ADVANCED CERAMICS

All-ceramic restorations can provide some of the

most esthetically pleasing restorations currently
available.
The chief disadvantage of the early restorations
was their low strength, which limited their use to
low stress situations
Brittle materials such as ceramics contain at least
two types of flaws where fracture is initiated
1. FABRICATION DEFECTS

Voids (porosity): Porosity constitutes a fracture-

initiation site. They are created during sintering
of ceramic. Vacuum sintering decreases porosity.
Hand condensation of porcelain slurry between
sintering stages also produce voids.
Micro-cracks occur upon cooling in crystal
containing ceramics due to thermal mismatch
between the crystal and the matrix.
WHAT IS SINTERING OF CERAMICS?
2. SURFACE CRACKS (Griffith flaws):
Surface cracks occur due to:
 Machining or grinding. The average natural flaw size varies
from 20 to 50 um. Using dull instruments will initiate surface
cracks.
 Rapid cooling from furnace temperature to room temperature.
The outer surface of porcelain will cool more rapidly than the
internal structure.
 Segmental contraction of the ceramic surface.
 Usually, fracture of the ceramic takes place from the most
severe flaw, which effectively determines the fracture resistance
of the restoration.
 METHODS OF
STRENGTHENING CERAMICS
Crystalline reinforcement (Dispersion strengthening):
Strengthening by crystalline reinforcement involves the introduction of a high
proportion of crystalline phase into the ceramic to improve the resistance to
crack propagation.  The reinforcing crystals can be leucite, lithium disilicate,
Alumina, or Zirconia crystals.
The crystals will increase the strength through:
a. Deflection of the advancing crack.
b. A crystalline phase with greater thermal expansion coefficient (e.g. Leucite) than the matrix
produces stresses near the crystal-matrix interface. Such tangential stresses tend to divert the crack
around the particle.
Alumina particles acting as crack stoppers
Chemical strengthening (Ion-Exchange,
Chemical tempering)
The principle is to exchange small ions present
within the ceramic matrix (sodium); for larger
ions (potassium).
forcing the potassium ion creates large residual
compressive stresses.
Any applied load must first overcome this built
in compression layer before the surface can be
placed into tension, resulting in an increase in
fracture resistance.
Thermal tempering (fast cooling):
Thermal tempering occurs when glass is rapidly cooled
from near the softening temperature.
Rapid cooling produces a skin of rigid glass
surrounding a soft core. As the molten core solidifies, it
tends to shrink but the outer skin remains rigid. The pull
of the solidifying molten core, as it shrinks creates
residual tensile stresses within the outer surface.
These forces should be overcome before cracks can
propagate and fracture can occur.
Fired porcelain mass On rapid cooling the outer layer
solidifies first

The outer layer is placed under Solidification of inner layer

tensile stresses begins with pulling action
Stress induced transformation (Transformation
toughening):
stresses at crack tip will be consumed to change the crystal structure of ceramic
from phase to another phase.
Partially stabilized zirconia :Stresses cause the transformation from tetragonal to
monoclinic Zirconia, thereby leading to strengthening as a result of an increase
in grain volume in the vicinity of the crack tip.
Glazing:
The principle is the formation of low expansion surface layer fired at high
temperature.
Upon cooling the low expansion glaze placed the surface of the ceramic in
compression and reduces the depth and width of surface flaws.
self glazing consists of an additional firing in air following the original firing,
without application of low expansion glaze.
Over glaze involves firing of a low fusing glass layer over the finished
restoration.
Prevention of stress corrosion (static fatigue)
The strength of ceramics is reduced in moist environments.
This weakening is due to a chemical reaction between water and the ceramic
at the tip of the crack, resulting in an increase in the crack size; a phenomenon
called stress corrosion or static fatigue.
In industry, coatings are used to reduce stress corrosion of glass and ceramics.
Similar coatings have been tried experimentally for their effect on dental
ceramics.
Controlled crystallization of glass (Ceramming):
produces a network of overlapping crystals within the glass matrix. This adds
to the strength of the ceramic and to its resistance to fracture and crack
propagation. E.g. Dicor ceramics which contain Mica crystals
Using high strength ceramic core materials:
High strength substructure core is built and then a veneer with conventional
ceramic materials for esthetics is applied.
Example: In-ceram
 CLASSIFICATION OF ALL
CERAMIC SYSTEMS
ACCORDING TO THE
TECHNIQUE OF
CONSTRUCTION:
1. Aluminous core ceramics ,OR, refrectory die technique.
2. Slip-cast ceramics
3. Castable ceramics
4. Heat pressed ceramics
5. Machined ceramics
6. Metal reinforced systems
1-Aluminous ceramics:
2-Slip-cast Ceramics
use of a high strength ceramic core (high alumina content) that is
covered with a veneering esthetic ceramic. The amount of alumina in
this core material can be as high as 90%.
Slip is an aqueous suspension of the alumina particles in water
The slip is applied on a porous refractory die which absorbs the
water from the slip
The refractory die shrinks more than the condensed slip
In-Ceram Alumina/Zirconia/Spinel

