ALL CERAMIC RESTORATION

INTRODUCTION
▹ The demand for metal free ceramics with highly biocompatible
dental restorative material has increased during the past decade
▹ All ceramic restorations are made without a metallic core or
substructure
▹ This make them esthetically more superior to the metal ceramic
restoration
▹ For meeting the requirements of dental materials with improved
strength and toughness, various new ceramic materials as well as
new techniques have been developed during the past decade.
▹ These recent developments have attempted to overcome the
principal disadvantages of inherent brittleness and the potential to
abrade the opposing dentition by either the use of increasingly
complex technology or by the simplification of existing techniques
and/ or materials.
CLASSIFICATION
▹ Based on composition and fabrication:
1. Conventional (powder-slurry) ceramics
2. Castable ceramics
3. Machinable ceramics
4. Pressable ceramics
5. Infiltrated ceramics.
 ▹ Based on the presence of specific attributes within their
formulation:
1. Glass-matrix ceramics
2. Polycrystalline ceramics
3. Resin-matrix ceramics
CONVENTIONAL (POWDER-SLURRY) CERAMICS
▹ These products are available in powder form to which water is
added by the technician to produce slurry
▹ In order to form the contours of the restoration, slurry is built up in
layers on a die.
▹ The powders supplied with characterizing stains and glazes are
available in different shades and translucencies.
ALUMINOUS CORE PORCELAIN
• Mc Lean and Hughes 1965 developed a PJC with an alumina
reinforced(VITADUR N CORE)
• Significant improvement in fracture resistance
• Consisted of a glass matrix containing between 40-50 wt% of
Al2O3.
• Large sintering shrinkage (15-20%)
• Inadequate translucency
▹ Objective
Improve aesthetics by a replacement of the thicker metal coping
with a thin platinum foil, thus allowing more room for porcelain
 The first aluminous core porcelains contained 40% to 50% alumina
by weight.
▹ Principle indication: maxillary anterior crown restoration
▹ Bonding aluminous porcelain to platinum foil copings by use of
tin oxide coatings on platinum foil.
▹ Bonded foil –
Acts as an inner skin on the fit surface -- Reduces subsurface
porosity and formation of micro cracks in the porcelain
Increasing the fracture resistance of crowns and bridges.
▹ DISADVANTAGES
▹ Extensive reduction, dentin preparation
▹ Bonding is limited.
▹ Porcelain used for veneering in PFM cant be used with aluminous
core porcelain
▹ CTE Alumina core: 8x 10-6/0C Hence requires similar low
expansion veneer porcelain. CTE Veneering porcelain for PFM: 13
x 10-6/0C
▹ Extensive cracking results upon bonding these materials owing to
thermal stresses
MAGNESIA – REINFORCED PORCELAIN
▹ Magnesia core porcelains was developed as an experimental
material in 1984 by O’Brien.
▹ Magnesia was used as the basis of high expansion core material
because co efficient of thermal expansion of magnesia is 13.5 X 10
-6/°c.
▹ The core material is made by reacting magnesia with a silica glass
within the 1100-1150°C temperature range.
▹ Magnesia crystals strengthen glass matrix by both dispersion
strengthening and crystallization within the matrix .
▹ Advantages
• Increased co-efficient of thermal expansion
• Improved strength (glass infiltration of magnesia core)
• High expansion property
LEUCITE-REINFORCED PORCELAIN
• They are feldspathic porcelains, dispersion strengthened by
crystallization of leucite crystals in the glass-matrix.
• The leucite and glassy components are fused during the baking
process at 10200C.
• Leucite crystals in the glass - matrix (50%).
 Strength : Nucleation and growth of leucite crystals.
 Translucency- Closeness of the refractive index of leucite with that
of the glass matrix.
 Flexure strength- approximately 140 MPa.
▹ Advantages
• High strength (leucite reinforcement)
 • Good translucency
• Moderate flexural strength
Disadvantages
• Marginal inaccuracy due to sintering shrinkage.
• Fracture in posterior teeth.
• High abrasive effect on opposing teeth.
HYDROTHERMAL CERAMICS
▹ The hydrothermal ceramic systems are basically low fusing
porcelains containing hydroxyl groups in the glass matrix.
