METAL FREE CERAMICS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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Introduction :
Ceramics in dentistry is a recent phenomenon, the
desire for a durable and esthetic material is
ancient. Al...
Dental porcelain play an important role in the
fabrication of the most esthetic fixed partial
dentures. Translucency, ligh...
Selection :
 The primary advantage of using metal free

ceramic system is to increase the depth of
translucency and light...
Factors influence the selection of
crown system :
Strength.
 Simplicity of fabrication.
 Potential for high volume produ...
Indications :
The fracture resistance of all-ceramic crown is
based on adequate support by the
preparation, proper patient...
Conservation of tooth structure and
maintenance of periodontal health.
♣ Lower incisors where space is available.
♣ Limite...
Contra-indications:








In the cases of parafunctional activity of the
mandible,e.g. bruxism. Or any deflective
ma...
Aluminous Porcelain
Vs
Metal Ceramics

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Aluminous porcelain :
Advantages :
1. Good esthetics is easily obtained if the
core porcelain is placed correctly.
2. Full...
Aluminous Porcelain :
Disadvantages :
1. Cannot be used in posterior regions.
2. Parafunctional movements.
3. Long span br...
Metal Ceramics :
Advantages :
1. Very high strength due to prevention of
crack propagation.
2. Improved fit.
3. Long span ...
Disadvantages :









Increased opacity and light reflectivity.
Risk of over contouring – metal .5 mm and the
res...
Constituents of Dental
Porcelain :
Silicon dioxide – SiO2 – Glass forming matrix,
glass formers.
Boric oxide –B2O3 – (Glas...
Properties of Dental Porcelain :
Low fusing temperature.
 High viscosity.
 Resistance to devitrification.
 Translucent....
Strength of All Ceramic Crowns :
The objective of fabricating all ceramic crown is to
provide the patient with lasting est...
Dental porcelain is also susceptible to “static
Fatigue”which is generally caused by a
stress dependent chemical reaction ...
Surface Flaws :
A high strength ceramic with a badly flawed surface
may perform worse in a clinical situation than a
weake...
Core Thickness :
The rigidity and thickness of the ceramic core play
an essential role in the flexural strength of the
who...
Strengthening Mechanisms :
Crack-tip interactions :
Dispersion strengthening with Alumina,
Leucite, Zirconia and Magnesium...
Crack-tip Shielding :

Events triggered by the high stresses in the crack tip
region act to reduce the stresses.
Dispersio...
Crack Bridging :

The second phase crystalline structure acts as
a “bandage”to prevent crack from opening
further.Crystall...
Crystalline dispersion
Strengthening :

Strengthening
method

Clinical system

Fused Alumina
sintered into a
Hi – Ceram
ma...
Glass infiltration strengthening :
Reinforcing
crystals

Clinical System Charestrestics

Alumina

In-Ceram
Alumina (Vita)
...
Crystallization of Glasses :
Strengthening
method

Clinical system

Characteristics

Conversion by
“Ceramming”

Dicor
(Den...
Classification of Dental Porcelain
A L L -C E R A M IC S

R e i n fo rc i n g M a te ri a l

G e n a ra l S y s te m

F i ...
Firing Temperature :
High Fusing : 1290`C – 1370`C
These are used for the manufacture of
porcelain teeth.
Composed of Feld...
Low / Medium Fusing Porcelains
Low and medium fusing porcelains are
manufactured by a process called Fritting.

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General Classification
1. Conventional powder ceramics
2. Castable ceramics
3. Pressable ceramics
4. Infiltrated ceramics
...
Castable Ceramics :
These products are supplied as solid ceramic ingots,
which are used for fabrication of cores or full
c...
Powder Slurry Ceramics :
These products are supplied as powders to which the
technician adds distilled water to produce a ...
Pressable Ceramics :
These are also supplied as ingots, these product are
melted at higher temperatures and pressed into a...
Infiltrated Ceramics :
These are glass infiltrated core ceramics. This
involves slipcasting technique for making
the core,...
Machinable Ceramics
These products are supplied as ingots in various
shades and are milled into desired form. These
machin...
Preparations for All-Ceramic Crowns :

The role of the tooth preparation for a
porcelain jacket crown is to provide suppor...
The Design :

The design of an ideal all-ceramic crown preparation is to
provide maximum strength of the crown by establis...
Length of the preparation :

When a load is applied from a lingual direction, the labial
shoulder is placed under compress...
Length of the preparation :

The ideal incisal reduction 2 mm and must not exceed more
than 1/3rd of the anatomical crown ...
Shoulder :

A well defined shoulder with adequate width improves the
fracture resistance of the crown because it provides
...
Shoulder / Chamfer :
When the shoulder angle of the preparation to the
longitudinal axis of the tooth is greater than 90`,...
Shoulder / Chamfer :
A chamfer is conservative and simpler to
execute and has been described as an option
for cast glass c...
Shoulder width :
A shoulder of uniform thickness may round
the preparation excessively and compromise
resistance form. For...
Shoulder width :

These specifications for a shoulder of non uniform
width provide for conservatism, support, and
resistan...
Shoulder curvature (interproximally) :

The finish lines should follow a smooth curvature
that it is not too steep inter-p...
Facial & Lingual reduction :
The minimal acceptable facial thickness of porcelain
from an esthetic standpoint is 1.0mm, an...
Facial & Lingual reduction :
Practically lingual thickness should be in the
1 – 1.3 mm range, and the absolute
minimum sho...
Taper :
Minimal taper is recommended for maximum surface
area and support of the preparation. Excessive
taper of the prepa...
Taper :

Excessive porcelain bulk has an adverse effect on
strength. It is not the bulk that gives the strength to
the cro...
CASTABLE CERAMICS
DICOR*
CERAPEARL*

Summary

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DICOR
The castable glass ceramic system
History
Material
Advantages & Disadvantages
Indications & Contraindications
Cl...
History :
The DICOR castable glass ceramic is one of the
pyoceram ceramics manufactured by Corning
glass ware.
 Founded i...
Composition


Consists of three crystalline forms,
SiO2, = 45% -70% (w/w)
K2O, = 20% (w/w)
MgO, = 3% - 13% (w/w)
MgF2 = 4...
Material :






Technically described as Tetrasilicic fluoromica
glass ceramic.
Tetrasilicic fluoromica crystals
55% v...
Advantages :


Strength -

Feldspathic porcelains and some all porcelains, are
glasses, and they are subject to the inher...
Marginal adaptation :
Dicor casting are statistically more consistent in
terms of “fit”than were the gold crowns.
 The th...
Biocompatibility

:

 Lesser plaque accumulation.

good marginal fit.
 Fluoride content inhibits bacterial
colonization....
Wear Potential :

This system has a microhardness closely matched
to enamel, while the microhardness of feldspathic
porcel...
Wear potential…..
 The surface can be polished to a very

smooth non porous finish smoother than
glazed feldspathic porce...
Thermal conductivity :


Low thermal conductivity that insulates the
underlying tooth from temperature changes.

Simplici...
Esthetics :

There is a close match in translucency between the
cast ceramic material and enamel.
 The numerous, small mi...
Disadvantages :
 Special equipment and cost.
 Moderate strength.
 No fixed partial denture application.
 High failure ...
Indications :

 Anterior PJC.
 Inlays, onlays, three quarter crowns.
 Partial veneers, especially in periodontally

com...
Contraindications :

 Clinical crown length is short.
 FPD.

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Clinical Procedure :
 The tooth structure is sufficiently removed

to allow an adequate thickness of the
material for str...
Tooth preparation :


Incisal or occlusal - 1.5 mm- 2.0 mm.



Facial or lingual - 1.0 mm – 1.5 mm.
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Laboratory Procedures :
Die preparation.
 Waxing & Spruing.
 Investing & Mold conditioning.
 Casting.
 Divesting.
 Sp...
Die Preparation :
Casts shoulb free of 0cclusal artifacts,air bubbles and
other inaccuracies.
Dies must be prepared with p...
Prepared Die :

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Waxing :






Die lubricant is applied over the die spacer to
prevent adherence of the wax to the die.
All contours o...
Wax Pattern :

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Spruing :







One 8 or 10 gauge wax sprue, attached to the
incisal surface of the anterior patterns, provides an
ad...
Spruing :
Length must be approx 3 – 4 mm.
 The pattern should be located so that its
most distal point is approx 6 – 7 mm...
Spruing :

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Investment :








Wax pattern must be cleansed with a debublizing
agent, any excess must be removed.
Non-corroding...
Castable ceramic investment* :

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Investment :








This material exhibits no setting expansion but
produces approx 1.5% thermal expansion at high
te...
Investment :
After the wax pettern is carefully filled and
coated, the remaining material should be
vibrated into the ring...
Investment :

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Mold conditioning :





A two stage mold conditioning is employed.
The invested pattern is placed in a cold furnace,
t...
Casting :
A 4 gm ceramic ingot is loaded in the ceramic
crucible.
The amount of ceramic material required to
make a good c...
Ceramic ingot; Ceramic crucible:

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Casting Machine :
The Dentsply DICOR casting machine
features a platinum electric resistance-type
muffle mounted on a elec...
Dentsply DICOR Casting
Machine :

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Dentsply DICOR Casting
Machine :

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Casting Procedure :







An ideal temperature of 1100`C is maintained for
10 min to stabilize the muffle.
The cruci...
Casting Procedure :







The rear muffle door is opened .
The casting ring is removed from the burnout
furnace and p...
Casting Procedure :


The casting ring is removed form the
machine and allowed to dool for 45 min
before divesting.

Dive...
Divesting :






The bulk of the investment material can be broken
away from the casting with finger pressure.
The rem...
Sprue removal :
The cast crown is cut off at the junction of
sprue and button using a suitable single or
double side diamo...
Casting :

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Embedding :







The casting is embedded in the ceramic
embedment material, so that the ceramming
process can take p...
Embedding :


Additional embedment is used to cover and
protect the glass crown. The material should be
allowed to set fo...
Ceramming :





This process is accomplished by a precisely
controlled ceramming furnace.
The furnace temperature is g...
DICOR Ceramming Furnace :

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Ceramming tray :

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DICOR Ceramming Furnace :

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Ceramming



The proper ceram cycle is verified by the use of a
pyrometric cone.
The characteristic droop will provide v...
Ceramming verification :

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Postceram divesting :
The tray is allowed to cool to room
temperature.
 The embedment is broken.
 The crown is cleaned b...
Wax pattern – Glass form - crystalline form - finished crown

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Crown finishing :






Crystalline glass crown is inspected for internal
nodules or irregularities, which may interfer...
Crown finishing :







The fine opaque white skin covering the crown
must be removed. The sprue is finished and the
...
Characterization & Glazing :







After the ceramming process the casring is
achromatic, the desired hue is decided ...
Characterization & Glazing :

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Unglazed & Glazed crowns :

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Completed crown :

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Cementation :






The color value is modified by a series od
dentsply shaded cements.these cements are color
coordina...
Dicor shaded cements :

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CERAPEARL :
Introduction
 Composition
 Properties
 Lab technique


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Introduction :
Bioceram group have developed castable
ceramic material (Hobo & Kyocera) which
may be classified as CaO.P O...
Composition :
It is composed of CaO.P O .MgO.SiO plus
traces of other elements.
 CaO.P O - are the main ingredients and a...
Properties :
Melts at 1460`C and can be cast. The
casting has an amorphous microstructure
and when it is reheated at 870`C...
Lab Technique :








Casts are poured in type IV dental stone.
After the die sealant,spacer and separator is
appli...
Lab Technique :







The investment mold is transferred to a high heat
processor specially developed for this system...
Lab Technique :
The crystalization starts at 750`C then
maintained for 15 min =, then reached at
870`C for 1 hr.
 Translu...
Conventional
POWDER SLURRY
CERAMICS
Vita Hi-Ceram*
Optec HSP*
Duceram LFC*
Summary

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VITA Hi-Ceram :
Material properties
 Laboratory procedures.


