all ceramic crowns /certified fixed orthodontic courses by Indian dental academy

Dental Ceramics-II
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

All ceramic systems
Stronger materials that involve better fabricating
techniques.
Can be etched and bonded to the underlying
tooth structure with newer dentin adhesives.
Greater tooth reduction than what was previously
used for PJC’s is carried out

Classification of all ceramic systems.
Processing technique and the major crystalline phase.
Sintered Porcelains.
Glass Ceramics.
Machinable Ceramics
Slip Cast ceramics
Hot pressed injection molded

Leucite- reinforced feldspathic porcelain:
Optec HSP
Aluminous based porcelain( Pt foil):
Vitadur- N TM core
Alumina based porcelain: Hi ceram
Magnesia based feldspathic
porcelain( Experimental)
Zirconia based porcelain: Mirage II
Hydrothermal low fusing Ceramics:
Duceram LFC.
Sintered Porcelains

Mica based: Dicor
Hydroxyapatite based: Cerapearl
Lithia based: Experimental.
Glass Ceramics.
Machinable
ceramics.
Cerec system
Celay system
Procera system

Slip Cast
Ceramics
Alumina based( In- Ceram)
In – Ceram Spinell
In – Ceram Zirconia
In- Ceram 2000.
Leucite based: IPS Empress
Spinel based: Alceram
Hot pressed,
injection
molded

Mc Lean and Hughes in 1965.
Vitadur N Core( Vident, Baldwin Park, CA)
123 Mpa
Alumina:
High modulus of elasticity( 350 Gpa)
High fracture toughness( 3.5 to 4 Mpa).
Dispersion in a glassy matrix of similar CTE .
Significant strengthening of the core.
Core was baked on a platinum foil.
Later veneered with matched expansion
porcelain.
Aluminous based Porcelain( Pt foil)

Hi- Ceram( Vident, Baldwin Park, CA).
139 Mpa( compared to 65 Mpa).
Alumina.
directly baked on the refractory die.
Aluminous core porcelain( Directly on the refractory die)
Reduce the surface area of
the matrix where microcracks
form.
Crack stoppers preventing
propogation of crack.
Alumina crystals:

Why Alumina?
Good Mechanical properties.
Similar CTE and MOE.
Interfacial region between alumina and
porcelain virtually stress free.
Crystals rather than fine powdered alumina used.
Advantages of aluminous porcelains:
Increased flexural strength,
Increased elasticity and toughness.

Poor esthetics ( Used as a core only).
Extensive reduction, dentin preparation.
Bonding is limited.
High failure rates.
Porcelain used for veneering in PFM cant be
used with aluminous core porcelain:
CTE Alumina core: 8x 10-6/0C
requires similar low expansion veneer
porcelain.
CTE Veneering porcelain for PFM: 13 x 10-6/0C
Extensive cracking results upon bonding these
materials owing to thermal stresses.
Disadvantages of Aluminous porcelain

Leucite reinforced feldspathic Porcelain:
Optec HSP( Jeneric/ Pentron)
Feldspathic porcelain with 45% vol tetragonal leucite.
Higher modulus of rupture and compressive strength.
Does not require core unlike aluminous PJC.
Leucite and glass fuse together at 10200
C.
Large thermal contraction mismatch:
leucite ( 22- 25x10-6/0C)
glassy matrix( 8x10-6/0C)
To overcome this:
K ions-> Ru and Ce ions.
Formation of sanidine after heat treatment:705 to 980
0C
K
Ru, Ce

Lack of metal or opaque substructure,
Good translucency compared to alumina crowns.
Moderate flexural strength( 146 Mpa),
Ability to be used without special laboratory
equipment.
Can be etched.
Advantages:
Disadvantages: Marginal inaccuracy caused by sintering
shrinkage.
Potential to fracture in posterior teeth.
Increased leucite content :relatively high invitro
wear of opposing teeth.
Requires a special die material.
Uses:
Leucite reinforced Feldspathic Porcelain.
Inlays, onlays, crowns for low stress areas and veneers

O’Brien. Experimental. 1985.
High expansion core material.
CTE :magnesia 13.5 x10-6/0
C.
Dispersion strengthening by the magnesia crystals
in a vitreous matrix.
Crystallization within the matrix.( Precipitation of
fosterite crystals.)
Magnesia based core ceramic
Hexagonal close
packed structure
( Alumina)
Face centered
cubic
lattice( Magnesi
a)
Strengthening:

Magnesia based core porcelain
Advantages High CTE:
Same body and enamel porcelains used for PFM
crowns can be used for all ceramic
Flexural strength of magnesia core :131 Mpa
Twice as high as feldspathic porcelain( 65 Mpa).
Esthetics superior to PFM.
Disadvantages
Not used for fixed partial dentures.

