Dental Ceramics

Introduction

Ceramic is derived from the Greek word keramikos -earthen.

Ceramic is derived from Sanskrit word meaning burnt earth.

Although many advances have been made in composites and

glass ionomers, ceramic material holds a special place in dentistry.

Its color, translucency and vitality cannot be matched by any

material.
2

Ceramics
Compounds of one or more metals with a non metallic element that

may be used as a single structural component or as one of the

several layers that are used in the fabrication of a ceramic based
prosthesis .

(GPT- 7)

Porcelain

are composed of essentially the same materials, the principle

difference being in the proportion of the primary ingredients (such as
feldspar, silica and kaolin/ clay) and firing procedures (temperature,
method etc).

All porcelains are ceramics, but not all ceramics are porcelains.
3

History..

History of porcelain used as a dental material goes back nearly 250 years.

1728 - the use of porcelain in dentistry was first mentioned by Pirre

Fauchard.

1774 Alexis Duchateau, with the assistance of a Parisian dentist Nicholas

Dubois de Chemant, made the first successful porcelain dentures replacing
the stained and malodorous ivory prostheses of Duchateau

History..

1806 to1808 - Fonzi an Italian dentist introduced the first porcelain teeth that
contained embedded platinum pins. But they never met with great approval
because of their brittleness and opacity. He also used metal oxides to produce 26
shades of color in porcelain.

1825- Samuel Stockton began fabrication of fused porcelain teeth in Philadelphia.

His initials were represented in the name of the S.S.White company.

1837 John Murphy of London introduced the plantium foil technique

History..

1884 Dr Charles H.Land pioneered the development of the first glass furnace
for fusing porcelain.

1887 Dr C.H.Land of Detroit developed the first porcelain jacket crown (PJC)
using the Platinum Foil Matrix technique.

1894 Levitt Ellsworth Custer developed the first electric furnace for porcelain.

1903 - Dr.Charles Land introduced first ceramic crowns to dentistry.

History..

1910 High fusing electric furnaces (fusion at 20000 F) were

recommended to minimize the firing shrinkage and application of
hydrofluoric acid to the fitting surface to produce a honeycomb
appearance to enhance retention.

1923 - Wain - inlays and onlays using dental porcelain.

1940 - with advent of acrylics PJC lost popularity.

1957 S. D. Stookey invented glass-ceramic.

8

History..

1958 - Vines et al, introduced finer porcelain powders for vacuum

firing. It was the first major improvement in the esthetics, because
it increased the translucency of all-porcelain crowns.

1962- Weinstein et al patented formulations of feldspathic porcelain

and alloys that bonded chemically & were thermally compatible
with feldspathic porcelains.
1963 - first commercial porcelain developed by Vita Zahnfabrik.

History..

1965- McLean & Hughes introduced dental aluminous core

ceramic with significant improvement in fracture resistance.

1968 W.T. MacCulloch fabricated denture teeth from a glassceramic. He suggested the possibility of using glass-ceramics in
inlays and crowns.

1976 McLean & Sced developed the platinum bonded alumina

crown. The attachment of aluminous porcelain to the platinum was
achieved by surface coating of the metal with a thin layer of tin.
10

History..

1983 Sozio & Riley first described shrink-free ceramics (marketed as

Cerestore), which was followed by development of injection-molded
castable glass-ceramic by the University of Zurich (marketed as IPS
Empress).

1984- Adair & Grossman introduced Dicor glass-ceramic.

1985 First CAD/CAM crown was publically milled and installed in the
mouth

1986 The first generation CEREC 1 (Siemens) CAD/CAM system was

introduced.
11

History..

1988 Michael Sadoun first introduced In-ceram, a glass-infiltrated

aluminous porcelain.

1989 The concept of all-ceramic post & core was introduced using
Dicor glass-ceramic initially, followed by In-cream, IPS Empress and
Zirconica ceramics.

1993 The Procera CAD/CAM system was developed by Andersson

M. & Oden by a co- operative effort between Nobel Biocare and
Sandvik.

12

History..

1994 The second generation CEREC 2 (Siemens/Sirona)

CAD/CAM system was presented.

Late 1990s IPS Empress 2, a second generation pressable

ceramic made from lithium-disilicate frame work with an apatite
layered ceramic was introduced

1999 IPS SIGN (Ivoclar AG), a feldspar-free fluorapatite glass

ceramic system for use in metal-ceramics was presented.
13

History..

2000 two dimensional CEREC 3 was presented.

2002 - Lava uses a laser optical system to digitize information from

multiple abutment margins

2005 The three dimensional CEREC 3D was presented.

Scanning and designing

3 dimensional viewing

Milling

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Classification of Dental Ceramics

According to Type
1.
2.
3.
4.
5.
6.
7.

Feldspathic porcelain
Leucite-reinforced porcelain
Aluminous porcelain
Alumina
Glass-infiltrated alumina
Glass-infiltrated spinel
Glass-ceramic.

According to Processing Method

1.
2.
3.

Sintering
Casting
Machining
K.J. Anusavice, 1996, Phillips 10th edition)

15

Classification

According to Use or Indications

Anterior Crowns

Veneers

Post & cores

Posterior Crowns

Fixed Partial Dentures

Denture teeth, inlay, onlay, Ceramic brackets for orthodontic treatment.

16

(By K.J. Anusavice, 1996, Phillips 10th edition).

According to Substructure Material

1. Cast metal
2. Swaged metal
3. Glass-ceramic
4. CAD-CAM porcelain
5. Sintered ceramic core.

17

According to Microstructure
1. Non-Crystalline Ceramics e.g.: Feldspathic porcelain
2. Crystalline Ceramics e.g.: Aluminous porcelain,
Glass-Ceramics

According to Method of Firing

1. Air fired.
2. Vacuum fired

According to Firing Temperature

1.
2.
3.
4.

Ultra low fusing (<850oC)

Low fusing (850oC -1100oC)
Medium fusing (1100oC -1300oC)
High fusing (>1300oC)
18

Classification

According to Varieties Used/ Application

1.

Core porcelain

2.

Opaque porcelain

3.

Body (dentin) porcelain

4.

Gingival, cervical or neck porcelain

5.

Enamel (incisal) porcelain

6.

Color frits (pigments)

7.

