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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

DENTAL CERAMIC (PORCELAIN)


Porcelain has many application in restorative dentistry. Jacket crown, porcelain fused to
metal bridgework, veneers,and Inlays.
Porcelain has excellent esthetics, is mild to tissues, and resists wear extremely well.
Porcelain is a white translucent ceramic fired at high temperatures.

Classification of dental porcelain:


Porcelain can be classified by firing temperature to:
1. High-fusing (1290 to 1370 C).
2. Medium-fusing (1090 to 1260 C.).
3. Low-fusing (870 to 1065 C.).
High fusing porcelain is usually used for for the manufacture of denture teeth and the
original porcelain jacket crowns. While the metal ceramic veneer restoration is fired in
temperature rang of 950 C to 1020 (low-fusing porcelain).

Composition of Dental Porcelain:


Dental porcelain is produced from:
Feldspar 70 – 90 %
Quartz 11 – 18 %
Kaolin 1 – 10 %
The main constituent of feldspar is silicon dioxide, present in the form of Potassium
Aluminum silicate (ortho-clase), sodium aluminum silicate (albite). When it fusion, it forms
glassy material which give the porcelain its translucency. It acts as a matrix for the high
fusing quartz (Sio2).
Quartz forms a refractory skeleton around the other material fuse. It helps the porcelain
restoration maintain its form during firing.
Kaolin, a clay is sticky material that binds the particles together when the porcelain is
unfired.
The constituents of typical low and medium fusing porcelain are shown in table (1)
Metalic oxides are added to make the porcelain opaque as zirconium oxide, titanium oxide,
and tin oxide.
Certain other metallic substances are added to produce color in the porcelain:
Yellow - Indium Pink – Chromium, Tin.
Black – Iron oxide Blue – Cobalt salts.

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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

Metal Ceramic Restoration


The metal ceramic restoration first became available commercially during the later
1950s, and today this technique is considered a routine procedure.
The metal ceramic restoration is composed of a metal casting, or coping, that fits over
the tooth preparation, and porcelain fused to the coping that is mechanically and
chemically bonded to it through firing (Baking). Porcelain fused to metal restorations is
greater strength and resistance to fracture than porcelain alone.

Types of Porcelain:( Layers of metal – ceramic restorations Fig. 1)


The metal coping is covered with three layers of porcelain:
1. Opaque porcelain: It is applied as a first ceramic coat and performs to major
functions, it masks the color of the alloy, and it is responsible for the metal –
ceramic bond.
2. Body porcelain: It makes up the bulk of the restoration providing most of the
color, or shade.
3. Incisal porcelain, which is a translucent layer in the incisal portion of the tooth.

Fig (1) Layers of metal ceramic restoration.

Bonding Mechanism:
Four mechanisms have been described to explain the bond between the ceramic veneer
and the metal substructure:

1. Mechanical entrapment or bonding:

Due to the geometry and surface irregularities of the alloy contributes little to the strength
of the interface, even though air-abrasion with aluminum oxide increases the surface area
for potential mechanical interlocking.
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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

2. Compressive forces:

Compressive stresses within a metal – ceramic restoration are developed by a properly


designed coping and a slightly higher, coefficient of thermal expansion (C.O.T.E.) for metal
coping than for the porcelain veneered over it. This slight difference in (C.O.T.E) will cause
the porcelain to “draw” toward the metal coping when the restoration cools after firing.
3. Van der Waal’s forces:

This force comprises an affinity based on a mutual attraction of charged molecules. They
contribute to bonding, but they make only a minor contribution to overall bond strength.

4. Chemical bonding:

It is indicated by formation of an oxide layer on the metal, and by bond strength that
is increased by firing in an oxidizing atmosphere. When fired in air, trace elements in
the gold alloy, such as tin, indium, gallium, or iron, migrate to the surface, form
oxides, and subsequently bond to similar oxides in the opaque layer of the porcelain.
In the base metal Ni-Cr system there is a great formation of oxides, since all the metal
elements in this alloy system are oxidizable.
The bond strength of true adhesion is such that failure or fracture will occur in the porcelain
rather than at porcelain-metal interface. The clean separation of porcelain from the metal
coping is evidence of bond failure from contamination of the coping surface, or an
excessive oxide layer. Fig. (2)

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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

Alloys Used:
The porcelain and metal used for a restoration must have compatible melting temperatures
and coefficient of thermal expansion. The melting alloy used in the coping must be
170 to 280 C (300 – 500 F)higher than the fusing temperature of the porcelain applied to it
Many alloys have been used for metal – ceramic restoration.