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Material :
This is a aluminum oxide reinforced hard
core porcelain.
 Alumina reinforced core consists of 50% of
aluminous...
A comparision of the bending strengths of vita Hi-Ceram
and Vitadur-N core porcelains
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Merits :
Highly accurate margins.
 Higher melting points and greater stability.
 For both anterior and posterior crowns,...
Clinical Procedures :
Heavy chamfer or shoulder with internal
angles rounded.
 Regular impression procedures.


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Lab Procedures :
Preparing the refractory die.
 Hard core porcelain framework.
 Crown buildup.


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Refractory Die :


Prepared die on the
master model.

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

To create the
necessary
space for the
cement,
apply Vita
interspace
varnish on to
the die in 2
or 3 coatings.

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

Apply a
coat of thin
insulating
grease onto
the
duplicating
base and
ring, fix the
die into the
duplicating
base and
th...


The hi-ceram
duplicating
paste consists
of paste, liquid
and catalyst,
should be
stirred quickly
to obtain a
homogenous...


To avoid
any creating
bubbles, fill
the mold by
pouring in
the mixture
in a fine
stream.
Working
time approx
2 ½ min.
S...


Remove the
die from the
solidified
cast of
duplicating
paste, and
clean off the
interspace
varnish
using the
interspace...


Mix the
refractory HiCeram die
material together
with the die
material liquid:
for this, the
liquid should be
drawn int...


On a vibrator
without any
bubbles fill the
mold that is to
be duplicated.
While it is still
soft, set a
porcelain
retai...


The setting time
for Hi-Ceram
die material
varies between
1 ½ - 2 hrs,
depending on
the room
temperature.
After no more...


The die should be set on
a porcelain tray for the
refractory material to
harden. Pre dry the die
in the VITA Vacumat
20...


In the Vita
Vacumat 200 :
prog 5.5, end
temp 1,000`C,
pre-drying time
10 min, heating
time 10 min, hold
time 3 min. In ...
Constructing the hard core
porcelain

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

The Hi-Ceram hard
core porcelain has to
be applied and fired
in three layers
altogether : 1. The
wash firing.; 2. Half
...


Prior to
each new
application
of Hi-Ceram
hard core
porcelain,
the die
should first
be allowed
to cool and
then left to...


Excess water
should be
soaked up. Next,
Hi-Ceram hard
core porcelain
powder is mixed
together with
Vita modeling
liquid...


Pre dry the
die on the
lowered
firing tray
of the
furnace
until it has
again
turned light
green, and
then fire as
follo...
In the Vita vacumat 200:
programme 6.6, end temperature 1170`C,
pre-drying time 6 min, heating time 10 min,
hold time 0 mi...


Soak the die in water
again, and then apply
the hard core porcelain
for second firing. To
make sure of having the
corre...


The fully built up hard core porcelain in its
final form before the third firing.

For this, fire fire as follows, usin...
In the Vita vacumat 200:
Programme 6.7, end temperature 1170`C, predrying tome 6 min, heating up tome 6 min,
hold time 3 m...
The thickness of hard core porcelain
framework should not be less than 0.5 mm.
 For additional stability, a collar in HiC...


Just as with Vita
VMK metal-ceramic
porcelain, Hi-Ceram
hard core porcelains
can also be shaded
individually using the
...


The
refractory
die should
be blasted
away using
glass beads
at a
pressure of
1- 2 bar.

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

The finished HiCeram hard core
frame work on
the stone die.
Any areas of
interface or
feathered edges
should be
careful...


As the Hi-Ceram hard core framework has not
been constructed on the model, any areas that are
now found to have been bu...
The build up of the
crown :

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

The crown should
be built up to its
desired shape using
Vitadur-N dentin
porcelain, although
to compensate firing
shrin...


A little Vitadur-N
opacous dentin can
also be applied
palatally, so that
even in cases
where there is a
deeper than nor...


To create the
necessary space
for the enamel
porcelain, the
dentin should have
a crescent carved
away incisally and
for...


For individual
shading and
characterizatio
n, there are 5
Vitadur-N
opacous
dentin, 6
dentin effect,
2 enamel
effect an...


The shape of the
crown is now
built up in
Vitadur-N
enamel
porcelain. It
should be
somewhat over
dimensioned to
compens...


The crown is fired
as follows: either by
placing it onto a
fibrous pad firing
support (in which
case raise the
temperat...
In the Vita vacumat 200:
Programme 6.4, end temperature 960`C, predrying time 6 min, heating up time 6 min,
hold time 1 mi...


The fired Hi-Ceram crown should be ground
all over in the normal way, using a diamond
or a green silicon carbide bur. F...


Before each firing, it is also possible to
improve the accuracy of fit and esthetics of
the cervical margin: the stone ...


The cervical
porcelain should be
mixed with Vita
modeling liquid,
applied onto the
cervical margin,
condensed and then
...


Without being
tilted, the crown
should be
removed and
fired as ……

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Cervical porcelain firing in the Vita vacumat 200
programme 6.8, end temperature 940`C, predrying time 6 min, heating up t...
Glaze firing :


Applying the
Vitachrom ”L”
glaze No. 725
allows the
temperature for
the glaze firing
to be lowered,
ther...
Glaze firing in the Vita vacumat 200:
Programme 5.4, end temperature 920`C, predrying time 4 min, heating up time 3 min,
h...
Finished Vita Hi-ceram crowns

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Optec HSP

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Introduction:
Optec HSP(Jeneric / Pentron) is a Leucitereinforced feldspathic porcelain that is
condensed and sintered lik...


Because of its increased strength, Optec HSP*
does not require a core when used to fabricate all
ceramic restorations, ...
Advantages:
Lack of metal or opaque substructure.
 Good translucency.
 Moderate flexural strength.
 No special laborato...
Disadvantages:
Potential marginal inaccuracy caused by
porcelain sintering shrinkage.
 Potential to fracture in posterior...
Duceram LFC:

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Introduction:


The development of very low fusing
ceramics(fusing temperature 660`C) meant
that a simple and accurate te...
Method of Fabrication:
Tooth preparation.
Die preparation.
Ceramic core.
Ceramic buildup.

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Tooth preparation:

Preparation for a www.indiandentalacademy.com
CJC with a peripheral shoulder.
Ceramic coping preparation :
Refractory die.
 Initial ceramic connector layer.
 Ceramic core buildup.


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Ceramic
connector:

A fine layer of initial ceramic over the refractory die the
refractory die (Ducera-lay) is fired at 98...
Ceramic Core:
Lamination in
Duceram
ceramic
directly on the
refractory die
to produce a
ceramic
coping of 0.3
mm thickness...
Lamination
in Duceram
ceramic
directly on
the refractory
die to
produce a
ceramic
coping of 0.3
mm thickness

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Lamination
in Duceram
ceramic
directly on
the
refractory
die to
produce a
ceramic
coping of
0.3 mm
thickness
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The coping is
fired at 940`C.
Various shades
can be
introduced at
this stage.

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After firing the coping is gently sandblasted
off the refractory material using 50 micron
aluminum oxidewww.indiandentalac...
Prepared coping

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Ceramic Buildup:

The coping is replaced on the plaster cast.
Lamination can the be completed using a
low-fusing ceramic, ...
Completed Duceram-LFC Crown:

Facial view ^

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Completed Duceram-LFC Crown:

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Lingual view (Courtesy : Marc Cristou)
Properties:
Flexural strength – 110 Mpa.
 Hardness is close to that of natural tooth
due to absence of leucite.m
 Opales...
Fluorescence:


Comparison
of
fluorescence
of natural
teeth(green),
Duceram
LFC(blue),

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Fluorescence:

LFC (circle left); traditional ceramic material (circle
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right); natural tooth (...
Advantages:
Excellent marginal adaptation.
 Use of plaster master cast.
 No special equipment required.
 Allows for mod...
Indications:
Laminate veneers.
 Jacket crowns.
 Inlays.
 Onlays.
 If high transparency ceramic is required.


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Contraindications:
Masking grossly discolored tooth.
 When aiming for high fracture resistance.
 All other common contra...
MACHINABLE CERAMICS

Summary

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Classification:
M a c h in a b l e C e r a m ic s
C A D -C A M C e r a m ic s
a ceramic restoration
fabricated by use of a...
CAD – CAM Ceramics
CEREC
CEREC 2
CEREC 3

CEREC SCAN
CEREC InLAB
PROCERA
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Introduction:
The introduction of Computer-Aided-Designing &
Computer-Aided-Milling(CAD-CAM) systems to
prosthetic dentist...
History:
Optical scanning and computer generation of
restorations were attempted as early as 1971
(Altschuler, 1971/1973) ...
Objectives:
To eliminate traditional impression methods.
 To design, the future restoration in
accordance with the prepar...
Types of CAD – CAM Devices:
DIRECT:
Fully integrated CAD – CAM devices for
chair side restorative approach. CAD &
CAM stat...
Indirect Method:
The optical impression is taken in the dental
office, where CAD is done; data are
transmitted to CAM stat...
Indirect Method:








Because of the overall dimensions and the cost of
the indirect CAD – CAM devices, they are ...
Direct CAD - CAM

CEREC, CEREC 2,

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CEREC 3
C
E
R
E
C

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S
Y
S
T
E
CEREC Systems:
The CEREC system, developed in Zurich,
Switzerland has been marketed for several
years with the improvised ...
The equipment consists of a computer
integrated imaging and milling system, with
the restorations designed on the computer...
Materials used with CEREC’s:
Dicor MGC*(Machinable Glass Ceramic)(Dentsply):
This is a mica based machinable glass ceramic...
Materials used with CEREC’s:
Vita Mark II (Vident):
These contain sanidine (KALSi O ) as a major
crystalline phase within ...
Materials used with CEREC’s:
ProCad (Ivoclar):
Like Ivoclar's popular
Empress™ material,
ProCAD is reinforced
with tiny le...
Materials used with CEREC’s:
Vita IN-Ceram Blanks (Vita Zhanfabrik):
These are third generation blanks from Vita.


The S...
The Spinell Blanks:


The fine chemical and mechanical
properties of the highly pure synthetic
spinell are used with the ...
The Alumina Blanks:


These uses the advantages of the synthetic
corundum that is prepared from bauxite
prepared in elect...
The Zirconia Blanks:


This combines the fracture toughness of the
meta-stable tetragonal zirconium oxide
which is also r...
Clinical Procedure:
Preparation design.
Optical impression.
Computer generated restoration design.
Milling procedure.
www....
Tooth Preparation Design:


Tooth preparation follows typical allceramic guidelines.

Chamfer

Shoulder

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Optical impression







The surface of the prepared teeth often lacks
sufficient reflectivity or it may have facets ...


The operator actually feels the wand
vibrate as the camera oscillates to scan the
teeth at slightly different angles. T...
Optical impression:

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Design Phase:


With the
help of the
CEREC 3
Software we
can choose
the basis
software for
the
designing of
inlays/onlay
...
Shaping of the surfaces:
1.
2.
3.

Function
Correlation
Extrapolation

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Function:
This design programme takes design of the
antagonist.
 Correlation
This design programme allows to copy intact
...


