DENTAL CERAMICS

Namitha.A.P
1st year MDS
Dept.of Prosthodontics
 CONTENTS

Introduction
Definition
History of dental ceramics
Advantages and disadvantages
Structure
Basic constituents
Classification
Benefits and Drawbacks of metal ceramic restorations

2
 Metal Ceramic Systems
Composition
Fabrication of metal ceramic prosthesis
Cast metal for metal ceramic prostheses
Technical aspects of metal ceramic products
A. Cast metal coping and frameworks
B. Creep/sag
C. Bonding of porcelain to metal
D. Glazes and stain ceramics
Other metal ceramic systems
Methods of Strengthening Ceramics
3
All Ceramic Systems
Aluminous Porcelain
Effect of Design on Fracture Susceptibility of Metal-
Ceramic and All-Ceramic Restorations
Glass-Ceramics
Hot-Isostatically Pressed(HIP) Glass Ceramics
Glass Infiltrated Core Ceramics
Alumina Core Ceramic
Yttria-Stabilised Zirconia
Zirconia Toughened Alumina(ZTA)
Dispersion Strengthening and Toughening
Flourapatite Glass Ceramic
4
CAD-CAM Processing of Ceramics
Abrasiveness of Dental Ceramics
Clinical Performance of All-Ceramic Restorations
Chemical Attack of Glass-Phase Ceramics by Acidulated
Phosphate Fluoride
Porcelain Denture Teeth
Factors Affecting the Color and Appearance of Ceramics
Ceramic Veneers,Inlays,and Onlays
Critical Observation and Analysis of Fractures
Principles Governing the Selection of Dental Ceramics
Conclusion
References
5
 Need for strengthening
 Methods of strengthening
 All ceramic systems

1. Condensed/sintered
2. Castable ceramics
3. Hot isostaticallly pressed
ceramics
4. Glass infiltrated core ceramics
5. C A D CAM ceramics
 Abrasiveness of Dental Ceramics
 Chemical Attack of Glass-Phase Ceramics by
Acidulated Phosphate Fluoride
 Porcelain Denture Teeth
 Shade guides
 Critical Observation and Analysis of Fractures
 Principles Governing the Selection of Dental Ceramics
 Recent advances in dental ceramics
 Conclusion
 References
INTRODUCTION
•Keramos
•Burned
earth
•Clay

8
 Search for an ideal restorative material!

Challenges?!!
Why ceramics?
1. Biocompatible 1. Costly processing
2. Long term color stability equipments
3. Chemical durability 2. Specialised training for lab
technicians
4. Wear resistance
5. Ability to be formed into
precise shapes

9
 Definition
An inorganic compound with nonmetallic properties typically
consisting of oxygen and one or more metallic or semi metallic
elements( Eg: Aluminium, calcium, lithium, magnesium, potassium,
silicon, sodium, tin, titanium and zirconium) that is formulated to
produce the whole or part of a ceramic based prosthesis (GPT 7
Anusavice).

10
HISTORY OF DENTAL CERAMICS
A journey through time!!!

11
 Stone age>10,000 years ago!
• Craftman used rocks shaped in to 4
tools and artifacts by flaking 1

• Stone chips fractured away from 5

surface of hard,fine
3
grained/amorphous rocks
1. Chert
7
2. Flints
3. Ignimbrite 2 7

4. Indurated shale
5. Lava
6. Obsidian 6
8
7. Quartz
8. Silicified lime stone 12
 700 BC
Etruscans used teeth of ivory and
bone that were held in place by a
gold framework. These were
obtained from hippopotamus or
elephants and were used for many
years thereafter.
•Animal bone
•Ivory from hippopotamus and
elephant
•Human teeth sold by poor
•Teeth obtained from dead
13
 Pierre Fauchard
Chinese (1000AD) (1728)

•Porcelain • First to suggest the

developed by use of porcelain in
dentistry
chinese 14
 Pfaff(Germany)
1756
• Technique to make impression of mouth using
plaster of paris

15
 John Greenwood
(1789)
• carved teeth from hippo ivory for complete
dentures he made for George Washington.

16
 Dubois and Duchateau
(1774 A.D)
• French dentist Nicholas Dubois de Chemant
and his assistant Alexis Duchateau made the
first successful porcelain dentures for
Duchateau being tired of his stained and
malodorous ivory denture.

17
• 1774:Duchateau produced an
improved version of mineral
paste teeth
• Introduced to England by De
Chemant
• This baked compound was not
used to produce individual
teeth because there is no
effective way to attach the
teeth to denture base material
• •1789 Dubois continuously
improved porcelain
formulations and was awarded
French and British patents.

18
 Guiseppangelo Fonzi (Italian dentist)
1808
• Practiced in paris
• Individual porcelain teeth
posterior porcelain blocks
originally dubbed as ‘terro-
metallic teeth’ ‘french bean
teeth’
• Higher quality of porcelain
than chemant
• platinum attachment
mechanism
• Described as “little better
than crockery”

19
• 1817: Antoine
Plantou(French
dentist) : porcelain teeth
to America
• 1822:Peale,an artist
developed a baking
process in philadelphia
for these teeth
• 1837:ClaudiusAsh:an
improved version of
porcelain teeth

20
1825: Samuel Stockton: produces first
porcelain teeth in the US.
1839:invention of vulcanised rubber allowed
porcelain denture teeth to be used effectively in a
denture base.

1844: Stockton’s nephew found SS White

company : mass production of porcelain teeth.

1903:Dr. Charles Land : introduced first

ceramic crown using platinum foil matrix and
high-fusing feldspathic porcelain.
• Early 1960s- Weinstein et al introduced porcelain fused to metal
restoration(PFM)
1963: First commercial porcelain :Vita Zahnfabrik was developed.
1965 – aluminium porcelain was introduced by McLean and Huges
1968 – MacCulloch introduced the use of glass ceramic in dentistry
1983 – the concept of bonding composite resin to acid-etched porcelain was first
reported by Simonsen and Calamia
1983 – Horn reported the successful cementation of porcelain veeners using
adhesive cements
• 1983-84 – the first castable glass
ceramic was introduced by Grossman
and Adair called DICOR (tetrasilicic
flouromica crystals in glass matrix)

• 1985 – CAD/CAM technique were

developed.

• 1988- cerec1 system was introduced.

• 1989 – Sadoun developed the first slip

cast alumina ceramic called Inceram
alumina.

23
• 1989: Wohlwend and Scharer : Pressable
ceramic systems.
1991 : Celay copy milling system.
1992: Ultralow fusing ceramic Duceram LFC
Early 1990s- IPS Empress was developed containing approx 34vol%
leucite
1994 -CEREC II
Late 1990s- IPS Empress 2 was developed containing approx 70vol% of

Lithia disilicate crystals.

 Advantages

• Resistant to corrosion • Potential for matching

• Chemical inertness appearance of natural teeth
• Remain stable over long • Refractory nature
time periods. • Thermal insulating
• Biocompatible properties(low thermal
• High hardness conductivity and diffusivity)
• Resilient • Freedom from galvanic
effects(low electrical
conductivity)

25
 Disadvantages
• Susceptibility to tensile
fracture
• Brittleness
• Low to moderate strength
and fracture toughness
• Poor ductility/elongation
• Flexed easily when
heated and
cooled(Thermal shock)

26
27
• Brittle fracture

• Plastic deformation

28
 Structure
GLASS CRYSTAL
CERAMIC
PHASE PHASE

29
30
31
 Feldspathic porcelain
Glassy/Vitreous/Matrix phase
• Acts as matrix
• Feldspars are mixture of
Anhydrated alumino-silicates of
both
• Potash feldspar = K2O. Al2O3. 6
SiO2 A
• Soda feldspar = Na2O. Al2O3. 6
SiO2
• Increasing the amount of glassy
phase lowers the resistance to
crack propagation but increases
translucency
Crystalline/Mineral phase
• Dispersed within matrix
• Mineral phase including silica
and other oxides
• Improve strength and other
properties
• Eg.alumina,spinel,zirconia
ceramic restorations have
increased amounts of
crystalline phase (between
35% and 90%) for better
mechanical properties
32
33
 COMPOSITION
60 to 80%
Feldspar
basic glass former
3 to 5 %
Kaolin binder

15 to 25%
Quartz
filler
8 to 20 %
Alumina
glass former and flux
Oxides of sodium,potassium 9 to 15%
and calcium fluxes
<1%
Metal pigments
colour matching
35
Feldspar

SiO2 MATRIX-52-65%

Al2O3-ALUMINA-11-20%

K2O-POTASH-10-15%

Na2O-SODA-4-15%

OTHER ADDITIVES

By weight. 36
 Feldspar(Basic glass former)
• Naturally occurring mineral
• Also known as Albite
• Most of the components
needed to make dental
porcelain are present in it
• When fused at high
temperature it forms
feldspathic glass containing
potash feldspar/soda feldspar
• Quite colorless and
transparent

37
 Kaolin(Binder)
• White clay like material
(hydrated aluminum
silicate).
• Acts as a binder
• Gives opacity to the
mass.
• Some manufacturers
use sugar or starch
instead of kaolin.

38
 SILICA

CRYSTALLINE CRYSTALLI
CRISTOBALIT NE
E QUARTZ

CRYSTALLI NON
NE CRYSTALLINE
TRIDYMITE FUSED SILICA

39
 Quartz(Filler)
• Form of silica.
• Ground quartz acts as a
refractory skeleton
• Provides strength and
hardness to porcelain
during firing.
• It remains relatively
unchanged during and
after firing

40
 Alumina
• Replaces some of the
silica in the glass
network.
• Strength and opacity
• It alters the softening
point and increases the
viscosity of porcelain
during firing.

41
 Glass modifiers/Fluxes
Sintering temperature of crystalline silica is too high to use as a veneer on dental cast alloys
Coefficient of thermal contraction of crystalline silica is too
Alloys would melt
low for alloys

Bonds between the silica tetrahedra can be broken by the addition of alkali metal ions such as sodium, potassium, and calcium
These ions are associated with the oxygen atoms at the
Interruption of oxygen silicon bonds
corners of the tetrahedra

.Three-dimensional silica network contains many linear chains of silica tetrahedra that are able to move easily at lower temperatures than the
atoms that are locked into the three-dimensional structure of silica tetrahedra.
increased fluidity (decreased
Lower softening /fusion temperature Increases thermal expansion
viscosity)

Too high modifier concentration

glass may crystallize (devitrify) during porcelain firing

reduces the chemical durability
operations

42
 Color Modifiers
Metallic oxide colour

Titanium oxide yellowish brown

Nickel oxide Brown

Copper oxide Green

Cobalt oxide Blue

Manganese oxide Lavender

Zirconia, alumina, silica White

43
METAL COMPOSITION

44
 Requirements of the metal

1. Melting temperature higher than the

porcelain firing temperature
2. Able to form an oxide layer that provides the
chemical bond to porcelain
3. Coefficient of thermal expansion a little bit
higher than that of porcelain
4. No greening effect on the porcelain color
5. High elastic modulus
45
 CLASSIFICATION
1.Based on use/indications
Anterior crowns
Posterior crowns
Inlays
Onlays
Veneers
Post and cores
FPDs
Stain ceramic
Glaze ceramic.
46
 3.Principal crystal
2.Composition phase and /or matrix
phase
• Silica glass
• Leucite based
• Pure alumina feldspathic porcelain
• Pure zirconia • Leucite based glass
ceramic
• Silica glass
• Aluminous porcelain
• Leucite based glass
• Alumina
• Lithia based glass • Glass infused alumina
• Glass infused spinel
• Glass infused
alumina/zirconia 47
 4) Processing method:

• Sintering
• Partial sintering
• Glass infiltration
• CAD-CAM
• Copy milling
• Condensation
• Heat pressing
• Casting
• Slip-casting

48
 VENEERED AND STAINED
• Traditional metal-ceramic
restorations, some
aluminous porcelains
(Vitadur-N, Vitadur
Alpha, Hi-Ceram), and
pure alumina ceramic
(Procera AllCeram) are
condensed by vibration
and sintered at high
temperatures.

