INTRODUCTION

• Keramos
•Burned earth
• Clay
CERAMICS : Compounds of one or more metals with a nonmetallic element,
usually oxygen. They are formed of chemical and biochemical stable substances
that are strong, hard, brittle, and inert non-conductors of thermal and electrical
energy.

o The word Ceramic is derived from the Greek word “keramos”,

which literally means ‘burnt stuff’, but which has come to mean more
specifically a material produced by burning or firing.

o The American Ceramic Society had defined ceramics as

inorganic, non-metallic materials, which are crystalline in
nature
 Search for an ideal restorative material!

Why ceramics? Challenges?!!

1. Biocompatible 1. Costly
2. Long term color stability processing
equipments
3. Chemical durability
2. Specialised training for
4. Wear resistance
lab technicians
5. Ability to be formed into
precise shapes
 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).
A journey through time!!!
 HISTORY OF DENTAL CERAMICS

 Ceramic-like tools have been used by humans since the end of the Old Stone
Age around 10,000 B.C. to support the lifestyles and needs of fisher-hunter-
gatherer civilizations.

 The first porcelain tooth material was patented in 1789 by de Chemant, a

French dentist in collaboration with Duchateau, a French pharmacist.

 In 1808, Fonzi, an Italian dentist, invented a “terrometallic” porcelain tooth

held in place by a platinum pin or frame.
o Planteau, a French dentist, introduced porcelain teeth to the United States in 1817,
and Peale, an artist, developed a baking process in Philadelphia for these teeth in
1822.

o Charles Land introduced one of the first ceramic crowns to dentistry in 1903.

o Two of the most important breakthroughs responsible for the long-standing superb
esthetic performance and clinical survival probabilities of metal-ceramic
restorations are described in the patents of Weinstein and Weinstein (1962) and
Weinstein et al. (1962).

o The first commercial porcelain was developed by VITA Zahnfabrik in about

1963.
 1965 – Mc Lean & Hughes used glass- alumina composite instead of feldspar
porcelain resulting in stronger restorations.

 Improvement in all ceramic systems developed by controlled crystallization

of a glass (Dicor) was demonstrated by Adair and Grossman (1984).

 1989 – The concept of All-Ceramic post & core was introduced using Dicor glass-
ceramic initially, followed by In-cream, IPS Empress and Zirconia ceramics.

 New generation of ceramics, including Cercon, Lava, In Ceram Zirconia, IPS

Empress2, and Procera All Ceram were used for ceramic prostheses.
 Advantage
s
• Resistant to corrosion • Potential for matching appearance of
• Chemical inertness natural teeth
• Remain stable over long time • Refractory nature
periods. • Thermal insulating properties (low
• Biocompatible thermal conductivity and diffusivity)
• High hardness • Freedom from galvanic effects (low
• Resilient electrical conductivity)
 Disadvantages
• Susceptibility to tensile fracture
• Brittleness
• Low to moderate strength and
fracture toughness
• Poor ductility/elongation
• Flexed easily when heated and
cooled(Thermal shock)
 Structure
GLASS CRYSTA
CERAMIC
L
PHASE PHASE
 Structure
 Ceramics can appear as either crystalline or amorphous solids (also called
glasses). Thus, ceramics can be broadly classified as Non-crystalline
(Amorphous Solids or Glasses) and Crystalline ceramics.

 The mechanical and optical properties of dental ceramics mainly depend on the
nature and the amount of crystalline phase present.

 More the crystalline phase better will be the mechanical properties which in
turn would alter the aesthetics.
 Conventional or feldspathic porcelains are usually noncrystalline ceramics.
These conventional porcelains are very weak and brittle in nature leading to
fracture even under low stresses.

 Recent developments in the processing technology of dental ceramics have led

to the development of crystalline porcelains with suitable fillers such as
alumina, zirconia and hydroxy apatite.
 Non- Crystalline Ceramics

 These are a mixture of crystalline minerals (feldspar,

silica and alumina) in an amorphous (non-crystalline
matrix of glass) vitreous phase.

