All Ceramic Restoration was a document discussing various all-ceramic restoration techniques including porcelain jacket crowns, glass ceramics, slip-cast ceramics, CAD/CAM ceramics, and different commercial CAD/CAM systems. It provided classifications of all-ceramic systems, discussed their properties, advantages, disadvantages and fabrication methods over 3 sentences.

1. All Ceramic
Restoration
Dr.Rizwana Anjum
MDS
Dept Of Prosthodontics
Navodaya Dental College

2. ALL CERAMIC RESTORATION.
 All ceramic systems can provide better esthetics.
 Wide range of tranlucency opacities are available

3. Classification
• 1.Condensed Sintered/Porcelein Jacket Crown
• a.Traditional Jacket Crown
• b.PJC aluminous core )Hi Ceram)
• C.PJC Leucite reinforced core(optec )
• 2.Castable Glass Ceramic/Dicor/Cast glass ceramic
• 3.Pressable Glass Ceramic/heat pressed/Hot isostatically pressed
ceramic/Injection molded Ceramic
• a.Heat pressed Glass ceramic
• b.Heat pressed veenering Ceramic
• 4.Slip Cast Glass Infiltrated Ceramic
• a.Glass Infiltrated Alluminous Core(In-Ceram)
• b.Glass Infiltered Spinell Core(Inceram Spinell)
• C.Glass Infiltered Zirconia Core(Inceram-Zirconia)

4. 5.Milled Ceramic Restoration/ Core
a.Cad Cam
b.Copy Milled

5. • Traditional PJC/Conventional PJC:
• They are made by high fusing Feldpathic porcelein.
• They r v.brittle & tend to fracture
• Marginal adaptability is so poor
• So,they gradually lost there popularity

6. PCJ With Aluminous porcelains
• Mclean and Hughes developed aluminous porcelain in 1965
• As an alternative to PFM
• Objective of this technique- to improve the esthetics
• It contains 40-50% alumina
USE - anterior teeth

7. 8
• Indications
– Individual anterior teeth when excellent aesthetic
is required.
• Contraindications
– Heavy occlusion or bruxism
– Short clinical crowns
– Patients requiring splinting of teeth

8. 9
• Advantages
– Strength
– Aesthetics
• Disadvantages
– Limited to anterior tooth placement

9. phillips
PORCELAIN JACKET
CROWN ARE
MADE(PLATINUM FMT)
PLATINUM FOIL IS ADAPTED
TO THE DIE
THE CORE PORCELAIN IS
CONDENSED
PLACED IN THE FURNACE AND
FIRED
AFTER COOLING REST OF THE
CROWN IS BUILT
REMOVE THE FOIL

10. LEUCITE REINFORCED PORCELAIN(Optec-HSP)
• It is a feldspathic porcelain with a higher leucite crystal
content.
• Its manipulation ,condensation and firing quite similar to
alumina reinforced porcelain jacket crown
• USES – inlay,onlays ,veenersand low stress area.

11. 12
Leucite reinforced ceramics
• Weinston and Weinston 1962
• 45% tetragonal leucite crystals
• High flexural strength 104 MPa
• High coefficient of thermal expansion
– Tangential compressive stresses in glass

12. 13
• Advantages
– More esthetic than aluminous core
– Higher strength
– No special lab equipment
• Disadvantages
– Marginal inaccuracy
– Not strong for posterior teeth

13. CASTABLE GLASS CERAMIC/CERAPEARL
First commercially available castable ceramic-dicor,developed by
corning glass works.
Dicor is a castable glass and restoration is made
by “LOST WAX CASTING PROCESS”
1984 - Adair and Grossman

14. Indicated for inlay ,facial veneers or full crown restorations.
It contains about 55 vol% of tetrasilicic fluormica crystals
• Produces excellent esthetics because of the “chameleon”
effect.
PHILLIPS