Classification:
1) High noble alloys:
 Gold – Platinum – Palladium. (Au – Pt – Pd.)
 Gold – Palladium – Silver. (Au – Pd – Ag.)
 Gold – palladium. (Au – Pd.)
These alloys consist of at least 60% noble metal (Au, Pd, Pt) with at least 40% gold, 20%
other noble metal and 40% base metals.
2) Noble alloys:
 Palladium – Silver. (Pd – Ag.)
 High palladium.
These alloys consist of at least 25% noble metals and the remaining 75% base metals.
3) Predominantly base alloys:
These types are made up of less than 25% of the noble metals, and the remaining portion
consists of base metals.
The choice of an alloy will depend on a variety of factors, including cost, rigidity,
castability, ease of finishing and polishing, corrosion resistance, compatibility with
specific porcelain, and personal preference.
Alloys that have proven most satisfactory for metal – ceramic restoration are composed of
gold (44% - 55%) and Palladium (35% - 45%) with small amount of gallium, indium and
tin. Disadvantages of these alloys are cost and incompatibility with certain types of
porcelain.
Advantages of predominantly base alloys:
1- Low cost. 2- Increased strength and hardness.
3- High fusing temperature 4- Greater resistance to distortion during porcelain firing
Disadvantages of predominantly base alloys
1- Excessive oxide formation. 2- Difficulty in finishing and polishing
3- Questionable biocompatibility.
Beryllium, which is added to alloys to control oxide formation, is a carcinogen.
It can pose hazard to laboratory personal who may inhale it as dust.
Approximately 5% of the general population is sensitive to Nickel – containing
prostheses, and that sensitivity is 10 times as prevalent as in women as in men.
Nickel sensitivity should be considered in the diagnosis of any soft tissue changes that
occur after crown placement.
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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

Coping design:
There are four features should be considered when designing the metal coping for a metal-
ceramic restoration:
1-Thickness of metal coping and adjoining the porcelain.
2- placement of occlusal and proximal contacts.
3- Design of the facial margin.
4-Extensions of the area to be veneered for porcelain.

1- Thickness of metal:
For adequate strength and rigidity, a noble metal coping should be at least 0.3 – to – 0.5
mm thick, while 0.2 mm for a base metal coping.
Maximum restoration strength and longevity is achieved by coping rigidity. The metal
must not flex during seating or under occlusal forces, because flexure places the porcelain
in tension and lead to its shearing.
The ultimate goal of achieving uniform thickness of approximately 1.0 mm of porcelain
will dictate the thickness of the metal coping.(Fig .2 ).

Fig . 2. lwanson thickness gauge

2- Occlusal and Proximal Contacts:


The occlusal contacts should occur on metal whenever possible, because studies and
clinical experience have documented the highly abrasive nature of dental porcelain and its
deleterious effects on enamel or gold.(An study found that the glazed porcelain removes
40 times as much opposing tooth structure as gold.).
The porcelain – metal junction should be placed 1.0 mm from occlusal contacts at the
position of maximum intercuspation. Fig. (3). Contact near the junction can lead to metal
flow and subsequent porcelain fracture.
To minimize stress resulting from occlusal contacts on the lingual surface of maxillary
anterior restorations, the porcelain – metal junction should not placed in the vicinity of
those contacts with the mandibular teeth. The porcelain – metal junction must not placed
too close to the incisal edge. Incisal translucency will be destroyed and the chances of
porcelain fracture will be increased greatly because the porcelain is no longer supported by
metal. Fig. (4). When there is inadequate vertical overlap to place the contact on metal, the
porcelain – metal junction is placed far enough gingivally for the contact to occur on
porcelain. Fig. (5). Anterior metal – ceramic restoration with guidance in lateral
excursions and protrusion on porcelain will abrade opposing natural teeth. The patient
should be cautioned that the opposing natural teeth eventually will require restorations.

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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

The collar of exposed metal on the lingual should be at least 3.0 mm wide
incisogingivally. Wherever there will be porcelain on the lingual surface, there must be
greater tooth reduction.
Proximal contacts for anterior teeth should be on porcelain, which the dentist must
facilitate during the tooth preparation by adequate reduction of the interproximal areas.
Interproximal metal tends to darken the unrestored proximal surfaces of adjacent teeth.
An optimum stress distribution also occurs when the porcelain – metal junction is lingual
to the proximal contact areas.