49
 HOT PRESSED CERAMICS
• (IPS Empress, IPS Empress 2, Finesse All-
Ceramic, and OPC-3G) are heated, injected
under pressure into a mold, and then
veneered.

50
 CAST AND CERAMMED CROWNS
• Glass-ceramic
• Made using the lost-wax
technique.
• The glass was cast into
a mold, heat-treated to
form a glassceramic,
and colored with
shading porcelain and
surface stains.

51
 SLIP CAST CERAMICS
• A slurry of liquid and particles of
• In-Ceram alumina, magnesia-alumina silicate
• In-Ceram Spinell (spinel), or zirconia and alumina are
placed on a dry refractory die that
• In-Ceram Zirconia draws out the water from the slurry.
• The slip-cast deposit is sintered on
this die
• coated with a slurry of a glass-
phase layer.
• During firing, the glass melts and
infiltrates the porous ceramic core.
• Translucent porcelain veneers are
then fired onto the core to provide
final contour and color
52
 CAD-CAM

• The ceramic block materials (Dicor MGC, VITA

Cerec Mk I, and VITA Cerec Mk II) are shaped
into inlays, onlays, or crowns using a
CAD/CAM system (Cerec).
• These blocks can also be used in copy-milling
devices (Celay) that mill or machine blocks
into core shapes

53
54
5) Firing temperature:

55
6.Microstructure 7.Translucency

• Glass • Opaque
• Crystalline • Translucent
• Crystal-containing glass • Transparent

8.Fracture resistance 9.Abrasiveness

1. Low • (comparison relative to
2. Medium restorstion against tooth
3. High enamel).

56
 10.It’s function within ceramics

• Core ceramics-supports and reinforces the restoration

• Opaquer ceramics-masks or hides the metal
• Veneering ceramics
1. Body/dentin- dentin portion of natural teeth
2. Incisal - enamel portion of natural teeth
3. Gingival –gingival portion of teeth
• Translucent-translucent incisal enamel
• Stains
• Glazes

57
Applications of ceramics in dentistry

58
 All ceramic

Metal ceramic/PFM(porcelain
fused to metal

60
 METAL CARAMICS
Advantages Disadvantages
• High overall survival • Potential for metal allergy
percentage • Poor esthetics(Can not be
• Low fracture rate used when when a
• Less removal of tooth relatively high degree of
structure translucency is desired.)
• Less wear of antagonist • metal framework and lack
enamel of translucency sometimes
• Better marginal fit shows through gingiva
resulting in dark margins

61
Mandibular teeth abraded by opposing
porcelain surfaces

62
Metal ceramic system

63
 Types of Metal Ceramic Systems
1. Cast metal ceramic restorations
Cast noble metal alloys (feldspathic porcelain)
Cast base metal alloys (feldspathic porcelain)
Cast titanium (ultra low fusing porcelain)
2. Swaged metal ceramic restorations
Gold alloy foil coping (Renaissance, Captek)
Bonded platinum foil coping.

64
COMPOSITION OF METAL CERAMIC
DENTIN ENAMEL
PORCELAIN PORCELAIN
• Higher alkali content Silica (SiO2) 59.2 63.5

• The opaquer powder - Soda (Na2O) 4.8 5

high content of
Alumina 18.5 18.9
opacifiers. (Al2O3)
• Glazes - Higher Potash
(K2O)
11.8 2.3

concentration of glass Boric oxide 4.6 0.12

(B2O3)
modifiers like soda, Zinc oxide 0.58 0.11
potash and boric oxide. (ZnO)
Zirconium 0.39 0.13
A sample percentage composition oxide (ZrO2)
of porcelain powder for metal
ceramics
65
 Supplied as
1. Enamel porcelain powders in various shades (in bottles)
2. Dentin porcelain powders in various shades (in bottles)
3. Liquid for mixing enamel, dentin, gingival and transparent
4. Opaquer powders in various shades/ together with a liquid
for mixing
5. Gingival porcelain powder in various shades
6. Transparent porcelain powder
7. A variety of stain (color) powders
8. Glaze powder
9. Special liquid for mixing stains and glaze.

66
 Manipulation and technical considerations

• Conventional powder/slurry technique

Surface /
Sintering
Condensati
Pre-
heating/drying
on/packing
treatments
firing

P
or
c
el
ai
n
c
o
ol
in
g

67
 Condensation/packing
• Process of packing the
powder particles together Benefits
and removing excess water
1. Lower firing shrinkage
2. Less porosity (Improves
substructure of the
porcelain & dispense
trapped air )
3. Improved strength and
density
4. Remove excess water
5. Enhanced surface texture

68
 Techniques

1. Vibration-tapping/running
serrated instrument on the
forceps holding the metal
frame
2. Ultrasonic vibrators
3. Spatulation-a small spatula to
apply and smoothen wet
porcelain
4. Dry powder-placed on the
opposite side of wet
increment.water moves
towards the dry powder pulling
wet particles together

69
•Advantages of ultrasonic condensation
• Reduces the fluid content of
layered ceramics; resulting in
denser and more vibrant
porcelain mass.
• Enhances translucency and
the shade qualities of the
fired ceramic.
• Shrinkage can be reduced to
below 5%!
• Time-saving as it reduces the
number of compensatory
firing cycles

70
 CONDENSATION STEPS

1.Build up of 2.Build up of body 4.Build up of

3.Cut back
cervical porcelain porcelain enamel porcelain

71
 Dentin
• Pink powder+distilled
water/supplied liquid
• Glass spatula should be
used
• The main bulk of tooth
• A portion of the dentin in
the incisal area is cut back
for enamel porcelain.
Enamel
• White powder
• build the restoration
• Transparent porcelains used
near incisal edges
Gingival porcelain
• More darker cervical
portion
• (gingival/neck dentin)
72
• Return to furnace for sintering
• Additions in deficient areas
• Each additional firing is done at lower
temperature

73
 Pre-heating
• Placing the porcelain object
on a tray in front of/below
the muffle of a preheated
furnace
• at 650C for 5min for low
fusing porcelain
• at 480C for 8min for high
fusing porcelains till
reaching the green or
leathery state.
Significance of pre-heating stage:
• Removal of excess water
allowing the porcelain object
to gain its green strength.
• Preventing sudden production
of steam that could result in
voids or fractures.
• Ceramic particles held
together in the “green state”
after all liquid has been dried
off
74
Pre- heating

75
 Sintering procedure/firing
• The purpose of firing is to sinter the particles of
powder together properly for a specific time and
temperature combination to form the prosthesis
• The thermochemical reactions between the
porcelain powder components are virtually
completed during the original manufacturing
process. Thus. Some chemical reactions occur
during prolonged firing times or multiple firings

76
 Sintering procedure/firing
The initial firing temperature
• The voids are occupied by
the atmosphere of the
furnace.
• As the sintering of the
particles begins, the
porcelain particles bond at
their points of contact.
As temperature is raised
• The sintered glass gradually
flows to fill up the air
spaces.
• The particles fuse together
by sintering forming a
continuous mass, this
results in a decrease in
volume referred to as firing
shrinkage
77
With progression of firing The final firing stage
• The gaps between particles • The voids slowly rise to free
become porosities. The surfaces and disappear
viscosity of the glass is low
enough for it to flow due to
its own surface tension. The
result is that the porosity
voids will gradually become
rounded as firing proceeds

78
79
 Stages of porcelain maturity
Low • porcelain surface is quite porous porcelain grains begin to soften
and ‘tense’ at their contact points
• minimal Shrinkage
bisque • the fired porcelain body is extremely weak or friable

Medium • Pores still exist on the surface of porcelain The flow of glass grains is
increased. As a result, any entrapped furnace atmosphere that
could not escape via the grain boundaries becomes trapped and

bisque sphere shaped

• A definite shrinkage is evident

High • shrinkage smooth porcelain surface The flow of glass grains is

further increased, thereby completely sealing the surface and
presenting smoothness to the porcelain.

bisque • The fired porcelain body is strong and any corrections by grinding
can be made

80
Low bisque Medium
bisque

81
High bisque
 Over firing

1.reduce the strength due to

1.Firing at above the formation of undesirable crystal
correct firing phases at higher temperature [de-
vitrification]
temperature 2.increases the chances of slumping
[eliminate the shape we made and
2.longer firing time leave a globule of ceramic].

82
 Vacuum(negative pressure) firing
• Porcelain in furnace- packed powderparticles+air
channels around
• Air pressure reduced to 1/10th by vacuum pump
• Air around particles reduced,as temperature rises
the particles sinter together
• Closed pores with in porcelain mass.
• This helps to reduce porosity
• Air inside these pores are isolated from the furnace
atmosphere
83
 Porcelain surface treatment
Natural/au
Applied/ad
Polishing
d-on glaze
to glaze

C
u
st
o
m
st
ai
ni
n
g

84
 Cooling
• Should be well • Rapid cooling can cause
controlled cracks
• slowly • Induce stresses and
• Uniformly weakens ceramic
• Usually computer
controlled

85
If it cools too slowly
• Crystals form within the
glass body which will
degrade its optical
properties, turning if from a
clear glass into a cloudy
one. Devitrification.
[annealing]
if it is cooled too quickly
• Stress build up in the glass.
• To reduce the stresses ,it is
kept near the glass transition
temperature (its solidus) for a
long time so that the atoms in
the glass can rearrange just
enough to relieve the stress.
• When most of the stress has
been eliminated, the finished
glass is finally allowed to cool
to room temperature
86
1.Construction of the cast metal copings and
framework
• Can be produced by Most common method is
1. Casting of molten melting and casting.
metal
2. CAD-CAM Machining • A wax pattern of
restoration constructed
3. Electrolytic deposition
• Cast in metal
techniques
• High melting temperature
4. Swaged metal
of alloys-phosphate
processes
bonded investment

87
2.Metal preparation
• Clean metal surface-
essential for good bonding
• Oil from fingers and other
sources such as airlines –
possible contaminant
• Cleanse surface
• Finish with clean ceramic
bonded stones/sintered
diamonds
• Final sandblasting with high
purity alumina
3.Degassing and oxidizing
• Heat in porcelain furnace to
burn off any impurities to
the form thin oxide layer.
• Degas the interior structure
of alloy
• Eg.Olympia (Heraeus
Kulzer), a gold-palladium,
silver-free alloy, is heated in
the porcelain furnace to a
temperature of 1038 °C
88
 4.Opaqer
• Dense yellowish white powder+special liquid
• Mask/cover the metal frame and prevent it
from being visible
• Bond the veneering porcelains to the
underlying frame

89
• Condensed on the oxidized surface at a thickness of approximately 0.3 mm

• Fired to its sintering temperature.