Mirage II( Myron International, Kansas City).
Conventional feldspathic porcelain
Tetragonal Zirconia fibers
Zirconia based feldspathic porcelains
( Sintered.)
Monoclinic state
4.7%
Tetragonal
Mechanism of
strengthening
Cystallographic
transformation 1173 0C
CaO, MgO, Y205
and CeO

Zirconia based feldspathic porcelains.
Yttria stabilized Zirconia:
Fracture toughness
Thermal shock resistance Î
Properties such as translucency and fusion
temperature can be adversely affected.
Advantages
Disadvantages:

Hydrothermal Porcelains
Non feldspathic composition that forms a
plasticized surface layer when hydrated.
Surface hardness
Flexural strength
Plastic nature of the hydrated surface
Allows for deformation of surface flaws
Prevents them from propogating through the
bulk.
Duceram
LFC

Good flexural strength (110 MPa) and
fracture toughness
Greater density
Low hardness – less abrasive
Needs special die material
Advantages:
Disadvantages:
Hydrothermal Porcelains

SD Stookey at Corning glass works.
Mc Culloch WT in 1968.
Dicor
Corning Glass Works
Denstply international.
Adair and Grossman :Dicor.
Sumiya Hobo and Kyocera Bioceram:Cerapearl
Glass.
Heat treatment- Partial devitrification.
Crystals: Needles or plates.
Glass ceramic: Is a ceramic consisting of a
glass matrix phase and at least one crystal
phase that is produced by the controlled
crystallization of the glass.
Glass Ceramic

Heat treatment that causes microscopic plate like
crystals of crystalline material to grow within the
glass.
Ceramming
Crystal Nucleation.
Crystal Growth.
Nucleating
Agents
Metallic colloids.
Liquid phase separation.
Halides
Sulphides.
Glass ceramics

Rate of nucleation/growth
Temperature
T2
T1
2 stage heat
treatment
Dicor

Method of fabrication of castable glass ceramic
Phosphate bonded
investment.
Wax burn out and heat
soak 950 0
C
Centrifugal casting of molten
ceramic 13500
C.
Reinvest in leucite based gypsum bonded investmentwww.indiandentalacademy.com

Heat
treatment
Fabrication castable glass ceramic
10750
C for 10
hours
Reduced translucency.
Increased strength
Veneering
porcelain
Dicor Plus: Pigmented feldspathic porcelain
Willi’s Glass: A veneer of Vitadur N aluminous
porcln..

Mica based glass ceramics.
Dicor 55% vol of tetrasilicic flouramica crystals
increased strength and toughness
increased resistance to abrasion
thermal shock resistance
chemical durability
decreased translucency
Nucleating agents: Flouride.
House of cards: Microstructure.

Difference between Dicor and Dicor
MGC.
Dicor Dicor MGC
55%vol of tetrasilicic
fluoramica crystals.
70% vol of tetrasilicic
flouramica crystals which are
2 µm in diameter
Crystallization done by the
technician.
Higher quality product that is
crystallized by the
manufacturer and provided
as cadcam blanks or ingots.
Mechanical properties
similar.
Less translucent than Dicor.
Passage of light depends on:
Crystal size.
Difference in refractive index between glass matrix and crystal.

Improved esthetics: Chamaleon effect.
Uniformity and purity of the material.
Minimal processing shrinkage.
Good fit.
Low CTE equal to that of the tooth structure.
Minimal abrasiveness to the tooth structure.
Radioopacity like dentin.
Inherent resistance to plaque accumulation
( Seven times less than on natural teeth.)
Moderately high flexural strength.(152 MPa)
Advantages of Dicor:

Disadvantages of DICOR
Low tensile strength.
Inability to be colored internally
The colorant stains may be lost during occlusal
adjustment.
Chances of losing the low fusing feldspathic
porcelain which are applied for good shade
matching.
Labour intensive
High cost
Recently
discontinued
Inlays, Onlays,Complete crowns ,partial tooth coverageIndications www.indiandentalacademy.com

Hydroxyapatite based castable glass
ceramics: Cerapearl.
Sumiya Hobo and Kyocera Bioceram group of
Kyoto City, Japan .
Castable glass ceramic :CaO- P205- MgO-Si O2
Cerapearl
Oxyapatite
Hydroxyapatite
Moisture
Enamel

Properties of Cerapearl
Melts at 14600
C and flows like a melting glass.
CTE small enough to obtain accurate castings.
The cast material has an amorphous
microstructure when reheated at 8700
C forms
crystalline HA.
Biocompatible: Crystalline structure similar to
enamel.
Enamel: Regular arrangement.
Cerapearl: Irregular arrangement.
Hence same crystal components but superior
mechanical strength.
Modulus of rupture :150 Mpa.
Enamel
Cerapearl

Procedure for Cerapearl
Crowns thicker than metal ceramic because of poor flexural
characteristics.
Tooth
preparation 2mm: occlusal reduction
1.5 mm: axial reduction.
1.2 mm on the margin.
Heavy chamfer or shoulder finish line.
All sharp edges should be rounded.