Glazed porcelains

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Classification

According to method of fabrication

-(Marc Rosenblum & Alan Schulman JADA March 1997).

Cast metal systems : eg: Vita Metall Keramik (VMK 95)

Non- Cast Metal Systems Foil Crown Systems /All Ceramic

Systems
1. Conventional Powder Slurry Ceramics
2. Castable Ceramics
3. Machinable Ceramics
4. Pressable Ceramics
5. Infiltrated Ceramics
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1.Conventional Powder Slurry Ceramics

condensing & sintering.
1.

Alumina reinforced Porcelain e.g. Hi-Ceram

2.

Magnesia reinforced Porcelain e.g. Magnesia cores

3.

Leucite reinforced (High strength porcelain)

e.g. Optec HSP

4.

Zirconia whisker fiber reinforced e.g. Mirage II

5.

Low fusing ceramics

21

2. Castable Ceramics
casting & ceramming
1.

Flouromicas e.g. Dicor

2.

Apatite based Glass-Ceramics e.g. Cera Pearl

3.

Other Glass-Ceramics e.g. Lithia based, Calcium

phosphate based

22

3. Machinable Ceramics
Milling & machining
Analogous Systems
Grinding techniques :
a) Mechanical e.g. : Celay
b) Automatic e.g. Ceramatic II. DCP
Erosive techniques:
a) Sono-erosion e.g. Erosonic
b) Spark-erosion e.g. Procera
Digital systems (CAD / CAM):
Direct e.g. Cerec 1 & Cerec 2
Indirect e.g. Cicero, Denti CAD
23

4. Pressable Ceramics
pressure molding & sintering
1.

Shrink-Free Alumina Reinforced Ceramic (Injection Molded)

E.g. Cerestore / Alceram

2.

Leucite Reinforced Ceramic (Heat Transfer Molded)

E.g. IPS Empress, IPS Empress 2, Optec OPC.

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5. Infiltrated Ceramics
slip-casting, sintering & glass infiltration
1)

Alumina based
e.g. In-Ceram Alumina

2) Spinel based
e.g. In-Ceram Spinel
3) Zirconia based
e.g. In-Ceram Zirconia

25

Composition of Dental Ceramics

Ingredients

Wt %

Function

Feldspar

60-80

Basic glass former

Alumina

8-20

Strengthener, glass former, opacifier

Kaolin

3-5

Binder during firing

Quartz (crystalline silica)

15-20

Filler

Boric oxide

2-7

Glass modifiers, flux

Oxides of Na, K, Ca

9-15

Glass modifiers, interrupter, fluxes

Metallic pigments

<1%

Color matching

Oxides of Zr, Sn, Ba, Ti, B

Trace

As color pigments & shade

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Composition ..

Feldspar

These are a group of naturally occurring minerals, which are complex

alkali aluminium silicate.

Types of feldspar:
Soda feldspar Sodium alumina ( Na2O Al2O3, 2SiO2, 2H2O)
decreases fusion temperature
Potash feldspar Potassium aluminium silicate ( K2O, Al2O3, 6SiO2)
increases the viscosity of glass.

Proper potash content decreases the danger of excessive pyroplastic

flow during firing of porcelain, which could otherwise result in rounding of
the edges, loss of form ,shape; and the obliteration of surface
characteristics which contribute to a life like appearance.

27

Composition ..

Role of feldspar

It is a basic glass former

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, thus acts as a matrix and binds silica and kaolin.
Leucite formation

Between 1150o & 1530oc it undergoes incongruent melting and forms

crystals of leucite.

Leucite is a potassium aluminum silicate with large coefficient of

thermal expansion
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Composition ..

Function of Leucite

To raise the coefficient of thermal expansion of porcelain and bring it

closer to that of the metal substrate; consequently increasing the
hardness and fusion temperature.

Strengthening of porcelain
e.g. Optec HSP, Cerinate, & IPS Empress.

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Composition ..

Kaolin

Hydrated aluminum silicate.

Increases the mouldability of the plastic porcelain

Acts as a binder and helps in maintaining the shape of the unfired

porcelain during firing.
At high temperature, it fuses and reacts with other ingredients to

form the glassy matrix.

Drawback

Opacity even when present in very small quantities.

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Composition ..

Quartz (Crystalline Silica)

It is basically a glass consisting of 3-dimensional network of silica with a

very high fusion temperature.

Functions

Acts as a filler

Provides strength and hardness to porcelain.

Because it has a high melting point, it maintains the form (shape)

of a freestanding object during firing.

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Composition ..

Glass Modifiers or Fluxes

Can be defined as elements that interfere with the integrity of the

SiO2 (glass) network and alter their three-dimensional state.

Purpose

To lower the fusion temperature of a glass by reducing the amount

of cross-linking between the oxygen and glass forming elements.

Increase the flow of porcelain during firing.

e.g. Alkali metal ions such as Na, K or Ca (usually as carbonates).
If concentration is too high:

It reduces chemical durability of the glass. (resistance to

attack by water, acids and alkalis)

It causes the glass to crystallize or devitrify.

32

Alumina (Aluminum oxide)

One of the hardest and strongest oxides of aluminium

Increases viscosity of porcelain during firing.

Gives strength and opacity to the material.

Boric Oxide

Boric Oxide (B2 O3) although a powerful flux (glass modifier), it can
also act as a glass former and form its own glass network, producing
Boron Glasses.

12%- above which the less stable form BO3 takes over.
33

Composition ..

Water

Water is an important glass modifier.

The hydronium ion, H3O can replace Na or other metal ions in a

ceramic that contains glass modifiers.
Significance

This replacement is responsible for the phenomenon of slow crack

growth of ceramics that are exposed to tensile stresses and stored in
moist environment

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Composition ..

Coloring Agents

Dental porcelains colored by the addition of concentrated color frits

(generally metallic oxides) into the basic glass.

The glass thus obtained will be highly color saturated and when
ground to a fine powder, can be used in small amounts to modify the
uncolored porcelain powder.

Pink- Chromium or chrome-aluminia

Yellow indium
Blue- Cobalt salts in the form of oxide are useful in developing of the
enamel shades
Grey- Iron oxide (black) or platinum Grey: used for producing enamels
or grayer section of the dentin colors, and also for an effect of
35
translucency.

