Porcelain and its applications


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Porcelain and its applications

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. CONTENTS: 1. introduction 2. indications 3. contra indications 4. fabrication of porcelain 5. conventional method 6. internal characterization 7. glazing and surface characterization 8. different systems and their method of porcelain build up 9. recent advances in porcelain 10. conclusion 11. references www.indiandentalacademy.com
  3. 3. Denture teeth & Dentures -Duchateau 1774 Ceramic paintings and Vases www.indiandentalacademy.com
  4. 4. 1887 – CH. Land (platinum foil technique) 1962 PFM – Weinstein 1965 McLean and Hughes aluminium core porcelain 1957 Vines and Sommelman – Vaccum firing 1940 with advent of acrylics PJC lost popularity. www.indiandentalacademy.com
  5. 5.  1887 – CH. Land gave porcelain jacket crown  1965 - McLean and hughes -aluminous core porcelain  1980 - In ceram-slip casting, castable ceramics  Latest 1990’s - machinable ceramics(CADCAM) Evolution of all ceramic restorations : www.indiandentalacademy.com
  6. 6.  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 esthetics, translucency, light transmission and biocompatibility result can be achieved with ALL CERAMICS’s. www.indiandentalacademy.com
  7. 7. 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
  8. 8.  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 for the buccal shearing cusps. www.indiandentalacademy.com
  9. 9. In cases of parafunctional activity of the mandible,e.g. bruxism. Or any deflective malocclusions remaining uncorrected. Where occlusal clearance 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. www.indiandentalacademy.com
  10. 10. Porcelain modeling liquid Paper napkin Glass slab or palette Tissues or gauze squares Two cups of distilled water Glass spatula Serrated instrument Porcelain tweezers or hemostat Ceramist's sable brushes (no. 2,4, and 6) and whipping brush Razor blade or modeling knife Cyanoacrylate resin Colored pencil or felt marker Articulating tape Ceramic-bound stones Flexible thin diamond disk (about 20 mm in diameter) www.indiandentalacademy.com
  11. 11. Step-by-step Procedure. After the metal substructure has been oxidized, it must be inspected carefully. An uninterrupted oxide layer should cover the entire surface to be veneered www.indiandentalacademy.com
  12. 12. When selecting the opaque bottle, shake it to mix the powder thoroughly. Then place it on the bench to allow the smaller pigment particles to settle. Dispense a small amount of powder on a glass slab or palette. Add some modeling liquid and mix it with the spatula. Metal instruments should not be used Moisten the substructure with some of the liquid and pick up a small bead of opaque With the tip. of the brush or spatula. Apply it to the coping, which should be held with the porcelain tweezers. www.indiandentalacademy.com
  13. 13. Use light vibration to spread the material thinly and evenly. Excess moisture that comes to the surface can be blotted off with a clean tissue. Apply a second bead on top of the first and spread it in a similar manner. To minimize the entrapment of air when the two masses met, www.indiandentalacademy.com
  14. 14. Once the veneering surface is covered, add more material to a dry base. Wetting the initial application before adding more porcelain may be necessary. When the entire veneering surface has been covered, remove any excess material from other surfaces with the side of a slightly moistened brush www.indiandentalacademy.com
  15. 15. After removing any excess porcelain, carefully inspect the inside of the restoration for porcelain particles www.indiandentalacademy.com
  16. 16. Before firing, inspect the opaque application to see that it satisfies the following criteria 1. The entire veneering surface is “evenly covered with a smooth layer that masks the color of the metal” 2. There is “no excess” anywhere on the veneering surface 3. There is no “opaque on any external surface” adjacent to the veneer 4. There is no “opaque on the internal aspect” of the substructure. www.indiandentalacademy.com
  17. 17. If these criteria have been met, the coping is transferred to a sagger tray and placed near the open muffle of the porcelain furnace for several minutes. This allows moisture to evaporate. www.indiandentalacademy.com
  18. 18. After the first firing, remove the work from the muffle and set it aside to cool to room temperature When the veneer is removed from the furnace, it will appear yellow; however, when it has cooled, the more representative “matte - white” color is apparent. Fixed opaque should have an eggshell appearance www.indiandentalacademy.com
  19. 19. . After firing. check that the opaque application meets the following criteria: 1. Relatively “smooth even layer” masking the color of the framework 2. Eggshell appearance 3. “No excess” any external or internal surface of the restoration (which would prevent it from seating fully on the die) www.indiandentalacademy.com