Preparation of the model

Produce a model with removable
dies from a high-quality,
dimensionally stable stone

Duplicating
Duplicate with an impression.
 Mixing VITA In-Ceram special plaster

Impression is pored with special plaster

Special plaster cast
 Preparation of the slip

Powder weighing Adding liquid

Ultrasonic mixing
Application of the slip

Alumina core before glass infilteration

Glass infilteration
Veneering porcelain
Types of ceramics that can be used as a slip:
Alumina
Zirconia: contains zirconium oxide (ZrO2)
Spinel: contains a magnesium spinel ((Mg Al2O4) )
3-Castable glass ceramics
Lost wax technique is used to construct the restoration.
These ceramics can be melted and derived into a mould using similar
techniques used for metallic restorations
The ceramic is subjected to heat treatment procedure (ceramming) in which
crystals are initiated from the internal structure of the ceramic and the crystals
are increased in size.
The molten ceramic is forced into the mould using a special centrifugal
casting machine
Marginal gap is reduced
Dicor is based on mica crystals.
Cerapearl Castable ceramics also uses the same technique. They differ
in their chemical structure. As they contain a similar chemical
composition as enamel (hydroxyl-apatite) it is claimed that it is kinder
on the opposing dentition.
Dicor and Cerapearl are examples
4-Heat pressed glass ceramics:
The ceramic ingot is melted and pressed to the mould using a special furnace
under high temperature and pressure.
Leucite based ceramics (Empress I):
The ceramic contains 35-50% by volume leucite
Ceramic ingots are pressed at high temperature (from 900° C to 1165° C) into a
refractory mold made by the lost-wax technique.
finishing techniques
 Characterization technique (surface stain only)
 Layering technique
Tech
 It uses the lost wax tech ,but casting is done under pressure and high temperature.
 Wax pattern --------------- spruing/ investing/ casting/mold.

 Casting under pressure and high temperature 1100c from precerammed ingots containing leucite

 Ceramic restoration
The coefficient of thermal expansion of the core material for the veneering
technique is compatible with the thermal expansion coefficient of the veneering
porcelain.
Lithium Silicate based (Empress II)
The major crystalline phase of the core material is a lithium disilicate. The
material is pressed at 920° C
It is layered with a glass containing some dispersed apatite crystals
Lithium disilicte has an unsual microstructure in that it consists of many
small interlocking plate-like crystals cause cracks to deflect ,branch or
blunt ;thus ,the propagation of cracks though this material is arrested by the
lithium disilicate crystals.
Heat pressed glass ceramics
Leucite based and Lithium disillicate

Heat-pressed ceramic technique. A, Inlay preparation for a mandibular molar.

B, A wax pattern is made in a similar manner to conventional gold castings.
C, After investing the pattern, it is burned out, and a ceramic ingot and alumina
plunger are placed in the heated mold.
 E

D, The pressing is done under vacuum at 1150° C.

E, Sprue removal.
F, The restoration.
 MACHINED
CERAMICS
(CAD/CAM)
CAD: is the process of using software to help in
precision drawing and designing models.

CAM: is the process of using software to

manufacture models.
I- CEREC SYSTEMS
Cerec 2 ceramic inlay system.
A, The Cerec 2 system
B, Making an optical impression.
C, Image of a prepared tooth.
D, The preparation is marked and
the restoration designed on the
computer screen.
E, The restoration is machined
from a ceramic block.
The advantages of the CAD/CAM system:
1. Design, fabricate and cement an all ceramic prosthesis in a single
appointment.
2. No temporization needed.
3. Eliminates the possibilities of inaccuracies developed with indirect
techniques
4. Cut the sepsis chain between the dental clinic and lab.
5. The ceramic restorations produced with this technique have high flexural
strength, which lessens the possibility of ceramic fracture, because they
are milled from homogenous pre-cerammed blocks.
Disadvantages:
1. Expensive technology is needed
2. Color gradient of natural teeth is difficult to achieve since the whole
restoration is milled from a single block.
The CEREC systems:
 Cerec 1: Marginal adaptation was not perfect and occlusal anatomy could not be
reproduced. The system was therefore limited to constructing inlays.
 Cerec 2 Marginal adaptation is improved, and the occlusal anatomy can be shaped. The use of
this system is limited to inlays, onlays, veneers and single crowns.
 Cerec 3 Greater occlusal anatomy sophistication, Modified easier software, Better marginal
adaptation, Windows based system.
The ceramic blocks used can be:
 Vita mark II: contains sanidine (KAISi3O8) as a major crystalline phase within a glassy matrix
 Dicor MGC is a mica-based machinable glass-ceramic that contains 70 volume percent of
crystalline phase.
 ProCad is a leucite-containing ceramic designed for making machined restorations.
 E-max blocks: contain lithium disilicate as a major crystalline phase
II-CELAY SYSTEM
(COPY-MILLING)
Celay system (copy-milling):
•It uses a precision copy milling (similar to key milling) technique to
manufacture ceramic inlays or onlays or copings.
•The celay unit consist of two integrated but separate components copying tool
pantograph cutter.