Waxing A full arch impression is made.
Working cast fabricated with Type IV stone.
Dowel pins are employed.
Die spacer of 25μm is applied on the die
except within 1 mm of the finish line
Wax pattern is fabricated.

Casting
Wax sprue 2.5 mm in diameter and 35 mm long.
is attached to the thick portion of the wax
pattern. Other end :orifice of the ceramic
crucible.
A spl. phosphate bonded high heat investment
Investment exhibits the same CTE as Cerapearl’s
casting shrinkage( 0.53%).
The sprued wax pattern is located inside
preformed silicone form used for fabrication of
ringless investment mold and investment is
poured.

Burnout procedure for cerapearl.
Temperature less than 1000
C for 30 min.
Temperature is raised to 5000
C ,next 30 min.
Temperature is held at 8000
C for 30 min.
Electric oven
Ringless investment mold with
ceramic crucible on the top

Casting of cerapearl
Investment mold is transferred to a
specially designed casting machine.
8-10 g of raw Cerapearl is placed in
the ceramic crucible,
Melted under vacuum at 14600
C and
cast into the mold.

Crystallization of Cerapearl.
Started at 7500
C ,maintained for 15 min.
Temperature is then raised 500
C per min until
it reaches 8700
C and then held for one hour.
The apatite crystals would have occurred
during the process.

Trial insertion:Cerapearl.
Investment mold is removed from the
oven and cooled to room temperature.
Air abrading with 20 μ alumina oxide of
the casting.
The sprue is cut and polishing is done.

Staining and glazing:
Cerapearl is very white compared to enamel
Requires application of an external stain.
Cerastain by
Bioceram

Bonding to the tooth structure:
Similar in structure to enamel and GIC will
adhere.
Activation Process by which the casting is mechanically
and chemically treated to bond to the tooth
structure.
Mechanical Air abrasion.
Chemical UHK 001 activator solution
Once bonded, cerapearl is extremely strong.
Currently in research phase, not commercially available.

Bioactive glass.
Hench et al :20 years.
Bioactivity
Characteristic of the material to form bond
with the living tissue.
Implants and implantable products such as
DPC material.

Pressable ceramics.
Leucite based: Wohlwend et al 1989
IPS Empress and Optec OPC.
IPS Empress
Glass ceramic based on the leucite system.
Subjected to bulk crystallization.

Lack of metal.
Translucent ceramic core
Moderately high flexural strength
Excellent fit
Excellent esthetics.( Translucence, flouroscence and
opalescence)
Minimal shrinkage:
only shrinkage that occurs is during cooling, that
can be controlled with an investment having an
appropriate expansion.
IPS Empress
Advantages:
Disadvantages
Potential to fracture in the posterior areas.
Need to use resin cement to bond the crown
micromechanically to the tooth structure.
Expensive equipment.

Laboratory procedure for IPS Empress
lost wax technique
material is pressed into the mold under pressure,
not centrifugally driven
Wax pattern
fabrication
Investment in phosphate
bonded investment

IPS Empress
Burn out procedure.
Specialized mold – Alumina
plunger.
Ceramic ingot is placed under the
plunger.
Entire assembly heated to 11500
c.
Plunger presses the molten
ceramic into the mold.

Final surface of the restoration: Stain/ veneer
IPS Empress.

IPS Empress Leucite containing glass ceramic that
contains about 35% volume of leucite crystals.
The veneering ceramic also contains leucite
crystals in a glass matrix.
Anterior crowns, veneers, inlays.
IPS Empress II Core :Lithia disilicate crystals in a glass matrix
Veneering ceramic: contains apatite crystals.
All ceramic bridges
Anterior and posterior crowns.

IPS Empress II
70% vol of elongated Lithia
disilicate crystals
Crystal size: of 0.5 to 4 μm
Small interlocking plate like
crystals that are randomly
oriented
A second crystalline phase :lithium orthophosphate
(Li3PO4) of a much lower volume, also present

Property IPS Empress IPS Empress II
Core ceramic Glass ceramic with 35% vol of
leucite crystals.
Glass ceramic with 70%
vol of lithium disilicate
crystals.Lithium
orthophosphate in
much lower
concentrations.
Veneering
ceramic
Also contain leucite crystals in
glass matrix
Contains apatite
crystals which causes
light scattering similar to
tooth structure.
Processing
temperature
11800
C 9200
C

Property IPS Empress IPS Empress II
Flexural strength 112±10Mpa 400±40
Fracture
toughness MPa/
m1/2
1.3±0.1 3.3±0.3
Thermal
Expansion
coefficient(ppm/
0
C)
15±0.25 10.6±0.25
Veneering
temperature
9100
C 8000
C
Chemical
durability(μg/
cm2
100-200 50

Empress Eris
Leucite core ceramic is identical to the
veneering ceramic
Empress I
Empress II CTE of core ceramic is 10.6 ppm/0
C, hence a
compatible layering ceramic was to be
developed.
Empress Eris Apatite glass ceramic.