  20. 20. The use of several porcelains in one restoration is common. Body porcelains with increased opacity may be used where less translucency is required (e.g., gingival area of the pontic, incisal mamelons) to mimic existing anatomic features of adjacent natural teeth. www.indiandentalacademy.com
  21. 21. Dispense the neck, body, incisal and other powders on a glass slab or palette. Mix the powders with the recommended liquid or distilled water. The moisture content for these powders should be the same as for opaque porcelain Wet the previously fired opaque layer with a small amount of the liquid and place bead of neck powder on the cervical portion of the veneering surface www.indiandentalacademy.com
  22. 22. A tissue is held close for removal of excess surface moisture. During the entire buildup procedure the facial surface should not be blotted with tissue because the smaller pigment particles might be removed. www.indiandentalacademy.com
  23. 23. After placing the neck powered and sculpting it build the veneer to anatomic contour with body porcelain. Use the adjacent and opposing teeth as a guide. Where contact is anticipated between the wet buildup and stone cast, the cast can be coated with a small amount of Cyanoacrylate resin, immediately blown into a thin layer. This will seal the surface and prevent the absorption of moisture from the buildup www.indiandentalacademy.com
  24. 24. To compensate for the firing shrinkage that results when the particles fuse, slightly overbuild the porcelain. A typical metal – ceramic anterior crown will shrink 0.6mm at the incisal edge and 0.5mm midfacially When the body buildup is completed, assess it for proper mesiodistal, faciolingual and incisogingival contour. make a cut back for more translucent incisal powder. www.indiandentalacademy.com
  25. 25. Apply the incisal powder in the same manner and overbuild the restoration as described for body porcelain Mark the opposing teeth on the stone cast with a, red or green felt tip marker. These markings will not be absorbed if the cast first has been coated with Cyanoacrylate resin www.indiandentalacademy.com
  26. 26. Only red or green dyes burn off without leaving a residue, should be used for these markings. Blue or black pigments usually contain metal oxides or carbon, which after firing can discolor the porcelain Moisten the proximal contact areas immediately before removing the completed buildup from the cast The internal aspect of the coping should be re-inspected www.indiandentalacademy.com
  27. 27. . Place the restoration on a sagger tray close to the open muffle at the drying temperature recommended by the manufacturer. A drying time of 6 to 10 minutes is usually sufficient If restoration is fired prematurely the residual moisture in the buildup may generate steam, and the accompanying Vapour pressure will cause the buildup to explode. When the bake is completed, the work should cool to room temperature before further handling www.indiandentalacademy.com
  28. 28. cooling rates may lead to residual stresses that will eventually result in porcelain fracture during function Be especially critical when evaluating the first bake. If the surface is fissured, grind the porcelain before adding any more. The shape of the restoration should conform to the standards set by dental anatomy and the predetermined occlusal scheme for the patient www.indiandentalacademy.com
  29. 29. Remove all excess material with ceramic bound stones. A flexible diamond disk is imperative for proper shaping of the embrasure spaces. To extend its life, the disk should be kept moist When the restoration has been contoured and all necessary areas reduced, certain portions will probably require a second application of porcelain Before second corrective bake, clean the restoration ultrasonically to remove any grinding debris www.indiandentalacademy.com
  30. 30. Place the second body and incisal layers correctly on the slightly moistened low bisque bake However, multiple firing will lead to devitrification of the porcelain, with a loss of translucency and a decrease in the restoration’s fracture resistance www.indiandentalacademy.com
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  36. 36. Internal or intrinsic characterization or staining may be accomplished by incorporating colored pigments in the opaque, body, or incisal porcelain powders. These pigments are ceramic in nature and have physical properties similar to the porcelain powders If the internal characterization is not achieved properly then the porcelain must be stripped from the substructure www.indiandentalacademy.com
  37. 37. The appearance of the finished restoration depends on its color, shade, and characterizing dental porcelain to mimic the appearance of natural teeth The appearance of restorations can be influenced considerably through the selected use of optical illusion. The human eye is capable of discerning difference in height and width, but its depth perception is far less developed:. The perceived size of a tooth depends on the reflection of its line angles and the relative position and spacing of these reflections www.indiandentalacademy.com