A resin pattern is fabricated directly on the prepared tooth or on a master die.

The pattern is scanned and the picture is used to mill a presintered ceramic
blocks.
It is like key coping
The celay unit consist of two integrated but separate components
Copying tool pantograph cutter
Tooth preparation blue resin pattern inside patient mouth or on
working die
Resin pattern(pro inlay)
• Directly on the patient mouth.
• In directly on a master model using light cured composite.
Proinlay

Put inside the celay machine

Pantograph scan the pattern

The movement transfer to the copying tool which mill from ready
made ceramic block.

The restoration should be finished and polished using

1)micro-fine diamond followed by resin composite finishing disc.

2)pumice and water followed by calcium carbonate.

3)diamond paste.
The available blocks can be:
 Vita Mark II ceramic.
 In-Ceram Alumina
 In-Ceram Zirconia.
 In-Ceram spinel.

In-Ceram blocks produce copings that are glass infiltrated as the conventional
In-Ceram system. After coping is milled, glass is applied over the coping and
subjected to firing cycle. Excess glass is removed as usual. A veneering
ceramic is applied to complete the final esthetic properties of the restoration.
The celay machine The ceramic block

Milling of the block

Glass infiltration and veneering
III- THE PROCERA
SYSTEM
Steps:
In the clinic: Preparation, impression and working die.
In the dental lab: scanning the working die. Then sending the information to
the production unit (main station).
The sent information are used to calculate the anticipated shrinkage.
An enlarged die is machined to compensate for this shrinkage.
Alumina is dry pressed against the enlarged die, and the temperature is raised.
The coping is partially sintered.
The outer surfaces of the coping are milled to the desired shape
The coping is removed from the enlarged die, and fully sintered.
During this cycle, the coping shrinks to fit the dimensions of the original
working die.
The completed coping is then sent back to the laboratory, where it is veneered
with the compatible veneering ceramic
 Procera AllCeram System
The system takes in consideration the dimensional changes that take place
during sintering.
In this system; the station of producing the framework lies in a remote
location.
Thus one station would be able to serve many clinics even those present
outside the country since the information is sent via a modem, i.e. internet.
 
The Procera system. A, Tooth preparations for Procera crown on the maxillary central
incisors. B, The die.
C and D, The die is mapped using a contact scanner.
E, The shape of the prepared tooth is transferred to the computer screen.
F, Milling machine.
G, Enlarged die compensates for the sintering shrinkage.
H, High-alumina coping before and after sintering.
1, Body and incisal porcelains application. J, Cemented restorations
Optimum
connector
design

veneering
Lava system:

CAD/CAM as the Cerec procedure is used for the fabrication of Zirconia frame-
works.
The preparations are scanned and frameworks are milled from partially sintered
Zirconia blanks.
The size of the frameworks is precisely increased to allow for the shrinkage that
occurs during sintering.
The framework is sintered.
The core is veneered with layered esthetic porcelains.
The entire procedure from scanning to milling is completed at the center and then
returned to the lab
Cercon system
It requires a wax-up of the desired bridge framework.
This wax-up is then scanned and an oversized coping of partially
sintered Zirconia is milled out.
This oversized coping will afterwards be fired for 6-8 hours at high
temperature in order to produce a fully sintered Zirconia.
METAL REINFORCED
SYSTEMS

These are PFM restorations and NOT all

ceramic restorations.
The Captek System.
In the Captek system the coping is produced from 2 metal impregnated wax
sheets that are adapted to a die and fired.
The first sheet forms a porous gold-platinum-palladium layer that is
impregnated with 97% gold when the second sheet is fired.
Advantages of the system include excellent esthetics and marginal adaptation.
Electroformed:
The Helioform HF 600 system uses an electroforming technique to produce a
thin pure gold coping.
The gold is deposited on polyurethane dies that are coated with a silver spacer
using computer-controlled plating equipment to control thickness.
The coping is coated with a noble metal paste primer before porcelain
application.
Electroforming enables very good marginal adaptation (better than
conventional casting).
SELECTION OF ALL-CERAMIC SYSTEMS
 FRACTURE RESISTANCE: clinical studies have consistently shown good performance on
anterior teeth yet poor performance on molars and for FPDs. newer materials, such as Empress 2
and In-Ceram Zirconia, promise higher strength.

 ESTHETICS
 ABRASIVENESS

ALL-CERAMIC FIXED PARTIAL DENTURES:

 In-Ceram alumina was somewhat successful for anterior FPDs. The more recent lithium
disilicate, heat-pressed ceramic, Empress 2, and the CAD/CAM Procera systems have also been
recommended as suitable for anterior FPDs.
 A design with substantial connectors (typically 4 x 4 mm, as opposed to 2 x 3 mm recommended
for metal connectors).