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Ceramic Restorations 
DR. RAZAN AL MGHAWICH
Dental Ceramics 
 is an inorganic material that contains 
metallic or semi-metallic elements 
with non-metallic elements (usually 
oxygen). 
 Theses elements can be Aluminum, 
calcium, titanium ,silicon, zirconium 
,magnesium, phosphorous, 
potassium, lithium, sodium.
Dental ceramics 
 These materials can be defined by their inherent 
properties; they form hard, stiff, and brittle materials 
 This is due to the type of the atoms present, the nature of 
their inter-atomic bonding, which is ionic and covalent 
mostly ,& the shape of the atoms packed or held together 
 Other properties of ceramics are: 
 Wear resistance, refractory (high melting point), thermal 
insulators, non-magnetic, oxidation resistance, prone to 
thermal shock and chemically stable
Dental ceramics 
 Ceramics contains a crystalline phase and a glass (continues ) 
phase depending on structural arrangement of the atoms 
 In general, the more glassy the microstructure (i.e. non-crystalline) 
the more translucent it will appear, and the more 
crystalline, the more opaque 
 With a range from very translucent to very opaque. 
 This is especially based on the silica structure 
 a. Silicate Types: 
 (1) Clays (hydrated alumino-silicates)with water 
 (2) Feldspars (anhydrous alumino-silicates)no water 
 (3) Quartz (silica) 
 b. Non-silicate Types
Glass in general 
 Glass is an amorphous solid (non-crystalline) material that 
exhibits a glass transition 
 Glasses are typically brittle and can be optically transparent 
 The most familiar type of glass is soda-lime glass, which is 
composed of about 75% silicon dioxide (SiO2), sodium oxide 
(Na2O) from sodium carbonate (Na2CO3), lime (CaO) 
 In science, the term glass is defined in a broader sense, encompassing every solid 
that possesses a non-crystalline (i.e. amorphous) structure and exhibits a glass 
transition when heated towards the liquid state. 
 Quartz sand (silica) is the main raw material in commercial glass production 
 Quartz is the 2nd most abundant mineral in the Earth's continental crust, after 
feldspar. 
 It is made up of a continuous framework of SiO4 silicon–oxygen tetrahedra, with 
each oxygen being shared between two tetrahedra, giving an overall formula SiO2.
Crystalline in general 
 A crystal or crystalline solid is a solid material which 
constituent atoms, molecules or ions etc..,are arranged in 
an ordered pattern extending in all three spatial 
dimensions at a microscopic level 
 large crystals are usually identifiable by their 
macroscopic geometrical shape, consisting of flat faces 
with specific, characteristic orientations 
 The scientific definition of a "crystal" is based on the 
microscopic arrangement of atoms inside it, called the 
crystal structure. 
 A crystal is a solid where the atoms form a periodic 
arrangement
microstructure 
Microscopically, a single crystal has atoms in a near-perfect periodic 
arrangement; a polycrystal is composed of many microscopic crystals 
(called "crystallites" or "grains"); and an amorphous solid (such as glass) 
has no periodic arrangement even microscopically. 
crystalline polycrystalline amorphous
Feldspars 
 Feldspars (KAlSi3O8 – NaAlSi3O8 – CaAl2Si2O8) 
 are a group of rock-forming tecto-silicate minerals that 
make up as much as 60% of the Earth's crust 
 in glassmaking, alumina from feldspar improves product 
hardness, durability, and resistance to chemical 
corrosion, because it can crystallize 
 In ceramics, the alkalis in feldspar (calcium oxide, 
potassium oxide, and sodium oxide) act as a flux, 
lowering the melting temperature of a mixture. 
 Fluxes melt at an early stage in the firing process, 
forming a glassy matrix that bonds the other components 
of the system together
Classification based on the microstructural level 
 we can define ceramics by the nature of their composition of glass-to- 
crystalline ratio to four basic compositional categories, with a 
few subgroups: 
 composition category 1 – glass-based systems (mainly silica) 
 composition category 2 – glass-based systems 
mainly silica + crystalline fillers (typically Lucite, more recently, 
lithium disilicate) 
 composition category 3 – crystalline- based systems 
with glass fillers (mainly alumina) 
 composition category 4 – polycrystalline solids (alumina and 
zirconia) (no glass content at all only crystalline)
Other classification Systems for Dental Porcelains 
1. Classification Based on Fusion Temperatures: 
 High Fusing: 1288 - 1371 °C (2350 - 2500 °F), Used for : 
Denture Teeth, Aluminous Cores 
 Med Fusing: 1093 - 1260 °C (2000 - 2300 °F), Used for 
:Porcelain jacket crowns, Inlays 
 Low Fusing: 871 - 1066 °C (1600 - 1950 °F)Used for Porcelain 
fused to metal Restorations 
 Classification Based on Application Design: 
 a. Porcelain Core : Porcelain veneered onto porcelain cores 
 b. Porcelain Inlays and onlays 
 c. Cast Porcelain : Cast porcelain crown 
 d. Porcelain/Metal : Porcelain fused to metal
 Classification Based on Usage of Low Fusing Porcelains 
 a. Opaque Porcelains = Low Fusing Glass + Opacifiers 
 b. Body Porcelains = Low Fusing Glass + Colorants 
(1) Incisal or Enamel= Low Fusing Glass +little colorant 
(2) Gingival or Dentin=Low Fusing Glass +yellow oxides 
(3) Modifiers =Low Fusing Glass + white/gray oxides 
 c. Stains or Glazes = Low Fusing Glass + Colorants
Related Definitions and Terminology 
 Condensation=Padding &/or packing of porcelain powders into position prior to firing 
 Biscuit =Cohesive powder compact at particle-to-particle contacts after initial fusion 
 Frit = An unfused or partially fused powder mass. 