▹ The hydroxyl ion is added to the porcelain structure through
exposure to water or water vapours.
▹ The hydroxyl addition which Bertschetein and Stepanov termed as
“a plasticized layer” supposedly increases chemical resistance which
generates “smoother” surface profile, and possesses the unique capacity
of “healing” surface flaws through the ion exchange process.
▹ Hydrothermal ceramics can be formulated as two types :
A single phase porcelain
Eg: Duceram LFC® (Degussa Dental, South Plainfield, NJ)
A leucite containing two phase material
Eg.: Duceragold® (Degussa Dental, South Plainfield, NJ)
▹ Self healing effect of hydroxyl surface layer :
 Conventional porcelains contain surface microflaws or develop
them after exposure in the oral environment.
These flaw can increase over a time period, resulting in surface
dicolourations and reduction in flexural strength
Hydrothermal ceramics an ionic exchange occurs between alkali and
hydroxyl groups at the surface layer. This ionic exchange is suggestive
of an effect of “healing” surface flaws, thereby contributing to an
increase in strength.
ZIRCONIA BASED CERAMICS
▹ Conventional feldspathic porcelains where tetragonal Zirconia
fibres have been .
▹ Zirconia undergoes a crystallographic transformation from
tetragonal to monoclinic at 1150° C
▹ Partial stabilization can be obtained by using various oxides such
as CaO, MgO, Y2O3, and CeO, which allows the high-temperature
tetragonal phase to be retained at room temperature
INFILTRATED / SLIP CAST CERAMICS
▹ GLASS INFILTRATED CORE CERAMICS
• The internal surface is sandblasted (with 50m A12O3)
• Since the density of In-ceram core makes conventional
methods of etching with HF acid ineffective for bonding
with a resin-cement.
▹
 INCERAM ALUMINA
▹ Developed by a French scientist and dentist Dr.
Michael Sadoun (1980) and first introduced in France
in 1988.
Composition:
▹ Two three-dimensional interpenetrating phases :
• Alumina/ Al2O3 crystalline : 99.56 wt%
• An Infiltration of glass lanthanum aluminosilicate
Lanthanum
 Decreases the viscosity of the glass to assist infiltration
 Increases its refractive index to improve translucency.
Fabrication stages :
• Slip casting
• Veneering of core
▹ PROPERTIES
▹ STRENGTH :
Denselypackedcrystalline particles (70%alumina) limit crack
propagation and prevent fracture.
• Flexure strength : 450 MPa
COLOR
 • Final color : influenced by the color of the alumina core
(opaque).
• Colorants used : transitional metal ions incorporated into the glass
structure itself
• Spinel ceramic : the core is more transparent and its corresponding
infiltration glass is slightly tinted.
▹ Uses : Anterior crowns , posterior crowns and anterior FPD
ADVANTAGES
• Minimal firingshrinkage, hence an accurate fit.
• High flexure strengths (3 times)
• Aluminous core (opaque) : used to cover darkened teeth or post/
core.
• Wear of opposing teeth is lesser
• Biocompatible : less plaque accumulation.
DISADVANTAGES
• Requires specialized equipment.
• Poor optical properties or esthetics (opaque alumina core)
• Incapability of being etched
• Slip casting is a complex technique
• Considerable reduction of tooth surface
IN-CERAM SPINELL
 • Introduced due to the comparatively high opacity of the alumina
core.
• Incorporating magnesium aluminate (MgAl2O4) results in
improved optical properties characterized by
Increased translucency
About 25% reduction in flexural strength
• Spinel or Magnesium aluminate (Mg Al2O4) is a composition
containing Al2O3 and Mg2O.
ADVANTAGES
• Spinel renders greater strength characteristics.
• Spinell has extended uses (Inlay / Onlay, ceramic core material
and Veneers)
DISADVANTAGES
• Incapable to be etched by HF
• 25% reduction in flexural strength
IN-CERAM ZIRCONIA
▹ Contains tetragonal zirconia and alumina as the major crystalline
phase.
▹ Final core material –
30%wt Zirconia
70%wt Alumina
▹ Physical properties were improved without altering the proven
working procedure.