With using
all the
programmes
the operator
can digitally
design the
restoration
by moving
the cursor
along the
boundari...
The procedure can be stopped at any time
and can override the computer and allow
the operator to correct, the digitally
ge...
Milling Phase:
After all the data has been supplied, the
computer selects the size of the ceramic
block to be used in the ...
These blanks are factory fabricated and thus
are more homogenous and less porous than
materials that are made in the lab.
...
Milling process - - - - - - - - - - - Completed ceramic core

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Limitations of CEREC:
The CEREC system was acceptable with
regard to the longevity of adhesively
bonded restorations, but ...
Improvisation’s in CEREC 2:






The new camera provides more date with greater
accuracy with a resolution from 25 mic...
New Technology CEREC 3:
Software still easy and user friendly which
uses windows as operating system.
 Two compatible cam...
Advantages of CEREC System:
One or two appointments.
 Optical impression, max time required is 5
sec.
 Wear hardness sim...
Indirect CAD - CAM
CEREC* SCAN,
CEREC* In-LAB
PROCERA* SYSTEM

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CEREC SCAN:
Tooth preparation.
 Conventional impressions.
 Die preparation.
 Controlled by one of the practice pc’s.
 ...
CEREC SCAN (inclusive of both scanning
and milling device)with lap top(imaging
device).
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

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Scanning
device.
CEREC In-LAB:

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Controlled Scanning:
Consists of a compact milling unit with a
in-built scanner.
 This consists of non contact scanning f...
Scanning device

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Controlled Design:
Offers a complete spectrum of design
options for crowns and bridge framework.
 All relevant parameters...
Constant monitoring of connector cross section.

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Controlled shaping of spacer.

Pontic shapin...
Controlled milling:
Prior to each milling jib CEREC In-Lab
automatically checks the dimensional
accuracy of the milling to...
Parallel milling with two tools:

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High speed milling of copings and bridge frame work.

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Processing times:
Process step

Coping

Scanning
(automatic)

Approx. 10 min Approx. 20min

Design

Approx. 2 min

Milling...
Completed bridge framework

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I
n
di
c
at
io
n
s
of
C
E
R
E
C

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Procera* All-Ceram

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Introduction:


The Procera® System developed by Dr.
Matts Andersson for Nobel Biocare
embraces the concept of computer a...
Material:


The Procera® AllCeram Crown involves a
densely sintered high-purity alumina core
combined with a low fusing v...
Advantages:
The finished crown has a translucense very
similar to the natural tooth.
 Aluminum oxide is a highly biocompa...
Fabrication Procedures:
Tooth preparation.
 Die preparation.
 Scanning.
 Data transfer.
 Central milling.
 Applicatio...
Tooth preparation:


Since the scanner's
tip is rounded, the
finish line should
be a chamfer placed
sub-gingivally at
0.5...
Tooth preparation:


A relatively level
topography
should be
accomplished
during preparation
of the occlusal
surface of
p...
Tooth preparation:


The occlusal surface of
a posterior tooth is
shaped, eliminating
undercuts and sharp
edges. Steep sl...
Tooth preparation:
For anterior
dentition,
preparation of
the lingual
surface requires
shaping with
diamond bur to
elimina...
Tooth preparation:


Fine finish lines on
the prepared tooth
enable the scanner
to precisely register
all aspects of the
...
Tooth preparation:
Preparation
depths should
be between 1.0
mm and 1.5
mm, while the
occlusal
reduction
should be at
least...
Lab Procedures:
The cast is made in the conventional way,
the die is ditched to make the margin easier
to identify during ...


A technician using the special Procera design
station scans the die and designs the coping to
be fabricated. This stati...
The production starts with milling an
enlarged die to compensate for the sintering
shrinkage.
 An enlarged high-alumina c...
COPY MILLED
RESTORATIONS

CELAY* System
Mikrona Technologies
Switzerland.

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Introduction:
The Celay* is a well hand operated system
that represents an interesting alternative to
CAD – CAM system for...
Ceramic Blanks:

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Procedure:


Preparation:
shoulder with
rounded axiocervical line
angle.

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Resin coping:


A prototype
composite resin
coping is modeled
on the die.

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

The resin coping modeled with CELAY –
TECH is transferred on to the scanning /
milling platform.

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

Scanning of the prototype resin with
simultaneous of the copy milled crown
substructure.

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

Copy milled
substructure prior to
finishing.

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

The finished
sintered
substructure after
firing onto the die.

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Advantages:
Precisely fitting ceramic restorations can be
developed without a lab technician in high
grade factory fired p...
GLASS INFILTRATED
CERAMICS

Summary

In-Ceram* Alumina
In-Ceram* Spinell
In-Ceram* Zirconia
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History:
In 1985 a new ceramic material was
introduced. This system evolved from the
research of Dr. Mickael Sadoun in 198...
Introduction:
This system use a slip casting(a procedure
by which a fine particle ceramic, dispersed
in an aqueous liquid ...
Classification:
Reinforcing
crystals

Clinical System Charestrestics

Alumina

In-Ceram
Alumina (Vita)

High alumina
copin...
Properties:
Higher flexural
strengths, at least 3
times than the older
systems.
 In-Ceram Z = 700 Mpa
 In-Ceram A = 500 ...
Fracture toughness(in
Mpa x m),
 In-Ceram Z = 6.8
 In-Ceram A = 4.7
 In-Ceram S = 2.7


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Alumina:


Aluminum oxide, also known by its
mineralogical name corundum(in Tamil:
Korundum) occurs in nature in severa;
...


Natural corundum crystallizes
trigonally and frequently into barrel
shaped crystals.
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Can be manufactured synthetically using
the Vernuil process. Its melting point is
2054`C.
 Good insulation, abrasion resi...
In this system a bimodal
grain distribution with
a medium grain size
of approx. 3 microns
is used. At a
temperature of
112...


For the glass
infiltration a special
glass is used which
has an excellent
wetting power to
corundum and has a
very low ...


Only after the glass infiltration, that the
high strength, typical tooth color and
translucency if VITA In-Ceram Alumin...
The ceramic materials for substructures of
jacket crows have been enriched up to 60%
weight with aluminum oxide crystals w...
Synthetically produced corundum with a
grain size of 2 – 5 microns is used in InCeram Alumina.
 Bridges made with In-Cera...
Spinell:
Spinell (MgAl2O4) is a matural mineral
that is mainly found together with limestone
and dolomite, sometimes also ...
If the metal ions (Mg 2+ , Al 3+ ) in a highly
pure, colorless spinell are replaced by other
metal ions, striking color ch...
Structure of sintered , noninfiltrated spinell: basis for
the core.


Spinell structure after
infiltration with In-Ceram
...
Zirconia:
Principle of strengthening by the
incorporation of a crystalline material that is
capable of undergoing a change...


Principle of
transition
strengthening(lef
t) and a scanning
electron
micrograph
photo of a crack
(next to the red
line)...


Transition electron microscope photo of the
infiltrated In-Ceram Zirconia substructure.
X-ray diffraction studies of th...


Scanning electron microscope photos of InCeram Zirconia / VITADUR ALPHA. The
small picture in the upper right corner
sh...


As a result, the the particles of PSZ scatter
light as it passes through the bulk of the
porcelain, and this scattering...
Advantages:
Higher Flexural strength:
Flexural strength of In-Ceram is at least 3
times that of the older system.
 Better...
Higher modulus of elasticity than regular
feldspathic porcelain.
 Double the compressive strength as that of
regular feld...
Development of localized residual stress
fields during cooling, has been implicated as
a mechanism to improve toughness of...
Low weight.
 High acceptance.
 Perio-prosthodontic value:
 Good biocompatibility.
 Diminished plaque accumulation.
 H...
Disadvantages:
Expensive:
Use of specialized equipment and techniques
results in added cost of fabrication.
 The porous, ...
Wearing of opposing teeth:
Abrasion is the byproduct of the leucite crystal
within these materials affecting the opposing
...
Indications:

•Patient allergic to metal alloys.
•Optimum esthetic result.
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•Patient requiremen...
Contraindications:
Heavy occlusion or bruxism.
 Patients requiring splinting of teeth.
 Patients with short clinical cro...
Clinical
procedures
In-Ceram*
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Armamentarium:

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Armamentarium:

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

Divide the unprepared labial surface if the
tooth crown into three equal thirds.
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

Prepare two depth orientation grooves on
the labial surface of the tooth with a dualguided groovewww.indiandentalacadem...


Prepare palatal depth orientation grooves.
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

Prepare two incisal depth orientation
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grooves.


Condition after milling of all depth
orientation grooves.
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

Reduction of the hard tooth substance parallel
to the incisal third of the labial surface
between the second and the th...


Reduction in the area of the labial surface
between the first and the second milled groove
and thus almost parallel to ...


Correct preparation of the tooth in two planes.
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

Incorrect preparation; in one plane, therefore
insufficient reduction of substance. Due to
that insufficient wall thick...


Incorrect preparation of the tooth surface
lead to the risk of damaging of the pulp.
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

Application area of the proximal cutter.
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

Use of the step cutter with depth stops: this
cutting tool is to optimize the position and
quality of the prepared step...


Palatal side is prepared with a foot ball
diamond.
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

Smoothening of the sharp angles using a
bud shaped diamond.
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Defined marginal
reduction of 0.6 – 1.2
mm.
 Incisal or occlusal
depth 1.5 – 2 mm.
 Shoulder with
rounded axio-cervical
...
Laboratory Working
Procedure
In-Ceram*ALUMINA
In-Ceram*SPINELL
In-Ceram*ZIRCONIA
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Model Fabrication

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

A working model with removable dies from
a high-quality, dimensionally stable model
stone is prepared.
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

A master model that has not been
sectioned is fabricated, for positioning,
transferring and checking the crowns and
www...
Preparation for Duplication

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Blocking Out:



Check the sawed die carefully for undercuts
and block out www.indiandentalacademy.com
them.
Applying the interspace varnish:



The varnish must be applied to the plaster
dies in 2 – 3 coats approx. 45 microns.
ww...
Applying the interspace varnish:
Epoxy or galvanized dies require 4 coats
approx. 60 microns.
 ! Wait for at least 5 min ...
Waxing up the prop:



For the fabrication of bridgework, a prop
must be waxed up palatally in the area of the
www.indian...
Waxing up the prop:
The prop facilitates the application of the
slip material and allows increased
absorption of liquid an...
Duplication:

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

Duplicate with an addition polymerizing
silicone in a ratio of 1 : 1 using the dual
www.indiandentalacademy.com
impress...


Duplicate using the pouring method with
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the help of a duplicating mold.
Deflasking:

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

After deflasking allow the impression to
harden for approx. 30 min(according to
w
manufacturer).ww.indiandentalacademy....


Spray a wetting agent on to the impression
and allow the www.indiandentalacademy.com
agent to dry.
Stirring the
VITA In-Ceram*
Special Plaster:

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Mixing:



VITA In-Ceram special plaster 20g : 4.6 ml
w
distilled water.ww.indiandentalacademy.com
Mixing:
Pour 4.6 ml of distilled water into the
mixing beaker, then min the content of the
sachet of VITA In-Ceram special...
Pouring:



Pour the plaster in to the mould slowly in
small increments without the formation of
air bubbles. www.indiand...
Preparation for the
application of the
SLIP

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Deflasking:



After filling the special plaster into the
special plasterwww.indiandentalacademy.com after 2 hrs.
mold, d...
Grinding the special die:



After deflasking the base must be ground flat. During
this, the models must be kept dry.


...
Separating the bridge model:



Partly section the special plaster model
from beneath using a separating disc.
www.indian...
Attaching the bridge model:



Glue the special plaster bridge model onto a
VITA In-Ceram firing tray using
cyanoacrylate...
Sectioning the bridge unit:



After approx.10 min, section the plaster model
between the abutment teeth with a sharp saw...
Margin preparation:



Mark the margins with a super polymer
color cartridge.
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Manufacturing the
SLIP:

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

Weigh out exactly 38 g of VITA In-Ceram
alumina powder.
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

Pour the contents of 1 ampoule of ZITA In-Ceram
alumina mixing liquid and 1 drop of VITA InCeram Alumina additive into ...