 Firing = Heating of porcelain powder or biscuits to eliminate the porosity and form a 
completely solid mass 
 Soaking = Holding at a fixed firing temperature. 
 coefficient of thermal expansion= The degree of expansion divided by the change in 
temperature 
 Thermal expansion= the tendency of matter to change in volume in response to a 
change in temperature, through heat transfer
Feldspathic porcelains 
 Technically it is a glass rather than true porcelain( translucent) 
 But since we want a crystalline phase with the amorphous phase 
in dental porcelain we add feldspar 
 feldspar is the main component in it ,feldspar has a tendency to 
form a crystalline phase (leucite) 
 Feldspars (KAlSi3O8 – NaAlSi3O8 – CaAl2Si2O8) 
 In addition feldspathic porcelains contain kaolin as a binder 
(Al2Si2O5(OH)4) 
 Quartz as a filler and strengthen agent 
 Metallic oxides for opacity and color 
 Some oxidative elements most present(tin, indium ,gallium) for 
the porcelain to bond to the alloy 
 Used in porcelain fused to metal restorations
Leucite 
 Leucite is a rock-forming mineral composed of potassium and 
aluminum tecto-silicate K[AlSi2O6] 
 Leucite occur as a crystalline phase 
 It has a large coefficient of thermal expansion compared to 
glass 
• Feldspar tend to form leucite when 
melted 
• Feldspathic porcelain contain leucite 
crystalline phase 
• Note : There is another type of glass 
based ceramic reinforced with 
luecite crowns used in all ceramic 
restorations
Porcelain fused to metal restorations 
 fixed restorations composed of a substructure metal layer and 
covered with 3 layers of feildspathic porcelain 
The metal alloy part is composed of Noble metals ( gold 
platinum, or palladium) they can be classified to : 
 High noble alloys :contain 40 % or more noble metals 
 Noble alloys :contain 25 % to 40 % noble metal 
 Base metal alloys: contain less than 25 % noble metals 
 The metal coefficient of thermal expansion should be higher 
than that of porcelain to place the porcelain in slight 
compression when cooled (which gives it a stronger state); the 
alloy part should expand more than porcelain when they are 
heated to the same temperature 
 Porcelain is stronger under compressive forces than under 
tensile forces
PFM 
• The alloys should have high yield strength that minimize their permanent 
deformation under occlusal surface 
• They should be stiff ( high modulus of elasticity ) that minimize their flexure 
especially their long span bridges 
• Note: porcelain may fracture secondary to flexure or deformation of the metal 
substructure ,because of its low ductility 
• Advantages of the added Metal substructure : 
• High strength. withstand stresses. Thermal compatibility. Less crack 
propagation. High resistance to fracture. Give good marginal fit 
Bonding porcelain to metal : 
 Occurs via mechanical and chemical bonding 
 Mechanical bonding : interdigitating between the opaque layer of porcelain and 
the alloy which increases with surface roughness & wetting of the metal 
 Chemical bonding: occur via the oxide mixing layer (metal-oxide-porcelain) 
from the opaque layer and the metal; oxidation of metal is accomplished by 
heating the metal structure in a furnace before adding the porcelain
Porcelain fused to metal design 
 The metal part is the substructure 
and should be 0.5 mm in thickness 
 The metal-porcelain junction should 
be at least 1.5 mm away from the 
occlusal contact 
 All internal angles should be 
rounded to prevent stress 
concentration 
 The metal-porcelain junction should 
be at right angle to avoid porcelain 
fracture 
 the porcelain 1 to 1.5 mm (thickest at 
the occlusal contact ) build from 3 
layers 
The 3 layers of porcelain are : 
1- the opaque layer: masking the metal and the 
dark oxide layer, with minimum thickness of 
0.1 mm 
2- body or dentine layer : the thickest used to 
build most of the crown gives the color and 
shade 
3- incisal or enamel porcelain : the most 
translucent layer to give a natural appearance
PFM failure 
 Mechanical or chemical 
failures 
1- Metal failure: 
 . Incomplete degassing 
 . Incorrect metal conditioner 
 . Reused metal alloy 
2-Porcelain-to-Metal Fractures: 
(Most common site for short-term failures to occur. Most common for base metals.) 
a. (adhesive failure modes ) 
Contamination of metal surface (oxide-metal interface failure ) 
Contamination of oxide surface (oxide-porcelain interface failure) 
Porcelain metal interface failure : oxide layer wasn’t formed 
b. (Cohesive failure modes ) 
Oxide- oxide failure : the oxide layer is too thick, Thick oxide layers should be 
sandblasted prior to porcelainizing to minimize the oxide thickness
Porcelain failure 
A- porcelain fracture: (Most common site for long-term 
failures to occur. Design or fatigue problems.) 