ADVANTAGES
• High flexural strength
1.4 times the stability
2-3 times impact capacity compared to ln-Ceram Alumina
• Excellent Marginal Accuracy
• Biocompatibility
Disadvantages
• Poor esthetics due to increased opacity
• Inability to etch
CASTABLE CERAMICS
• Introduced by Mc Culloch in 1968
• Di-Cor
• New types
• Cera pearl
• Canasite glass ceramic
• Optimal pressable ceramic
• Olympus castable ceramics
• Castable phosphate glass ceramic
 DICOR
▹ Dicor system composed of SiO2; K2O. MgO, and MgF2. Small
amounts of Al2.O3 and ZrO2 are added for durability and a
fluorescing agent is added for esthetics.
▹ Dicor contain Tetra silicic fluor mica Crystals
▹ Lost wax casting technique is used , similar to that employed for
metals.
▹ Uses centrifugal casting machine.
▹ Glass subjected to heat treatment (1075 degree c for 10 hrs) that
causes microscopic plate like crystals of crystalline material to
grow with in the glass matrix.
▹ This heat treatment (which involves crystal nucleation and crystal
growth process) is known as “ceramming”.
▹ The crystals function in 2 ways:
1) They create a relatively opaque material out of initially
transparent crown
2) They significantly increase the fracture resistance and
strength of ceramic.
These crystals are also less abrasive to opposing tooth structure than the
leucite crystals found in traditional feldspathic porcelains
▹ CHAMELEON EFFECT
▹ Dicor is a glass, it is capable of producing a “Chameleon Effect”
i.e. part of the colour of the restoration is picked up from the
 adjacent teeth as well as from the cement used for luting the
restoration.
▹ The transparent crystals scatter the incoming light and also its
color, as if the light is bouncing off a large number of small
mirrors that reflect the light and spread it over the entire glass-
ceramic Chameleon Effect
▹ Ceramming done from 650-1075°c for 1½ hrs and sustained for
6hrs in order to form tetra silicic flouromica crystals
▹ This procedure leads to controlled crystallization by internal
nucleation and crystal growth of microscopic plates like mica
crystals within the glass matrix
▹ Advantages –
• Ease of fabrication
• Improved aesthetics
• Moderately high flexural strength
• Low thermal expansion equal to that of tooth structure
• Minimal abrasiveness to tooth
• Biocompatibility
• Less bacterial counts
Disadvantages
Its limited use in low-stress areas Its inability to be coloured internally.
CASTABLE APATITE GLASS CERAMIC (CERAPEARL)
• 1985 -Sumiya Hobo & Iwata
• Crystalline microstructure similar to natural enamel
• Mechanical properties superior to enamel
• The main crystalline phase is oxylapatite ,transformable into
hydroxyapatite when exposed to moisture.
▹ Composition
CaO- 45% reacts with P2O5
P2O5 -15% - Aids in glass formation
SiO2 - 35% - Forms the glass matrix.
MgO -5% - Decreases the viscosity (anti flux)
Others: Trace elements
(Nucleating agents during ceramming)
▹ CHEMISTRYCeramming :
▹ The ceramming oven is preheated at 750°C for 15 minutes. After
the cast glass ceramic is placed in the oven the temperature is
raised at the rate 500C / min until it reaches 870°C and held for 1
hr.
▹ PROPERTIES
▹ Cerapearl is similar to natural enamel in Composition
▹ Density2-2.97gm/cm²m/cm2
▹ Refractive index-1.66
 ▹ Thermal conductivity-0.002
▹ Hardness-343KHN
▹ Clinical success : (crowns) 2 year success rate –100%
PRESSABLE CERAMICS
• Supplied as ceramic ingots
Fabricated using Lost Wax technique and heat pressed into the mould
• Steps:
• Wax pattern – invested in phosphate bonded investment
• Placed in specialized mould with alumina plunger
• After burnout, ceramic ingot is placed under plunger and
heated to 11500C
• Veneered using feldspathic ceramics
▹ CLASSIFICATION
Shrink free ceramics
• Cerestore
• Al-ceram
Leucite reinforced glass ceramics
• IPS empress
• Optec/OPC
Lithia reinforced glass ceramic
• IPS empress 2
 • OPC 3G
CERESTORE(Shrink Free Ceramics)
• Consists of Al2O3 and MgO mixed with Barium glass frits.
