  • 306. 306  Reduction of the hard tooth substance parallelReduction of the hard tooth substance parallel to the incisal third of the labial surfaceto the incisal third of the labial surface between the second and the third milledbetween the second and the third milled groove.groove. www.indiandentalacademy.com
  • 307. 307  Reduction in the area of the labial surfaceReduction in the area of the labial surface between the first and the second milled groovebetween the first and the second milled groove and thus almost parallel to the path ofand thus almost parallel to the path of insertion.insertion. www.indiandentalacademy.com
  • 308. 308  Correct preparation of the tooth in two planes.Correct preparation of the tooth in two planes.www.indiandentalacademy.com
  • 309. 309  Incorrect preparation; in one plane, thereforeIncorrect preparation; in one plane, therefore insufficient reduction of substance. Due toinsufficient reduction of substance. Due to that insufficient wall thickness of crown,that insufficient wall thickness of crown, crown mat fracture.crown mat fracture.www.indiandentalacademy.com
  • 310. 310  Incorrect preparation of the tooth surfaceIncorrect preparation of the tooth surface lead to the risk of damaging of the pulp.lead to the risk of damaging of the pulp.www.indiandentalacademy.com
  • 311. 311  Application area of the proximal cutter.Application area of the proximal cutter. www.indiandentalacademy.com
  • 312. 312  Use of the step cutter with depth stops: thisUse of the step cutter with depth stops: this cutting tool is to optimize the position andcutting tool is to optimize the position and quality of the prepared step.quality of the prepared step.www.indiandentalacademy.com
  • 313. 313  Palatal side is prepared with a foot ballPalatal side is prepared with a foot ball diamond.diamond. www.indiandentalacademy.com
  • 314. 314  Smoothening of the sharp angles using aSmoothening of the sharp angles using a bud shaped diamond.bud shaped diamond. www.indiandentalacademy.com
  • 315. 315  Defined marginalDefined marginal reduction of 0.6 – 1.2reduction of 0.6 – 1.2 mm.mm.  Incisal or occlusalIncisal or occlusal depth 1.5 – 2 mm.depth 1.5 – 2 mm.  Shoulder withShoulder with rounded axio-cervicalrounded axio-cervical line angle / chamfer isline angle / chamfer is indicated in reducedindicated in reduced tooth substance.tooth substance. Flat chamfers, shoulder preparation with more than 100`angulations, tangential preparations are contraindicated.www.indiandentalacademy.com
  • 316. 316 Laboratory Working Procedure In-Ceram*ALUMINA In-Ceram*SPINELL In-Ceram*ZIRCONIA www.indiandentalacademy.com
  • 317. 317 Model Fabrication www.indiandentalacademy.com
  • 318. 318  AA working modelworking model with removable dies fromwith removable dies from a high-quality, dimensionally stable modela high-quality, dimensionally stable model stone is prepared.stone is prepared.www.indiandentalacademy.com
  • 319. 319  AA master modelmaster model that has not beenthat has not been sectioned is fabricated, for positioning,sectioned is fabricated, for positioning, transferring and checking the crowns andtransferring and checking the crowns andwww.indiandentalacademy.com
  • 320. 320 Preparation for Duplication www.indiandentalacademy.com
  • 321. 321  Check the sawed die carefully for undercutsCheck the sawed die carefully for undercuts and block out them.and block out them. Blocking Out: www.indiandentalacademy.com
  • 322. 322 Applying the interspace varnish:  The varnish must be applied to theThe varnish must be applied to the plasterplaster diesdies in 2 – 3 coats approx. 45 microns.in 2 – 3 coats approx. 45 microns.www.indiandentalacademy.com
  • 323. 323 Applying the interspace varnish:  Epoxy or galvanized dies require 4 coatsEpoxy or galvanized dies require 4 coats approx. 60 microns.approx. 60 microns.  ! Wait for at least 5 min after each! Wait for at least 5 min after each application of the varnish. After applyingapplication of the varnish. After applying the last coat wait for 20 min to ensurethe last coat wait for 20 min to ensure complete drying.complete drying.  ! Do not extend the interspace varnish over! Do not extend the interspace varnish over the shoulder.the shoulder. www.indiandentalacademy.com
  • 324. 324 Waxing up the prop:  For the fabrication of bridgework, a propFor the fabrication of bridgework, a prop must be waxed up palatally in the area of themust be waxed up palatally in the area of the pontic.pontic. www.indiandentalacademy.com
  • 325. 325  The prop facilitates the application of theThe prop facilitates the application of the slip material and allows increasedslip material and allows increased absorption of liquid and quicker extractionabsorption of liquid and quicker extraction during the application of the slip.during the application of the slip.  ! The waxed up prop must not have any! The waxed up prop must not have any under cuts.under cuts. Waxing up the prop: www.indiandentalacademy.com
  • 326. 326 Duplication: www.indiandentalacademy.com
  • 327. 327  Duplicate with an addition polymerizingDuplicate with an addition polymerizing silicone in a ratio of 1 : 1 using the dualsilicone in a ratio of 1 : 1 using the dual impression technique orimpression technique orwww.indiandentalacademy.com
  • 328. 328  Duplicate using the pouring method withDuplicate using the pouring method with the help of a duplicating mold.the help of a duplicating mold.www.indiandentalacademy.com
  • 329. 329 Deflasking: www.indiandentalacademy.com
  • 330. 330  After deflasking allow the impression toAfter deflasking allow the impression to harden for approx. 30 min(according toharden for approx. 30 min(according to manufacturer).manufacturer).www.indiandentalacademy.com
  • 331. 331  Spray a wetting agent on to the impressionSpray a wetting agent on to the impression and allow the agent to dry.and allow the agent to dry.www.indiandentalacademy.com
  • 332. 332 Stirring the VITA In-Ceram* Special Plaster: www.indiandentalacademy.com
  • 333. 333 Mixing:  VITA In-Ceram special plaster 20g : 4.6 mlVITA In-Ceram special plaster 20g : 4.6 ml distilled water.distilled water.www.indiandentalacademy.com
  • 334. 334 Mixing:  Pour 4.6 ml of distilled water into thePour 4.6 ml of distilled water into the mixing beaker, then min the content of themixing beaker, then min the content of the sachet of VITA In-Ceram special plaster bysachet of VITA In-Ceram special plaster by hand. Then mix under vacuum for 20 sec.hand. Then mix under vacuum for 20 sec.  ! Make sure the mixing unit is clean and! Make sure the mixing unit is clean and dry. The processing time can be lengtheneddry. The processing time can be lengthened by adding chilled distilled water.by adding chilled distilled water. www.indiandentalacademy.com
  • 335. 335 Pouring:  Pour the plaster in to the mould slowly inPour the plaster in to the mould slowly in small increments without the formation ofsmall increments without the formation of air bubbles.air bubbles. www.indiandentalacademy.com
  • 336. 336 Preparation for the application of the SLIP www.indiandentalacademy.com
  • 337. 337 Deflasking:  After filling the special plaster into theAfter filling the special plaster into the special plaster mold, deflask after 2 hrs.special plaster mold, deflask after 2 hrs.www.indiandentalacademy.com
  • 338. 338 Grinding the special die:  After deflasking the base must be ground flat. DuringAfter deflasking the base must be ground flat. During this, the models must be kept dry.this, the models must be kept dry.  ! Any absorption of water of water on the hardened special de! Any absorption of water of water on the hardened special de has a negative effect on the expansion behavior.has a negative effect on the expansion behavior.www.indiandentalacademy.com
  • 339. 339 Separating the bridge model:  Partly section the special plaster modelPartly section the special plaster model from beneath using a separating disc.from beneath using a separating disc.www.indiandentalacademy.com
  • 340. 340 Attaching the bridge model:  Glue the special plaster bridge model onto aGlue the special plaster bridge model onto a VITA In-Ceram firing tray usingVITA In-Ceram firing tray using cyanoacrylate adhesive.cyanoacrylate adhesive.www.indiandentalacademy.com
