All ceramics clinical/academy of orthodontics

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All ceramics clinical/academy of orthodontics

  1. 1. All – ceramicsAll – ceramics oror metal free ceramicsmetal free ceramics INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. CONTENTSCONTENTS  INTRODUCTIONINTRODUCTION  HISTORY OF CERAMICSHISTORY OF CERAMICS  CLASSIFICATIONS OF SYSTEMSCLASSIFICATIONS OF SYSTEMS  Strengthening mechanismsStrengthening mechanisms  Various systemsVarious systems  Comparision of systemsComparision of systems  SELECTION CRITERIASELECTION CRITERIA  CONCLUSIONCONCLUSION www.indiandentalacademy.com
  3. 3. INTRODUCTIONINTRODUCTION  The desire for a restorative material to be durable and esthetic is ancient.The desire for a restorative material to be durable and esthetic is ancient. Routine use of ceramics as restorative material is a recent phenomenon.Routine use of ceramics as restorative material is a recent phenomenon.  Since the advent of metal free ceramic materials, the esthetic value of theSince the advent of metal free ceramic materials, the esthetic value of the restorations were overlooked and gained popularity in last three decades.restorations were overlooked and gained popularity in last three decades.  Considerable research and development were carried out to improve theConsiderable research and development were carried out to improve the strength of all ceramics comparable to metal ceramics.strength of all ceramics comparable to metal ceramics.  Current thinking and trends about all ceramics will be emphasised in thisCurrent thinking and trends about all ceramics will be emphasised in this presentation.presentation. www.indiandentalacademy.com
  4. 4. DefinitionsDefinitions  CERAMICSCERAMICS : compounds of one or more: compounds of one or more metals with a nonmetallic element, usuallymetals with a nonmetallic element, usually oxygen. They are formed of chemical andoxygen. They are formed of chemical and biochemical stable substances that are strong,biochemical stable substances that are strong, hard, brittle, and inert nonconductors of thermalhard, brittle, and inert nonconductors of thermal and electrical energyand electrical energy  PORCELAINPORCELAIN: a ceramic material formed of: a ceramic material formed of infusible elements joined by lower fusinginfusible elements joined by lower fusing materials.materials. www.indiandentalacademy.com
  5. 5. History of ceramicsHistory of ceramics  Alexis duchateau in 1774 – denture teethAlexis duchateau in 1774 – denture teeth  C.H. Land – ceramic crowns and inlaysC.H. Land – ceramic crowns and inlays  The first comercial porcelain was developed by VitaThe first comercial porcelain was developed by Vita Zahnfabrik in about 1963.Zahnfabrik in about 1963.  1965 , Mc lean and Hughes developed dental aluminous1965 , Mc lean and Hughes developed dental aluminous core ceramiccore ceramic  In 1968 , MacCulloch first proposed the use of glassIn 1968 , MacCulloch first proposed the use of glass ceramicceramic  In 1970s and 1980s , the porcelain fused to metalIn 1970s and 1980s , the porcelain fused to metal restorations became the primary restorationrestorations became the primary restoration www.indiandentalacademy.com
  6. 6. HistoryHistory  In 1984 , Adair and Grossman developed aIn 1984 , Adair and Grossman developed a ceramic system by controlled crystallization of aceramic system by controlled crystallization of a glass ( Dicor ) .glass ( Dicor ) .  Glass infiltrated ceramics (INCERAM ) wereGlass infiltrated ceramics (INCERAM ) were introduced in 1988. The strength of theseintroduced in 1988. The strength of these ceramics is about 3 to 4 times greater than earlierceramics is about 3 to 4 times greater than earlier alumina core material.alumina core material.  In 1990s , pressable glass-ceramics ( IPSIn 1990s , pressable glass-ceramics ( IPS Empress )Empress ) www.indiandentalacademy.com
  7. 7. HistoryHistory  First chair side-produced ceramic inlay based onFirst chair side-produced ceramic inlay based on CAD-CAM unit (Cerec, Siemens) wasCAD-CAM unit (Cerec, Siemens) was introduced in 1985.introduced in 1985.  Second generation Cerec system i.e. Cerec-2,Second generation Cerec system i.e. Cerec-2, was introduced in 1994.was introduced in 1994.  Third generation Cerec system i.e. Cerec-3, wasThird generation Cerec system i.e. Cerec-3, was introduced in 2000.introduced in 2000.  PROCERA system was introduced in 1993.PROCERA system was introduced in 1993. www.indiandentalacademy.com
  8. 8. All ceramicsAll ceramics  Ceramic coresCeramic cores  High strength ceramicsHigh strength ceramics  Poor estheticsPoor esthetics  Veneering materialVeneering material  Low strength ceramicsLow strength ceramics  Good estheticsGood esthetics Strongest – non esthetic core materialsStrongest – non esthetic core materials www.indiandentalacademy.com
  9. 9. CLASSIFICATIONCLASSIFICATION  Ceramics can be classified in four categoriesCeramics can be classified in four categories  Silicate ceramicsSilicate ceramics  An amorphous glass phase with a porous structure Main component is SiO2 Dental porcelain fall in this category  Oxide ceramicsOxide ceramics  Presence of mainly oxides (Al2O3, MgO with either no glass phase or Small content of glass phase . www.indiandentalacademy.com
  10. 10. CLASSIFICATIONCLASSIFICATION  Non-oxide ceramicsNon-oxide ceramics  Impractical for dentistry - high processing temp, unaesthetic color & opacity  Glass ceramicsGlass ceramics  Partially crystallized glasses that are produced by nucleation and growth of Crystals in the glass matrix phase. www.indiandentalacademy.com
