Copy of metal free ceramics/certified fixed orthodontic courses by Indian dental academy

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

METAL CERAMICS
METAL FREE CERAMICS

General ClassificationGeneral Classification
1. Castable ceramics
2.Conventional powder ceramics
3. Pressable ceramics
4.Infiltrated ceramics
5. Machinable ceramics

Castable Ceramics :
These products are supplied as solid ceramic
ingots, which are used for fabrication of cores or
full contour restorations using a lost wax and
centrifugal casting technique. Generally, one
shade of material is available. Which is covered
by conventional feldspathic porcelain or is
stained to obtain proper shading and
characterization of the final restoration.
e.g. DICOR (Corning glass, Dentsply).
CERAPEARL (Bioceram, Kyocera)

Dicor shaded cements :

Powder Slurry Ceramics :
Supplied as powders to which the technician adds
distilled water to produce a slurry, which is build
up in layers on a die material to form the
contours of the restoration.
The powders are available in different shades and
translucencies, and are supplied with
characterizing stains and glazes.
e.g. OPTEC H.S.P (Jeneric/Pentron)
DUCERAM L.F.C (Ducera Inc)
Vita Hi-Ceram (Vita Zahnfabrik)

Pressable Ceramics :
Supplied as ingots, these product are melted at
higher temperatures and pressed into a mould
using a lost wax technique.
These pressed form can be made into full contour,
or can be used as a substrate for layering
technique.
They are leucite based.
e.g. IPS Empress I (Ivoclar vivadent)
OPC (Optec Pressable Ceramic)
ALCERAM (Cerestore, Innotek dental corp)
IPS Empress 2* (Lithium disilicate)www.indiandentalacademy.com

LEUCITE REINFORCED GLASS
CERAMICS
Leucite – KAlSi2O6
Reinforcing phase due to tangential stresses it
creates within the porcelain
Varies from 35%-50% by volume
Flexural strength – 120 Mpa

Mechanical Strength is Insufficient for
construction of All Ceramic Bridges
Crowns
Inlays
Veneers
Leucite containing materials are
IPS Empress (Ivoclar)
IPS Finnesse .
Authentic Pressable Ceramics

HOT PRESSED CERAMIC
Ceramic is heated to a
specified temperature and
forced under pressure to fill
a cavity in a refractory
mould.
Marginal adaptation better
than high strength alumina
core materials.

1180 degrees over a period1180 degrees over a period
of 45minof 45min
High Degree of Marginal Fit can be AchievedHigh Degree of Marginal Fit can be Achieved

Infiltrated Ceramics :
These are glass infiltrated core ceramics. This
involves slipcasting technique for making the
core, and the contours of the restoration are
obtained by individual layering and staining
techniques.
e.g. In-CERAM (Vita Zahnfabrik)
Alumina
Zirconia
Spinell

Most Translucent
Glass infiltrated
Magnesium Aluminum Oxide core for Improved
Translucency
The strength of in ceram is about three times more
greater than earlier alumina core materials.
Marginal fit reported to be very good.
INCERAM

INCERAM ZIRCONIA
Glass-infiltrated Alumina with 35% partially stabilized Zirconia
core
Good Marginal Fit
High strength of 700 Mpa
Fracture toughness- 6-8 Mpa.m1/2
High level of opacity - not recommended for Anterior
Prosthesis
Posterior Crowns and FPDs, Post & Core, Implants
Strongest And Toughest Of Available Ceramics

Zirconia:
 Principle of strengthening by the
incorporation of a crystalline material that is
capable of undergoing a change in crystal
structure when placed under stresses.
 This crystalline material is usually termed as
Partially Stabilized Zirconia(PSZ).
 The energy required for the transformation of
PSZ is taken from the energy that allows the
crack to propagate.
 One drawback of PSZ is that its refractive
index is much higher than that of the
surrounding glass matrix.

 Principle of
transition
strengthening(left
) and a scanning
electron
micrograph photo
of a crack (next to
the red line) that is
running through
the infiltration
glass of the
substructure
material and
stopped (head of
the arrow) by a
zirconium oxide
grain (whit color).