  • 341. 341 Sectioning the bridge unit:  After approx.10 min, section the plaster modelAfter approx.10 min, section the plaster model between the abutment teeth with a sharp saw blade,between the abutment teeth with a sharp saw blade, in order to prevent damage to the bridgein order to prevent damage to the bridge substructure due to the shrinkage in the plastersubstructure due to the shrinkage in the plaster during sintering firing.during sintering firing.www.indiandentalacademy.com
  • 342. 342 Margin preparation:  Mark the margins with a super polymerMark the margins with a super polymer color cartridge.color cartridge.www.indiandentalacademy.com
  • 343. 343 Manufacturing the SLIP: www.indiandentalacademy.com
  • 344. 344  Weigh out exactly 38 g of VITA In-CeramWeigh out exactly 38 g of VITA In-Ceram alumina powder.alumina powder.www.indiandentalacademy.com
  • 345. 345  Pour the contents of 1 ampoule of ZITA In-CeramPour the contents of 1 ampoule of ZITA In-Ceram alumina mixing liquid and 1 drop of VITA In-alumina mixing liquid and 1 drop of VITA In- Ceram Alumina additive into a glass beaker andCeram Alumina additive into a glass beaker and mix briefly in the VITASONIC.mix briefly in the VITASONIC.www.indiandentalacademy.com
  • 346. 346  Place the glass beaker on a vibrator andPlace the glass beaker on a vibrator and spatulate the 38 g of VITA In-Ceramspatulate the 38 g of VITA In-Ceram Alumina powder slowly into the liquid inAlumina powder slowly into the liquid in several small portions.several small portions.www.indiandentalacademy.com
  • 347. 347  Mixing must be interrupted at least 3 timesMixing must be interrupted at least 3 times in order to place the glass beaker in thein order to place the glass beaker in the VITASONIC ultrasonic unit for 2 min eachVITASONIC ultrasonic unit for 2 min each time.time.  ! The water in the VITASONIC must be! The water in the VITASONIC must be chilled.chilled. www.indiandentalacademy.com
  • 348. 348  After the entire powder is added, place the glassAfter the entire powder is added, place the glass beaker in the VITASONIC for 7 min.beaker in the VITASONIC for 7 min.  ! After mixing, the slip must be homogenous.! After mixing, the slip must be homogenous.www.indiandentalacademy.com
  • 349. 349  The mixture must be evacuated for 1 min.The mixture must be evacuated for 1 min. (e.g. with a vacuum investment unit).(e.g. with a vacuum investment unit).www.indiandentalacademy.com
  • 350. 350  Pour the slip from the glass beaker into thePour the slip from the glass beaker into the enclosed plastic mixing cup.enclosed plastic mixing cup. www.indiandentalacademy.com
  • 351. 351 Applying the SLIP www.indiandentalacademy.com
  • 352. 352  Start to apply the slip in the area of theStart to apply the slip in the area of the pontic.pontic.  Build up to half of the height of the pontic.Build up to half of the height of the pontic.  Then coat the abutment dies fully and connectThen coat the abutment dies fully and connectwww.indiandentalacademy.com
  • 353. 353  ! Proceed rapidly when building up the remaining! Proceed rapidly when building up the remaining slip.slip.  ! Do not interrupt this process, so that drying out! Do not interrupt this process, so that drying out the layers is that have already been built up isthe layers is that have already been built up is prevented (onion-skin effect).prevented (onion-skin effect).www.indiandentalacademy.com
  • 354. 354 Dimensions of the substructure: The connectors must be as thick as possible.The connectors must be as thick as possible. www.indiandentalacademy.com
  • 355. 355  Deep grooves, as a custom in the metalDeep grooves, as a custom in the metal ceramic technique must be avoided sinceceramic technique must be avoided since they would result in cracks.they would result in cracks.www.indiandentalacademy.com
  • 356. 356  Single crown copings must be designed inSingle crown copings must be designed in such a way that they correspond on a reducedsuch a way that they correspond on a reduced scale to the tooth form to be replaced.scale to the tooth form to be replaced. •The wall thickness of the anterior crown coping must be at least 0.5 mm. Posterior crown coping must be at least 0.7 mm and 0.5 mm circumferentially . www.indiandentalacademy.com
  • 357. 357  Since fine reworking is always requiredSince fine reworking is always required after sintering, the slip should be appliedafter sintering, the slip should be applied more richly prior to sintering firing.more richly prior to sintering firing.www.indiandentalacademy.com
  • 358. 358  Carefully expose the preparation marginCarefully expose the preparation margin with a scalpel until the marking can be seen.with a scalpel until the marking can be seen.www.indiandentalacademy.com
  • 359. 359  Final shaping of the substructure is onlyFinal shaping of the substructure is only carried out after sintering.carried out after sintering.www.indiandentalacademy.com
  • 360. 360 Sintering firing: www.indiandentalacademy.com
  • 361. 361  After firing allow the substructures to coolAfter firing allow the substructures to cool down to 400`C in the closed firingdown to 400`C in the closed firing temperature, and then to the roomtemperature, and then to the room temperature with the furnace opened.temperature with the furnace opened.www.indiandentalacademy.com
  • 362. 362 Sintered substructure:  Since the plaster model has contractedSince the plaster model has contracted during firing, the sintered substructure canduring firing, the sintered substructure can be easily removed from it.be easily removed from it.www.indiandentalacademy.com
  • 363. 363 Checking the fit of the coping on the working model:  Before continuing the work on the workingBefore continuing the work on the working model, remove the interspace varnish.model, remove the interspace varnish.  In order to check the accuracy of the fit,In order to check the accuracy of the fit, carefully place the sintered substructure oncarefully place the sintered substructure on the working model again.the working model again. www.indiandentalacademy.com
  • 364. 364  Do not exert pressure.Do not exert pressure. www.indiandentalacademy.com
  • 365. 365  Due to dust formation when grindingDue to dust formation when grinding sintered dental ceramic products, alwayssintered dental ceramic products, always wear a face mask. Work behind a shield andwear a face mask. Work behind a shield and use a suction unit.use a suction unit.www.indiandentalacademy.com
  • 366. 366  Adjust contours and functioning byAdjust contours and functioning by grinding slightly(fine diamond, low speeds,grinding slightly(fine diamond, low speeds, minimum pressure).minimum pressure).www.indiandentalacademy.com
  • 367. 367  Be cautious in the marginal area, use very fineBe cautious in the marginal area, use very fine grained diamond or rubber disc at low speed withgrained diamond or rubber disc at low speed with minimum pressure.minimum pressure.  Contours and functioning must be controlled now,Contours and functioning must be controlled now, if required adjusted, because no furtherif required adjusted, because no further adjustments can be performed after the glassadjustments can be performed after the glass infiltration firing.infiltration firing. www.indiandentalacademy.com
  • 368. 368 Completed substructure: www.indiandentalacademy.com
  • 369. 369 Defect repair by optimizer www.indiandentalacademy.com
  • 370. 370  The VITA-In-Ceram Optimizer is a mixtureThe VITA-In-Ceram Optimizer is a mixture of Aluminum oxide powder and wax and isof Aluminum oxide powder and wax and is used to fill up small defects in ground orused to fill up small defects in ground or slip-coated or sintered In-Ceram crown andslip-coated or sintered In-Ceram crown and bridge substructures.bridge substructures.www.indiandentalacademy.com
  • 371. 371  Separating agent is added onto the die andSeparating agent is added onto the die and blow completely dry.blow completely dry.  Take up Vita In-Ceram Alumina OptimizerTake up Vita In-Ceram Alumina Optimizer with an electric wax knife and apply to thewith an electric wax knife and apply to the crown margin.crown margin.www.indiandentalacademy.com