15. • ADVANTAGES - ease of fabrication
improved esthetics
good marginal fit
minimal processing shrinkage
moderately high flexural strength
DISADVANTAGES - inadequate strength for posterior use
inability to coloured internally

16. FABRICATION(PHILLIPS)
PATTERN
CONSTUCTED IN
WAX(INVESTED
WITH IM)
BURNING OUT
THE WAX
DICOR GLASS
MELTED AND CAST
INTO
MOLD(CENTRIFUG
AL CASTING
MACHINE)
CERAMMING
BUILT UP WITH
VENEERING
PORCELAIN
&FIRED

17. • CERAMMIMG:
• It is heat treatment procedureby which glass is strengthed.
• It results in developing of microscopic crystals of mica,which
• A.Improves strength and toughness of the glass
• B.Improves the esthetic of the restoration,it reduces
tranparency of glass making more opaque and less glass like.

18. 19
Properties
– Increased strength and toughness
– Increased resistance to abrasion
– Increased thermal shock resistance
– Increased chemical durability
– Decreased translucency

19. 20
• Indications
– Veneers
– Inlays
– Onlays
– Anterior and posterior crowns
– Three-quarter crowns.

20. 21
• Contraindications
– Strong lateral forces
– Heavy bruxism and wear
– Short clinical teeth
– Large pulp

21. 22
• Advantages
– Ease of fabrication
– Improved esthetics – “chameleon effect”
– Minimal processing shrinkage
– Good marginal fit
– Moderately high flexural strength
– Low thermal expansion
– Less abrasiveness

22. 23
• Disadvantages
– Limited to use in low stress areas
– Inability to color intrinsically
– Low tensile strength
– Technique sensitive
– High failure rate – 35%

23. 24
Heat Pressed Glass Ceramics
(Injection Moulded)
• Mc Culloh in1968
• Application of external
pressure to sinter and
shape ceramics

24. Types & Mode of Supply
• Supplied as Ingots
• 1.Heat Pressed Glass Ceramics
• a.Leucite KAlSi2O6 reinforced (IPS
Empress,Cerpress,Optimal)
• b.Leucite Disilicate Reinforced(IPS Empress 2)
• 2.Heat Pressed Veneering Ceramics use as
pressed layer over machine ceramics(IPS
ZirPress,Vita PM9)

25. 26
• Advantages:-
– Lack of metal
– Translucent ceramic core
– Moderately high flexural strength
– Excellent fit

26. 27
• Disadvantages:-
– Potential to fracture in posterior areas
– Need special laboratory equipment
– Less fracture toughness than alumina reinforced
crowns

27. IPS Empress

28. 29
Fabrication Of Injection Moulded
Ceramic
Wax pattern fabricated
Ingot and plugger heated to 1165 °C at 0.4 MPa
Temp maintained for 20 min
Core built up
Layering /Staining technique

29. 2. Leucite glass-ceramics
molding
furnace chamber
(1075, or 1180 °C)
pressure unit
pressing plunger
(1.8 - 2.0 MPa)
Al2O3 plunger
glass-ceramic
ingot
specimen
investment
cylinder
II
IPS Empress®
lost wax technique
mold

30. GLASS INFILTRATED RESTORATION(SLIP-CAST
CERAMICS)
 There are 3 types depending o n core material used
 1)in-ceram spinell
 2)in-ceram alumina
 3)in-ceram zirconia

31. Glass infiltrated alumina core porcelain-INCERAM(ICA)
phillips
• The core of ICA consists of 70 wt% alumina
infiltrated with 30wt% sodium lanthanum glass.
Advantages
Four times more strength than other ceramics
Enhanced marginal adaptation
• Disadvantages
Poor esthetics
Complex procedure
Cost
• Indications
Anterior crowns and bridges
Posterior crowns

32. Glass infiltrated spinell core (INCERAM
SPINELL) (ICS)
• Offshoot of inceram alumina
• It uses MgAl2O4
• More translucent and so more esthetic
• Strength is low
• phillips

