ALL CERAMIC

RESTORATIONS

INTRODUCTION

Beauty is in the eye of beholder

Margaret Hungerford
1878

 Poetry and literature .for centuries indicated contributes to

beauty
Through the ages different cultures/races have had their own
concepts of beauty and estheticsdifference of opinion even
among sexes, man may find ferrari attractive..
Aborgines of Australia..gold and jewels inlays
Indonesian women..lacquered teeth red to indicate
respectability
Todays modern societyclean white teeth

Therefore one should expect all shades of appreciation

and recognition abilities from the patient and
reviewing public.

Esthetics is neither completely science nor completely art .

Who is an artist ? An artist is one who creates beautiful things
simply by interpretative recordings of his emotions and feelings.
Such a person does not necessarily know , just how he creates his
work of art,for he pocesses an inborn talent.
one not so blessed with instinct and feelings must rely upon the
science of esthetics and clinical practice to develop the skills.
WHY ALL CERAMIC ?

Definition of Ceramics
Compounds of one or more metals
with a non-metallic element, usually
oxygen, they are formed of
chemically and biochemically stable
substances that are strong, hard,
brittle and inherent non conductors
of thermal and electrical energy

HISTORICAL PERSPECTIVE

In 700 B.C., the Etruscans made ivory teeth and bone teeth .
Even Dentures were made in Ivory(a hard,smooth white substance
composed of dentin elephant tusk ..
Porcelain was obtained in China by fluxing white china clay with chine
stone to produce a white translucent stone ware in about 1000 A.D

In 1774 Alexis Du Chateau, a French chemist became dissatisfied with the

odor, taste, and discoloration of his hippopotamus ivory denture..
With the assistance of de Chemant, a Parisian dentist, he made the first
successful porcelain dentures.

Picture shows partial denture of about

1830,porcelain teeth of fonzis design
have been
Soldered to a gold backing

One piece porcelain

upper denture crafted
by Dr John
Scarborough,Lambertvi
lle, New Jersey 1868.

In 1962 Weinstein and Weinstein patented a leucite( white material

consisiting of potassium aluminium silicate ) containing
porcelain frit ( a glassy fused substance ) for use in metal-ceramic
restorations.
The first commercial porcelain was developed in 1965 by Vita Zahnfabrik.
A significant improvement in fracture resistance was reported by Mc Lean
and Hughes High in 1965 with the introduction of aluminous core porcelain

Indications
Inlays, Onlays, Laminate veneer, Crowns and bridges

Advantages
1234-

Superior esthetics
High tensile strength
Bio-compatible
Cut sepsis chain between Lab. And clinic (in case of
CAD-CAM system)
Contraindications
1- Long span bridge (in most types)
2- Cases of increased occlusal load
3- When esthetic demands are not essential

Disadvantages
1- Low strength properties as compared to PFM
2- Color of luting cement affect the shade

CLASSIFICATION

1.ACCORDING TO FIRING
TEMPERATURE:

High fusing
Medium fusing
Low fusing
Ultra low fusing

: 1300 degree centigrade

: 1101-1300 degree centigrade
: 850-1100 degree centigrade
:< 850 degree centigrade

2.ACCORDING TO USE:
Anterior
Posterior
Crowns
Veneers
Post and cores
FPD

3.ACCORDING TO COMPOSITION:
Pure alumina
Pure Zirconia
Silica glass
Leucite( white mineral containing potassium
aluminium silicate ) based glass ceramic
Lithia( litium oxide ) based glass ceramic

FELDSPAR
SILICA
KAOLIN
QUARTZ
ALUMINA
FLUXES:
COLORING AGENTS
OPACIFYING AGENT
FLUORESCENCE

STRUCTURE

Dental
porcelains
contain a
crystal phase
and glass
phase based
on the silica
structure. This
structure is
characterized
by the Si-O
tetrahedron in
which a Si 4+
cation is
positioned at
the center of a
tetrahedron
with O- anions
at each four

Classification of all ceramic

1. Conventional powder slurry ceramics
systems
- Optec HSP Leucite reinforced porcelain
- Duceram LFC Hydrothermal low fusing ceramic
- Hi Ceram alumina reinforced porcelain
2. Non-cored systems based sintering of dental ceramics
- Meriage
- Fortess
3. Computer aided design / Computer aided milling
(CAD\CAM)
- Cerec
4. CAD\CAM with Aluminum oxide coping
- Procera
5. Castable ceramics
- Dicor

Classification of all ceramic

systems
6. Infiltrated ceramics
- Inceram
7. Pressable ceramics
- IPS impress
- Optec Pressable ceramics
8. Machineable
9. New shrink free ceramics
10.Hybrid ceramics
11. Ormocers

Classification of all ceramic

systems
According
to composition
A. Leucite reinforced
glass-ceramics(OPTEC
HSP/OPTIMAL OPC, IPS EMPRESS)
B. Cast glass-ceramics (DICOR, DICOR MGC)
C. High alumina ceramics (INCERAM, INCERAM SPINELL)
D. CAD-CAM (PROCERA, CEREC)
E. Precision copy milling (CELAY)
F. Low (temperature) fusing ceramics (FINESSE,
DUCERAM)

All Ceramic Systems

Conventional powder slurry ceramics
Optec HSP :
Developed by Jeneric Inc / USA

Optec ceramic is a feldspathic composition glass filled with

crystalline leucite (potassium aluminum silicate )

This ceramic has high level of leucite hence got a greater

strength than traditional feldspathic porcelain: Leucite is
dispersed in a glassy matrix.