  • 372. 372  Remove the excess with a paper napkin andRemove the excess with a paper napkin and the hot wax knife.the hot wax knife.  Remove the substructure from the die.Remove the substructure from the die.  Place the substructure on the model againPlace the substructure on the model again and check the optimizer that has beenand check the optimizer that has been applied.applied. www.indiandentalacademy.com
  • 373. 373 Sintering:  Fix the substructure on a platinum rod orFix the substructure on a platinum rod or place it on a fibrous pad firing support coplace it on a fibrous pad firing support co that the so that the optimizer will not comethat the so that the optimizer will not come into contact with it.into contact with it.www.indiandentalacademy.com
  • 374. 374  Firing chart.Firing chart. Use ceramic furnaces in which no alloys are fired. Check the fit on the working model. www.indiandentalacademy.com
  • 375. 375 Material testing:  To check the sintered substructures forTo check the sintered substructures for possible micro-cracks using the Vita In-possible micro-cracks using the Vita In- Ceram testing liquid.Ceram testing liquid.www.indiandentalacademy.com
  • 376. 376  The crown on the left is ok.The crown on the left is ok.  The crown on the right must beThe crown on the right must be manufactured once again.manufactured once again.www.indiandentalacademy.com
  • 377. 377 Application of the glass powder:  Mix Vita In-Ceram Alumina glass powderMix Vita In-Ceram Alumina glass powder with distilled water to obtain a thinwith distilled water to obtain a thin consistency.consistency.  Apply 1 – 2 rich coats with a thickness of 1Apply 1 – 2 rich coats with a thickness of 1 – 2 mm only on the outer surface of the– 2 mm only on the outer surface of the sintered substructure using a brush.sintered substructure using a brush.  The margin of the crown must not beThe margin of the crown must not be coated.coated. www.indiandentalacademy.com
  • 378. 378www.indiandentalacademy.com
  • 379. 379  ! During the glass infiltration of bridge! During the glass infiltration of bridge substructures on platinum foil, the basalsubstructures on platinum foil, the basal surface of the pontic must not be coveredsurface of the pontic must not be covered with glass powder. This can cause air in thewith glass powder. This can cause air in the sintered pontic to escape, otherwisesintered pontic to escape, otherwise complete glass infiltration will not takecomplete glass infiltration will not take place.place. www.indiandentalacademy.com
  • 380. 380www.indiandentalacademy.com
  • 381. 381 Glass infiltration firing in INCERAMAT:  Place the crown copings on platinum pins inPlace the crown copings on platinum pins in the firing tray, so that the crown margins dothe firing tray, so that the crown margins do not come in to contact with the platinum pinnot come in to contact with the platinum pin in order to prevent the glass fromin order to prevent the glass from penetrating into the interior of the crown.penetrating into the interior of the crown. www.indiandentalacademy.com
  • 382. 382www.indiandentalacademy.com
  • 383. 383  Place the coated crown copings onto a piecePlace the coated crown copings onto a piece of platinum foil (Pt = 95%, Au = %5) inof platinum foil (Pt = 95%, Au = %5) in order to carry out the glass infiltration firingorder to carry out the glass infiltration firing and preheat shortly.and preheat shortly.www.indiandentalacademy.com
  • 384. 384 Firing chart: www.indiandentalacademy.com
  • 385. 385 Glass infiltration firing in the VACUMAT:  The glass infiltration of crown copings canThe glass infiltration of crown copings can also be carried out in the dental ceramicalso be carried out in the dental ceramic furnace under vacuum.furnace under vacuum.www.indiandentalacademy.com
  • 386. 386 Firing chart: www.indiandentalacademy.com
  • 387. 387 Glass infiltration firing of bridge substructures in INCERAMAT:  Place the coated bridge substructure for thePlace the coated bridge substructure for the glass infiltration firing on a piece ofglass infiltration firing on a piece of platinum foil of 0.1 mm thick.platinum foil of 0.1 mm thick.www.indiandentalacademy.com
  • 388. 388 Firing chart : www.indiandentalacademy.com
  • 389. 389  ! In the case of incomplete infiltration – if! In the case of incomplete infiltration – if there are chalk-like areas – the infiltrationthere are chalk-like areas – the infiltration process should be repeated.process should be repeated.www.indiandentalacademy.com
  • 390. 390  Remove the excess glass with a coarseRemove the excess glass with a coarse grained diamond instrument or heatlessgrained diamond instrument or heatless abrasive almost down to the substructure.abrasive almost down to the substructure.www.indiandentalacademy.com
  • 391. 391  Sandblast residual material with 50 micronsSandblast residual material with 50 microns aluminum oxide at a maximum pressure ofaluminum oxide at a maximum pressure of approx. 3.0 bar.approx. 3.0 bar.www.indiandentalacademy.com
  • 392. 392 Glass control firing:  Place the substructure on a fibrous padPlace the substructure on a fibrous pad supporting on a Vita firing support W .supporting on a Vita firing support W .www.indiandentalacademy.com
  • 393. 393  Firing chart:Firing chart: www.indiandentalacademy.com
  • 394. 394 Finishing:  After the glass control firing sandblast theAfter the glass control firing sandblast the crown with 50 microns aluminum oxide at acrown with 50 microns aluminum oxide at a maximum pressure of 3 bar.maximum pressure of 3 bar.www.indiandentalacademy.com
  • 395. 395 Finished substructures: www.indiandentalacademy.com
  • 396. 396 Possible Errors: www.indiandentalacademy.com
  • 397. 397 Inadequate fit:  Insufficiently or incorrectly blocked out.Insufficiently or incorrectly blocked out.  Interspace varnish applied to shoulder.Interspace varnish applied to shoulder.  Dies were not repositioned correctly afterDies were not repositioned correctly after the application of interspace varnish.the application of interspace varnish.  Recovery time of silicone not followed.Recovery time of silicone not followed.  Distorted impressions.Distorted impressions.  Mixing ratios not followed.Mixing ratios not followed.  Setting time not followed.Setting time not followed.www.indiandentalacademy.com
  • 398. 398  Improper firing temperatures.Improper firing temperatures.  Preparation margin not exposed exactlyPreparation margin not exposed exactly after the application of the slip.after the application of the slip.  Improperly sandblasted glass.Improperly sandblasted glass.  Marginal areas were sandblasted usingMarginal areas were sandblasted using excessive pressure.excessive pressure. www.indiandentalacademy.com
  • 399. 399 Fractured bridges:  Prop was not waxed up correctly.Prop was not waxed up correctly.  Prop has undercuts.Prop has undercuts.  Special plaster model was not sawed.Special plaster model was not sawed.  Insufficient exposure of prop afterInsufficient exposure of prop after application of slip, slip coated substructuresapplication of slip, slip coated substructures feature micro-cracks.feature micro-cracks. www.indiandentalacademy.com
  • 400. 400 Sintering problems: Loose flakes in the crown after sintering firing:Loose flakes in the crown after sintering firing:  Die was not wetted sufficiently during theDie was not wetted sufficiently during the application of the first.application of the first.  Slip coat (rapid drying-up, consequence:Slip coat (rapid drying-up, consequence: onion skin effect)onion skin effect) Glazing, greenish discolorations in the crown:Glazing, greenish discolorations in the crown:  Furnace temperature too high.Furnace temperature too high. www.indiandentalacademy.com
  • 401. 401 Veneering With VITADUR*ALPHA LAYERING TECHNIQUE www.indiandentalacademy.com
  • 402. 402 VITA In-Ceram Alumina crown and bridge substructures: www.indiandentalacademy.com