  11. 11. CLASSIFICATIONCLASSIFICATION  ACCORDING TO TYPE:ACCORDING TO TYPE:  Feldspathic porcelainFeldspathic porcelain  Aluminous porcelainAluminous porcelain  Glass infiltrated aluminousGlass infiltrated aluminous  Glass infiltrated spinelGlass infiltrated spinel  Glass ceramicsGlass ceramics www.indiandentalacademy.com
  12. 12. CLASSIFICATIONCLASSIFICATION  ACCORDING TO FIRINGACCORDING TO FIRING TEMPERATURE:TEMPERATURE:  High fusing > 1300 cHigh fusing > 1300 c  Medium fusing 1101 –1300 CMedium fusing 1101 –1300 C  Low fusing 850 – 1101 CLow fusing 850 – 1101 C  Ultra low fusing <850 C.Ultra low fusing <850 C. www.indiandentalacademy.com
  13. 13. CLASSIFICATIONCLASSIFICATION  According to Substructure materialAccording to Substructure material  Glass ceramicGlass ceramic  CAD- CAM porcelainCAD- CAM porcelain  Sintered ceramic coreSintered ceramic core www.indiandentalacademy.com
  14. 14. CLASSIFICATIONCLASSIFICATION According to the technique of FabricationAccording to the technique of Fabrication 1. Conventional powder slurry system1. Conventional powder slurry system  Medium fusing Felspathic porcelainMedium fusing Felspathic porcelain  Aluminous porcelainAluminous porcelain  DUCERAM LFC (Degussa)DUCERAM LFC (Degussa)  OPTEC HSP (Jeneric/Pentron)OPTEC HSP (Jeneric/Pentron) www.indiandentalacademy.com
  15. 15.  2. Castable ceramics2. Castable ceramics  DicorDicor  Cerapearl (Kyocera Inc.)Cerapearl (Kyocera Inc.)  3. Pressable ceramics3. Pressable ceramics  IPS Empress I, II , cosmo, (Ivoclar)IPS Empress I, II , cosmo, (Ivoclar)  Optec pressable ceramics (Jeneric/Pentron)Optec pressable ceramics (Jeneric/Pentron)  Cergo (Dentsply )Cergo (Dentsply )  VitaPress ( Vitadent )VitaPress ( Vitadent )  4. Glass infiltrated ceramics4. Glass infiltrated ceramics  In-Ceram aluminia (Vident)In-Ceram aluminia (Vident)  In-Ceram spinell (Vident)In-Ceram spinell (Vident)  In-Ceram zirconia (Vident)In-Ceram zirconia (Vident) www.indiandentalacademy.com
  16. 16.  5. Injection molded ceramics5. Injection molded ceramics  Alceram (Cerestore)Alceram (Cerestore)  6. Machinable ceramics6. Machinable ceramics  CAD CAMCAD CAM  Cerec: Vita Mark I, Vita Mark II,Cerec: Vita Mark I, Vita Mark II,  Dicor MGC( Machinable Glass Ceramic)Dicor MGC( Machinable Glass Ceramic)  ProceraProcera  Cercon baseCercon base  VitaBloc alumina , spinell & zirconiaVitaBloc alumina , spinell & zirconia  Lava frameLava frame  Celay( coping milling )Celay( coping milling ) www.indiandentalacademy.com
  17. 17. Flaws in brittle ceramicsFlaws in brittle ceramics  Fabrication defectsFabrication defects  Condensation with ceramic slurry by hand induce porosityCondensation with ceramic slurry by hand induce porosity  Porosity will be fracture initiation sitePorosity will be fracture initiation site  Due to Thermal contraction mismatchDue to Thermal contraction mismatch  Surface cracksSurface cracks  Induced by machining or grindingInduced by machining or grinding  Fracture takes place from the most severe flawFracture takes place from the most severe flaw  Depends on size and spatial distribution of crackDepends on size and spatial distribution of crack www.indiandentalacademy.com
  18. 18. METHOD TO OVERCOMEMETHOD TO OVERCOME Methods of strengthening brittle materials Designing components to decrease stress concentration Development of residual compressive stresses Interruption of crack propagation 1. Dispersion of crystalline phase 2. Transformation toughening 1. Ion exchange 2. Thermal tempering 3. Thermal compatibility www.indiandentalacademy.com
  19. 19. STRENGTHENING MECHANISMSSTRENGTHENING MECHANISMS  Strengthened byStrengthened by  Crystalline reinforcementCrystalline reinforcement  Chemical strengtheningChemical strengthening  Stress induced transformationStress induced transformation  GlazingGlazing  Prevention of stress corrosionPrevention of stress corrosion www.indiandentalacademy.com
  20. 20. Crystalline reinforcementCrystalline reinforcement  high proportions of crystalline phase like leucitehigh proportions of crystalline phase like leucite to improve the resistance to crack propagationto improve the resistance to crack propagation  Crack deflection brought about byCrack deflection brought about by  Weakened interface between grains in single-phaseWeakened interface between grains in single-phase materials caused by incomplete sinteringmaterials caused by incomplete sintering  Residual strains between two phase materialsResidual strains between two phase materials www.indiandentalacademy.com
  21. 21. Crystalline reinforcementCrystalline reinforcement  Greater thermal coefficient ofGreater thermal coefficient of expansion of crystalline phaseexpansion of crystalline phase than the matrix producesthan the matrix produces tangential compressive stresstangential compressive stress near crystal-matrix interfacenear crystal-matrix interface  This tangential stress divert theThis tangential stress divert the crack around the particlecrack around the particle  Leucite has the greater theramalLeucite has the greater theramal expansion than than glassyexpansion than than glassy matrixmatrix www.indiandentalacademy.com
  22. 22. Chemical strengtheningChemical strengthening  Ion exchange by replacement of small allkaliIon exchange by replacement of small allkali ions with larger ions below the strain point ofions with larger ions below the strain point of ceramicceramic  Stress relaxation is not possible in theirStress relaxation is not possible in their temperature range, exchange of ions lead totemperature range, exchange of ions lead to compressive layer at the surfacecompressive layer at the surface  Ions of salts with melting point lower than theIons of salts with melting point lower than the glass transition temperature of ceramic materialglass transition temperature of ceramic material were chosenwere chosen www.indiandentalacademy.com