• On firing crystalline transformation produces Magnesium
aluminate spinel, which occupies a greater volume than the
original mixed oxides compensates for the conventional firing
shrinkage.
• Unfired Cerestore core :
▹ Al2O3
MgO
Glass frit
Silicone resin
Fillers
Fired Cerestore core :
α- Al2O3 (Corrundum)
MgAl2O4 (Spinel)
Ba Mg2Al3 (Si9Al2O3) – Barium osumilite
▹ PROPERTIES
• Flexural strength : 225 Mpa
• Fit : exceptional fit because of direct moulding process.
• Low thermal conductivity
• Radiodensity similar to enamel
 • Biocompatible
▹ Advantages
• Dimensional stability of the core material in the molded (unfired)
and fired states
• Better accuracy of fit and marginal integrity
• Esthetics
• Biocompatible (inert) and resistant to plaque formation (glazed
surface)
• Radio density similar to that of enamel
• Low thermal conductivity; thus reduced thermal sensitivity
• Low coefficient of thermal expansion and high modulus of
elasticity results in protection of cement seal
▹ Disadvantages
• Complex
• Specialized laboratory equipment and cost
• Inadequate flexural strength compared to the metal-ceramic
restorations
• Poor abrasion resistance, hence not recommended in
patients with heavy bruxism or inadequate clearance
• LIMITATIONS and high clinical failure rates of Cerestore led to
the withdrawal of this product from the market.
Improved version : 70 to 90% higher flexural strength - marketed as
Al Ceram.
IPS-EMPRESS
• This technique was first described by Wohlwend & Scharer; and
marketed by Ivoclar (Vivadent Schaan, Liechtensein).
• Is a pre-cerammed, pre-coloured leucite reinforced glass-ceramic
formed from the leucite system (SiO2-AI2O3-K20) by controlled
surface crystallization, subsequent process stages and heat
treatment
• The partially pre-cerammed product of leucite-reinforced ceramic
powder available in different shades is pressed into ingots and
sintered
• Ingots are heated in the pressing furnace until molten and then
injected into the investment mold.
▹ COMPOSITION
• Pre cerammed, pre colored : INGOTS
▹ FABRICATION
▹ Lost-wax technique:
▹ Wax pattern is invested
▹ Burnout (at 850°C)
▹ Following the burn out procedure, the ring
along with the investment is placed in a specialized
mould that has an alumina plunger
▹ The ceramic ingot is placed under the plunger
 ▹ The entire assembly is heated to 1150°C and the plunger presses
the molten ceramic into the mould
▹ The cylinder is then pressed under vacuum into the mould and held
under pressure to allow complete and accurate fill of the
investment cavity
▹ The crown is formed in dentin shades
▹ Enamel layering is added in Empress furnace for necessary
translucency and staining .
▹ PROPERTIES
• Flexural strength : 160-180 Mpa
The increase in strength has been attributed to :
• Pressing step which increases the density of leucite
crystals
• Subsequent heat treatments which initiate growth of
additional leucite crystals
• Esthetics : High esthetic value (translucent,
fluorescent)
• Clinical survival : 95% survival rate of 2-4 years (Deniz G et al
2002)
• Marginal adaptation : Better marginal adaptation compared to
aluminous core material.
▹ Advantages
• Lack of metal or an opaque ceramic core
• Moderate flexural strength (160-180 MPa)
 • Excellent fit (low-shrinkage ceramic)
• Improved esthetics (translucent, fluorescent)
• Etch-able
• Less susceptible to fatigue and stress failure
• Less abrasive to opposing tooth
• Biocompatible material
DISADVANTAGES
• Potential to fracture in posterior areas.
• Special laboratory equipment such as pressing oven and die
material (expensive)
• Inability to cover the color of a darkened tooth preparation or post
and core, since the crowns are relatively translucent.
• Compressive strength and flexural strength lesser than metal-
ceramic or glass-infiltrated (In- Ceram) crowns.
