Advances in All Ceramic Restorations


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a presentation on advances of all ceramic restorations, giving some details on dental materials used in esthetic zone.

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Advances in All Ceramic Restorations

  1. 1. Alaa AlQutub Umm AlQura University, Faculty of Dentistry
  2. 2. Types of materials used in esthetic zone <ul><li>Metal ceramic restoration: </li></ul><ul><li>Metal ceramic alloy features : </li></ul><ul><li>Produce surface oxide </li></ul><ul><li>Coefficient of thermal expansion is greater than that of porcelain veneer </li></ul><ul><li>Melting range higher than the fusing temperature of dental porcelain. </li></ul><ul><li>Not distort at firing T. of porcelain </li></ul><ul><li>Ease of use </li></ul><ul><li>Biocompatible </li></ul>
  3. 3. <ul><li>Classification of dental casting alloys: </li></ul><ul><li>Based on functi on -> (type I,II,III, IV) </li></ul><ul><li>Based on color or composition -> </li></ul><ul><li>yellow golds </li></ul><ul><li>White golds </li></ul><ul><li>Low gold </li></ul><ul><li>High palladium </li></ul><ul><li>Silver palladium </li></ul><ul><li>Palladium silver </li></ul><ul><li>ADA classification : </li></ul><ul><li>High noble (noble metal content >60 % and gold >40%) </li></ul><ul><li>Noble (noble metal content >25% ) </li></ul><ul><li>Predominantly base (noble metal content <25%). </li></ul>
  4. 4. <ul><li>Chemical components of dental porcelain : </li></ul><ul><li>Kaolin , Feldspar , Quartz , Alumina </li></ul><ul><li>Component of dental porcelain kit : </li></ul><ul><li>Opaque porcelain : </li></ul><ul><li>Made by addition of insoluble metallic oxides----high refractive indices </li></ul><ul><li>Thickness of this layer depends on: brand of porcelain and the shade ) Minimum thickness .2mm and the maximum is .5mm ( </li></ul><ul><li>Function: it establish the metal porcelain bond </li></ul><ul><li>it masks the color of the metal </li></ul>
  5. 5. <ul><li>2 . Dentine porcelain: </li></ul><ul><li>It correspond in color to the dentin of natural teeth </li></ul><ul><li>The bulk of the crown is made by it </li></ul><ul><li>Major determinant for shade </li></ul><ul><li>It may extend to the incisal one third or occlusal surfaces   </li></ul><ul><li>3. Enamel porcelain : </li></ul><ul><li>More translucent than the dentin porcelain </li></ul><ul><li>Restricted range of shades </li></ul><ul><li>Not restricted to one area of a tooth </li></ul><ul><li>4. Translucent porcelain: </li></ul><ul><li>Don’t allow for transmission of all light </li></ul><ul><li>Applied to the entire surface of the crown </li></ul><ul><li>Gives depth and natural enamel like translucency </li></ul>
  6. 6. <ul><li>  </li></ul><ul><li>5. Stains : </li></ul><ul><li>Contain less silica or alumina more sodium and potassium oxides </li></ul><ul><li>Mixed with lower fusion point porcelain </li></ul><ul><li>  </li></ul><ul><li>6. Glazes: </li></ul><ul><li>Colorless low fusing porcelain </li></ul><ul><li>Fills small surface porosities and irregularities </li></ul><ul><li>Re creats the glassy appearance of natural tooth </li></ul>
  7. 7. <ul><li>Mechanism of bonding : </li></ul><ul><li>Van der waal forces </li></ul><ul><li>Mechanical retention </li></ul><ul><li>Compression bonding </li></ul><ul><li>Direct chemical bonding </li></ul><ul><li>Requirements to bond to metal: </li></ul><ul><li>High CTE </li></ul><ul><li>It should have slightly lower CTE than that of the alloy </li></ul><ul><li>  </li></ul>
  8. 8. <ul><li>Oxidation: </li></ul><ul><li>Cleans the metal of organic debris and remove trapped gases </li></ul><ul><li>It allows specific oxides to form on the metal surface  </li></ul><ul><li>Over oxidation responsible for bond failure </li></ul><ul><li>  </li></ul><ul><li>Post oxidation treatment: </li></ul><ul><li>For removing oxide layer : </li></ul><ul><li>Chemical method </li></ul><ul><li>Mechanical method </li></ul>