Place the glass beaker on a vibrator and
spatulate the 38 g of VITA In-Ceram
Alumina powder slowly into the liquid in
w...
Mixing must be interrupted at least 3 times
in order to place the glass beaker in the
VITASONIC ultrasonic unit for 2 min ...



After the entire powder is added, place the glass
beaker in the VITASONIC for 7 min.
! After mixing, the slip must be...


The mixture must be evacuated for 1 min.
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(e.g. with a vacuum investment unit).


Pour the slip from the glass beaker into the
enclosed plastic mixing cup.
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Applying the SLIP

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Start to apply the slip in the area of the
pontic.
 Build up to half of the height of the pontic.
 Then coat the abutmen...




! Proceed rapidly when building up the remaining
slip.
! Do not interrupt this process, so that drying out
the layer...
Dimensions of the substructure:

The connectors must be as thick as possible.
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

Deep grooves, as a custom in the metal
ceramic technique must be avoided since
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they would r...
•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
a...


Since fine reworking is always required
after sintering, the slip should be applied
more richly prior to sintering firi...


Carefully expose the preparation margin
with a scalpel www.indiandentalacademy.com
until the marking can be seen.


Final shaping of the substructure is only
carried out after sintering.
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Sintering firing:

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

After firing allow the substructures to cool
down to 400`C in the closed firing
temperature, and then to the room
www.i...
Sintered substructure:



Since the plaster model has contracted
during firing, the sintered substructure can
be easily r...
Checking the fit of the coping on
the working model:
Before continuing the work on the working
model, remove the interspac...


Do not exert pressure.
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

Due to dust formation when grinding
sintered dental ceramic products, always
wear a face mask. Work behind a shield and...


Adjust contours and functioning by
grinding slightly(fine diamond, low speeds,
minimum pressure).
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Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
Metal free ceramics /certified fixed orthodontic courses by Indian dental academy
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Metal free ceramics /certified fixed orthodontic courses by Indian dental academy

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Metal free ceramics /certified fixed orthodontic courses by Indian dental academy