 The glass-forming matrix of dental porcelains uses the

basic silicone oxygen (Si-O) network.

 Their structures are characterized by chains of

(SiO4)4− tetrahedra in which Si4+ cations are positioned
at the center of each tetrahedron with O− anions at
each of the four corners.
 The primary structural unit in all silicate structures is the negatively charged
siliconoxygen tetrahedron (SiO4) 4− .

 The SiO4 tetrahedra are linked by sharing their corners.They are arranged as linked
chains of tetrahedra, each of which contains two oxygen atoms for every silicon
atom.

 The atomic bonds in this glass structure have both a covalent and ionic character
thus making it stable.

 This stable structure, imparts some important qualities like excellent thermal,
optical and insulating characteristics, inertness, translucency to the glass matrix.
 Alkali cations such as potassium or sodium
tend to disrupt silicate chains leading to
lower sintering temperatures and increased
coefficients of thermal expansion.

 Molecules with one oxygen atom (such as

Na2O, K2O,or CaO) are useful in dental
porcelain as fluxes. They may also act as
opacifiers.

 Molecules that contain three oxygen atoms for

every two other atoms (such as Al2O3) are
used as stabilizers.
 Crystalline Ceramics

 Regular dental porcelain, being of a glassy nature is largely non crystalline

and exhibits only a short range order in anatomic arrangement.

 The only true crystalline ceramic used in restorative dentistry is

Alumina(Al2O3); which is one of the hardest and probably the strongest oxides
known. Crystalline ceramics may have ionic or covalent bonds (Ionic crystals
are compounds of metals with oxygen. e.g.: Alumina.
 Ceramics are reinforced with crystalline inclusions such as alumina and
leucite into the glass matrix to form crystal glass composites as a part of
strengthening the material and improving its fracture resistance
(dispersion strengthening).

 McLean and Hughes (1965) introduced the first generation of

reinforced porcelains for porcelain jacket crowns, which are
generally referred to as “Aluminous porcelains” .
 Glass Formation
When silica melts, it produces an extremely viscous
liquid.

cooled rapidly

The solid formed is more to likely be a glass

(Vitreous Structure) called Fused Quartz.

This process of forming a glass is called

‘Vitrification’.
 Composition
 Dental ceramics are mainly composed with
crystalline minerals and glass matrix.

Denture Tooth Feldspathic Aluminous

Porcelain Porcelain porcelain

Begins as a mixture Used for ceramo-metal Used in pjs’s. It is

of
powders of feldspar, restorations; begins as composed of mixture
clay and quartz. mixture of powders of similar to that of
potassium feldspar and feldspathic porcelain
glass. It can also be with increased amounts
used for fabricating of aluminium oxide.
porcelain veneers and
inlays.
Feldspar

SiO2 MATRIX-52-65%

Al2O3-ALUMINA-11-20%

K2O-POTASH-10-15%

Na2O-SODA-4-15%

OTHER ADDITIVES

By weight.
 Feldspar (Basic glass former)
• Naturally occurring mineral and composed of two alkali
aluminum silicates such as potassium aluminum silicate
(K2O-Al2O3-6SiO2); also called as potash feldspar or
orthoclase and soda aluminum silicate (Na2O-Al2O3-6SiO2);
also called as soda feldspar.
• 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.
Role of feldspar :
Glass phase formation:
• During firing, the feldspar fuses and forms a glassy phase that softens and
flows slightly allowing the porcelain powder particles to coalesce together.

• The glassy phase forms a translucent glassy matrix between the other
components in the dense solid.

Leucite formation:
• Another important property of feldspar is its tendency to form the crystalline
mineral leucite when melted, which is exploited to advantage in the
manufacture of porcelain suitable for metal bonding.
 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.
 CRYSTALLINE
QUARTZ

CRYSTALLINE
CRISTOBALITE SILICA NON
CRYSTALLINE
FUSED SILICA

CRYSTALLIN
E
TRIDYMITE
 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.