Low firing temperature: Superior
compatibility with lithium disilicate.
Apatite crystals influence translucency,
brightness and light scattering ability of
layering ceramics.
Empress Eris

Empress Esthetic
New leucite reinforced glass ceramic
Lee culp et al

Broader ingot shade
range.
Greater homogeneity.
Greater density.
Greater flexural strength.
Chameleon effect.
Natural translucency and
fluorescence
Excellent press results.
Same processing and
pressing temperature
1075/1967 0
C as that of
staining technique
Empress esthetic

OPC and OPC3G
Optimal pressable ceramic.
OPC: Similar to IPS Empress, Leucite
containing.
OPC3G: Similar to IPS Empress2, lithium
disilicate.

Spinel based pressed ceramic
Non shrink
ceramic
Alumina and magnesium oxide
Magnesium aluminate spinel( Higher volume)
Cerestore
Method of
fabrication
Wax pattern.
Investing.
Mold formation.
A mixture of alumina, wax, silicone resin,
magnesia and glass is then heated to allow
flow and injected into the mold

Cerestore method of fabrication.
A series of reactions between the main
oxide components.
Formation of spinel( Magnesium aluminate.
Volume expansion associated with spinel
formation compensates for shrinkage during
firing.)
Advantage
of Cerestore Excellent fit of the restoration.

Disadvantage of Shrinkfree
Cerestore
Much higher crystalline content than
Aluminous porcelain, but no significant
difference in strength.
Cerestore microstructure Fit surface shows rough
unideal surface.
Porosity
Alceram( Innotek Dental Corp, Lakewood.)
Injection molded tech- Magnesium spinel

Slip Cast Ceramics:(Glass infiltrated
Ceramics)
Is a process used to form “green” ceramic
shapes by applying a slurry of ceramic
particles and water or a special liquid to form
a porous substrate( such as die material),
thereby allowing capillary action to remove
water and densify the mass of deposited
particles.
refers to an as- pressed condition before
sintering.
Slip Casting:
Green state:

Ceramic core formed onto a
refractory die from a fine slurry of
alumina powder
die has dried, it is sintered for 10
hours at 1120°C.
Solid phase sintering alone occurs,
No liquid phase sintering.( High
melting range of alumina.)
Slip casting.

Coping thus created held together
only at contact points.
Porous structure:6-10Mpa.
Infiltrated with a ( low viscosity)
lanthanum glass to form a dense
ceramic.
Veneering with conventional
feldspathic porcelain.
Slip casting.

In ceram Alumina
In ceram Spinell
In ceram Zirconia
In ceram Sprint
In ceram 2000:
In ceram 2000AL Cubes( Pure aluminium oxide cubes
In ceram 2000YZ Cubes( Pure zirconium oxide cubes)
In ceram family:

Ceramic
Block
Ceramic
type
Ceramic
veneer
Indications Manufact
urer
Flexural
strength.
In- Ceram
Spinell
MgO-Al2
O3
Vitadur
alpha( Alu
minous
porcelain)
Anterior
crowns
Vident 350Mpa
In- Ceram
Alumina
Al2
O3
Vitadur
alpha( Alu
minous
porcelain)
Anterior
and
posterior
crowns.
Anterior
FPDs.
Vident 500Mpa
In-Ceram
Zirconia
Al2
O3
-ZrO2
Vitadur
alpha( Alu
minous
porcelain)
Posterior
crowns
and
posterior
FPDs
Vident 700Mpa
Comparison

In ceram alumina
70% weight of
alumina
30% sodium
lanthanum glass.

In Ceram Spinell
More translucent than ICA.
Less flexural strength.
Adjacent teeth translucent
Porous
Infiltrated www.indiandentalacademy.com

In Ceram Zirconia
70% weight of alumina and 30% wt of
zirconia.

In- Ceram Sprint
“The time saving system”
Provides for rapid production of alumina
crown copings.
The furnace firing time dramatically
reduced compared with the conventional
firing method
A conventional firing method can be used
but it must be capable of holding a
temperature of 11200
C for 40 min.

In Ceram 2000
In- Ceram
2000 AL
Indications:
Anterior and Posterior crowns
Three unit anterior bridges
Inner part of telescopic crowns for optimum
esthetics.
In ceram
2000YZ
Ceramic Steel.
Flexural strength of more than 900
Mpa
Delicate framework- more room for
creativity.

In- Vizion All ceramics( Vident )
Proven strength of VITA YZ
ceramic frameworks.
Highly esthetic properties of
VITA VM9 veneering material.
Indications:
Long span bridges.
Anterior and posterior
crowns.
Anterior and posterior
bridges.