  38. 38. The surface texture of a metal ceramic rest should resemble that of the adjacent teeth, including selected characterizing irregularities that exist on those teeth. Several rules of light reflection must be remembered when attempting to accomplish this 1. A flat surface will reflect primarily parallel bundles 2. A convex surface will result in divergence fleeted light, whereas a concave surface will create a convergent light bundle 3. Sharp transitions (e.g., geometric line angles) will result in line reflections, but smooth, gentle flowing curved surfaces will create a reflection pattern with greater surface area. www.indiandentalacademy.com
  39. 39. Care must also be taken not to "overcharacterised” which would draw attention to the restoration and reveal that it is artificial. www.indiandentalacademy.com
  40. 40. Metal ceramic restorations are glazed to create a shiny surface similar to that of natural teeth. The glazing cycle can be performed concurrently with any necessary surface characterization In autoglazing the contoured bisque is raised to its fusion temperature and maintained for a time before cooling. A pyroplastic surface flow occurs, and a vitreous layer or surface glaze is formed. www.indiandentalacademy.com
  41. 41. www.indiandentalacademy.com
  42. 42. Apply the glaze material in the usual manner using a brush. Make sure not to apply the glaze material either too thick or too thin layers. www.indiandentalacademy.com
  43. 43. www.indiandentalacademy.com
  44. 44. By contrast in overglazing a separate mix of powder liquid is applied to the surface of a shaped restoration, and the restoration is subsequently fired. The firing procedure is similar to that for autoglazing, www.indiandentalacademy.com
  45. 45. Surface stains are highly pigmented glazes which can be mixed with glycerin and water When it turns white and chalky, any excess that may have been accidentally applied to the metal surface is removed, .and the restoration is fired www.indiandentalacademy.com
  46. 46. Before starting the staining procedure, make sure the restoration is free of dirt and grease. A roughened surface is favorable. www.indiandentalacademy.com
  47. 47. Apply the stains as thinly as possible, avoid pooling and too thick layers. www.indiandentalacademy.com
  48. 48. Many patients object to the grayness at the margin associated with metal-ceramic restorations. However, hiding the margin subgingivally may not be possible. If esthetics is of prime importance, a collarless metal-ceramic crown should be considered. www.indiandentalacademy.com
  49. 49. The collarless crown's most obvious advantage is the esthetic improvement it offers compared to the conventional metal- ceramic restoration Plaque removal also is easier when gingival tissues are in contact with vacuum-fired glazed porcelain than when they are contacting highly polished gold. . Therefore, porcelain would appear to be the material of choice for restorations that will be in contact with gingival tissues www.indiandentalacademy.com
  50. 50. Due to careless handling, fracture of the unsupported margin is sometimes a problem during try-in or cementation In addition, the collarless metal-ceramic restoration is more time consuming and therefore more costly to make www.indiandentalacademy.com
  51. 51. A porcelain labial margin is indicated when a conventional metal- ceramic restoration will not create the desired esthetic result It is contraindication when an extremely smooth,1 mm-wide shoulder cannot be prepared in the area of the ceramic veneer. the limitations of the operator and technical auxiliaries should be carefully and objectively assessed before the dentist and patient submit themselves to a fixed prosthesis consisting multiple collarless retainers www.indiandentalacademy.com
  52. 52. Platinum foil matrix Technique: Step-by-step procedure 1.Wax the metal substructure and cast it in the conventional manner. 2.To prevent the foil from becoming distorted on removal, block out undercuts apical to the margin. Modeling compound is suitable for the shoulder of this step. www.indiandentalacademy.com
  53. 53. 3.Burnish a small piece of platinum foil onto the facial portion of the die where the porcelain margin is to be placed, and extend it a few millimeters onto the axial wall of the preparation. 4. After burnishing, trim it so there is a 2-to3-mn “skirt” lying cervical to the margin www.indiandentalacademy.com
  54. 54. Remove the casting from the die, together with the foil, and position the assembly between the electrodes of an orthodontic spot welder. The foil can now be welded to the framework, which should be done as close as possible to the edge of the metal. Four or five welds are usually adequate to attach the foil to the substructure. The restoration is then fabricated in a conventional manner, www.indiandentalacademy.com