  1. 1. METAL 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, the desire for a durable and esthetic material is ancient. Although metals have many characteristics that make them useful in dentistry they do not look like natural teeth. In contrast a superb esthetic and biocompatible result can be achieved with ALL CERAMICS’s. Ceramic is the most natural appearing prosthetic restorative material for missing tooth substance. www.indiandentalacademy.com
  3. 3. Dental porcelain play an important role in the fabrication of the most esthetic fixed partial dentures. Translucency, light transmission, and biocompatibility give dental ceramics highly desirable esthetic properties. However, the brittle nature of dental porcelains, which are basically noncrystalline glasses composed of structural units of silicon and oxygen (SiO tetrahedra) limit the use of this material. 4 www.indiandentalacademy.com
  4. 4. Selection :  The primary advantage of using metal free ceramic system is to increase the depth of translucency and light transmission in the crown either deep into the crown or across the entire crown.  Esthetic results vary from system to system, and in a laboratory setting several factors influence the choice one crown system over another…. www.indiandentalacademy.com
  5. 5. Factors influence the selection of crown system : Strength.  Simplicity of fabrication.  Potential for high volume production.  Marginal and internal fit.  Cost-benefit analysis.  Personal experience.  Esthetic performance.  www.indiandentalacademy.com
  6. 6. Indications : The fracture resistance of all-ceramic crown is based on adequate support by the preparation, proper patient selection, strength of crown material and type of luting cement. Indications include…. ♣ All anterior teeth where esthetics is of prime factor. www.indiandentalacademy.com
  7. 7. Conservation of tooth structure and maintenance of periodontal health. ♣ Lower incisors where space is available. ♣ Limited use on the premolar teeth where the occlusion allows some protection of the buccal shearing cusps. ♣ www.indiandentalacademy.com
  8. 8. Contra-indications:     In the cases of parafunctional activity of the mandible,e.g. bruxism. Or any deflective malocclusions remain uncorrected. Where occlusal clearance after after tooth preparation is less than 0.8 mm, e.g. very thin teeth, deep incisal over jets with lingual wear facets. Insufficient tooth support or where the preparation design causes sudden changes of thickness in the porcelain. Molar teeth. www.indiandentalacademy.com
  9. 9. Aluminous Porcelain Vs Metal Ceramics www.indiandentalacademy.com
  10. 10. Aluminous porcelain : Advantages : 1. Good esthetics is easily obtained if the core porcelain is placed correctly. 2. Full lingual core porcelains protect the crown against opposing incisors. 3. The resistance to pyroplastic flow or slump of the core porcelain can produce better fits than regular porcelains. www.indiandentalacademy.com 4. Greater depth of translucency obtained.
  11. 11. Aluminous Porcelain : Disadvantages : 1. Cannot be used in posterior regions. 2. Parafunctional movements. 3. Long span bridges. 4. Tooth preparation is even more. www.indiandentalacademy.com
  12. 12. Metal Ceramics : Advantages : 1. Very high strength due to prevention of crack propagation. 2. Improved fit. 3. Long span bridges. 4. Availability. 5. Economical. www.indiandentalacademy.com
  13. 13. Disadvantages :       Increased opacity and light reflectivity. Risk of over contouring – metal .5 mm and the rest is ceramic material. Metal margin exposure. The fit of long span bridges may be affected by the creep of the metal during successive bakes of porcelain. Difficult to obtain good esthetics. Porcelains used in the metal-ceramic technique are more liable to devitrify which can produce cloudiness. www.indiandentalacademy.com
  14. 14. Constituents of Dental Porcelain : Silicon dioxide – SiO2 – Glass forming matrix, glass formers. Boric oxide –B2O3 – (Glass modifiers /Flux) Lowers the softening point, lower viscosity, higher expansion. Oxides of potassium, Sodium, calcium, lithium, magnesium (Glass modifiers). Aluminum oxide – Al2O3 – (intermediate oxides) reduces viscosity, lowers firing temperature. Phosphorus pentoxide – P2O5 – opalescence, glass forming oxide. www.indiandentalacademy.com
  15. 15. Properties of Dental Porcelain : Low fusing temperature.  High viscosity.  Resistance to devitrification.  Translucent.  www.indiandentalacademy.com
  16. 16. Strength of All Ceramic Crowns : The objective of fabricating all ceramic crown is to provide the patient with lasting esthetic restorations. New materials are been advocated as replacement for metal ceramic restoration. The strength of ceramic is greatly influenced by the presence of surface flaws acting as stress initiators and causing widening and propagation of microcracks through the material from the surface. Therefore dental porcelain is much weaker in tension than in compression and is prone to brittle fracture. www.indiandentalacademy.com
  17. 17. Dental porcelain is also susceptible to “static Fatigue”which is generally caused by a stress dependent chemical reaction between water vapor and the surface flaws in the restoration. This causes flaws to grow to critical dimensions, allowing spontaneous crack propagation, resulting in a fracture with comparatively little occlusal loading, particularly over long periods. www.indiandentalacademy.com
  18. 18. Surface Flaws : A high strength ceramic with a badly flawed surface may perform worse in a clinical situation than a weaker ceramic with comparatively flaw-free surface. The fracture pattern of cast glass ceramic, aluminous porcelains is always initiated at the surfaces and usually at the locations involving porosities. Kelley et al classified porcelain defects into Processing defects – Machining scratches, porosities, and impurity inclusions. Inherent material defects – large grains, residual stresses and microcracks. www.indiandentalacademy.com
  19. 19. Core Thickness : The rigidity and thickness of the ceramic core play an essential role in the flexural strength of the whole restoration.sections less than 1mm should be avoided, and ideally dentist should aim for cross sections of 1.5 mm. The ideal aluminous porcelain coping for incisors should exhibit: * a lingual surface atleast 1 mm thick: *a lingual collar extended proximally, similar to a metal coping: *the incisal labial area thinned to 0.3 mm for esthetics. www.indiandentalacademy.com
  20. 20. Strengthening Mechanisms : Crack-tip interactions : Dispersion strengthening with Alumina, Leucite, Zirconia and Magnesium aluminum oxide spinell crystals. Obstacles in the microstructure impede crack propagation by reorienting and deflecting the plane of fracture. www.indiandentalacademy.com
  21. 21. Crack-tip Shielding : Events triggered by the high stresses in the crack tip region act to reduce the stresses. Dispersion strengthening by Glass Infusion of slip cast alumina ceramics, (Micro-crack toughening). Dispersion strengthening of PSZ ceramics, (Transformation toughening). www.indiandentalacademy.com
  22. 22. Crack Bridging : The second phase crystalline structure acts as a “bandage”to prevent crack from opening further.Crystallization of Glasses by Ceramming. www.indiandentalacademy.com
  23. 23. Crystalline dispersion Strengthening : Strengthening method Clinical system Fused Alumina sintered into a Hi – Ceram matched expansion (Vident) glass. Characteristics Alumina reinforced ceramics Leucite crystals dispersed through the body of the crown Optec(Jeneric/Pent Leucite reinforced ron) IPS Empress Heat pressed (ivoclar) leucite-reinforced Crystallized magnesiun aluminum oxede spinell Al-Ceram (Innotek Dental Corp.) formerly Cerestore. www.indiandentalacademy.com Shrik-free alumina ceramic.
  24. 24. Glass infiltration strengthening : Reinforcing crystals Clinical System Charestrestics Alumina In-Ceram Alumina (Vita) High alumina coping infused with a low fusing glass Zirconia In-Ceram Zirconia (Vita) High Zirconia coping infused with a low fusing glass Magnesium oxide spinell In-Ceram Spinell (Vita) High Spinell coping infused with a low fusing glass www.indiandentalacademy.com
  25. 25. Crystallization of Glasses : Strengthening method Clinical system Characteristics Conversion by “Ceramming” Dicor (Dentsply) Castable glass ceramic with tetrasilic fluormica crystals Conversion by Cerapearl “Crystallization” (Kyocera america Inc.) www.indiandentalacademy.com Castable apatite ceramic
  26. 26. Classification of Dental Porcelain A L L -C E R A M IC S R e i n fo rc i n g M a te ri a l G e n a ra l S y s te m F i r i n g T e m p e ra tu re A lu m in a M a g n e s iu n s p in e l P o w d e r s l u rry C a s ta b l e H ih g F u s in g Z ir c o n iu m L e u c it e P re s s a b l e In fi l t ra te d L o w F u s in g Z i r c o n i a W h i s k e rs H ig h A lu m in a M a c h in a b le www.indiandentalacademy.com M e d iu m F u s in g Summary
  27. 27. Firing Temperature : High Fusing : 1290`C – 1370`C These are used for the manufacture of porcelain teeth. Composed of Feldspar=70%-90%, Quart= 11%-18%, Kaolin= 1%-10%. www.indiandentalacademy.com
  28. 28. Low / Medium Fusing Porcelains Low and medium fusing porcelains are manufactured by a process called Fritting. www.indiandentalacademy.com
  29. 29. General 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, which are used for fabrication of cores or full contour restorations using a lost wax and centrifugal casting technique. Generally, one shade of material is available. Which is covered by conventional feldspathic porcelain or is stained to obtain proper shading and characterization of the final restoration. e.g. DICOR (Corning glass, Dentsply). CERAPEARL (Bioceram, Kyocera) www.indiandentalacademy.com
  31. 31. Powder Slurry Ceramics : These products are supplied as powders to which the technician adds distilled water to produce a slurry, which is build up in layers on a die material to form the contours of the restoration. The powders are available in different shades and translucencies, and are supplied with characterizing stains and glazes. e.g. OPTEC H.S.P (Jeneric/Pentron) DUCERAM L.F.C (Ducera Inc) www.indiandentalacademy.com Vita Hi-Ceram (Vita Zahnfabrik)
  32. 32. Pressable Ceramics : These are also supplied as ingots, these product are melted at higher temperatures and pressed into a mould using a lost wax technique. These pressed form can be made into full contour, or can be used as a substrate for conventional feldspathic porcelain buildup, or can be built up by layering technique. e.g. IPS Empress I, II (Ivoclar vivadent) OPC (Optec Pressable Ceramic) ALCERAM (Cerestore, Innotek dental corp) www.indiandentalacademy.com
  33. 33. Infiltrated Ceramics : These are glass infiltrated core ceramics. This involves slipcasting technique for making the core, and the contours of the restoration are obtained by individual layering and staining techniques. e.g. In-CERAM (Vita Zahnfabrik) Alumina Zirconia Spinell www.indiandentalacademy.com
  34. 34. Machinable Ceramics These products are supplied as ingots in various shades and are milled into desired form. These machined restorations can be stained and glazed to obtain desired characterization. They are of two types : CAD-CAM = Computer Aided Designing – Computer Aided Milling. e.g. CEREC (Sirona) Ivoclar ProCAD (Ivoclar, Spring) Dicor M.G.C (Dentsply) Copy Milling = CELAY (Mikrona Technologies) www.indiandentalacademy.com
  35. 35. Preparations for All-Ceramic Crowns : The role of the tooth preparation for a porcelain jacket crown is to provide support for the prosthesis with uniform porcelain thickness. It was recognized that the most frequent cause of JC failure was improper tooth preparation. www.indiandentalacademy.com
  36. 36. The Design : The design of an ideal all-ceramic crown preparation is to provide maximum strength of the crown by establishing flat planes at right angles to the forces of mastication and avoiding sharp line angles. A shoulder margin is also required because it offers superior strength as compared to www.indiandentalacademy.com chamfer.
  37. 37. Length of the preparation : When a load is applied from a lingual direction, the labial shoulder is placed under compression and only the length of the preparation at the incisal lingual aspect provides significant resistance to this force.short preparations cause 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 more than 1/3rd of the anatomical crown . If the incisal reduction is too thin, it should be thickened and placed at a right angle to the direction of stress by reducing the preparation to a length of 2/3rd www.indiandentalacademy.com of the anatomical crown.
  39. 39. Shoulder : A well defined shoulder with adequate width improves the fracture resistance of the crown because it provides additional bulk at the margins that is placed at right angles to the direction of stresses The more the intimate the contact between the preparation and the ceramic crown higher the resistance to fracture on occlusal loading.www.indiandentalacademy.com
  40. 40. Shoulder / Chamfer : When the shoulder angle of the preparation to the longitudinal axis of the tooth is greater than 90`, the risk if porcelain fracture increases. The internal shoulder angle should be rounded to reduce the stress concentration factor up to 50% and because sharp internal line angles cannot be easily reproduced with porcelain. Similarly , the internal rounded shoulder is recommended for the In-Ceram* crown to facilitate the adaptation of the aluminous oxide slip on the die. www.indiandentalacademy.com
  41. 41. Shoulder / Chamfer : A chamfer is conservative and simpler to execute and has been described as an option for cast glass ceramic restorations. www.indiandentalacademy.com
  42. 42. Shoulder width : A shoulder of uniform thickness may round the preparation excessively and compromise resistance form. For a maxillary central incisor, the lingual and facial shoulder width should be I mm with a minimum of 0.8 mm, and the interproximal width should be 0.5 mm because the proximal walls of the crown flare out and provide sufficient strength in the proximal area www.indiandentalacademy.com
  43. 43. Shoulder width : These specifications for a shoulder of non uniform width provide for conservatism, support, and resistance of the preparation to stresses. www.indiandentalacademy.com
  44. 44. Shoulder curvature (interproximally) : The finish lines should follow a smooth curvature that it is not too steep inter-proximally to avoid a potential v shaped notch that could split the labial off the lingual aspect of the crown. www.indiandentalacademy.com
  45. 45. Facial & Lingual reduction : The minimal acceptable facial thickness of porcelain from an esthetic standpoint is 1.0mm, and the ideal depth of reduction on the midfacial aspect of a typical maxillary central incisor for an aluminous porcelain jacket crown should be 1.3 mm. Facial depths of reduction up to 1.5mm have also been recommended for molded, castable, and slip-cast ceramics. Lingual thickness values of 1.5 mm are ideal but are difficult to achieve routinely. www.indiandentalacademy.com
  46. 46. Facial & Lingual reduction : Practically lingual thickness should be in the 1 – 1.3 mm range, and the absolute minimum should be 0.8 mm. The lingual aspect of the preparation should be shaped to avoid uneven sections of the crowns and sharp line angles must be avoided. www.indiandentalacademy.com