27
 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.
 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
 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

 CLASSIFICATION
1.Based on use/indications
• Anterior crowns
Posterior crowns Inlays
• Onlays
Veneers
• Post and cores FPDs
• Stain ceramic Glaze
ceramic.
 3.Principal crystal phase
2.Composition
and /or matrix phase
• Pure alumina
• Silica glass
• Pure zirconia
• Leucite based feldspathic porcelain
• Silica glass
• Leucite based glass ceramic
• Leucite based glass
• Lithia based glass • Aluminous porcelain
• Alumina
• Glass infused alumina
• Glass infused spinel
• Glass infused alumina/zirconia

45
4) Processing method:

• Sintering
• Partial sintering
• Glass infiltration
• CAD-CAM
• Copy milling
• Condensation
• Heat pressing
• Casting
• Slip-casting
 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.
 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.
 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.
 SLIP CAST CERAMICS
• In-Ceram • A slurry of liquid and particles of alumina,
• In-Ceram Spinell magnesia-alumina silicate (spinel), or zirconia
• In-Ceram and alumina are placed on a dry refractory die
that draws out the water from the slurry.
Zirconia • 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
 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
5) Firing temperature:
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).
Applications of ceramics in dentistry
Metal ceramic/PFM (Porcelain All ceramic
fused to metal

44
Metal Ceramic System
 METAL CARAMICS
Advantages Disadvantages
• High overall survival • Potential for metal allergy
percentage • Poor esthetics(Can not be used when
• Low fracture rate when a relatively high degree of
• Less removal of tooth structure translucency is desired.)
• Less wear of antagonist • Metal framework and lack of
enamel translucency sometimes shows
• Better marginal fit through gingiva resulting in dark
margins
 Types of Metal Ceramic Systems
Cast metal ceramic restorations
• Cast noble metal alloys (feldspathic porcelain)
• Cast base metal alloys (feldspathic porcelain)
• Cast titanium (ultra low fusing porcelain)
Swaged metal ceramic restorations
• Gold alloy foil coping (Renaissance, Captek)
• Bonded platinum foil coping.
 COMPOSITION OF METAL CERAMIC
DENTIN ENAMEL
PORCELAIN PORCELAIN
Silica (SiO2) 59.2 63.5
• Higher alkali content
• The opaquer powder - high content Soda (Na2O) 4.8 5
of opacifiers. Alumina 18.5 18.9
• Glazes - Higher concentration of glass (Al2O3)
modifiers like soda, potash and boric Potas 11.8 2.3
h
oxide. (K2O)
A sample percentage composition of porcelain powder Boric oxide 4.6 0.12
for metal ceramics (B2O3)
Zinc oxide 0.58 0.11
(ZnO)
Zirconium 0.39 0.13
oxide (ZrO2)
 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.
 Construction of the cast metal
copings and framework
Most common
Can be produced by method is melting and
1. Casting of molten metal casting.

2. CAD-CAM Machining
• A wax pattern of
3. Electrolytic deposition restoration constructed
techniques • Cast in metal
4. Swaged metal • High melting temperature
processes of alloys-phosphate
bonded investment
Metal preparation Degassing and oxidizing
• Clean metal surface- essential for • Heat in porcelain furnace to burn
good bonding off any impurities to the form thin
• Oil from fingers and other oxide layer.
sources such as airlines – possible • Degas the interior structure of
contaminant alloy
• Cleanse surface • Eg.Olympia (Heraeus Kulzer), a
• Finish with clean ceramic gold-palladium, silver-free alloy,
bonded stones/sintered diamonds is heated in the porcelain furnace
• Final sandblasting with high purity to a temperature of 1038 °C
alumina
 Opaquer
• 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
• 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.
 Bonding Of Porcelain To Metal
1. Chemical/atomic bonding 2.Mechanical interlocking
• Primary bonding mechanism • Principal bond in some
• An adherent oxide layer is essential systems
• Infiltration (flow) of the fused
Base metal alloys-chromic oxide
ceramic into the surface
Noble metal alloys-iridium
oxide irregularities of the metal coping
• Inadequate oxide formation / • Sandblasting prepares metal
excessive oxide build up surface

