All ceramic restorations PDF

ALL CERAMIC RESTORATIONS Dr. Marwan Aggag BDS, MSc, PhD, FICOI LECTURER of FIXED PROSTHODONTICS Classification of ceramic systems All-ceramic systems  I- Glass-based (Feldspathic) ▪ IV- Zirconia ceramic...

ALL CERAMIC RESTORATIONS Dr. Marwan Aggag BDS, MSc, PhD, FICOI LECTURER of FIXED PROSTHODONTICS Classification of ceramic systems All-ceramic systems  I- Glass-based (Feldspathic) ▪ IV- Zirconia ceramic  II- Reinforced Glass ceramics ▪ V- Resin based ceramics ▪ IPS Empress (ceramic reinforced resins) ▪ IPS e-Max ceramics Vita Enamic ▪ Vita Suprinity. 10% Zirconia Lava Ultimate Visio ligne ▪ Celtra Duo 10% Zirconia CeraSmart  III- Glass infilterated alumina Brilliant ▪ In-ceram Grandio ▪ In-ceram ▪ Spinel Microstructural Classification Category I Glass-based systems (mainly silica) Acid etched ceramic contained more than 50% silica Feldspathic (Silica Based) Glass-based systems contain mainly silicon dioxide (also known as silica or quartz), which contains various amounts of alumina (Alumino-silicates). and various amounts of potassium and sodium, are known as feldspars.  The traditional type of dental ceramics are feldspar-based, composed of the significant amount of feldspar (KAlSi O ), quartz 3 8 (SiO ), and kaolin (Al O ·2SiO ·2H O). 2 2 3 2 2 Feldspar rocks are grounded, milled to obtain the purest powder. Quartz or silica (SiO2) is the matrix component (55–65%) responsible for the translucency of the restoration. As it is not a strong material, 20–25% alumina (Al O ) is added as a reinforcing 2 3 component. The mechanical properties are low flexural strength, usually in the 60–70 MPa range. Used as 1- Veneer materials for the specific veneering of alumina-based core systems ceramic substructures. 2- Veneers using either a refractory die technique or a platinum foil.  These materials have also been developed into very fine-grain machinable blocks, such as Vitablocs Mark II for use with the Cerec CAD/CAM system. This material is machinable glass for the fabrication of veneers, inlays and onlays. The benefit of a premanufactured block is that there is no residual porosity in the finished core that could act as a weak point, which could lead to catastrophic failure VITABLOCS® are the most used feldspar-based CAD/CAM ceramics with an average grain size of 4μm and flexural strength of 120 MPa. In (1991) VITA has promoted Mark II, a monochromatic material with improved chemical composition and physical properties. To imitate the natural colors of the tooth, VITA has introduced next generations: VITABLOCS® TriLuxe (2003) and TriLuxe forte (2007) polychromatic four-layer shade gradient. Further improvement with VITABLOCS® RealLife (2010), polychromatic feldspar ceramic with different 3D color intensity. Classification of ceramic systems All-ceramic systems  I- Glass-based (Feldspathic) ▪ IV- Zirconia ceramic  II- Reinforced Glass ceramics ▪ V- Resin based ceramics ▪ IPS Empress (ceramic reinforced resins) ▪ IPS e-Max ceramics Vita Enamic ▪ Vita Suprinity. 10% Zirconia Lava Ultimate Visio ligne ▪ Celtra Duo 10% Zirconia CeraSmart  III- Glass infilterated alumina Brilliant ▪ In-ceram Grandio ▪ In-ceram ▪ Spinel Microstructural Classification Category II (Synthetic) Glass-based system with fillers (crystalline leucite or lithium disilicate) This category subdivided into three subcategories. Microstructural Classification Category II (Synthetic) 1: Low-to-moderate leucite-containing feldspathic glass These materials are called “feldspathic porcelains” Leucite is added to these materials to raise the coefficient of thermal expansion. They can be applied to metals and zirconia. (eg, Vita VM13,) Microstructural Classification Category II (Synthetic) 2: High-leucite containing glass IPS Empress contain Leucite crystal as a major crystalline phase dispersed (35%-50%) in a glassy matrix. The flexural strength is about 160 MPa. The final shade of the restorations are adjusted by staining or veneering. It indicated for: 1- Single anterior crown, -IPS Empress CAD contain leucite crystals evenly 2- Inlays, onlays, distributed throughout a glass matrix. 3-Laminate veneer. -Does not require a second heating cycle to initiate the crystalline phase of leucite crystal. -Chair-side restoration ( Mill, Polish, Done) Microstructural Classification Category II (Synthetic) 3: Lithium-disilicate glass ceramic A new type of glass ceramic introduced by Ivoclar as IPS Empress II (now called IPS e.max), where the alumino-silicate glass has lithium-disilicate was added. This material can be very translucent even with the high crystalline content due to the relatively low refractive index of the lithium-disilicate crystals  IPS Empress II lithium disilicate crystal are dispersed 60% in an interlocking structure that hinder crack propagation by means of energy absorbing processes. 