IPS EMPRESS 2
▹ Second generation of pressable materials for all- ceramic bridges.
▹ Indicated in all ceramic bridges ,anterior and posterior crowns
▹ It is similar except that the core contains Lithia disilicate crystals
in a glass matrix and veneering ceramics contains apatite crystals
▹ The lithium disilicate has an unusual microstructure in that it
contains very small inter locking crystals that are very randomly
oriented
 ▹ This is ideal from point of view of strength because the needle like
crystals cause cracks to deflect, blanch or blunt thus propagation of
cracks through this material is arrested by lithium disilicate
crystals ,providing substantial increase in flexural strength.
▹ The high strength creates the possibility of not only creating
anterior and posterior crowns but also posterior bridges .
▹ ADVANTAGES
• High biocompatibility
• Excellent fracture resistance
• High radiopacity
• Outstanding translucency
IPS E.MAX PRESS
▹ The new all ceramic system (lithium disilicate) from ivoclar
vivadent ,which is marketed under the brand name IPS e .max for
the press and CAD CAM technology
▹  PROPERTIES of lithium disilicate (LS2)
1. Highly aesthetic
2. Highly thermal shock resistant glass ceramic due to the low
thermal expansion.
3. High strength material that can be cemented or bonded.
4. Offers a unique solution with its ability to offer a full
contour restoration fabricated from one high-strength ceramic, thereby
eliminating the challenge of managing 2 dissimilar materials.
 MACHINABLE CERAMICS
▹ CLASSIFICATION
▹ CAD-CAM Ceramics
▹ In dentistry, the major developments of dental CAD/CAM
systems occurred in the 1980s.
▹ There were three pioneers in particular who contributed to the
development of the current dental CAD/CAMsystems.

• Dr. Duret contributed in the field of dental CAD/CAM

development.
• Dr. Moermann, the developer of the CEREC® system3.
• Dr. Andersson, the developer of the Procera.
COMMERCIALLY AVAILABLE CAD/CAM SYSTEMS
▹ CEREC (SIRONA)
▹ SIRONA IN LAB
▹ EVEREST (KAVO)
▹ CERCON (DENTSPLY)
▹ LAVA (3M ESPE)
▹ ZENO (WEILAND)
▹ 5 tec (ZIRKONZAHN)
ESSENTIALS OF A CAD/CAM SYSTEM

SCANNER/DIGITIZER –virtual impression

COMPUTER – virtual design
MILLING STATION – produces the restoration or framework
CERAMIC BLANKS – raw material for the restoration
FURNANCE - for post sintering and ceramming
THE CEREC SYSTEM
 CEREC concept was given in 1980 by developed by Siemens.
 The term was selected for the CAD/ CAM machine from the
words “CEramic REConstruction”
 CEREC I was restricted to Inlays, Onlays and Veneers
• Consists of:
• 3-D video camera (scan head)
• Electronic image processor with memory unit
• Digital processor
• Miniature Milling machine
▹ STEP I – POWDER APPLICATION
▹ Optical impression
▹ STEP 2– RESTORATION DESIGN
▹ Milling of the ceramic restoration
▹ Porcelain block is mounted on a metal stub which is then loaded on
milling unit.
▹ Entire milling operation takes 4 – 6 minutes.
▹ Milling is done by means of a diamond covered disk in
conjunction with high velocity air – water spray
▹ Advantages
• Translucency and color of porcelain very closely to natural dental
tissues
• Quality of ceramic is not changed during processing
• Can be placed in one visit
• Prefabricated ceramic is wear resistant
▹ Clinical shortcoming of Cerec 1 system:
 Although the CEREC system generated all internal and
external aspects of the restoration, the occlusal anatomy had to be
developed by the clinician using a flame-shaped, fine-particle
diamond instrument and conventional porcelain polishing
procedures were required to finalize the restoration.
 Inaccuracy of fit or large interfacial gaps.
 Clinical fracture related to insufficient depth of
preparation.
 Relatively poor esthetics due to the uniform colour and
lack of characterization in the materials used.