Composition ..

Green- Chromium oxide: is generally avoided since green is the

characteristic color of glass.
Other pigments used may be

Titanium oxide yellow brown,

manganese oxide- lavender,

iron/nickel oxide- brown,

copper oxide green.

36

Opacifying Agents
consists of a metal oxide.

Reduces the translucency of porcelain

Produces dentin colors in particular, which requires greater opacity

than that of enamel colors.

The common metallic oxides used are

Cerium oxide, Titanium oxide,Tin oxide, and

Zirconium oxide (ZrO2)- most popularly used opacifying agent.

37

Mode of Supply
Porcelain kit consists of:

Fine ceramic powders of different shades of enamel, dentin,

core/opaque

Special liquid/ distilled water- vehicle/medium for ceramic powder

(binder)

Stains or color modifiers

Glazes

Various enamel, dentin and opaquer porcelains

38

Methods of fabricating ceramic restorations

Condensing and Sintering,

Casting & Ceramming

Milling (Machining) by mechanical and digital systems.

Pressure molding & Sintering

Slip casting, Sintering & Glass infiltration

39

Fabrication of Porcelain
However, fabrication of a conventional porcelain restoration is
basically composed of the following stages:

Condensation

Sintering

Glazing

Cooling.

40

Mixing of powder and liquid

41

Condensation

Process of packing the powder particles together & removing excess

water is known as condensation.

Porcelain powder particles within the mass are closely packed in

order to reduce volume shrinkage of porcelain & minimize porosity in
the fired porcelain.

Porcelain should not dry out as the porcelain is held together due to
surface tension.
42

Condensation

Methods of condensation
1.

Spatulation

2.

Brush technique

3.

Vibration

4.

Ultrasonic

Condensation of porcelain slurry on

a metal framework
43

Condensation

Spatulation
Article is carefully smoothened with a spatula when extra water from

inside comes to the surface by capillary action which is removed by

blotting paper or linen cloth.

Brush technique

This method employs the addition of dry porcelain powder on the

surface by a brush to the side opposite of wet porcelain to absorb the
moisture.

As the water is drawn towards the dry powder, the wet particles are
pulled together.

44

Condensation

Vibration Method

This method used mild vibration to pack the wet powder densely on
the underlying framework.

The excess water is blotted away with a clean tissue

An electrically operated brush called the Vibra Brush can also be
used in this technique, which although very efficient, lacks the
flexibility offered by the light weight hand held sable brush.

Ultrasonic method

Ultrasonic vibrations are transmitted electrically & water coming

out is removed using blotting paper or linen cloth.

45

Sintering

The process of fusing the condensed mass is known as firing/ sintering.

Porcelain firing unit (muffle chamber) is preheated to 650oC & article to

be fired is placed in a fire clay tray & then placed on a platform.

Preheating the porcelain by placing it in front of the muffle is essential.

Direct heating causes rapid steam production that breaks up the mass.

46

Firing procedure

Platform is raised & article is held inside

muffle chamber for 5 min. (remaining water is
converted into steam & comes out).

Door of muffle chamber is closed & evacuated

by connecting it to a vacuum pump.

Temperature is gradually raised to firing

temperature of porcelain.

Muffle Chamber
47

Shrinks 30-40% by volume.

During firing there is partial fusion of particles at their point of

contact. As the temperature is raised the fused glass gradually
flows to fill up air spaces.

Vacuum firing is done to reduce porosity in porcelain.

48

Firing procedure

Stages of Maturity
Stages are known as bisque/biscuit stages.
Different stages are:

Low bisque stage

Medium bisque stage

High bisque stage.

Less the number of firings, higher is the strength and better

is the esthetics.
49

Firing procedure

Low Bisque Stage

As temperature rises, surface of the particles begin to soften &

these loose particles just begin to join.

No volume shrinkage.

If firing is stopped at this stage, particles form a porous mass.

Weak & friable

Opaque

Used in glass infiltrated ceramics- Inceram

50

Firing procedure

Medium Bisque Stage

On further heating, more softening of particles takes place & they

begin to melt.

Better cohesion.

Slight volume shrinkage.

Reduced although still porous

Moderate strength

Less opaque and color has developed

51

Firing procedure

High Bisque Stage

Further heating causes melting of all particles producing complete

cohesion & maximum volume shrinkage.

Porosity absent

High Strength

Relatively smooth surface with a light sheen

Color & translucency developed

As liquid is highly viscous, it retains its shape for some time

If heating is prolonged, liquid gradually flows under gravity i.e.

pyroplastic flow, & article looses sharp corners & its shape.

Firing is discontinued usually at this stage for complete melting.

52

Glazes

Colorless porcelain applied to the surface to give it a glossy lifelike

appearance.

Does not contain opacifiers.

Low fusion temperature.

Contain lot of glass modifiers.

Glazing

To remove surface cracks & improve the flexure strength

Two types :
Auto glazing or Self glazing
Over glazing

53

Glazing

Auto glazing or Self glazing

Temperature of porcelain is quickly raised to melt surface particles
which flow & fill all the microcracks.

Over glazing
A thin layer of transparent glaze porcelain of lower fusion temperature
is coated on body porcelain & is then fired at lower temperature only to
melt outer layer of glaze porcelain which flows into surface cracks.
54

Cooling of the fired article

Muffle chamber is gradually cooled according to manufacturer instructions for

porcelain to undergo uniform shrinkage to minimize formation of micro cracks

Platform is then brought down & the article is removed.

Surface microcracks can be filled by the application of Glaze

55

Properties

Excellent esthetic properties :: suitable stains can be applied ::

color parameters (hue, chroma & value) are permanent.

Color stability

Chemically inert, excellent biocompatibility

Chemical stability: insoluble and impermeable to oral fluids,

chemical degradation by fluoride attack.

56

Properties

Low coefficient of thermal expansion, nearly same as tooth enamel

6.4 -7.8 x 10-6/oc.

Dimensional stability: stable after firing

Low thermal conductivity

Compressive strength: good 480 MPA.

Greater surface hardness (460 KHN) than tooth enamel (343 KHN)
: abrasion & wearing of opposing natural tooth and metal
restorations

57

Properties

Brittle

Tensile strength - 35-50 MPA

Modulus of elasticity: low 40 GPa

Shear strength: low 110 MPa.