1. Design or procedural errors: 
 a. Too little bulk of metal 
 b. Sharp angles in porcelain 
 c. Improper margin design 
 D. Inadequate framework design 
2. Malocclusion or impact stresses 
3. Thermal contraction incompatibility: 
 a. Built-in stresses generate cracks at pores 
 b. Thermal fatigue propagates cracks
Porcelain failure 
B- Intra-Porcelain Failures: 
1. "Gray or Black" shades in porcelain color: 
 a. Insufficient opaque porcelain 
 b. Improper opaque firing 
 d. Porcelain oven contamination 
2. Porcelain surface cracks: 
 a. Improper cooling rate 
 b. Thermal cycling 
 c. Over-glazed or under-fired porcelain 
 d. Improper porcelain selection 
3. Porcelain surface roughness: 
 a. Improper finishing and polishing agents 
 b. Acid dissolution (topical fluorides)
 REPAIR SYSTEMS: 
 A. Silane + Acrylic (e.g., FUSION, George Taub Products, Inc.) 
 B. Silane + Composite (e,g., PULPDENT Porcelain Repair Kit) 
 C. Silane + Composite (e.g., MIRAGE PFM Repari)
Drawbacks of PFM restorations 
 Inadequate structure for ceramics - thickness of metal 
coping. 
 More occlusal clearance required 
 Transparent metallic hue - anterior teeth 
 Metal exposed in case of gingival recession 
 Patients allergy to metals especially base metal alloys 
 Casting procedural errors with metals 
 The extra bonding failures at porcelain-metal interface
All- ceramic restorations 
 In some hand-layered porcelain restorations , feldspathic porcelain 
is fused to aluminum oxide, glass-infiltrated aluminum oxide 
(alumina) or zirconium-oxide (zirconia) creating a high-strength, 
highly aesthetic, metal-free crown or bridge. 
 In other traditional restorations, this porcelain is layered onto a 
metal substructure and often display color brightness, an opaque 
"headlight", and dark oxide lines (a "black line" in the vicinity of the 
gum line). 
 As these dark metal substructures are not conducive to a natural 
appearance, metal-free restorations are typically more aesthetically 
pleasing to the patient 
 But as the PFM restorations having a different core porcelain 
material than the outer layer has a disadvantage of the chipping of 
the outer porcelain layer because the bond between the 2 layers is 
not as strong as wanted
All-ceramic restorations 
 monolithic restoration :it is fabricated in full from a single block of 
material. 
 The material used for this type of restorations has to be strong enough, 
especially for posterior teeth 
 Very strong porcelains are mostly opaque with no fluorescence 
 using a monolithic restoration means using one color from the cervical 
area to the occlusal and depending only on outer stains this whole 
process is considered less esthetic 
 Plus it can be abrasive of the opposing tooth 
 Monolithic anterior crowns, with less occlusal stress can be fabricated 
entirely from an esthetic porcelain material
All- ceramic restorations
All- Ceramic 
restorations
Glass ceramics with crystalline fillers 
 Glass ceramics with Leucite filler : 
 E.x. IPS empress® : 
Can be press-ceramic or 
CAD/CAM machinable ceramic 
Provided as ingots or blocks 
 Indications: Single-tooth restorations (Inlays, onlays, 
veneers, anterior and posterior crowns) 
Not suitable for bridges or more than one unit restoration 
,because its toughness and strength range from medium to 
high
Glass ceramics with crystalline fillers 
 Glass ceramics with Lithium disilicate (LS2) fillers 
 E.x. IPS empress 2® or IPS e.max® 
 Supported with zirconium oxide for added strength , it may 
also be used for bridges in the posterior area. 
 either the press or the CAD/CAM technology 
Indications 
 Thin veneers (0.3 mm) 
 Minimally invasive inlays and onlays 
 Partial crowns and crowns 
 Implant superstructures 
 3-unit anterior/premolar bridges (only IPS e.max Press) 
 3-unit bridges (zirconium-oxide supported only IPS e.max 
CAD)
Oxide Ceramics with glass infiltration 
 Example : Vident® all-ceramic In-ceram® products 
1-( VITA In-ceram Alumina)® 
 Alumina based ceramic 75% Al2O3 with 25% glass infiltrations 
 single unit anterior or posterior crowns and three-unit anterior bridges. 