Machinable Ceramics
These products are supplied as ingots in various
shades and are milled into desired form. These
machined restorations can be stained and glazed
to obtain desired characterization.

Classification:
a ceramic restoration
fabricated by use of a
computer aided design -
computer aided milling
a process of milling a
structure using a device that
traces the surface of a metal,
ceramic or a polymer
pattern and transfers the
traced spatial positions to a
cutting station.
C A D -C A M C e r a m ic s C o p y -M il l e d C e r a m ic s
M ac h in able C er a m ic s

CAD-CAM
 DCS–PRESIDENT -1991
 AUTO MILL – 1994
 CEREC 2 – 1994
 CEREC 3 – 2000
 Procera all Ceram
System.
COPY MILLING
 CELAY – 1991
 PRO CAM - 1996
COPY MILLING and CAD-CAMCOPY MILLING and CAD-CAM

Types of CAD – CAM Devices:
 DIRECT:
Fully integrated CAD – CAM devices for chair
side restorative approach. CAD & CAM
stations are located at the dental office.
 INDIRECT:
System that consists of several modules with at
least, distinctive CAD & CAM stations.

Cercon(Dentsply) and Lava (3M ESPE)
Zirconia Core Ceramics
CERCON, DCS-PRESIDENT
White Colored Core limit their indications from an
esthetic standpoint.
LAVA
Core Relatively Translucent and at the same time
may Mask Underlying Discolored Abutments.

CERCON SYSTEM
Conventional Waxing
Techniques
DCS-PRESIDENT & LAVA systemsDCS-PRESIDENT & LAVA systems
CAD TechnologyCAD Technology
&&
Different Features and Design Options.Different Features and Design Options.

CEREC SYSTEMS
(Seimens, Germany )
Utilizes CAD-CAM technology
 CEREC 2 System - 1994.
 CEREC 3 SYSTEM -2001

CEREC 2 SYSTEM
CAD - CIM
COMPUTER INTEGRATED MILLING
The Marginal Fit and Accuracy of restorations is
Superior to CEREC
OCCLUSAL MORPHOLOGY MACHINED

CEREC 2 OCCLUSAL MORPHOLOGY MACHINEDOCCLUSAL MORPHOLOGY MACHINED

CEREC 3
Network and
Multimedia ready
combination with an
Intraoral Color Video
Camera
OR
Digital Radiographic
Unit

Fabrication of restorations Accelerated
(24 min.-27% time saving)
Rapid occlusal and functional registration is possible
and
ACCURATE OCCLUSION established
Eliminates waiting periods for image adjustment, data
storage , matching of two optical impressions in
construction of occlusal surfaces with correlation
and functional modes.

FORM GRINDING UNITFORM GRINDING UNIT
Greater DetailGreater Detail than Cerec 2than Cerec 2 and fitted with oneand fitted with one
CylindricalCylindrical and oneand one TaperedTapered diamond rotatorydiamond rotatory
tool andtool and controlled withcontrolled with radio communicationradio communication
from the control unit independent of its location.from the control unit independent of its location.
The next restoration can be designedThe next restoration can be designed
while the first is being milledwhile the first is being milled

Intra Oral 3 Dimensional Scanning
Camera
Optical impression recorded with Single Exposure
from Single Viewing Line, representing the
Preparation and Insertion Axes respectively in a
Fraction of a second without Reference
Markings on the Teeth and is Reproducible.

Materials used with
CEREC’s:
 Dicor MGC*(Machinable Glass Ceramic)(Dentsply):
Vita Mark II (Vident

Materials used with
CEREC’s: Vita Mark II (Vident):
These contain sanidine (KALSi3O8) as a major
crystalline phase within a glassy matrix.

Materials used with
CEREC’s:
 Vita IN-Ceram Blanks (Vita Zhanfabrik):
These are third generation blanks from Vita.
 The Spinell MgAl2O4.
 The Alumina Al2O3.
 The Zirconia ZrO2.