33. INCERAM – ZIRCONIA (ICZ)
• Has a core of 30 wt % zirconia and 70 wt % alumina
• Strongest and toughest of all three core ceramics
• Its use is limited to posterior crowns and FPDs because of its
high level of core opacity

34. 35
Slip Casting Technique
Two dies
Slip applied
Sintering at 1100oC for 2 hrs
Glass infiltration step at 1120°C
Core fabricated

35. • Two dies r required.1 for stone &other in
refractory die material
• Preparing d slip-measured quantity(38)of alumina
powder is added slowly into a beaker containing
1 ampoule of mixing liquid and a drop of additive
liquid. mixing is done with help of special ultra
sonic unit. The water in the vitasonic should be
chilled using ice cubes.The prepared slip should b
smooth and homogenous .The slip is applied on
to d refractory die using the slip cast method.

36. • Once started slip should not be allowed to dry
out before the coping is completed. The
process is continued until an alumina coping
of sufficient thickness is obtained
• The fragile slip cast alumina coping is dried at
120degree centigrade for 2 hrs.
• The coping is sintered for 10hrs at 1120
• After sintering the copings are tested for
cracks using special dye

37. • The next step is glass infiltration.Glass powder is
mixed with distilled water.1 or 2 thick coats is
applied on to the sintered alumina coping and
fired for 2 to 3 hrs at 1110degree centigrade on a
platinum foil. The glass melts and infiltrates into
the porous alumina coping through capillary
action.
• The excess glass forms a glassy layer on the
surface which is trimmed of using special
diamond burs, followed by sand blasting.

38. • The glass firing is caried out.
• The coping is then built up using special
veneering ceramics`

39. CAD-CAM ceramics
•Computer aided designing and computer aided milling
.
•The internal surface of inlays or crowns is ground with diamond
discs according to the scanned image of the praparation

40. Computer-aided design/computer-aided
manufacturing (CAD/CAM) technology
which was developed in the late 1980s for
dentistry, incorporates the above mentioned
techniques and it significantly reduced and/or
eliminated problems associated with dental
castings.
4
1

41. In dentistry, the major developments of dental
CAD/CAM systems occurred in the 1980s.
Dr. Duret – developer of Sopha System
Dr. Moermann - the developer of the CEREC
system
Dr. Andersson - the developer of the Procera
system
42

42. GENERAL
PRINCIPLES
19

43. CAD/CAM SYSTEMS
All CAD/CAMsystems consist of three components:
1) A digitalization tool/scanner that transforms
geometry into digital data that can be processed by
the computer
2) Software that processes data and, depending on the
application, produces a data set for the product to be
fabricated
3) A production technology that transforms the data set
into the desiredproduct.
20

44. 21

45. CAD/CAM - PRODUCTION
CONCEPTS
Depending on the location of the components
of the CAD/CAM systems, in dentistry three
different production conceptsare available:
1) chairside production
2) laboratory production
3) centralised fabrication in aproductioncentre.
22

46. CAD/CAM COMPONENTS
23

47. CAD/CAMcomponents can be groupedinto
three:
1) Scanner / Data collectingtool
2) Design software
3) Processing devices
48

48. 1. Scanner
49
It includes the data collection tools that measure
three dimensional jaw and tooth structures and
transform them into digital data sets.
Basically there are two different scanning
possibilities:
1) optical scanners
2) mechanical scanners.

49. 50

50. 51

51. 3.a) 3-axis milling devices
52
This type of milling device has degrees of
movement in the three spatial directions, and so
the mill path points are uniquely defined by the
X -, Y -, and Z – values
A milling of subsections, axis divergences and
convergences, however, is not possible
This demands a virtual blocking in such areas

52. The advantages of these milling devices are short
milling times and simplified control by means of the
three axis.
Also these devices are less costly than those with a
higher number of axes.
Examples of 3-axis devises:
inLab (Sirona),
Lava (3MESPE),
Cercon brain(DeguDent).
53

53. 3.b) 4-axis milling devices
54
In addition to the three spatial axes, the tension
bridge for the component can also be turned
infinitely variably .
As a result it is possible to adjust
constructions with a large vertical
bridge
height
displacement into the usual mould dimensions and
thus save material and milling time.
Example: Zeno (Wieland-Imes).