2-(VITA In-ceram Spinell)® 
 spinell based caramics78% MgAl2O4 with 22%Glass infiltration 
 for single unit anterior crowns only 
3-(VITA In-ceram Zirconia) ® 
56% Al2O3 ,24% ZrO2 with 20 % glass infiltration 
 high level of translucency & flexural strength 
 indicated for single unit posterior and three-unit posterior bridges. 
All available in machinable block form for cerec inLaband other milling 
systems
Polycrystalline ceramics 
 Doesn’t contain a glass phase at all, usually made from alumina or zirconia 
oxides 
 Considered a very hard dental material so its used as a core layered with 
more esthetic other dental ceramics like fieldspathic ceramics, or can be used 
as monolithic crowns, Monolithic ceramic crowns tend to be dense in 
appearance with a high value and they lack translucency and fluorescence 
 Alumina cores without glass are produced by milling pre-sintered blocks of 
the material utilizing a CAD/CAM dentistry technique. 
 The zirconia substructure (core) is usually designed using CAD/CAM 
techniques of an impression, model or patient mouth, then its milled from a 
block of zirconia in a soft pre-sintered state, then sintered again in a furnace 
where it shrinks by 20% and reaches its full strength of approximately 
850MPa.
Zirconia 
 Zirconia is the hardest known ceramic in industry and the 
strongest material used in dentistry 
 The zirconia used in dentistry is zirconium oxide which has 
been stabilized with the addition of yttrium oxide. its full 
name is yttria-stabilized zirconia or YSZ. 
 Advantage of zirconia cores : 
 1- allow light to pass as a normal tooth would and that gives a 
natural look, unlike other metal cores that block the light. 
 2- The normal too hot/cold sensations that can be felt with 
other crowns does not normally occur because of reduced 
thermal conductivity 
 disadvantage of core zirconia :bond strength of layered 
porcelain fused to zirconia core is not strong enough
Zirconia 
 1- tetragonal polycrystalline zirconia, partially stabilized with yttrium oxide 
 there is pre-sintered zirconia and HIP (hot isostatic pressing) zirconia then 
used with cad/cam technology 
 has very high strength & toughness , suitable for posterior long span bridges 
 Its usually opaque 
 Example : Lava™Zirconia from 3M™ESPE™ , (VITA In-Ceram) YZ™ 
 Suggested indications 
 Monolithic full-contour crowns.. 
 3,4 5- and 6-unit bridges. 
 Curved and long-span bridges. 
 Cantilever bridges. 
 Inlay and onlay bridges. 
 Anterior adhesive bridges. 
 Primary crowns/Telescopes and Implant abutments.
Alumina 
 2- alumina oxide polycrystalline 
 Example : 
 (Vita In-ceram AL) ™= 100 %Al2O3 
 IPS e.max ZirCAD™ 
 Indicated for posterior crowns and bridges 
 High strength and toughness 
 Opaque 
 Fabricated by sintering and CAD/CAM technology 
 Note : alumina cores can be glass infiltered which has 
significantly higher porcelain bond strength over CAD/CAM 
produced zirconia and alumina cores without glass
Fabrication of dental ceramics 
 The traditional ceramic process generally follows this sequence: 
 Milling → Batching → Mixing → Forming → Drying → Firing → 
Assembly. 
 Milling is the process by which materials are reduced from a 
large size to a smaller size 
 Forming is making the mixed material into shapes. Forming can 
involve: (1) Extrusion, such as extruding "slugs" to make bricks, 
(2) Pressing to make shaped parts, (3) Slip casting 
 Sintering is the process of forming a solid mass of material by 
heat and/or pressure, without melting it to the point of 
liquefaction
 CAD/CAM (computer-aided design and computer-aided 
manufacturing): 
 CAD/CAM dentistry uses subtractive processes (such as 
CNC milling) and additive processes (such as 3D 
printing) to produce physical instances from 3D models. 
 Two basic techniques can be used for CAD/CAM 
restorations: 
- Chairside single-visit technique 
-Integrated chairside–laboratory CAD/CAM procedure
CAD/CAM 
 Increasing the speed of design and creation 
 Increasing the convenience or simplicity of the design, 
creation, and insertion processes 
 making possible restorations and appliances that otherwise 
would have been infeasible. 
 Utilizing in-office CAD/CAM restorations can be done in a 
single patient visit. 
 Reducing unit cost and making affordable restorations and 
appliances that otherwise would have been prohibitively 
expensive. 
 However, to date, chairside CAD/CAM often involves extra 
time on the part of the dentist, and the fee is often at least two 
times higher than for conventional restorative treatments 
using lab services.
CAD/CAM 
 CAD/CAM use special partially sintered ceramic, which 
are fired again after machining. 
 CAD/CAM restorations created with glass-ceramic 
CEREC technology appear to last well, demonstrated 
excellent fit, strength and longevity 
 As adjunctive techniques, software, and materials 
improved, the chairside use of CAD/CAM (use within 
dental offices/surgeries) increased. 
 For example, the commercialization of Cerec by Siemens 
made CAD/CAM available to dentists who formerly 
would not have had avenues for using it.