  55. 55. 7. When the coronal portion has been shaped to a satisfactory contour, burnish the foil and fill in the ditched portion with cervical porcelain. 8. When the desired contour has been obtained after firing, time the platinum skirt. 9. Leave the platinum that covers the shoulder portion of the preparation and seat the crown on the original die for final cervical contouring www.indiandentalacademy.com
  56. 56. 10. When satisfied with characterization, staining, and glazing, remove the foil and cement the restoration after verifying the fit one more time. www.indiandentalacademy.com
  57. 57. www.indiandentalacademy.com
  58. 58. Because this technique is less time consuming and easier to perform then the platinum foil technique, it is more widely used. The substructure is fabricated in the same manner, but the die is coated with a layer of Cyanoacrylate resin, and the porcelain is condensed directly onto it Separation is achieved with a porcelain release agent www.indiandentalacademy.com
  59. 59. The principal difficulty associated with the Cyanoacrylate technique occurs during the staining and glazing firing. because the porcelain is not supported as in the platinum foil technique , the margin tends to round off slightly; therefore ,special shoulder powders are needed. www.indiandentalacademy.com
  60. 60. Step-by-step procedure: 1.Apply Cyanoacrylate resin to the labial margin area of the die. This acts as a sealant of the porous stone. Compressed air should be used to minimize the thickness of the film. 2. Apply porcelain release agent to the shoulder of the prepared die. 3.Seat the opaqued casting on the die. www.indiandentalacademy.com
  61. 61. 4. Mix shoulder porcelain and apply it directly to die and the opaque porcelain. 5. After the first firing of the shoulder porcelain ,reseat the crown on the die. At this time, the restoration should examined for margin discrepancies. www.indiandentalacademy.com
  62. 62. 6. Reduplicate the die, reseat the crown, and apply a thinner mix of shoulder powder to the margin 7. When the firing is completed, use a water-soluble marking agent to detect premature contacts. The marking agent is applied to the shoulder, and the restoration is then gently tried on the die. The markings will be visible on the porcelain and the inner aspect of the casting. www.indiandentalacademy.com
  63. 63. 8. Adjust any areas of contact of the restoration and proceed with the conventional buildup of body and incisal porcelains, followed by glazing of the final restoration. www.indiandentalacademy.com
  64. 64. Step-by step procedure: 1. After coating the substructure with opaque porcelain, lubricate the die with a porcelain release agent. 2. Apply the porcelain- wax mixture to the cervical shoulder . use an electric waxing instrument to flow it into the proper areas. 3. with a conventional wax-carving instrument, shape the material and blend it into the opaque www.indiandentalacademy.com
  65. 65. 4.A second application will be needed. Using the electric waxing instrument, keep the mixture liquid long enough so that capillary action can draw it into the marginal discrepancies The restoration is completed in the conventional manner. www.indiandentalacademy.com
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  67. 67. The high strength ceramic core was first introduced to dentistry by Mclean and Hughes in 1965. they advocated using aluminous porcelain, which is composed of aluminum oxide (alumina) crystals dispersed in a glassy matrix The technique devised by Mclean used an opaque inner core containing 50% by weight alumina for high strength www.indiandentalacademy.com
  68. 68. High strength core frameworks for all ceramic restorations can be produced with a slip casting procedure such as the In-cream. Slip casting is a traditional technique in the ceramic industry and is used to make sanitary ware The starting media in slip-casting is a slip that is an aqueous suspension of fine alumina in water with dispersing agents. The slip is applied on to a porous refractory die, which absorbs the water from the slip and leads to the condensation of the slip on the die. The piece is then fired at high temperature(11500 C). www.indiandentalacademy.com
  69. 69. Weigh out exactly 38 g of VITA In-Ceram alumina powder. www.indiandentalacademy.com
  70. 70. Start to apply the slip in the area of the pontic. Build up to half of the height of the pontic. Then coat the abutment dies fully and connect them to the pontic.www.indiandentalacademy.com
  71. 71. ! Proceed rapidly when building up the remaining slip. ! Do not interrupt this process, so that drying out of layers that have already been built up is prevented (onion-skin effect).www.indiandentalacademy.com
  72. 72. Carefully expose the preparation margin with a scalpel until the marking can be seen. www.indiandentalacademy.com
  73. 73. www.indiandentalacademy.com
  74. 74. 1965 Mc lean and Hughes 40 t0 50 wt% of Al2O3 Flexural strength 131 Mpa Platinum foil technique ALUMINOUS CORE PORCELAIN Finished CoresMaster model with dies Platinum foil adapted to die (Hi-Ceram) www.indiandentalacademy.com
  75. 75. Unsintered CrownsDentin Ceramic additions Finished Crowns on dies Post-Cementation www.indiandentalacademy.com