  • 403. 403  VITA In-Ceram Alumina crown and bridgeVITA In-Ceram Alumina crown and bridge substructures ready for veneering.substructures ready for veneering.www.indiandentalacademy.com
  • 404. 404 Opaque dentin:  Apply the opaque dentin in the requiredApply the opaque dentin in the required shade, beginning at the cervical area, toshade, beginning at the cervical area, to cover the entire surface of the substructure.cover the entire surface of the substructure.www.indiandentalacademy.com
  • 405. 405  Completed opaque dentin.Completed opaque dentin.www.indiandentalacademy.com
  • 406. 406 Dentin:  Dentin is applied and built up to the finalDentin is applied and built up to the final shape of the crown. At this stage theshape of the crown. At this stage the occlusion, laterotrusion and protrusionocclusion, laterotrusion and protrusion should be checked in the articulator.should be checked in the articulator.www.indiandentalacademy.com
  • 407. 407  To make enough space for the enamel, it isTo make enough space for the enamel, it is necessary to reduce the volume of thenecessary to reduce the volume of the dentin accordingly.dentin accordingly.www.indiandentalacademy.com
  • 408. 408  Applying enamel in several small portions toApplying enamel in several small portions to complete the shape of the crown or thecomplete the shape of the crown or the occlusal surface. The crown should beocclusal surface. The crown should be modeled slightly larger than the actual toothmodeled slightly larger than the actual tooth size to compensate for firing shrinkage.size to compensate for firing shrinkage.www.indiandentalacademy.com
  • 409. 409  In the case of bridges separate the teethIn the case of bridges separate the teeth down to the substructure before the firstdown to the substructure before the first firing.firing. www.indiandentalacademy.com
  • 410. 410  The finished build up ready for the firstThe finished build up ready for the first firing.firing. www.indiandentalacademy.com
  • 411. 411  Firing chart:Firing chart: www.indiandentalacademy.com
  • 412. 412  Bridge after first firingBridge after first firingwww.indiandentalacademy.com
  • 413. 413 Correction layering:  Build up the inter-dental areas and the basalBuild up the inter-dental areas and the basal surface of the pontic with Opaque dentin.surface of the pontic with Opaque dentin.www.indiandentalacademy.com
  • 414. 414  Complete the contour corrections withComplete the contour corrections with Dentin in the body of the tooth and enamelDentin in the body of the tooth and enamel in the incisal area.in the incisal area.www.indiandentalacademy.com
  • 415. 415  Firing chart:Firing chart: www.indiandentalacademy.com
  • 416. 416  Crown and bridge after correction firing.Crown and bridge after correction firing.www.indiandentalacademy.com
  • 417. 417 Finishing:  Trim the bridge or crown. Polish to obtainTrim the bridge or crown. Polish to obtain an even, homogenous surface for the glazean even, homogenous surface for the glaze firing.firing. www.indiandentalacademy.com
  • 418. 418  To guarantee perfect articulation check theTo guarantee perfect articulation check the occlusion, protrusion and laterotrusion onceocclusion, protrusion and laterotrusion once more in the articulator.more in the articulator.www.indiandentalacademy.com
  • 419. 419 Glaze and stains applied.Glaze and stains applied.www.indiandentalacademy.com
  • 420. 420www.indiandentalacademy.com
  • 421. 421 Firing Chart: www.indiandentalacademy.com
  • 422. 422  The finished restoration on the model.The finished restoration on the model. Afterwards the interior surfaces of theAfterwards the interior surfaces of the finished restoration must be sandblastedfinished restoration must be sandblasted once again with 50 microns aluminumonce again with 50 microns aluminum oxide at a maximum pressure of 3 bar.oxide at a maximum pressure of 3 bar.www.indiandentalacademy.com
  • 423. 423 Finished restoration: www.indiandentalacademy.com
  • 424. 424 VITA Individual Layering Technique: www.indiandentalacademy.com
  • 425. 425 Opaque dentin / luminaries:  Apply the individually shaded opaqueApply the individually shaded opaque dentine and luminaries to the entire labialdentine and luminaries to the entire labial surface.surface.  Enhancing the shade of the crown using theEnhancing the shade of the crown using the Vitadur Alpha Luminaries.Vitadur Alpha Luminaries. www.indiandentalacademy.com
  • 426. 426www.indiandentalacademy.com
  • 427. 427  Washing or mixing in Luminaries, e.g. LMWashing or mixing in Luminaries, e.g. LM 5 in the cervical areas, LM 1 in the middle5 in the cervical areas, LM 1 in the middle third and LM 3 in the incisal area. Appliedthird and LM 3 in the incisal area. Applied in the gingival or incisal area, these dentalin the gingival or incisal area, these dental ceramics enhance the distribution of light inceramics enhance the distribution of light in the restoration.the restoration.www.indiandentalacademy.com
  • 428. 428 Applying the DENTINE:  The dentin is applied in the required shade .The dentin is applied in the required shade . The mamelons can be lightened mesiallyThe mamelons can be lightened mesially and distally with a lighter dentine.and distally with a lighter dentine.www.indiandentalacademy.com
  • 429. 429 Incisal Mirror build-up:  The incisal area is built up to the desiredThe incisal area is built up to the desired height with T4 (translucent).height with T4 (translucent).www.indiandentalacademy.com
  • 430. 430 Applying Intensive:  Intensives can be applied to add individualIntensives can be applied to add individual shading and characterizations.shading and characterizations.www.indiandentalacademy.com
  • 431. 431 First intermediate firing: www.indiandentalacademy.com
  • 432. 432 Crown after the first firing.Crown after the first firing.www.indiandentalacademy.com
  • 433. 433  Mainly light shaded Translucent andMainly light shaded Translucent and Cervical porcelains are applied forCervical porcelains are applied for correction.correction. Correction: www.indiandentalacademy.com
  • 434. 434www.indiandentalacademy.com
  • 435. 435 Correction firing: www.indiandentalacademy.com
  • 436. 436 Finishing:  After the correction firing, trim and polishAfter the correction firing, trim and polish the crown as usual.the crown as usual.www.indiandentalacademy.com
  • 437. 437 Glazing:  Cover the entire surface of the crown withCover the entire surface of the crown with the glaze material.the glaze material.www.indiandentalacademy.com
  • 438. 438 Glaze Firing: www.indiandentalacademy.com
  • 439. 439 Finished restoration:  Before insertion, the inner surface of theBefore insertion, the inner surface of the finished restoration should be sandblastedfinished restoration should be sandblasted once more with 50 micron aluminum oxideonce more with 50 micron aluminum oxide at a maximum pressure of approx. 3 bar.at a maximum pressure of approx. 3 bar.www.indiandentalacademy.com
  • 440. 440 INJECTION MOLDED / PRESSABLE CERAMICS IPS EMPRESS* I, IIIPS EMPRESS* I, II CERESTORE* (ALCERAM)CERESTORE* (ALCERAM) Summary www.indiandentalacademy.com
  • 441. 441 IPS Empress www.indiandentalacademy.com
  • 442. 442 IPS Empress system:  Since 1090, it has been possible to fabricateSince 1090, it has been possible to fabricate all-ceramic restorations using the IPSall-ceramic restorations using the IPS Empress hot-press procedure (Wohlwend,Empress hot-press procedure (Wohlwend, 1990).1990).  IPS Empress is a leucite-reinforced glassIPS Empress is a leucite-reinforced glass ceramic.ceramic.  Pre-cerammed glass ceramic that is heatedPre-cerammed glass ceramic that is heated in a cylinder and injected into a mold underin a cylinder and injected into a mold under high pressure and at high temperature.high pressure and at high temperature.www.indiandentalacademy.com
  • 443. 443 Material:  This is a glass ceramic material that is madeThis is a glass ceramic material that is made up of a glass phase and a leucite phase. Theup of a glass phase and a leucite phase. The growth of the leucite crystals starts at thegrowth of the leucite crystals starts at the grain edges of a ground starting glass.grain edges of a ground starting glass. These leucite crystals grow in a multi-stepThese leucite crystals grow in a multi-step fabrication process up to a size of fewfabrication process up to a size of few microns.microns. www.indiandentalacademy.com
