Week 11 The Metal Ceramic Crowns

Learning Outcomes
Prosthodontics Theoretical
The Metal-Ceramic Crowns
At the end of this lecture student able to;
Dr. Berkman ALBAYRAK mec(p>m)
Assistant Professor ->
1. Understand what the metal-ceramic crown (PFM) is.
Bahçeşehir University
School of Dental Medicine 2. Learn the indications and contraindications of PFMs. ↓
Department of Prosthodontics
3. Discuss the advantages and disadvantages of PFMs.
berkman.albayrak@dent.bau.edu.tr
4. Interpret the preparation steps and armamentarium of PFMs.
5. Compare the material choice and the place of PMFs in clinical situations according to a clinical case.
The Metal-Ceramic Crowns 26.12.2022 DENT2001 © Assist. Prof. Berkman Albayrak
Recommended Reading Introduction
Contemporary fixed prosthodontics

Rosenstiel et al
Ch 9 - The Metal-Ceramic
① • In many dental practices, the metal-ceramic crown
Crown Preparation remains one of the most widely used fixed
restorations.
2
• This restoration offers a predictable esthetic result,
-
Fundamentals of fixed prosthodontics.

coupled with sound physical properties.
-
Herbert T. Shillingburg
Ch 10 - Preparations for
Full Coverage Crowns
The Metal-Ceramic Crowns 26.12.2022 DENT2001 © Assist. Prof. Berkman Albayrak The Metal-Ceramic Crowns 26.12.2022 DENT2001 © Assist. Prof. Berkman Albayrak
Introduction Introduction
not
only
mechanicallychemically
①#
· The metal-ceramic restoration consists of a metal substructure supporting a ceramic veneer that is mechanically and
chemically bonded to it. The chemical component of the bond is achieved through firing.
C
Ceramic
Opaque • Metal-ceramic crowns consist of a complete-coverage
s
⑧
metal crown (or substructure) that is veneered with a
layer of fused porcelain to mimic the appearance of a
- ↓
↑ natural tooth.
Metal Coping
metal-ceramic crown preparation requires substantial additional tooth reduction 1 - 1.5
wherever the metal substructure is to be veneered with dental porcelain

1,s
Introduction Indications When do we use it
↑
1.Required complete coverage & esthetic demands CanTeior TeeTh).
its metal substructure can accommodate

2.Retainer for fixed dental prostheses cast or soldered connec- tors.
3.Supporting teeth for removable partial dentures (RPD)

(incorporate occlusal and cingulum rests and milled
proximal and reciprocal guide planes)
Indications Contraindications S
When can’t we use it

↳ has contraindications
case we prefer
cuz High risk of
composite resin
pulp exposure,
"porcelin liminate veneer
in
-
This
cartes,traumaorestoration
-
4.Extensive tooth destruction due to All Ceramic

r
3 crown.
->
5.Need for superior retention and strength

1.Presence of active caries
6.Endodontically treated tooth

2.Untreated periodontal disease
7.Need to recontour axial surfaces or correct minor

3.Patients with large pulp chambers
malinclinations. >
8.Altering the occlusal plane
Advantages Advantages
11 IV. Straightforward achieve adequate resistance

Cuz of
1 I.Combines the strength of cast metal with the esthetics of
S V. Enables correction of axial form. The complete-coverage aspect of metal-ceramic crowns
ceramics. 6 VI. Degree of difficulty is comparable complete cast crown. ↓
2
II.Natural appearance
3 III.Retentive qualities are excellent because all axial walls are

included in the preparation,
Disadvantages Disadvantages
with all-ceramic crowns, a somewhat greater range of brightness can be achieved
restoration material.
provide
'
space for they may appear slightly grayish in comparison with the translucency that
TooTn reduction To
can be achieved with all-ceramic crowns.
->
in
1)
I.Significant tooth reduction for the restorative materials. IV.Slightly grayish compared to translucency of ACC
glasslike nature of the veneering material, a metal-
↓
ceramic crown is subject to brittle fracture
2
-
II.Subgingivally margin is potential for periodontal V.Subjected to brittle fracture I cut of poor fabrication Technique).
disease.
However
To achieve better esthetics, the facial margin of an anterior restoration we can
use
is often placed subgingivally, which increases the potential for periodontal disease.
supragingival.
6 problemd
VI.Difficulty of accurate shade selection ↳ Frequent
1
-> less
3 III.Slightly inferior esthetics compared to all ceramic
-
crown (ACC). 7 VII.Expensive

