Metal free ceramics / dental ceramic lab courses

EVALUATION OF CERAMICS FOREVALUATION OF CERAMICS FOR
ALL CERAMIC RESTORATIONSALL CERAMIC RESTORATIONS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com

The purpose of the present paper is to
Review Advances in New Materials and
Techniques available for making all-
ceramic dental restorations.

One of the most serious drawbacks with theOne of the most serious drawbacks with the
earlier described porcelains wasearlier described porcelains was their lack oftheir lack of
strength and toughnessstrength and toughness which seriouslywhich seriously
limited their uselimited their use
To overcome this theTo overcome this the developmentsdevelopments areare
1.1. Provide dental porcelain with support from aProvide dental porcelain with support from a
stronger substructurestronger substructure
2.2. Ceramics which are stronger and tougherCeramics which are stronger and tougher

REINFORCED CERAMIC COREREINFORCED CERAMIC CORE
SYSTEMSSYSTEMS
RESIN BONDED CERAMICSRESIN BONDED CERAMICS

REINFORCED CERAMIC COREREINFORCED CERAMIC CORE
SYSTEMSSYSTEMS
CORE CERAMICCORE CERAMIC
““Opaque dental ceramic material thatOpaque dental ceramic material that
provides sufficient strength ,provides sufficient strength ,
toughness and stiffness to supporttoughness and stiffness to support
overlying layers of veneeringoverlying layers of veneering
ceramics”ceramics”
- Philips’- Philips’

RESIN BONDEDRESIN BONDED
CERAMICSCERAMICS
Support Of Ceramic Is Provided BySupport Of Ceramic Is Provided By
Tooth Structure Itself By TheTooth Structure Itself By The
Bonding The Esthetic CeramicsBonding The Esthetic Ceramics
Directly To The Enamel AndDirectly To The Enamel And
Dentine.Dentine.

Based on high density core material from VITA In-Based on high density core material from VITA In-
Ceram Alumina.Ceram Alumina.
WOL-CERAMWOL-CERAM EPC-CAMEPC-CAM
(Electro-Phoretic Ceramic Deposition Technology(Electro-Phoretic Ceramic Deposition Technology
&&
Computer Aided Manufacturing)Computer Aided Manufacturing)
WOL – CERAMWOL – CERAM

Electronically Deposited Alumina Oxide coping
gives the highest marginal integrity.

Ensures a Perfect Fit for ANY Preparation Designs
Featheredge Chamfer Shoulder

Electrically Conductive Wax Prior to
Dippingwww.indiandentalacademy.comwww.indiandentalacademy.com

AdvantagesAdvantages
Clinical ease ofClinical ease of
preparationpreparation
Precise fit systemPrecise fit system
Natural lookingNatural looking
estheticsesthetics
Good strengthGood strength
IndicationsIndications
Full coverage crownsFull coverage crowns
BridgesBridges

Most Translucent
Glass infiltrated
Magnesium Aluminum Oxide core for
Improved Translucency
avoiding the typical yellow opacity of the
In-Ceram
INCERAM SPINEL
(Vident)

Reduced flexural strengthReduced flexural strength - 350 mpa- 350 mpa
(compared to Inceram Alumina 400-(compared to Inceram Alumina 400-
500mpa)500mpa)
InlaysInlays
OnlaysOnlays
Anterior CrownsAnterior Crowns
VeneersVeneers

INCERAM ZIRCONIAINCERAM ZIRCONIA
Glass-infiltrated Alumina withGlass-infiltrated Alumina with 35% partially stabilized35% partially stabilized
Zirconia coreZirconia core
Good Marginal FitGood Marginal Fit
High strength of 700 MpaHigh strength of 700 Mpa
Fracture toughness- 6-8 Mpa.mFracture toughness- 6-8 Mpa.m1/21/2
High level of opacity - not recommended forHigh level of opacity - not recommended for
Anterior ProsthesisAnterior Prosthesis
Posterior Crowns and FPDs, Post & Core, ImplantsPosterior Crowns and FPDs, Post & Core, Implants
Strongest And Toughest Of Available CeramicsStrongest And Toughest Of Available Ceramicswww.indiandentalacademy.comwww.indiandentalacademy.com

