CS2-19. Hybrid Ceramics - Assoc. Prof. Dr. Özay Önöral.pdf

1 Assoc. Prof. Dr. Özay ÖNÖRAL COURSE ID Code of Committee: CS-2 Name of Committee: Fixed Prosthetic Restorations Lecturer: Assoc. Prof. Dr. Özay Önöral Topic of the Course: Hybrid (Resin-Matrix) Ceramics Duration of the Course: 50 minutes After completion of this course, the student will...

1 Assoc. Prof. Dr. Özay ÖNÖRAL COURSE ID Code of Committee: CS-2 Name of Committee: Fixed Prosthetic Restorations Lecturer: Assoc. Prof. Dr. Özay Önöral Topic of the Course: Hybrid (Resin-Matrix) Ceramics Duration of the Course: 50 minutes After completion of this course, the student will be able to: Define the chemical structure of resin-matrix ceramics Express their advantageous and disadvantageous characteristics Classify resin-matrix ceramics commercially Optically and mechanically compare resin-matrix ceramics (existing commercial samples) Select case-specific resin-matrix ceramics and justify their choice. Contemporary Fixed Prosthodontics, 6th Edition. Book by Junhei Fujimoto, Martin F. Land, and Stephen F. Rosenstiel. Published by Elsevier in 2022. Anusavice KJ, Shen C, Rawls HR (2013). Phillips’ Science of Dental Materials. (12th ed.). St. Louis: Elsevier Mosby. Learning Objectives of the Course: Suggested References to Review: Near East University, Faculty of Dentistry 2 Assoc. Prof. Dr. Özay ÖNÖRAL HYBRID CERAMICS 1 Introduction to Hybrid Ceramic Chemistry and Advantageous Properties Dental ceramics and composite resins form two main groups of aesthetic restorative materials. Ceramic materials provide superiority to composite resins in terms of aesthetics, biocompatibility, durability, mechanical properties, and resistance to discoloration. Ceramics do not absorb the incoming load due to their high bending strength and elastic modulus and tend to be less flexible and more fragile. On the other hand, composite resins show less abrasive properties in antagonist enamel tissue than ceramics. In addition, composite resins are easy to finish, polish and repair. Milling of composite resin blocks with the CAD-CAM device takes less time compared to ceramic blocks and causes less wear (abrasion) on the burs used. Therefore, new CAD-CAM restoration materials have been developed to combine the advantageous properties of dental ceramics and composite resins. These materials are named by researchers as resin-matrix ceramic, hybrid ceramic, or resin ceramic hybrid materials. Advantageous properties are: • • • • • Can be applied to the patient in a single session. Less preparation in dental tissue Less abrasive to antagonist tooth tissue It is faster to milling and does not require baking (heat treatment) after manufacturing. Polishing the restoration surface with rubber burs and/or polish pastes is easy and it can maintain its gloss in the oral environment for a long period • Restoration surface can be easily modified intraorally or extraorally and repaired easily, when necessary, by using light-cured composite resins. • Due to its elastic module being very close to dentin, it shows better flexural and fracture strength. • Compared to ceramics, it is more resistant to cracking and flaw in marginal edges during milling. Near East University, Faculty of Dentistry 3 Assoc. Prof. Dr. Özay ÖNÖRAL Available Commercial Examples 1. Lava Ultimate During the fabrication of blocks, silane molecule is added to the structure to provide a chemical connection between nanoparticles and the resin matrix. UDMA, the main component of the matrix structure, polymerizes with high temperature (HT). During the production of the nanoceramic block, it does not require additional heat treatment since it is fully sintered. Full crown indication of the material was removed by the manufacturer in 2015 due to the high rate of decementation. High translucency is preferred only if enamel tissue is to be replaced and there is no discoloration in the tooth that will require masking. Low translucency is preferred for masking the color if the preparation contains the dentine and if there is coloration in the related tooth. It is stated that the restoration should be adhered with adhesive resin cement. It is recommended not to etch the inner surface (intaglio) of the restoration with hydrofluoric acid (HF) or phosphoric acid. Adhesive containing silane primer is applied to the restoration surface. 2. GC Cerasmart On the restoration surface, surface characteristics and polishing can be done with the nano-filled glaze and painting kit (OPTIGLAZE) of the manufacturer company (GC Corporation). It is stated that the restoration should be adhered with adhesive resin cement. The restoration surface is cleaned and dried and a primer containing silane is applied. As a surface treatment, air-borne particle abrasion with aluminum oxide (Al2O3) particles and hydrofluoric acid etching are recommended. Near East University, Faculty of Dentistry 4 Assoc. Prof. Dr. Özay ÖNÖRAL 3. Shofu Block HT In order to provide aesthetics better in the anterior region and in order to imitate chromatic opaque dentin tissue and translucent enamel layer; a polychromatic block form with two different color layers was developed. It is stated that the surface can also be roughened with a diamond bur. It is stated that HF acid is not required for surface roughening. It is stated that the restoration should be adhered with adhesive resin cement. The restoration surface is cleaned and dried and a primer containing silane is applied. As a surface treatment, air-borne particle abrasion with aluminum oxide (Al2O3) particles is recommended. 4. Grandio Block It is recommended not to make surface roughening with hydrofluoric acid (HF) or phosphoric acid. It is stated that the restoration should be adhered with adhesive resin cement. The restoration surface is cleaned and dried and a bond containing silane is applied. As a surface treatment, air-borne particle abrasion with aluminum oxide (Al2O3) particles is recommended. 5. Brilliant Crios HF acid should not be used to roughen the restoration surface. It is stated that the restoration should be adhered with adhesive resin cement. After the restoration surface is cleaned and dried, the adhesive containing Near East University, Faculty of Dentistry 5 Assoc. Prof. Dr. Özay ÖNÖRAL resin primer is applied. It is stated that no other bonding agent or silane should be used. As a surface treatment, airborne particle abrasion with aluminum oxide (Al2O3) particles is recommended. 6. Katana Avencia It is stated that the restoration should be adhered with adhesive resin cement. Adhesive containing silane is applied to the surface. As a surface treatment, air-borne particle abrasion with aluminum oxide (Al2O3) particles is recommended. 7. Ambarino High Class It is stated that the restoration should be adhered with adhesive resin cement. Adhesive containing silane is applied to the surface. As a surface treatment, air-borne particle abrasion with aluminum oxide (Al2O3) particles is recommended. Near East University, Faculty of Dentistry 6 Assoc. Prof. Dr. Özay ÖNÖRAL 8. Vita Enamic Polymer infiltrated ceramic materials (PICN): Also called double-networked materials, ceramic-based interpenetrated phase materials or interpenetrated-phase ceramic-resin composites. PICN is produced by high temperature (HT) and pressure (HP) polymerization. PICN obtained as a result of monomer infiltration into a presinterized glass ceramic network differs considerably from other resin matrix ceramic materials with diffuse filler. Thanks to this process, the mechanical properties of the material are improved by obtaining a higher volume of filler content. The ceramic network structure creates a three-dimensional framework of the interconnected (as opposed to dispersal) particles, helping it more effectively dissipate incoming stresses in all directions and gain resistance to fracture. The microstructure of PICN provides the material with a modulus of elasticity ranging between those of enamel and dentin. Due to the ceramic network structure of the material, its surface can be roughened with hydrofluoric acid for adhesive cementation and silane application can be done. In addition, the polychromatic block, which has six different fine color gradients from cervical to incisal, has been developed. Near East University, Faculty of Dentistry