Final - Material Science in Fixed Prosth _YKK.txt

Material Science in Fixed Prosthodontics P r o f. Y o u n g K. K i m D M D D M Sc F A C P Diplomate & Fellow, American Board of Prosthodontics Clinical Assistant Professor, NYUCD, Dept. of Prosthodontics Editor & Co-leader, NYU Implant Restorative Protocol Editor & Co-leader, NYU Robotic...

Material Science in Fixed Prosthodontics P r o f. Y o u n g K. K i m D M D D M Sc F A C P Diplomate & Fellow, American Board of Prosthodontics Clinical Assistant Professor, NYUCD, Dept. of Prosthodontics Editor & Co-leader, NYU Implant Restorative Protocol Editor & Co-leader, NYU Robotics Surgical Protocol Course director, Fixed prosthodontics II NEW YORK UNIVERSITY COLLEGE OF DENTISTRY Advancements Vs Photo by pexels.com Fundamentals Amit Bajwa, NYU DDS ’21 Fundamentals “ CA N N OT B E IGNORED” Giugliano TS, Kim YK, Bowley JF. Rotational torque-values in crown restorations with variations of occlusal cusp angulation in theoretical premolar- and molar-tooth forms, Journal of Prosthetic Dentistry, accepted Material science in fixed prosthodontics C R OW N S | CEMENTS CA S E S Material science in fixed prosthodontics C R OW N S | CEMENTS CA S E S • Full metal • Metal-ceramics • Feldspathic porcelain • Glass-ceramics • Polycrystalline ceramics • Polymer-infiltrated ceramic networks (PICN) Material science in fixed prosthodontics C R OW N S | CEMENTS CA S E S • Zinc-oxide eugenol & non-eugenol • Water-based • Zinc polycarboxylate • Zinc phosphate • Glass-ionomer • Resin-based • Self-curing • Light-curing • Dual-curing Material science in fixed prosthodontics C R OW N S | CEMENTS CA S E S • Case scenarios • Practical questions Material science in fixed prosthodontics ≥ 60% (gold and platinum group)
 High Noble Alloys C R OW N S CEMENTS CA S E S Full-metal and gold ≥ 40% Titanium and Titanium Alloys Noble Alloys Predominantly Base Alloys Titanium ≥ 85% ≥ 25% (gold and platinum group) < 25% (gold and platinum group) ADA dental alloy classification (ADA Council on Scientific Affairs, 2003. Material science in fixed prosthodontics “Noble metal alloys” • Longest use in dental Hx • Often referred as the standard • Noble = gold + platinum-group metals • Thermodynamically stable → inert in a moist environment (resisting corrosion) • Soft / malleable → mixing with additional elements → increasing strength C R OW N S CEMENTS CA S E S Full-metal Morris HF, Manz M, Stoffer W, Weir D. Casting alloys: the materials and “The Clinical Effects”. Adv Dent Res 1992;6:28-31. Material science in fixed prosthodontics “Noble metal alloys” Yield Strength Type Applications Elongation Low-stress small single tooth fixed restorations. 0 — — Low-stress single-tooth fixed restorations:
 one-surface inlays, veneered crowns. 1 80 18 Single-tooth fixed restorations:
 crowns or inlays without restriction on the number of surfaces. 2 180 10 Multiple-unit fixed prostheses, e.g. bridges 270 5 3 Appliances with thin sections subject to very high forces:
 removable partial dentures, clasps, etc. 4 360 2 High stiffness (greater than 150 GPa) and strength:
 thin removable partial dentures,
 parts with thin cross sections, clasps. 500 2 5 C R OW N S CEMENTS CA S E S Full-metal Anusavice KJ, Shen C, Rawls HR. Phillips’ science of dental materials: Elsevier Health Sciences; 2013. Material science in fixed prosthodontics “Base metal alloys” • Ni-Cr & Co-Cr = most common • Corrosion resistance via passive oxide layer • Hardness → complicating adjustments C R OW N S CEMENTS CA S E S Full-metal Geurtsen W. Biocompatibility of dental casting alloys. Crit Rev Oral Biol Med 2002;13(1):71-84. Material science in fixed prosthodontics • Gold standard (excellent biocompatibility and strength) • Advantageous with heavy occlusal forces (static & dynamic) C R OW N S CEMENTS CA S E S Full-metal “Pros & Cons” • Minimal prep reduction • Increasing price of precious metals (profitability issues) • Esthetics concerns Material