• Delamination of overlying
porcelain
 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)
3.Coeff. of thermal expansion mismatch 4. Application of a special
bonding agent:
• As a result of higher metal contraction
on cooling , - The fused porcelain will • Certain metal system (electro-
be sucked (attracted) more strongly forming) requires the application
into the metal surface irregularities. - of specific bonding paste before
Residual compressive stresses will building-up the porcelain. Bonding
developed in and strengthen the of porcelain to the metal Coping
porcelain.
 Condensation / Packing
• Process of packing the powder
particles together and removing Benefits
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
 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
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
 CONDENSATION STEPS

1.Build up of cervical 2.Build up of body 3.Cut back 4.Build up of enamel

porcelain porcelain porcelain
 Pre-Heating
• Placing the porcelain object on a
tray in front of/below the muffle of Significance of pre-heating stage:
a preheated furnace • Removal of excess water allowing the
• at 650C for 5min for low fusing porcelain object to gain its green
porcelain strength.
• at 480C for 8min for high • Preventing sudden production of steam
fusing porcelains till reaching that could result in voids or fractures.
the green or leathery state. • Ceramic particles held
together in the “green state” after all
liquid has been dried off
Pre-Heating
 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
 As temperature is raised
The initial firing temperature • The sintered glass gradually
• The voids are occupied by the flows to fill up the air spaces.
atmosphere of the furnace. • The particles fuse together by
• As the sintering of the sintering forming a continuous
particles begins, the porcelain mass, this results in a decrease in
particles bond at their points of volume referred to as firing
contact. shrinkage
With progression of firing The final firing stage
• The gaps between particles • The voids slowly rise to
become porosities. The viscosity free surfaces and disappear
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
 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
Low bisque Medium bisque

High bisque
 Porcelain surface treatment

Natural/auto glaze

Applied/add-on glaze

Polishing

Custom staining
 Cooling

• Should be well
• Rapid cooling can cause
controlled slowly
cracks
• Uniformly
• Induce stresses and
• Usually computer
weakens ceramic
controlled
If it cools too slowly If it is cooled too quickly

• Crystals form within the • Stress build up in the glass.

glass body which will • To reduce the stresses ,it is kept near
degrade its optical the glass transition temperature (its solidus)
for a long time so that the atoms in the
properties, turning if from a
glass can rearrange just enough to relieve
clear glass into a cloudy the stress.
one. Devitrification.
• When most of the stress has been
[annealing] eliminated, the finished glass is finally
allowed to cool to room temperature
 Glazing
Objectives
• Life like appearance/Esthetics
Auto glazed veneer ceramic
• Improves Strength and life Steps
• Color match to adjacent teeth • Restoration is tried in
or restorations
mouth
• Seal surface flaws
• Occlusion checked
• Reduce stress concentrations
• Adjusted by grinding
• Inhibits crack propagation
• Enhances Hygiene • Smoothen with a fine
stone
• Reduces wear of opposing
teeth • Restoration is ready for
glazing!
Over glaze Self glaze