Inner surface of the core alumina rather than silica,
no coupling agents effectively bond the core to resins.
These high strength cores cannot be resin bonded to
the tooth structure.
Bonding to the tooth structure:
Techniques for improving bonding of the high strength core
Sadoun and
Asmussen(1994):
Creation of a roughened surface by application
of fine grained silica to the Inceram core.
Kern and
Thompson(1994):
Applied silica coatings by a thermal process
and a tribochemical process to enhance
bondingwww.indiandentalacademy.com

Occlusal reduction = 2 mm
Axial reduction = 1.5 mm
Heavy chamfer = 1.2 mm
Sufficient thickness and height of connector
4mm height
Large gingival radius of curvature
Preparation for glass infiltrated
ceramics.

High flexural strength and fracture
toughness.
Good marginal adaptation because of
decreased shrinkage.
Esthetics.
Biocompatibility.
Track record of 5-10 years.
Ability to be used with conventional luting
cements.
Advantages of the glass infiltrated
systems:

Opaque gingival collar.
Minimum core thickness of 0.5 mm.
No etching/ bonding.
Technique sensitive
High cost.
Disadvantages of glass infiltrated systems.
If functionally appropriate design of the
restoration is not ensured:
Insufficient hard tooth substance.
Inadequate preparation results.
Bruxism.
Severe discoloration of prepared teeth.
Contraindications

In- Ceram Procedure
Model fabrication
Die duplication

Refractory die material

13.5 g : 1 Ampoule

Glass infiltration.

In- Ceram fabrication.
Veneering with feldspathic
porclelain.

Pure alumina core
Increased strength
Superior translucency compared to the glass
infiltrated systems
Techceram
0.1 to 1 mm alumina core base layer is
produced using a thermal spray technique
density of 80% to 90% .
Optimum strength and translucency are
achieved by a sintering process at 11700
C

Advantages of TechCeram:
The range of base layer thickness make
this technique versatile.
Inner fitting surface is rough on the
microscale.
Does not require etching or silane
bonding
Procera Allceram Discussed later

CADCAM Blocks
Ceramic
block
Ceramic type Ceramic
veneer
Indications Manufacturer
ZrO2
based
Cercon Base Presintered
ZrO2,
post
sintered after
milling.
Cercon
Ceram S
Crowns and
FPDs
Dentsply
Ceramco.
Lava Frame ZrO2,
Presintered
and post
sintered
Lava Ceram Crowns and
FPDs
3M, ESPE.
DC-Zirkon ZrO2
Vitadur D
Triceram
Crowns and
FPDs
DCS
Dental/Vita
Vitablocs
zirconia
ZrO2
Vitadur alpha Crowns and
FPDs
Vident
Denzir ZrO2
Empress2 Crowns and
FPDs
Decim/
Ivoclar

Ceramic block Ceramic
type
Ceramic
veneer
Indications Manufactur
er
DC- Kristall Triceram Crowns DCS
Dental/ Vita
ProCad Maltechnik Veneers,
inlays,
onlays and
crowns.
Ivoclar
Aluminium oxide based
Procera AllCeram Al2
03
All Ceram Crowns and
FPDs
Nobel
Biocare
Synthoceram Al2
03
Sintagon Crowns Elephant
Vitablocks Alumina Al2
03
Vitadur
alpha
Crowns and
FPDs
Vident
Vitablocks Spinell Al2
03
Vitadur
alpha
Crowns Vident
Leucite based.

Feldspathic porcelain
Vitablocs
Mark II
Maltechnik Veneers,
inlays ,
onlays and
crowns.
Vident
Ceramic
block
Ceramic
type
Ceramic
veneer
Indications Manufacturer
Vitablocs Mark II has fine grain sized feldspathic porcelain.
Produces less abrasive wear than Vitablocs Mark I
Strength has been increased from 93 to 152 Mpa.

Copy milling technique/ Grinding
technique:
Automatic ( CeramaticII )
Manual( Celay)
Erosive technique.
Digital systems:
CAD CAM technology
Analogous Systems

Copy Milling sytems:
Milling a restoration from ceramic.
Celay ( Mikrona , Switzerland) 1991
Ceromatic II

Celay
Dr. Stephen T Eidenberg, at the University of Zurich 1991.
manually controlled rather than computer controlled
Proinlay
A hand operated contacting probe traces
the external contour of an acrylic or wax inlay,
previously fabricated directly in the mouth
Proinlay is then copied using a scanning tool
or micropalpation method.
Final restoration is then milled from the
ceramic block.( Feldspathic or aluminium
oxide). Stains and glazes.
Milling time:
20-30 min.

Celay
Advantages
A precisely fitting ceramic restoration
can be developed in one patient
session.
It can be developed without the need
for laboratory technician
Disadvantage
Difficulty in producing accurate
proinlay.
Labor intensive.