54. 3.c) 5-axis milling devices
In addition to the three spatial dimensions and the
rotatable tension bridge (4th axis), the 5-axis milling
device has the possibility of rotating the milling spindle
(5th axis)
This enables the milling of complex geometries with
complex shapes such as denture base resins.
Trial of a Cad/Cam system for fabricating dentures-Dental materials
journal-2011 45

55. Example in the
Engine (KaVo).
Example in the
56
Laboratory Area: Everest
Production Centre: HSC
Milling Device (etkon).

56. MILLING VARIANTS
Dry processing
Applied mainly with respect to zirconium oxide
blanks with a low degree of pre-sintering.
Advavtages:
Minimal investment costs for the millingdevice
No moisture absorption by the die ZrO2mould
Disadvantages:
Higher shrinkage values for theframeworks.
48

57. Wet milling
In this process the milling diamond or carbide cutter
is protected by a spray of cool liquid against
overheating of the milled material.
Useful for all metals and glass ceramic material in
order to avoid damage through heat development.
‘Wet’ processing is recommended, if zirconium oxide
ceramic with a higher degree of pre-sintering is
employed for the milling process.
58

58. Examples:
Everest (KaVo), Zeno
8060 (Wieland-Imes),
inLab (Sirona).
59

59. 3 D PRINTING
It is another manufacturing approach to build
objects, one layer at a time and adding multiple
layers to form an object.
It is also known as additive manufacturing or
rapid prototyping (RP).
60

60. Materials for CAD/CAM
Processing
70

61. Materials
62
Materials for processing by CAD/CAM devices
depends on the respective production system
Some milling devices are specifically designed
for the production ZrO2 frames, while others
cover the complete palette of materials from
resins to glass ceramics and high performance
ceramics.

62. The materials normally processedby
CAD/CAMsystems include:
1) Metals
2) Resin materials
3) Silica based ceramics
4) Infiltrated ceramics
5) Oxide ceramics
63

63. COMMON COMMERCIAL
CAD/CAM SYSTEMS
86

64. CAD/CAM systems
may be categorized as:
In-officesystem
Laboratory based system
Milling center system
87

65. In-Office systems
88

66. CEREC
67
Sirona, with their CEREC line of products, is the only
manufacturer that currently provides both in-office and
laboratory-based systems.
CEREC 1 and CEREC 2 – optical scan of the prepared
tooth with a charged-coupled device (CCD) camera, and
the system automatically generates a 3D digital image
on the monitor
Then, the restoration is designed and milled

67. Laboratory-Based Systems
92

68. CEREC inLab
69
It is a laboratory-based system
Working dies are laser-scanned and a digital image of
the virtual model is displayed on a computer screen.
After designing the coping or framework, the laboratory
technician inserts the appropriate ceramic block into
the CEREC inLab machine for milling.

69. Milling Center Systems
97

70. Procera
71
Procera/AllCeram was introduced in 1994
Uses an innovative concept for generating alumina
and zirconia copings.
The master die is scanned and the data is send to
the processing center.
After processing,the coping is send back to the lab
for porcelain veneering.

71. Advantages
130

72. The advantages of using CAD/CAM technology
for the fabrication of crowns and FPDs can be
summarized as:
1) application of new materials
2) reduced labor
3) cost effectiveness and
4) quality control.
73

73. Draw
backs
:
74
 Need for costlyequipment
 Need for extendedtraining
 Technique sensitive
 Inability to image in a wet environment

74. T
oconclude,
As Duret stated, “The systems will continue
to improve in versatility, accuracy, and cost
effectiveness and will be a part of routine
dental practice in comingtime”.
75