Because many proce- dural steps are required for both metal casting and
porcelain application
regulu reducin
RERD-Tungsten Burs
↑
FOOTBALL-WHEEL BURS - > lingual reduction
Preparation FETD
PROPE ->
> should margin.
massing depin.
Preparation
FINISHING STONES ·
OFF ANGLE HATCHEST
5
• Explorer and periodontal probe
[ • Round-ended rotary diamonds (regular grit for bulk
6 • Off-angle hatchets
reduction, fine grit for finishing) or tungsten carbide
burs
2 • Football- or wheel-shaped diamond (for lingual
reduction of anterior teeth)
3 • Flat-ended, tapered diamond (for shoulder margin
- -
preparation)
I
• Finishing stones
Preparation All metal - ceramic crowm Preparation
Step-by-Step Procedure
Depth grooves: Two lanes
&cervical portion
9 I. Depth grooves incisal /oculsal
portion.
7 II. Incisal or occlusal reduction 7 • Center of the facial surface
3 III. Labial or buccal reduction 7 • Mesiofacial line angle
u IV. Axial reduction 3 • Distofacial line angle
S
V. Final finishing
Preparation Preparation
twoplane2nd
we
Depth grooves: <Two planes Depth Grooves:
Vincisal
Y • Cervical plane parallels the long axis of the tooth • 1st plane parallels the long axis of the tooth
cerical
plane.
• I
Incisal plane follows the normal facial contour • 2nd plane follows the normal facial contour
I incisethe ,
canieiorize in clannance-Imm.
Preparation Preparation -
pocTeior Teeth cleanace ->

minaman
2mm.
endmo imm
damnance
Depth grooves:
1
~
13m deep
Depth Grooves:
1
• 2-mm clearance on the incisal edge is required.
incisal/oculsaly
⑧
j • Perform the facial reduction in the planes
*
plane.
·
Corical
& 7
• Three depth grooves (about 1.8 mm deep)
• Approximately 1.3 mm deep -

-
Uniform,
Foun
- 2m
deep-
1
3 • On a posterior tooth, minimum of 2 mm clearance is
n ↳ required.
cervical plane determines the path of placement of the completed restoration . The incisal or
occlusal plane provides the space needed for the porcelain veneer
minumem To
CanTeiorTeeTh). 3
Incisal (Occlusal) Reduction: ~ Imm.
shoulder -
- 1.3mm
↳ preferable.
!
Labial (Buccal) Reduction:
⑰ • 2-mm incisal reduction
2 mm of clearance for adequate material thickness to allow translucency in the completed restoration . a
① • A minimum of 1.2 mm reduction
>
• Posterior teeth with less reduction (esthetics)
because esthetics is not as critical.
his - >
shorten AxialwalIs
⑦ • Satisfactory appearance (1.5 mm is preferable)
Carfalls
• Caution to excessive occlusal reduction
- .
↳ less rejection
excessive occlusal reduction will shorten the axial preparation walls and thus is a common cause of # Resistance.
inadequacies in retention and resistance form in the completed preparation.
Form, 3• Create a shoulder margin at the cervical margin
most of the retention is derived from the proximal walls).
• Remove the islands of remaining tooth structure. ↳scam
To ensure esthetics, the shoulder margin must extend into

the interproximal area. badlyDanged incisors.
⑥
Labial (Buccal) Reduction:
For This
enter
forpourpImTrinas
case.
o
/
④
• 1 mm shoulder margin
OEpridontal
Dieses
Beapical
in
margin
pre
<-
• Extend into proximal embrasures
gingivalonTow
↓
X
masing
suprasinsical
we
Asusing gingival Displace second instruma]
29 ->
using
-> it, oneproximalhere
&placing
To ensure ThoT d wonT
placenT.
I reboud-geTouTL afTe
restoration
prepared cus
previsoly
of existing The 'Cord' musT no < T -
engage: The pinioned volatory
instrumeaustcavingone
Axial Reduction Of
(Proximal & Lingual): Walls Finishing: The margin must provide distinct resistance to vertical displacement of the tip of a
periodontal probe or an explorer, and it must be smooth and continuous
circumferentially
⑦
· Suﬃcient tooth structure must be removed to provide a distinct, smooth chamfer margin
of about 0.5 mm in width
- -
8.
I
• Chamfer margin 0.5 mm (
• Smooth and continuous circumferentially
lingual concavity is prepared for adequate clearance for the
7 • 6 degrees taper
These walls should converge slightly from cervical to incisal or occlusal. A taper of approximately 6 degrees,
restorative materials. Typically, a 1-mm thickness is required if the
-
Scentric contacts in the completed-
restoration are to be located on
7 • Rounded line angles All other line angles should be rounded,
metal.
- -
3
• Lingual concavity, clearance = Thick
1mm (if metal) 3
• Smooth finishing
- (c Ls) z the completed preparation should have a satin finish, free from
obvious diamond scratch marks
/
4
• Single depth groove (center of lingual surface-LS) u
-
anterior teeth, usually only a single depth groove is placed in the