  23. 23. Stress induced transformationStress induced transformation  Polycrystalline zirconia in which stress-inducedPolycrystalline zirconia in which stress-induced transformation can strengthen ceramicstransformation can strengthen ceramics  Teteragonal zirconiaTeteragonal zirconia monoclinic zirconiamonoclinic zirconia  Monoclinic zirconia at room temperatureMonoclinic zirconia at room temperature  Tetragonal zirconia at 1170 and 2370 degreesTetragonal zirconia at 1170 and 2370 degrees  To retain tetragonal form of zirconia at roomTo retain tetragonal form of zirconia at room temperature oxides such as yttrium oxide are added.temperature oxides such as yttrium oxide are added.  Increase in grain volume in the vicinity of crack tipIncrease in grain volume in the vicinity of crack tip www.indiandentalacademy.com
  24. 24. GlazingGlazing  The addition of a surface glaze can also be used to strengthen ceramics  The principle is the formation of a low-expansion surface layer formed at high temperature.  Upon cooling, the low-expansion glaze places the surface of the ceramic in compression and reduces the depth and width of surface flaws.  Selfglazing does not significantly improve the flexure strength of feldspathic dental porcelain www.indiandentalacademy.com
  25. 25. Prevention of stress corrosionPrevention of stress corrosion  The strength of ceramics is reduced in moist environments.  This weakening is due to a chemical reaction between water and the ceramic at the tip of the strength- controlling crack  Resulting in an increase in the crack size-a phenomenon called stress-corrosion or static fatigue.  Prevention:  Reducing the moisture exposure at the internal surface where the fracture thought to initiate  Baking ceramic on a metal foil as in the Captek system of ceramic www.indiandentalacademy.com
  26. 26. ALUMINOUS PORCELAINALUMINOUS PORCELAIN (Hi-Ceram-Vita Zahnfabrik)(Hi-Ceram-Vita Zahnfabrik)  Developed byDeveloped by Mclean and Hughes in 1965Mclean and Hughes in 1965  Feldspathic porcelain to which approx. 50%Feldspathic porcelain to which approx. 50% aluminum oxide is added to increase strength.aluminum oxide is added to increase strength. www.indiandentalacademy.com
  27. 27. Aluminous core porcelainAluminous core porcelain  Porcelains used in this technique arePorcelains used in this technique are  Core porcelainCore porcelain--; highest strength opaque porcelain- 50% by; highest strength opaque porcelain- 50% by wt fused alumina crystalswt fused alumina crystals  body porcelainbody porcelain - 15% crystal alumina and- 15% crystal alumina and  enamel porcelainenamel porcelain -- 5% crystal alumina5% crystal alumina  Firing temp.Firing temp.  Core-1050-1100 degree CCore-1050-1100 degree C  Veneer- 900-995 degree CVeneer- 900-995 degree C www.indiandentalacademy.com
  28. 28. Diagramatic representationDiagramatic representation www.indiandentalacademy.com
  29. 29. Aluminous core porcelainAluminous core porcelain AdvantageAdvantage  Simple fabricationSimple fabrication  Improved strength compared to conventionalImproved strength compared to conventional feldspathic porcelain (95% success rate onfeldspathic porcelain (95% success rate on maxillary anterior teeth)maxillary anterior teeth) www.indiandentalacademy.com
  30. 30. Aluminous core porcelainAluminous core porcelain DisadvantageDisadvantage  Alumina is veryAlumina is very brightbright, therefore crown must be built to, therefore crown must be built to disguise the core. Some times bright at neck.disguise the core. Some times bright at neck.  Not indicated for posterior teeth (15% fracture), FDPs andNot indicated for posterior teeth (15% fracture), FDPs and in cases of bruxism.in cases of bruxism.  Aluminous porcelainAluminous porcelain shrinksshrinks during the baking procedure,during the baking procedure, the fit of finished aluminous crown is generally muchthe fit of finished aluminous crown is generally much poorer than that of ceramo-metal crowns.poorer than that of ceramo-metal crowns. www.indiandentalacademy.com
  31. 31. PLATINUM FOIL TECHNIQUEPLATINUM FOIL TECHNIQUE  ADVANTAGESADVANTAGES  No need of refractory dieNo need of refractory die  Easy to measure thickness during fabricationEasy to measure thickness during fabrication  DISADVANTAGESDISADVANTAGES  Foil distortion possibleFoil distortion possible  Difficult to assess actual colourDifficult to assess actual colour www.indiandentalacademy.com
  32. 32. www.indiandentalacademy.com
  33. 33. www.indiandentalacademy.com
  34. 34.  Core porcelain is appliedCore porcelain is applied and then firedand then fired www.indiandentalacademy.com
  35. 35.  Building body dentineBuilding body dentine  Completed dentineCompleted dentine porcelain build upporcelain build up www.indiandentalacademy.com
  36. 36.  Cut back of the incisal dentineCut back of the incisal dentine  Enamel blend smoothenedEnamel blend smoothened with brushwith brush www.indiandentalacademy.com
  37. 37. Application of enamel porcelainApplication of enamel porcelain Completed enamel build upCompleted enamel build up Small quantity of stains are addedSmall quantity of stains are added www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com
  39. 39. Completed restorationCompleted restoration www.indiandentalacademy.com
  40. 40. SLIP CAST CERAMICSSLIP CAST CERAMICS  In-ceram-developed by Dr. Sadoun in paris.In-ceram-developed by Dr. Sadoun in paris.  In In-ceram system the glass infiltrated aluminaIn In-ceram system the glass infiltrated alumina core is produced by “SLIP CASTING”core is produced by “SLIP CASTING” procedure.procedure. www.indiandentalacademy.com