  76. 76. Al2O3 slip Glass infiltration Vita Inceramat3 Giordono 1995 : Al2O3 Core glass infiltrated Ceramic > Strength than Hi- Ceram, Di-Cor & Feldspathic Porcelain Vaccumat 4000 Premium www.indiandentalacademy.com
  77. 77. Duplication In-Ceram refractory dies In-Ceram application Al2O3 slip vita inceramat Working model Glass infiltration 4hrsShrinkage of www.indiandentalacademy.com
  78. 78. Application of body and incisal porcelain Postoperative veiw of In-Ceram crowns Finished In- Ceram copings (Air abraded) Finished crowns Preoperative veiw Probster et al : Strength of In-Ceram > IPS Empress < PFM www.indiandentalacademy.com
  79. 79. Fabrication Procedure : 1. Duplicate the working die with an elastomeric impression material and pour it with the special refractory die material 2. Mix the appropriate shade of alumina slip with ultrasonic agitation, place the mixture under a vacuum, brush apply it to the-plaster die and shape it with a blade, trimming back to the margins carefully www.indiandentalacademy.com
  80. 80. 3. The slip is fired in a special furnace initially through a prolonged drying cycle to 120°. C (248° F) that dries the die material, which shrinks away from the core. Then the alumina is fired at 1120° C (2048° F) the resulting core is porous and weak at this stage but can be carefully transferred to the master die after the die spacer is removed. The relatively low sintering shrinkage (about 0.3%) is compensated for by an expansion of the refractory material. www.indiandentalacademy.com
  81. 81. 4. Paint a thick coat of the appropriate shade of glass mixture on to the surface of the core and fire at 1100°C (2012°F) As the glass melts. 5. Remove excess glass from the core by grinding and airborne particle abrasion. Body and incisal porcelain is applied to the core in manner similar to that for metal ceramic crowns. 6. After moistening the core, mix the powder with modeling liquid and apply increments with a brush. www.indiandentalacademy.com
  82. 82. 7. Remove moisture with a paper tissue held against lingual surface. The capillary action will condense the porcelain particles slight vibration brings further moisture to the surface before the next increment is added. To prevent voids from forming between increments always add to a moist surface. 8. When the crown has the correct shape cut it back to allow room for incisal porcelain www.indiandentalacademy.com
  83. 83. 9. Apply incisal porcelain, overbuilding the incisal edge by 1 to 1.5 mm to allow for firing shrinkage. 10. Lightly condense the buildup with a large whipping brush. Absorb excess moisture with a tissue. 11. Remove the crown from the working cast and add material inter approximately to allow for shrinkage. 12. Dry the crown and fire it. www.indiandentalacademy.com
  84. 84. Leucite based: Hot pressed ceramics are becoming increasingly popular in dentistry. The restorations are waxed, invested, and pressed in Most hot pressed materials contain leucite as major crystalline phase, dispersed in a glassy matrix www.indiandentalacademy.com
  85. 85. Empress 2 ingots www.indiandentalacademy.com
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  88. 88. The ingot support and the aluminum oxide plunger is placed in the cold furnace. www.indiandentalacademy.com
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  90. 90. After selecting the exact press parameters, Place the investment ring with the ingot, in the press furnace and start the process by closing the head. www.indiandentalacademy.com
  91. 91. The press cycle runs automatically. A beep sound indicates the end of the press cycle. www.indiandentalacademy.com
  92. 92. Mark the length of the plunger on the cooled investment ring. www.indiandentalacademy.com
  93. 93. Separate the investment ring using a separating disc. This predetermined breaking point enables reliable separation of the ingot and the ceramic material. www.indiandentalacademy.com
  94. 94. Break the investment ring at the predetermined breaking point using a plaster knife. www.indiandentalacademy.com
  95. 95. For fine divestment, only 2 bar (30 psi) pressure is applied. www.indiandentalacademy.com
  96. 96. LEUCITE REINFORCED IPS EMPRESS Pre cerammed Ingots Processing : www.indiandentalacademy.com
  97. 97. Wax pattern Ceramic ingot & Al plunger Investing Pressing under vaccum 11500C Sprue removal Burn out 8500 C 26 min hold www.indiandentalacademy.com
  98. 98. The crystal size varies from 3 to 10 nm and the leucite content varies from about 50% by volume depending on the material Ceramic ingots are pressed at high temperature from 9000 C to 11650 C [16500 F to 21300 F] depending on the material into a refractor mold made by the lost-wax technique. www.indiandentalacademy.com
  99. 99. Two finishing techniques can be used: a characterization technique (surface stain only) and a layering technique, involving the application of a veneering porcelain the currently available leucite-containing materials for pressing are IPS Empress, optimal Pressable ceramic and two lower fusing materials, Cerpress and Finesse. www.indiandentalacademy.com
