Zirconia all ceramic restorations/ dentistry course in india

ZIRCONIA BASED ALLZIRCONIA BASED ALL
CERAMICCERAMIC
RESTORATIONSRESTORATIONS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com

Spectacular smile,a ziphyr….that canSpectacular smile,a ziphyr….that can
beat the oschen and acher in thebeat the oschen and acher in the
western sky!!!western sky!!!

ZirconiumZirconium
 Derived from the Arabic word “Zargon”, whichDerived from the Arabic word “Zargon”, which
means golden in colour.means golden in colour.
 Discovered in 1789 by German chemist MartinDiscovered in 1789 by German chemist Martin
Heinrich Klaproth.Heinrich Klaproth.
 Late sixties evolved as a ceramic biomaterial forLate sixties evolved as a ceramic biomaterial for
use in orthopedics.use in orthopedics.
 In 1990s, it’s use began as endodontic posts andIn 1990s, it’s use began as endodontic posts and
as implant abutments.as implant abutments.

Structural propertiesStructural properties
 Tetragonal polycrystalline partiallyTetragonal polycrystalline partially
stabilized with Yttriumstabilized with Yttrium
 Zirconium oxide – 94.9%Zirconium oxide – 94.9%
Yttrium oxide - 5.1%Yttrium oxide - 5.1%
 Critical grain size < 0.8 micronsCritical grain size < 0.8 microns

 Occurs inOccurs in three crystallographicthree crystallographic forms.forms.
 MonoclinicMonoclinic at room temperature and stable tillat room temperature and stable till
1170 degree celcius.1170 degree celcius.
 Tetragonal phase- from 1170 degree celcius toTetragonal phase- from 1170 degree celcius to
<2370 degree celcius.<2370 degree celcius.
 Cubic phase at 2370 degree ceicius till it’sCubic phase at 2370 degree ceicius till it’s
melting point of 2680 degree celcius.melting point of 2680 degree celcius.
 During cooling, T-M transformation takes place.During cooling, T-M transformation takes place.

MONOCLINIC
TERAGONALTETRAGONAL
CUBIC
>1170
>2370
<1070
coo www.indiandentalacademy.comwww.indiandentalacademy.com

 An associated volumetric expansion ( 3%-5% ) takesAn associated volumetric expansion ( 3%-5% ) takes
place. Non stabilized pure zirconium oxide would burstplace. Non stabilized pure zirconium oxide would burst
due to the volume increase in the grains and tensiondue to the volume increase in the grains and tension
within.within.
 Addition of stabilizing oxides- Partially stabilized zirconiaAddition of stabilizing oxides- Partially stabilized zirconia
(PSZ)(PSZ)
 Improved mechanical and physical properties.Improved mechanical and physical properties.
 When tensile stresses act on the crack tip in PSZ,When tensile stresses act on the crack tip in PSZ,
transformation of T phase to M phase occurs.transformation of T phase to M phase occurs.
 Local increase of 3-5% in volume- TransformationLocal increase of 3-5% in volume- Transformation
tougheningtoughening

Typical CharacteristicsTypical Characteristics ::
- High temperature bearing capability- High temperature bearing capability
- High density(>6g/cubic cm)- High density(>6g/cubic cm)
- High strength and fracture toughness- High strength and fracture toughness
Compressive strength 2000MPaCompressive strength 2000MPa
Flexural strength 900-1200 MPaFlexural strength 900-1200 MPa

High hardness and wear resistanceHigh hardness and wear resistance
Low thermal conductivity(2Wm/K)Low thermal conductivity(2Wm/K)
Good chemical corrosion resistanceGood chemical corrosion resistance

Design and ManufactureDesign and Manufacture

Scanning the preparationScanning the preparation

Milling of Zr blocksMilling of Zr blocks

CAD / CAM SystemCAD / CAM System

FabricationFabrication

Material Selection Criteria :Material Selection Criteria :
(1) Esthetics(1) Esthetics
(2) Occlusal scheme(2) Occlusal scheme
Intra-articular TMJ signs or symptoms,Intra-articular TMJ signs or symptoms,
occlusal muscle disorders,occlusal muscle disorders,
masticatory muscle fatigue,masticatory muscle fatigue,
tooth wear,tooth wear,
tooth migration.tooth migration.

(3) Quantity of remaining enamel(3) Quantity of remaining enamel
(4) Quantity or quality of remaining dentin(4) Quantity or quality of remaining dentin
(5) Conservation of tooth structure(5) Conservation of tooth structure

Typical ApplicationsTypical Applications
- Space shuttles- Space shuttles
- Automobiles- Automobiles
- Cutting blades- Cutting blades
- Cumbustion engines- Cumbustion engines
 Research has proven that the highResearch has proven that the high
strength zirconia ceramic has thestrength zirconia ceramic has the
potential to give prosthetic care inpotential to give prosthetic care in
dentistry.dentistry.

Advantages :Advantages :
(1) Superior esthetics(1) Superior esthetics
-dental zirconia ensures natural gloss and-dental zirconia ensures natural gloss and
translucencytranslucency
-dark and discolored margins eliminated-dark and discolored margins eliminated
(2) High strength(2) High strength
-fracture resistance-fracture resistance
-crack resistance-crack resistance
-flexural strength (~900MPa )-flexural strength (~900MPa )
(3) Biocompatible(3) Biocompatible
- no allergic response till date.- no allergic response till date.