science in fixed prosthodontics • Ddd • D • C R OW N S CEMENTS CA S E S Metal-ceramics “s” Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics “PFM (still prevalent)” • Most common type of indirect restoration before the rise of CAD/CAM-based ceramics • Strength and durability of the metal alloy core • Aesthetic natural esthetics with exterior porcelain Zarone F, Russo S, Sorrentino R. From porcelain-fused-to-metal to zirconia: clinical and experimental considerations. Dent Mater 2011;27(1):83-96. Material science in fixed prosthodontics M e t a l - c e r a m i c s “Coefficient of linear thermal expansion (CTE)” C R OW N S CEMENTS CA S E S • CTE of the alloy must be near the same range OR slightly higher than the veneering ceramic • Palladium (low CTE) highly compatible with various ceramics • Base metal alloys with more technique sensitivity due to hardness and stiffness Leinfelder KF. Porcelain esthetics for the 21st century. J Am Dent Assoc 2000;131 Suppl:47S-51S. Material science in fixed prosthodontics • Mechanical bonding C R OW N S CEMENTS CA S E S Metal-ceramics “How does it layer?” • Surface energy (i.e. wetting) • Surface roughness (i.e. mechanical interdigitation & distributing surface area) Mackert JR Jr, Parry EE, Hashinger DT, Fairhurst CW. Measurement of oxide adherence to PFM alloys. J Dent Res. 1984 Material science in fixed prosthodontics • Chemical bonding C R OW N S CEMENTS CA S E S Metal-ceramics “How does it layer?” • Via oxide mixing • Thin metal oxide for alloying with the porcelain (oxide) • Transition zone of oxides from the metal to bulk porcelain • Oxidation of metal alloys (or surface pre-Txs) → the initial oxide layer for bonding • Sn, In, Fe or Zn may be added to the original alloy • Possible pre-oxidizing Txs • Potential painting metallizing bonding agents onto the surface Mackert JR Jr, Parry EE, Hashinger DT, Fairhurst CW. Measurement of oxide adherence to PFM alloys. J Dent Res. 1984 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics “Pros & Cons” • Long-track record • Combination of structural base durability & esthetics • Non-homogenous (i.e. potential chipping) • Technique sensitivity • Potential glazing peeling in acidic environment Material science in fixed prosthodontics 1990s Nobel Biocare CAD/CAM Procera® 1950s Abraham Weinstein PFM crown C R OW N S CEMENTS History of CA S E S ceramics 1998 Ivoclair IPS Empress II 2006 Re-emerging LS2 Cerec® & inLab® 1998 Creamy GmbH & Co Authentic® 1889 Charles H. Land All-porcelain “jacket” crown (PJC) 1980s Leucite-containing Empress® 1 and optimal pressable glass (OPC) Glass-infused alumina core 1950s Corning Glass Works Dicor® crown 1965 W. McLean and TH Hughes New PJC with innercore of aluminous porcelain (40-50%) Helvey G, A history of dental ceramics, Compendium, May 2010, Vol 31, Issue 4 Material science in fixed prosthodontics Classification Components Silicon dioxide - possessing a glassy matrix + varying amounts of a crystalline phase CL- I (powder/liquid) Low-to-moderate (< 50%) leucite-containing feldspathic glass → requiring bonding CL-II-A (glass ceramics) Modertate-to-high (> 50%) crystalline-containing glass or glass ceramics CL-II-B (glass ceramics) CL-III-A (high-strength crystalline) Porous matrix block using CAD/CAM CL-III-B (high-strength crystalline) High-strength 100% crystalline ceramics CL-IV (metal) Highly supportive substrate metal with CL-I layering C R OW N S CEMENTS CA S E S Classifications Products Creation Porcelain, Jensen Dental; Ceramco 3, DENTSPLY; EX-3, Kurary IPS Empress CAD, Ivoclar Vivadent; Authentic, Jenson Dental IPS e.max, Ivoclar Vivadent; Zirconia-reinforced lithium silicates (ZLSs) {VITA Suprinity, VITA Zahnfrabrik; CELTRA Duo, DENTSPLY} Disappearing & replaced by 100% polycrystalline ceramics Alumina-based (Procera, Nobel Biocare); New zirconia-based (LAVA, 3M; Prettau, Zirkonzahn) Captek, Argen USA Inc McLaren EA & Figueira J, Updating classifications of