The system uses cerec vita blocs.
Proinlay is produced in the patient’s mouth or model.
Fixed on the scanning side of the machine.
The scanning and machining is executed
simultaneously and fully automatically.
Ceramatic II: Automated copy milling system:

Erosion method
Ultrasonic/ Sono erosion( DFE, Erosonic)
a metal based negative form of the interior
and exterior contours of the restoration.
intensive copper plating of the impression
by wax moulding and casting
Sonotrodes are fitted together and guided
into a ceramic blank after connecting to an
ultrasonic generator under slight pressure.
The ceramic blank is surrounded by an
abrasive suspension of hard particles such as
boron carbide.
On acceleration by ultrasonics erodes the
restoration of the ceramic block .www.indiandentalacademy.com

Procera ( Nobel Biocare)
1987 by Anderson and Nobel Biocare, Goteborg, Sweden
Procera AllTitan
Titanium substructure.
Low fusing porcelain.
Procera
Allceram Densely sintered, high purity aluminium
oxide coping.
Low fusing AllCeram veneering porcelains.

Preparation for Procera
2mm occlusal or incisal
1.5 mm axial.
distinct chamfer shoulder and rounded line angles.
Preparation
Impresssion- Die

Computer controlled design station in the dental lab
Dentist
Procera Sandvik, Stockholm
Procera

Procera
Clinician

Computer controlled design
station in dental laboratory
Scanning tool with a
sapphire ball.
50,000 data points to get a
3D image which is modified.

Stockholm, Sweden:
Enlarge the model by 20% and coping
fabricated.( Pure alumina)
Sent back to the lab.
Veneering by the technician.

Advantages :
Procera
High flexural strength.(500-700Mpa)
High hardness.
Good marginal fit.
More translucent than infiltrated ceramics.
Disadvantages
Procera
Cannot be etched.
Requires special equipment and computer software.

Systems using Yttrium stabilized Zirconia
CERCON( DeguDent, Dentsply
International).
DCS- President(DCS Production, Allschwill,
Switzerland).
Lava( 3M ESPE, Germany)
CERCON ( DeguDent, Dentsply International)
Cercon brain:
Milling and Scanning of
the wax pattern.
Classic mode.
Art Mode.
Unsintered

Advantages of using partially sintered YTZP:
Decreased milling time.
Reduces the wear of the milling components.
Reduces the potential for inclusion of material
defects throughout the milling procedure

LAVA and DCS President
Fully sintered blocks.
Other
systems:
Cicero( Computer integrated ceramic
reconstruction).
Sopha( Designed by Duret)
DentiCAD( BEGO, Bremen, Germany and
DentiCAD, USA
Non contact optical
scanner Lava milling unit LAVA THERM

CEREC
Professor W Mormann and Dr. M Brandestini in 1980
at the University of Zurich, Switzerland.
Only commercially available chairside dental
CAD/CAM system.
1985: The first patients were treated
1988: CEREC 1( Brains, Zurich, Switzerland)
1994: CEREC 2( Siemens, Benshelm, Germany)
2000: CEREC 3( Sirona, Bensheim, Germany)

Fabrication of simple inlays.
Substraction fabrication method of
preformed ceramic blocks.
Very sharp internal angles of the
restorations could not be administered.
Large grinding wheels associated with the
original CEREC system.
The occlusal surface cannot be fabricated
with CEREC 1.
CEREC1

CEREC 2
CEREC2 was significantly improved.
Addition of a further cylindrical grinder
Allowing the addition of occlusal pits
and fissures.
Concave and biconvex contouring of
veneers.
Occlusal surface can be ground with
CEREC2

CEREC 3
Radiocontrolled operating
system whereby the design and
milling chamber units can be
deployed separately.
Data acquisition and milling
to be carried out
simultaneously.
The milling unit of CEREC 3 is
also equipped with laser
scanner
A cylindrical floor and wall and a tapered cylindrical rotary
diamond milling tool( coated with 64 µm-grit diamonds.
The angle of taper, which is 450
, which is used to shape the
occlusal surface of the restoration.
Simplifies occlusal and functional registrationwww.indiandentalacademy.com

Simplifies occlusal and functional registration
Provides a more flexible and detailed milling procedure
than its predecessors.
Separate Acquisition Chairline

CEREC 3D
latest version.
allows a 3D view of the preparation and
proposed restoration.
“ Self Adjusting Crown”
automated occlusion tool.
Antagonist mode.
Superior marginal fit.
Precise Proximal
Contacts.

Computer
monitor
Function
switches
Base containing
pump unit and
water supply
Storage
drawers
Optical
impression
Tracker ball
Milling unit

Steps for fabrication of CADCAM
Restorations
Computer surface digitization
Computer aided designing.
Computer aided manufacturing.
Computer aided esthetics.
Computer aided finishing.