  41. 41. Slip cast ceramicsSlip cast ceramics  SLIP- dispersion of alumina particles in water.SLIP- dispersion of alumina particles in water.  Slip casting is the science of preparing stableSlip casting is the science of preparing stable suspensions and fabricating structures bysuspensions and fabricating structures by building a solid layer on the surface of a porousbuilding a solid layer on the surface of a porous mold that absorbs the liquid phase by means ofmold that absorbs the liquid phase by means of capillary forces.capillary forces. www.indiandentalacademy.com
  42. 42. Slip cast ceramicsSlip cast ceramics  The starting media is a “slip” i.e. an aqueous suspensionThe starting media is a “slip” i.e. an aqueous suspension of fine alumina particles in water (or 1% polyvinylof fine alumina particles in water (or 1% polyvinyl alcohol).alcohol).  Slip is applied on to a porous special refractory dieSlip is applied on to a porous special refractory die which absorbs water from the slip and leads towhich absorbs water from the slip and leads to condensation of the slip on die.condensation of the slip on die.  This is then fired at temp. of about 1150This is then fired at temp. of about 1150OO CC www.indiandentalacademy.com
  43. 43. Slip cast ceramicsSlip cast ceramics  The refractory die shrinks more than slip and thusThe refractory die shrinks more than slip and thus allows easy separation after firing.allows easy separation after firing.  This initial shrinking process of alumina core producesThis initial shrinking process of alumina core produces minimum volume shrinkage, since temperature andminimum volume shrinkage, since temperature and time are sufficient only to cause bonding betweentime are sufficient only to cause bonding between particles at small area.particles at small area.  Therefore marginal adaptation of this core is excellentTherefore marginal adaptation of this core is excellent because of minimal shrinkage.because of minimal shrinkage. www.indiandentalacademy.com
  44. 44. GLASS INFILTRATIONGLASS INFILTRATION  Fired porous core is glass infiltrated (low fusing SodiumFired porous core is glass infiltrated (low fusing Sodium lanthanum glass).lanthanum glass).  Molten glass is drawn into the pores by capillary actionMolten glass is drawn into the pores by capillary action at higher temperature (1120 degree C) over 4-5 hourat higher temperature (1120 degree C) over 4-5 hour period.period.  The diffusion of glass through porous alumina fills theThe diffusion of glass through porous alumina fills the spaces between alumina particles, which enhancesspaces between alumina particles, which enhances strength and color (increases its index of refraction andstrength and color (increases its index of refraction and thus increases translucency).thus increases translucency). www.indiandentalacademy.com
  45. 45. PROCEDURE (Inceram)PROCEDURE (Inceram) www.indiandentalacademy.com
  46. 46. www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com
  48. 48. InceramInceram  The strength of In-ceram is 3-4 times more thanThe strength of In-ceram is 3-4 times more than earlier alumina core materials.earlier alumina core materials.  Concentration of alumina in In-ceram is 72%,Concentration of alumina in In-ceram is 72%, compared to 50% in aluminous porcelain.compared to 50% in aluminous porcelain. www.indiandentalacademy.com
  49. 49. CASTABLE GLASS CERAMICSCASTABLE GLASS CERAMICS  A glass -ceramic is material that is formed into theA glass -ceramic is material that is formed into the desired shape as a glass, then subjected to a heatdesired shape as a glass, then subjected to a heat treatment to induce partial devitrification (ie loss oftreatment to induce partial devitrification (ie loss of glassy structure by crystallization of the glass).glassy structure by crystallization of the glass).  The crystalline particles, needles, or plates formedThe crystalline particles, needles, or plates formed during this process serve to interrupt the propagationduring this process serve to interrupt the propagation of cracks in the material when an intraoral force isof cracks in the material when an intraoral force is applied, thereby causing increased strength andapplied, thereby causing increased strength and toughnesstoughness www.indiandentalacademy.com
  50. 50. CASTABLE GLASS CERAMICSCASTABLE GLASS CERAMICS  The use of glass-ceramics in dentistry was firstThe use of glass-ceramics in dentistry was first proposed by MacCulloch in 1968.proposed by MacCulloch in 1968.  The first commercially available castable ceramicThe first commercially available castable ceramic material for dental use, Dicor, was developed bymaterial for dental use, Dicor, was developed by Corning Glass Works and marketed by DentsplyCorning Glass Works and marketed by Dentsply International.International. www.indiandentalacademy.com
  51. 51. DICORDICOR  Dicor system composed of SiO2; K2O. MgO, andDicor system composed of SiO2; K2O. MgO, and MgF2. Small amounts of Al2.O3 and ZrO2 are addedMgF2. Small amounts of Al2.O3 and ZrO2 are added for durability and a fluorescing agent is added forfor durability and a fluorescing agent is added for esthetics.esthetics.  Dicor contain Tetra silicic fluor mica CrystalsDicor contain Tetra silicic fluor mica Crystals  Lost wax casting technique is used , similar to thatLost wax casting technique is used , similar to that employed for metals.employed for metals.  Uses centrifugal casting machineUses centrifugal casting machine www.indiandentalacademy.com
  52. 52. DICORDICOR www.indiandentalacademy.com