Shrinkage

Volumetric - 35 45 %,

Linear - 11 14 %

Minimized by using lesser binder, proper condensation, build up of

restoration 1/3rd larger than original size and firing in successive
stages.
58

Why are Ceramics weak ?

1. Brittle Covalent bonds
2. Inherent flaws
3. > # in moist environment

Sintering Process

Griffiths Flaw

Crack Growth

On moisture exposure crack growth is accelerated

D.W. Jones- 1983

59

In ceramics, micro cracks are caused by

The condensation, melting and sintering process.

The high contact angle of ceramics on metal.

Differences in the coefficient of thermal expansion between alloy or

core and veneers.

Grinding and abrasion.

Tensile stresses during function.

60

Methods
to
Strengthen Porcelain

61

According to K. J. Anusavice
(Phillips Science of D Materials, 1996)

1. Methods of Strengthening brittle materials

2. Methods of designing components to minimize
stress concentrations and tensile stresses

62

A. Methods of strengthening brittle materials

Residual compressive
stresses
1.Ion exchange
2.Thermal tempering
3.Thermal compatibility

Interruption of crack
propagation

Dispersion
of crystalline
phase
Al, dicor

Transformation
toughening
Particle stabilized
zirconia

B) Methods of designing components to minimize stress

concentrations and tensile stresses
1. Reducing stress raisers
2. Minimize tensile stresses

63

A. Methods of strengthening brittle materials

Development of Residual Compressive Stresses

This is one of the widely used methods of strengthening glasses

and ceramics.

Strengthening is gained by the fact that, residual stresses must first

be negated by developing tensile stresses before any net tensile
stress develops.

64

Development of residual compressive stresses..

Ion exchange or chemical tempering

Smaller Na+ ions are exchanged by K+ ion which are 35% bigger.

This replacement by ion exchange introduces large residual

compressive stresses (roughly 700mpa/1,00,000 psi).

Squeezing of K into a smaller space, termed as stuffing.

Soda feldspathic porcelain is kept immersed in molten KNO 3 solution

for 20-30 min.

Limitation

Alumina reinforced materials, Dicor glass-ceramic core and some

conventional feldspathic porcelains with high potash feldspar content.
65

Development of residual compressive stresses..

Thermal tempering

It creates residual compressive stresses by rapidly cooling

(quenching) the surface of the object while it is still hot, and in the
molten state.

This rapid cooling produces a skin of rigid glass surrounding a

molten core.

As the molten core solidifies, it shrinks, creating residual

compressive stresses within the outer surface.

66

Development of residual compressive stresses..

Thermal tempering

This method is used to strengthen glasses used for automobile

windows and windshield, sliding glass doors and diving masks.

For dental applications, it is more effective to quench hot glassphase ceramics in silicone oil or other special liquids rather than
using air jets that may not uniformly cool

67

Development of residual compressive stresses..

Thermal compatibility /
Thermal expansion coefficient mismatching

Veneering ceramic with two or more layers of ceramic

compositions having slightly different coefficient of thermal
expansions; one layer contracting slightly more than other layers
thus inducing residual compressive stresses.

eg. Inceram, Metal-ceramic restorations

On cooling metal contracts more than ceramic, thus leaving the
outer layer of ceramic in residual compressive stresses
68

A. Methods of strengthening brittle materials

Interruption of crack propagation

This method involves strengthening glasses and

ceramics by reinforcing them with a dispersed phase
of a different material that is capable of hindering a
crack from propagating through the material.

69

Interruption of crack propagation

Dispersion of crystalline phase

Tough crystalline material like alumina, leucite, lithia disilicate,

magnesia is added in particulate form.

Crack cannot propagate through alumina as easily as it propagates in

the glass.

E.g. Dicor

Coefficient of thermal expansion between the particle and glass

requires a close match.

70

Interruption of crack propagation

Transformation toughening

A crystalline material that is capable of undergoing a change of

crystal structure when placed under stress is incorporated.

E.g. partially stabilized zirconia which, at lower temperature,

transforms into more stable & harder monoclinic phase with an
increase in volume

Refractive index of PSZ is higher than glass.

71

B. Methods of designing components to minimize stress

concentrations and tensile stresses

Reducing Stress Raisers

Stress Raisers are discontinuities in ceramic structures that

cause stress concentration.

E.g. Abrupt changes in shape or thickness in the ceramic, renders the

restoration more prone to failure

Creases or folds of the Platinum foil substrate in PJC, become

embedded in the porcelain and leave behind notches (stress
raisers).

72

B. Methods of designing components to minimize stress

concentrations and tensile stresses

Minimizing Tensile Stress

In Metal-Ceramic Crowns -

The strong, yet ductile metal coping minimizes flexure of the porcelain
structure in an attempt to overcome the associated tensile stress.

Both, the Bonded Platinum foil technique and the Swaged Alloy foil
technique are also based on this same concept.

Favorable occlusion in PJC helps to avoid tensile stress.

73

Esthetic Properties of Dental Ceramics

The principal reason for the choice of porcelain as a restorative

material is its esthetic qualities in matching the adjacent tooth
structure in translucency, color and chroma.

74

Color production in natural teeth

E Incident = E Scattered + E Reflected + E Absorbed +E Transmitted
+E Fluoresced

75

Variations of Tooth Color

Incisal third

Middle third

Cervical/gingival third

Enamel covering with little This region consists

Enamel thins down

or no dentin underneath

predominantly of dentin,

towards the cervical line,

produces a wrap around

hence the overlying

hence the underlying

effect which results in

enamel takes on some of

dentinal hue results in a

increased translucency in

the dentinal hue (yellow-

deep hue ranging from

the incisal third and

orange) which is modified

approximal areas.

by the translucent blue

orange-yellow to often a
distinct brown depending

grey enamel resulting in a on the degree of

composite colour.

calcification of dentin.

76

Shade Guide

photo

Dental porcelains are pigmented by the inclusion of oxides to

provide desired shades.

Specimens of each shade (collectively called a shade guide).