 CAD/CAM systems include a digital impression system, 3D dental 
design software and a chairside mill that function as a single 
system. 
 an image (scan) is taken of the prepared tooth and the surrounding 
teeth. 
 This image, called a digital impression, draws the data into a 
computer. 
 Proprietary software then creates a replacement part for the 
missing areas of the tooth, creating a virtual restoration. 
 This is called reverse engineering. 
 The software sends this virtual data to a milling machine where the 
replacement part is carved out of a solid block of ceramic or 
composite resin. 
 Stains and glazes are fired to the surfaces of the milled ceramic 
crown or bridge to correct the otherwise monochromatic 
appearance of the restoration.
 aesthetic drawbacks: 
 They rely mostly on superficial staining to achieve a more 
natural appearance, unlike hand-layered porcelain 
restorations, which possess a deep-set coloration due to 
the multi-layering.

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Ceramic restorations

  • 1. Ceramic Restorations DR. RAZAN AL MGHAWICH
  • 2. Dental Ceramics  is an inorganic material that contains metallic or semi-metallic elements with non-metallic elements (usually oxygen).  Theses elements can be Aluminum, calcium, titanium ,silicon, zirconium ,magnesium, phosphorous, potassium, lithium, sodium.
  • 3. Dental ceramics  These materials can be defined by their inherent properties; they form hard, stiff, and brittle materials  This is due to the type of the atoms present, the nature of their inter-atomic bonding, which is ionic and covalent mostly ,& the shape of the atoms packed or held together  Other properties of ceramics are:  Wear resistance, refractory (high melting point), thermal insulators, non-magnetic, oxidation resistance, prone to thermal shock and chemically stable
  • 4. Dental ceramics  Ceramics contains a crystalline phase and a glass (continues ) phase depending on structural arrangement of the atoms  In general, the more glassy the microstructure (i.e. non-crystalline) the more translucent it will appear, and the more crystalline, the more opaque  With a range from very translucent to very opaque.  This is especially based on the silica structure  a. Silicate Types:  (1) Clays (hydrated alumino-silicates)with water  (2) Feldspars (anhydrous alumino-silicates)no water  (3) Quartz (silica)  b. Non-silicate Types
  • 5. Glass in general  Glass is an amorphous solid (non-crystalline) material that exhibits a glass transition  Glasses are typically brittle and can be optically transparent  The most familiar type of glass is soda-lime glass, which is composed of about 75% silicon dioxide (SiO2), sodium oxide (Na2O) from sodium carbonate (Na2CO3), lime (CaO)  In science, the term glass is defined in a broader sense, encompassing every solid that possesses a non-crystalline (i.e. amorphous) structure and exhibits a glass transition when heated towards the liquid state.  Quartz sand (silica) is the main raw material in commercial glass production  Quartz is the 2nd most abundant mineral in the Earth's continental crust, after feldspar.  It is made up of a continuous framework of SiO4 silicon–oxygen tetrahedra, with each oxygen being shared between two tetrahedra, giving an overall formula SiO2.
  • 6. Crystalline in general  A crystal or crystalline solid is a solid material which constituent atoms, molecules or ions etc..,are arranged in an ordered pattern extending in all three spatial dimensions at a microscopic level  large crystals are usually identifiable by their macroscopic geometrical shape, consisting of flat faces with specific, characteristic orientations  The scientific definition of a "crystal" is based on the microscopic arrangement of atoms inside it, called the crystal structure.  A crystal is a solid where the atoms form a periodic arrangement
  • 7. microstructure Microscopically, a single crystal has atoms in a near-perfect periodic arrangement; a polycrystal is composed of many microscopic crystals (called "crystallites" or "grains"); and an amorphous solid (such as glass) has no periodic arrangement even microscopically. crystalline polycrystalline amorphous
  • 8. Feldspars  Feldspars (KAlSi3O8 – NaAlSi3O8 – CaAl2Si2O8)  are a group of rock-forming tecto-silicate minerals that make up as much as 60% of the Earth's crust  in glassmaking, alumina from feldspar improves product hardness, durability, and resistance to chemical corrosion, because it can crystallize  In ceramics, the alkalis in feldspar (calcium oxide, potassium oxide, and sodium oxide) act as a flux, lowering the melting temperature of a mixture.  Fluxes melt at an early stage in the firing process, forming a glassy matrix that bonds the other components of the system together
  • 9. Classification based on the microstructural level  we can define ceramics by the nature of their composition of glass-to- crystalline ratio to four basic compositional categories, with a few subgroups:  composition category 1 – glass-based systems (mainly silica)  composition category 2 – glass-based systems mainly silica + crystalline fillers (typically Lucite, more recently, lithium disilicate)  composition category 3 – crystalline- based systems with glass fillers (mainly alumina)  composition category 4 – polycrystalline solids (alumina and zirconia) (no glass content at all only crystalline)