  53. 53.  This heat treatment (which involves crystal nucleation andThis heat treatment (which involves crystal nucleation and crystal growth process) is known as “Ceramming”.crystal growth process) is known as “Ceramming”. The crystals function in 2 ways:The crystals function in 2 ways: 1) They create a relatively opaque material out of initially1) They create a relatively opaque material out of initially transparent crown,transparent crown, 2) they significantly increase the fracture resistance and2) they significantly increase the fracture resistance and strength of ceramic. These crystals are also less abrasivestrength of ceramic. These crystals are also less abrasive to opposing tooth structure than the leucite crystals foundto opposing tooth structure than the leucite crystals found in traditional feldspathic porcelainsin traditional feldspathic porcelains www.indiandentalacademy.com
  54. 54. www.indiandentalacademy.com
  55. 55. Dicor – optical propertyDicor – optical property  Dicor is a glass, it isDicor is a glass, it is capable of producing acapable of producing a “Chameleon Effect” ( i.e.“Chameleon Effect” ( i.e. part of the colour of thepart of the colour of the restoration is picked uprestoration is picked up from the adjacent teeth asfrom the adjacent teeth as well as from the cementwell as from the cement used for luting theused for luting the restoration).restoration). www.indiandentalacademy.com
  56. 56. DicorDicor  Advantage :Advantage :  Good marginal adaptationGood marginal adaptation  Abrasiveness is same as that of the toothAbrasiveness is same as that of the tooth  Chameleon effectChameleon effect  Disadvantage:Disadvantage:  Increased cost,Increased cost,  Increased time of fabrication.Increased time of fabrication.  When used for posterior crowns, ceramic crowns are mostWhen used for posterior crowns, ceramic crowns are most susceptible to fracturesusceptible to fracture www.indiandentalacademy.com
  57. 57. DicorDicor  Instead of using stains, alternative technique isInstead of using stains, alternative technique is to cast the glass as a core and bake veneerto cast the glass as a core and bake veneer shaded feldspathic porcelain over it. This isshaded feldspathic porcelain over it. This is called ascalled as Willi’s glass.Willi’s glass.  Color can then be built in layers.Color can then be built in layers.  Dentsply has introducedDentsply has introduced Dicor PlusDicor Plus which is awhich is a shaded feldspathic porcelain veneer applied toshaded feldspathic porcelain veneer applied to the Dicor substratethe Dicor substrate www.indiandentalacademy.com
  58. 58. HEAT PRESSED CERAMICSHEAT PRESSED CERAMICS  Leucite basedLeucite based  Characterization (surface stain only)Characterization (surface stain only)  Layering technique ( veneering)Layering technique ( veneering)  IPS EMPRESS, optimal pressable , cerpress , FineeseIPS EMPRESS, optimal pressable , cerpress , Fineese  Lithium silicate basedLithium silicate based  Major crystalline phase is lithium silicateMajor crystalline phase is lithium silicate  Layered with glass contained some dispersed apatite crystalsLayered with glass contained some dispersed apatite crystals  IPS EMPRESS 2IPS EMPRESS 2 www.indiandentalacademy.com
  59. 59.  These ceramics uses lost wax technique, butThese ceramics uses lost wax technique, but unlike castable ceramics they are not cast. Theyunlike castable ceramics they are not cast. They are pressed into the mold.are pressed into the mold.  They are supplied as ingots which are melted atThey are supplied as ingots which are melted at high temperature and pressed.high temperature and pressed. www.indiandentalacademy.com
  60. 60. IPS EmpressIPS Empress  Leucite reinforced Ceramic Comes in Pre-Leucite reinforced Ceramic Comes in Pre- cerammed cylinders ( ingots) of various shade.cerammed cylinders ( ingots) of various shade.  Ingots are heated and molded under pressure toIngots are heated and molded under pressure to produce restorations.produce restorations.  Either full contour crown in wax and thenEither full contour crown in wax and then stainedstained  OR Wax pattern formed like a substructureOR Wax pattern formed like a substructure (core material) which is later veneered by(core material) which is later veneered by veneering porcelainveneering porcelain www.indiandentalacademy.com
  61. 61. www.indiandentalacademy.com
  62. 62.  Insert a ceramic ingot of the appropriate shade and aluminaInsert a ceramic ingot of the appropriate shade and alumina plunger in the sprue .plunger in the sprue .  After heating to 1150After heating to 115000 c , the soften ceramic is slowly pressed intoc , the soften ceramic is slowly pressed into the mold under vaccum .the mold under vaccum . www.indiandentalacademy.com
  63. 63. Pressable ceramic - FurnacePressable ceramic - Furnace www.indiandentalacademy.com
  64. 64. Recovering the restorationRecovering the restoration www.indiandentalacademy.com
  65. 65. PRESSABLE CERAMICPRESSABLE CERAMIC  Veneering porcelainVeneering porcelain  IPS Empress - EmpressIPS Empress - Empress  IPS Empress 2 - Empress 2, ErisIPS Empress 2 - Empress 2, Eris  Optec - optecOptec - optec  Cergo - Ducera GoldCergo - Ducera Gold  Vita Press - Vita OmegaVita Press - Vita Omega www.indiandentalacademy.com
  66. 66. MACHINABLE CERAMICSMACHINABLE CERAMICS  ADVANTAGES:ADVANTAGES:  No shrinkage after pressingNo shrinkage after pressing  Stability of crown retained after several firingStability of crown retained after several firing  High flexural strengthHigh flexural strength  Increased marginal fitIncreased marginal fit  DISADVANTAGE:DISADVANTAGE:  Expensive.Expensive.  Available only for single tooth restorationAvailable only for single tooth restoration www.indiandentalacademy.com
  67. 67. MACHINABLE CERAMICSMACHINABLE CERAMICS  These products are supplied as ceramic ingots inThese products are supplied as ceramic ingots in various shades and are used in computer aidedvarious shades and are used in computer aided designing-computer aided manufacturing (CAD-designing-computer aided manufacturing (CAD- CAM) procedures.CAM) procedures.  Ceramic ingots do not require further highCeramic ingots do not require further high temperature processing.temperature processing. www.indiandentalacademy.com