Disadvantages in using shade guides

Tabs are much thicker

Tabs are more translucent than teeth

The necks of the shade tabs are made from a deeper hue and this
region tends to distract the observers matching ability in the gingival
third of the tab

77

Shade Matching Guidelines

Remove all lipstick, heavy make-up, or large jewelry

Use cool, color-corrected fluorescent lighting or sunlight near the window

(during middle portion of the day )

If eyes seem fatigued to yellow, look at a blue napkin or blue wall to

desensitize the eyes

Select basic hue of tooth by matching the shade of patients canine

(most highly chromatic tooth)

Color matching should be done under two or more different light sources
78

Metal Ceramics

Most widely used prosthesis system in fixed prosthodontics

Mechanical properties
Metal

Esthetic properties
Ceramic

79

Parts of Ceramic Crown

Cross section of metal-ceramic crown

80

Technical procedures in Metal ceramic restorations

Casting

Heat degassing treatment

Finishing

Sandblasting

Condensation of porcelain

81

Ideal Requirements for Metals & Ceramic

Both the metal and ceramics must have coefficients of thermal

contraction that are closely matched such that the metal has a
slightly higher value.

High proportional limit, high modulus of elasticity (to reduce stress

on the porcelain)

High fusion temperature (more than porcelain)

Should exhibit minimal creep during firing of the porcelain

82

Ideal Requirements for Metals & Ceramic

Possess adequate mechanical strength for multiple splinting and

bridge work.

The surface metal oxide should not discolor the porcelain or

interfere with glass formation.

Biocompatible

Chemically stable (high corrosion resistance)

Ability to wet & bond metal surface

83

Types of Metal Ceramic Systems

Cast metal ceramic alloys

High Noble alloys

Noble alloys

Base-metal alloys

Foil Copings

Bonded platinum foil coping

Swaged gold foil coping

84

High Noble alloys

Metal-ceramic alloys containing > 40 wt% gold and at least 60 wt%

of noble metals (Gold, Platinum and palladium and/or the other
noble metals)

Platinum - hardens the gold

Palladium - lowers the coefficient of thermal expansion

Melting temperature : 1000oC-1150oC.

85

Noble alloys

According to the ADA classification of 1984,noble alloys contain at

least 25 wt% of the noble metals, but not necessarily contain any
gold.

Pd reduces tarnishing effect of Ag & Cu.

Melting temperature : 1000oC-1250oC.

Base-metal alloys

Cr or Ti alloys : Ni-Cr-Mo-Be, Ni-Cr-Mo, Co-Cr-Mo,

Superior mechanical properties.

Melting temperature : 1300oC or more.

Ti-Al-V.

86

Advantages of Base Metal Alloys

Higher hardness and elastic modulus (stiffness) values, permit the

fabrication of thinner copings (upto 0.1mm) and thus its use in long
span FPDs.

More sag - resistant at elevated temperatures.

Substantial cost difference between base - metal and noble metal

alloys. The intrinsic value of the component elements is significantly
lesser than that of noble-metal alloys.
87

Limiting Features

Higher solidification shrinkage requires special compensatory

procedures to obtain acceptable fitting.

Potential for porcelain delamination due to separation of poorly adherent

oxide layer from the metal substrate.

Potential toxicity of Beryllium and allergic potential of Nickel.

Poor resistance to tarnish and corrosion of nickel containing alloys.

Chair side-grinding and polishing requires more chair-side time and the
use of high-speed equipment due to the high hardness/strength.
88

Non - Cast Metal - Ceramic Systems

Non-Cast Metal-Ceramic Systems are an advancement in the

fabrication of metal-ceramic restorations, which permits the
fabrication of a metal-ceramic restoration without waxing, investing or
casting.

It was introduced by Dr. Itzhak Shoher and Aaron Whiteman.

89

Bonded Platinum Foil Coping

Bonding aluminous porcelain to platinum foil.

Platinum foil is electroplated with tin & then oxidized in a furnace

(degassing)

Thicker cast metal coping is replaced by thinner platinum foil ::

allowing more space for porcelain :: improved esthetics

90

Swaged Gold Foil Coping

Renaissance type

Use of a golden foil is intended to warm the color of the crown and
facilitate tooth color (Yellowish tinge).

Laminated swaged gold alloy foil supplied in fluted shape

Foil is swaged onto die & flame sintered to form a coping

Interfacial alloy powder is applied & fired, & the coping is then
veneered with porcelain

Burnishing the margin

Flame sintering

91

Captek System

Bonding to porcelain is achieved by the formation of an intermediate

layer of material such as Capbond metal-ceramic bonder.

Two strips of highly malleable metal powder impregnated wax are

adapted to a refractory die.

The first strip contains a gold, platinum and palladium alloy and the
second is impregnated with all-gold.

92

Captek System

The first strip is fired onto a refractory die at 10750 C for 11mins
producing a rigid porous layer.

Application and firing of the second strip is said to result in capillary

infiltration of the spongiform network by the molten gold, resulting
in a metal alloy framework with density similar to that of
conventional castings.
93

Metal-Ceramic Bonding

Development of a durable bond and the thermal compatibility

between the porcelain and the alloy are the primary requirements
for the success of a metal - ceramic restoration.

Metal-Ceramic Bonding Techniques

Mechanical

Chemical
94

Mechanical Method

Bonding surface of cast metal is made rough using diamond &

carbide burs, or sandblasting (with pure alumina).

This results in increased surface area.

Mechanical interlocking

Pd Ag alloys form no external oxides- hence mechanical bonding

95

Chemical Method

Primary bonding mechanism

Presence of adherent oxide layer is essential for good bond formation

In precious metals, tin oxide and iridium oxide are responsible for bond
formation

In base metals, chromium oxide forms the bond.

For a good bond, metal substructure should be free of contamination

Metal is oxidized in a furnace at 950oC for 5 min.

96

Electrodeposition

Ceramic bonding on to metals by electrodeposition of metal castings

and heating to form suitable metal oxides.