ceramics dental materials: a guide to material selection, Compendium, June 2015 Material science in fixed prosthodontics C R OW N S CEMENTS Feldspathic CA S E S porcelain • Class-I (Powder/liquid) • The very first all-ceramic restoration • Primarily containing silicon dioxide • Made from natural feldspars (i.e. alumni-silicates with potassium, sodium, barium, or calcium) • Possessing glassy matrix + varying amounts of a crystalline phase • Fabricated by hand • High translucency & esthetics • Ideal for significant enamel remains • Requiring thickness = 0.2 - 0.3mm McLaren EA, Cao PT. Ceramics in dentistry–part I: classes of materi- als. Inside Dentistry. 2009;5(9):433-422. Material science in fixed prosthodontics • Most preservative prep design as ceramics (even “prep-less”) C R OW N S CEMENTS Feldspathic CA S E S porcelain “Pros & Cons” • Most esthetic (mimicking natural translucency) • Dependent on the remaining enamels • Systematic bonding protocol is a must • Inappropriate for heavy occlusal contact regions Material science in fixed prosthodontics Photo by Alexander Grey C R OW N S CEMENTS CA S E S Glass ceramics Material science in fixed prosthodontics Crystalline phase C R OW N S CEMENTS CA S E S Glass ceramics Glassy phase Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48. Material science in fixed prosthodontics Crystalline phase C R OW N S CEMENTS CA S E S Glass ceramics Glassy phase • bond strength to resin cements • vitreous phase by crystals • affecting glass-ceramic properties (strength & translucency) Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48. Material science in fixed prosthodontics “Leucite-reinforced” C R OW N S CEMENTS CA S E S Glass ceramics Material science in fixed prosthodontics “Leucite-reinforced” C R OW N S CEMENTS CA S E S Glass ceramics Material science in fixed prosthodontics “Leucite-reinforced” C R OW N S CEMENTS CA S E S Glass ceramics SiO2, Al2O3, and K2O Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48 Ivoclar vivadent. IPS Empress CAD! Scientific documentation. 2011 Material science in fixed prosthodontics “Leucite-reinforced” Crystallization C R OW N S CEMENTS CA S E S Glass ceramics Leucite crystals (KAlSi2O6; 35-45% vol) • Toughening mechanism of crack deflection • Flexural strength 160 MPa SiO2, Al2O3, and K2O Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48 Ivoclar vivadent. IPS Empress CAD! Scientific documentation. 2011 Material science in fixed prosthodontics “Leucite-reinforced” Crystallization C R OW N S CEMENTS CA S E S Glass ceramics Leucite crystals (KAlSi2O6; 35-45% vol) • Toughening mechanism of crack deflection • Flexural strength 160 MPa SiO2, Al2O3, and K2O Leucite-reinforced glass-ceramics • IPS Empress CAD (Ivoclar Vivadent) • Both vitreous + crystal reinforcement • Flexible CAD-CAM blocks available • High & low translucent Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48 Ivoclar vivadent. IPS Empress CAD! Scientific documentation. 2011 Material science in fixed prosthodontics “Lithium-disilicate reinforced” C R OW N S CEMENTS CA S E S Glass ceramics Material science in fixed prosthodontics “Lithium-disilicate reinforced” C R OW N S CEMENTS CA S E S Glass ceramics Lithium disilicate crystals (65% vol) • Significant reinforcement → biaxial flexural strength • Flexural strength 450-550 MPa Ivoclar vivadent. IPS E.max CAD! Scientific documentation. 2005. Material science in fixed prosthodontics “Lithium-disilicate reinforced” C R OW N S CEMENTS CA S E S Glass ceramics Lithium disilicate crystals (65% vol) • Significant reinforcement → biaxial flexural strength • Flexural strength 450-550 MPa Lithium-disilicate reinforced glass-ceramics • IPS e.max CAD (Ivoclar Vivadent) • Both occlusal stress + esthetic demand • Veneers, partial posterior coverage, and anterior/posterior full crowns • Available as CAD-CAM blocks or ingots for pressing • High, medium, or low translucent • High opacity (HO) for copings on discolored preps • Can be layered with porcelain or monolithic Ivoclar vivadent. IPS E.max CAD! Scientific documentation. 