  • 444. 444 Material: ………  This semi-finished product in powder formThis semi-finished product in powder form is then pressed to ingots and fired.is then pressed to ingots and fired.  The compressive strain resulting from theThe compressive strain resulting from the leucite crystal structure in a silicate glassleucite crystal structure in a silicate glass matrix provides increased stability.matrix provides increased stability.  This material is based on a system of…..This material is based on a system of….. SiOSiO22 – Al2O– Al2O33 – K– K22O and complies with ISOO and complies with ISO 6872 ‘Dental Ceramic’.6872 ‘Dental Ceramic’. www.indiandentalacademy.com
  • 445. 445 Standard composition:  SiOSiO22 == 59.0 – 63.0%59.0 – 63.0%  KK22OO == 10 – 14%10 – 14%  AlAl22OO33 == 17 – 21%17 – 21%  CeOCeO22 == 0 – 1%0 – 1%  BB22OO33 == 0- 1%0- 1%  NaNa22OO == 3.5 – 6.5%3.5 – 6.5%  BaOBaO == 0 – 1.5%0 – 1.5%  CaOCaO == 0.5 – 2.5%0.5 – 2.5%  TiOTiO22 == 0 – 0.5%0 – 0.5%  + pigments+ pigments == 0.5 – 1%0.5 – 1%www.indiandentalacademy.com
  • 446. 446 IPS Empress*2: www.indiandentalacademy.com
  • 447. 447 Introduction:  As the flexural strength of IPS Empress is belowAs the flexural strength of IPS Empress is below 200 Mpa, this material is not suitable for bridges.200 Mpa, this material is not suitable for bridges.  A new higher strength IPS Empress 2 replaces theA new higher strength IPS Empress 2 replaces the older material.older material.  The strength of ceramics can be increased byThe strength of ceramics can be increased by maximizing the crystalline content, but a highermaximizing the crystalline content, but a higher degree of crystalinity cause the material to lookdegree of crystalinity cause the material to look opaque. Therefore, increasing the strength of theopaque. Therefore, increasing the strength of the material without compromising its translucencymaterial without compromising its translucency was a challenging in the development of IPSwas a challenging in the development of IPS Empress*2Empress*2 www.indiandentalacademy.com
  • 448. 448 General:  This new IPA Empress 2 ceramic for theThis new IPA Empress 2 ceramic for the layering technique is composed of twolayering technique is composed of two different glass ceramics: a framework and adifferent glass ceramics: a framework and a layering glass ceramic.layering glass ceramic.  Charecterestics of glass ceramic;Charecterestics of glass ceramic; The initial product is a glass in which crystalsThe initial product is a glass in which crystals are formed by means of controlledare formed by means of controlled nucleation and crystallization.nucleation and crystallization. The final product contains at least one type ofThe final product contains at least one type of crystal embedded in a glass matrix.crystal embedded in a glass matrix.www.indiandentalacademy.com
  • 449. 449 Framework material:  The framework material is a lithium-The framework material is a lithium- disilicate glass ceramic.disilicate glass ceramic.  The crystalline phase consists of elongatedThe crystalline phase consists of elongated lithium disilicate crystals measuring approx.lithium disilicate crystals measuring approx. 0.5 – 5 microns in length. In addition, the0.5 – 5 microns in length. In addition, the microstructure also contains small lithiummicrostructure also contains small lithium orthophosphate crystals measuring 0.1 – 0.3orthophosphate crystals measuring 0.1 – 0.3 microns. (microstructure of ingots).microns. (microstructure of ingots). www.indiandentalacademy.com
  • 450. 450 Microstructure of pressed ceramic: Empress 2 ingots are pressed in the EmpressEmpress 2 ingots are pressed in the Empress 1 pressing furnace, several differences must1 pressing furnace, several differences must be noted,…..be noted,…..  The pressing temperature is 920`C. thisThe pressing temperature is 920`C. this temperature should be accurately set.temperature should be accurately set.  The pressing behavior of Empress 2 differsThe pressing behavior of Empress 2 differs from that of the leucite ceramic (Empress 1),from that of the leucite ceramic (Empress 1), they demonstrate different temperaturethey demonstrate different temperature viscosity function. Therefore excessivelyviscosity function. Therefore excessively high & excessively low pressinghigh & excessively low pressing temperatures are favorable for the propertiestemperatures are favorable for the properties of the final product.of the final product.www.indiandentalacademy.com
  • 451. 451  After the pressing procedure, the SEM imageAfter the pressing procedure, the SEM image shows a very dense microstructure of theshows a very dense microstructure of the lithium disilicate crystals.lithium disilicate crystals.  It contains more than 60% of the elongatedIt contains more than 60% of the elongated crystals measuring about 0.5 – 5 microns incrystals measuring about 0.5 – 5 microns in volume of the glass ceramic is considerablyvolume of the glass ceramic is considerably higher than the crystal content of leucite glasshigher than the crystal content of leucite glass ceramic.ceramic.  In addition to lithium disilicate, lithiumIn addition to lithium disilicate, lithium orthophosphate occurs as a secondary crystalorthophosphate occurs as a secondary crystal phase. The crystallites of this phase measuringphase. The crystallites of this phase measuring 0.1 – 0.3 microns are comparatively small.0.1 – 0.3 microns are comparatively small. They are evident throughout theThey are evident throughout the microstructure of the glass ceramic.microstructure of the glass ceramic.www.indiandentalacademy.com
  • 452. 452 Standard composition:  SiOSiO22 == 57 – 80%57 – 80%  AlAl22OO33 == 0 – 5%0 – 5%  LaLa22OO33 == 0.1 – 6%0.1 – 6%  MgOMgO == 0 –5 %0 –5 %  ZnOZnO == 0 – 8%0 – 8%  KK22OO == 0 – 13%0 – 13%  LiLi22OO == 11 – 19%11 – 19%  PP22OO55 == 0 – 11%0 – 11%  Additional ingredientsAdditional ingredients + Pigments+ Pigments == 0 – 8%0 – 8%www.indiandentalacademy.com
  • 453. 453 Layering ceramic:  This is a sintered glass ceramic which isThis is a sintered glass ceramic which is coated upon the lithium disilicate glasscoated upon the lithium disilicate glass ceramic framework. This is supplied inceramic framework. This is supplied in powder form. They have been developed inpowder form. They have been developed in various versions called ‘Dentin’, ‘Incisal’,various versions called ‘Dentin’, ‘Incisal’, ‘Impulse, Transpa’, Effect.‘Impulse, Transpa’, Effect.  Their crystalline phase consists of apatiteTheir crystalline phase consists of apatite (flourapatite).(flourapatite). www.indiandentalacademy.com
  • 454. 454 Standard composition:  SiOSiO22 == 45 – 70%45 – 70%  AlAl22OO33 == 5 – 22%5 – 22%  PP22OO55 == 0.5 – 6.5%0.5 – 6.5%  KK22OO == 3 – 9%3 – 9%  NaNa22OO == 4 – 13%4 – 13%  CaOCaO == 1 –11%1 –11%  FF == 0.1 – 2.5%0.1 – 2.5%  +Pigments+Pigments == 0 – 3%0 – 3% www.indiandentalacademy.com
  • 455. 455 Indications: www.indiandentalacademy.com
  • 456. 456 Clinical procedure: www.indiandentalacademy.com
  • 457. 457 Shade selection:  Tooth cleaning is necessary before shadeTooth cleaning is necessary before shade selection. Do not over dry the tooth.selection. Do not over dry the tooth.www.indiandentalacademy.com
  • 458. 458 Tooth preparation:  A chamfer /A chamfer / shouldershoulder preparation (10preparation (10 – 30`) with– 30`) with rounded innerrounded inner angles.the widthangles.the width of the circularof the circular margin shouldmargin should be approx.1 mm.be approx.1 mm. www.indiandentalacademy.com
  • 459. 459  Reduce the axialReduce the axial walls of the toothwalls of the tooth on the incisal thirdon the incisal third of the crown byof the crown by approx. 1.5 mm.approx. 1.5 mm.  The incisal orThe incisal or occlusal reductionocclusal reduction should be approx.should be approx. 1.5 – 2 mm.1.5 – 2 mm.  Anterior crowns,Anterior crowns, the labial orthe labial or palatal reductionpalatal reduction should be approx.should be approx. 1 – 1.5 mm.1 – 1.5 mm. www.indiandentalacademy.com