  47. 47. Taper : Minimal taper is recommended for maximum surface area and support of the preparation. Excessive taper of the preparation correlates with a reduction in breaking strength and increase in stress concentration in the area where support is lacking. A 5`taper is ideal and would ensure maximum resistance form with only one path of insertion of the crown but it is also difficult to achieve without producing undercuts. The safest and most practical convergence angle of all-ceramic preparations is 10`taper, which represents an acceptable compromise between taper and strength. www.indiandentalacademy.com
  48. 48. Taper : Excessive porcelain bulk has an adverse effect on strength. It is not the bulk that gives the strength to the crown, it is the resistance to flexure provided by the support from the preparation and the accuracy of the fit. www.indiandentalacademy.com
  49. 49. CASTABLE CERAMICS DICOR* CERAPEARL* Summary www.indiandentalacademy.com
  50. 50. DICOR The castable glass ceramic system History Material Advantages & Disadvantages Indications & Contraindications Clinical procedures Laboratory procedures  www.indiandentalacademy.com
  51. 51. History : The DICOR castable glass ceramic is one of the pyoceram ceramics manufactured by Corning glass ware.  Founded in the year 1978, after 6 years of intensive research this ceramic system was introduced to dentistry.  The present system represents the cumulative efforts of Peter.J.Adair of BIOCOR Inc., David Grossman Ph.D of the Corning Glass ware & Dentsply International.  www.indiandentalacademy.com
  52. 52. Composition  Consists of three crystalline forms, SiO2, = 45% -70% (w/w) K2O, = 20% (w/w) MgO, = 3% - 13% (w/w) MgF2 = 4% - 9% (w/w)(Fluoride as a nucleating agent forming nucleation sites to aid the crystal growth during the process of ceramming, ;eading to a growth of approx 1 micron small tetrasilicic crystals). Small amounts of AlO3, ZrO2,BaO Fluorescing agents. www.indiandentalacademy.com
  53. 53. Material :    Technically described as Tetrasilicic fluoromica glass ceramic. Tetrasilicic fluoromica crystals 55% vol Glass 45% vol These miniscule crystals lie interlaced within the glass phase in the direction of the casting. On the surface of the cerammed glass are Enstatite crystals of thickness microns. These occur through fluorine depletion which occurs through the interaction with the embedment material needed for the ceramming process. These crystals are in orthogonal in direction to the surface and are www.indiandentalacademy.com whitish and opaque.
  54. 54. Advantages :  Strength - Feldspathic porcelains and some all porcelains, are glasses, and they are subject to the inherent frailties of glass (super cooled liquids).  The tetrasilicic mica crystals(K2Mg5Si8O20F4) are similar to mica.  These crystals stop the propagation Griffith flaws.  www.indiandentalacademy.com
  55. 55. Marginal adaptation : Dicor casting are statistically more consistent in terms of “fit”than were the gold crowns.  The thermal expansion of coefficient of cast glass ceramic is close to that of natural enamel. This means expansion and contraction during normal temperature fluctuations, thus maintaining a good marginal seal.  www.indiandentalacademy.com
  56. 56. Biocompatibility :  Lesser plaque accumulation. good marginal fit.  Fluoride content inhibits bacterial colonization.  The surface of the restoration is smooth and non porous.  www.indiandentalacademy.com
  57. 57. Wear Potential : This system has a microhardness closely matched to enamel, while the microhardness of feldspathic porcelains is one third greater.  Cast Ceramic (KHN) = 362.  Enamel (KHN) = 343.  www.indiandentalacademy.com contd….
  58. 58. Wear potential…..  The surface can be polished to a very smooth non porous finish smoother than glazed feldspathic porcelain.  Lingual contours that represent a physiologic anterior guidance are also a crucial factor in minimizing wear. www.indiandentalacademy.com
  59. 59. Thermal conductivity :  Low thermal conductivity that insulates the underlying tooth from temperature changes. Simplicity www.indiandentalacademy.com
  60. 60. Esthetics : There is a close match in translucency between the cast ceramic material and enamel.  The numerous, small mica crystals that constitute the structure of the castable ceramic are loosely matched in the index of refraction to the surrounding glass phase that bonds the material. Thus the intensity of light scattering at each glass crystal interface is less, that is more suitable. Increase in crystalinity ensures more scattering.  Veneering porcelains also can be used to modify translucency and better color depth.  This material is capable of producing chameleon effect, where part of the color of the restoration is picked up from the adjacent teeth as well as the www.indiandentalacademy.com 
  61. 61. Disadvantages :  Special equipment and cost.  Moderate strength.  No fixed partial denture application.  High failure rate in posterior regions of the mouth, as well as recent developments of other materials, led to the phasing of this product. www.indiandentalacademy.com
  62. 62. Indications :  Anterior PJC.  Inlays, onlays, three quarter crowns.  Partial veneers, especially in periodontally compromised teeth www.indiandentalacademy.com
  63. 63. Contraindications :  Clinical crown length is short.  FPD. www.indiandentalacademy.com
  64. 64. Clinical Procedure :  The tooth structure is sufficiently removed to allow an adequate thickness of the material for strength and color saturation.  For castable ceramics, the tooth reduction on all surfaces must be no less than 1.2mm.  Heavy chamfer (135`)`or shoulder margin.  6`- 8`taper and all line angles rounded.  Standard impression procedures are followed. www.indiandentalacademy.com
  65. 65. Tooth preparation :  Incisal or occlusal - 1.5 mm- 2.0 mm.  Facial or lingual - 1.0 mm – 1.5 mm. www.indiandentalacademy.com
  66. 66. Laboratory Procedures : Die preparation.  Waxing & Spruing.  Investing & Mold conditioning.  Casting.  Divesting.  Sprue removal.  Embedding.  Ceramming & post ceram divesting.  Finishing, coloring. www.indiandentalacademy.com 
  67. 67. Die Preparation : Casts shoulb free of 0cclusal artifacts,air bubbles and other inaccuracies. Dies must be prepared with proper indexing. The dies should be sectioned, trimmed and refined with care. Any existing undercuts must bu blocked out to ensure wax pattern removal without distortion. Die sealant should be used. A die spacer of appropriate shade is applied on 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 to prevent adherence of the wax to the die. All contours of the wax crown should have a minimum thickness of at least 1mm to ensure adequate strength of the crown. A smooth and completely formed internal surface of the waxed crown is necessary. A wild-Leitz stereomicroscope with fibre optic light can be used to avoid any over extensions in the margins. www.indiandentalacademy.com
  70. 70. Wax Pattern : www.indiandentalacademy.com
  71. 71. Spruing :     One 8 or 10 gauge wax sprue, attached to the incisal surface of the anterior patterns, provides an adequate gate for the ingress of the ceramic material. Posterior patterns are usually require 10 gauge sprues attached to the lingual and buccal cusp tips. Sprue placement on molar patterns should be diagonally opposed for more uniform flow of the fluid ceramic. A sprue design incorporating a perpendicular reservoir has also produced adequate casting. www.indiandentalacademy.com
  72. 72. Spruing : Length must be approx 3 – 4 mm.  The pattern should be located so that its most distal point is approx 6 – 7 mm from the open end of the casting ring to allow adequate diffusion of the mold glass through the investment.  www.indiandentalacademy.com
  73. 73. Spruing : www.indiandentalacademy.com
  74. 74. Investment :      Wax pattern must be cleansed with a debublizing agent, any excess must be removed. Non-corroding casting rings that are resistant to oxidation at high temperature must be used. 2 layers of Kaoliner* a ring liner material (an asbestos liner)is placed inside the ring,to permit suffficient expansion. The ring liner is saturated eith water for about 10 sec before ceating the ring on to the crucible former. A special phosphate bonded investment is used www.indiandentalacademy.com
  75. 75. Castable ceramic investment* : www.indiandentalacademy.com
  76. 76. Investment :     This material exhibits no setting expansion but produces approx 1.5% thermal expansion at high temperatures. 8 ml of distilled water must be mixed with 60 gm of investment powder for 30 sec under vacuum with power spatulation. After spatulation additional vibration under vacuum is carried for 20 – 30 sec. The mixed investment should be carefully applied on to the wax pattern with a camel’s hair brush. www.indiandentalacademy.com
  77. 77. Investment : After the wax pettern is carefully filled and coated, the remaining material should be vibrated into the ring allowing an excess to remain above the open ends of the ring.  After bench setting for 1 hr the excess material should be trimmed even with the 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. The invested pattern is placed in a cold furnace, the temperature is raised to 249`C, and maintained for 30 min (heat soak), 10 min of additional time for each ring should be added if more than three rings are placed at a time. The temperature is raised to 899`C, and maintained for 2 hrs (heat soak), similarly 10 min added for each ring. www.indiandentalacademy.com
  80. 80. Casting : A 4 gm ceramic ingot is loaded in the ceramic crucible. The amount of ceramic material required to make a good casting can be determined when multiplied by a conversion factor of 2.6, the weight of the wax pattern, sprues and button should not exceed 4gm . 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 machine features a platinum electric resistance-type muffle mounted on a electrically driven straight centrifugal casting arm.  The machine is fitted with a special 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 for 10 min to stabilize the muffle. The crucible containing the ceramic ingot is inserted through the rear muffle door. The crucible is properly positioned in the muffle for melting the glass by the help if a special tool. The rear door is closed, the melting temperature is adjusted to 1360`C, and the melt switch is turned on. After reaching the determined temperature, this will be maintained for 6 min. www.indiandentalacademy.com
  86. 86. Casting Procedure :     The rear muffle door is opened . The casting ring is removed from the burnout furnace and placed in the cradle with the crucible and gate facing the muffle. The front muffle door is opened and the muffle assembly is slid forward towards the casting ring until it is seated. The casting machine cover is shut and the casting switch is turned on. The casting arm spins automatically for 4 ½ min and then stops. By the end of the spin cycle the casting will cool down www.indiandentalacademy.com
  87. 87. Casting Procedure :  The casting ring is removed form the machine and allowed to dool for 45 min 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 broken away from the casting with finger pressure. The remaining casting should be removed with an air abrasive tool using 25 micron aluminum oxide at 40 p.s.I. The margin areas should be protected by covering with the finger to prevent chipping. www.indiandentalacademy.com
  89. 89. Sprue removal : The cast crown is cut off at the junction of sprue and button using a suitable single or double side diamond disc.  The sprue is cut near the glass button to avoid chipping.  The remaining button must be dicsarde and cannot be reused because the glass is altered during melting cycle.  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 ceramic embedment material, so that the ceramming process can take place. During this ceramming procedure the glass is concerted into a 55% crystalline form. The glass casting is embedded in a mixture of 18 ml distilled water and 50gm of embedment powder. Hand mixing is sufficient. The inside of the crown is carefully filled with the embedment mix and then it is placed on a tray with a concave receptacle in which additional material is placed. www.indiandentalacademy.com
  92. 92. Embedding :  Additional embedment is used to cover and protect the glass crown. The material should be allowed to set for 45 – 60 min. www.indiandentalacademy.com
  93. 93. Ceramming :    This process is accomplished by a precisely controlled ceramming furnace. The furnace temperature is gradually increased to 1075`C for 3 ½ hrs, this temperature should be maintained for 6 hrs. the furnace is cooled to 200`C and the embedment tray is removed. The ceramming process involves a two-stage heat treatment. The first heat treatment is carried at the temperature for maximum nucleation of crystals, so maximum no: of crystals are formed. The temperature is held for some time for the crystal 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 a pyrometric cone. The characteristic droop will provide verification that proper time and temperature has allowed the development of the desired crystalline properties in the casting. www.indiandentalacademy.com
  98. 98. Ceramming verification : www.indiandentalacademy.com
  99. 99. Postceram divesting : The tray is allowed to cool to room temperature.  The embedment is broken.  The crown is cleaned by air-blasting with 25 micron aluminum oxide at 40 p.s.I at a distance of approx 6inches.  The margins should be protected from 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 internal nodules or irregularities, which may interfere with seating of the casting on the die. These irregularities csn be removed with extrafine diamond points. The crows is seated on to the die and examined for marginal overextensions. If any, must be removed with fine white point or rubber wheel rotating at low speed. The remaining sprue is removed with a double sided diamond disc rotating at slow speed. www.indiandentalacademy.com
  102. 102. Crown finishing :     The fine opaque white skin covering the crown must be removed. The sprue is finished and the skin is lightly removed with a fine rubber abrasive wheel. After removal of the skin the crown is air blasted with 25 microns aluminum oxide at 40 psi. The primary and secondary occlusal anatomy can be defined with small round and inverted cone T.C burs. Corrections can be done with an add-on material. The casting is dried in front of the open muffle at 593`C and introduced into muffle under vacuum to a temperaturewww.indiandentalacademy.commin and can be of 968`C for 1 shaped and adjusted to desired contours.
  103. 103. Characterization & Glazing :     After the ceramming process the casring is achromatic, the desired hue is decided by the shading porcelains. The blending of enamel and body colors must occur while they are wet. The first and the second shading porcelains should be fired at a slightly lower temperature to prevent over glazing and glassy appearance of the crown. Castable ceramics can be fired repeatedly in a conventional glazing oven without affecting the physical properties or marginal integrity of the material 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 od dentsply shaded cements.these cements are color coordinated with the die spacers that are earlier used. If a natural colored tooth preparation exists, a translucent glass ionomer cement is indicated. In those cases the tooth structure or a metal core is present, the use of properly colored cement can be of good esthetic value. During cementation process, controlled, positive finger pressure should be used to seat the crown onto the prepared tooth. Excess cement is www.indiandentalacademy.com completely removed after the setting is complete.
  108. 108. Dicor shaded cements : www.indiandentalacademy.com
  109. 109. CERAPEARL : Introduction  Composition  Properties  Lab technique  www.indiandentalacademy.com