• Translucent porcelain is applied
• Tooth form is created.
• Porcelain powder is applied by the condensation methods
• The unit is again fired.
• Several cycles of porcelain application and firing may be necessary to
complete the restoration.
• A final glaze is then produced either by self-glazing or firing an overglaze
layer.

90
 Creep/sag
• When an alloy is heated close to its
solidus temperature, it may become
susceptible to flow under its own
mass
• The degree of creep can be
enhanced by the size of the
prosthesis and the number of firings
that are required for porcelain
veneering.
• All metal-ceramic alloys should have
a solidus temperature that is
significantly higher than the sintering
temperature of the porcelain so as to
minimize creep deformation

91
 Bonding of porcelain to metal
1.Chemical/atomic bonding
• Primary bonding mechanism
• An adherent oxide layer is
essential
1. Base metal alloys-chromic oxide
2. Noble metal alloys-iridium oxide
• Inadequate oxide
formation/excessive oxide build
up
Delamination of overlying
porcelain
2.Mechanical interlocking
• Principal bond in some
systems
• Infiltration (flow) of the
fused ceramic into the
surface irregularities of the
metal coping
• Sandblasting prepares metal
surface
92
Sand blasting

93
94
Chemical bonding
• Ionic bond between the metal
oxide layer and the opaque
porcelain.
• Metal degassing is important
for oxide formation, removing
the surface contaminants and
greases.
• Thin oxide layer (in case of
noble alloys) provides stronger
bond than the thick one (in
case of base metal alloys)

95
3.Coeff. of thermal expansion mismatch:
• Certain metal system
• As a result of higher metal
contraction on cooling , - The
fused porcelain will be
sucked (attracted) more
strongly into the metal
surface irregularities. -
Residual compressive
stresses will developed in
and strengthen the porcelain.
4. Application of a special bonding agent:
(electro-forming) requires
the application of specific
bonding paste before
building-up the porcelain.
Bonding of porcelain to the
metal Coping
96
Durability of metal ceramic bonding

Mechanical inter Inter atomic

locking/inter atomic bonding across
bonding at the
inteface between
the oxide-
porcelain and metal porcelain
oxide interface

Type and magnitude of

residual stress in the
veneering ceramic

97
 Glazing
Objectives
• Life like appearance/Esthetics
• Improves Strength and life
• Color match to adjacent teeth
or restorations
• Seal surface flaws
• Reduce stress concentrations
• Inhibits crack propagation
• Enhances Hygiene
• Reduces wear of opposing
teeth
Auto glazed veneer ceramic
Steps
• Restoration is tried in
mouth
• Occlusion checked
• Adjusted by grinding
• Smoothen with a fine stone
• Restoration is ready for
glazing!
98
Smooth and glossy surface to the restoration
Over glaze
• Glaze powder+special liquid
• Applied on to restoration
• Firing temperature<that of
body porcelain
• Firing cycles does not
include vacuum
• Disadvantage-Chemical
durability less compared to
self glaze(because of the
high flux content)
Self glaze
• No separate glaze layer
• Restoration subjected to
controlled heating at fusion
temperature
• Only surface layer melts and
flows to form a vitreous layer
resembling glaze
• Disadvantage-porcelain must
be stripped completely if it is
unacceptable
99
 Glazing
• Have adequate durability
when produced in thickness
of 50micron or more
• If dentist is adjusting the
occlusion by grinding with
diamond bur can weaken
glaze
Polishing
• Using special abrasives
• Sof-
Lex(3M,Minneapolis,MN),Fi
nishing disks (Shofu, Kyoto,
Japan) porcelain laminate
polishing kit, or other
abrasive system.
• Difficult to polish
100
• Even after polish/glaze
surface will breakdown
in presence of solvants
in our everyday diets
• Further degradation
during exposure of glass
phase ceramics such as
porcelain to acidulated
phosphate fluoride

101
 Surface staining
characterisation and effects
• Stain powders + special liquid
Natural teeth- variety of hues and
• Applied and blended with brush colors
1. Intrinsic( like white flourosis
stains)
2. Acquired (like coffee,tobacco)

By staining and characterisation more

emphasis on recreating natural
look
Can include
3. Defects
Porcelain stains and glazes 4. Cracks
Stains-tinted glazes 5. Other anomalies on enamel

102
103
Glazes
• Colorless porcelain
• Do not contain opacifiers
• Lower fusion temperature
• Increased content of glass
modifiers
• Less chemically durable
Stains
• High concentration of color
modifiers
• Lower fusion temperature
• Increased content of glass
modifiers
• To provide individual color
variation

104
105
 Other metal ceramic systems
Bonded platinum foil ceramic
Swaged gold alloy foil ceramic crowns crowns/Aluminous core porcelain

106
 Swaged gold alloy foil ceramic crowns

Renaissance and Captek Advantages

• Novel way of making a • Thinner foil alloy
metal frame without having • Greater thickness of
to cast it. ceramic
• Developed by Shoher and • Improved esthetics!
Whiteman • Gold color of alloy
• Captek(capillary casting
technique)

107
CAPTEK P CAPTEK G

•Platinum/palladium/ • 97.5%-GOLD
gold • 2.5%-SILVER
•Porous structure
•Serves as internal
reinforcing skeleton.
•On heating in a • Provides characteristic gold
furnace captek P acts color
as metal sponge
draws hot liquid gold
completely into it

Final coping is a composite structure 108

Technique

109
 Bonded platinum foil ceramic crowns
• Platinum foil coping
adapted on to the die
• Electrodeposition
technique-to improve
bonding and esthetics
• Thin layer of tin is
electrodeposited on to the
foil and then oxidized in a
furnace
Advantages
• Gold color enhances vitality
of porcelain thereby
esthetics
• Tin helps in chemical
bonding
• Improves wetting and
reduce porosity.
110
 Electrodeposition Technique
• Improve both esthetics and bonding
• A layer of gold is electrodeposited on to the
metal
• Followed by a quick minimal deposition of tin
• Can be used on metals such as stainless
steel,cobalt chromium,titanium,and other non
gold and low gold alloys

111
 Platinum matrix fabrication. A, A diamond-shaped foil is adapted to the facial surface (a cutting guide
is provided with the foil). B, Two cuts are made, one to each incisal corner, and a triangle of foil is
removed by cutting at 45 degrees toward the corners. C, The foil is folded onto the lingual surface and
burnished. D and E, It is then gathered on the lingual surface with tweezers and adapted with finger
pressure. F, The foil is trimmed to follow the lingual contour evenly. The two ends are separated, and
one is trimmed to exactly half the width of the other. G and H, The long end is folded over the short
end, and relieving cuts are made . Then the three-thickness joint is folded toward the short end. I, The
foil is adapted with a wooden point, always starting from the incisal edge and working toward the
margin. 112
J. A beaver-tail burnisher is used to adapt the
margin, working the foil toward the internal angle
to prevent a perforation. Better adaptation can be
achieved by swaging at this stage. The matrix is
removed with sticky wax
K. and annealed in a Bunsen flame
L.to relieve work hardening.
M. The completed platinum foil matrix. 113
 Need of
Strengthening

Scratches
High
inter
atomic
forces
Stress
crack concentratio porosit
s y
n points
Still fails
to
exhibit
strength
defects
 Griffith’s microcracks
 Named after discoverer
 Minute submicroscopic surface defects (scratches
and cracks) present on the glass surface
 Act as stress concentration centers when subjected
to tensile stresses
 Large radius at tip causes large tensile stresses at
their tips leading to crack propagation
 Stress concentration phenomenon
Numerous minute scratches/flaws
present on the surface

Behave as sharp slits(tip narrows as

spacing between several atoms in
the materials)

Under intra oral loading tensile

stress concentrated at tip of these
flaws.

Stress concentration geometry

at tip of
each surface flaw.
Stress concentration
phenomenon(continues)
Increased localized stress
to extremely high levels.

Induced tensile stress >

nominal strength of material
structure

Bonds at notch tips rupture

Forms a crack!!
As the crack propagates;
Stress concentration
is maintained at
crack tip.

Crack moves Meets another

completely through crack/pore/crystalline
the material particle.
 processing Reduction
in size of
cracks
Removal Reduction
of in
surface number
flaws of cracks
cracks
Increase
in
strength
production handling
Stress raisers How to avoid stress
raisers
 Sufficient bulk
 Minimum sharp
angular changes
 Proper proportioning
 Discontinuities in brittle
materials  Proper compaction
 Abrupt change in  Proper drying
shape/thickness in ceramic
 Firing under vacuum
contour
 Cause stress concentration  Slow
in these areas cooling
 Restoration more prone to  Glazing
fracture
Why ceramics fails far below their
tensile strength??
Flaws/cracks

Prosthesis Micro
design structure

Load Residual
processing
orientation
stresses

Loading
rate
 Methods of strengthening
Development of Interruption of crack
residual compressive propagation
stresses
 Dispersion
 Development of strengthening
residual compressive  Transformatio
stresses n toughening
 Reduced number of
firing cycles
 Optimal design
of prostheses
 Ion exchange
 Thermal
tempering
 Development of residual
compressive stresses
Process of
cooling to room
Sintering at high temperature
temperature
1 Fabrication of metal
ceramic/all
ceramic Hot pressing a Mis match in
veneering ceramic on coefficient of thermal
to the metal or contraction of
core ceramic adjacent materials

Bonded platinum foil Metal contracts

aluminous porcelain slightly more than
2 ceramics.
crown technique

Metal pulls the

ceramics inwards-
Swaged gold alloy compression of
3 foil technique porcelain
 Disadvantages
 There is a limit to coefficient mismatch that can
be tolerated
 Difference in coefficient of thermal contraction
causes considerable shear stress at interface
 Maximum tolerable difference 0.5 M/0K to 0.7 M/0K
 If more - premature failure in shear
 Reduced number of firing cycles
Firing
cycle
Chemical reactions

Increase in concentrations of crystalline leucite(K2O.Al2O3 .4SiO2)

High expansion crystal phase Affects coefficient of thermal
contraction

Multiple
Increase in thermal expansion firings Mismatch between porcelain
Exceeds that of
coefficient and metal
metal

Stresses during cooling

Induces crack formation and propagation
Optimal design of prostheses
1.Tougher and stronger ceramics

• Can sustain higher tensile stresses before crack develop in areas

of tensile stress

2.Well rounded line angles

• Reduce stress concentration in the restoration where
tensile
component of bending stress will develop
3.Avoid knife edge margins

• To avoid risk of cracking or chipping during

firing
4.Use finest grit abrasive
• Reduce probability of forming microcracks and reduce depth
of
microfissures produced by abrasive particles
Atypical designs-leads to ceramic
fracture
 a four-unit metal-
ceramic cast-joined
bridge with two
connector fractures at
the two cast-joined
sections in the metal
framework.
 Fluorescent dye
illumination allows
better visibility of the
two areas of ceramic
cracking.
 B)Schematic of a
properly designed cast-
joined three-unit bridge
framework.
 C) Five possible cross-
sectional designs for
cast- joining at the
pontic.
 D)Plot of force versus
strain for a solid bar.
 Design 1 was the best
choice of the five
designs on the left.
5.Height of connector can be increased to a
maximum of 4 mm

 Tensile stresses can be reduced using greater

connector height
a connector height > 4 mm - anatomic form in the
buccal area of a posterior FPD too bulky and
unesthetic
When connector size < recommended
 Radius of curvature of gingival embrasure portion of
the inter proximal connector is broadened
6.Radius of curvature of gingival
embrasure portion of the inter
proximal connector is broadened
Ion exchange
Sodium containing
glass
Small ionic diameter(90 pm)

Immersed in molten potassium

salt
K + exchanges place with Na+ Remain in place even after cooling

Concentration driven
phenomenon
Equlibrium eventually established Not a complete exchange

K+ions is 35% larger (133pm) than Na + ion.