3- Extent of Veneered Area:


1- To place occlusal contact in metal, the porcelain on the facial surface extends over the
cusp tip and about half of the way down the lingual incline of the facial cusp on maxillary
premolars Fig. (6), and molars Fig. (7). There must be a rounded ledge of metal under the
facial cusp to supporting the porcelain Fig. (8-A), otherwise the ceramic will fracture.
Fig. (8-B).

4- Variants for maxillary teeth include porcelain coverage of the mesial marginal ridge
Fig. (9), or complete coverage with porcelain of the occlusal surface. Fig. (10, 11).
5- Mandibular premolars and molars that will require complete porcelain coverage of
the occlusal surfaces depend on occlusal restoration of the opposing arch, and the
presence or absence of bruxism. The distal half of premolars and molars Fig.(12, 13)
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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

can be on metal, if the patient is extremely concerned about esthetics, the occlusal
surface of mandibular molar can be covered with porcelain. Fig. (14).
A 1 – 2 mm – wide metal collar can be used on the facial surface to minimize the
destruction of tooth structure for a facial shoulder. The patient should be informed
of the potential damage to opposing teeth and the necessity for a more destruction
crown preparation.
A posterior crown with porcelain occlusal coverage should have a 3 mm metal collar
on the lingual, with metal support under the marginal ridges.

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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

4- Facial Margins, fig 15:

The conventional facial margin for a metal – ceramic crown was a narrow metal
collar, when esthetic is important the metal collar was placed subgingivally
(fig 15-A), which may contribute to chronic gingival inflammation or more
serious periodontal problems. Gingival recession may occur from the trauma of
tooth preparation, impression making, or an improperly contoured provisional
restoration. Following cementation, 60% of subgingival margins become visible
within 2 – years period.
Sometimes the porcelain may extended onto the collar itself to avoid showing the
metal. (fig 15-B, C). This can create an over contoured gingival margin, thin,
fracture porcelain; or an undetected open margin.
To avoid the previous problems, and improved esthetics and periodontal health,
there is special porcelain called shoulder porcelain. (All – porcelain margin),
which are stronger in flexure than conventional porcelains, making the margin
more resistant to fracture. However the shoulder porcelain requires skilled
ceramist; otherwise the all-porcelain margins are contraindicated. (fig 15-D)

Fig 15:

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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

Laboratory Procedures Of Metal Ceramic Restoration

I- Waxing, Investing and Casting


A properly designed framework or coping for metal ceramic crown can be achieved
routinely only by waxing the restoration to complete anatomic contour Fig. (15). Then the
areas to be veneered with porcelain are cut back. This will allow an even thickness of
porcelain; proper porcelain-metal interfaces, good connector design, and optimally placed
occlusal contacts Fig. (16 to 20).
After complete waxing of coping and the others laboratory procedures such as investing
and casting like the full metal crown (see the third year lectures).

II- Metal Surface Treatment:

The surface of coping that receive porcelain must be properly finished to assure a strong
bond and an esthetic restoration, sharp angles, pits or any irregularities are to be avoided
because they can readily contribute to internal stress in final porcelain. Also a smooth
surface will facilitate wetting of the framework by the porcelain slurry.
To finish the veneering area (the surfaces that are to receive porcelain) use only new, clean
burs and non-contaminating stones and disc Fig (21).
The demarcation line between the veneered and unveneered areas of the coping should be
distinct with an external angle of 90 degrees and a rounded internal angle.
Check the thickness of the metal with a thickness gauge Fig. (22)
Try the casting in the patient’s mouth, check the marginal adaptation, and make any
occlusal or contour adjustments (see the third year lectures).

III- Heat Treatment ( Oxidation) :

The coping must be free from any remaining investment, abrasive particles or oils from
the skin left during handling of casting.
The coping is ready for the oxidation cycle. Heat treatment of noble metal alloys are
achieved by placing them in a furnace at low temperature 300 to 400 C in the atmosphere
(air or vacuum). The presence of the trace quantities of tin, gallium, and zinc in the noble
alloy to form oxides that enhance bonding with the porcelain.
On the other hand, the base metal alloy, readily oxidize so must be carefully controlled;
most alloys require air abrasion with 50 Mm aluminum oxide to reduce the layer of oxide.
Fig. (23) as excess oxide weakens the porcelain-to-metal bond.