Uses
Inlays
Onlays
Crowns for low stress areas
Veneers
Advantages
More translucent than alumina core crowns
Good flexural strength 146 mpa.
Does not require special processing equipment.
Lack of metal or opaque sub-structure
Can be etched to allow optimum bonding to Enamel or
Dentine
Restorations fit accurately
Disadvantages
Increased wear of opposing teeth
Potential marginal inaccuracy caused
sintering shrinkage
Potential to fracture in posterior teeth
Require special die material

by porcelain

 Alumina reinforced ceramic crownsHi Ceram

Core
material
Body Porcelain

Incisal Porcela

Duceram LFC
Hydrothermal low fusing ceramic
It is composed of an amorphous glass containing hydroxyl ions.
These hydroxyl ions allow a greater flexural strength due to ion exchange
mechanism,and also promote healing of surface micro cracks.
The restoration made in two layers the base layer is Duceram metal ceramic (a
leucite containing porcelain)wich is placed on refractory die using powder
slurry technique and backed at 930 deg.C.
Second layer is applied over basal layer using same tech. and baked at 660 deg.
C.

Castable Ceramics-Dicor

This product is supplied as solid ceramic ingots.

This is a poly-crystalline glass ceramic material,which is casted in a similar

manner to alloy castings.

Once the glass crown is cast(at about 1350 deg. C) it is then heat treated at
1075 deg. C for 10 hrs.this heat treatment is known as Ceramming

This causes partial crystallisation of tetrasilicic mica crystals to produce a glass

ceramic material.

These crystals function in two ways

A) creating a relatively opaque material out of the initially transparent
glass crown
B) they significantly increase the fracture resistance and strength of the
ceramic

 Infilterated Ceramics-Inceram

High-strength core frameworks for all-ceramic restorations

can be produced with a slip-casting procedure such as the
In-Ceram.
An aqueous suspension of fine alumina particles in
water
The slip is applied onto a porous refractory die..
The piece is then fired at high temperature (1150 C).
The refractory die shrinks more than the condensed slip,
which allows easy separation after firing.
The fired porous core is later
glass-infiltrated, a unique process
in which molten glass is drawn into
the pores by capillary action at
high temperature

Pressable Ceramics

The ceramic is available in the form of ingots( bar or block )

and is primarily a Precerammed glass reinforced with
Leucite that prevents crack propagation without
significantly diminishing its translucency

IPS Empress
IPS Empress Esthetic ingots are available in 12 shades and 7
levels of translucency to fulfil even the most discerning.

Leucite based. Hot-pressed ceramics restorations are

waxed, invested, and pressed in a manner somewhat
similar to gold casting

IPS Empress
Investment Ring

IPS Silicone
Investment ring

Ceramic ingots are pressed at high temperature

(from 900 C to 1165 C depending on the material) into a
refractory mold made by the lost-wax technique.
- The ceramic ingots are available in different shades.
- Two finishing techniques can be used:
1- A characterization technique (surface stain only)
2- A layering technique, involving the application of a
veneering porcelain

Advantages
1- Lack of metal
2- Translucency of ceramic core
3- Moderately high flexure strength
4- Excellent fit & esthetic
Disadvantages
1- Fracture in posterior region
2- Need cementation by resin cement

Empress-2
This system consist of 2 components
1.

First component is a compressed core material of lithium

di silicate glass ceramic & lithium orthophosphate
crystals with a flexural strength of 350 mpa .

The scope of use of empress 2 for small bridges

&posterior teeth has widened compared to empress- 1
due to its increased flexural strength .

2. The second component is a new layer / laminated

material comprised of a fluoraptite glass crystals .

CAD/CAM
Procera
Cerec
CAD/CAM system
Computer aided design/Computer aided machining
are used for designing and milling of all restorations.
Advantages
1- Negligible porosity level
2- Freedom of making impression procedures
3- Time saving
4- Single Pt. appointment
5- Good Pt. acceptance
Disadvantages
1- Need costly equipments
2- Technique sensitive

 Celay System
- The Celay system uses a copy milling technique to

manufacture ceramic inlays or onlays.

- A resin pattern is fabricated directly on the prepared tooth
or on a master die, then the pattern is used to mill a
porcelain restoration.
- As with the Cerec system, the starting material is a
ceramic blank available in different shades. This material is
similar to Vita Mark II ceramic, used with the Cerec 2
system.
- Alternatively, blanks of the In Ceram Alumina or In Ceram
Spinell materials can be used
- Marginal accuracy seems to be good, a little better than
the Cerec 2 system