2005. Material science in fixed prosthodontics “Zirconia-reinforced lithium silicate” C R OW N S CEMENTS CA S E S Glass ceramics Lithium metasilicates & Lithium orthophosphates Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48 Material science in fixed prosthodontics “Zirconia-reinforced lithium silicate” Crystallization C R OW N S CEMENTS CA S E S Glass ceramics Lithium silicate + zirconium dioxide • Biaxial flexural strength 540 MPa Lithium metasilicates & Lithium orthophosphates Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48 Material science in fixed prosthodontics “Zirconia-reinforced lithium silicate” Crystallization C R OW N S CEMENTS CA S E S Glass ceramics Lithium silicate + zirconium dioxide • Biaxial flexural strength 540 MPa Lithium metasilicates & Lithium orthophosphates Zirconia-reinforced lithium silicate glass-ceramics • Vita Suprinity, Vita Zahnfabrik • For anterior and posterior full crowns, partial coverages, and veneers • Available as CAD-CAM blocks • Translucent and HT versions Seghi RR, Del Rio DL. Biomaterials: ceramic and adhesive technologies. Dent Clin North Am 2019;63:233–48 Material science in fixed prosthodontics • Highly esthetic & natural appearance (metal-free; no allergic reactions) C R OW N S CEMENTS CA S E S Glass ceramics • Biocompatible and durable • Stain resistance & tissue compatibility • Versatility • Adhesive • Strength • Translucency (in case of dark/metal prep) • Abrasiveness (potential wearing) • Thickness (more reduction) Material science in fixed prosthodontics Photo by Aaron Spray C R OW N S CEMENTS CA S E S Polycrystalline ceramics Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Polycrystalline ceramics No glassy phase Only crystalline phase • Previously alumina; currently dominated by zirconia-based • High strength but have low translucency • Limited adhesive bonding ability Material science in fixed prosthodontics “High-strength polycrystalline ceramics” Zirconium dioxide stabilized in tetragonal phase C R OW N S CEMENTS CA S E S Polycrystalline ceramics • Low volume of yttrium (3% mol or 4-6 wt%) • 3Y - tetragonal zirconium polycrystal (3Y - TZP) • Limited vol of cubic phase (<15%) • High flexural strength (900 - 1300 MPa) • Single crowns up to multi-unit restorations • Available as partially sintered blocks for CAD-CAM milling Zhang Y, Lawn BR. Novel zirconia materials in dentistry. J Dent Res 2018;97: 140–7. Material science in fixed prosthodontics “Translucent polycrystalline ceramics” C R OW N S CEMENTS CA S E S Polycrystalline ceramics To improve the translucency of monolithic • Increasing the level of yttrium (4-6 mol %) • Resulting partially stabilized zirconia (PSZ), so called 4Y - PSZ and 5Y - PSZ • Increasing grain size (via raising the sintering temperature) • Flexural strength (400 - 1000 MPa) • Single crowns up to multi-unit restorations • Available in blocks for CAD-CAM milling as both mono - / multi - chromatic (NEW) Zhang Y, Lawn BR. Novel zirconia materials in dentistry. J Dent Res 2018;97: 140–7. Material science in fixed prosthodontics “Translucent polycrystalline ceramics” C R OW N S CEMENTS CA S E S Polycrystalline ceramics Partially stabilized zirconia (PSZ) Krupa Bambal, NYU PGY Prosth ’22 Giacomo Romano MDT CDT Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Polycrystalline ceramics • Strength (suitable for heavy bite forces) • Most active R/D in modern dentistry • Biocompatible • Versatility (flexible options of Tx) • Less tooth reduction • Esthetic limitation • Brittleness Material science in fixed prosthodontics “Polymer-infiltrated ceramic networks (PICN)” C R OW N S CEMENTS CA S E S PICN Material science in fixed prosthodontics “Polymer-infiltrated ceramic networks (PICN)” C R OW N S CEMENTS CA S E S PICN Combining the advantages • Polymeric properties (elastic modulus more compatible with dentin) • Esthetic outcome + chemical stability of ceramics • Flexural strength of 150 MPa • Vita Enamic (Vita Zahnfabrik) Partially sintered ceramic matrix (86 wt %) Polymer matrix (14 wt %) • For anterior & posterior crowns, partial coverage, and veneers • Available as CAD-CAM blocks • Various color-gradients or translucencies Vita zahnfabrik. Vita Enamic! Technical and scientific documentation. 