Alloy coping is electrodeposited with a layer of pure gold & a

subsequent short flashing deposition of tin

Used with Co-Cr, Pa-Ag, stainless steel, high- & low-gold alloys

97

Electrodeposition

Advantages

Improved bonding due to improved wetting and reduced porosity at the

porcelain metal interface

Electrodeposited layer acts as a barrier between metal casting &

porcelain to inhibit diffusion of atoms from metal into porcelain

Gold colour of the oxide film enhances the vitality and esthetics of the
porcelain

Tin oxide aids in chemical bonding

The deposited layer acts as buffer zone to absorb stresses caused by

differences in Coe. of thermal expansions
98

Advantages of Metal-Ceramic

High strength & durability

High fracture resistance

Permanent esthetic quality compared to acrylic veneer

No staining along the interface between veneer & metal

Adequate marginal fit

Disadvantages

Flexure strains produced in long span bridges may fracture ceramics

Slightly poor esthetics

Darker margins near the gingiva

99

Bond Failures
O Brien (1977)
1.Metal Porcelain
Seen when metal surface is devoid of oxides or due to porous and
contaminated metal surface.
2.Metal oxide-Porcelain
Oxide layer remains firmly attached to metal, seen mostly in base
metal alloys.
3.Metal metal oxide
Metal oxide remains attached to porcelain, seen in base metal
alloys due to overproduction of chromium and nickel oxides.
100

Bond Failures

4.Metal oxide metal oxide

Fracture within the metal oxide.
Results from overproduction of oxide causing sandwich effect between metal and
porcelain.

5.Cohesive within metal

Common in bridges where joint area breaks, rare in single crowns.

6.Cohesive within porcelain

Tensile failure within porcelain.

101

Interfacial bond failure occurs primarily at three sites

Along the interfacial region between

opaque porcelain and the interaction
zone.

Within the interaction zone.

Along the interfacial region between

the metal and the interaction zone.
102

Porcelain Teeth

High-fusing or medium-fusing porcelains

Manufactured by packing two or more porcelains of differing

translucencies for each tooth into split metal moulds & then fired at
high temperature

Mechanical interlocking to denture base

Anterior teeth : projecting metal pins

Posterior teeth : diatoric holes

103

Porcelain Teeth..

Advantages

More natural looking than acrylic teeth

Excellent biocompatibility

More resistant to wear than natural teeth

Disadvantages

Brittle

Clicking sound on contact with opposing teeth

Require greater inter-ridge distance (cannot be ground like acrylic

teeth without destroying diatoric channels)

Higher density- increases the weight

Opposing natural teeth wear

All- Ceramic Restoration

Excellent esthetics as all its thickness is for the porcelain.

Earlier made up of traditional low-fusing porcelain fired onto a thin

platinum foil. PJC

To improve its strength use of a strong core of ceramics underneath

the traditional porcelain.

Core ceramics include:

Aluminious based ceramic

Magnesia based ceramic

Glass infiltrated aluminous ceramic

105

Aluminous porcelains (Hi-Ceram)

Mclean and Hughes - 1965

Contains 40-50% alumina

Strengthens ceramic by interruption of crack propagation

Used to construct core of PJC over which conventional enamel and

body porcelain are condensed

Mc lean 1979 Five year failure rate 2% for anteriors 15% for
posteriors
Seiber et al 1981: light reflection better than porcelain fused to metal

Aluminous porcelains.

Advantages

More esthetic than PFM

Strength twice that of conventional porcelain

Requires less removal of tooth structure

Disadvantages

Inadequate strength to be used on posterior tooth

More sintering shrinkage

Magnesia core porcelains

Used in place of aluminous core porcelains

High Coe. of thermal expansion (14.5 x10-6)

Castable Ceramics
1968 Mc Culloch
A glass ceramic material that can be casted using the lost wax process

Di-Cor

Cerestore

IPS Empress

New types
Cera pearl
Optimal pressable ceramic
Olympus castable ceramics

Castable glass ceramic

It is formed in to desired shape as a glass then subjected to heat

treatment to induce devitrification of glass

Known as ceramming

The crystalline particles thus formed interrupts crack propagation &

improves strength and toughness

The crown is cast at 1380oc

Final shading is achieved with external staining

Dicor

Dicor by Corning glass works

excellent esthetics because of the chameleon effect.

contains about 55 vol% of tetrasilicic fluormica crystals

Increased strength, thermal shock resistance, decreased translucency

Dicor MGC is a higher quality product that is crystallized by the

manufacturer and provided as CAD CAM blanks or ingots

Low tensile strength

Inability to be colored internally

Dicor ceramic crown

Wax pattern

Spruing

Centrifugal
casting 2600 f

Investing

Burnout
450 for 1\2 hr
1750 for 1\2hr

Cast glass coping

Divesting

Ceramming

Ceramming

Ceramming oven

Crystallised glass coping

Cerramming done from room temparature- 1900 f for 1 hrs and sustained
for 6hrs inorder to form tetra silicic flouro mica crystals

Conventional porcelain application & Firing

Finished crown

Castable glass ceramic

In another type ,ceramming produced hydrxyapatite crystals rather

than mica as in dicor

Coors porcelain company produced Cerestore

Cerestore contains 70% alumina and is partially crystallized as alphaAl203

Leucite reinforced ceramic (Optec HSP)

All ceramic crowns without a core

contains up to 45 vol% tetragonal leucite.

The greater leucite content leads to a higher modulus of rupture,

compressive strength and high thermal contraction of coefficient.

This large thermal contraction causes mismatch between leucite and

the glassy matrix results in the development of tangential compressive
stresses in the glass around the leucite crystals when cooled, these
stresses can act as crack deflectors and contribute to increase the
resistance to crack propagation.

Leucite reinforced ceramic (Optec HSP)

Advantages
High flexural strength
Excellent esthetics
Disadvantages
Abrasion against natural teeth is higher than that of conventional
feldspathic porcelain.
Poor marginal fit due to sintering shrinkage
Requires special equipment for fabrication

Indications
Inlays
Veneers
Low stress crowns and veneers

IPS-EMPRESS (Pressable Ceramic)

Hot pressed ceramics
2 types
IPS Empress
Leucite reinforced
K2O Al2O3 4 SiO2

IPS Empress 2
Lithium Disilicate
reinforced
SiO2 LiO2 P2O5 ZrO2

IPS Empress

Developed by Wohlwend at the dental institute, Zurich University, 1991

Type of leucite reinforced pressable ceramics contains about 35 vol%

leucite, available in pre-ceramed cylinders

Crowns are formed using the lost-wax process and hotpressing leucite
reinforced material into the mold using special furnace

IPS Empress

Wax preparation is made and placed on a specially designed

cylindrical crucible former and invested using a phosphate bonded
investment, the mold is heated in a burnout furnace to 850 0C.