  • 460. 460 Die shade selection:  The shade of the prepared die is determined usingThe shade of the prepared die is determined using the Die material shade guide. With the appropriatethe Die material shade guide. With the appropriate shade we can fabricate esthetically appealing,shade we can fabricate esthetically appealing, true-to-nature restorations. To achieve optimumtrue-to-nature restorations. To achieve optimum results, the dentin should be moist when the shaderesults, the dentin should be moist when the shade is determined.is determined. www.indiandentalacademy.com
  • 461. 461 Impression making:  An addition curing silicone or any otherAn addition curing silicone or any other suitable impression material can be used.suitable impression material can be used.www.indiandentalacademy.com
  • 462. 462 Color coding of IPS Empress system: www.indiandentalacademy.com
  • 463. 463 IPS Empress* (light blue) Ingots & add on materials for staining technique. Higher opaque ingots and add on materials for layering technique. Higher translucent materials for layering technique.www.indiandentalacademy.com
  • 464. 464 IPS Empress*2 (Yellow color) www.indiandentalacademy.com
  • 465. 465 Universal: (yellow/light-blue) www.indiandentalacademy.com
  • 466. 466 IPS Empress*2 Ceramic materials and Composition: www.indiandentalacademy.com
  • 467. 467  Empress 2 ingotsEmpress 2 ingots www.indiandentalacademy.com
  • 468. 468  Poly urethane dimethacrylate : 48 – 50% wt.Poly urethane dimethacrylate : 48 – 50% wt.  Paraffin oil : 4% wt.Paraffin oil : 4% wt.  Silica and copolymer : 47 – 50% wt.Silica and copolymer : 47 – 50% wt. www.indiandentalacademy.com
  • 469. 469  Liquid : 30%Liquid : 30% wt colloidalwt colloidal silicic acid insilicic acid in water.water.  Powder : 80%Powder : 80% wt silica,wt silica, MgO+NHMgO+NH44HH22PP OO44 : 20% wt.: 20% wt. www.indiandentalacademy.com
  • 470. 470  Liquid :Liquid : 30% wt colloidal silicic acid in water.30% wt colloidal silicic acid in water.  Powder :Powder : 80% wt silica, MgO+NH80% wt silica, MgO+NH44HH22POPO44 : 20% wt.: 20% wt.www.indiandentalacademy.com
  • 471. 471  Hydrofluoric acid :1% wt,Hydrofluoric acid :1% wt,  sulphuric acid : 2% wt in water.sulphuric acid : 2% wt in water. www.indiandentalacademy.com
  • 472. 472www.indiandentalacademy.com
  • 473. 473www.indiandentalacademy.com
  • 474. 474www.indiandentalacademy.com
  • 475. 475 Processing procedure 1. Fabricating the model. 2. Applying the spacer. 3. Connectors. 4. Contouring. 5. Spruing. 6. Investing. 7. Furnace calibration. 8. Pressing. 9. Divesting. 10. Control dieing. 11. Foundation firing. 12. Layering, staining, glazing. 13. Etching and cementation. www.indiandentalacademy.com
  • 476. 476 Fabricating the model:  Fabricate a type IV stone model withFabricate a type IV stone model with detachable segments according to thedetachable segments according to the impression.impression. www.indiandentalacademy.com
  • 477. 477 Applying the spacer:  It is advisable to apply a sealer to hardenIt is advisable to apply a sealer to harden the surface and to protect the die. Thisthe surface and to protect the die. This sealer must not cause any changes in thesealer must not cause any changes in the dimensions of the die.dimensions of the die. www.indiandentalacademy.com
  • 478. 478  For single crowns, apply two layers ofFor single crowns, apply two layers of spacer up to maximum 1 micron thickness.spacer up to maximum 1 micron thickness.www.indiandentalacademy.com
  • 479. 479  Bridge restorations also require two layersBridge restorations also require two layers of spacer. Apply an additional layer ofof spacer. Apply an additional layer of spacer to the intercoronal surfaces of thespacer to the intercoronal surfaces of the abutments (the area facing the pontic). Thisabutments (the area facing the pontic). This measure helps prevent undesired friction.measure helps prevent undesired friction.www.indiandentalacademy.com
  • 480. 480 IPS Bridge Connectors:  These are prefabricated anatomicallyThese are prefabricated anatomically shaped plastic connectors in six differentshaped plastic connectors in six different shapes.shapes.  Used to contour three unit bridges andUsed to contour three unit bridges and ensure adequate size of the connectorensure adequate size of the connector between the pontic and bridge abutment.between the pontic and bridge abutment.  IPS connectors C1 – C6 are designed toIPS connectors C1 – C6 are designed to achieve the correct connector dimensions.achieve the correct connector dimensions. www.indiandentalacademy.com
  • 481. 481 Areas of application: www.indiandentalacademy.com
  • 482. 482 Areas of application: www.indiandentalacademy.com
  • 483. 483 Procedure:  Select the connector recommended for theSelect the connector recommended for the region for which the fabricated bridge isregion for which the fabricated bridge is intended and remove it from the harness.intended and remove it from the harness.  Once the bridge abutment has been modeledOnce the bridge abutment has been modeled with wax, attach the selected connector towith wax, attach the selected connector to the connecter area between the pontic andthe connecter area between the pontic and the bridge abutment.the bridge abutment.  After that, complete modeling the full wax-After that, complete modeling the full wax- up and secure it with a silicone key.up and secure it with a silicone key.www.indiandentalacademy.com
  • 484. 484  The modeled bridge is now reduced in aThe modeled bridge is now reduced in a targeted fashion. In other words, the areatargeted fashion. In other words, the area that will be built up using layering materialthat will be built up using layering material after the press cycle has to be carefullyafter the press cycle has to be carefully reduced so that the framework thicknessreduced so that the framework thickness measures at least 0.8 mm.measures at least 0.8 mm.  The plastic connector ensures that theThe plastic connector ensures that the minimum connector thickness between theminimum connector thickness between the pontic and bridge abutment is automaticallypontic and bridge abutment is automatically observed during the reduction process.observed during the reduction process. www.indiandentalacademy.com
  • 485. 485  If the labio-lingual portion of the connectorIf the labio-lingual portion of the connector reduced, the portion of the incisal to thereduced, the portion of the incisal to the cervical has to be enlarged.cervical has to be enlarged. www.indiandentalacademy.com
  • 486. 486  The connector area should measure at leastThe connector area should measure at least 16 mm16 mm2.2. 4x4 mm.4x4 mm.www.indiandentalacademy.com
  • 487. 487 Framework : layering material thickness:  In order to achieve the best possible surfaceIn order to achieve the best possible surface stability by creating ample workingstability by creating ample working parameters and to design adequateparameters and to design adequate frameworks.frameworks.  The framework must be thicker than theThe framework must be thicker than the layering materiallayering material www.indiandentalacademy.com
  • 488. 488www.indiandentalacademy.com
  • 489. 489  Correct : the framework design supports the cusps. TheCorrect : the framework design supports the cusps. The wall thickness of the framework is at least 0.8 mm. Onlywall thickness of the framework is at least 0.8 mm. Only this design ensures adequate stability.this design ensures adequate stability. •Incorrect : the relationship between the framework and the total space available is not proportional.www.indiandentalacademy.com
  • 490. 490 Framework-pontic design: www.indiandentalacademy.com
  • 491. 491 Contour:  Framework design depending upon theFramework design depending upon the space availablespace available  Full Wax-up:Full Wax-up: Fabricate a full wax-up of the restoration. Use the IPS connectors to ensure the adequate size of the connector area between the pontic and the bridge abutment. www.indiandentalacademy.com
  • 492. 492 Wax-up with connector in place: www.indiandentalacademy.com