Milling process - - - - - - - - - - - Completed ceramic core

CEREC MILLING

PROCERA SYSTEM
(Nobel Biocare,Sweden)
Procera Scanner
scans the surface
of the prepared
tooth

Transmits theTransmits the
information to ainformation to a
computer controlledcomputer controlled
design station, wheredesign station, where
the Aluminum Oxidethe Aluminum Oxide
copings arecopings are
fabricated.fabricated.

The dental laboratories which decide to useThe dental laboratories which decide to use
the technique of Procera invest in Procerathe technique of Procera invest in Procera
Scanner. Using Procera® scanner and aScanner. Using Procera® scanner and a
standard PC, the shape of the tooth can bestandard PC, the shape of the tooth can be
registered with extremely high precision.registered with extremely high precision.
Procera

The coping is then designed on theThe coping is then designed on the
computer using the CADD (Computer Aidedcomputer using the CADD (Computer Aided
Dental Design) program. This information isDental Design) program. This information is
sent via the telecommunications networksent via the telecommunications network
to a Procera production unit where theto a Procera production unit where the
coping is produced.coping is produced.
Procera system

Using a unique software program fromUsing a unique software program from
Procera, the dental technician can use a 3DProcera, the dental technician can use a 3D
(three-dimensional) technique to create crown(three-dimensional) technique to create crown
designs for both teeth and implants.designs for both teeth and implants.
The target for the development work that isThe target for the development work that is
being done within Procera is to produce abeing done within Procera is to produce a
comprehensive CAD/CAM system for allcomprehensive CAD/CAM system for all
permanent prosthetics.permanent prosthetics.
Procera

The Procera coping has the ability toThe Procera coping has the ability to
transmit light without becomingtransmit light without becoming
transparent. When combined with Proceratransparent. When combined with Procera
AllCeram porcelain, these remarkableAllCeram porcelain, these remarkable
esthetic characteristics provide a vitalesthetic characteristics provide a vital
natural beauty and perfect shade blending.natural beauty and perfect shade blending.
Procera

Procera Allceram – Alumina based
( Nobel Biocare)
99.9 % Aluminum Oxide
Densely sintered, high purity alumina core on which
low fusing porcelain is built
Local dental lab scan the dies and the information is
sent to centres via internet enabled oversized dies
to be made.

Small defects caused by machining are eliminated
during sintering.
0.4 mm cores are used for esthetically critical crowns
on anterior teeth and first premolars.
Flexural strength is 487-699 MPa
Fracture toughness- 4.48 – 6 MPa.m1/2

Strength is twice that of In-Ceram and five
times that of Empress
Anterior & Posterior Crowns
Veneers
Onlays
Inlays.

PROCERA-ZIRCONIA BASED
Flexural strength TWICE that of Alumina
based
CAD-CAM
Ideal in areas of maximum strength
SINGLE UNITS ONLY

YTTRIUM TETRAGONAL ZIRCONIA
POLYCRYSTALS (Y-TZP) BASED
MOST RECENT
Excellent Mechanical Properties and
Biocompatibility
Early 1990s - Endodontic’ Dowels and Implant
Abutments.

Yttrium oxide is a stabilizing oxide added to
pure zirconia to stabilize it at room
temperature and to generate a multiphase
material known as
Partially Stabilized Zirconia
which gives it its
High Initial Strength and Fracture Toughness

Y-TZP cores are Glass Free
Do not exhibit
SUB CRITICAL CRACK PROPAGATIONSUB CRITICAL CRACK PROPAGATION.
Flexural strength ofFlexural strength of 900 to 1200 MPa900 to 1200 MPa
DoubleDouble of Alumina-based Materialsof Alumina-based Materials
3 Times3 Times Lithium DiSilicate–based MaterialsLithium DiSilicate–based Materials

Scanning device

Controlled shaping of spacer. Overall design.
Constant monitoring of connector cross section. Pontic shaping

Parallel milling with two tools:

High speed milling of copings and bridge frame work.