  • 10. Other classification Systems for Dental Porcelains 1. Classification Based on Fusion Temperatures:  High Fusing: 1288 - 1371 °C (2350 - 2500 °F), Used for : Denture Teeth, Aluminous Cores  Med Fusing: 1093 - 1260 °C (2000 - 2300 °F), Used for :Porcelain jacket crowns, Inlays  Low Fusing: 871 - 1066 °C (1600 - 1950 °F)Used for Porcelain fused to metal Restorations  Classification Based on Application Design:  a. Porcelain Core : Porcelain veneered onto porcelain cores  b. Porcelain Inlays and onlays  c. Cast Porcelain : Cast porcelain crown  d. Porcelain/Metal : Porcelain fused to metal
  • 11.  Classification Based on Usage of Low Fusing Porcelains  a. Opaque Porcelains = Low Fusing Glass + Opacifiers  b. Body Porcelains = Low Fusing Glass + Colorants (1) Incisal or Enamel= Low Fusing Glass +little colorant (2) Gingival or Dentin=Low Fusing Glass +yellow oxides (3) Modifiers =Low Fusing Glass + white/gray oxides  c. Stains or Glazes = Low Fusing Glass + Colorants
  • 12. Related Definitions and Terminology  Condensation=Padding &/or packing of porcelain powders into position prior to firing  Biscuit =Cohesive powder compact at particle-to-particle contacts after initial fusion  Frit = An unfused or partially fused powder mass.  Firing = Heating of porcelain powder or biscuits to eliminate the porosity and form a completely solid mass  Soaking = Holding at a fixed firing temperature.  coefficient of thermal expansion= The degree of expansion divided by the change in temperature  Thermal expansion= the tendency of matter to change in volume in response to a change in temperature, through heat transfer
  • 13. Feldspathic porcelains  Technically it is a glass rather than true porcelain( translucent)  But since we want a crystalline phase with the amorphous phase in dental porcelain we add feldspar  feldspar is the main component in it ,feldspar has a tendency to form a crystalline phase (leucite)  Feldspars (KAlSi3O8 – NaAlSi3O8 – CaAl2Si2O8)  In addition feldspathic porcelains contain kaolin as a binder (Al2Si2O5(OH)4)  Quartz as a filler and strengthen agent  Metallic oxides for opacity and color  Some oxidative elements most present(tin, indium ,gallium) for the porcelain to bond to the alloy  Used in porcelain fused to metal restorations
  • 14. Leucite  Leucite is a rock-forming mineral composed of potassium and aluminum tecto-silicate K[AlSi2O6]  Leucite occur as a crystalline phase  It has a large coefficient of thermal expansion compared to glass • Feldspar tend to form leucite when melted • Feldspathic porcelain contain leucite crystalline phase • Note : There is another type of glass based ceramic reinforced with luecite crowns used in all ceramic restorations
  • 15. Porcelain fused to metal restorations  fixed restorations composed of a substructure metal layer and covered with 3 layers of feildspathic porcelain The metal alloy part is composed of Noble metals ( gold platinum, or palladium) they can be classified to :  High noble alloys :contain 40 % or more noble metals  Noble alloys :contain 25 % to 40 % noble metal  Base metal alloys: contain less than 25 % noble metals  The metal coefficient of thermal expansion should be higher than that of porcelain to place the porcelain in slight compression when cooled (which gives it a stronger state); the alloy part should expand more than porcelain when they are heated to the same temperature  Porcelain is stronger under compressive forces than under tensile forces
  • 16. PFM • The alloys should have high yield strength that minimize their permanent deformation under occlusal surface • They should be stiff ( high modulus of elasticity ) that minimize their flexure especially their long span bridges • Note: porcelain may fracture secondary to flexure or deformation of the metal substructure ,because of its low ductility • Advantages of the added Metal substructure : • High strength. withstand stresses. Thermal compatibility. Less crack propagation. High resistance to fracture. Give good marginal fit Bonding porcelain to metal :  Occurs via mechanical and chemical bonding  Mechanical bonding : interdigitating between the opaque layer of porcelain and the alloy which increases with surface roughness & wetting of the metal  Chemical bonding: occur via the oxide mixing layer (metal-oxide-porcelain) from the opaque layer and the metal; oxidation of metal is accomplished by heating the metal structure in a furnace before adding the porcelain
  • 17. Porcelain fused to metal design  The metal part is the substructure and should be 0.5 mm in thickness  The metal-porcelain junction should be at least 1.5 mm away from the occlusal contact  All internal angles should be rounded to prevent stress concentration  The metal-porcelain junction should be at right angle to avoid porcelain fracture  the porcelain 1 to 1.5 mm (thickest at the occlusal contact ) build from 3 layers The 3 layers of porcelain are : 1- the opaque layer: masking the metal and the dark oxide layer, with minimum thickness of 0.1 mm 2- body or dentine layer : the thickest used to build most of the crown gives the color and shade 3- incisal or enamel porcelain : the most translucent layer to give a natural appearance
  • 18. PFM failure  Mechanical or chemical failures 1- Metal failure:  . Incomplete degassing  . Incorrect metal conditioner  . Reused metal alloy 2-Porcelain-to-Metal Fractures: (Most common site for short-term failures to occur. Most common for base metals.) a. (adhesive failure modes ) Contamination of metal surface (oxide-metal interface failure ) Contamination of oxide surface (oxide-porcelain interface failure) Porcelain metal interface failure : oxide layer wasn’t formed b. (Cohesive failure modes ) Oxide- oxide failure : the oxide layer is too thick, Thick oxide layers should be sandblasted prior to porcelainizing to minimize the oxide thickness