Procera Allceram – Alumina basedProcera Allceram – Alumina based
( Nobel Biocare)( Nobel Biocare)
99.9 % Aluminum Oxide99.9 % Aluminum Oxide
Densely sintered, high purity alumina core onDensely sintered, high purity alumina core on
which low fusing porcelain is builtwhich low fusing porcelain is built
Local dental lab scan the dies and the informationLocal dental lab scan the dies and the information
is sent to centres via internet enabled oversizedis sent to centres via internet enabled oversized
dies to be madedies to be made..www.indiandentalacademy.comwww.indiandentalacademy.com

Small defects caused by machining are eliminatedSmall defects caused by machining are eliminated
during sintering.during sintering.
0.4 mm cores are used for esthetically critical0.4 mm cores are used for esthetically critical
crowns on anterior teeth and first premolarscrowns on anterior teeth and first premolars..
Flexural strength is 487-699 MPaFlexural strength is 487-699 MPa
Fracture toughness- 4.48 – 6 MPa.mFracture toughness- 4.48 – 6 MPa.m1/21/2

Strength isStrength is twicetwice that of In-Ceram andthat of In-Ceram and
fivefive times that of Empresstimes that of Empress
Anterior & Posterior CrownsAnterior & Posterior Crowns
VeneersVeneers
OnlaysOnlays
Inlays.Inlays.

PROCERA-ZIRCONIA BASEDPROCERA-ZIRCONIA BASED
Flexural strengthFlexural strength TWICETWICE that of Aluminathat of Alumina
basedbased
CAD-CAMCAD-CAM
Ideal in areas of maximum strengthIdeal in areas of maximum strength
SINGLE UNITS ONLYSINGLE UNITS ONLY

YTTRIUM TETRAGONAL ZIRCONIAYTTRIUM TETRAGONAL ZIRCONIA
POLYCRYSTALS (Y-TZP) BASEDPOLYCRYSTALS (Y-TZP) BASED
MOST RECENTMOST RECENT
Excellent Mechanical Properties andExcellent Mechanical Properties and
BiocompatibilityBiocompatibility
Early 1990sEarly 1990s -- Endodontic’ Dowels andEndodontic’ Dowels and
Implant AbutmentsImplant Abutments..

Yttrium oxide is a stabilizing oxide added toYttrium oxide is a stabilizing oxide added to
pure zirconia to stabilize it at roompure zirconia to stabilize it at room
temperature and to generate a multiphasetemperature and to generate a multiphase
material known asmaterial known as
Partially Stabilized ZirconiaPartially Stabilized Zirconia
which gives it itswhich gives it its
High Initial Strength and Fracture ToughnessHigh Initial Strength and Fracture Toughness

Y-TZP cores are Glass Free
Do not exhibit
SUB CRITICAL CRACK PROPAGATIONSUB CRITICAL CRACK PROPAGATION.
Flexural strength ofFlexural strength of 900 to 1200 MPa900 to 1200 MPa
DoubleDouble of Alumina-based Materialsof Alumina-based Materials
3 Times3 Times Lithium DiSilicate–based MaterialsLithium DiSilicate–based Materials

ZIRCONIUM-OXIDE CERAMICSZIRCONIUM-OXIDE CERAMICS
indicated forindicated for
ENDODONTIC POSTS (Cera Post)ENDODONTIC POSTS (Cera Post)
IMPLANT ABUTMENTS (Ceradapt)IMPLANT ABUTMENTS (Ceradapt)
FULL-COVERAGE CROWNSFULL-COVERAGE CROWNS
FIXED PARTIAL DENTURESFIXED PARTIAL DENTURES

CER ADAPTCER ADAPT
((Wohlwend innovative).Wohlwend innovative).
ALUMINIUM OXIDE & YTRRIUMALUMINIUM OXIDE & YTRRIUM
STABILIZED ZIRCONIUMSTABILIZED ZIRCONIUM
OXIDEOXIDE
High Flexural StrengthHigh Flexural Strength
BiocompatibleBiocompatible
Low Corrosion Potential.Low Corrosion Potential.
Low Thermal ConductivityLow Thermal Conductivity
Enhanced Tissue CompatibilityEnhanced Tissue Compatibility
Low Colonization Potential thanLow Colonization Potential than
TitaniumTitaniumwww.indiandentalacademy.comwww.indiandentalacademy.com

CerconCercon((Dentsply)Dentsply) and Lavaand Lava (3M ESPE)(3M ESPE)
Zirconia Core CeramicsZirconia Core Ceramics
CERCON, DCS-PRESIDENTCERCON, DCS-PRESIDENT
White Colored Core limit their indications fromWhite Colored Core limit their indications from
an esthetic standpoint.an esthetic standpoint.
LAVALAVA
Core Relatively TranslucentCore Relatively Translucent and at the sameand at the same
time may Mask Underlying Discoloredtime may Mask Underlying Discolored
Abutments.Abutments.