Completed bridge framework

Cercon can be used in cases of multipleCercon can be used in cases of multiple
pontics in a row including posterior teeth.pontics in a row including posterior teeth.
Cercon is conventionally cemented withCercon is conventionally cemented with
glass ionomer cement or Enamel-dentinglass ionomer cement or Enamel-dentin
adhesive bonding system.adhesive bonding system.
Fabricated with yttria-stabilized zirconia,Fabricated with yttria-stabilized zirconia,
CerconCercon
Cercon SMART CERAMICS

cercon CAM or CAD-CAM System
cercon eye cercon art
cercon heatcercon cleancercon brain
cercon hardware

cercon smart ceramics – CAM

Cover the wax up with scan powder

separating the frame work
• the not sintered
material shows a
chalky consistence
• first the frame-
work has to be
separated from
the frame
• therefore sandblasting with
50 µm Al2O3 with 1 bar
pressure has to be applied
onto the gates

Cercon heat

Units are place in the Cercon Heat. The temperature goes up
to 13500
C and holds for 2 hours.
• Put the crown or the framework
with the occlusal side on the
furnace tile.
• Push the start button and the
sintering process begins.
• After 6.5 hours the shrinking
process is done.

Always use water-cooled turbines
for grinding the sintered
frameworks

The framework should be sandblasted with
110 µm Al2O3 and a pressure of 2,5 bar
carefully except for the margins and cleaned
with steam water

Veneering with Cercon Ceram KISS

PFM Bridge restoration with
insufficent margins on the
teeth 12 to 21.
Preparation of the teeth for a
zirconia all-ceramic restoration.
After the insertion of the
Cercon all-ceramic bridge.

Teeth 13 and 12 with multiple and
extensive insufficent composit
restorations.
Set-up of the teeth 13 and 12with
quartz fiber posts, composit and
preparation.
One week after the insertion of
the Cercon all-ceramic crowns.

Cercon Zirconia is unique among dentalCercon Zirconia is unique among dental
ceramics in that it exhibits a physical propertyceramics in that it exhibits a physical property
calledcalled “transformation toughness.”“transformation toughness.” WhenWhen
stress is applied to the material, it goesstress is applied to the material, it goes
through an instantaneous phasethrough an instantaneous phase
transformation that acts as a clamp to preventtransformation that acts as a clamp to prevent
crack development. This phenomenon is ofcrack development. This phenomenon is of
great importance in fatigue situations such asgreat importance in fatigue situations such as
those caused by chewing forces onthose caused by chewing forces on
restorations.restorations.
Cercon

Manufactured using a computer controlledManufactured using a computer controlled
milling machine, these restorations aremilling machine, these restorations are
machined to precise tolerances, withmachined to precise tolerances, with
outstanding fit and marginal integrity, andoutstanding fit and marginal integrity, and
of course STRENGTH!of course STRENGTH!
Cercon

CELAY* System
MikronaTechnologies
Switzerland.

Introduction:
 The Celay* is a well hand operated system
that represents an interesting alternative to
CAD – CAM system for the dental
laboratory.Marginal accuracy seems to be
good ,a little better than the Cerec 2 system.

Ceramic Blanks:

Procedure:

LavaTM
Crowns & Bridges

• The processing of Zirconia effects the
clinical requirements for a dental restorations
• Excellent marginal fit.
• Good compatibility with oral tissues.

Marginal Fit
Greenbody state
Exact and reproducible sintering parameters
Homogeneity of the material
No deformation during sintering process
2 µm
Sintered Material

 Colored with liquid chemistry
 Developed together with Zirconia
 8 different shades
 Characterized by different absorption spectra
matched to the Vita Classic
 Real different colors instead of dilution of same
coloring components
Staining
Lava FrameLava Frame
Shade LiquidShade Liquid FS 1FS 1 FS 2FS 2 FS 3FS 3 FS 4FS 4 FS 5FS 5 FS 6FS 6 FS 7FS 7
Translation inTranslation in
VITA ClassicVITA Classic
ColorsColors
A1A1
B1B1
B2B2
C1C1
A2A2
A3A3
A3,5A3,5
A4A4
B3B3
B4B4
C2C2
C3C3
C4C4
D2D2
D3D3
D4D4