2013 Material science in fixed prosthodontics “Polymer-infiltrated ceramic networks (PICN)” C R OW N S CEMENTS CA S E S PICN • Crack resistance • Light weight • Biocompatible • Limited long-term data • Abrasive • Not as translucent compared to glass ceramics Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Types of cements Temporary Permanent Heboyan A, et al, Dental Luting Cements: An Updated Comprehensive Review, Molecules 2023, 28, 1619. Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Types of cements Oil-based • Zinc-oxide eugenol • Temporary GIC Temporary Oil-free • Zinc-oxide non-eugenol Permanent Heboyan A, et al, Dental Luting Cements: An Updated Comprehensive Review, Molecules 2023, 28, 1619. Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Types of cements Oil-based • Zinc-oxide eugenol • Temporary GIC Temporary Oil-free • Zinc-oxide non-eugenol • Zinc polycarboxylate • Zinc phosphate Water-based Resin-based • Glass-ionomer cement (GIC) • Conventional GIC • Resin-modified GIC Permanent • Self-curing / light-curing / dual-curing • Adhesive / self-adhesive Heboyan A, et al, Dental Luting Cements: An Updated Comprehensive Review, Molecules 2023, 28, 1619. Material science in fixed prosthodontics “TempBond” Z i n c o x i d e p o w d e r • slight antimicrobial C R OW N S CEMENTS CA S E S Zinc-oxide eugenol “Oil-based” Eugenol liquid • main ingredient in clove oil • strong antimicrobial & analgesic properties Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 TE MP OR AR Y Material science in fixed prosthodontics “TempBond” Z i n c o x i d e p o w d e r • slight antimicrobial C R OW N S CEMENTS CA S E S Zinc-oxide eugenol “Oil-based” • Widely used in temporary restorative or filling material • Pros • Biocompatible (no adverse effects) • Antimicrobial • Easy manipulation • Insulation & anti-inflammatory potential • Cons • Lacking long-term durability (thus, temporary use) • Limited machanical strength Eugenol liquid • Staining • main ingredient in clove oil • strong antimicrobial & analgesic properties • Rare allergic reaction to eugenol • Inhibition of resin polymerization • Thus, affecting the resin bonding cementation Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 TE MP OR AR Y Material science in fixed prosthodontics “TempBond NE” Z i n c o x i d e p o w d e r • slight antimicrobial C R OW N S CEMENTS CA S E S Zinc-oxide non-eugenol “Oil- free” Non-eugenol liquids McCabe, J. F., Walls, A. W. G. Applied Dental Materials. Blackwell Publishing, 2008 TE MP OR AR Y Material science in fixed prosthodontics “TempBond NE” Z i n c o x i d e p o w d e r • slight antimicrobial C R OW N S CEMENTS CA S E S Zinc-oxide non-eugenol “Oil- free” • Widely used in temporary restorative or filling material • Pros • Biocompatible (similar to ZOE w eugenol) • Slight antimicrobial (from zinc oxide powder) • Easy manipulation • Cons • Lacking long-term durability (thus, temporary use) Non-eugenol liquids • Limited machanical strength • Staining • Absence of eugenol benefit (i.e. pain relief and anti-inflammatory) McCabe, J. F., Walls, A. W. G. Applied Dental Materials. Blackwell Publishing, 2008 TE MP OR AR Y Material science in fixed prosthodontics “Durelon” Z i n c o x i d e p o w d e r C R OW N S CEMENTS CA S E S Zinc-polycarboxylate “W a t e r - b a s e d” Polyacrylic acid liquid Craig, R. G., Powers, J. M., Wataha, J. C. Dental Materials: Properties and Manipulation. Mosby, 2011 PE RM AN EN T Material science in fixed prosthodontics “Durelon” Z i n c o x i d e p o w d e r C R OW N S CEMENTS