 CEREC 2 SYSTEM
• Morman & Brandestini in 1994
• Constant further development
Major changes include:
• Enlargement of grinding unit from 3 to 6 axes
• Sophisticated software technology : occlusal surfaces
Minor technical innovations:
• Magnification factor increased from 8x to 12x
• Improved grinding precision by 24 times
• Improved accuracy of fit
▹ Other technical innovations of Cerec 2 compared to Cerec 1
▹ Data representation in the image memory and processing
increased by 8 times
▹ Magnification factor increased from x8 to x12 for improved
accuracy during measurements.
▹ Monitor can be swiveled and tilted, thus facilitating visual control
of the video image.
CEREC 3 SYSTEM
 CEREC 3D is an acronym for Chairside Economical Restoration
of Esthetic Ceramics introduced in January, 2001
 Cerec 3D uses CAD/CAM (Computer Aided Design/Computer
Aided Manufacturing) Technology, incorporating a camera,
 computer and milling machine in one instrument. The dentist uses
a special camera to take an accurate picture of the damaged tooth.
▹ This optical impression is transferred and displayed on a color
computer screen, where the dentist uses CAD technology to design
the restoration.
▹ Then CAM takes over and automatically creates the restoration
while the patient waits. Finally, the dentist bonds the new
restoration to the surface of the old tooth.
▹ The whole process takes about one hour.
ANALOGUS SYSTEMS : COPY MILLING
CELAY SYSTEM -Dr. Stefan Eidenbenz, University of Zurich,
developed this 8 axis milling machine called CELAY in 1990.
▹ It has two main features:
A Hand Operated contacting probe that traces the external contours
of an acrylic or wax inlay, fabricated in mouth.
A milling arm, follows the probe by means of a pantographic arm,
with 8 degrees of freedom, thus cuts the copy of a “Pro Inlay (wax or
acrylic pattern)” from a porcelain block.
CELAY employs no computer; a direct copy milled restoration is
obtained
▹ Based on the size of the piece to be copied ,the ideal ceramic
blocks of various sizes is selected from the prefabricated blocks
vita colors A4,A3 and A 3.5
▹ The pro inlay is scanned with different scanning tools and after
scanning corresponds to diamond coated millling unit
 ▹ There are four main steps in this procedure:
Fabrication of a PRO – INLAY
Copy Milling
Insertion
Finishing.
PROCERA ALLCERAM SYSTEM
 PROCERA system was introduced in 1986.
 Initially it was used to fabricate crowns and FPDs by combining
a Titanium substructure with a low fusing veneering porcelain.
 Later in 1993 it was used to produce All ceramic crowns.
 The crown is composed of a densely sintered, high purity
aluminium oxide coping that is combined with a low fusing
veneering porcelain.
▹ Procera® Piccolo
▹ enables single tooth scanning for crowns, laminates and
abutments.
▹ Procera® Forte
▹ scan crowns, laminates and abutments as well as bridges.
▹ Sapphire ball forms thetip of the scanner.
▹ Extremely light pressure of approx 20g maintains the probe in
contact with the die
 ▹ Within 3 mins , more than 50,000 data points are gathered ,
defining the three dimensional shape of the die .
▹ Next step in designing is to establish the thickness of the coping to
be fabricated.
▹ Relief space for the luting agent is automatically established by
computer algorithm .
▹ Sintering shrinkage of 20% is taken into account , so enlarge
model of the preparation is made with the help of the CAD-CAM
technique .
▹ High purity aluminum oxide powder is compacted against the
enlarged die
▹ The outer surface is milled and the coping is sintered to full density
.
▹ Then veneering porcelain is added
ANALOGUS SYSTEMS : EROSIVE TECHNIQUES
SPARK EROSION
It refers to 'Electrical Discharge Machining' (EDM.
It may be defined as a metal removal process using a series of sparks
to erode material from a work piece in a liquid medium under carefully
controlled conditions
The liquid medium usually, is a light oil called the ‘dielectric fluid’.
It functions as an insulator, a conductor and a coolant and flushes away
the particles of metal generated by the sparks.
▹
 SONO EROSION
▹ Based on ultrasonic methods.
• First, metallic negative moulds (so-called sonotrodes) are
produced of the desired restoration, both from the occlusal as well as
from the basal direction.