• Free from scratches
center of the lingual surface. For molars, three grooves can be
• Lingual chamfer margin
et
placed ->
As the lingual chamfer margin is developed, extend it buccally into the proximal area to blend with the interproximal
shoulder margin that was placed earlier
silden
>.
it
&
displayma) iD
css) 10
F
Controlled
- ↳ by
Tissue 1,)
using
fine-grit Dimowed -
svoine voices
instruments
-
-2
->
iDa -> o
A, Completed preparation. Note that the transition from incisal to axial walls is rounded, and a distinct 90-degree or slightly sloped shoulder
margin has been established. It is important that the proximal axial reduction of both the shoulder and chamfer margins of the preparation are
exactly in the same plane. B, An even E
chamfer margin width and a smooth transition between lingual and axial surfaces. The chamfer margin is xdi]>
distinct and blends smoothly into the facial shoulder margin. C, When a maxillary molar is prepared for a metal ceramic crown, note the
two-plane facial reduction to provide both adequate retention and space for the ceramic material.
incisa To axial wall Round.

⑲
Transition From -
· Distinegoodoreshoulderestablishedand ensure that the
enlingual, avid
sozulshoulde-chatelmoginaeinsamela salesen
⑦
isfacial
Distinc), blend smothly shoulder margin) -
*
S Chance margins retintion
* 6 Two place reduction doing (preperation maxmola

of provide
adequle
space For Cermaic material]
CLINICAL CASE CLINICAL CASE
SUMMARY SUMMARY
See you in next lecture…
The Metal-Ceramic Crowns 26.12.2022 DENT2001 © Assist. Prof. Berkman Albayrak

Week 11 The Metal Ceramic Crowns

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Week 11 The Metal Ceramic Crowns

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Learning Outcomes

The Metal-Ceramic Crowns 26.12.2022 DENT2001 © Assist. Prof. Berkman Albayrak

Recommended Reading Introduction

Contemporary fixed prosthodontics

Fundamentals of fixed prosthodontics.

Opaque • Metal-ceramic crowns consist of a complete-coverage

wherever the metal substructure is to be veneered with dental porcelain

Introduction Indications When do we use it

its metal substructure can accommodate

3.Supporting teeth for removable partial dentures (RPD)

When can’t we use it

4.Extensive tooth destruction due to All Ceramic

5.Need for superior retention and strength

6.Endodontically treated tooth

7.Need to recontour axial surfaces or correct minor

8.Altering the occlusal plane

11 IV. Straightforward achieve adequate resistance

ceramics. 6 VI. Degree of difficulty is comparable complete cast crown. ↓

3 III.Retentive qualities are excellent because all axial walls are

crown (ACC). 7 VII.Expensive

OFF ANGLE HATCHEST

pocTeior Teeth cleanace ->

• Approximately 1.3 mm deep -

• Remove the islands of remaining tooth structure. ↳scam

To ensure esthetics, the shoulder margin must extend into

engage: The pinioned volatory

anterior teeth, usually only a single depth groove is placed in the

incisa To axial wall Round.

· Distinegoodoreshoulderestablishedand ensure that the

* 6 Two place reduction doing (preperation maxmola

CLINICAL CASE CLINICAL CASE

CLINICAL CASE CLINICAL CASE

CLINICAL CASE CLINICAL CASE

CLINICAL CASE CLINICAL CASE

See you in next lecture…

The Metal-Ceramic Crowns 26.12.2022 DENT2001 © Assist. Prof. Berkman Albayrak

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