Large residual compressive Ion exchange up to depth of Loses due to
stresses 100 micro meter finishing,wear,long term
exposure to oral fluids
 Thermal tempering

Residual
tensile
Molten core stresses in
Rigid
solidifies inner
Rapid cooling of surface surface ;shrinks core
of material while in + and pull +
molten state/quenching rigid outer
molten surface Residual
inner inwards compressiv
core e stresses
within
outer
surface
 Most widely used method of strengthening glass
In dentistry silicone oil and other special liquids are
used for quenching ceramics instead of water/air
Dispersion strengthening and
toughening
Reinforced with a dispersed phase of a different
material
Addition of smaller and tougher filler particles

Dispersed phase interferes with crack

propagation
Absorbs energy from crack Prevents its driving force propagation

Increase in fracture resistance

Examples of
dispersed crystalline Action depends on
phases
 Type
 Leucite  Size
 Lithium disilicate  Volume fractions
 Alumina  Inter particle spacing
 Magnesia alumina  Their CTE as
spinel compared to glass
 Zirconia matrix
 Tetra silicic flouromica
 fracture
toughness (KIc)
in Mpa/m2
34 vol % of
IPS 1.
leucite crystals
3
Empress

Soda-lime-
silica glass
0.75

70 vol
% IPS e.max 3.
lithium Press 3
disilicat
e
Applications
Aluminous porcelain

• Al2O3 particles were dispersed in a glassy porcelain matrix

Hot pressed glass ceramics

• IPS Empress-leucite crystals
• IPS Empress2-lithia
disilicate

OPTEC HSP

• Leucite reinforced
Glass infiltrated core ceramics

• In Ceram-alumina,In Ceram spinel-MgAl2O3 (Magnesia alumina spinel)

Transformation toughening
Absorbs energy
A change in
required for
crystal structure
propagation of
under stress
crack

Crack shielding
and toughening of
ceramic
Zirconium dioxide (ZrO2),
or zirconia Should not be confused with

 Biomaterial since the 1. with cubic zirconia, ZrO2,

1970s. which is a cubic
 hip replacement crystalline form of
zirconia used as a
material
diamond simulant
 in dentistry for crown
2. zirconium, which is a
and bridge applications lustrous, gray-white,
since 2004. strong transition metal
 white crystalline oxide of 3. zircon (also known as
zirconium. zirkon), which is
zirconium silicate,
ZrSiO4..
 Properties of zirconia
 unique mechanical and electrical properties
 extremely useful in heat insulators, oxygen sensors,
and fuel cells.
 nonmetal with an extremely low thermal conductivity
 chemically inert and highly corrosion resistant.
 tetragonal-to monoclinic phase transition results in
cracks in bulk zirconia samples and a reduction in
strength and toughness.
 Under this condition pure zirconia would be useless
for dental restorative applications.
 Temp>23670C
CUBIC
STRU C T U R E

1167 °C-2367 °C Temp<1167

TETRAGONAL M O N O C LIN I C

3% to
5%
volume
increase
 High-temperature tetragonal
phase can be
stabilized at room temperature by
.
 Doping with Mg, Ca,  stabilizing oxides
Sc,Y, or Nd 1.magnesium oxide
 Reduce the crystal size (MgO), 2.yttrium oxide
to less than 10 nm (Y2O3), 3.calcium oxide
 Yttria stabilized zirconia (CaO), 4.cerium oxide
ceramics is known as (Ce2O3) (highly soluble
ceramic steel(due to trivalent stabilizers)
transformatio Fracture toughness of PSZ=8-10 MPa/m
n toughening) Flexural strength=900MPa
Conventional ceramics =1.1-3
Mpa/m
 I NC RE A S E
LOCALISED
LOCALIZED VOLUME HIGH LOCAL FRACTURE
S I G N I F I CA N T TRA N SFO RM A C O M PRESSIVE
P R O P O R T I O N OF EXPANSION
TION IN TO ADJACENT T O STRESS T O U G H N ES
M E T A STABLE MONOCLINIC AROUND
C R A C K TIPS S AND
T E T R A G O N A L P H A SE PHASE C R A C K TIPS I NH I B I T
CRACK
PRO PA G ATI
OAN
 • Most common

Y203 stabilizer
3-5 mol %
• yttria-stabilized zirconia or yttria-stabilized
tetragonal zirconia polycrystals (Y-TZP).

• Mg-PSZ core ceramic (Denzir-M,

MgO
Dentronic AB, Skellefteå, Sweden).

• Ce-TZP/Al2O3 core

Ce 2 O 3
ceramic
• (NanoZir, Panasonic, Japan).
ALL CERAMIC SYSTEMS
Classification Based On Their Type
And Method Of Fabrication
condensed sintere
d

Castable Glass
glass ceramic
ceramics s
Injection Hot
moulded isostaicall
glass y pressed
ceramics glass
Glass ceramics
infiltrated Slip cast
core
ceramic
ceramics
s
Machinable C A D CAM
ceramics Ceramics
 ADVANTAGES
 Most life like and  Porcelain crowns
esthetically cemented on natural
pleasing abutments and those
 It is translucent, cemented on artificial
color stable, brilliant supports have the same
 uniformly reduced incidence of fracture;
therefore, a porcelain
and balanced
crown can be
preparation
successfully used after a
 long life expectancy
cast- metal post and
 fine textured core has been placed on
restoration a non – vital tooth
 increased impact
strength
 Biologically
 DISADVANTAGES
 Excessive tooth reduction
 High cost of materials and processing equipments
 Wear of opposing tooth and restoration
 Low repair potential
 Brittleness of ceramics
 Difficult intraoral polishing
 Fragility when cemented with conventional
cements.
 DISADVANTAGES
 Margin may not be as accurate as a cast margin and a
cement line of varying dimensions can form that tends
to wash out and stain when conventional cements are
used. Therefore resin of resin ionomer type cements
are recommended.
 Cervical shadowing or “ black line” is caused by “
disruption of the light harmony between the root and
crown” of the prepared tooth and the overlying soft
tissues.To avoid this esthetic problem, the facial
margin
should be placed subgingivally, but no more than half
way between the gingival crest and the depth of the
sulcus.
 INDICATIONS

 Obtaining the best esthetic is the single most

important consideration.
 The patient is allergic to metal.
 CONTRA INDICATIONS
 Preparation of all- ceramic crown would unavoidably
cause pulpal involvement.
 The patient participates in contact sports or has a
parafunctional habit such as pipe smoking that involves heavy
contact on small areas of the dentition.
 Severe bruxism/clenching/malocclusion
 Extensive wear of tooth structure/restoration
 Excessive bite force capability/heavy occlusal forces
 Previous history of all ceramic inlay/crown fracture
 Limited interocclusal distance : in cases of short clinical
crowns, deep overbite, natural tooth is not completely
erupted or with a supra erupted opposing tooth
 Inability to maintain a dry field
Sintered/Condensed
Leucite- reinforced feldspathic porcelain
• Optec HSP

Aluminous based porcelain( Pt foil)

• Vitadur- N TM core

Alumina based porcelain

• Hi Ceram

Zirconia based porcelain: Mirage II

• Mirage II

Magnesia based feldspathic

porcelain( Experimental)

• experimental

Hydrothermal low fusing Ceramics:

• Duceram LFC
 Porcelain Jacket Crown

Types
 Crowns made
entirely of  Porcelain Jacket

crown
jacket
Porcelain
feldspathic Crown- traditional
porcelain  Porcelain Jacket
 Constructed on a Crown with
platinum foil matrix Aluminous core
/glass ceramic crowns
crowns
which is Ceramic jacket
 Porcelain Jacket
subsequently Crown- with Leucite
removed reinforced core(Optec
HSP)
 ALUMINOUS PORCELAIN
 McLean and Hughes (1965)
 Increased content of alumina crystals in the core(40-
50%)
 Slightly better esthetics for anterior teeth than
metal ceramic crowns
 Inadequate to use for posterior teeth.
 ALUMINOUS CORE PORCELAIN
Platinum foil technique

 40 t0 50 wt% of Al2O3

 Flexural strength 131 Mpa

Master Platinum foil It supports Finished Cores

model with adapted to porcelain
dies die,Platinum
during
condensati
foil on and
as
functions
matrix firing
 Dentin Ceramic Unsintered Crowns Finished Crowns on
additions dies

Post-Cementation
Mc lean 1979 Five year failure rate 2% for anteriors 15% for
posteriors Large sintering shrinkage
Seiber et al 1981 :light reflection better than porcelain fused to metal
INDICATIONS CONTRAINDICA TIONS

 The preparation is conical

 shoulder thickness of with a little retention.
only 0.5mm possible on  Short teeth or where
the labial surface. there is too little tooth
structure to support such
 occlusal clearance
a restoration.
> 0.5mm in lateral  occlusal clearance <
excursions. 0.5mm.
 The patient habitually
grinds or clenches the
teeth.
 The
as a posterior
patient requires
FPD. a
reinforced restoration, such
 ADVANTAGES
 withstand torque better than conventional porcelains with
fracture rates slightly less than 0.5% (MCLEAN)
 Pure alumina is 6 times stronger than standard
porcelains.Thus by combining alumina core with standard
porcelain, you get a restoration which is twice the strength of
porcelain alone (ABRAMOWSKY)
 Low thermal conductivity
 During processing, the alumina and porcelain unite by
chemical bond thus no problem in the adhesion between the
different materials
 Both materials show the same co-efficient of expansion
and contraction
 Good color consistency
HI CERAM 1985
borrowing a technique from industrial manufacturing.
It is a system similar to aluminous core ceramic
crown, using an epoxy die, a swaged resin coping and
a conventionally applied ceramic
Indications Contra indications
 Anterior crowns  For posterior crowns
 Posterior crowns where occlusal stress
where occlusal
conditions are is high.
favorable.
 Patients who do not want
a metal core.
 Patients who are allergic
to metals.
 Patients who require light
reflection from tooth
through the core of the
crown for esthetic
purpose.
 OPTEC-HSP-Leucite reinforced
 porcelain
feldspathic porcelain with Advantages
a higher leucite crystal
content (leucite reinforced).
 Its manipulation,
condensation and firing is
quite similar to the alumina
reinforced porcelain jacket
crowns (using platinum foil
matrix).
 Uses Inlays, onlays, veneers
and
low stress crowns.