CERCON SYSTEMCERCON SYSTEM
Conventional WaxingConventional Waxing
TechniquesTechniques
DCS-PRESIDENT & LAVA systemsDCS-PRESIDENT & LAVA systems
CAD TechnologyCAD Technology
&&
Different Features and Design Options.Different Features and Design Options.

Disadvantage with all High Strength CoreDisadvantage with all High Strength Core
systems is thatsystems is that
None Of Them Are Amenable To AcidNone Of Them Are Amenable To Acid
EtchingEtching
Fit surface are made of alumina rather thanFit surface are made of alumina rather than
silica, no coupling agents are available thatsilica, no coupling agents are available that
can effectively bond to the core resinscan effectively bond to the core resins
CANNOT BE RESIN BONDED TO THECANNOT BE RESIN BONDED TO THE
TOOTH SURFACETOOTH SURFACE

Etched with 9.6% Hydrofluoric AcidEtched with 9.6% Hydrofluoric Acid
Increase Strength of PorcelainsIncrease Strength of Porcelains
Natural dentine acts as CoreNatural dentine acts as Core
Extension of use fromExtension of use from
VeneersVeneers toto Anterior and Posterior Crowns andAnterior and Posterior Crowns and
InlaysInlays

GLASS CERAMICSGLASS CERAMICS
LEUCITE BASEDLEUCITE BASED
LITHIUM DISILICATE BASEDLITHIUM DISILICATE BASED
FLUOROMICA BASEDFLUOROMICA BASED

GLASS CERAMICSGLASS CERAMICS
Multiphased solids containing a Residual GlassMultiphased solids containing a Residual Glass
Phase with a Finely Dispersed CrystallinePhase with a Finely Dispersed Crystalline
PhasePhase
To ensure a high strength of glass ceramic theTo ensure a high strength of glass ceramic the
crystals should be numerous and uniformlycrystals should be numerous and uniformly
distributed throughout the glassy phase.distributed throughout the glassy phase.

LEUCITE REINFORCED GLASSLEUCITE REINFORCED GLASS
CERAMICSCERAMICS
Leucite – KAlSiLeucite – KAlSi22OO66
Reinforcing phase due to tangential stresses itReinforcing phase due to tangential stresses it
creates within the porcelaincreates within the porcelain
Varies from 35%-50% by volumeVaries from 35%-50% by volume
Flexural strength – 120 MpaFlexural strength – 120 Mpa

Mechanical Strength is InsufficientMechanical Strength is Insufficient forfor
construction of All Ceramic Bridgesconstruction of All Ceramic Bridges
CrownsCrowns
InlaysInlays
VeneersVeneers
Leucite containing materials areLeucite containing materials are
IPS EmpressIPS Empress (Ivoclar)(Ivoclar)
IPS FinnesseIPS Finnesse ..
Authentic Pressable CeramicsAuthentic Pressable Ceramicswww.indiandentalacademy.comwww.indiandentalacademy.com

IPS FINNESSEIPS FINNESSE
((Micro Dental Laboratories)Micro Dental Laboratories)
““PERFECTION INPERFECTION IN
PORCELAIN”PORCELAIN”
8-10% leucite crystals8-10% leucite crystals
Less wearLess wear onon
opposing dentitionopposing dentition

HIGHLY POLISHABLEHIGHLY POLISHABLE
Flexural strength – 125mpaFlexural strength – 125mpa
Fracture toughness – 1.25 Mpa.m1/2Fracture toughness – 1.25 Mpa.m1/2
INLAYSINLAYS
ONLAYSONLAYS
VENEERSVENEERS
FULL COVERAGE CROWNSFULL COVERAGE CROWNS..www.indiandentalacademy.comwww.indiandentalacademy.com