(4) Optimal fit(4) Optimal fit
- eliminates conventional laboratory- eliminates conventional laboratory
proceduresprocedures
- provides ample opportunity for- provides ample opportunity for
aesthetic layering with the overlayaesthetic layering with the overlay
porcelain.porcelain.
(5) Easy preparation and cementation(5) Easy preparation and cementation
- conservative tooth preparation- conservative tooth preparation
- conventional / resin based cements- conventional / resin based cements
(6) Excellent insulating behaviour.(6) Excellent insulating behaviour.

Disadvantages :Disadvantages :
(1) Expensive(1) Expensive
-CAD/CAM supported cutting technique-CAD/CAM supported cutting technique
(2) Difficult to re-intervene(2) Difficult to re-intervene
-zirconia posts are difficult to remove from-zirconia posts are difficult to remove from
root canalroot canal
(3) Bond between veneer ceramic and zirconia(3) Bond between veneer ceramic and zirconia
framework is the weakest component in theframework is the weakest component in the
layered structure.layered structure.
(4) Nonavailability of longitudinal study.(4) Nonavailability of longitudinal study.

Indications :Indications :
 Anterior and posterior all ceramic crownsAnterior and posterior all ceramic crowns
and bridges requiring high strengthand bridges requiring high strength
 Post and core (Endodontics)Post and core (Endodontics)
 Implant abutmentsImplant abutments
 Orthodontic bracketsOrthodontic brackets

Contraindications :Contraindications :
 Reduced inter-occlusal distanceReduced inter-occlusal distance
 Deep vertical overlapDeep vertical overlap
 Opposing supra-erupted teethOpposing supra-erupted teeth
 Parafunctional habitsParafunctional habits
 Very short clinical crownVery short clinical crown

Clinical Guidelines:Clinical Guidelines:
 Patient selectionPatient selection
 Detailed intraoral examinationDetailed intraoral examination
 Minimal clinical height of prospectiveMinimal clinical height of prospective
abutment- 4mmabutment- 4mm
 Total surface area of the connector – 7 toTotal surface area of the connector – 7 to
16 mm16 mm

Preparation Guidelines :Preparation Guidelines :
 Local anesthesiaLocal anesthesia
 Depth guidesDepth guides
 Axial reduction 1.2-1.5mmAxial reduction 1.2-1.5mm
 Occlusal reductiuon 1.5-2.0mmOcclusal reductiuon 1.5-2.0mm
 Axial taper 5-6 degreesAxial taper 5-6 degrees
 Optimal preparation is a shoulder(0.8-1.0mm) orOptimal preparation is a shoulder(0.8-1.0mm) or
chamfer which must be applied at an angle of 5chamfer which must be applied at an angle of 5
degrees.degrees.
 The inside angle of the shoulder preparationThe inside angle of the shoulder preparation
must be given a rounded contour.must be given a rounded contour.
 Distinct gingival finish lineDistinct gingival finish line

 Double cord techniqueDouble cord technique
 Suitable hemostatic agentSuitable hemostatic agent
 Clean with water sprayClean with water spray
 Impression making- use addition siliconeImpression making- use addition silicone
 Double mix techniqueDouble mix technique

Impression makingImpression making

 Shade selectionShade selection

Cementation Guidelines :Cementation Guidelines :
- Internal surface of the restoration must- Internal surface of the restoration must
be roughbe rough
- Clean tooth surface of all residual- Clean tooth surface of all residual
temporary cement.temporary cement.
- Conventional or resin based cements can- Conventional or resin based cements can
be used.be used.

 Rehabilitation………Rehabilitation………
bringing back to life!bringing back to life!

ConclusionConclusion::
Knowledge of the properties of theKnowledge of the properties of the
restorative material is a prerequisite torestorative material is a prerequisite to
provide high standard restorations that willprovide high standard restorations that will
ultimately be appreciated by the patients.ultimately be appreciated by the patients.
A combination of superior physicalA combination of superior physical
properties, biocompatibility and excellentproperties, biocompatibility and excellent
esthetics make TZP popular among theesthetics make TZP popular among the
contemporary all ceramic materials.contemporary all ceramic materials.

References:References:
Anusavice:Anusavice: Phillip’s Science of Dental Materials; Eleventh edition.Phillip’s Science of Dental Materials; Eleventh edition.
Shillingburg: Fundamentals of Fixed Prosthoidontics; Third editionShillingburg: Fundamentals of Fixed Prosthoidontics; Third edition
Fracture resistance and reliability of new zirconia posts:Fracture resistance and reliability of new zirconia posts: J of ProsthetJ of Prosthet DentDent 2004;91;342-2004;91;342-
348348
In -vitro fracture resistance of posterior metal crown and all ceramic inlay retained resinIn -vitro fracture resistance of posterior metal crown and all ceramic inlay retained resin
bonded fixed partial denture:bonded fixed partial denture: J of ProsthetJ of Prosthet DentDent2004;92;365-3702004;92;365-370
Esthetic enhancement of ceramic crown with zirconia dowels and cores:Esthetic enhancement of ceramic crown with zirconia dowels and cores: J of ProsthetJ of Prosthet
DentDent 2004;92;116-1192004;92;116-119
Selective infiltration etching technique for a strong and durable bond of resin cements toSelective infiltration etching technique for a strong and durable bond of resin cements to
zirconia based materials:zirconia based materials: J of Prosthet DentJ of Prosthet Dent 2007:98;379-3882007:98;379-388
A new oxide based high strength all ceramic material:A new oxide based high strength all ceramic material: The Journal OfThe Journal Of IndianIndian
Prosthodontic SocietyProsthodontic Society; Oct 2007;Vol 7; Issue 4;175-78; Oct 2007;Vol 7; Issue 4;175-78

Zirconia all ceramic restorations/ dentistry course in india

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