• Glaze powder+special liquid • No separate glaze layer

• Applied on to restoration • Restoration subjected to controlled
heating at fusion temperature
• Firing temperature<that of body
• Only surface layer melts and flows
porcelain to form a vitreous layer resembling
• Firing cycles does not glaze
include vacuum • Disadvantage - porcelain must be
• Disadvantage - Chemical stripped completely if it is
durability less compared to self unacceptable
glaze(because of the high flux
content)
Glazing Polishing
• Have adequate durability when • Using special abrasives
produced in thickness of • Sof- Lex(3M,Minneapolis,MN),Fi
50micron or more nishing disks (Shofu, Kyoto, Japan)
• If dentist is adjusting the porcelain laminate polishing kit, or
occlusion by grinding with other abrasive system.
diamond bur can weaken glaze • Difficult to polish
• 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
Glazes Stains
• Colorless porcelain • High concentration of color
• Do not contain opacifiers modifiers
• Lower fusion temperature • Lower fusion temperature
• Increased content of glass • Increased content of glass
modifiers modifiers
• Less chemically durable • To provide individual
color
variation
 Methods for strengthening ceramics

The principal deficiencies faced by ceramics are - brittleness, low

fracture toughness and low tensile strength.

Methods used to overcome the deficiencies fall into 2 general

categories:

1. Method of strengthening brittle materials.

2. Method of designing components to minimize the stress

concentrations and tensile stresses.
I. Method of strengthening materials:
In the oral environment tensile stresses are usually created by bending forces,
and the maximum tensile stresses occur at the surface of the restoration.

It is for this reason removal of the surface flaws can result in the increased
strength of the material. Smoothing and reducing flaws is one of the reason for
glazing of dental porcelain.

 Strengthening of the brittle materials can be done in a 2 ways.

a) Development of residual compressive stresses within the surface of the
material.

b) Interruption of crack propagation through the material.

1. Development of residual compressive stresses within the surface of
the material:

• One widely used method of strengthening ceramics is the introduction

of residual compressive stresses.

• Strength is gained by virtue of the fact that the residual stresses

developed must first be negated by the developing tensile stresses
before a net tensile stress develops in the material.

• THREE of the methods used in achieving this objective are:

a. Ion exchange mechanism:

 This technique is called as chemical tempering and is the most sophisticated

and effective way of introducing residual compressive stresses.

 In this procedure a sodium containing glass is placed in a bath of molten

potassium nitrate, potassium ions in the bath exchange places with some of the
sodium ions in the surface of the glass particle.

 The potassium ion is about 35% larger than the sodium ion. The squeezing of
the potassium ion into place formerly occupied by sodium ion creates large residual
compressive stresses in the surface of the glass. These residual stresses produce a
strengthening effect.

 This process is best used on the internal surface of the crown, veneer/inlay as
the surface is protected from grinding and exposure to acids.
 The technique is as
follows:

a) Characterize the finished crown and adjust the occlusion.

b) Place the crown into a mould of analytically pure potassium nitrate powder
which is in a small porcelain crucible/ stainless steel container.

c) Place the container in a cool furnace and raise the temperature slowly to 500°C

d) Hold the temperature at 500 C for 6 hours.

e) Remove the crown from the solution and allow it to drain in the furnace.
Remove the crown from the furnace and cool to room temperature.
b. Thermal tempering:

 This is the most common method of strengthening glass.

 This creates residual surface compressive stresses by rapidly cooling

(quenching) the surface of the object while it is hot and in the softened state.

 This rapid cooling produces a skin of rigid glass surrounding a soft molten
core. As the molten core solidifies, it tends to shrink, but the outer skin
remains rigid.

 The pull of the solidifying molten core as it shrinks, creates residual tensile
stresses in the core and residual compressive stresses within the outer surface.
For dental applications it is more effective to quench the glass phase ceramics
in silicone oil or other special liquids than using air as it may not uniformly cool
the surface.

c.Thermal compatibility method applies to porcelain fused metals. The

metal and porcelain should be selected with slight mismatch in their
thermal contraction coefficient.

 Usually the difference of 0.5 × 10–6/°C in thermal expansion between

metals and porcelain .

 It causes the metal to contract slightly more than does the ceramic during
cooling after firing the porcelain which results in development of residual
compression in the ceramic surface
2) Interruption of crack propagation-
a) Dispersion of crystalline phase –

 Crystalline reinforcement:
◦ A method of strengthening glasses and ceramics is to reinforce them with a
dispresed phase of different material that is capable of hindering crack
propagation through the material.