Surface digitization
Active Triangulation
One Angle
Effective depth of greater than
20mm.

Optical impression: Scanning device
20-600µm
Titanium dioxide.
Polysorbate film, the
imaging liquid

Computer aided designing
Cerec
R2005

Computer Aided Manufacturing
Electrically driven and
lubricated with water.

Ormocers
Organically modified ceramics or Ormosils.
Light cured organic and inorganic copolymers.
Methacrylate substituted alkosilanes.
Silica filler is organically modified by adding
methacrylate groups .
Mol Wt: 2000-20,000( BisGMA 500)
Admira and Definite

Advantages:
Low shrinkage due to high molecular wt.
1.88%
Good abrasion resistance
Fluoride release
Good esthetics
Condensable
Biocompatible.
Uses:
Fillings in anterior and posterior regions
Ormocers

Ceromers
Ceramic optimized polymer (light cured)
optimized chemical process and an
optimize curing process
highly dispersed micro hybrid composite
based on mouldable ceramic
Class I and II posterior restorations.
Class III and IV anterior restorations.
Class V restorations
Inlays/onlays with extraoral post-
tempering .
Repair of composites.
Tetric Ceram
Indications

Targis( Ivoclar vivadent)
Composition:
75-85 weight % of Inorganic filler
Ceramic particle
Organic matrix
Indications of (Targis)
Metal-free bridges with Vectris fmwk
Metal-free single posterior crowns with
Vectris fmwk
Metal-reinforced crown, bridge, and
implant veneers
Metal-free anterior crowns
Metal-free inlays,onlays, veneers
Metal-reinforced combination dentures

Contraindications:
•Metal-free bridges with more than one pontic
between two abutment teeth
Good wear resistance
Good strength
Easily contoured without slumping
Adhesive bonding
Fluoride release (Tetric Ceram)
Advantages
Ceromers
Disadvantages
Ceromers
Needs complete isolation
Cannot be used in very high stress
regions
Preferably supragingival margins

Hybrid ceramics
Hahn ;new ceramic material which is a hybrid
between organic and inorganic components
Organic and inorganic components
Polyvinyl siloxane 50 vol%
Titanium( active filler 1µm) 30%
Inert filler (Al2O3) 15%
Titanium boride 5%
Handled like composite and cured.
Heat treatment at 1150ºC for 6 hrs in N2
atmosphere.
Few minutes in O2 for surface treatment
Organic and
inorganic
components

LUMINEERS
No prep technique.
Slightly stained, discolored, chipped,
maligned teeth without removal of
tooth structure.
Bonded to the enamel.
0.3 to 0.5 mm.

Material Product Modulus of
Rupture
Reinforcing
Component
Aluminous
Core( Pt foil)
Vitadur N Core 123Mpa Alumina
Aluminous core Hi Ceram
( Vident)
139Mpa Alumina
Leucite reinforced
feldspathic
Optec HSP
(Pentron)
104Mpa Leucite
Magnesia based
feldspathic porcelain
Experimental 269Mpa Forsterite
Zirconia based
porcelain
Mirage II
( Myron
International)
70Mpa Zirconia fibers
Mica glass Ceramic Dicor( Denstply
International)
125Mpa Tetrasilicic
flourmica

Rupture
Reinforcing
Component
Hydroxyapatite
Glass ceramic
Cerapearl
( Kyocera)
150 Mpa Hydroxyapatite
Lithia based
Glass ceramic
Experimental 188 Mpa Lithium disilicate
Machinable
glass Ceramic
Dicor MGC 229 Mpa Tetrasilicic
fluormica
Machinable
ceramic
Vita Mark II 122 Mpa Sanidine
Slip cast
alumina
In Ceram 446 Alumina
Slip Cast
alumina
In Ceram
Spinell
378 Spinell
Slip Cast
alumina
In Ceram
zirconai
604 Zirconia

Rupture
Reinforcing
Component
Injection molded
aluminous Porcelain
Alceram
Innotek Dental
162 Alumina
Heat pressed, leucite
Reinforced.
IPS Empress
(Ivoclar NA)
97 Leucite

Processin
g
method
Sintered Cast/Cer
ammed
Presinter
ed/
Milled/
Postsinte
red
Enlarged
die and
sintered
Hot
pressed
Sintered
and
glass
infiltrate
d
CADCAM
Type of
construc
tion
Metal
ceramic
Ceramic Ceramic Ceramic Ceramic Ceramic Ceramic
Indicatio
ns
Anterior
and
posterior
crowns
and
FPDs
Anterior
and
posterior
crowns
Anterior
and
posterior
crowns
and
FPDs
Anterior
and
posterior
crowns
Leucite
reinforce
d:
Anterior
and
posterior
crowns.
Lithia
disilicate
reinforce
d:
Premolar
FPDs.
Spinell:
Anterior
crowns.
Alumina:
Anterior
and
posterior
crowns
and
anterior
3 unit
FPDs.
Zirconia
core:
Posterior
crowns
and
posterior
FPDs.
Anterior and
posterior
crowns and
FPDs