 Mechanical/chemical bonding
 Coefficient of thermal expansion adjusted to the core
material
 No pretreatment of surfaces necessary
Interface ZrO2 - Veneering
SEM Picture Lava Ceram™ on Lava™
Internal measurement
polycrystalline
Lava™-ZrO2
Lava Ceram ™
Veneering porcelain
Good wetting behavior at interface

LavaTM
Zirconia
 Precise fit
 Most important to doctors1
 Exceptional marginal fit2,3,4
 Proven strength
 Proven High Strength – 1440
MPa
3-pt bend test5
 100% survival rate in 5-yr
clinical study6
 Natural Esthetics
 Natural translucency
 Patented substructure
system available in 8 shades
1
Key Group Study, October 2006, “Accuracy of fit” listed as #1 out of 16 possible attributes. 134 total doctor responses
2
A.J.T. SHANNON, F. QIAN, P. TAN, and D. GRATTON, University of Iowa, Iowa City, USA, 2007
3
A. Piwowarczyk, H.-C. Lauer (2006), Determining the marginal fit of CAD/CAM bridge frameworks, Pan European Federation Conference (PEF; CED) #0254
4
F. Beuer, T. Fischer, K.-J. ERdelt, H.-U. Aggstaller, K. Spiegl, W. Gernet; (2005) IADR #1336 and In vitro Study Marginal fit of Lava restorations; F. Beuer,
T. Fischer, K.-J. ERdelt, H.-U. Aggstaller, K. Spiegl, W. Gernet, industrial report (2006)
5
3M ESPE Internal 3 pt- Bending Test – ISO 6872, July/September 2005
6
3-unit posterior bridges, Start 2000, P. Pospeich, University of Homburg, Homburg
µ
Mean Marginal Gap: Vertical Gap2
PFM
PFM Lava Zirconia

Lava™ Zirconia: Esthetics
8 Shades
Available in 8 shades--matched to
VITA® Classic Shade Guide
 Patented substructure shading system
VITA is a registered trademark of VITA Zahnfabrik.
Uniform coloring of the framework
Minimal influence to translucency
Minimal reduction in strength

Possible Indications withPossible Indications with
the Lava™ Systemthe Lava™ System
Crowns (anterior andCrowns (anterior and
posterior)posterior)
3- and 4-unit bridges3- and 4-unit bridges
5- and 6-unit bridges5- and 6-unit bridges
Inlay bridges*Inlay bridges*
Maryland bridges*Maryland bridges*
Cantilever bridges*Cantilever bridges*
* Tests have proven:
Lava™ Zirconia shows a sufficient strength for this indication. However, this type of indication overall can
have a higher failure risk due to decementation and secondary
caries regardless of manufacturer. Please refer to national and regional dental associations for more
information.

Quelle: Universität Frankfurt/Main Zahnarzt: P. Weigl Zahntechnik: E. Krenz

Quelle: Universität Frankfurt/Main Zahnarzt: P. Weigl Zahntechnik: C. Fischer

Quelle: Universität Frankfurt/Main

Zahnarzt: Dr. S. Rinke Zahntechnik: ZTM P. Finke

restauration with cercon and cergo

Cercon Link
Cercon link
Attachment for
bridge framework
on divergent
posts

Fixing the Cercon Link

Fitting and veneering the
primary part

Wax – up secondary part

Cercon Link bridge fixed in the mouth

New materials and techniques in dentalNew materials and techniques in dental
ceramics will continue to play a role inceramics will continue to play a role in
the provision of esthetic restorations.the provision of esthetic restorations.
The dentist needs to update himselfThe dentist needs to update himself
about the recent advances in dentalabout the recent advances in dental
ceramics to ensure that correct choice isceramics to ensure that correct choice is
made for each patientmade for each patientwww.indiandentalacademy.com

Copy of metal free ceramics/certified fixed orthodontic courses by Indian dental academy

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