  110. 110. Introduction : Bioceram group have developed castable ceramic material (Hobo & Kyocera) which may be classified as CaO.P O .MgO.SiO glass ceramic.  Its crystalline structure is similar to that of enamel.  Biocompatible and is indicated for crowns and inlays.  2 www.indiandentalacademy.com 5 2
  111. 111. Composition : It is composed of CaO.P O .MgO.SiO plus traces of other elements.  CaO.P O - are the main ingredients and aid in glass formation. Essential to form hydroxyapatite crystals.  Mg O. CaO – decrease the viscosity.  SiO in combination with P O – form the matrix.  2 2 2 5 2 5 2 www.indiandentalacademy.com 5
  112. 112. Properties : Melts at 1460`C and can be cast. The casting has an amorphous microstructure and when it is reheated at 870`C for 1 hr, it forms crystalline oxyapatite. This apatite is clinically unstable and when exposed to moisture becomes crystalline hydrooxyapatite.  It has similar crystalline arrangement as enamel but the crystals are irregular providing superior mechanical strength. www.indiandentalacademy.com 
  113. 113. Lab Technique :      Casts are poured in type IV dental stone. After the die sealant,spacer and separator is applied, the wax up is done and sprue is attached. Invested in phosphate bonded investment in a silicone mold. After seraration of the silicone mold 60 min later, it is dried in an oven at temperature less than 100`C for 30 min. Then the temperature is raised to 500`C and then to 800`C for 30 min. www.indiandentalacademy.com
  114. 114. Lab Technique :     The investment mold is transferred to a high heat processor specially developed for this system. 8 – 10 gm of new Cerapearl is placed in the ceramic crucible and melted under vacuum at 1400`C and cast into a mold. Upon completion of casting the ring is transferred to crystallization mold. The process by which the casting is re-heated under appropriate conditions to develop the micro-crystals of apatite is termed crystallization. It makes the casting highly dense, strong, hard and www.indiandentalacademy.com chemically stable.
  115. 115. Lab Technique : The crystalization starts at 750`C then maintained for 15 min =, then reached at 870`C for 1 hr.  Translucency is similar to enamel.  External stains can also be given after cooling.  www.indiandentalacademy.com
  116. 116. Conventional POWDER SLURRY CERAMICS Vita Hi-Ceram* Optec HSP* Duceram LFC* Summary www.indiandentalacademy.com
  117. 117. VITA Hi-Ceram : Material properties  Laboratory procedures.  www.indiandentalacademy.com
  118. 118. Material : This is a aluminum oxide reinforced hard core porcelain.  Alumina reinforced core consists of 50% of aluminous crystals in a matrix of low fusing glass of matching thermal expansion.  Aluminous core porcelains are twice 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.  Higher melting points and greater stability.  For both anterior and posterior crowns, veneers.  www.indiandentalacademy.com
  121. 121. Clinical Procedures : Heavy chamfer or shoulder with internal angles rounded.  Regular impression procedures.  www.indiandentalacademy.com
  122. 122. Lab Procedures : Preparing the refractory die.  Hard core porcelain framework.  Crown buildup.  www.indiandentalacademy.com
  123. 123. Refractory Die :  Prepared die on the master model. www.indiandentalacademy.com
  124. 124.  To create the necessary space for the cement, apply Vita interspace varnish on to the die in 2 or 3 coatings. www.indiandentalacademy.com
  125. 125.  Apply a coat of thin insulating grease onto the duplicating base and ring, fix the die into the duplicating base and then place the ring into position. www.indiandentalacademy.com
  126. 126.  The hi-ceram duplicating paste consists of paste, liquid and catalyst, should be stirred quickly to obtain a homogenous mix. NOTE : first mix the paste and liquid together and then stir in the catalyst. www.indiandentalacademy.com
  127. 127.  To avoid any creating bubbles, fill the mold by pouring in the mixture in a fine stream. Working time approx 2 ½ min. Setting time – 20 – 30 min. www.indiandentalacademy.com
  128. 128.  Remove the die from the solidified cast of duplicating paste, and clean off the interspace varnish using the interspace varnish thinner. www.indiandentalacademy.com
  129. 129.  Mix the refractory HiCeram die material together with the die material liquid: for this, the liquid should be drawn into the dosing syringe to the 3 ml mark, for one 15 gm sachet of powder. *Stir the two materials for at least 1 www.indiandentalacademy.com min.
  130. 130.  On a vibrator without any bubbles fill the mold that is to be duplicated. While it is still soft, set a porcelain retaining pin into the die material, so as to later be able to safely fix the die onto a porcelain firing tray. www.indiandentalacademy.com
  131. 131.  The setting time for Hi-Ceram die material varies between 1 ½ - 2 hrs, depending on the room temperature. After no more than 6 hrs the die is removed from the mold. www.indiandentalacademy.com
  132. 132.  The die should be set on a porcelain tray for the refractory material to harden. Pre dry the die in the VITA Vacumat 200 /100 : with the furnace on standby(or prog A), lower the firing tray by manual control key and the place the die onto it. Only when the die material has turned light green the following prog is initiated ………. www.indiandentalacademy.com
  133. 133.  In the Vita Vacumat 200 : prog 5.5, end temp 1,000`C, pre-drying time 10 min, heating time 10 min, hold time 3 min. In the Vita Vacumat 100 : prog 5, end temp 1000`C, predrying time 10 min, heating time 10 min, hold time 3 min. www.indiandentalacademy.com
  134. 134. Constructing the hard core porcelain www.indiandentalacademy.com
  135. 135.  The Hi-Ceram hard core porcelain has to be applied and fired in three layers altogether : 1. The wash firing.; 2. Half of the required thickness with protuberances for later checking on the thickness of the porcelain.; 3. Full build-up as a smaller version of the crown it is to become. Minimum thickness0.5mm. www.indiandentalacademy.com
  136. 136.  Prior to each new application of Hi-Ceram hard core porcelain, the die should first be allowed to cool and then left to soak in water until no more bubbles are being emitted. www.indiandentalacademy.com
  137. 137.  Excess water should be soaked up. Next, Hi-Ceram hard core porcelain powder is mixed together with Vita modeling liquid “P” to a thin, creamy consistency. This is then applied as a thin wash onto the die. www.indiandentalacademy.com
  138. 138.  Pre dry the die on the lowered firing tray of the furnace until it has again turned light green, and then fire as follows, using a standby temperature of 600`C : www.indiandentalacademy.com
  139. 139. In the Vita vacumat 200: programme 6.6, end temperature 1170`C, pre-drying time 6 min, heating time 10 min, hold time 0 min, vacuum firing time 10 min.  In the Vita vacumat 100: programme 6, end temperature 1170`C, predrying time 6 min, heating time 10 min, hold time 0 min, vacuum firing time 10 www.indiandentalacademy.com min. 
  140. 140.  Soak the die in water again, and then apply the hard core porcelain for second firing. To make sure of having the correct thickness of HiCeram hard core porcelain, protuberances or points can be constructed for control purposes. The firing instructions are the same as for the 1st hard core porcelain www.indiandentalacademy.com firing.
  141. 141.  The fully built up hard core porcelain in its 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: Programme 6.7, end temperature 1170`C, predrying tome 6 min, heating up tome 6 min, hold time 3 min, vacuum firing time 10 min.  In the Vita vacumat 100: Programme 6, end temperature 1170`C, predrying time 6min, heating up tome 10 min, hold time 3 min, vacuum firing time 10 www.indiandentalacademy.com min. 
  143. 143. The thickness of hard core porcelain framework should not be less than 0.5 mm.  For additional stability, a collar in HiCeram hard core porcelain can be added palatally or lingually.  www.indiandentalacademy.com
  144. 144.  Just as with Vita VMK metal-ceramic porcelain, Hi-Ceram hard core porcelains can also be shaded individually using the Hi-Ceram COLOR hard-core porcelains, e.g. ti reinforce the shade from within in cases where the thickness of the dentin porcelain is thinner than normal. www.indiandentalacademy.com
  145. 145.  The refractory die should be blasted away using glass beads at a pressure of 1- 2 bar. www.indiandentalacademy.com
  146. 146.  The finished HiCeram hard core frame work on the stone die. Any areas of interface or feathered edges should be carefully ground down or removed using a fine-grained diamond. www.indiandentalacademy.com
  147. 147.  As the Hi-Ceram hard core framework has not been constructed on the model, any areas that are now found to have been built up too high or too thick can be corrected using a fie grained diamond. www.indiandentalacademy.com
  148. 148. The build up of the crown : www.indiandentalacademy.com
  149. 149.  The crown should be built up to its desired shape using Vitadur-N dentin porcelain, although to compensate firing shrinkage it must be built longer incisally. The cervix of the hard core framework can be coated before hand using Vitadur-N opacous porcelain. www.indiandentalacademy.com
  150. 150.  A little Vitadur-N opacous dentin can also be applied palatally, so that even in cases where there is a deeper than normal bite by the occluding teeth, any shining through of the HiCeram hard core porcelain will be completely avoided. www.indiandentalacademy.com
  151. 151.  To create the necessary space for the enamel porcelain, the dentin should have a crescent carved away incisally and for the smooth transition between the dentin and enamel, then also be smoothened using a flattened brush. www.indiandentalacademy.com
  152. 152.  For individual shading and characterizatio n, there are 5 Vitadur-N opacous dentin, 6 dentin effect, 2 enamel effect and 7 COLOR porcelains www.indiandentalacademy.com available.
  153. 153.  The shape of the crown is now built up in Vitadur-N enamel porcelain. It should be somewhat over dimensioned to compensate firing shrinkage. www.indiandentalacademy.com
  154. 154.  The crown is fired as follows: either by placing it onto a fibrous pad firing support (in which case raise the temperature by 10`C), or by wrapping a normal crown stand in the fibrous pad material and then placing the crown loosely onto it: www.indiandentalacademy.com
  155. 155. In the Vita vacumat 200: Programme 6.4, end temperature 960`C, predrying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min.  In the Vita vacumat : Programme 6, end temperature 960`C, predrying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min.  www.indiandentalacademy.com
  156. 156.  The fired Hi-Ceram crown should be ground all over in the normal way, using a diamond or a green silicon carbide bur. For corrections, clean without using any cleansing agent but with a clean brush under 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 to improve the accuracy of fit and esthetics of the cervical margin: the stone die should first be insulated using one drop thin bodied super glue. This sealing of the surface will prevent the die from soaking up any moisture from the porcelain. Next, to prevent to prevent the modeled porcelain from sticking to the die, the chamfer should be thinly coated with Hi-Ceram die release before applying the cervical porcelain. www.indiandentalacademy.com
  158. 158.  The cervical porcelain should be mixed with Vita modeling liquid, applied onto the cervical margin, condensed and then bottled. Excess cervical porcelains should then be removed using either a clean finger or a dry brush. www.indiandentalacademy.com
  159. 159.  Without being tilted, the crown should be removed and fired as …… www.indiandentalacademy.com
  160. 160. Cervical porcelain firing in the Vita vacumat 200 programme 6.8, end temperature 940`C, predrying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min. Cervical porcelain firing in the Vita vacumat 100 programme 6, end temperature 940`C, predrying time 6 min, heating up time 6 min, hold time 1 min, vacuum firing time 6 min. www.indiandentalacademy.com
  161. 161. Glaze firing :  Applying the Vitachrom ”L” glaze No. 725 allows the temperature for the glaze firing to be lowered, thereby guarantying that the cervical margins retain w its accurate fit.ww.indiandentalacademy.com
  162. 162. Glaze firing in the Vita vacumat 200: Programme 5.4, end temperature 920`C, predrying time 4 min, heating up time 3 min, hold time 1 min.  Glaze firing in the Vita vacumat 100: Programme 5, end temperature 920`C, predrying time 4 min, heating up time 3 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 Leucitereinforced feldspathic porcelain that is condensed and sintered like aluminous porcelain and traditional porcelain. Has greater strength than traditional feldspathic porcelains due to increased amount of leucite. The manufacturer disperses the leucite crystals in a glassy matrix by controlling their nucleation crystal growth during the initial production of the porcelain powder. www.indiandentalacademy.com
  166. 166.  Because of its increased strength, Optec HSP* does not require a core when used to fabricate all ceramic restorations, as is necessary with aluminous PJC’s. the body and incisal porcelains are pigmented to provide the desired shade and translucency. The leucite and glass components are fused together during the baking process (1020`C). The buildup and contouring of the crown is done on a special semi-permeable die material. It has a moderately opaque core compared with a metal or an aluminous porcelain core, it is more translucent than alumina-core crowns and glass infiltrated alumina core crowns. www.indiandentalacademy.com
  167. 167. Advantages: Lack of metal or opaque substructure.  Good translucency.  Moderate flexural strength.  No special laboratory equipments needed.  www.indiandentalacademy.com
  168. 168. Disadvantages: Potential marginal inaccuracy caused by porcelain sintering shrinkage.  Potential to fracture in posterior teeth. Leucite reinforced porcelain that is condensed and sintered shrinks when fired because of the volumetric decrease caused by sintering, and the fit of the crowns made from this ceramic is not as good as that of PFM crowns with metal margins.  www.indiandentalacademy.com
  169. 169. Duceram LFC: www.indiandentalacademy.com
  170. 170. Introduction:  The development of very low fusing ceramics(fusing temperature 660`C) meant that a simple and accurate technique for building up and firing all-ceramic restorations. www.indiandentalacademy.com
  171. 171. Method of Fabrication: Tooth preparation. Die preparation. Ceramic core. Ceramic buildup. www.indiandentalacademy.com
  172. 172. Tooth preparation: Preparation for a www.indiandentalacademy.com CJC with a peripheral shoulder.
  173. 173. Ceramic coping preparation : Refractory die.  Initial ceramic connector layer.  Ceramic core buildup.  www.indiandentalacademy.com
  174. 174. Ceramic connector: A fine layer of initial ceramic over the refractory die the refractory die (Ducera-lay) is fired at 980`C. This connector www.indiandentalacademy.com layer should be bright and even
  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 oxidewww.indiandentalacademy.com powder.
  180. 180. Prepared coping www.indiandentalacademy.com
  181. 181. Ceramic Buildup: The coping is replaced on the plaster cast. Lamination can the be completed using a low-fusing ceramic, which will be fired at 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: www.indiandentalacademy.com Lingual view (Courtesy : Marc Cristou)