  68. 68. MACHINABLE CERAMICSMACHINABLE CERAMICS  They are placed in a machining apparatus toThey are placed in a machining apparatus to produce the desired contours .produce the desired contours .  Can be made as core ceramic which can beCan be made as core ceramic which can be veneered to obtain desired esthetics.veneered to obtain desired esthetics.  The machined restoration can be stained or canThe machined restoration can be stained or can be veneered by feldspathic porcelain to obtainbe veneered by feldspathic porcelain to obtain desired characterization.desired characterization. www.indiandentalacademy.com
  69. 69. CEREC SYSTEMCEREC SYSTEM Vita Block IVita Block I VidentVident Vita Block IIVita Block II VidentVident ProCadProCad IvoclarIvoclar Dicor MGCDicor MGC DentsplyDentsply Procera AllceramProcera Allceram Nobel biocareNobel biocare DenzirDenzir DentronicDentronic LavaLava 3M ESPE3M ESPE CELAY (coping milling )CELAY (coping milling ) CelayCelay VidentVident OPTICAL SCANNING MECHANICAL SCANNING www.indiandentalacademy.com
  70. 70. ADVANTAGESADVANTAGES  Removes ceramic processing-Removes ceramic processing-  Therefore micro structure control is in the hands ofTherefore micro structure control is in the hands of manufacturer.manufacturer.  Many properties (physical and optical ) are directlyMany properties (physical and optical ) are directly dependent on how the ceramic is made.dependent on how the ceramic is made.  Manufacturer merely provides a few sizes ofManufacturer merely provides a few sizes of simple blocks and the complex shaping issimple blocks and the complex shaping is controlled by the machining process.controlled by the machining process.  Although the machining does lower the strengthAlthough the machining does lower the strength of ceramics, strength is still equal or superior toof ceramics, strength is still equal or superior to the strengths of lab fabricated ceramicsthe strengths of lab fabricated ceramics www.indiandentalacademy.com
  71. 71. CEREC SYSTEMCEREC SYSTEM  DISADVANTAGEDISADVANTAGE  Gap between the restoration and tooth structure isGap between the restoration and tooth structure is considerably wider than that in other type of ceramicconsiderably wider than that in other type of ceramic systems .systems . www.indiandentalacademy.com
  72. 72. CEREC SYSTEMCEREC SYSTEM (Sirona Dental System, Germany)(Sirona Dental System, Germany)  CERamic + REConstructionCERamic + REConstruction  The basic philosophy of the CEREC unit was toThe basic philosophy of the CEREC unit was to associate an optical impression method with aassociate an optical impression method with a computer-driven fabrication module in a single mobilecomputer-driven fabrication module in a single mobile workstation. The system development includedworkstation. The system development included computer-aided 3-D imaging-designing and numericallycomputer-aided 3-D imaging-designing and numerically controlled machining of the restoration.controlled machining of the restoration. www.indiandentalacademy.com
  73. 73. CerecCerec  CEREC was first CAD/CAM system inCEREC was first CAD/CAM system in restorative dentistry.restorative dentistry.  Cerec I was introduced in 1985.Cerec I was introduced in 1985.  Second generation Cerec system i.e. Cerec-2,Second generation Cerec system i.e. Cerec-2, was introduced in 1994.was introduced in 1994.  Third generation Cerec system i.e. Cerec-3, wasThird generation Cerec system i.e. Cerec-3, was introduced in 2000.introduced in 2000. www.indiandentalacademy.com
  74. 74. PROCEDUREPROCEDURE www.indiandentalacademy.com
  75. 75. CerecCerec  There is difference in reflection and absorption of theThere is difference in reflection and absorption of the incident light angles and dissimilar optical properties ofincident light angles and dissimilar optical properties of dental tissues. Therefore entire field of view should bedental tissues. Therefore entire field of view should be coated with a thin opaque layer.coated with a thin opaque layer.  This Titanium oxide layer over prepared toothThis Titanium oxide layer over prepared tooth produces a highly uniform scattering of light which isproduces a highly uniform scattering of light which is appropriate for optical impression.appropriate for optical impression. www.indiandentalacademy.com
  76. 76. www.indiandentalacademy.com
  77. 77. ADVANTAGESADVANTAGES  Good strength and fracture resistance.Good strength and fracture resistance.  No impression makingNo impression making  Very low porosityVery low porosity  Take very less time for fabrication( 20 mins,Take very less time for fabrication( 20 mins, 3-5 mins for cerec 3)3-5 mins for cerec 3)  Meant for a chair side approach. No need ofMeant for a chair side approach. No need of sending to lab. Need for only onesending to lab. Need for only one appointmentappointment www.indiandentalacademy.com
  78. 78. DISADAVNTAGEDISADAVNTAGE  Equipment is costly.Equipment is costly.  Technique sensitive nature of surface imaging.Technique sensitive nature of surface imaging.  Marginal fit not as good as other systems.Marginal fit not as good as other systems. www.indiandentalacademy.com
  79. 79. Advantage of cerec 3Advantage of cerec 3 www.indiandentalacademy.com
  80. 80. ProCADProCAD  It is a new Cerec ceramic material based on leucite-It is a new Cerec ceramic material based on leucite- reinforced glass-ceramics with increased strength.reinforced glass-ceramics with increased strength.  ProCAD BlocksProCAD Blocks  –– VeneersVeneers  –– Partial crownsPartial crowns  –– Anterior andAnterior and posterior crownsposterior crowns www.indiandentalacademy.com