  • 19. Porcelain failure A- porcelain fracture: (Most common site for long-term failures to occur. Design or fatigue problems.) 1. Design or procedural errors:  a. Too little bulk of metal  b. Sharp angles in porcelain  c. Improper margin design  D. Inadequate framework design 2. Malocclusion or impact stresses 3. Thermal contraction incompatibility:  a. Built-in stresses generate cracks at pores  b. Thermal fatigue propagates cracks
  • 20. Porcelain failure B- Intra-Porcelain Failures: 1. "Gray or Black" shades in porcelain color:  a. Insufficient opaque porcelain  b. Improper opaque firing  d. Porcelain oven contamination 2. Porcelain surface cracks:  a. Improper cooling rate  b. Thermal cycling  c. Over-glazed or under-fired porcelain  d. Improper porcelain selection 3. Porcelain surface roughness:  a. Improper finishing and polishing agents  b. Acid dissolution (topical fluorides)
  • 21.  REPAIR SYSTEMS:  A. Silane + Acrylic (e.g., FUSION, George Taub Products, Inc.)  B. Silane + Composite (e,g., PULPDENT Porcelain Repair Kit)  C. Silane + Composite (e.g., MIRAGE PFM Repari)
  • 22. Drawbacks of PFM restorations  Inadequate structure for ceramics - thickness of metal coping.  More occlusal clearance required  Transparent metallic hue - anterior teeth  Metal exposed in case of gingival recession  Patients allergy to metals especially base metal alloys  Casting procedural errors with metals  The extra bonding failures at porcelain-metal interface
  • 23. All- ceramic restorations  In some hand-layered porcelain restorations , feldspathic porcelain is fused to aluminum oxide, glass-infiltrated aluminum oxide (alumina) or zirconium-oxide (zirconia) creating a high-strength, highly aesthetic, metal-free crown or bridge.  In other traditional restorations, this porcelain is layered onto a metal substructure and often display color brightness, an opaque "headlight", and dark oxide lines (a "black line" in the vicinity of the gum line).  As these dark metal substructures are not conducive to a natural appearance, metal-free restorations are typically more aesthetically pleasing to the patient  But as the PFM restorations having a different core porcelain material than the outer layer has a disadvantage of the chipping of the outer porcelain layer because the bond between the 2 layers is not as strong as wanted
  • 24. All-ceramic restorations  monolithic restoration :it is fabricated in full from a single block of material.  The material used for this type of restorations has to be strong enough, especially for posterior teeth  Very strong porcelains are mostly opaque with no fluorescence  using a monolithic restoration means using one color from the cervical area to the occlusal and depending only on outer stains this whole process is considered less esthetic  Plus it can be abrasive of the opposing tooth  Monolithic anterior crowns, with less occlusal stress can be fabricated entirely from an esthetic porcelain material
  • 27. Glass ceramics with crystalline fillers  Glass ceramics with Leucite filler :  E.x. IPS empress® : Can be press-ceramic or CAD/CAM machinable ceramic Provided as ingots or blocks  Indications: Single-tooth restorations (Inlays, onlays, veneers, anterior and posterior crowns) Not suitable for bridges or more than one unit restoration ,because its toughness and strength range from medium to high
  • 28. Glass ceramics with crystalline fillers  Glass ceramics with Lithium disilicate (LS2) fillers  E.x. IPS empress 2® or IPS e.max®  Supported with zirconium oxide for added strength , it may also be used for bridges in the posterior area.  either the press or the CAD/CAM technology Indications  Thin veneers (0.3 mm)  Minimally invasive inlays and onlays  Partial crowns and crowns  Implant superstructures  3-unit anterior/premolar bridges (only IPS e.max Press)  3-unit bridges (zirconium-oxide supported only IPS e.max CAD)
  • 29. Oxide Ceramics with glass infiltration  Example : Vident® all-ceramic In-ceram® products 1-( VITA In-ceram Alumina)®  Alumina based ceramic 75% Al2O3 with 25% glass infiltrations  single unit anterior or posterior crowns and three-unit anterior bridges. 2-(VITA In-ceram Spinell)®  spinell based caramics78% MgAl2O4 with 22%Glass infiltration  for single unit anterior crowns only 3-(VITA In-ceram Zirconia) ® 56% Al2O3 ,24% ZrO2 with 20 % glass infiltration  high level of translucency & flexural strength  indicated for single unit posterior and three-unit posterior bridges. All available in machinable block form for cerec inLaband other milling systems
  • 30. Polycrystalline ceramics  Doesn’t contain a glass phase at all, usually made from alumina or zirconia oxides  Considered a very hard dental material so its used as a core layered with more esthetic other dental ceramics like fieldspathic ceramics, or can be used as monolithic crowns, Monolithic ceramic crowns tend to be dense in appearance with a high value and they lack translucency and fluorescence  Alumina cores without glass are produced by milling pre-sintered blocks of the material utilizing a CAD/CAM dentistry technique.  The zirconia substructure (core) is usually designed using CAD/CAM techniques of an impression, model or patient mouth, then its milled from a block of zirconia in a soft pre-sintered state, then sintered again in a furnace where it shrinks by 20% and reaches its full strength of approximately 850MPa.