  100. 100. Lithium Silicate based. IPS Empress 2 is recently introduced hot-pressed ceramic. The major crysta1line phase of the core material is a lithium disilicate. The material is pressed at 9200 C (1690 F) and layered with a glass containing some dispersed apatite crystals. application for anterior three unit fixed partial dentures. www.indiandentalacademy.com
  101. 101. 1. Wax the restoration to final contour, sprue, and. 2. Heat the investment to 8000 C to burn out the wax pattern. 3. Insert a ceramic ingot of the approximate shade and alumina plunger in the special pressing furnace. 4. After heating to 11500 C, the softened ceramic is slowly pressed into the mold under vacuum www.indiandentalacademy.com
  102. 102. 5. After pressing recover the restoration from the investment by airborne particle abrasion, remove the Sprue , and refit it to the die. Esthetics can be enhanced by applying an enamel layer of matching porcelain or by adding surface characterization. The procedure for an FPD is similar. www.indiandentalacademy.com
  103. 103. The evolution of CAD /CAM systems for the production of machined inlays, onlays, veeners crowns led to the development of a new generation of ceramics that are machinable. www.indiandentalacademy.com
  104. 104. CEREC SYSTEMS PROCERA SYSTEM CELAY SYSTEM www.indiandentalacademy.com
  105. 105. CEREC SYSTEMS Materials involved : Vita mart II, Dicor MGC and Pro Cad Sanidine KAlSi3O8 Mica crystals 70% Leucite containing ceramic CERamic REConstruction, Optical scanning www.indiandentalacademy.com
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  108. 108. The compact, mobile unit consists of three components: a small camera, a computer screen and a three – axis – of – rotation milling machine. www.indiandentalacademy.com
  109. 109. The cad/cam cerec system has evolved from the: cerec-1,which fabricated only marginally fitting single and dual surface ceramic inlays. Cerec-2,which showed advances in computing, upgraded software and expanded form of grinding technique. www.indiandentalacademy.com
  110. 110. Cerec-3 that can design well-fitting inlays, onlays, crowns, veneers etc., in a single visit. www.indiandentalacademy.com
  111. 111. 3D cerec Scanning and designing 3 dimensional viewing Millingwww.indiandentalacademy.com
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  114. 114. referred to as “ceramic steel”. www.indiandentalacademy.com
  115. 115. www.indiandentalacademy.com
  116. 116. Parallel milling with two tools: www.indiandentalacademy.com
  117. 117. High speed milling of copings and bridge frame work. www.indiandentalacademy.com
  118. 118. www.indiandentalacademy.com
  119. 119. Cerec system. The cerec system has been marketed for several years with the improved cerec 2 system introduced in the mid- 1990s. www.indiandentalacademy.com
  120. 120. Fabrication procedure: 1.Tooth preparation follows typical all ceramic guidelines. 2.Coat the preparation with opaque powder 3. Image the preparation with the optical scanner, aligning the camera with the path of insertion of the restoration When the best view is obtained, it is stored in the computer. 4. Identify and mark the margins and contours on the computer screen. computer software assists with this step www.indiandentalacademy.com
  121. 121. 5. Insert the appropriate shade of ceramic block in the milling machine. The fabrication time for a crown is about 20 minutes . Additional characterization is achieved with stains. 6. Try the restoration back in the mouth, etch, and, lute it to place as described. www.indiandentalacademy.com
  122. 122. The Celay system uses a “copy milling” technique to manufacture ceramic inlays or onlays. This material is similar to Vita Mark ll. ceramic, used with the Cerec 2 system. Alternatively, blanks of the InCeram Alumina or InCeram Spinell materials can be used. Marginal accuracy seems to be good, a little better than the Cerec 2 system. www.indiandentalacademy.com
  123. 123. CELAY SYSTEM Uses copy milling technique Resin pattern fabricated directly on master die and pattern is used for milling porcelain restorations Jacot et al 1998 : in ceram blanks in celay system. Inlay pattern mounted (copy side) Copy milling pattern out of ceramic material (milling side) www.indiandentalacademy.com
  124. 124. The Procera AllCeram system involves an industrial CAD/ CAM processes. The die is mechanically scanned by the technician, and the data are sent to a work station where an enlarged die is milled using a computer-controlled milling machine. This enlargement is necessary to compensate for the sintering shrinkage www.indiandentalacademy.com
  125. 125. PROCERA SYSTEM Dies are enlarged to compensate for sintering shrinkage. Scanning Milling machine Shape on computer screen Contact scanner www.indiandentalacademy.com
  126. 126. Processing method Procera restorations www.indiandentalacademy.com