350 ± 50 MPa  IPS e-max press The crystalline phase is a lithium disilicate and makes up some 70% of the volume of the glass ceramic. After bonding (400 - 450 MPa ) e-max press (500 - 530 MPa ) e-max CAD The lithium disilicate (LS2) IPS e.max Press ingots are available in five translucency levels and in an Impulse version. These restorations are based on the lost wax technique. where the restorations are waxed, invested and pressed  Indications ✓Veneer , inlay , onlay ✓Anterior and posterior crowns ✓3-unit anterior FPD ✓3-unit FPD up to the second premolar as the as abutment tooth  Contraindications Posterior FPD reaching into the molar region 4 unit FPD Inlay-retained FPD Patients with short dentition Bruxism Cantilever bridges  VITA SUPRINITY VITA SUPRINITY, a new generation of glass ceramic material products. The glass ceramic is enriched with zirconia (approx. 10 % by weight) to offer a high-strength, zirconia-reinforced lithium silicate ceramic (ZLS) Posterior crowns Anterior crown (420 MPa ) Implant-supported crown Veneer  CELTRA Duo High strength glass ceramics with 10% zirconia-reinforced lithium silicate – ZLS. (210 MPa ) polishing Indicated for single-unit anterior and posterior (370 MPa ) firing crowns, single-tooth implant superstructures, as (420 MPa ) bonding well as inlays, onlays and veneers  VITA AMBRIA The Vita Ambria (ZLS) like Vita Suprinity in that it contained 10% zirconia fillers in its lithium disilicate glass-ceramic matrix. very high stability (> 500 MPa) to be used for the fabrication of various dental restorations including  inlays, Therefore, Vita Ambria showed  onlays, more fracture resistance than IPS  full veneer crowns,  three- units FPD up to the second premolars e.max press Classification of ceramic systems All-ceramic systems  I- Glass-based (Feldspathic) ▪ IV- Zirconia ceramic  II- Reinforced Glass ceramics ▪ V- Resin based ceramics ▪ IPS Empress (ceramic reinforced resins) ▪ IPS e-Max ceramics Vita Enamic ▪ Vita Suprinity. 10% Zirconia Lava Ultimate Visio ligne ▪ Celtra Duo 10% Zirconia CeraSmart  III- Glass infilterated alumina Brilliant ▪ In-ceram Grandio ▪ In-ceram ▪ Spinel Microstructural Classification Category III (Non Silica Based) Crystalline-Based systems with glass filler (mainly alumina) Introduced in 1988 e.g. In-Ceram Infiltrated ceramics (slip-cast) Infiltrated Ceramic (slip-Cast ceramic) Glass infiltrated Alumina products in 2 components:- a. Powder (Aluminium oxide ) porous substructure. b. Glass infiltrated at high temp. into porous substructure Interpenetrating phase materials are generally fabricated by first creating a porous matrix, in the case of VITA In-Ceram a ceramic sponge. The pores are then filled by a second-phase material, a lanthanum aluminosilicate glass, using capillary action to draw a liquid or molten glass into all the pores to produce the dense interpenetrating material. A- The core is formed from slurries of the fine alumina powder and water ("slip") and is applied to an absorbent refractory die, which Then sintered for 10 hours at 1120°C. to produce a porous core. Importance of absorbent refractory die 1-Absorbs the water from the slip and leads to its condensation. 2-The refractory die shrinks more than the condensed slip, allows easy separation. B- The residual pores are then infused with molten glass by capillary action- hence the name In-Ceram fired at 1100°C for 4–6 hours. Vitadur alpha Aluminious veneering porcelain is then applied using conventional powder slurry tech. Indications Anterior and posterior crowns 3-unit anterior FPD (300-600 MPa) In-Ceram veneered by lower strength materials to achieve final esthetic When the core is thinned to 0.5 strength drop to 225 Mpa  Two modification for In-Ceram technique 1. In-Ceram contains magnesium oxide crystal to form alumina- magnesium oxide (spinel) as a major crystalline phase which improve the translucency but decrease the strength by 25% to 40%.  Two modification for In-Ceram technique 2. In-Ceram zirconia : Contains zirconium oxide crystal Its strength is 1.4 times that of In-Ceram alumina but is associated with increased opacity. Thank you