1.more esthetic - core is less
opaque (more translucent)
compared to the aluminous
porcelain
2.Higher strength
3.No need of special
laboratory equipment
 Disadvantages
4.Fit is not as good as
metal ceramic crowns
5.Potential marginal
inaccuracy.
6.Not strong enough for
posterior use.
 Duceram LFC/Hydrothermal low
fusing
ceramics
Advantages
 It’s a low fusing  greater density
hydrothermal ceramic
 higher flexural strength
 consists of an amorphous
glass containing hydroxyl (-  greater fracture
OH) ions.
resistance
 was developed in mid-
1980  lower abrasion than
 first time marketed in feldspathic
1989 porcelain.
 use in all ceramic prostheses,  Being highly
ceramic/ metal-ceramic
inlay, and partial crowns. polishable they do
not require glazing
 Duracem MC • The base layer containing Leucite
• condensed on a refractory die using
(Duceram conventional powder slurry technique and
Metal sintered at 930 0C.
Ceramic )
Duceram LFC • The veneering layer
• Duceram LFC is condensed with this base
(Duceram Low layer
Fusing and sintered at 660oC
Ceramic)
Castable Glass ceramics
Dicor
• flouromica
s
Dicor MGC

Cerapearl(bioceram)
• Apatite based
 Glass ceramics
TYPES OF
GLASS
CERAMICS
 MacCulloch in 1968.
 used a continuous
glass- molding process HOT
to produce denture ISO S TATIC
ALLY
C A STA BLE

C E RA M I C S
teeth. PRESSED
C E RA M I C S

 suggested that it should

be possible to fabricate
M A C H INABLE
crowns and inlays by CERAMICS

centrifugal casting of
molten glass.
GLASS CMEateRrailAsi Mofm
r e d in tothe desired shape as a
IC S
glass
Subjected to heat treatment to induce partial devitrification

Loss of glassy structure by crystallisation of

glass
Crystalline particles, needles, or plates
when an intraoral force was applied interrupt the propagation of cracks in the
material

Promotes increased strength and

toughness
 CASTABLE GLASS CERAMICS

Supplied as
 Properties are  Glass ingots
more closer to  Pre crystallised form-
glass Dicor MGC(as
 Only porcelain machinable blanks for
C A D CAM)
restoration made by
centrifugal casting Uses
 Inlays
technique
 Onlays
 Unique ceramming
 Veneers
process-enhance growth
 Low stress crowns
of mica crystals
Dicor
 The first commercially available castable ceramic
material for dental use
 Developed by Corning Glass Works
 Marketed by Dentsply International
 Adair and Grossman
 Fabrication of DICOR crown

Pattern constructed in
wax

Invested in refractory material like

a regular cast metal crown

After buring out wax,nuggets of

Dicor glass are melted and cast into
the mould in a centrifugal casting
machine
Glass casting is carefully removed from the
investment by sandblasting and the sprues
are gently cut away

The glass was then covered by a protective

“embedment” material and subjected to a heat
treatment(ceramming)

microscopic platelike crystals of tetrasilicic

fluormica to grow within the glass matrix.This
crystal nucleation and growth process is
called ceramming

Once the glass was cerammed, it was fit on the

prepared dies, ground as necessary, and coated
with veneering porcelain and a stain and glaze layer
to match the shape and appearance of adjacent
teeth
Advantages Disadvantages

 Ease of fabrication  Inadequate strength

 Good esthetics(greater for posterior use
translucency and  Internal characteristaion
chameleon effect) not possible
 Improved strength
 Has to be stained
and fracture
toughness externally to
 Good marginal fit improve esthetics
 Very low processing
shrinkage
 Low abrasion of
opposing teeth
 CHAMELEON EFFECT

 Dicor glass-ceramic was capable of producing remarkably

good esthetics, perhaps because of the “chameleon” effect, in
which part of the color of the restoration was picked up
from the adjacent teeth as well as from the tinted cements
used for luting the restorations.
 The transparent crystals scatter the incoming light.The light
and also its color, is disbursed 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.
Dicor
 characterized by the controlled crystallization
(termed ceramming) of a glass through the presence
of one or more nucleating agents.
 55% by volume of tetrasilicic
fluormica (KMg2.5Si4O10F2)
 was derived from the quaternary ceramic system,
K2O- MgF2MgO-SiO2.
 low flexural strength (110 to 172 MPa)
 low fracture toughness (1.6 to 2.1 MPa•m1/2)
 Difference between Dicor and Dicor
MGC.

Dicor Dicor MGC

55%vol of 70% vol of tetrasilicic
tetrasilicic flouramica crystals which
fluoramica crystals. are 2 µm in diameter
Crystallization done by Higher quality product that
the technician. is crystallized by the
manufacturer and provided
as cadcam blanks or
ingots.
Mechanical properties Less translucent than Dicor.
similar.
Only one shade Dark and light
. shades available
Flexural strength is more
 Hydroxyapatite based
castable glass ceramics:
Cerapearl Cerapearl.
Sumiya Hobo and Kyocera Bioceram group of
Kyoto City, Japan .
Castable glass ceramic :CaO- P205- MgO-Si O2

Oxyapatite
Moisture

Hydroxyapatite

Ename
 Properties of Cerapearl
Melts at 14600C and flows like

a melting glass. CTE small enough to obtain

accurate castings.

The cast material has an amorphous microstructure

when reheated at 8700C forms crystalline HA.

Biocompatible: Crystalline structure similar to enamel.

Enamel
Enamel: Regular arrangement.
Cerapearl: Irregular
arrangement.

Hence same crystal components but superior

mechanical strength.
Modulus of rupture :150 Mpa.
Cerapearl
 Procedure For Cerapearl
Crowns thicker than metal ceramic because of poor flexural
characteristics. 2mm: occlusal
Tooth
preparation 1.5reduction
mm: axial reduction.
1.2 mm on the margin.
Heavy chamfer or shoulder finish
line. All sharp edges should be
rounded.
W axing
A full arch impression is made.
Working cast fabricated with Type IV
stone. Dowel pins are employed.
Die spacer of 25μm is applied on the
die except within 1 mm of the finish
line Wax pattern is fabricated
 Wax sprue 2.5 mm in diameter and 35 mm long. is
Casting attached to the thick portion of the wax pattern.
Other end :orifice of the ceramic crucible.

A spl. phosphate bonded high heat investment

Investment exhibits the same CTE as Cerapearl’s
casting shrinkage( 0.53%).

The sprued wax pattern is located inside preformed

silicone form used for fabrication of ringless
investment mold and investment is poured.

Burnout procedure for cerapearl Electric

oven
Temperature less than 1000C for 30 min.
Temperature is raised to 5000C ,next 30
min. Temperature is held at 8000C for 30
min.

Ringless investment mold with

ceramic crucible on the top
Casting of Investment mold is transferred to
cerapearl a specially designed casting .
machine
8-10 g of raw Cerapearl is
placed in the ceramic crucible,

Melted under vacuum at

14600C
and cast into the mold.

Crystallization of Cerapearl.

Started at 7500C ,maintained for 15 min.

Temperature is then raised 500C per min until it

reaches 8700C and then held for one hour.

The apatite
crystals would have occurred during the
process.
Trial insertion:Cerapearl.

Investment mold is removed from the oven

and cooled to room temperature.

Air abrading with 20 μ alumina oxide of

the casting.

The sprue is cut and polishing is done.

Cerastain by
Bioceram
Staining and glazing:
Cerapearl is very white compared to
enamel Requires application of an external
stain.
Slip cast ceramics/glass infiltrated
In Ceram
core ceramics
• ALUMIN A

In Ceram Spinell(ICS)
• MAGNESIA ALUMINA SPINELL

In Ceram Zirconia
• ZIRCONIA

In Ceram 2000
 GLASS INFILTRATED CERAMICS
A process used to
form green ceramic
shape by applying a
slurry of ceramic
particles and water or
a special liquid to a
porous substrate Such
as a die material, there
by allowing capillary
action to remove
water and densify the
mass of deposited
particles
 GLASS INFILTRATED CORE
CERAMICS/SLIP
 Minimize sintering
CAST
3 G L A S CERAMICS
S INFILTRATED
C O R E C E R A M I C SYSTEMS
shrinkage
 Ensure adequate
fit
 Each of these partially Magnesia
Partiall - alumina
sintered ceramics can be y spinel
infiltrated with a sintered (MgAl2O 4)
lanthanum glass without
alumina
any significant
dimensional change. Zirconia-
alumina
core.
 VITA
In- • 85%alumina by volume
Ceram
Alumina
• Mean flexural strength-
600MPa

In- • magnesia alumina spinel

Ceram (MgAl2O4)
• More translucent
Spinell • Mean strength-350MPa
(ICS)
In- • 62% alumina, 20% zirconia, and
18% infiltrated glass
Ceram • Mean flexural strength-620MPa
Zirconia
Glass infiltrated ceramics

• Uses
 In addition to the usual inlays,
onlays, veneers and low
stress(anterior and posterior)
crowns, this material can be
used to construct low stress
anterior bridges. Because of its
occasional tendency to fracture
when used for bridge
construction its use should be
carefully selected
 For people allergic to metal
• based bridges
 Where esthetics is absolutely
critical
 Powder particles coated with a polymer – even
suspension
pH of water adjusted to create a charge on ceramic particles

Slip applied on to the gypsum die with brush-ceramic

core by capillary action of porous
Water is removed
Packed rigid network of ceramic particles
gypsum

Sintered (11200 C for 10 hrs or

more)
Porous core

Infiltrated with lanthanum based glass

Forms inter penetrating
Lanthanum glass melts Flows into network
pores
 Fabrication
 Two dies are required
1. In stone
2. In refractory die material

Working model

In-Ceram
refractory Duplication
dies
 Preparing the slips- A slurry of alumina is prepared and
deposited on the refractory die using the slip cast
method (the water from the slurry is absorbed by the
porous die leaving a layer of alumina on the
surface).The process is continued until a alumina
coping of sufficient thickness is obtained.
 Prepared slip should be

smooth and
homogenous
 The fragile slip cast alumina coping is
dried at 120°C for 2 hours.