  127. 127. Step by step procedure : 1. Tooth preparation follows all ceramic guidelines. 2. The cast is made in the conventional way but the die is ditched to make the margin easier to identify during scanning 3. The die is mapped using a contact scanner 4. The shape of the prepared tooth is transferred to the computer screen www.indiandentalacademy.com
  128. 128. 5. The design of the restoration is transferred to the manufacturer via computer line 6. The production process starts with milling an enlarged die to compensate for the sintering shrinkage 7. An enlarged high-alumina coping is milled that shrinks to the desired shape after sintering 8. The coping is returned to the laboratory and body and incisal porcelains are applied in the conventional manner www.indiandentalacademy.com
  129. 129. In the captek system the coping is produced from two metal- impregnated wax sheets that are adapted to a die and fried. The first sheet forms a porous gold platinum palladium layer that is impregnated with 97% gold. Advantages of the system include excellent esthetics and marginal adaptation. www.indiandentalacademy.com
  130. 130. Fabrication Procedure 1. Duplicate the working die in the special refractory material. 2. Cut a piece of the gold platinum palladium impregnated wax sheet 3. Adapt the foil to the die. Then it is fired to 107C (1965 F) forming a porous metal coping. 4. Adapt the second gold impregnated wax and refire, Capillary action draws the gold into the porous gold platinum palladium structure to form the finished coping www.indiandentalacademy.com
  131. 131. Build up the opaque body and incisal porcelains in manner similar to that for a conventional metal ceramic crown. Glaze the completed restoration and polish the metal foil at the margin. The procedure has been adapted for FPD’s. www.indiandentalacademy.com
  132. 132. Electroformed : The Helioform HF 600 system uses an electroforming technique to produce a thin Pure gold coping. . www.indiandentalacademy.com
  133. 133. (HELIO FORM HF 600 SYSTEM) Equipment Polyurethane dies Completed restorations ELECTRO FORMED www.indiandentalacademy.com
  134. 134. Step by step procedure 1. Duplicate the working die with the poly urethane material 2. Drill the polyurethane and glue the electrode into the die 3. Apply an even coat of the silver spacer to the preparation and allow it to dry 4. Insert the dies into the plating equipment. A magnetic stirrer ensures circulation of the cyanide free gold sulfite solution www.indiandentalacademy.com
  135. 135. 5. Turn on the electrical current, and gold will be deposited on the die at an appropriate rate of 0.02mm per hour. 6. Remove the plated copings by heating the dies and remove the silver spacer with nitric acid or air abrasion. 7. Trim flash from the margin with an abrasive silicone wheel and seat the coping on the die 8. Air-abrade the surface and apply the special bonding paste before porcelain application www.indiandentalacademy.com
  136. 136. Porcelain labial veneers can be fabricated using a refractory die technique as well as on a platinum matrix www.indiandentalacademy.com
  137. 137. Ceramic veneer F P D Ceramic inlay metal reinforced F P D Ceramic veneer / Composite substructure F P D www.indiandentalacademy.com
  138. 138. Step-by-step Procedure : 1. Modify the working die by blocking" out tooth undercuts with modeling plastic 2. Adapt the platinum foil (0.025 mm). Careful adaptation is essential for good fit, especially at the proximal incisal margin, where the tinner's joint is made. www.indiandentalacademy.com
  139. 139. 3. Remove, clean, and degas the foil. Airborne particle abrasion can be used for this step. Porcelain labial veneers can also be made with hot pressed ceramics and the machinable systems. 4. Build up and fire the veneers. This is generally done in two or three layers, particularly if the veneer is required to mask tetracycline staining and a more opaque initial layer is applied. www.indiandentalacademy.com
  140. 140. 5. Contour and glaze the facings.. 6. Remove the foil before try-in www.indiandentalacademy.com
  141. 141. 1. Pour an elastomeric impression of the prepared teeth in Type IV or V stone; then repour it or duplicate it in ceramic refractory, 2. Trim the refractory cast as far as possible to minimize the quantity of ammonia released during decontamination. 3. Mark the margins lightly with a special pencil . Decontaminate the cast by firing according to the manufacturer's instructions www.indiandentalacademy.com
  142. 142. 5. Allow the cast to. cool and then soak it in soaking liquid or distilled water for 5 minutes. This will seal the die and prevent moisture from being drawn out of the porcelain buildup: 6. Apply an initial layer of porcelain to the die and fire www.indiandentalacademy.com
  143. 143. 7. Build up the restorations onto moist dies; for inlays, leave short of the margins. 8. Make a relieving cut through the central fossa and fire the porcelain 9. Fill in the central fossa area and build up to the margins and 10 Contour and refine occlusion and proximal contacts. Glaze according to the. 11. Remove the investment. Transfer the restorations to the master dies on the mounted cast www.indiandentalacademy.com