CA S E S Zinc-polycarboxylate “W a t e r - b a s e d” • “FIRST CHEMICAL BOND” cement • Pros • Adhesive properties • Biocompatible • Minimal microleakge • Easy manipulation • Cons • Limited mechanical strength Polyacrylic acid liquid • Solubility → degradation in moisture over time • May not be as esthetic Craig, R. G., Powers, J. M., Wataha, J. C. Dental Materials: Properties and Manipulation. Mosby, 2011 PE RM AN EN T Material science in fixed prosthodontics Zinc oxide powder C R OW N S CEMENTS CA S E S Zinc-phosphate “W a t e r - b a s e d” Liquids with phosphoric acid Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics Zinc oxide powder C R OW N S CEMENTS CA S E S Zinc-phosphate “W a t e r - b a s e d” Liquids with phosphoric Zinc phosphate crystals acid Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics Zinc oxide powder C R OW N S CEMENTS CA S E S Zinc-phosphate “W a t e r - b a s e d” • Most commonly used (PAST); replaced with resin cement (CURRENT) • Pros • Adhesive properties • Biocompatible Liquids with phosphoric Zinc phosphate crystals acid • Durability • Clinical track record • Thin film thickness compared to others • Cons • Solubility → degradation in moisture over time • “Cold plate” usage suggested (controlling setting time) • Lack of esthetics • Potential post-op sensitivity Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics “GIC” F l u o r o a l u m i n o s i l i c a t e g l a s s C R OW N S CEMENTS CA S E S Glass-ionomer “W a t e r - b a s e d” Polyacrylic acid liquid Mount, G. J., Hume, W. R. A New Look at Glass-Ionomer Restorations. Quintessence Publishing, 2002 PE RM AN EN T Material science in fixed prosthodontics “GIC” F l u o r o a l u m i n o s i l i c a t e g l a s s C R OW N S CEMENTS CA S E S Glass-ionomer “W a t e r - b a s e d” • Known for its ability to bond & release fluoride • Pros • Chemical adhesion • Flouride releasing • Biocompatibility • Aesthetics (i.e. tooth color shades) • Cons • Limited strength (compared to resin-based) Polyacrylic acid liquid • Sensitivity to moisture • Solubility • Setting time Mount, G. J., Hume, W. R. A New Look at Glass-Ionomer Restorations. Quintessence Publishing, 2002 PE RM AN EN T Material science in fixed prosthodontics “RMGIC” C R OW N S CEMENTS CA S E S Resin-modified glass-ionomer “W a t e r - b a s e d” Glass particles Light curable resin Water-based polyalkenoic acid Mount, G. J., Hume, W. R. A New Look at Glass-Ionomer Restorations. Quintessence Publishing, 2002 PE RM AN EN T Material science in fixed prosthodontics “RMGIC” C R OW N S CEMENTS CA S E S Resin-modified glass-ionomer “Hybrid” Glass particles Light curable resin • Hybrid containing multi-components (GI + resin-based) • Pros • Chemical & mechanical bonding • Flouride releasing • Esthetic • Versatility • Reduced sensitivity to moisture Water-based polyalkenoic acid • Cons • Strength limitation • Setting time • Moisture sensivity • Cost Mount, G. J., Hume, W. R. A New Look at Glass-Ionomer Restorations. Quintessence Publishing, 2002 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Resin-based (self-curing) Fillers Resin matrix Chemical initiator system Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Resin-based (self-curing) Fillers Resin matrix Chemical initiator system Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Resin-based (self-curing) Fillers Resin matrix • Auto-polymerization WITHOUT the need of light exposure • Pros • Controlled polymerization • Versatility • Bond strength • Reduced sensitivity to light Chemical initiator system • Cons • Polymerization shrinkage • Working time • Temperature sensivitiy • Sensitivity to moisture • Potential incomplete polymerization Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Resin-based (light-curing) Fillers Resin matrix Photo-initiator system Craig, R. G., Powers, J. M., Wataha, J. C. Dental Materials: Properties and Manipulation. Mosby, 2011 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Resin-based (light-curing) Fillers Resin matrix • Activating the photo-initiator with specific wavelength of light • Pros • Controlled polymerization • Short working time • Minimal shrinkage • Reduced sensivity to moisture • Esthetic Photo-initiator system • Cons • Equipment dependency • Depth limitation • Shade matching sensitivity • Cost • Tissue heating potential Craig, R. G., Powers, J. M., Wataha, J. C. Dental Materials: Properties and Manipulation. Mosby, 2011 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Resin-based (dual-curing) Fillers Resin matrix Dual-Initiator system Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Resin-based (dual-curing) Fillers Resin matrix • Both photo- & chemical- polymerization • Pros • Versatility • Controlled polymerization • Short working time • Reduced sensitivity to moisture • Esthetics Dual-Initiator system • Cons • Complexity • Equipment dependency • Cost • Tissue heating potential • Shade matching Anusavice, K. J., Shen, C., Rawls, H. R. Phillips’ Science of Dental Materials. Saunders, 2012 PE RM AN EN T Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Full-metal “Heavy occlusal forces, Worn-down dentitions, Eccentric interferences, Lack of inter-occlusal space” Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Full-metal Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Full-metal Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics “FDPs, Shade matching, Verification with copings” Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics “Survey crowns” Sally Kim, NYU DDS ’21 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics “Survey crowns” Sally Kim, NYU DDS ’21 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics “Survey crowns” Sally Kim, NYU DDS ’21 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics Full-metal “Retention & resistance forms = critical!” • Pre-treatment (if needed) • Surface roughening (inner surface of crown) • Adhesive (metal-primer) • Choices of cements • Zinc phosphate • Glass-ionomer • Resin-based Rosenstiel, S. F., Land, M. F., Crispin, B. J. Dental Luting Agents. Contemporary Fixed Prosthodontics. Elsevier, 2015 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Metal-ceramics Full-metal “GC Fuji®” • Pre-treatment (if needed) • Surface roughening (inner surface of crown) • Adhesive (metal-primer) • Choices of cements • Zinc phosphate • Glass-ionomer • Resin-based Rosenstiel, S. F., Land, M. F., Crispin, B. J. Dental Luting Agents. Contemporary Fixed Prosthodontics. Elsevier, 2015 Material science in fixed prosthodontics C R OW N S CEMENTS Feldspathic CA S E S porcelain “Esthetic, Conservative, Minimally invasive” Material science in fixed prosthodontics C R OW N S CEMENTS Feldspathic CA S E S porcelain “Resin-based” Intra-oral restoration try-in Etch with 9.8% HF acid for 2min, rinse and dry Ultrasonic cleaning in alcohol for 5min Silane application for 20s and dry Proper isolation (saliva control is the key!) Pretreat tooth surface Light-cure or dual-cure composite resin luting agent Markus BB, et al, Current protocols for resin-bonded dental ceramics, Dent Clin N Am 66 (2022) 603-625 Material science in fixed prosthodontics “Esthetic, C R OW N S CEMENTS CA S E S Glass ceramics “Leucite-reinforced” Material science in fixed prosthodontics “Esthetic, Conservative, C R OW N S CEMENTS CA S E S Glass ceramics “Leucite-reinforced” Material science in fixed prosthodontics “Esthetic, C R OW N S CEMENTS CA S E S Glass ceramics “Leucite-reinforced” Conservative, Minimally invasive” Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Glass ceramics “Leucite-reinforced” Intra-oral restoration try-in Etch with 9.8% HF acid for 1min, rinse and dry Ultrasonic cleaning in alcohol for 5min “Resin-based” Silane application for 20s and dry Proper isolation (saliva control is the key!) Pretreat tooth surface Light-cure or dual-cure composite resin luting agent Markus BB, et al, Current protocols