The coping is sintered (Inceramat

furnace ) for 10 hrs at11200 C

vita inceramat

After sintering the coping are

tested
for cracks using a special dye
 A slurry of glass material
is applied on to the
sintered alumina coping
and fired for 3 to 5 hours
at 1120°C.
The glass fuses and
infiltrates into the porous
alumina coping through
capillary action
 The excess glass forms a glassy layer on the
surface which is trimmed off using special
diamond burs.
 The coping is now ready for the rest of the build
up using dentin and enamel veneering material
(Vita VM7)

Vaccumat 4000 Premium

 Finished In-
Ceram copings Finished crowns
Application of body
(Air abraded)
and incisal
porcelain

Preoperative veiw Postoperative veiw of

In-Ceram crowns

Probster et al : Strength of In-Ceram > IPS Empress <

PFM
ADVANTAGES D I S A DVA N TA GE S

 Comparatively less
 Good fit and
esthetic because of
marginal adaptation
 Good strength
the opacity of the
alumina core.
 Giordono 1995 : Al2O3
 Quite tedious to
Core glass infiltrated
Ceramic > Strength fabricate.
than Hi-Ceram, Di-Cor  Not all the bridges were
& Feldspathic Porcelain successful, a few of
 Strong enough for them did fracture
posterior single occasionally.
crowns and anterior
FPD use
Pressable/Hot Isostatically
Pressed/Injection Moulded
Ceramics
IPS Empress
• Ivoclar
Vivadent Contain
Cerpress SL Pressable Ceramic 35% vol
System ofLeucite
• Leach and
Dillon
crystal
Finesse All Ceramic
s
System
• DENSTSPLY Ceramco

IPS Empress11 Contain

• Ivoclar
65-
Vivadent
70%
OptecOPC 3G vol
disilicate
• Pentron laboratory technologies lithia
 HOT-ISOSTATICALLY
PRESSED(HIP) GLASS-
CERAMICS
 Leucite IPS
reinforcedK2O – Empress,Finesse,
HEAT PRESSED Al2O3 – 4 SiO2 O ptimal,Cerpress
GLASS
CERAMICS
Lithium Disilicate
reinforcedSiO2 – IPS Empress
PRESSA BLE LiO2 – P2O5 – ZrO2 II,OPC 3G
CERAMICS

HEAT PRESSED IPS

VE NE E RI N G
CERAMICS ZirPress,VitaPM9
 First generation pressable ceramics

The most well-known The glassmatrix layering

leucite-based products ceramic for these core
 IPS Empress materials also contains
(Ivoclar Vivadent) leucite.
 Cerpress SL Pressable
 low flexural strength (up
Ceramic System to 112 MPa) and fracture
(Leach and Dillon) toughness (0.9 to 1.3
 Finesse All-Ceramic
MPa•m1/2) but twice that
of feldspathic ceramic
System
 Higher porosity (9%)
(DENTSPLY
Ceramco).  not recommended for
molar crowns or bridges.
Second generation pressable ceramics
 IPS Empress 2 (Ivoclar
Vivadent) and Optec
 contain approximately
OPC 3G (Pentron
65% to 70% by
Laboratory volume of
Technologies)
lithia disilicate
 Initially lithium
(Li2O•2SiO2) as the
metasilicate,cristobalite
principal crystal phase.
forms
 narrow sintering range-
 Final structure- highly
processing of ceramic
interlocked lithium
prostheses very technique
disilicate crystals(0.5µ
sensitive
in length and 0.8µ in
diameter)
 Second generation pressable ceramics

Advantages  mean flexural strength is

approximately 350 MPa
 Improved strength compared with the 112-
MPa strength of leucite-
( Inter locked micro
based glass-ceramics.
structure and layered  This strength and a
crystals) fracture toughness of 3.3
 crack propagation MPa·m1/2 for lithia
is difficult in a disilicate–based glass-
ceramics are generally
direction sufficient for
perpendicular to the
1.most anterior and
crystals alignment posterior crowns
 Flexural strength twice 2.anterior three unit bridges
that of 1st generation.
EMPRESS 2
 Reasons for improved flexural strength
Difference in coefficient of thermal expansion of glassy matrix and
crystals
Tangential compressive stresses develop around leucite/lithium disilicate crystals

Contributes to crack
deflection
Prevent crack propagation Improved mechanical properties

Additional re crystallisation during firing

Additional firings Improved flexural strength

 Fabrication of Pressable ceramics
 Technique similar
to injection Glass ceramic
ingot is
moulding heated
 Since from a single ingot
– mono chromatic Allowed to flow
 Can be cast as coping under pressure into
mould using lost
and layered with wax technique
veneering ceramics
 Used for inlays, onlays,
Contoured,
single crowns and stained, and glazed
veneers for final finish
FABRICATION
 The wax patterns of the restoration are invested in
refractory material and heated to 8500 C in a furnace
to burn off the wax and to create mould space
 Burn out 8500 C

It is then transferred to
the pressing furnace
 Ceramic ingot
&an Alumina
plunger is
inserted in to the
sprue

Pressing temperature

1075-11800 C-IPS
Empress
9200 C-IPS Empress II
Under air pressure-1500
psi
  Core of restoration is retrieved from the
flask

 Compatible veneering porcelains are added to core

to build up final restoration
Property IPS Empress IPS Empress II

Core ceramic Glass ceramic with 35% vol of
leucite crystals.
Glass ceramic with
70% vol of lithium
disilicate
crystals.Lithium
orthophosphate in
much lower
concentrations.

Veneering Also contain leucite crystals Contains apatite

ceramic in glass matrix crystals which causes
light scattering similar
to tooth structure.

Processing 11800C 9200C

temperatur
e
Property IPS Empress IPS Empress II
Flexural strength 112±10Mpa 400±40
Fracture 1.3±0.1 3.3±0.3
toughness MPa/
m1/2
Thermal 15±0.25 10.6±0.25
Expansion
coefficient(ppm/
0C)

Veneering 9100C 8000C

temperatur
e
Chemical 100-200 50
durability(μg
/ cm2
Heat pressed(hot isostatically
pressed)ceramics /injection
moulded
Advantages Disadvantages
ceramics
 Better fit- because of  Need for
lower firing costly
shrinkage equipment
 Better esthetics-absence  Potential fracture

of metal or an opaque of posterior areas

core
Edward B Goldin 2005 compared leucite IPS Empress with PFM

Mean marginal discrepancy 94 + 41

PFM
81 +25 IPS
Machinable ceramics

Milled or machined
ceramics CAD
CAM Systems
Copy milled
systems
Essentials of a CAD CAM
System
Scanner/digitizer
• Virtual impression

Computer
• Virtual design (CAD)

Milling station
• Produces the restoration or
framework
Ceramic blanks
• Raw material for
restoration
Furnace
• Post sintering,ceramming
 Schematic representation of CAD
CAM production
Contact probes Restoration
Tooth / optical or framework
scanning design(CAD)
preparation

Conventional impression and Restoration or framework

die fabrication milling(CAM)

Furthur processing-simple
Wax glazing and staining to post
pattern sintering and build up with
veneering ceramics
 SCANNER OR DIGITIZER

 CONTACT PROBES

 Physically contacts the

die as it moves along its
surface while transmitting
the information to the
computer
 Eg.Procera Forte
contact scanner
Scanners

Laboratory scanners
•Intra oral hand held wands
 Larger scanners
 Chair side
Scan the scanners
cast or die
1.Reflects
use a camera to
light(visible
capture multiple
light,laser
images or LED)
 Captures it with a
 Eg.white light optical
camera2.Two cameras to
scanner
Createthe
capture an optical
object from of
impression multiple
prepared
angles and
tooth usingadjacent
white light
Eg.Kavo Everest
structures
3.Laser planes projected in a
 Stitch multiple images to a
grid pattern
3D image in computer
Procera
optical
scanner-
conoscopi
c
holography
 Most recent versions of digital
impression softwares
 3M ESPE Lava Allow complete 3D
Chairside Oral visualisation of the
Scanner C.O.S projected restoration
 3M ESPE CEREC AC with virtual seating
 Sirona Dental Systems capabilities
 Various surfaces of the
 LLC;E4D Dentist
virtual restoration can
 D4D Technologies
be modified in all three
 iTero
dimensions prior to
 Cadent,Inc. machining
 Based on active optical
Parallel wavefront
confocal sampling
imaging- 3 sensors collect video data
100000 point from different perspectives
maps at 300 20 3D datas per second
focal depths 24 million datapoints per
spaced 50µ arch
apart

Lava Chairside Oral

iTero Scanner C.O.S
 3M ESPE CEREC
AC

High speed swept laser beam

combined with a camera
CEREC Bluecam-blue light Series of 3D SCANS
emitting diode and Principle of LASER
camera system triangulation
Active triangulation to
create images of the tooth
surface
 Computer/CAD Process
 Restoration/core is designed based on software
 Can automatically detect finish line
 Some use a library of tooth shapes stored in
computer and suggest the proposed restoration
 A recording of bite registration is also added to the
data
 Combined information+3D optical impression-establishes
approximate zone in which the new restroration can
exist
 Can modify and correct the design if required
 MILLING STATION

 Signals from computer - milling tool which shapes

the ceramic block (according to the computer
generated designs)
 Performed by a diamond or carbide milling tool
 Cerec station-2 diamond bur to grind internal
and external surface simultaneously
 Other machines-single tool moving along multiple
axis(2- 5 axis)
 Everest or kavo engine-5 axis milling station;Can mill
both ceramic and titanium
 Can be
produced
by limited in their
processing speed and
their ability to
by chair-side process large cases.
milling
units  processing multiple jobs with a
high level of accuracy and
reproducibility.
 very expensive( with typical
industrial costs in excess of several
hundred thousand USD for
milling industrial C A D CAMS)
processe
CERAMIC BLANKS
Feldspathic porcelain blanks

• Vitablocs Mark II (Vita)

Glass ceramic blanks

• DIcor MGC,(tetrasilicis flouromica)Pro Cad,Everest G(Kavo)(leucite),IPS

emax CAD(Kavo)(lithia disilicate)

Glass infiltrated blanks

• Alumina,(Vita InCeram Alumina)spinell,(Vita InCeram Spinell),zirconia(Vita In Ceram
Zircona)
Pre sintered blanks
• Alumina (Vita In Ceram AL),
• Yttria stabilized zirconia (Vita In Ceram YZ)

Sintered blanks

• Yttria stabilized zirconia (Everest ZH

blanks)
 Machinable ceramics
Feldspathic porcelain-
blanks

blanks
ceramic
From Copy milled
Vitablocs Mark II Alumina blocks-
Lithia disilicate glass Celay In Ceram
ceramic-IPS e max
From C A D CAM

MgAl2O3 blocks-In
CAD,Kavo Ceram spinell
Glass infiltrated
ceramic

Partially sintered
zirconia-Vita In
Ceram YZ
Sintered zirconia-
Everest ZH
Feldspathic porcelain blanks
• Can be milled to full
contour
Leucite reinforced

• Can be milled into full

contour
Glass infiltrated blanks

• Usually machined as cores or FPD substructures

• Subsequent glass infiltration,veneering,and glazing

Lithium disilicate

• Machined in intermediate crystalline state-material shows characteristic

blue shade
• In this stage easier to shape and try in mouth
• Followed by simple, quick crystallization process-30 mnts
 MACHINABLE ALL CERAMIC
MATERIALS
SOFT M A C H I N I N G
HARD MACHINING F O L L O W I N G S I N TE R IN G

 Machined in  In partially sintered state

fully sintered  Later fully sintered
state  Requires milling of an enlarged restoration
 Restoration is to compensate for sintering shrinkage
machined  Used for alumina,spinell,zirconia(difficult to
directly to machine in fully sintered state) Copings
final size are furthur glass infiltrated
 Microstructure similar to that of slip cast
ceramics
 Final marginal accuracy within 50µ
 Hard machining
Tooth
preparation
Optical scanning Computerisation of image

Design restoration with aid of

computer

Machining of restoration from ceramic blocks by a computer controlled milling machine

Bond to tooth preparation with resin

Takes only few
cements
minutes
Presintered Zirconia
 Most zirconia frameworks
are fabricated by machining
a porous or partially fired
block
 Used as cores for
crowns and FPDs
 Softer and easier to mill
 Milled to larger
size(20%)
 Shaped by carbide burs
 Post sintering
 Sintering time-6-7.5
hours
 Sintering temperature-
1350- 15300 C
Sintered Zirconia
 No need of post sintering
 No shrinkage is expected
 Takes more time(2hrs for
a single crown) and wear
of milling tool(extreme
hardness)
 Shaped by diamond
disks and burs
 Core construction for
crowns and long span
anterior and posterior
 GREEN • Cercon (Degudent/DENTSPLY