  81. 81. PROCERA ALL CERAM SYSTEMPROCERA ALL CERAM SYSTEM (Nobel Biocare)(Nobel Biocare)  PROCERA system was introduced in 1986.PROCERA system was introduced in 1986.  Initially it was used to fabricate crowns andInitially it was used to fabricate crowns and FPDs by combining a Titanium substructureFPDs by combining a Titanium substructure with a low fusing veneering porcelain.with a low fusing veneering porcelain.  Later in 1993 it was used to produce AllLater in 1993 it was used to produce All ceramic crowns.ceramic crowns.  The crown is composed of a densely sintered,The crown is composed of a densely sintered, high purity aluminium oxide coping that ishigh purity aluminium oxide coping that is combined with a low fusing veneering porcelain.combined with a low fusing veneering porcelain. www.indiandentalacademy.com
  82. 82. PROCEDUREPROCEDURE  Procera® PiccoloProcera® Piccolo  enables single toothenables single tooth scanning for crowns,scanning for crowns, laminates and abutments.laminates and abutments.  Procera® ForteProcera® Forte  scan crowns, laminatesscan crowns, laminates and abutments as well asand abutments as well as bridges.bridges. www.indiandentalacademy.com
  83. 83. ProceraProcera Within 3 mins , more than 50,000 data points areWithin 3 mins , more than 50,000 data points are gathered , defining the three dimensional shape of the diegathered , defining the three dimensional shape of the die Then the margins are marked in the two diemensionalThen the margins are marked in the two diemensional plotsplots www.indiandentalacademy.com
  84. 84. ProceraProcera  Next step in designing is to establish theNext step in designing is to establish the thickness of the coping to be fabricated.thickness of the coping to be fabricated.  Relief space for the luting agent is automaticallyRelief space for the luting agent is automatically established by computer algorithm .established by computer algorithm .  File saved in computer and transferred to theFile saved in computer and transferred to the production station (Switzerland)production station (Switzerland) www.indiandentalacademy.com
  85. 85. ProceraProcera  Sintering shrinkage of 20% is taken intoSintering shrinkage of 20% is taken into account, so enlarge model of the preparation isaccount, so enlarge model of the preparation is made with the help of the CAD-CAMmade with the help of the CAD-CAM technique.technique.  High purity aluminum oxide powder isHigh purity aluminum oxide powder is compacted against the enlarged die .compacted against the enlarged die .  The outer surface is milled and the coping isThe outer surface is milled and the coping is sintered to full density .sintered to full density .  Then veneering porcelain is addedThen veneering porcelain is added www.indiandentalacademy.com
  86. 86. LAVA CAD-CAM SYSTEMLAVA CAD-CAM SYSTEM ((3M ESPE)3M ESPE)  The ceramic framework consists of zirconiaThe ceramic framework consists of zirconia supplemented by a specially designed overlaysupplemented by a specially designed overlay porcelain (Lava Ceram). The frameworks areporcelain (Lava Ceram). The frameworks are fabricated using CAD/CAM manufacturingfabricated using CAD/CAM manufacturing techniques and uses pre-sintered zirconia blankstechniques and uses pre-sintered zirconia blanks www.indiandentalacademy.com
  87. 87. LAVA SYSTEMLAVA SYSTEM www.indiandentalacademy.com
  88. 88. LAVALAVA  ADVANTAGEADVANTAGE  Superior strength of zirconia with high fractureSuperior strength of zirconia with high fracture resistance Flexural strength >1100 MParesistance Flexural strength >1100 MPa  Ideal for 3 and 4 unit bridge, crownsIdeal for 3 and 4 unit bridge, crowns  Good marginal fit.Good marginal fit.  Lava Frame zirconia is particularly suitable forLava Frame zirconia is particularly suitable for posterior bridge frameworks and for long spans.posterior bridge frameworks and for long spans. www.indiandentalacademy.com
  89. 89. CELAY SYSTEMCELAY SYSTEM (MIKRONA TECHNOLOGIES)(MIKRONA TECHNOLOGIES)  Uses copy milling technique.Uses copy milling technique.  This system is based on a mechanical device that is usedThis system is based on a mechanical device that is used to trace the surface of a prefabricated pattern of ato trace the surface of a prefabricated pattern of a designed restoration made from a blue resin baseddesigned restoration made from a blue resin based composite( Celay-tech, ESPE).composite( Celay-tech, ESPE).  The resin pattern can be produced directly on theThe resin pattern can be produced directly on the prepared tooth or indirectly on dies made fromprepared tooth or indirectly on dies made from impression. As the tracing tool passes over the pattern aimpression. As the tracing tool passes over the pattern a milling machine duplicates these movements and grindsmilling machine duplicates these movements and grinds a copy of this pattern from block of aluminaa copy of this pattern from block of alumina www.indiandentalacademy.com
  90. 90. CelayCelay www.indiandentalacademy.com
  91. 91. CelayCelay  AdvantageAdvantage  Improved strengthImproved strength  Better marginal adaptation as compared to CerecBetter marginal adaptation as compared to Cerec system.system. www.indiandentalacademy.com
  92. 92. Comparison of different Metal freeComparison of different Metal free ceramic systemsceramic systems 4 groups of ceramic systems used for porcelain4 groups of ceramic systems used for porcelain laminate veneers were comparedlaminate veneers were compared Systems compared wereSystems compared were 1.1. Feldspathic porcelain baked using traditionalFeldspathic porcelain baked using traditional powder-water slurry methodpowder-water slurry method 2.2. Castable ceramicsCastable ceramics 3.3. Heat pressed ceramicsHeat pressed ceramics 4.4. Machinable ceramicsMachinable ceramicswww.indiandentalacademy.com