for resin-bonded dental ceramics, Dent Clin N Am 66 (2022) 603-625 Material science in fixed prosthodontics G l a s s c e r a m i c s “Lithium-disilicate reinforced” C R OW N S CEMENTS CA S E S Savitha Bathini, NYU DDS ’21 Material science in fixed prosthodontics G l a s s c e r a m i c s “Lithium-disilicate reinforced” C R OW N S CEMENTS CA S E S Savitha Bathini, NYU DDS ’21 Material science in fixed prosthodontics G l a s s c e r a m i c s “Lithium-disilicate reinforced” C R OW N S CEMENTS CA S E S Intra-oral restoration try-in Etch with 4.6% HF acid for 20s, rinse and dry Ultrasonic cleaning in alcohol for 5min “Resin-based” Silane application for 20s and dry Proper isolation (saliva control is the key!) Pretreat tooth surface Light-cure or dual-cure composite resin luting agent Markus BB, et al, Current protocols for resin-bonded dental ceramics, Dent Clin N Am 66 (2022) 603-625 Material science in fixed prosthodontics P I C N “Polymer-infiltrated ceramic networks” C R OW N S CEMENTS CA S E S “Resin-based” Intra-oral restoration try-in Etch with 9.8% HF acid for 1min, rinse and dry Ultrasonic cleaning in alcohol for 5min Silane application for 20s and dry Proper isolation (saliva control is the key!) Pretreat tooth surface Light-cure or dual-cure composite resin luting agent Markus BB, et al, Current protocols for resin-bonded dental ceramics, Dent Clin N Am 66 (2022) 603-625 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Polycrystalline ceramics “Monolithic zirconia” Sarah Lee, NYU DDS ’21 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Polycrystalline ceramics “PFZ” Anne Hou NYU DDS ’21 Material science in fixed prosthodontics C R OW N S CEMENTS CA S E S Polycrystalline ceramics “PFZ” Anne Hou NYU DDS ’21 Material science in fixed prosthodontics Intra-oral restoration try-in Ultrasonic cleaning in alcohol for 5min Airborne particle abrasion (APA) with 50um alumina at 2 bar pressure Application of special phosphate monomer-based primer Proper isolation method Pretreat tooth surface Dual-cure or self-cure composite resin luting agent C R OW N S CEMENTS CA S E S Polycrystalline ceramics “Zirconia” Markus BB, et al, Current protocols for resin-bonded dental ceramics, Dent Clin N Am 66 (2022) 603-625 Material science in fixed prosthodontics Q U E S T I O N S “ What do we have in our clinic ? ” C R OW N S Cement CEMENTS CA S E S “RelyX Unicem” Self Adhesive Universal Resin Material science in fixed prosthodontics Q U E S T I O N S “ What do we have in our clinic ? ” C R OW N S CEMENTS CA S E S “RelyX MATERIAL Metal, PFM Glass ceramic Zirconia Unicem” PRE-TREATMENT Sand blast with aluminum oxide <40um Clean with alcohol, rinse, dry Etch with HF acid Rinse 15s, dry with air free of oil Silane treatment Sand blast with aluminum oxide 40um Clean with alcohol and dry EXAMPLES — IPS Empress, Empress 2, Feldspathics, InCeram alumina or zirconia Lava Crowns & Bridges TM Material science in fixed prosthodontics “Why do C R OW N S CEMENTS CA S E S Q U E ST I O N S we sandblast?” • Enhanced bond strength • Removal of contaminants • Uniform surface • Minimizing micro-leakage Van Meerbeek, B., Perdigão, J., Lambrechts, P., et al. The clinical performance of adhesives. The Journal of Dentistry, 1995 Material science in fixed prosthodontics “What if no steam C R OW N S CEMENTS CA S E S Q U E ST I O N S cleaning ?” • Ultrasonic cleaner • Air/water syringe & high vol suction • Cleaning agent • Pumice or prophy paste • Irrigation with water or saline Christensen, G. J. Clinical observations: sandblasting for in-office crown recementation. The Journal of the American Dental Association, 2009, 140(8), 990-991. Material science in fixed prosthodontics “What if no steam C R OW N S “IvoClean” Universal cleaning paste cleans the bonding CEMENTS CA S E S Q U E ST I O N S cleaning ?” surfaces after try-in Thank you Instagram Youtube Linkedin YKK Website [email protected] @ykk_pros YKP r o s t h o d im s tonti