Authentic Pressable CeramicAuthentic Pressable Ceramic
(Microstar)(Microstar)
Low FusingLow Fusing
Most Delicate Forms can be AccuratelyMost Delicate Forms can be Accurately
ReproducedReproduced
Staining and Layering TechniqueStaining and Layering Technique
Anterior CrownsAnterior Crowns
Inlays/ OnlaysInlays/ Onlays
VeneersVeneerswww.indiandentalacademy.comwww.indiandentalacademy.com

IPS EMPRESS IIIPS EMPRESS II
(Micro Dental Laboratories)(Micro Dental Laboratories)
Lithium Disilicate crystals in glass matrixLithium Disilicate crystals in glass matrix
LiLi22SiSi22OO55
Veneering ceramic –Veneering ceramic – Apatite CrystalsApatite Crystals
70% of volume of glass ceramic70% of volume of glass ceramic
Lithium Disilicate and Apatite GlassLithium Disilicate and Apatite Glass
CeramicsCeramics

Consists of small interlocking plate like crystalsConsists of small interlocking plate like crystals
randomly oriented which Block Propagation ofrandomly oriented which Block Propagation of
CracksCracks
Increased flexural strength – 350-450 MPaIncreased flexural strength – 350-450 MPa
3 times GREATER than IPS Empress3 times GREATER than IPS Empress
Accurate fitAccurate fit
Less Translucent than IPS EmpressLess Translucent than IPS Empress
3 unit FPDs Anterior to 23 unit FPDs Anterior to 2ndnd
premolarpremolar
CROWNS /VENEERS/INLAYSCROWNS /VENEERS/INLAYS

IPS ERISIPS ERIS
(Ivoclar)(Ivoclar)
LITHIUM DISILICATE crystals adds strength to bridgeLITHIUM DISILICATE crystals adds strength to bridge
spansspans
Layering material containsLayering material contains FLUOROAPATITEFLUOROAPATITE crystalscrystals
Flexural strength – 350-400MPaFlexural strength – 350-400MPa
Fracture toughness - 3.2Mpa.mFracture toughness - 3.2Mpa.m1/21/2
Excellent Marginal AdaptationExcellent Marginal Adaptation
Full Coverage Crowns and Anterior FPDsFull Coverage Crowns and Anterior FPDs

HOT PRESSED CERAMICHOT PRESSED CERAMIC
Ceramic is heated to aCeramic is heated to a
specifiedspecified
temperature andtemperature and
forced underforced under
pressure to fill apressure to fill a
cavity in a refractorycavity in a refractory
mouldmould

1180 degrees over a period1180 degrees over a period
of 45minof 45min
High Degree of Marginal Fit can be AchievedHigh Degree of Marginal Fit can be Achieved

Although newer core ceramics haveAlthough newer core ceramics have
excellent fracture resistance,excellent fracture resistance,
improper design of the connectorimproper design of the connector
area of a FPD can significantlyarea of a FPD can significantly
reduce the fracture resistance andreduce the fracture resistance and
clinical survivability of theclinical survivability of the
prosthesisprosthesis

TECHNIQUESTECHNIQUES
CAD-CAMCAD-CAM
• DCS–PRESIDENT -1991DCS–PRESIDENT -1991
• AUTO MILL – 1994AUTO MILL – 1994
• CEREC 2 – 1994CEREC 2 – 1994
• CEREC 3 – 2000CEREC 3 – 2000
COPY MILLINGCOPY MILLING
• CELAY – 1991CELAY – 1991
• PROCERA 1994PROCERA 1994
• PRO CAM - 1996PRO CAM - 1996
COPY MILLING and CAD-CAMCOPY MILLING and CAD-CAM

CEREC SYSTEMSCEREC SYSTEMS
(Seimens, Germany )(Seimens, Germany )
Utilizes CAD-CAM technologyUtilizes CAD-CAM technology
• CEREC 2 System - 1994CEREC 2 System - 1994..
• CEREC 3 SYSTEM -2001CEREC 3 SYSTEM -2001

CEREC 2 SYSTEMCEREC 2 SYSTEM
CAD - CIMCAD - CIM
COMPUTER INTEGRATED MILLINGCOMPUTER INTEGRATED MILLING
The Marginal Fit and Accuracy of restorationsThe Marginal Fit and Accuracy of restorations
is Superior to CERECis Superior to CEREC
OCCLUSAL MORPHOLOGY MACHINEDOCCLUSAL MORPHOLOGY MACHINED