Wax pattern

Investing

Burn out 8500 C

IPS Empress

The pre- ceramed cylinder is heated to 1100 oc at which it is plastisized, injected

under pressure at high temperature in to the mould for complete filling of
investment cavity

Injected under pressure at high temperature for 45 minutes into a mold to

produce ceramic substructure.

Ceramic ingot &

Al plunger

Pressing under vaccum

11500C 26 min hold

Sprue removal

IPS Empress

The crown is formed in dentin shades over which enamel layer is

added

The crown can be finished by two techniques staining, glazing or

by layering, involving veneering porcelain.

Edward B Goldin 2005 compared leucite IPS Empress with PFM

Mean marginal discrepancy 94 + 41 PFM
81 +25 IPS
Clinical survival : Deniz G in 2002
95% survival 2-4 years
Marginal adaptation : Shearer et al in 1996 : better marginal adaptation
122
with hot pressed ceramics than aluminous core material.

IPS Empress

Indications
Anterior crowns
Inlays
Laminate veneers
Post and cores

Contraindications
Clinical crown length of the tooth is
exceptionally short
tooth, reduction would compromise
resistance and retention of the
preparation.
Parafunctional habit

Advantages:
High flexural strength (126-165
Mpa )
No shrinkage after pressing
Excellent fit and esthetics
Stability of shape

Disadvantages:
Limited to single tooth restoration
Potential to fracture in posterior
areas

IPS Empress

IPS Empress
PROPERTIES

Flexural Strength

- 120 Mpa initially and 182 Mpa

after heat treatment.
Fracture toughness - 1.3 Mpa.
Abrasion behaviour and Translucency -similar to that of
natural teeth
Solubility
- <200mg/cm2
Pressing temperature - 11800 C
Application of the
- 9100 C
sintered glass ceramic

IPS Empress 2
Lithium Disilicate reinforced

To extend the use of resin-bonded ceramic restorations and use them for
bridge construction, a glass ceramic lithium based system has been
developed.
The framework is fabricated with lost-wax and heat-pressure technique
IPS Empress 2 has a core of lithia disilicate crystals in a glass matrix
and veneering ceramic contains apatite crystals which causes light
scattering similar to that of enamel
The core microstructure of the two is different which is responsible for
slight decrease in translucency of IPS Empress 2

IPS Empress 2

Full contouring

Cut back

Sprued pattern

Investing

Ingot pressing

IPS Empress 2

The needle-like crystals cause cracks to deflect, thus the

propagation of cracks through this material is arrested by the
lithium disilicate crystals, providing a substantial increase in the
flexural strength.

IPS Empress 2

INDICATIONS
Three unit bridges for the anterior and posterior regions upto the
first premolar
Crowns in anterior and posterior regions

CONTRAINDICATION
Short crown length
Parafunctional habits

In-ceram

( Slip casting technique )

Saadoun 1989

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

Flexural
strength

In-ceram Alumina

In-ceram
Spinell

In-ceram
Zirconia

350 MPa

500 MPa

700 MPa

Glass infiltrated alumina core porcelain- Inceram

Relies on slip casting to produce high strength core

Fine sized alumina core with improved strength

The core is fired for 10hrs at 1100oc in a special furnace

Glass is infiltrated in to core frame work over 4 to 5 hrs at 1120 oc

by capillary action, enhancing colour and strength

Glass infiltrated alumina core porcelainINCERAM(ICA)

The core of ICA consists of 70 wt% alumina

infiltrated with 30wt% sodium lanthanum glass.
Advantages
Four times more strength than other ceramics
Enhanced marginal adaptation
Disadvantages
Poor esthetics
Complex procedure
Cost
Indications
Anterior crowns and bridges
Posterior crowns

Cross section of an INCERAM crown

Al2O3 slip

Glass infiltration

Giordono 1995 : Al2O3 Core glass infiltrated Ceramic > Strength

than Hi-Ceram, Di-Cor & Feldspathic Porcelain

Vita Inceramat3

Vaccumat 4000 Premium

Working model

Duplication

In-Ceram
application

Al2O3 slip

Shrinkage of dies

In-Ceram
refractory dies

vita inceramat

10 hrs 1120 c2hrs

Glass infiltration
4hrs 1100c

Finished InCeram copings

(Air abraded)

Application of body
and incisal porcelain

Preoperative veiw

Finished crowns

Postoperative veiw
of In-Ceram crowns

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

Glass infiltrated spinell core (Inceram Spinell) (ICS)

Offshoot of inceram

It uses MgAl2O4

More translucent and so more esthetic

Strength is low

Inceram Zirconia (ICZ)

Has a core of 30 wt % zirconia and 70 wt % alumina

Strongest and toughest of all three core ceramics

Its use is limited to posterior crowns and FPDs because of its high
level of core opacity

CAD-CAM Ceramics

These are known as COMPUTER AIDED DESIGN COMPUTER

AIDED MACHINED CERAMICS

CAD/CAM systems have dramatically enhanced dentistry by providing

high-quality restorations.

The operator can design the inlay/ onlay and the computer directs the
milling machine in the appropriate fabrication of the restoration

CAD-CAM Ceramics

Advantages

Less chairside time

No need for impression making
Reduced porosity & greater strength
Single appointment (inlays)

Disadvantages

Cost
Marginal inaccuracy
Technique sensitive
Inability to build layers of porcelain

Copy milled ceramics

A new system (Celay by Mikron Technologies, Switzerland) uses a copy

milling technique to produce ceramic cores and substructures for
bridges

A pattern of coping is prepared directly or indirectly with special blue

resin based composite

A tracing tool passes over the pattern and guides a milling tool which
grinds a copy of the pattern from a block of ceramic (Inceram or
Inceram spinell)

It is then infiltrated with glass and veneered with porcelain and fired to
complete the restoration

Celay

Introduced in 1992, by Dr. Stefan Eeidenbaez, Zurich

Uses copy-milling technique to manufacture ceramic inlays or onlays

from resin analogs

It is fine grained feldspathic porcelain that is said to reduce the wear of

antagonist tooth structure

Mechanical device based on pantographic tracing of a resin inlay or

onlay fabricated directly onto the prepared tooth or onto the master die

Material used is a ceramic blank available in different shades, contains

sanidine as the major crystalline phase within a glassy matrix.