IV- Porcelain Addition:

To obtain optimum strength and esthetic, the build up of porcelain is a skill that requires a
great deal of practice to develop.

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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

(A)- Opaque Porcelaine Application:


Opaque porcelain is applied first to mask the metal to give the restoration its basic shade
and to initiate the porcelain-metal bond.
1- Paint the coping with a thin coating of distilled water or special liquid.
2- Mix small amount of opaque powder with the same liquid, a thin wash is applied
with a brush Fig. (24). The coping is dried and fired under vacuum to a specific
temperature and then under air for 1 minute.
3- The second application of opaque should mask the metal Fig. (25-A). The powder-
liquid mixture is creamy consistency, applied to the coping with a brush in a
vibrating motion (25-B), excess liquid is removed with a dry tissue and firing. The
opaque layer should be 0.3mm.thikness.

(B)-All-Porcelain Margin Fabrication:


1- Mark the shoulder finish line on the die using the side of a red pencil Fig.(26), apply a
cyanoacrylate cement to seal the die in the area of the facial shoulder Fig. (27)and blow
off the excess liquid with compressed air to insure a uniform thin layer of sealant Fig.
(28).
2- Apply a special lubricant, then seat the coping on the die Fig. (29); and apply mixture of
shoulder porcelain to the facial shoulder, it should be extend approximately 2-3 mm. Onto
the coping Fig. (30 to 32).
3- Carefully remove the coping from the die, inspect the inside of the casting, and remove
any found. Fig. (33, 34).
4- Gently place the coping on a sagger tray Fig. (35), after dry, fire it under vacuum
(According to manufacture instructions)
5- Inspect the shoulder porcelain on the die after firing; a small opening may be apparent at
the facial margin Fig. (36); more shoulder porcelain can be added to the discrepancy Fig.
(37-A, B & C); remove the coping from the die and fire it, when the margin is satisfactory
Fig. (38).

(C)- Dentin (body) and Enamel (incisal) Porcelain Application:


1- Mix dentin porcelain with liquid to a creamy consistency, then apply it to over the
opaque Fig. (39, 40) vibrate it to condense the completed build up should be over
contoured Fig. (41, 42).
2- The dentin porcelain is cut back to allow placement of the incisal porcelain
Fig. (43, 44).
3- Apply the enamel porcelain to restore the full contour of the restoration. Fig. (93,94).
4- Use carving instrument or brushes to shape the porcelain to its final contours Fig.
(95,96).
5- Over all, make the crown one-fifth larger than the desired size to compensate for the
20% shrinkage that will occur during firing. Fig. (97); small amount of porcelain is
added to the two inter proximal contact Fig. (98) remove any extend of porcelain to
the unveneered metal,dried,fired under vacuum .
6- Try the restoration on the working cast Following the correction bake, the crown may
not seat completely or it may have other minor deficiencies Fig. (99). Adjustments are

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‫ حمسن احلمزي‬/‫ د‬Fixed Prosthodontic ( C & B )‫) مستوى رابع طب األسنان‬11,12, and 13( ‫حماضرة رقم‬

made on the porcelain with diamond discs, aluminum oxide or carborandum stone .
Fig. (100).

(D)- Porcelain Surface Treatment:

After try-in and adjustment the porcelain fused to metal restoration ; the restoration must
receive a surface treatment that include one of the following:

1. Natural or Auto- glaze (self glaze):

Porcelain has the ability to glaze itself when held at its fusing temperature under air for 1
to 4 minutes.
However the porcelain loses its ability to form a natural glaze after multiple firings.
Caution must be exercised not to over-fire the porcelain. It may return to a more
crystalline state and become milky or cloudy in appearance (loss of natural
appearance), a condition knowndevitrification

2. Applied Over-glaze:

Applied over glaze is a low-fusing clear porcelain that is painted on the surface of the
restoration and fired at a fusing temperatures much lower than dentin and enamel
porcelain.

3. Polishing the porcelain surface:

Recently, an acceptable surface may obtained by using a commercially available system


(special kit of polishing the porcelain). This type showed the polished porcelain to be less
destructive of tooth structure in the opposing arch than glazed porcelain.

More information:
1- Fundamental of prosthodontics (Shillinburg latest edition.)
2- Contemporary Fixed prosthodontics (Rosenstiel et al.).
3- Planning and Making Crown and Bridges (Smith et al)

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