  184. 184. Properties: Flexural strength – 110 Mpa.  Hardness is close to that of natural tooth due to absence of leucite.m  Opalescence of the natural tooth can be reproduced.  Fluorescence of LFC is very close to that of natural tooth.  www.indiandentalacademy.com
  185. 185. Fluorescence:  Comparison of fluorescence of natural teeth(green), Duceram LFC(blue), www.indiandentalacademy.com
  186. 186. Fluorescence: LFC (circle left); traditional ceramic material (circle www.indiandentalacademy.com right); natural tooth (middle).
  187. 187. Advantages: Excellent marginal adaptation.  Use of plaster master cast.  No special equipment required.  Allows for modification by repeated firings.  Abrasion rate close to that of natural tooth.  Good visual qualities, including best reproduction of opalescence of natural teeth.  www.indiandentalacademy.com
  188. 188. Indications: Laminate veneers.  Jacket crowns.  Inlays.  Onlays.  If high transparency ceramic is required.  www.indiandentalacademy.com
  189. 189. Contraindications: Masking grossly discolored tooth.  When aiming for high fracture resistance.  All other common contraindications.  www.indiandentalacademy.com
  190. 190. MACHINABLE CERAMICS Summary www.indiandentalacademy.com
  191. 191. Classification: M a c h in a b l e C e r a m ic s C A D -C A M C e r a m ic s a ceramic restoration fabricated by use of a computer aided design computer aided milling C o p y -M il l e d C e r a m ic s 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. www.indiandentalacademy.com
  192. 192. CAD – CAM Ceramics CEREC CEREC 2 CEREC 3 CEREC SCAN CEREC InLAB PROCERA www.indiandentalacademy.com
  193. 193. Introduction: The introduction of Computer-Aided-Designing & Computer-Aided-Milling(CAD-CAM) systems to prosthetic dentistry represents a major technological breakthrough. It is now possible to design and fabricate ceramic restorations at a single appointment, as opposed to the traditional method of making impressions, fabricating of provisional prosthesis, and using a lab for development of the restoration. These restorations save dentists and patients time, provide an esthetic restoration, and have the potential for wear www.indiandentalacademy.com resistance.
  194. 194. History: Optical scanning and computer generation of restorations were attempted as early as 1971 (Altschuler, 1971/1973) but the continued improvement in technology, a number of systems are currently being investigated at this time……… Duret & Preston 1981 Brendestini et al 1985 Rekow 1987 Williams 1987 Duret et al 1988 www.indiandentalacademy.com
  195. 195. Objectives: To eliminate traditional impression methods.  To design, the future restoration in accordance with the preparation, the function and natural anatomy,e.g. with the use of computer.  To produce the restoration chair side.  To improve the restoration qualities, mechanical resistance, marginal fit, surface www.indiandentalacademy.com quality and esthetics. 
  196. 196. Types of CAD – CAM Devices: DIRECT: Fully integrated CAD – CAM devices for chair side restorative approach. CAD & CAM stations are located at the dental office.  INDIRECT: System that consists of several modules with at least, distinctive CAD & CAM stations.  www.indiandentalacademy.com
  197. 197. Indirect Method: The optical impression is taken in the dental office, where CAD is done; data are transmitted to CAM station for restoration fabrication.  The optical impression is taken in the dental office; collected information is then transmitted to a central station, where CAD & CAM modules operate.  www.indiandentalacademy.com
  198. 198. Indirect Method:       Because of the overall dimensions and the cost of the indirect CAD – CAM devices, they are usually not located in the dental office, but more likely in a central laboratory where data is collected from different treatment places. E.g. …. Duret system*. Procera system* (Noble Bio-Care). Cicero system* (Elephant Industries). President system* (DCS Dental). CEREC SCAN* & CEREC InLAB* (Sirona Dental company) www.indiandentalacademy.com
  199. 199. Direct CAD - CAM CEREC, CEREC 2, www.indiandentalacademy.com CEREC 3
  200. 200. C E R E C www.indiandentalacademy.com S Y S T E
  201. 201. CEREC Systems: The CEREC system, developed in Zurich, Switzerland has been marketed for several years with the improvised CEREC 2 introduced in mid 1990’s, upgraded to CEREC 3 in the year 2000. www.indiandentalacademy.com
  202. 202. The equipment consists of a computer integrated imaging and milling system, with the restorations designed on the computer screen www.indiandentalacademy.com
  203. 203. Materials used with CEREC’s: Dicor MGC*(Machinable Glass Ceramic)(Dentsply): This is a mica based machinable glass ceramic containing 70% vol of crystalline phase. The unique “House of Cards” microstructure found in Dicor MGC is due to the inter locking of the small platelet shaped micacrystals with an average size of 1 – 2 microns. This particular structure leads to multiple crack deflections and ensures greater strength than leucite containing www.indiandentalacademy.com ceramics. 
  204. 204. Materials used with CEREC’s: Vita Mark II (Vident): These contain sanidine (KALSi O ) as a major crystalline phase within a glassy matrix.  3 www.indiandentalacademy.com 8
  205. 205. Materials used with CEREC’s: ProCad (Ivoclar): Like Ivoclar's popular Empress™ material, ProCAD is reinforced with tiny leucite particles, and has been referred to 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): These are third generation blanks from Vita.  The Spinell MgAl O .  The Alumina Al O .  The Zirconia ZrO  2 2 4 3 2. www.indiandentalacademy.com
  207. 207. The Spinell Blanks:  The fine chemical and mechanical properties of the highly pure synthetic spinell are used with the aim to obtain an esthetically appealing, translucent ceramic structures. www.indiandentalacademy.com
  208. 208. The Alumina Blanks:  These uses the advantages of the synthetic corundum that is prepared from bauxite prepared in electric melting furnace. The result is a dental all ceramic system with convincing mechanical properties. www.indiandentalacademy.com
  209. 209. The Zirconia Blanks:  This combines the fracture toughness of the meta-stable tetragonal zirconium oxide which is also referred to as “ceramic steel”. www.indiandentalacademy.com
  210. 210. Clinical Procedure: Preparation design. Optical impression. Computer generated restoration design. Milling procedure. www.indiandentalacademy.com
  211. 211. Tooth Preparation Design:  Tooth preparation follows typical allceramic guidelines. Chamfer Shoulder www.indiandentalacademy.com
  212. 212. Optical impression     The surface of the prepared teeth often lacks sufficient reflectivity or it may have facets that give an uneven glaze to the computer screen. It is therefore necessary to coat the preparation with a special powder (titanium dioxide) that has proper light reflectivity. Rubber dam must be placed to prevent fogging of the camera lens and to aid in isolation. Cerec is the first system that makes intra-oral scanned impressions a reality. This is done through a small hand held camera. The camera, which resembles a wand, illuminates the prepared tooth and the 2 adjacent teeth with its light source and processes the image with the 3-D measuring www.indiandentalacademy.com
  213. 213.  The operator actually feels the wand vibrate as the camera oscillates to scan the teeth at slightly different angles. The Cerec software then blends these images to create its 3D map of the topography. This optical scanning system could well be the precursor of much expanded use of optical scanning in dentistry. However, the inability to scan sub gingival margin areas and some interproximal areas must (but probably will) be overcome before optical scanning becomes mainstream. www.indiandentalacademy.com
  214. 214. Optical impression: www.indiandentalacademy.com
  215. 215. www.indiandentalacademy.com
  216. 216. Design Phase:  With the help of the CEREC 3 Software we can choose the basis software for the designing of inlays/onlay s or crowns or veneers. www.indiandentalacademy.com
  217. 217. Shaping of the surfaces: 1. 2. 3. Function Correlation Extrapolation www.indiandentalacademy.com
  218. 218. Function: This design programme takes design of the antagonist.  Correlation This design programme allows to copy intact occlusal surfaces.  Extrapolation This programme calculates the dimensions of the restoration with reference to a tooth database and as well as with the adjacent teeth. www.indiandentalacademy.com 
  219. 219.  With using all the programmes the operator can digitally design the restoration by moving the cursor along the boundaries. www.indiandentalacademy.com
  220. 220. The procedure can be stopped at any time and can override the computer and allow the operator to correct, the digitally generated features.  Once the restoration has been designed, the computer develops a 3-D model on the screen.  All the information is stored.  The design phase usually takes 2 – 8 min.  www.indiandentalacademy.com
  221. 221. Milling Phase: After all the data has been supplied, the computer selects the size of the ceramic block to be used in the milling process.  There are wide range :  Composition.  Shade.  Size.  www.indiandentalacademy.com
  222. 222. These blanks are factory fabricated and thus are more homogenous and less porous than materials that are made in the lab.  These materials also produce “chameleon effect”.  The material is mounted on the metal stud, which allows it to be inserted in to the milling hub.  Once the material is inserted. The window 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 with regard to the longevity of adhesively bonded restorations, but the amount of manual corrections to make the restoration fit was too high. Hence it was important to improve the accuracy and fit.  Diamond disc was only tool for cutting. Hence it was important to incorporate an additional diamond cutting instrument.  Dentist’s required intensive training for CAD. So it was important to achieve easy, and user friendly software for CAD. www.indiandentalacademy.com 
  225. 225. Improvisation’s in CEREC 2:    The new camera provides more date with greater accuracy with a resolution from 25 microns to 50 microns. The new technology has an on board 32 bit processor which increases the resolution of the monitor and a a added color screen. The mew machine has two cutting heads instead 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 which uses windows as operating system.  Two compatible cameras availableSIROCAM 2 / SIDEXIS.  Precise restorations.  Extra-oral and intra-oral measuring.  Rapid production.  The imaging unit and the milling unit can be linked via cable, IRD port, networked. www.indiandentalacademy.com  Supported with online help and design. 
  227. 227. Advantages of CEREC System: One or two appointments.  Optical impression, max time required is 5 sec.  Wear hardness similar to enamel.  Less fracture due to single homogenous block.  Excellent polish.  Improved esthetics.  Time saving.  Good occlusal morphology in relation to www.indiandentalacademy.com antagonist. 
  228. 228. Indirect CAD - CAM CEREC* SCAN, CEREC* In-LAB PROCERA* SYSTEM www.indiandentalacademy.com
  229. 229. CEREC SCAN: Tooth preparation.  Conventional impressions.  Die preparation.  Controlled by one of the practice pc’s.  Can be upgrade to CEREC 3.  Works upon CEREC 3 software.  Intra oral scanning device is not present.  www.indiandentalacademy.com
  230. 230. CEREC SCAN (inclusive of both scanning and milling device)with lap top(imaging device). www.indiandentalacademy.com
  231. 231.  www.indiandentalacademy.com Scanning device.
  232. 232. CEREC In-LAB: www.indiandentalacademy.com
  233. 233. Controlled Scanning: Consists of a compact milling unit with a in-built scanner.  This consists of non contact scanning for utmost precision.  Software runs on Windows* 98.  www.indiandentalacademy.com
  234. 234. Scanning device www.indiandentalacademy.com
  235. 235. Controlled Design: Offers a complete spectrum of design options for crowns and bridge framework.  All relevant parameters can be adjusted individually …for example, the occlusal and radial wall thickness and the cross sectional area of the bridge connectors.  This system gives a visual thickness if operator falls short of the minimum material specific wall thickness.  Thus the operator exerts complete control over the design process ay all times.  www.indiandentalacademy.com
  236. 236. Constant monitoring of connector cross section. www.indiandentalacademy.com Controlled shaping of spacer. Pontic shaping Overall design.
  237. 237. Controlled milling: Prior to each milling jib CEREC In-Lab automatically checks the dimensional accuracy of the milling tools. The integrated soft touch control monitors the calibration of the tools throughout the milling process and compensates for any 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 step Coping Scanning (automatic) Approx. 10 min Approx. 20min Design Approx. 2 min Milling (automatic) Approx. 15 min Approx. 50 min www.indiandentalacademy.com Bridge framework Approx. 6 min
  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. Matts Andersson for Nobel Biocare embraces the concept of computer assisted design and computer assisted machining and is a method that appears to satisfy these needs. With the Procera® System the technician can design a coping for a full crown restoration controlling the thickness, emergence profile, and precision of fit. The design data can be forwarded to the manufacturing facility and the coping produced in various materials. www.indiandentalacademy.com
  245. 245. Material:  The Procera® AllCeram Crown involves a densely sintered high-purity alumina core combined with a low fusing veneering porcelain fabricated by the pressed powder technology. www.indiandentalacademy.com
  246. 246. Advantages: The finished crown has a translucense very similar to the natural tooth.  Aluminum oxide is a highly biocompatible material, comparable to titanium.  The coping is made of dense-sintered aluminum oxide to maximize strength.  The Procera® technique guarantees high precision for optimal fit.  www.indiandentalacademy.com
  247. 247. Fabrication Procedures: Tooth preparation.  Die preparation.  Scanning.  Data transfer.  Central milling.  Application of conventional porcelains.  www.indiandentalacademy.com
  248. 248. Tooth preparation:  Since the scanner's tip is rounded, the finish line should be a chamfer placed sub-gingivally at 0.5 mm to 0.7mm. A rounded shoulder may be also an appropriate design. www.indiandentalacademy.com
  249. 249. Tooth preparation:  A relatively level topography should be accomplished during preparation of the occlusal surface of posterior dentition. www.indiandentalacademy.com
  250. 250. Tooth preparation:  The occlusal surface of a posterior tooth is shaped, eliminating undercuts and sharp edges. Steep slopes and sharp groves are avoided to enable the scanner to recognize all of the information through the tip. www.indiandentalacademy.com
  251. 251. Tooth preparation: For anterior dentition, preparation of the lingual surface requires shaping with diamond bur to eliminate debris.  www.indiandentalacademy.com
  252. 252. Tooth preparation:  Fine finish lines on the prepared tooth enable the scanner to precisely register all aspects of the die models, directly affecting the marginal fit of the definitive restoration. www.indiandentalacademy.com
  253. 253. Tooth preparation: Preparation depths should be between 1.0 mm and 1.5 mm, while the occlusal reduction should be at least 2.0 mm.  www.indiandentalacademy.com
  254. 254. Lab Procedures: The cast is made in the conventional way, the die is ditched to make the margin easier to identify during scanning.  The die is