◦ The crystalline phase with greater thermal expansion coefficient than the
matrix produces tangential compressive stress (and radial tension) near the
crystal matrix interface. Such tangential stresses divert the crack around the
particle.

92
◦ When a tough, crystalline material such as a alumina in particulate form is
added to a glass, the glass is toughened and strengthened because the crack
cannot penetrate the alumina particles as easily as it can the glass and this
technique is applied in the development of aluminous porcelains for PJCs.

◦ Another ceramic dental material that uses reinforcement of a glass by a

dispersed crystalline substance is Dicor glass-ceramic.
b) Transformation toughening-

◦ A newer technique of strengthening glasses involves the incorporation of a

crystalline material that is capable of undergoing a change in crystal
structure when placed under stress.
◦ The crystalline material usually used is termed partially stabilized
Zirconia (PZC).
◦ The energy required for the transformation of PSZ is taken from the energy
that allows the crack to propagate.
◦ One drawback of PSZ is an opacifying effect that may not be aesthetic in
most dental restorations.
94
 Tetragonal phase is not stable at room temperature and it can
transform to the monoclinic phase leading to a corresponding volume
increase.

 When sufficient stress develops in the tetragonal structure and a crack

in the area begins to propagate, the metastable tetragonal crystals
(grains) precipitates next to the crack tip can transform to the stable
monoclinic form.
Methods of designing components to minimize stress concentrations and
tensile stresses

The design should avoid exposure of ceramics to high tensile stresses. It should
also avoid stress concentration at sharp angles or marked changes in thickness.

a) Minimizing tensile stresses:

When porcelain is fired onto a rigid material the shape of the metal will
influence the stresses set up in the porcelain.

If it is a full coverage crown the metal being of higher thermal expansion will
contract faster than the porcelain, as a result the metal is placed in tension and
the porcelain in compression.
For partial metal coverage the junction between the metal and
porcelain is therefore a potential site for high stress as the area with
only metal will have no balancing compressive forces.

b.Reducing stress raisers

Stress raisers are discontinuities in ceramic structures in brittle

materials that cause stress concentration.

Abrupt changes in shape/ thickness in the ceramic contour can act as

stress raisers and make the restoration more prone to failure.

Sharp line angles in preparation and small particle of porcelain along

internal margin of crown also causes tensile stresses.
 If the occlusion is not adjusted properly on a porcelain surface,
contact points rather than contact areas will greatly increase the
localized stresses in the porcelain surface as well as within the
internal surface of the crown.

 These contact stresses can lead to the formation of the so- called
Hertzian cone cracks, which may lead to chipping of the occlusal
surface.
Benefits and drawbacks of metal-ceramic restorations
1. A properly made metal-ceramic crown is more fracture
resistant and durable than most all-ceramic crowns and
bridges.

2. A metal coping or framework provides an advantage

compared with zirconia-based ceramic prostheses when
endodontic access openings through crowns are required.

3. Temporary repairs for ceramic fractures that extend to the

metal framework are possible without the need for intraoral
sandblasting treatment by using current resin bonding agents.
Disadvantages of metal-ceramic prostheses

 Abrasive damage to opposing dentition

 Potential for fracture
 Excessive exposure to acidulated fluoride can enhance chemical
degradation of ceramic surface.
 Patient may be exposed to silaceous dust by inhalation during grinding.
 The potential for metal allergy.
 Not the best esthetic choice for restoring a single maxillary anterior tooth.
 A dark line at the facial margin of a metal-ceramic crown associated with
a metal collar or metal margin is a significant esthetic concern when
gingival recession occurs.
ALL CERAMIC SYSTEMS
Classification Based On Their Type And Method Of
Fabrication
Condense Sintere
d d