  • 31. Zirconia  Zirconia is the hardest known ceramic in industry and the strongest material used in dentistry  The zirconia used in dentistry is zirconium oxide which has been stabilized with the addition of yttrium oxide. its full name is yttria-stabilized zirconia or YSZ.  Advantage of zirconia cores :  1- allow light to pass as a normal tooth would and that gives a natural look, unlike other metal cores that block the light.  2- The normal too hot/cold sensations that can be felt with other crowns does not normally occur because of reduced thermal conductivity  disadvantage of core zirconia :bond strength of layered porcelain fused to zirconia core is not strong enough
  • 32. Zirconia  1- tetragonal polycrystalline zirconia, partially stabilized with yttrium oxide  there is pre-sintered zirconia and HIP (hot isostatic pressing) zirconia then used with cad/cam technology  has very high strength & toughness , suitable for posterior long span bridges  Its usually opaque  Example : Lava™Zirconia from 3M™ESPE™ , (VITA In-Ceram) YZ™  Suggested indications  Monolithic full-contour crowns..  3,4 5- and 6-unit bridges.  Curved and long-span bridges.  Cantilever bridges.  Inlay and onlay bridges.  Anterior adhesive bridges.  Primary crowns/Telescopes and Implant abutments.
  • 33. Alumina  2- alumina oxide polycrystalline  Example :  (Vita In-ceram AL) ™= 100 %Al2O3  IPS e.max ZirCAD™  Indicated for posterior crowns and bridges  High strength and toughness  Opaque  Fabricated by sintering and CAD/CAM technology  Note : alumina cores can be glass infiltered which has significantly higher porcelain bond strength over CAD/CAM produced zirconia and alumina cores without glass
  • 34. Fabrication of dental ceramics  The traditional ceramic process generally follows this sequence:  Milling → Batching → Mixing → Forming → Drying → Firing → Assembly.  Milling is the process by which materials are reduced from a large size to a smaller size  Forming is making the mixed material into shapes. Forming can involve: (1) Extrusion, such as extruding "slugs" to make bricks, (2) Pressing to make shaped parts, (3) Slip casting  Sintering is the process of forming a solid mass of material by heat and/or pressure, without melting it to the point of liquefaction
  • 35.  CAD/CAM (computer-aided design and computer-aided manufacturing):  CAD/CAM dentistry uses subtractive processes (such as CNC milling) and additive processes (such as 3D printing) to produce physical instances from 3D models.  Two basic techniques can be used for CAD/CAM restorations: - Chairside single-visit technique -Integrated chairside–laboratory CAD/CAM procedure
  • 36.
  • 37. CAD/CAM  Increasing the speed of design and creation  Increasing the convenience or simplicity of the design, creation, and insertion processes  making possible restorations and appliances that otherwise would have been infeasible.  Utilizing in-office CAD/CAM restorations can be done in a single patient visit.  Reducing unit cost and making affordable restorations and appliances that otherwise would have been prohibitively expensive.  However, to date, chairside CAD/CAM often involves extra time on the part of the dentist, and the fee is often at least two times higher than for conventional restorative treatments using lab services.
  • 38.
  • 39. CAD/CAM  CAD/CAM use special partially sintered ceramic, which are fired again after machining.  CAD/CAM restorations created with glass-ceramic CEREC technology appear to last well, demonstrated excellent fit, strength and longevity  As adjunctive techniques, software, and materials improved, the chairside use of CAD/CAM (use within dental offices/surgeries) increased.  For example, the commercialization of Cerec by Siemens made CAD/CAM available to dentists who formerly would not have had avenues for using it.
  • 40.  CAD/CAM systems include a digital impression system, 3D dental design software and a chairside mill that function as a single system.  an image (scan) is taken of the prepared tooth and the surrounding teeth.  This image, called a digital impression, draws the data into a computer.  Proprietary software then creates a replacement part for the missing areas of the tooth, creating a virtual restoration.  This is called reverse engineering.  The software sends this virtual data to a milling machine where the replacement part is carved out of a solid block of ceramic or composite resin.  Stains and glazes are fired to the surfaces of the milled ceramic crown or bridge to correct the otherwise monochromatic appearance of the restoration.
  • 41.  aesthetic drawbacks:  They rely mostly on superficial staining to achieve a more natural appearance, unlike hand-layered porcelain restorations, which possess a deep-set coloration due to the multi-layering.