STATE Ceramco)
• Lava (3M ESPE),
• ZirkonZahn (USA),

MILLING • HintEls Zirkon TPZ-G

(DigiDent)

PARTIALL
• IPS e.max ZirCAD (Ivoclar Vivadent)
• VITA In-Ceram YZ Cubes (VITA

Y Zahnfabrik),
• Everest (Kavo Dental),

SINTERED • Hint-Els Zirkon TZP-W (Digident)

• DC-Shrink (DCS)

MILLING • Precident DCS (DCS)

FULLY
SINTERED • Denzir Premium HIP Zirconia (Etkon
USA)
STATE • Zirkon Pro 50 (Cynovad)
• Kavo Everest ZH Blanks (Kavo Dental)
MILLING
 a simulated digitized image of a
crown to be produced from a
ceramic blank and an adjacent
image of a partially milled crown.
 Cerec ceramic block, a milled
inlay form, and the final inlay.
A four-unit Cercon core ceramic
framework can be milled in the
green state
Simulated try in
after sintering, staining, and glazing
the veneering ceramic
 Procedural sequence for producing
ceramic prostheses by a CAD-CAM
system using partially sintered blanks:

Set the blank Set the Insert appropriate

enlargemen milling/machining
in
t factor tool
milling machine

Clean the Cut the

Remove the
partially sintered framework from
framework blank using framework and
completely diamond disk residual blank
 Place the Set the thermal
framework in the processing
Dry the
isothermal hot conditions according
framework
zone of the to sintering
completely
sintering furnace instructions

Inspect for surface Sinter the

and sub surface After cooling framework to
flaws using fibre remove framework achieve optimal
optic trans density
illumination
 Evaluate the Use water cooled
framework for diamond tool to
adequacy of wall perform minor
thickness,ease of adjustment
seating,and marginal corrections
fit

Depanding on the Rinse the

Transitional liner
zirconia product framework
prior to application
framework used thouroughly with
of veneering
with or without water and dry it
ceramic
veneering ceramic completely
 COPY MILLED (CAM) SYSTEMS
 Wax pattern of restoration is scanned
 Replica is milled out of the ceramic
blank
Celay Cercon Ceramill
system
• Mikrona • Degudent,
Technologies • Dentsply
, • Has both
Spreitenbac C A D CAM
h, and copy
Switzerland milling
system
 Cerco
Cela
n
y
 CELAY SYSTEMS
 Uses copy milling technique
 Resin pattern fabricated directly on master die
and pattern is used for milling porcelain restorations
 Jacot et al 1998 : in ceram blanks in celay system.

Copy milling pattern

Inlay pattern mounted
out of ceramic
(copy side)
material
(milling side)
 It is an innovative system developed by Dr.Stefan
I. Eidenbenz at the university of Zurich in 1994
 It is a high precision, manually operated copy milling
machine and the fabrication principle is the same as
for 'Key' duplication.
The resin pattern can
be produced directly
on
prepared teeth or indirectly
on dies made from
impressions

prefabricated pattern of the

designed restoration made
from a blue resin-based
composite (Celay-Tech,
ESPE, Seefeld-Oberbay,
As the tracing tool passes over
the pattern, a milling machine
duplicates these movements as
it grinds a copy of the pattern
from a block of Alumina or
other ceramic material
Advantages
 Precisely fitting ceramic
restorations can be
developed without a lab
technician in high grade
factory fired porcelain, in
a very short time in one
session.
 The grains are finer
than conventional In-
Ceram, therefore the
strength is more than
conventional.
Disadvantages
 the accuracy of the copy-
milled crowns is
dependent on the care,
time, and the profile
tracing ability of the
technician, the marginal
quality of crowns made
from the copy-milling
technique is likely to be
inferior to that of
copings made from the
hot pressing method.
 3.CERCON
 It is commonly called as a CAM system as it does
not have a C A D component.
 This system scans the wax pattern and mills a zirconia
bridge coping from presintered zirconia blanks, which
is sintered at 1,3500C for 6-8 hrs.
 Veneering is done later on to provide esthetic
contour.
 Marginal adaptation for the cercon crowns and fixed
partial dentures was reported 31.3 μm and 29.3
μm respectively.
 Ceramill system
 Based on pantograph type of copy milling
 ‘puts material back in the hands of technician,
 To create a zirconia coping,user applies light cure
resin over a traditional die
 Attaches resin pattern into a plastic plate
 Inserts it into milling unit side by side with YtZP
zirconia blank
Two conjoined arms of Ceramill system

• User manually traces

Holds the resin build up
the with probe tip
probe tip
• Simultaneously mills a
Milling duplicate coping out
handpiec of the zirconia block
e
 MOST COMMON
CAD CAM
SYSTEMS
Direct CAD - CAM
1.CEREC(Chair Side Economic
Reconstruction of Esthetic Ceramic)
CEREC 1
• 1980-
Optical scanner is used to scan
s the preparation or the
impression and a 3D image is
formed on the monitor.There is
CEREC a milling unit to prepare the
II restoration
• 1996
Can record multiple images within a
CEREC few seconds, which enables the
III clinician to prepare multiple teeth
in same quadrant thereby creating
• 2000 a virtual cast for that quadrant
 Cerec System consists
of :
 A 3-D video
camera (scan head)
 An electronic
processor
image
processor)
(video with
memory unit (contour
memory)

(computer)
A connected
digital to,

processor
A miniature
milling machine (3-axis
machine)
 Materials used with
CEREC
 Dicor MGC (Machinable Glass Ceramic)(Dentsply)-
mica based machinable glass ceramic containing 70%
vol of crystalline phase

 Vita Mark II (Vident):contain sanidine (KALSi3O 8)

as a major crystalline phase within a glassy matrix.
 ProCad (Ivoclar):Like Ivoclar's popular Empress™
material, ProCAD is reinforced with tiny leucite
particles, and has been referred to as: "Empress on a
stick".

 Vita IN-Ceram Blanks (Vita Zhanfabrik):

 IN-Ceram Spinell.
 IN-Ceram Alumina.
 IN-Ceram Zirconia
 Clinical Procedure:
 Tooth preparation follows typical all-ceramic
guidelines.
 Optical impression
 Clinical shortcomingof 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
 The changes include :
 Enlargement of the grinding unit from 3 axis to 6 axis
 Upgrading of the software with more sophisticated technology
which allows machining of the occlusal surfaces for the
occlusion and the complex machining of the floor parts.
 Other technical innovations of Cerec 2 compared to Cerec 1:
 The improved Cerec 2 camera : new design, easy to handle,
a detachable cover (asepsis/sterilization), reduction in the pixel
size/picture element to improve accuracy and reduce errors.
 Data representation in the image memory and processing
increased by 8 times, while the computing capacity is 6
times more efficient.
 Magnification factor increased from x8 to x12
forimproved accuracy during measurements.
 Improved in rigidity and grinding precision by 24
times.
 Improved accuracy of
fit
 Cerec 3
 Software still easy and user friendly which uses
windows as operating system.
 Two compatible cameras available- SIROCAM
2 / SIDEXIS.
 Precise restorations.
 Extra-oral and intra-oral measuring.
 Rapid production.
 The imaging unit and the milling unit can be linked
via cable, IRD port, networked.
 Supported with online help and design.
Cerec-3 that can design well-fitting inlays, onlays, crowns, veneers etc.,
in a single visit.
 Advantages of CEREC System
 One or two appointments.
 Optical impression, max time required is 5 sec.
 Wear hardness similar to enamel.
 Less fracture due to single homogenous block.
 Excellent polish.
 Improved esthetics.
 Time saving.
 Good occlusal morphology in relation to
antagonist.
 INDIRECT CAD - CAM
System that consists of several modules with at least,
two distinctive C A D & CAM stations
 The optical impression is taken in the dental office,
where C A D is done; data are transmitted to CAM
station for restoration fabrication.
 The optical impression is taken in the dental office;
collected information is then transmitted to a
central station, where C A D & CAM modules
operate.
 Because of the overall dimensions and the cost of the
indirect C A D – CAM devices, they are usually not
located in the dental office, but more likely in a central
laboratory where data is collected from different
treatment places.
E.g.
 Duret system.
 Procera system (Noble Bio-Care).
 Cicero system(Elephant Industries).
 President system (DCS Dental).
 CEREC SCAN & CEREC InLAB (Sirona Dental
company)
CEREC SCAN

 CEREC SCAN (inclusive of both scanning and

milling device)with lap top(imaging device).
 Tooth preparation.
 Conventional impressions.
 Die preparation.
 Controlled by one of the practice pc’s.
 Works upon CEREC 3 software.
 Intra oral scanning device is not
present.
CEREC In-LAB
Parallel milling with two
tools
High speed milling of copings and bridge frame work.
 2. DCS Precident
 Consists of a laser Scanner called as Preciscan
and a multitool milling center called Precimill CAM.
 The DCS software automatically provides suggestions
for connector sizes and pontic forms.
 It can scan upto 14 dies simultaneously and mill
30 frameworks in one fully automated operation.
 It can also mill titanium and fully dense sintered
zirconia.
An in vitro study showed that marginal discrepancies of
alumina and zirconia based posterior fixed partial
denture
machined by the DCS system was between 60 μm
to 70μm
 3. Procera All Ceram System
 introduced in 1994.
 first system which provides outsourced fabrication using
a network connection.
 According to research data average marginal gap for
Procera all Ceram restoration ranges from 54 μm to
64 μm.
PROCERA
SYSTEM
 Procera All-Ceram
 Developed by Dr. Matts Andersson for Nobel Biocare
embraces the concept of computer assisted design
and computer assisted machining .
 The technician can design a coping for a full crown
restoration controlling the thickness, emergence
profile, and precision of fit.
 The design data can be forwarded to the
manufacturing facility and the coping produced in
various materials.
 The Procera AllCeram Crown involves a densely
sintered high-purity alumina core combined with a low
fusing veneering porcelain fabricated by the pressed
powder technology.
 Advantages:
 The finished crown has a translucence very similar to
the natural tooth.
 Aluminum oxide is a highly biocompatible
material, comparable to titanium.
 The coping is made of dense-sintered aluminum oxide
to maximize strength.
 The Procera technique guarantees high precision
for optimal fit.
 A technician using the special Procera design station
scans the die and designs the coping to be
fabricated.This station consists of a computer, a modem
and the Procera scanner
 Once positioned on the scanner, a probe lightly
touches the die as it is rotated. A 3D map is produced
from this "tactile scan" that consists of approximately
50,000 data points from around the die.
  After the master die is
scanned all the 3-D
images are transferred to
the processing center
through Contact scanner
an internet link
 an enlarged die is milled
by a computer
controlled milling
machines.
 The coping is sent to
the lab for veneering of Shape on computer screen
porcelain
 4. CICERO system (computer
 integrated crown
it was introduced by Denison Reconstruction)
et al in 1999,
 it includes optical scanning, metal and Ceramic
sintering and computer assisted milling to obtain
restoration.
 The aim of CICERO is mass production of
ceramic restorations at one integrated site.
 It includes rapid custom fabrication of high strength
alumina coping and also partially finished crowns to be
delivered to dental laboratories where porcelain
layering or finishing can be done.
 5.Lava
system
 introduced in 2002
 mainly used for fabricating zirconia framework for the all
ceramic restorations.
 Yttria stabilized tetragonal zirconia poly crystals (Y-TZP)
are used in this system are better than the
conventional ceramics as they have greater fracture
resistance.
 uses a laser optical system to transfer and
digitize information received from the
preparation.
 The Lava C A D software suggests a pontic
automatically according to the margin.
 Cementing of ceramic
restorations
-Resin
 Increase bonding
the retention agents
of all-ceramic crowns and
bridges.
 High bond strength
 Esthetics at margins is better
 Improved translucence
 Increase the fracture resistance and survivability
of ceramic restorations
 Reduces water access to the inner ceramic
surface
 Etching blunts the tips of microcracks within
the ceramic,thereby inhibiting crack
propagation
Bonding of cement to porcelain can
be • improved by
Create minute irregularities on the inner surface-
help the cement to retain better
1.Sandblastin • Clean in distilled water in an ultrasonic bath-10
g minutes