• Both sonotrodes fitting exactly together in the equational plane of
the intended restoration are guided onto a ceramic blank after connecting
to an ultrasonic generator, under slight pressure.
• The ceramic blank is surrounded by an abrasive suspension of
hard particles, such as boron carbide, which are accelerated by
ultrasonics, and thus erode the restoration out of the ceramic blank
LAVA ZIRCONIA CORE CERAMICS
▹ Features of the YTZP blanks :
▹ They are pre sintered
▹ The shade of the core material can also be stained resulting in the
ability to control the shading of the restoration.
▹ The core is translucent in comparison with other zirconia based
ceramic core systems .
Other systems
▹ Sopha ( designed by DURET )
▹ DentiCAD(BEGO ,Germany and DentiCAD ,USA)
RESIN MATRIX CERAMICS
polymer-matrices containing predominantly inorganic refractory
compounds that may include porcelains, glasses, ceramics, and glass-
ceramics
Organic matrix (polymer) highly filled with ceramic particles Contains
> 50% by weight ceramics
▹ CLASSIFICATION
 Resin nanoceramic
 Glass ceramic in a resin interpenetrating matrix
 Zirconia-silica ceramic in a resin interpenetrating matrix
▹ RESIN NANOCERAMICS
Highly cured resin matrix reinforced with nano ceramic.
Contains –
80% by weight nanoceramic
Silica nanoparticles (200 nm diameter),
zirconia nanoparticles (4 to 11 nm diameter)
zirconia-silica nanoclusters.
Eg: Lava Ultimate, 3M ESPE
▹ Glass ceramic in a resin interpenetrating matrix
Known as hybrid ceramic.
Feldspathic ceramic network + polymer network = dual network
feldspathic ceramic network (86% by weight / 75% by volume)
polymer network (14% by weight / 25% by volume)
ceramic part
- 58% to 63% SiO2,
- 20% to 23% Al2O3,
- 6% to 11% Na2O,
- 4% to 6% K2O,
- 0.5% to 2% B2O3,
- <1% of Zr2O and CaO.
▹ Polymer network
- Urethane dimethacrylate (UDMA) and
- Triethylene glycol dimethacrylate (TEGDMA)
Eg, Enamic, Vita
FABRICATION:
Sintering the powder porcelain to about 70 percentage of its density and
later infiltarting with polymers.
Flexural strength -160 Mpa ,elastic modulus -38 Gpa
ADVANTAGE:
▹ Low brittleness
▹ Less milling time
Zirconia-silica ceramic in a resin interpenetrating matrix
▹ Polymer infiltrated with Zirconia-silica ceramic.
▹ Composition
- silica powder,
- zirconium silicate,
- UDMA,
- TEGDMA,
- micro-fumed silica,
- pigments
Eg: Shofu Block HC, Shofu

Eg: MZ100 Block, Paradigm MZ-100 Blocks, 3M ESPE

BONDING OF PORCELAINS
▹ CEMENTATION:
▹ Before going into the types of cements available for different
ceramic restorations, its important to know the surface treatments
that has been done to improve the mechanical retention
Surface treatments:
5 - 9.6% hydrofluoric acid
Reacts with silica and forms hexafluorosilicate crystals which gets
removed by rinsing with water - honey comb appearance thereby aids in
retention
 ▸ Air abrasion
1oo um aluminium oxide abrasion, 250 kpa pressure
50 um aluminium oxide abrasion
▸ Laser treatment
CO2
Er:YAG
▸ Tribochemical silica coating
ROCATEC system
110 um aluminium oxide, 250 kpa
110 um aluminium oxide or 30 um of silica modified aluminum oxide
Followed by silane coupling agent application
▹ Clinical considerations:
▹ Acid etching:
▸ Feldspathic porcelain, IPS empress, IPS empress 2
▸ Air abrasion should not be done for feldspathic- volume loss,
▹ Air abrasion:
▸ INCERAM alumina, INCERAM zirconia
▸ Does not have superior effect in improving the retention
▸ Acid etching cant be done, because these ceramics have low
silica content.
Zirconia:
Air abrasion is contraindicated, because it causes mechanical fatigue.