  • 493. 493 Wax–up from buccal: www.indiandentalacademy.com
  • 494. 494 Wax-up from palatal: www.indiandentalacademy.com
  • 495. 495 Version A:adequate space available:  After full wax up, the buccal and the lingualAfter full wax up, the buccal and the lingual portion of the modeled framework isportion of the modeled framework is reduced in a targeted fashion.reduced in a targeted fashion.  Subsequently reduce the the wax-up by theSubsequently reduce the the wax-up by the space required for the layering materialspace required for the layering material applied after pressing.applied after pressing. www.indiandentalacademy.com
  • 496. 496 The buccal-labial….. www.indiandentalacademy.com
  • 497. 497 The palatal-lingual ……. www.indiandentalacademy.com
  • 498. 498 Final wax framework for layering: www.indiandentalacademy.com
  • 499. 499 Version B: Only limited space available(reduced layering technique)  If only limited space is available, only theIf only limited space is available, only the buccal and incisal portion of the waxed-upbuccal and incisal portion of the waxed-up framework are reduced in a targetedframework are reduced in a targeted fashion.fashion.  The palatal – lingual portion is waxed-up toThe palatal – lingual portion is waxed-up to its full contour(anatomical shape).its full contour(anatomical shape).  Minimum thickness between the pontic andMinimum thickness between the pontic and the bridge abutment isthe bridge abutment is maintained(connector).maintained(connector).www.indiandentalacademy.com
  • 500. 500 Reduced buccal-incisal portion: www.indiandentalacademy.com
  • 501. 501 Palatal-lingual portion in its full contour (anatomical shape): www.indiandentalacademy.com
  • 502. 502 Areas to be built up with layering material: www.indiandentalacademy.com
  • 503. 503 Spruing of the framework pattern:  Single crowns:Single crowns: For single crowns depending on the size andFor single crowns depending on the size and volume of the wax pattern, attach an axialvolume of the wax pattern, attach an axial sprue in the direction of flow of the ceramicsprue in the direction of flow of the ceramic material.material. Use round profile 2.5 – 3 mm / 8 gauge:Use round profile 2.5 – 3 mm / 8 gauge: length 3 mm – max 8 mm.length 3 mm – max 8 mm. www.indiandentalacademy.com
  • 504. 504  Bridges:Bridges: For 3 unit bridges, attach an 8 gauge round profile axial wax sprue directly into the abutment teeth at an angle of 45 – 60àpprox. The attachment points of the sprue to the object and the sprue former must be rounded and smooth. Avoid sharp edges.www.indiandentalacademy.com
  • 505. 505  Wax pattern-sprue attachment:Wax pattern-sprue attachment: -- Pattern angled at 45 60`. -- The distance between the paper ring and the patter must be at least 10 mm. -- All sprue attachments are flared and smooth.www.indiandentalacademy.com
  • 506. 506 Correct spruing: www.indiandentalacademy.com
  • 507. 507 Incorrect spruing: www.indiandentalacademy.com
  • 508. 508 Incorrect spruing: www.indiandentalacademy.com
  • 509. 509 Correct spruing: www.indiandentalacademy.com
  • 510. 510 Correct spruing: www.indiandentalacademy.com
  • 511. 511 Incorrect spruing: www.indiandentalacademy.com
  • 512. 512 Correct spruing: www.indiandentalacademy.com
  • 513. 513 Incorrect spruing: www.indiandentalacademy.com
  • 514. 514 Incorrect spruing: www.indiandentalacademy.com
  • 515. 515 Correct spruing: www.indiandentalacademy.com
  • 516. 516 Incorrect spruing: www.indiandentalacademy.com
  • 517. 517 Incorrect spruing: www.indiandentalacademy.com
  • 518. 518 Correct spruing: www.indiandentalacademy.com
  • 519. 519 Incorrect spruing: www.indiandentalacademy.com
  • 520. 520 Incorrect spruing: www.indiandentalacademy.com
  • 521. 521 Ideal spruing: www.indiandentalacademy.com
  • 522. 522 Investing:  Investment is carried out with the IPSInvestment is carried out with the IPS Empress 2 special investment material.Empress 2 special investment material.  Weigh the ring base (seal the opening of theWeigh the ring base (seal the opening of the ring base with wax ).ring base with wax ).  Position the objects to be pressed on thePosition the objects to be pressed on the ring base and attach them with wax, weighring base and attach them with wax, weigh again.again.  The difference between the two values isThe difference between the two values is the weight of the wax used.the weight of the wax used. www.indiandentalacademy.com
  • 523. 523  Large investment ring :Large investment ring : Up to 1.3g wax weight requires one largeUp to 1.3g wax weight requires one large ingot.ingot.  Small investment ring:Small investment ring: Up to max 0.5 g wax weight requires oneUp to max 0.5 g wax weight requires one small ingot.small ingot. www.indiandentalacademy.com
  • 524. 524  Remove the protective tape from the new 2-Remove the protective tape from the new 2- in-1 IPS Empress paper ring, form ain-1 IPS Empress paper ring, form a cylinder exactly along the marked line andcylinder exactly along the marked line and press the two end together.press the two end together.www.indiandentalacademy.com
  • 525. 525  Set the paper ring on the base of theSet the paper ring on the base of the investment ring and check it for correct fit.investment ring and check it for correct fit. Use the ring stabilizer to stabilize the paperUse the ring stabilizer to stabilize the paper ring.ring. www.indiandentalacademy.com
  • 526. 526  Mix the special investment material underMix the special investment material under vacuum according to the instructions.vacuum according to the instructions. www.indiandentalacademy.com
  • 527. 527  Fill the paper ring slightly below theFill the paper ring slightly below the stabilizing ring.stabilizing ring.www.indiandentalacademy.com
  • 528. 528  Remove the stabilizing ring and slowlyRemove the stabilizing ring and slowly place the ring gauge on the investment withplace the ring gauge on the investment with a hinged movement.a hinged movement.www.indiandentalacademy.com
  • 529. 529  After the setting time, remove the ringAfter the setting time, remove the ring gauge and the ring base with a turninggauge and the ring base with a turning movement. Remove the paper ring. Removemovement. Remove the paper ring. Remove the rough spots on the bottom surface of thethe rough spots on the bottom surface of the investment ring with a plaster knife.investment ring with a plaster knife.www.indiandentalacademy.com
  • 530. 530  Check for 90`angle.Check for 90`angle. www.indiandentalacademy.com
  • 531. 531 Preheating:  If several investment rings are preheatedIf several investment rings are preheated simultaneously, mark them, either with waxsimultaneously, mark them, either with wax on the ring base before investing or with aon the ring base before investing or with a fireproof pen after investing.fireproof pen after investing.www.indiandentalacademy.com
  • 532. 532  The ingot support and the aluminum oxideThe ingot support and the aluminum oxide plunger is placed in the cold furnace.plunger is placed in the cold furnace.www.indiandentalacademy.com
  • 533. 533  The ingot support and the aluminum oxideThe ingot support and the aluminum oxide plunger are placed in the cold furnace,plunger are placed in the cold furnace, while the speed investment ring is onlywhile the speed investment ring is only placed in the furnace once the finalplaced in the furnace once the final temperature has been reached.temperature has been reached.  When placing the investment ring into theWhen placing the investment ring into the furnace, make sure that the furnacefurnace, make sure that the furnace temperature does not drop down.temperature does not drop down.  But the special investment ring is placed inBut the special investment ring is placed in the clod furnace with the aluminum oxidethe clod furnace with the aluminum oxide plunger and the ingot support.plunger and the ingot support. www.indiandentalacademy.com
