All-Ceramic Systems Quiz

All-Ceramic Systems

• Various all-ceramic systems exist, categorized for study purposes.
• A primary category is glass-based systems (primarily silica).
• Another category is reinforced glass ceramics, including IPS Empress, IPS e.Max, Vita Suprinity, and Celtra Duo. These often contain various amounts of zirconia (e.g., 10% Zirconia).
• A third category is glass-infiltrated alumina (e.g., In-ceram, Spinel).
• A fourth is Zirconia ceramic.
• A fifth category is resin-based ceramics (including ceramic-reinforced resins), like Vita Enamic, Lava Ultimate, Visio ligne, CeraSmart, Brilliant, and Grandio.

Microstructural Category I: Glass-Based Systems

• Glass-based systems (primarily silica) have acid-etched ceramic containing more than 50% silica.
• Feldspathic (Silica Based) is a type of glass-based system.
• Glass-based systems primarily contain silicon dioxide (silica or quartz).
• Alumino-silicates, containing various amounts of potassium and sodium, are known as feldspars.

Traditional Dental Ceramics (Feldspar-Based)

• Traditional feldspathic ceramics are composed of feldspar, quartz, and kaolin.
• Feldspar rocks are ground and milled to obtain a pure powder form.
• Quartz (silica) (55-65%) is responsible for translucency in restorations.
• Alumina (20-25%) is added to improve strength.

Mechanical Properties and Applications

• Flexural strength of feldspathic ceramics is typically between 60-70 MPa
• Used primarily as veneer materials for alumina-based core systems and ceramic substructures.
• Can be prepared using refractory die technique or platinum foil.

Premanufactured Blocks and Porosity

• Pre-manufactured blocks have no residual porosity, which is a significant advantage over other methods.
• Porosity in the core can weaken restorations and cause catastrophic failure.

VITABLOCS® Feldspar-Based CAD/CAM Ceramics

• VITABLOCS are popular feldspar-based CAD/CAM ceramics, having an average grain size of 4µm and 120 MPa flexural strength.
• VITA Mark II, a monochromatic material, helps enhance natural tooth coloration (1991)
• Generations include VITABLOCS® TriLuxe (2003) and TriLuxe forte (2007). These use a polychromatic four-layer shade gradient.
• Further development led to VITABLOCS® RealLife (2010), which is a polychromatic feldspar ceramic with 3D color intensity.

Category II (Synthetic): Glass-Based Systems with Fillers

• This category includes glass-based systems containing fillers like crystalline leucite or lithium disilicate.
• Two types of high leucite containing glass are described in the slides:
  • Low-to-moderate leucite-containing feldspathic glass (e.g., Vita VM13). This type is added to materials to enhance thermal expansion.
  • High-leucite containing glass (e.g., IPS Empress). These have Leucite crystals dispersed (35%-50%) in a glassy matrix. The flexural strength is around 160 MPa.
• A new type of glass-ceramic was introduced by Ivoclar as IPS Empress II (now IPS e.max) where alumino-silicate glass has lithium-disilicate was added.

Lithium Disilicate (IPS Empress II/IPS e.max)

• Lithium disilicate crystals are dispersed in an interlocking structure hindering crack propagation.
• Strength of IPS Empress II is around 350 ± 50 MPa.
• IPS e.max press and CAD have different strengths (400–450 MPa, 500–530 MPa ), respectively)
• These are available in different translucency levels and the Impulse version.
• They use a lost-wax technique.

Category III (Non-Silica Based): Crystalline-Based Systems with Glass Filler (mainly alumina).

• These systems were introduced in 1988.
• Examples include In-Ceram infiltrated ceramics (slip-cast).
• These systems use a two-component approach: alumina powder is mixed with a glass substance that is infiltrated at high temp into the porous substructure.
• The pores are filled using lanthanum aluminosilicate glass.
• This technique creates a dense interpenetrating material. The initial porous core is created from alumina powder mixed with water (slip) and is applied to an absorbent refractory die, which absorbs the water and allows the slip to condense.
• The core is sintered for 10 hours at 1120°C to make it porous.
• The important points about the refractory die include water absorption and shrinkage, for easy removal.

In-Ceram Modifications

• In-Ceram contains magnesium oxide crystal which forms alumina-magnesium oxide (spinel). This increases translucency but decreases strength by 25–40%.
• In-Ceram zirconia contains zirconium oxide. This increases strength to 1.4 times that of alumina but increases opacity.

Indications and Contraindications for All-Ceramic Systems

• Indications includes veneers, inlays, onlays, anterior and posterior crowns, 3-unit anterior FPD, and 3-unit FDP up to the second premolar.
• Contraindications include posterior FPD reaching into the molar region, 4 unit FPD, inlay-retained FPD, short dentition, bruxism, and cantilever bridges.

VITA SUPRINITY and VITA AMBRIA

• VITA SUPRINITY is a new generation of glass ceramics enriched with zirconia (approx 10% by weight) offering a high-strength, zirconia-reinforced lithium silicate ceramic (ZLS). Its strength is 420 MPa,
• VITA AMBRIA (ZLS) is similar in composition to Vita Suprinity, containing 10% zirconia filled into its lithium disilicate glass-ceramic matrix, which increases fracture resistance more than the IPS eMAX press.
• Strength of Vita Ambria is > 500 MPa

VITA SUPRINITY Applications:

• Posterior crowns
• Anterior crowns
• Implant-supported crowns
• Veneers

CELTRA DUO Applications

• Indicated for single-unit anterior and posterior crowns and single-tooth implant superstructures, as well as inlays, onlays and veneers.

Test your knowledge on various all-ceramic systems categorized for study. This quiz covers glass-based systems, reinforced glass ceramics, and resin-based ceramics, along with their specific types and materials. Challenge yourself and enhance your understanding of these essential materials in dentistry.