Celay

Scanning of the prepared cavity is done with a 3-D scanner,

restoration is designed from the image shown on the computer
screen by using a series of icons or symbols

Can electronically design the restoration by moving a cursor along

the limits of the preparation, thereby defining its boundaries

Design phase usually takes from 2 to 8 minutes

After data have supplied, the computer selects the size of ceramic
block to be used in the milling process

Diamond wheel is driven by the electric motor, which generally takes

4 to 7 minutes to complete the procedure

CELAY

It is then infiltrated with glass and veneered with porcelain and fired to
complete the restoration

Cementation involves etching the tooth with a 37 % solution of

phosphoric acid for 20 seconds, tooth is then washed and dried and a
bonding agent is applied, ceramic restoration is etched on its
undersurface, outside the mouth

Dual cure microfill composite resin luting agent is used to bond the inlay,
onlay or veneer, after photocuring the occlusal anatomy can be created,
accomplished intraoraly with fine-particle diamonds.

CELAY

ADVANTAGES

Single appointment
Bonded restoration for strength.
Reduced marginal gap
Hardness similar to enamel
Less fracture of the inlay because it is milled from a solid
Homogeneous block
Excellent polishing characteristics, esthetics
Preparation, fabrication, Cementation in 1 to11/2 hours.

Procera

Introduced in 1994
Embraces the concept of CAD/CAM to fabricate dental restorations
Available as Procera laminate
Procera crowns
Procera Bridge
Procera Implant Bridge
This crown is composed of a densely sintered high-purity
aluminum oxide coping that as combined with the low-fusing
Allceram veneering porcelain
Content of aluminum oxide in these coping is 99.9% and the
strength for this ceramic material is highest among all-ceramic
restoration

PROCERA PREPARATION

Die is prepared from impression, scanned at a local laboratory,

which is saved as file in computer and
send to laboratory in Sweden, where coping is
prepared
Coping is produced by a special process, which
involves sintering 99.5% pure alumina at
16001700C,fully densified
coping is then returned to the dental laboratory for building in the
crowns aesthetics using compatible feldspathic glasses,
turnaround time is approximately 24 hours

PROCERA

ADVANTAGES
Biocompatibility -Aluminum oxide coping material does not show
any leakage or dissolution of aluminum at any of the pH levels
Occulsal surface will not damage the opposing natural tooth
Translucency-Procera coping is translucent, thus will not allow any
staining of the underlying dentin
High strengthFlexural strength 700 mpa.
DISADVANTAGES
Very few laboratories offer this system
INDICATIONS
Used in metal sensitive patients

Procera Alltitan

In this technique titanium core is used, the external contours of the

individual titanium cores for bridges are milled and graphite rods
create the fitting surface by the spark erosion process.

Individual components of the bridge are then welded by laser before

the addition of special porcelains to layer the surface to the full
contour

CEREC

Introduced in 1991, feldspathic porcelain of high strength and fine

grain size is used.

Used in cases of inlays, onlays, partial crowns, crowns (posterior

& anterior), and veneers

One of the most researched restorative systems on the market,

with documented success rates of more than 90% after 10 years

Preparation Of CEREC

A cast of the prepared teeth made using a specialized CAD-CAMcompatible stone that is sprayed with Quickcheck indicator spray

After the die preparation, the die is loaded into the bridge holder of
the CEREC inLab unit; the bridge holder is then placed in the
machine for scanning.

A digital image of the cast is displayed on

the screen, In-Ceram block is inserted

into the unit for automatic milling

CEREC

After milling is complete, the fit of framework

is tested on the die stone.
Consistency of a coping is chalk-like, any

necessary adjustments can be accomplished

quickly and easily

The proper amount and shade of glass required

is applied
The coping is placed in the In-Ceram furnace
for infiltration.

CEREC

Excess glass is removed by sandblasting the coping, luminary coat

is applied for refraction of light.

The appropriate shade of porcelain and modifiers are applied for a

natural appearance

Glaze is applied, and the restoration is now complete and ready for
placement

LAVA

Introduced in 2002, Lava uses a laser optical system to digitize

information from multiple abutment margins
The Lava All-Ceramic System comprises a CAD/CAM procedure
for the fabrication of allceramic Crowns and Bridges for anterior
and posterior applications.
CAD software scan the die automatically finds the margin and
suggests a pontic, the framework designed to be 20% larger to
compensate for sintering shrinkage

LAVA

After the cut dies of the preparation is made, the milling center
will digitalize the model by using the optical scanner Lava Scan
The restoration will then be virtually designed on the monitor
using a CAD, the data is sent to Lava Form, a milling unit (CAM)
The restoration is milled from a pre-sintered zirconia blank,
which can be colored in 8 different shades and which is then
sintered to its final density in the furnace
The milling center returns the finished framework to the lab who
will then veneer the framework with Lava Ceram and give it the
final artistic finish.

LAVA

ADVANTAGES
With the classic color scheme, all tooth shades can be easily
reproduced, special effect components and stains lead to a natural
esthetic

High level of biocompatibility

Anterior and posterior crown and bridge

Conclusion
The difference with & without Ceramics is self evident

156

References

Journal of Indian Prosthodontic society oct.2002,vol.2

no.3
Notes on dental materials- V K Subbarao
Basic dental materials- Manappallil
The science and art of dental ceramics Mc lean vol 2

157

References

Anusavice : Philips Science of Dental Materials Xth & XIth

Edn.
Craig : Dental Materials : Properties & Manipulation VI th,
VIIth & VIIIth Edn.
J. F. McCabe : Applied Dental Material VIIth Edn.
Jack Ferracane : Materials in Dentistry Principles &
Application

158

Repair of Ceramic Restoration

This can be done if the fracture is not too

extensive.

Repaired in the mouth using a resin

composite in dry field.

Residual stresses in porcelain when coe. Of

thermal expansion of porcelain is more than
metal

Metal-Ceramic Bonding

Fusion temperature of ceramics : 900oC-1000oC.

Highly viscous liquid having large surface tension (365

dynes/cm).

Angle of contact (130o) with alloy surface.

Ceramic liquid does not wet & bond with metal surface.

161