  • 534. 534  Do not preheat the Empress investing withDo not preheat the Empress investing with other investment and casting objects (e.g.other investment and casting objects (e.g. soldering models, metal casting rings, etc).soldering models, metal casting rings, etc).  Clean and calibrate the preheat furnace.Clean and calibrate the preheat furnace.www.indiandentalacademy.com
  • 535. 535 Pressing: www.indiandentalacademy.com
  • 536. 536 Press parameters for EP-500: www.indiandentalacademy.com
  • 537. 537 Pressing in the EP-600:  Programme selection for the IPS empress 2Programme selection for the IPS empress 2 layering technique by pressing F3.layering technique by pressing F3.www.indiandentalacademy.com
  • 538. 538  And select the ring size.And select the ring size.www.indiandentalacademy.com
  • 539. 539 Placing the ingots:  Large investment ring:Large investment ring: Single restorations: maximum 1 large ingot or 1Single restorations: maximum 1 large ingot or 1 small ingot.small ingot. Bridges:Bridges: maximum 1 large ingot.maximum 1 large ingot.  Small investment ring:Small investment ring: Maximum 1 small ingot per pressing cycle.Maximum 1 small ingot per pressing cycle. Do not use 2 small ingots.Do not use 2 small ingots. www.indiandentalacademy.com
  • 540. 540  Remove the ring from the preheatingRemove the ring from the preheating furnace immediately after the completion offurnace immediately after the completion of the preheating cycle. Place thethe preheating cycle. Place the corresponding cold ingots for the layeringcorresponding cold ingots for the layering technique in the investment ring.technique in the investment ring.www.indiandentalacademy.com
  • 541. 541  Placement of a large ingot (several crownsPlacement of a large ingot (several crowns or bridge)or bridge) www.indiandentalacademy.com
  • 542. 542  After selecting the exact press parameters,After selecting the exact press parameters, Place the investment ring with the ingot, inPlace the investment ring with the ingot, in the press furnace and start the process bythe press furnace and start the process by closing the head.closing the head.www.indiandentalacademy.com
  • 543. 543  The press cycle runs automatically. A beepThe press cycle runs automatically. A beep sound indicates the end of the press cycle.sound indicates the end of the press cycle.www.indiandentalacademy.com
  • 544. 544  Remove the investment ring from theRemove the investment ring from the furnace immediately after the program isfurnace immediately after the program is completed and close the furnace.completed and close the furnace.  Place the investment ring on a wide-meshedPlace the investment ring on a wide-meshed grid (IPS Empress cooling rack) and allowgrid (IPS Empress cooling rack) and allow it to cool to room temperature.it to cool to room temperature.  The grid ensures quick and even cooling ofThe grid ensures quick and even cooling of the investment ring and prevents undesiredthe investment ring and prevents undesired heat accumulation.heat accumulation. www.indiandentalacademy.com
  • 545. 545 Divesting:  After approx. 60 minutes, after cooling, theAfter approx. 60 minutes, after cooling, the investment ring may shoe cracks. Theseinvestment ring may shoe cracks. These cracks are developed during cooling as acracks are developed during cooling as a result of the different CTE’s of the variousresult of the different CTE’s of the various materials (the ingot, pressed material,materials (the ingot, pressed material, investment material).investment material).  But do not compromise the result of theBut do not compromise the result of the pressing cycle.pressing cycle. www.indiandentalacademy.com
  • 546. 546  Mark the length of the plunger on theMark the length of the plunger on the cooled investment ring.cooled investment ring.www.indiandentalacademy.com
  • 547. 547  Separate the investment ring using aSeparate the investment ring using a separating disc. This predeterminedseparating disc. This predetermined breaking point enables reliable separation ofbreaking point enables reliable separation of the ingot and the ceramic material.the ingot and the ceramic material.www.indiandentalacademy.com
  • 548. 548  Break the investment ring at theBreak the investment ring at the predetermined breaking point using apredetermined breaking point using a plaster knife.plaster knife. www.indiandentalacademy.com
  • 549. 549  Rough divestment is carried carried out withRough divestment is carried carried out with polishing jet medium at 60 psi pressure.polishing jet medium at 60 psi pressure.www.indiandentalacademy.com
  • 550. 550  For fine divestment, only 2 bar (30 psi)For fine divestment, only 2 bar (30 psi) pressure is applied.pressure is applied.www.indiandentalacademy.com
  • 551. 551  Remove the reaction layer from the pressedRemove the reaction layer from the pressed framework using the invex liquid.framework using the invex liquid.  Immerse the object in invex liquid for max.Immerse the object in invex liquid for max. 30 min, and thoruoghly rinse the framework30 min, and thoruoghly rinse the framework with water and blast it with aluminum oxidewith water and blast it with aluminum oxide powder of 100 microns size at 15 psipowder of 100 microns size at 15 psi pressure.pressure.  If the reaction later is not completelyIf the reaction later is not completely removed, bubbles may form, whichremoved, bubbles may form, which subsequently lead to bonding problems andsubsequently lead to bonding problems and crack in the layering ceramic.crack in the layering ceramic. www.indiandentalacademy.com
  • 552. 552  WhenWhen divesting thedivesting the object, blastobject, blast from thefrom the directiondirection indicated inindicated in thethe schematicschematic diagram.diagram. www.indiandentalacademy.com
  • 553. 553  Press result after pressing at too lowPress result after pressing at too low temperature.temperature. www.indiandentalacademy.com
  • 554. 554  If the temperature of the furnace has beenIf the temperature of the furnace has been set correctly, the pressed objects exhibitset correctly, the pressed objects exhibit only a thin reaction layer that can be easilyonly a thin reaction layer that can be easily removed.removed. www.indiandentalacademy.com
  • 555. 555  If the object is pressed at too highIf the object is pressed at too high temperature a substantial reaction layer istemperature a substantial reaction layer is forms that is difficult to remove. If theforms that is difficult to remove. If the reaction layer is not completely removed, thereaction layer is not completely removed, the bond to the layering material is impaired.bond to the layering material is impaired.www.indiandentalacademy.com
  • 556. 556 Removing and finishing:  Excessive grinding results in localExcessive grinding results in local overheating of the ceramic framework andoverheating of the ceramic framework and may lead to micro-crack formation.may lead to micro-crack formation.  Therefore keep grinding to minimum.Therefore keep grinding to minimum.  Avoid inhalation of grinding dust.Avoid inhalation of grinding dust. www.indiandentalacademy.com
  • 557. 557  Use a fine diamond disk to cut the sprues. Guide theUse a fine diamond disk to cut the sprues. Guide the diamond disk through a wet sponge during cuttingdiamond disk through a wet sponge during cutting to ensure permanent wetting of the area to beto ensure permanent wetting of the area to be ground. In this way, overheating of the ceramicground. In this way, overheating of the ceramic framework is avoided. Use ceramic burs to processframework is avoided. Use ceramic burs to process the attachment points of the sprues.the attachment points of the sprues.www.indiandentalacademy.com
  • 558. 558  Make sure that the material thickness isMake sure that the material thickness is of at least 0.8 mm throughout, andof at least 0.8 mm throughout, and never prepare the framework less thannever prepare the framework less than 0.8 mm.0.8 mm.  Avoid excessive heating of the pressedAvoid excessive heating of the pressed material.material.  Never use rotary instruments to cleanNever use rotary instruments to clean the framework. Only blast withthe framework. Only blast with aluminum oxide powder (100 micronsaluminum oxide powder (100 microns at 15 psi).at 15 psi). www.indiandentalacademy.com