  9. 9. II . All ceramic materials <ul><li>Aluminous core ceramic: </li></ul><ul><li>. Composed of aluminum oxide crystal in a glassy matrix. </li></ul><ul><li>. an opaque inner core composed of(50%) alumina for high strength . this core was veneered with a combination of esthetic body and enamel porcaline. </li></ul><ul><li>. 40% stronger than traditional porcalin. </li></ul><ul><li>  </li></ul><ul><li>Slip cast ceramic(in- ceram): </li></ul><ul><li>. Used in crowns and veneers </li></ul><ul><li>. In ceram is about 3-4 times greater than earlier alumina </li></ul><ul><li>. 2 modified porcalin (in ceram ) :in ceram S pinell(mgal 2o4) - in ceram zirconia(zro2) </li></ul><ul><li>. Adv :. high strength .high fracture toughness </li></ul><ul><li>. Dis: fair marginal fit. High enamel abrsiveness </li></ul>
  10. 11. <ul><li>Machined ceramic (CAD/ CAMsystems ) </li></ul><ul><li>Cerec system: </li></ul><ul><li>consist of computer integrated imaging and milling system at lest 3 materials can be used(vita mark dicor. MGC .procad) </li></ul><ul><li>Disadvantages : poor marginal fit , lack of sophistication marginal adabtation of cerec 2 is improved and the occ anatomy can be shaped </li></ul><ul><li>Celay system : </li></ul><ul><li>uses a copy milling technique to manufature ceramic inlay and onlay </li></ul><ul><li>Advantages : marginal ccuracy seem to be little better than the cerec 2 </li></ul><ul><li>procera system: </li></ul><ul><li>advantages : very high fracture togh medium strength </li></ul><ul><li>Disadvantages : fair marginl fit </li></ul><ul><li>  </li></ul>
  11. 12. <ul><li>Metal reinforced : </li></ul><ul><li>Types: </li></ul><ul><li>Captec system and electroformed (produces a thin pure gold coping) </li></ul><ul><li>Advantages: </li></ul><ul><li>good marginal fit - excellent esthetic -medium enamel abrasion - medium fracture tough </li></ul><ul><li>disadvantages : </li></ul><ul><li>low strength </li></ul>
  12. 13. <ul><li>  </li></ul><ul><li>Indi cation : </li></ul><ul><li>optimal esthetic need . </li></ul><ul><li>decrease wear to opposing teeth . </li></ul><ul><li>conservative abutment prep use of adhesive luting tech. </li></ul><ul><li>metal free </li></ul><ul><li>Contraindications : </li></ul><ul><li>inability to maintaine fluid control . </li></ul><ul><li>long span needed. </li></ul><ul><li>pt with parafunctional habit. </li></ul><ul><li>Unglazed opposing porcelain. </li></ul><ul><li>Pt who abuse alcohol </li></ul><ul><li>Advantage :  </li></ul><ul><li>Good flexure strength and other physical characteristics. </li></ul><ul><li>FRC is translucent and require no opaque masking. </li></ul><ul><li>FRC have been to make two –phase all –polymer prostheses (internal glass fiber reinforced composite covered by a particulate composite) </li></ul><ul><li>  </li></ul><ul><li>  </li></ul>III. Fiber reinforced composites
  13. 14. <ul><li>Available materials: </li></ul><ul><li>Classified according to : </li></ul><ul><li>1 . type of fiber ( glass ,polyethylene and carbon ) </li></ul><ul><li>2 . fiber orientation ( unidirectional , braided and woven ) </li></ul><ul><li>3 . whether the fiber is impregenated by the dentist or lab: </li></ul><ul><li>there are available non - impregnated materials (polyethylene weaves and glass weaves). Or preimpregnated material (Vectris , Fiberkor , splint-it ) . </li></ul><ul><li>4 . whether the material is formed by hand or with a machine. </li></ul>
  14. 15. Tooth Preparation For All Ceramic Restoration
  15. 16. <ul><li>Indications: </li></ul><ul><li>High esthetic requirement </li></ul><ul><li>The tooth should be relatively intact with suffient coronal structure to support the restoration </li></ul><ul><li>Favorable distribution of the occlusal load </li></ul><ul><li>Contraindications: </li></ul><ul><li>When more conservative restoration can be used </li></ul><ul><li>Rarely recommended for molar teeth </li></ul><ul><li>  </li></ul>
  16. 17. <ul><li>Preparation: </li></ul>
  17. 19. <ul><li>Preparation steps: </li></ul>
  18. 21. <ul><li>Preparation steps: </li></ul>
  19. 22. <ul><li>Difference between preparation of all-Ceramic restorations and other types of preparation especially preparation of fiber-reinforced composite restorations </li></ul>
  20. 23. Cast Restorations Intra-Coronal Intra-Radicular Inlays Onlays Post & Core Extra-Coronal All Metal Full Coverage Partial Coverage All Ceramic PFM Modif. ¾ Crown Pin modif ¾ crown Proximal ½ crown 7/8 Crown Revere ¾ Crown ¾ Crown
  21. 24. Metal Ceramic preparation (PMF)
  22. 25. Partial Coverage
  23. 27. <ul><li>anterior </li></ul>
  24. 30. Fiber-Reinforced composite FPD