CEREC 2 OCCLUSAL MORPHOLOGY MACHINEDOCCLUSAL MORPHOLOGY MACHINED

CEREC 3CEREC 3
Network andNetwork and
Multimedia readyMultimedia ready
combination with ancombination with an
Intraoral Color VideoIntraoral Color Video
CameraCamera
OROR
Digital RadiographicDigital Radiographic
UnitUnit www.indiandentalacademy.comwww.indiandentalacademy.com

Fabrication of restorationsFabrication of restorations AcceleratedAccelerated
(24 min.-27% time saving)(24 min.-27% time saving)
Rapid occlusal and functional registration isRapid occlusal and functional registration is
possible andpossible and
ACCURATE OCCLUSIONACCURATE OCCLUSION establishedestablished
Eliminates waiting periods for image adjustment,Eliminates waiting periods for image adjustment,
data storage , matching of two opticaldata storage , matching of two optical
impressions in construction of occlusal surfacesimpressions in construction of occlusal surfaces
with correlation and functional modes.with correlation and functional modes.

FORM GRINDING UNITFORM GRINDING UNIT
Greater DetailGreater Detail than Cerec 2than Cerec 2 and fitted with oneand fitted with one
CylindricalCylindrical and oneand one TaperedTapered diamond rotatorydiamond rotatory
tool andtool and controlled withcontrolled with radio communicationradio communication
from the control unit independent of its location.from the control unit independent of its location.
The next restoration can be designedThe next restoration can be designed
while the first is being milledwhile the first is being milled

Intra Oral 3 Dimensional ScanningIntra Oral 3 Dimensional Scanning
CameraCamera
Optical impression recorded with SingleOptical impression recorded with Single
Exposure from Single Viewing Line,Exposure from Single Viewing Line,
representing the Preparation and Insertionrepresenting the Preparation and Insertion
Axes respectively in a Fraction of a secondAxes respectively in a Fraction of a second
without Reference Markings on the Teethwithout Reference Markings on the Teeth
and is Reproducible.and is Reproducible.

SCANNING PRINCIPLESCANNING PRINCIPLE
Principle Of Active TriangulationPrinciple Of Active Triangulation
The camera projects a linear pattern underThe camera projects a linear pattern under
triangulation angle on the preparation, and thetriangulation angle on the preparation, and the
projected image is recorded.projected image is recorded.
Amount of shift depending on the Depth ofAmount of shift depending on the Depth of
preparation.preparation.

CEREC 2 cameraCEREC 2 camera
Depth scale is limitedDepth scale is limited to 6.4mm.with timeto 6.4mm.with time
consuming software adjustments the depth scaleconsuming software adjustments the depth scale
can be stretched to 14mm.can be stretched to 14mm.
CEREC 3CEREC 3
withwith active double triangulationactive double triangulation principleprinciple
preparation recorded from two differentpreparation recorded from two different
triangulation angles providingtriangulation angles providing
immediateimmediate depth scale of >20mmdepth scale of >20mm..
The double set of data is processed immediatelyThe double set of data is processed immediately
through a specialized ‘twin grab board’through a specialized ‘twin grab board’www.indiandentalacademy.comwww.indiandentalacademy.com

COMPUTER AIDED DESIGNCOMPUTER AIDED DESIGN
The two -impressionThe two -impression CorrelationCorrelation andand FunctionFunction
modes for designing crowns can proceedmodes for designing crowns can proceed
using occlusion and preparation opticalusing occlusion and preparation optical
impressions without loss of timeimpressions without loss of time
Large carious lesion withLarge carious lesion with loss of cusp orloss of cusp or
insufficient occlusal surfaceinsufficient occlusal surface the situationthe situation
can be recorded in function designcan be recorded in function design
modemode..

• The remaining intact cusps and partThe remaining intact cusps and part
of occlusal surfaces are recorded byof occlusal surfaces are recorded by
an “an “occlusal impression”occlusal impression”
• After preparation they are matchedAfter preparation they are matched
with the “with the “preparation impressions”preparation impressions”

Computer Aided MachiningComputer Aided Machining
Cerec 3 system has aCerec 3 system has a
Separate Recording and Design UnitSeparate Recording and Design Unit
andand
Form-Grinding UnitForm-Grinding Unit

The change from disks to Cylindrical andThe change from disks to Cylindrical and
Tapered burs were used toTapered burs were used to Replicate BetterReplicate Better
Occlusal Morphology.Occlusal Morphology.www.indiandentalacademy.comwww.indiandentalacademy.com