Castable Glass
Glass Ceramics
Ceramics
Hot
Injection Isostaticall
Moulded Glass y Pressed
Ceramics Glass
Ceramics
Glass Slip Cast
Infiltrated Ceramics
Core Ceramics

Machinabl Cad Cam

e Ceramics
Ceramics
 ADVANTAGES

• Most life like and • Porcelain crowns cemented

esthetically pleasing on natural abutments and
those cemented on artificial
• It is translucent, color
supports have the same
stable, brilliant incidence of fracture;
• Uniformly reduced and therefore, a porcelain crown
balanced preparation can be successfully used
• Long life expectancy after a cast - metal post and
• Fine textured restoration core has been placed on a
non – vital tooth
• Increased impact strength
• Biologically acceptable (well
tolerated by the soft tissues)
 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.
 CONTRAINDICATIONS
• 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 -
feldspathic porcelain traditional
• Constructed on a platinum foil
• Porcelain Jacket Crown
matrix which is subsequently with Aluminous core
removed • Porcelain Jacket Crown -
with Leucite reinforced core
(Optec HSP)
 OPTEC-HSP-LEUCITE REINFORCED PORCELAIN
Advantages
• More esthetic - core is less opaque (more
• Feldspathic porcelain with a higher translucent) compared to the aluminous
leucite crystal content (leucite porcelain
reinforced). • Higher strength
• Its manipulation, condensation and • No need of special laboratory equipment
firing is quite similar to the alumina
reinforced porcelain jacket crowns Disadvantages
(using platinum foil matrix).
• Fit is not as good as metal ceramic
• Uses inlays, onlays, veneers and Low crowns
stress crowns.
• Potential marginal inaccuracy.
• Not strong enough for Posterior use.
 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

 40 to 50 wt% of Al2O3
PLATINUM FOIL TECHNIQUE
 Flexural strength 131 Mpa

Master model Platinum foil It supports Finished Cores

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

Post-Cementation
 I N D I C AT I O N S CONTRAINDICA TIONS

• Shoulder thickness of only 0.5mm • The preparation is conical with a

possible on the labial surface. little retention.
• Occlusal clearance > 0.5mm • Short teeth or where there is too
in lateral excursions. little tooth structure to support such
a restoration.
• occlusal clearance < 0.5mm.
• The patient habitually grinds or
clenches the teeth.
• The patient requires a reinforced
restoration, such as a posterior FPD.
 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
It is a system similar to aluminous core ceramic crown, using an epoxy die, a
swaged resin coping and conventionally applied ceramic
Indications Contraindications
• Anterior crowns • For posterior crowns where
• Posterior crowns where occlusal stress is high.
occlusal conditions are
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.
 DUCERAM LFC/HYDROTHERMAL LOW FUSING
CERAMICS
Advantages
• It’s a low fusing Hydrothermal
ceramic • Greater density
• Consists of an amorphous glass • Higher flexural strength
containing hydroxyl (-OH) ions. • Greater fracture resistance
• Was developed in mid-1980
• First time marketed in 1989
• Lower abrasion than
• Use in all ceramic prostheses, feldspathic porcelain.
ceramic / metal-ceramic inlay, and • Being highly polishable
partial crowns. 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 STATIC
ALLY
C A STA BLE

CERAM ICS
teeth. PRESSED
CERAM ICS

 suggested that it should

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

centrifugal casting of
molten glass.
GLASS CMEateRrailAsi Mofm
r e d in tothe desired shape as
IC S
a 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 more  Glass ingots
closer to glass  Pre crystallised form-
 Only porcelain Dicor MGC(as
restoration made by machinable blanks for
C A D CAM)
centrifugal casting
technique Uses
 Inlays
 Unique ceramming
 Onlays
process-enhance growth
 Veneers
of mica crystals
 Low stress crowns
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
Slip cast ceramics/glass infiltrated core ceramics
In Ceram
• 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 ACERAMICS
S 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 • Mean flexural strength-
Alumina 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 a
low stress(anterior and posterior) crowns, this
material can be used to construct low stress
anterior bridges. Because of its occasional tend
to fracture when used for bridge construction
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