  93. 93. Feldspathic porcelainFeldspathic porcelain  Advantage: Allow minimal veneer thickness ofAdvantage: Allow minimal veneer thickness of 0.3mm,therefore the amount of tooth structure0.3mm,therefore the amount of tooth structure that has to be removed for preparation can bethat has to be removed for preparation can be kept to minimumkept to minimum  Disadvantage: Feldspathic porcelain are brittleDisadvantage: Feldspathic porcelain are brittle www.indiandentalacademy.com
  94. 94. Castable ceramics and Heat pressedCastable ceramics and Heat pressed ceramicsceramics  They offer greater flexural strength when veneerThey offer greater flexural strength when veneer thickness is more than 0.5 mm therefore thethickness is more than 0.5 mm therefore the preparation must be 0.6 to 0.8 mm in thickness –preparation must be 0.6 to 0.8 mm in thickness – conflicts with conservative nature of theconflicts with conservative nature of the restorationrestoration www.indiandentalacademy.com
  95. 95. Machinable CeramicsMachinable Ceramics  Veneer restorations produced by CAD/CAM or CopyVeneer restorations produced by CAD/CAM or Copy Milling techniques result in a mean interfacial gapMilling techniques result in a mean interfacial gap between the restoration and the tooth structure , that isbetween the restoration and the tooth structure , that is considerably wider than that of other all-ceramicconsiderably wider than that of other all-ceramic systemssystems  Although this gap is filled with composite resinAlthough this gap is filled with composite resin cement ,the cement itself will be subjected to wear,cement ,the cement itself will be subjected to wear, which may impair long term success.which may impair long term success. www.indiandentalacademy.com
  96. 96. Metal reinforced systemsMetal reinforced systems  Eg. CaptekEg. Captek  Involves adaptation of two metal imprignatedInvolves adaptation of two metal imprignated wax sheets and firedwax sheets and fired  First layer forms platinum palladium layer on theFirst layer forms platinum palladium layer on the diedie  Second layer forms gold platinum layerSecond layer forms gold platinum layer  Build up body with opaque and incisal porcelainBuild up body with opaque and incisal porcelain simillar to conventional metal ceramicssimillar to conventional metal ceramics www.indiandentalacademy.com
  97. 97. Selection of all ceramicsSelection of all ceramics  Fracture resistanceFracture resistance  EstheticsEsthetics  AbrasivenessAbrasiveness www.indiandentalacademy.com
  98. 98. Choice of systemChoice of system  Single crownSingle crown  CaptekCaptek  Inceram spinellInceram spinell  inceraminceram  Cercon zirconiaCercon zirconia  Procera aluminaProcera alumina  Procera zirconiaProcera zirconia www.indiandentalacademy.com
  99. 99. Choice of systemChoice of system  Inlays onlays and veneersInlays onlays and veneers  Ceramco 3Ceramco 3  IPS EmpressIPS Empress  FinesseFinesse  In – ceramIn – ceram  In-ceram spinellIn-ceram spinell  Mark IIMark II  ProCADProCAD www.indiandentalacademy.com
  100. 100. Choice of systemChoice of system  Fixed Dental ProsthesisFixed Dental Prosthesis AnteriorsAnteriors  IPS Empress IIIPS Empress II  In-Ceram ZirconiaIn-Ceram Zirconia  All machinableAll machinable PosteriorsPosteriors  Inceram ZirconiaInceram Zirconia  All machinableAll machinable www.indiandentalacademy.com
  101. 101. Marginal fit and enamel abrasivenessMarginal fit and enamel abrasiveness  Excellent marginal fitExcellent marginal fit  CaptekCaptek  Fair marginal fitFair marginal fit  ALL OTHER TESTED ALL CERAMICSALL OTHER TESTED ALL CERAMICS  High abrasivenessHigh abrasiveness  In-Ceram ( all types )In-Ceram ( all types )  Very low enamel abrasivenessVery low enamel abrasiveness  IPS Empress2IPS Empress2 www.indiandentalacademy.com
  102. 102. ETCHING AND SILANATINGETCHING AND SILANATING  Support the restoration in soft wax with theSupport the restoration in soft wax with the fitting surface upper mostfitting surface upper most  Apply 1 mm coat of etching gel to the fittingApply 1 mm coat of etching gel to the fitting surface onlysurface only  The etching time depends on the ceramicThe etching time depends on the ceramic material (feldspathic porcelain etched for 5 min)material (feldspathic porcelain etched for 5 min)  Very carefully rinse away under running waterVery carefully rinse away under running water and dry it.and dry it.  Apply silane according to manufactureApply silane according to manufacture recommendationsrecommendations www.indiandentalacademy.com
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  104. 104. www.indiandentalacademy.com
  105. 105. CONCLUSIONCONCLUSION  For many years all ceramic crowns were the material ofFor many years all ceramic crowns were the material of choice to produce esthetic restorations.choice to produce esthetic restorations.  Research and developments were carried out toResearch and developments were carried out to improve strength comparable to metal ceramicimprove strength comparable to metal ceramic restorationsrestorations  Unfortunately the marginal fit of all all-ceramicUnfortunately the marginal fit of all all-ceramic restorations were not comparable to metal ceramic.restorations were not comparable to metal ceramic.  The long term clinical experience and research were stillThe long term clinical experience and research were still lacking and hence the choice of all ceramic left to thelacking and hence the choice of all ceramic left to the dental practitioner.dental practitioner. www.indiandentalacademy.com
  106. 106. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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