CELAY SYSTEMCELAY SYSTEM
((Mikrona, Switzerland,1991Mikrona, Switzerland,1991
• Proinlay made from lightProinlay made from light
curing resin compositecuring resin composite
directly in cavity/on thedirectly in cavity/on the
die.die.
• The inner and occlusalThe inner and occlusal
morphology of proinlaymorphology of proinlay
are copiedare copied
• Final restoration isFinal restoration is
performed by theperformed by the CELAYCELAY
Milling Machine.Milling Machine. www.indiandentalacademy.comwww.indiandentalacademy.com

PROCERA SYSTEMPROCERA SYSTEM
((Nobel Biocare,Sweden)Nobel Biocare,Sweden)
Procera ScannerProcera Scanner
scans the surfacescans the surface
of the preparedof the prepared
toothtooth

Transmits theTransmits the
information to ainformation to a
computer controlledcomputer controlled
design station, wheredesign station, where
the Aluminum Oxidethe Aluminum Oxide
copings arecopings are
fabricated.fabricated.

Review of LiteratureReview of Literature
1.1. Yoichiro Ichikawa et al (1992).Yoichiro Ichikawa et al (1992).
Conducted a study to evaluate the tissue reaction andConducted a study to evaluate the tissue reaction and
stability of partially stabilized Zirconia ,in vivo, withstability of partially stabilized Zirconia ,in vivo, with
the use of subcutaneous implantation test. Theythe use of subcutaneous implantation test. They
concluded that zirconia ceramic is biocompatible andconcluded that zirconia ceramic is biocompatible and
no degradation of the ceramic occurredno degradation of the ceramic occurred
2.2. Seghi RR et al (1995).Seghi RR et al (1995).
Evaluated the resistance to crack propagation of 11 ceramicEvaluated the resistance to crack propagation of 11 ceramic
materials which included Fluormica-, Leucite-,materials which included Fluormica-, Leucite-,
alumina-, and Zirconia-reinforced glasses. Their studyalumina-, and Zirconia-reinforced glasses. Their study
showed that Alumina reinforced material had theshowed that Alumina reinforced material had the
highest toughness values and Leucite and Fluormicahighest toughness values and Leucite and Fluormica
increase the toughness of ceramic materials.increase the toughness of ceramic materials.www.indiandentalacademy.comwww.indiandentalacademy.com

3.3. Russell et al (1995)Russell et al (1995)
Assessed the performance of the Procera systemAssessed the performance of the Procera system
and stated that it is cost effective, precise andand stated that it is cost effective, precise and
biocompatible computerized method of crownbiocompatible computerized method of crown
fabrication though not superior to manualfabrication though not superior to manual
laboratory fabrication procedures by thelaboratory fabrication procedures by the
technician.technician.
4.4. Wagner WC et al(1996)Wagner WC et al(1996)
Conducted study on three ceramic crown coreConducted study on three ceramic crown core
materials, namely Empress, Inceram andmaterials, namely Empress, Inceram and
Procera Allceram for their biaxial flexuralProcera Allceram for their biaxial flexural
strength and fracture toughness. Theystrength and fracture toughness. They
concluded that both Procera and Inceram wereconcluded that both Procera and Inceram were
superior to Empress in fractural toughnesssuperior to Empress in fractural toughness..

5.5. Agneta Oden et al(1998)Agneta Oden et al(1998)
Evaluated the clinical performance of 100 ProceraEvaluated the clinical performance of 100 Procera
Allceram crowns after 5 years in service andAllceram crowns after 5 years in service and
concluded that the crowns maybe theconcluded that the crowns maybe the
restoration of choice for anterior and posteriorrestoration of choice for anterior and posterior
single crown restorations.single crown restorations.
6.6. Per Vult Von Steyen et al (2001)Per Vult Von Steyen et al (2001)
Investigated the properties of Inceram for use inInvestigated the properties of Inceram for use in
Posterior FPD and evaluated the clinicalPosterior FPD and evaluated the clinical
methods regarding preparation technique,methods regarding preparation technique,
design and choice of cement. They concludeddesign and choice of cement. They concluded
that when properly employed the Inceramthat when properly employed the Inceram
technique is acceptable for 3 unit FPD intechnique is acceptable for 3 unit FPD in
posterior region.posterior region.