  144. 144. The performance of all ceramics restoration has been enhanced by the use of resin bonding. This technique was first devised for the porcelain laminate veneer technique and has been applied to other ceramic restorations. The technique uses hydrofluoric acid or a less toxic substitute to etch the ceramic and a silane coupling agent to bond a resin Luting agent to the ceramic. The Luting agent is bonded to enamel later etching with phosphoric acid as with resin retained FPDs and bonded to dentine with a dentine bonding agent www.indiandentalacademy.com
  145. 145. All ceramic Resin bonded fixed partial dentures Introduced 1986-1988 Ibsen et al and Garber et al Matthias kern 2005 :Cantilever all-ceramic resin bonded FPD www.indiandentalacademy.com
  146. 146. 1. Support the restoration in soft wax with the fitting surface uppermost. 2. Apply a 1-mm coat of the etching gel to the fitting surface only. 3. The etching time will depend on the ceramic material. Feldspathic porcelain is typically etched for 5 minutes. 4. Very carefully rinse away the gel under running water. 5. Continue to rinse until all the gel color has been removed. www.indiandentalacademy.com
  147. 147. 6. Dry the ceramic with oil-free air 7. Apply the silane according to the manufacturer's recommendations. and care must be taken to clean the fitting face thoroughly with alcohol before cementation, www.indiandentalacademy.com
  148. 148. www.indiandentalacademy.com
  149. 149. 1993 Luthy et al – Post made of TZP-ZrO2 High flexural strength 1400 Mpa 1994 Sandhaus – Zirconia post with composite core 1995 Akagawa et al - Castable ceramic attached to zirconia post 1997 Ivoclar – introduced Ceramic core directly pressed onto Zirconia post Direct method Indirect method www.indiandentalacademy.com
  150. 150. RECENT APPLICATIONS OF CERAMICS IN SURGERY Recently, the world of surgery is amazed with a sensation : Atraumatic scalpels made of ceramics. The cutting edge cannot be made thinner than 0.7 microns when metal is used. Ceramics made up of zirconium dioxide nano-powder with admixtures of aluminum and yttrium in water, can serve to form such a material which can be used to produce the cutting edge thickness of 0.1 - 0.2 microns. The post operative wound heals up 2 -3 times quicker if the ceramic scalpel is used, as the blades had dissected the tissue without traumatizing it. (Mendeleev University of Chemical Technology, Moscow, 14/03/2003) www.indiandentalacademy.com
  151. 151. Ceramics in Orthodontics  Most recent application of ceramics in orthodontics is in fabrication of orthodontic brackets.  The development and demand for these items has been driven solely by esthetics.  Polycrystalline alumina is the material of choice in this application. Advantages::  A profitable alternative to metal brackets.  Bonds and debonds like metal.  Excellent control of tooth movement.  Less friction for better treatment times.  Lowest profile in an all-ceramic bracket.  Maximum patient comfort. www.indiandentalacademy.com
  152. 152. Implants and ceramics: Entering the New Millennium.  The demand for optimal single tooth implant esthetics has lead to perhaps the most exciting development in implant abutment design, the ceramic abutment.  Three different designs are currently available: CerAdapt. CeraOne. CeraBase. (The Intl Journal of Oral & Maxillofacial Implants 2000; vol 15; Pg 76-94) www.indiandentalacademy.com
  153. 153. Improved materials and the bonded ceramic technique have renewed interest in all ceramic restorations. The highest strength materials may be suitable for high stress applications including FPDs However they are relatively new and still lack the support of long-term clinical experience and research www.indiandentalacademy.com
  154. 154. Each system has its own merits, but may also have shortcomings. Combinations of materials and techniques are beginning to emerge which aim to exploit the best features of each. Glass-ceramic and glass-infiltrated alumina blocks for CAD-CAM restoration production are examples of these and it is anticipated that this trend is likely to continue…. www.indiandentalacademy.com
  155. 155. One who works with his hands is a labourer www.indiandentalacademy.com
  156. 156. One who works with his hands & mind is a craftsman www.indiandentalacademy.com
  157. 157. One who works with his hands , mind & heart is an artist www.indiandentalacademy.com
  158. 158. www.indiandentalacademy.com
  159. 159. Kennth.J.Anusavice. Science of dental materials; 10th edition, Kennth.J.Anusavice. Tylmans theory and practice of fixed prosthodontics. Fundamentals of fixed prosthodontics: third edition, Prof Herbert T Shillinburg. Restorative dental materials, 10th edition; Craig CG. Applied dental materials; 8th edition, John F McCabe and Angus W G Walls. Stephen F Rosenstiel; Contemporary Fixed Prosthodontics Herbert T Shillinburg; Fundamentals of Tooth Preparations www.indiandentalacademy.com
  160. 160. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com