Esthetic crowns for posterior primary teeth presented at the congress of KAPD 2014, Seoul.

1. CDC해운대어린이치과
김 성 기

5. ZIRCONI
A

7. WHAT IS ZIRCONIA?
• Physical property : close to metal
• Color : tooth-like
• “Ceramic Steel”

8. 압축강도(Mpa) 인장강도(Mpa)
Composite resin 70~80 30~50
Amalgam 300~500 45~60
GI 93~226 -
Porcelain 150~600 30~60
ZPC 100~160 3~8
ZOE 2~14 -
Ni-Cr - 400~1000
Enamel 270~400 -
Dentin 230~300 40~50
ZIRCONIA 2000 900~1200

9. Scanning electron microscopy(SEM) observation of
fibroblasts cultured on zirconia : cells grow on the
whole zirconia surface, covering it with a cellular layer.

10. Kinder Krown
(pre-veneered)
NuSmile ZR
Dr. Jorge Casian
Adem(Mexico)

12. 6 weeks later
Notice : plaque accumulation on SSC and
healthy gingiva on NuSmile ZR(canine)

13. 마모

14. Dental wear is defined as tooth loss or surface damage
caused by direct contact between teeth or between
teeth and other materials. Dental wear, one of the
physiological phenomena that are experienced in a
lifetime, occurs as a complex form of chemical and
mechanical wear.
The surface hardness and friction coefficient are
commonly used to estimate the degree of wear of
restorative dental materials. Conventionally, greater
hardness has been believed to cause more wear.
Therefore, more wear was expected from zirconia, as
zirconia has strong surface hardness.
According to scientific studies, however, there is no
significant correlation between the restoration
hardness and the degree of wear of antagonistic teeth.
On the other hand, the degree of wear is more affected
by the surface structure and the roughness of the
restorations or environmental factors.

15. 0.119
0.031
0.078

16. Wear of Pediatric Enamel by Different
Ceramic Materials
Gary Frey, DDS
Davette Johnson, DDS
Houston Center for Biomaterials and Biomimetics
University of Texas School of Dentistry at Houston
7500 Cambridge St. Suite 5350
Houston, TX 77054-2008
Stylus Material X-axis wear Y-axis wear Depth
1 Zirconia 93.6 microns 98.8 microns 46 microns
3 Zirconia 118.2 microns 110.6 microns 112 microns
5 Zirconia 93.2 microns 75.1 microns 75 microns
7 Zirconia 94.8 microns 85.3 microns 41 microns
2 Alumina 100.2 microns 95.3 microns 42 microns
4 Alumina 101.6 microns 88.3 microns 57 microns
6 Alumina 94.3 microns 105.0 microns 54 microns
8 Alumina 87.3 microns 95.3 microns 66 microns
height width
Using a Leinfelder style in-vitro wear-test apparatus, 800,000 cycles

17. Zirconia Stylus Tips
Wear screening performed with
LEINFELDER testing instrument
What about wear to opposing primary teeth?
Frey et al., Houston Center for Biomaterials and Biomimetics (2012)

19. Preparation

20. Use a football or coarse tapered diamond to
reduce the occlusal surface of the tooth 1-2mm
following occlusal contours.
Tooth Preparation

21. Carefully prep tooth supragingivally to avoid tissue
masceration. Reduce the tooth 20% overall or 0.5-
1.25 mm on all planes of the tooth.
Black stripe – 5855

22. Use a fine thin tapered diamond - create a
feather-edge margin 1-2mm subgingivally
Green Stripe - 6852
Make sure no subgingival shoulders
or ledges remain

23. Round line angles.
Overall tooth reduction = approximately 20%

29. cementation

30. Ready-made crown
Bonding or luting?
Gap-filling!

32. Contamination!
(blood, saliva)
Preparation!
(tooth structure, taper)

34. Bonding agent +
ceramic primer
Self-etching
primer to dentin
One component One component
Classification of Resin Cement

36. Bonding Mechanisms of Zirconia-
based Ceramics

37. O
OH
OH
P
R
Zr Zr
O
OOO
Zr Zr
O
OO
OO
O
P
R
 Bonding mechanism of MDP to Zirconia

38. 38
 Bonding mechanism of Phosphoric ester monomer to zirconia
Zr4+
Zr4+
Zr4+
Zr4+
P P
O-
O O
OH
H
O
HO O
O-
O
H
O
R R

39. © 3M 2008. All Rights Rese
rved.
Self-adhesive chemistry
Result: highly crosslinked, hydrophobic 3D network
3M ESPE self-adhesive resin cements
- Unique chemistry

40. ₩10,000/g
₩14,000/g
₩10,000/g
₩9,800/g
₩13,720/g
₩11,620/g

42. Zirconia-cement interface?
Cement-tooth interface!

45. 3 weeks later

48. 2 weeks later

51. 2 weeks later

52. 2 months later

53. 5 months later

54. Inadequate reduction of buccal bulge resulting in horizontal extension and MB Rotation

60. 6M

62. 1 week later

65. 1 week later

75. kimsungki99@gmail.com