2.Chemica • Done with hydroflourous acid or ammonium

biflouride
l etching • 2minutes

3.Use of • Functions as coupling agent(difunctional

molecule)
silane • for silica based porcelains
primers
 SILANE PRIMERS/COUPLING AGENTS

 Contain one or more

silicon atoms
 3-
methacryloxypropyl
trimethoxysilane
 Silane primers provide
covalent bonds that
promote adhesion at the
interface between polymers The bonding stage of
and hydrolytically stable
silane primer or adhesive
silica based substrates,
assuming that the substrate to a silicabased ceramic.
is free of contaminants
Silane as a di functional molecule
• Capable of co
polymerisation with
M ethacrylate
methacrylate
group
based adhesives
and resins

• that are hydrolyzed to

silanols (Si–OH) for
bonding to inorganics
Methoxy
such as silica-based
group(– ceramics or metal
OCH3) oxide substrates
through the formation
of siloxane (– Si–O–
Si–) bonds.
Reaction of silanes with
slica based ceramics-4
Hydrolysis stages
• Of methoxy
groups
Condensation

• Of oligomers

Hydrogen bonding

• the oligomers then hydrogen bond with O H groups of the

substrate.
Bond formation
• during curing, covalent links are formed with the substrate
with
simultaneous loss of water
 Factors affecting abrasiveness of
dental
Properties of the ceramics
crystal phase particles and the
glass matrix (if present)
 hardness  abrasiveness of foods,
 tensile strength
 residual stress
 fracture toughness
 subsurface quality (voids
or other imperfections)
 fatigue resistance  magnitude and orientation
 particle-glass bonding of applied forces
 particle-glass interface  chewing patterns
integrity  bruxing frequency
 chemical durability  contact area
 exposure frequency to  lubrication by saliva
corrosive chemical agents  duration of exposure to
 acidulated phosphate abrasive particles.
fluoride, carbonated
beverages
 Minimizing excessive wear of enamel
(1) ensure cuspid-guided disocclusion
(2) eliminate occlusal prematurities
(3) use metal in functional bruxing areas
(4) if occlusion is in ceramic, use ultralow-fusing
ceramics
(5) polish functional ceramic surfaces
(6) re polish ceramic surfaces periodically
(7) readjust occlusion periodically if needed.
CHEMICAL ATTACK OF GLASS-PHASE CERAMICS
BY ACIDULATED PHOSPHATE FLUORIDE
 When glazed feldspathic porcelain is exposed to
1.23% APF or by 8% stannous fluoride, a surface
roughness is produced within 4 min.
a 30-min exposure to 1.23% APF gel appears to
preferentially attack the glass phase (areas with white
precipitate particles) of a gingival (body) porcelain.

P LAQ UE B R E A K D O W N OF
ROUGHNESS STAINING
ACCUMULATION THE STRUCTU RE
 CHEMICAL ATTACK OF GLASS-PHASE
CERAMICS BY ACIDULATED PHOSPHATE
FLUORIDE
 Acidulated phosphate fluoride (APF), one of the most
commonly used fluoride gels, is known to etch glass by
selective leaching of sodium ions, thereby disrupting
the silica network.
Use of lower concentrations( 0.4% stannous fluoride
and 2% sodium fluoride)-no significant effect
 Avoid the use of APF gels when composites and
ceramics are present.
 Should not be used on glazed porcelain surfaces. If such
a gel is used, surface of the restoration should be
protected with petroleum jelly, cocoa butter, or wax.
 PORCELAIN DENTURE TEETH
 Denture teeth are made by packing two or
more porcelains of differing translucencies(High
fusing porcelains) for each tooth into metal
molds.
 They are fired on large trays in high-temperature
ovens.
 Porcelain teeth are designed to be retained on
the denture base by mechanical interlocking.
Anterio • are made with
projecting metal pins
r that become
surrounded with the
teeth denture base resin
during processing,

• are molded with

Posterio diatoric spaces(holes)
into which the
r denture base resin
may flow.
teeth
ADVANTAGES
 more esthetically satisfactory
(natural looking)
 much more resistant to
wear
 Excellent biocompatibility
 only type of denture teeth
that allow the denture to
be rebased (replacement of
the entire acrylic denture
base)
D I S A DVA N TA GE S
 Brittleness
 Need for mechanical retention
 Extra time required to grind
and contour the surfaces
 Clicking sound produced on
contact with the opposing
teeth.
 Higher density;increased
weight
 Require a greater interridge
distance because they cannot
be ground as thin in the ridge
lap area as acrylic teeth
without destroying the diatoric
channels that provide their
only means of retention to the
denture base resin.
 SHADE GUIDES
 Shade guides are produced by dental
ceramic manufacturers
1.to assist dentists and lab technicians in selecting
optimum ceramic shades
2.for communicating the desired prosthesis appearance
to each other.
 Shade guides made of porcelain are used most often
by dentists to describe a desired appearance of a
natural tooth or ceramic prosthesis.
 Hue-is the basic color Value is the
amount of
Chroma is grayness or
the intensity of whiteness. To
that color, so lower the value
that a higher means to
A darken, and to
B D degree of
SHADES OF raise the value
ORANG SHADES OF YELLOWISH chroma
ISH YEL BROWN means to
BROW LOW would have a lighten. The
N higher " C " shades can
concentration be used to
of hue. indicate four
basic values.
 Valu
Saturation Hue
e
From your
selected
Determine The Value group, Check whether
Lightness Level (Value) remove the middle
• Hold shade guide to tab (M) and
the natural
patient’s mouth at spread the tooth is
arms length samples out like more yellowish
• Start with darkest a fan or more
group moving Select one of the
right to left three shade
reddish than
• Select Value group 1, 2, samples the
3, 4, or 5 to determine shade
Chroma/saturatio sample
n
 Deficiencies of shade guides
1. Shade guide tabs are much thicker than the thickness of
ceramic that is used for dental crowns or veneers, and they
are more translucent than teeth and ceramic crowns
backed by a nontranslucent dentin substructure or
veneering ceramics backed by an opaque core ceramic, or
a metal framework
2. Much of the incident light is transmitted through a tab. In
contrast, most of the incident light on a crown is
reflected except at the incisal edge and at proximal
incisal areas.
3. the necks of shade tabs are made from a deeper hue—
that is, higher chroma—and this region tends to distract
the
observer’s matching ability in the gingival third of the tab.To
avoid this situation, some clinicians grind away the neck
area
The VITA Easyshade
 It is a simple-t.o-use point and click digital
spectrophotometer that provides instant dental
shade readouts regardless of the lighting
conditions.
• Defines how the desired shade is developing between
biscuit firings, regardless if the crown is wet or dry.

• This approach assures that the

final success of the shade will
exhibit color from within, rather
than a stained external surface
Fracture of ceramic-ceramic prostheses
(Hientze and Rousson-2010)

Grade • Need
1 polishing
Grade • Need
2 repair
Grade • Need
3 replacement
 Repair of ceramic restorations

Porcelain
etching gel(HFl Bonding agent
acid)

Opaquer(mas
k the Glaze
metal)
 Repair of ceramic restorations

Gingival
tissues
Bonding After
are Ceramic is O paquer(fo
agent is trimming
protected etched r metal
applied and shaping
with a with the ceramics)
gel and light –final glaze
protectiv
cured
e
gel(Kool
Dam)

For bulk repair a regular light cured composite is

used
FACTORS ASSOCIATED WITH
FRACTURE OF ALL CERAMIC
desig
PROSTHESES
material
n
inheren
t
propertie surface
s defects

residua loading bite

force and load
l orientation
stress

procedural processing
errors defects

die
t
 Factors contributing
to

Crack Crack Bulk

initiatio chipping fracture
propagation
n

Surface Bruxing Loading Load Load

treatment Excessive loads distribution magnitude Transient
loading location cooling
during try in stresses

Inadequate Inadequate
crown core Improper
thickness thickness connector
Residual size
cooling Improper
core Quality of
stresses framework Voids in cement
design cement layer
layer or at Elastic
Bond moduli of
quality of cement Elastic
ceramic moduli of supporting
Inadequate ceramic substrate
veneer to interface components
tooth materials
preparation core
ceramic
 How to reduce risk for ceramic fracture?

Sufficient tooth Adequate prostheses Distributed vertical

reduction design loading

meticulous attention
sufficient thickness of to the
ceramics recommended
manufacturers’
procedures
Selection criteria for dental ceramics

Esthetic
demands of
patient

Amount Type of
of tooth luting
reductio cemen
n t
 Selection criteria for dental ceramics
Single • All types of metal ceramics
• up to 2nd molar

crowns
• Glass ceramics

Anterior • up to pre molars

• Maximum of four

bridge units

Long • Zirconia-based

span ceramics

bridges • Zirconia based restorations

• Only when adequate tooth preparation is

Anterior possible
• Proper veneering of zirconia core
How to make a decision?
Intra oral
conditions

Optimal
Esthetic
treatment
needs
options

Material to
Minimize
risk factors be expectations
used/design

Financial
Survival
resources of
time
the patient

Anticipated
success
rates
 Longevity of ceramic restoration

Factors
Metal ceramic
5-8
 Material factors restorations
years

 Dentist,lab,technici
an factors
 Patient factors Longevit
y
 Operator reliability
15 years-up
to
 Prevailing oral All ceramic 90% retention

conditions restoration
s
3-5 years-100%
retention
Survival rate of all ceramics

Hot
pressing
CAD-CAM techniqu
ceramics e

Powder
condensatio
n
 IDENT-CERAM System for
 identification
Introduced in 2007 of ceramic products
 To identify
1.manufacturer/compa
ny 2.brand name
3.composition of
materials
 Six in number
 Recognizable letter
code- helps to ensure
proper insurance coding
 practical way to
document informations
The letter codes

Ident Ceram Ident Alloy

AO • HIGH NOBLE

HN
• FDA LISTED ALUMINIUM OXIDE

• FDA APPROVED
YTTRIUM ZIRCONIA

YZ • FDA REGISTERED LITHIUM

N
DISILICATE GLASS CERAMIC
• N OBLE
• FDA CLEARED LEUCITE
GLASS CERAMIC

LD • PREDOMINANTLY BASE
METAL
• FDA REGISTERED LEUCITE GLASS

LG