Commonly used cements:
▹ GIC
▹ Composite resin (Panavia F 2.0; Kuraray, Tokyo,Japan),
▹ Compomer (Dyract Cem Plus;Dentsply Intl),
▹ Resin-modified glass ionomer (RelyX Luting; 3M ESPE),
▹ Self-adhesive composite resin (RelyX Unicem; 3M ESPE)
Methods of Strengthening Ceramics
▹ Minimize the effect of stress raisers
• Stress raisers are discontinuities in ceramic and metal ceramic
structure that causes stress concentration.
• Restoration should be designed in such a way that it avoids
exposure of ceramic to high tensile stresses.
• Use of maximum thickness of ceramic on the occlusal surface.
• Abrupt changes in the shape or thickness in ceramic contour
should be avoided.
• Sharp line angles in the preparation can cause stress concentration
▹ Develop residual compressive stresses
• The coefficient of thermal contraction of metal should be slightly
higher than that of porcelain.
• Metal contracts slightly more than the porcelain on cooling from
firing temperature to room temperature
• Leave porcelain in residual compression and provides additional
strength for the prostheses.
▹ Minimize the number of firing cycles
▹ Leucite is a high expansion crystal phase which affects the thermal
contraction coefficient of porcelain.
▹ Multiple firings increases concentration of crystalline leucite.
▹ Increasing the no. of firing cycles can increase the CTE of
veneering porcelain. This leads to stresses on cooling.
▹ Dispersion Strengthening
• Process of strengthening ceramics by reinforcing them with a
dispersed phase of a different material.
• Most dental ceramics are reinforced by dispersion of crystalline
substances.
• Ex. Alumina in aluminous porcelain, spinel in In Ceram.
• When crystalline material such as alumina (Al₂O₃) is
added to a glass, strengthened and crack propagation does not
take place easily.
▹ Transformation Toughening
▹ Dental ceramics based primarily on zirconia crystals when heated
to a temperature between 1470°C and 2010°C undergo change in
the crystal structure from tetragonal to a monoclinic phase at
approx. 1150°C
▹ The toughening mechanism results from the
 controlled transformation tetragonal phase to the stable
monoclinic phase.
▹ Ion exchange/ Chemical tempering
• Effective method of inducing residual compressive stresses.
• Sodium containing glass particle is placed in a bath of molten
potassium nitrate
• Exchange of ions take place
• Since potassium ion is 35% larger than sodium ion, squeezing of
the potassium ion creates very large residual compressive stresses.
• Potassium rich slurry, applied to ceramic surface and heated to
450°C for 30 mins.
▹ Thermal Tempering
▹ Creates residual compressive stresses by rapidly cooling the
surface of the object while it is in the molten state.
▹ Rapid cooling produces a skin of rigid glass surrounding a molten
core.
▹ The solidifying molten core as it shrinks, creates residual
compressive stress within the outer surface.
▹ OTHER APPLICATIONS OF CERAMICS
▹ ALL CERAMIC POST & CORES
DRAWBACKS of conventional Metal Post & Core
• Decrease depth of translucency of restoration
 • Shine through in cervical root, altering appearance of thin
gingival tissue
• Corrosion products
▹ ADVANTAGES of All-ceramic Post & Core
All ceramic restoration transmits certain percentage of incident light to
ceramic core & post .Color of final restoration will be derived from an
internal shade
Depth of translucency in cervical root area
Biocompatible
▹ MATERIALS USED
• In–ceram
• Dense – sintered alumina ceramic
• Zirconium oxide ceramics
▹ CERAMIC-DENTAL IMPLANTS
• Ceramic oxides : resistant to corrosion
• Tissue grow into surface porosity
• Ceramic Coating for Implant
▹ Bioactive Ceramics: High density Alumina, TriCalcium Phosphate,
High Alumina polymer composite
▹ Inert Ceramics : Alumina, Zirconium Oxide
▹ CERAMIC INSERTS
• Megafillers for direct posterior composite restorations
 • Reduce bulk of composite resin
• Decrease shrinkage
• Minimize wear
▹ Composition
• Glass inserts
• Lithium – alumino-silicate glass (heat treated & silanated)
eg: Beta –Quartz Glass –ceramic inserts