7.7. Antonio Scarano et al (2004)Antonio Scarano et al (2004)
Conducted a study to characterize the percentage ofConducted a study to characterize the percentage of
surface covered bacteria on commercially puresurface covered bacteria on commercially pure
Titanium and Zirconium Oxide disks and showed thatTitanium and Zirconium Oxide disks and showed that
zirconium oxide maybe a suitable material forzirconium oxide maybe a suitable material for
manufacturing Implant abutments with lowmanufacturing Implant abutments with low
colonization potential.colonization potential.
8.8. Josephine F Esquivel et al (2004)Josephine F Esquivel et al (2004)
Conducted a research to determine the clinical success rateConducted a research to determine the clinical success rate
of lithium disilicate base core ceramic for use inof lithium disilicate base core ceramic for use in
Posterior FPD’s as a function of bite force, cementPosterior FPD’s as a function of bite force, cement
type, connector height and width. They concluded thattype, connector height and width. They concluded that
the performance was promising with only 7 % fracturethe performance was promising with only 7 % fracture
rate in 2 years.rate in 2 years.

Revolution in dental ceramics in the last decade ledRevolution in dental ceramics in the last decade led
to its use as Anterior and Posterior restorativeto its use as Anterior and Posterior restorative
materialmaterial..
• IPS FINESSE is “Perfection in Porcelain”IPS FINESSE is “Perfection in Porcelain”
with improved esthetics and less wear on oppositewith improved esthetics and less wear on opposite
tooth but with decreased strengthtooth but with decreased strength
• IPS Empress 2,IPS Empress 2, Wol–ceramWol–ceram and IPS Finesse usedand IPS Finesse used
for Anterior FPDsfor Anterior FPDs
• Inceram Zirconia used for Posterior FPDSInceram Zirconia used for Posterior FPDS
• Zirconia can also be used for Implants and PostsZirconia can also be used for Implants and Posts

New materials and techniques in dentalNew materials and techniques in dental
ceramics will continue to play a role inceramics will continue to play a role in
the provision of esthetic restorations.the provision of esthetic restorations.
The dentist needs to update himselfThe dentist needs to update himself
about the recent advances in dentalabout the recent advances in dental
ceramics to ensure that correct choice isceramics to ensure that correct choice is
made for each patientmade for each patientwww.indiandentalacademy.comwww.indiandentalacademy.com

ReferencesReferences
• Anusavice Kenneth J.: Phillips Science of Dental Materials. 12Anusavice Kenneth J.: Phillips Science of Dental Materials. 12thth
edition, W.B. Saunders, 2001edition, W.B. Saunders, 2001
• Combe E.C.: Notes on dental materials: 6Combe E.C.: Notes on dental materials: 6thth
ed. Churchilled. Churchill
Livingstone, 1992.Livingstone, 1992.
• Craig Robert G. and Powers J.M.: Restorative dental materials.Craig Robert G. and Powers J.M.: Restorative dental materials.
1111thth
ed. Mosby Inc. 2002.ed. Mosby Inc. 2002.
• Gladwin Marcia, Bagby Michael: Clinical aspects of dentalGladwin Marcia, Bagby Michael: Clinical aspects of dental
materials, Lippincott, 2000.materials, Lippincott, 2000.
• McCabe J.F. and Walls A.W.G.: Applied dental materials, 8McCabe J.F. and Walls A.W.G.: Applied dental materials, 8thth
ed.ed.
Blackwell Science Limited, 1998.Blackwell Science Limited, 1998.
•

•O’Brien W.J.: Dental material and their selection, 2nd ed.O’Brien W.J.: Dental material and their selection, 2nd ed.
Quintessence, 1997.Quintessence, 1997.
•Van Noort Richard: Introduction to dental materials,Van Noort Richard: Introduction to dental materials,
Mosby 1994.Mosby 1994.
•Ariel J Raigrodski. Contemporary materials andAriel J Raigrodski. Contemporary materials and
technologies for all-ceramic fixed partial dentures: areviewtechnologies for all-ceramic fixed partial dentures: areview
of literature.J Prosthet Dent2004;92:557-62of literature.J Prosthet Dent2004;92:557-62
•Yoichiro Ichikawa,Yasumasa Akagawa, HirosamaYoichiro Ichikawa,Yasumasa Akagawa, Hirosama
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