Processin
g method
Sintered Cast/Cer
ammed
Presintered/
Milled/
Postsintered
Enlarge
d die
and
sintered
Hot
pressed
Sintered
and glass
infiltrated
CADCAM
Margin
quality
Poor
margins
Good
margins
Fair to good
margins.
Fair to
good
margins.
Good to
excellen
t
margins
Fair to
good
margins
Fair to good
margins
Appeara
nce
Opaque Translucen
t
Opaque Opaqu
e
Slightly
transluc
ent
Opaque Slightly
translucent to
Translucent
Relative
strength
Weak Weak Very strong Strong Modera
tely
strong
Moderately
to Very
strong
Moderately
strong.
Relative
toughnes
s
low low Very high High Modera
tely high
Moderately
high to very
high
Low to high
Acid
etchabilit
y
Etchable Etchable No No Etchabl
e
Not
indicated
Etchable

Abrasiven
ess of
the
core
Modera
tely
abrasiv
e
Minimally
abrasive
Highly
abrasive
Highly
abrasiv
e
Modera
tely
abrasive
Highly
abrasive
Minimally to
Highly
abrasive
Ease of
cuttin
g
remo
val
Easy Easy Difficult Difficult Easy Difficult Easy to difficult
Treatment
time
Two
visit
s
Two visits Two visits Two
visits
Two
visits
Two visits One visit
Processin
g method
Sintered Cast/Cer
ammed
Presintered/
Milled/
Postsintered
Enlarge
d die
and
sintered
Hot
pressed
Sintered
and glass
infiltrated
CADCAM

Major
drawb
acks
Weak
and
Unsuitabl
e
as a core
for full
ceramic
crowns or
FPDs
No
products
are
currently
available
Tends to
appear
too
opaque if
tooth
reduction
is
Inadequa
te,
not
etchable
Tends to
appear
too
opaque if
tooth
reduction
is
inadequa
te,
not
etchable
Leucite
reinforced
type
not
indicated
for FPDs,
Lithia
disilicate
type
limited to
crowns
and 3 unit
FPDs
extending
o 2nd
premolar;
requires
large
connectr
All, but
spinel
type
tends to
look too
opaque if
tooth
reduction
is
inadequa
te
Requires
a uniform
light-
reflecting
powder
deposit to
ensure
adequate
image
quality
Sintered
Cast/Cer
ammed
Presintere
d/
Milled/
Postsinter
ed
Enlarge
d die
and
sintered
Hot
pressed
CADCAMSintered
and glass
infiltrated

Sintered
Cast/Cer
ammed
Presintere
d/
Milled/
Postsinter
ed
Enlarge
d die
and
sintered
Hot
pressed
CADCAMSintered
and glass
infiltrated
Optec HSP,
Duceram
LFC,
HighCeram
,
Mirage II.
Dicor,
Cerapearl.
Lava,
DC- Zirkon,
Procera all
Ceram
Cercon IPS
Empress,
IPS Empress
2,
Empress
Esthetic,
Finesse all
ceramic,
Optec
OPC.
In- Ceram
SpinellAlum
na,Zirconia
ProCad,
Vitablocs
Mark II

Smoothest surface : least wear and damage to the
opposing surfaces.
Polishing or polishing followed by glazing
Polishing is preferred over glazing as a procedure to
reduce abrasion damage of the enamel.
Ceramic surfaces should be refinished periodically
after acid exposure, especially APF.
Shofu porcelain polishing kit followed with diamond
paste.
Soflex disks without a diamond paste with water
coolant.
The diamond paste is applied to the ceramic surface
using a Robinson Wheel Brush or a felt wheel.
Reducing abrasiveness of Ceramics by polishing
and grinding:
Polishing
systems:

Ensure cuspid guided disclusion.
Eliminate occlusal prematurities.
Use metal in functional bruxing areas.
If occlusion in ceramic, use ultralow fusing ceramics.
Polish functional ceramic surfaces.
Repolish ceramic surfaces periodically.
Readjust occlusion periodically if needed.
Guidelines for minimizing wear of enamel by
dental ceramic:

Bonding of Ceramic Prosthesis
Of their ability to reduce fracture of the ceramic
structures.
Because of the range of shades available to
produce an optimal esthetic appearance.
Etched with hydrofluoric acid( 7.5-10%) :
micromechanical bonding.
It is treated with a silane coupling agent to
improve the chemical bonding between the resin
and ceramic.
high density porcelains cannot be etched.

“united the qualities of beauty, solidity and comfort to the exigencies of
hygiene.”
Thank you….

all ceramic crowns /certified fixed orthodontic courses by Indian dental academy

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