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 System 35% vol
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

V E 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
OPC 3G (Pentron
 contain approximately 65% toLaboratory Technologies)
70% by volume of lithia disilicate
 Initially lithium
(Li2O•2SiO2) as the principalmetasilicate,cristobalite
crystal phase. forms
 narrow sintering range-  Final structure- highly
processing of ceramic prostheses
interlocked lithium
very technique sensitive disilicate crystals(0.5µ
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-based
( Inter locked micro
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 moulding Glass ceramic
ingot is
 Since from a single ingot heated
– mono chromatic
 Can be cast as coping Allowed to flow
and layered with under pressure into
mould using lost
veneering ceramics wax technique
 Used for inlays, onlays,
single crowns and
Contoured,
veneers stained, and glazed
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 Glass ceramic with
leucite crystals. 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
ceramics
Advantages Disadvantages

 Better fit- because of  Need for

lower firing costly
shrinkage equipment
 Potential fracture of
 Better esthetics-absence
of metal or an opaque 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 or
Tooth preparation / optical framework
scanning design(CAD)

Conventional impression and Restoration or framework

die fabrication milling(CAM)

Furthur processing-simple
Wax pattern glazing and staining to post
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
Larger scanners
•Intra oral hand held wands  Scan the cast or die

 Chair side scanners 1. use a camera to

capture multiple
 Reflects light(visible images
light,laser or LED)  Eg.white light optical
 Captures it with a camera scanner 2.Two cameras to
 Create an optical impressioncapture the
object from multiple
of prepared tooth and angles using white light
adjacent structures Eg.Kavo Everest
 Stitch multiple images to a 3D
3.Laser planes projected in a
image in computer grid pattern
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
From Copy milled
ceramic
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 NT E R I NG

 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 minutes
cements
Presintered Zirconia Sintered Zirconia
 Most zirconia frameworks
are fabricated by machining
a porous or partially fired  No need of post sintering
block  No shrinkage is expected
 Used as cores for
crowns and FPDs  Takes more time(2hrs for a single
 Softer and easier to mill crown) and wear of milling
 Milled to larger tool(extreme hardness)
size(20%)  Shaped by diamond disks and burs
 Shaped by carbide burs  Core construction for crowns and l
 Post sintering span anterior and posterior FPDS
 Sintering time-6-7.5
hours
 Sintering temperature-
1350- 15300 C
GREEN • Cercon (Degudent/DENTSPLY Ceramco)
• Lava (3M ESPE),
STATE • ZirkonZahn (USA),

MILLING • HintEls Zirkon TPZ-G

(DigiDent)

• IPS e.max ZirCAD (Ivoclar Vivadent)

PARTIALL • 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)
• Zirkon Pro 50 (Cynovad)
STATE • 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
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 Disadvantages

 Precisely fitting ceramic  the accuracy of the copy-

restorations can be milled crowns is
developed without a lab dependent on the care,
technician in high grade time, and the profile
factory fired porcelain, in tracing ability of the
a very short time in one technician, the marginal
session. quality of crowns made
from the copy-milling
 The grains are finer
technique is likely to be
than conventional In- inferior to that of
Ceram, therefore the copings made from the
strength is more than hot pressing method.
conventional.
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) with
(video
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 shortcoming of Cerec 1 system :
 Although the CEREC system generated all internal
and external aspects of the restoration, the occlusal
anatomy had to be developed by the clinician using a
flame-shaped, fine-particle diamond instrument and
conventional porcelain polishing procedures were
required to finalize the restoration.
 Inaccuracy of fit or large interfacial gaps.
 Clinical fracture related to insufficient depth
of preparation.
 Relatively poor esthetics due to the uniform colour
and lack of characterization in the materials used.
Cerec 2
 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
 itReconstruction)
was introduced by Denison 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.