DENTAL CERAMICS

&
ITS RECENT
ADVANCEMENTS
 CERAMIC- MEANING

• Ceram.ic(adj.1850) of or relating to the

manufacture of any product made
essentially from a non metallic mineral
by firing at a high temperature.

• Journal of prosthodontic dentistry-vol.94-no.1

• The more restrictive term is
porcelain.

• It refers to a specific
compositional range of ceramic
material made by mixing kaolin,
quartz, and feldspar, and firing at
high temperature.
• Dental ceramics for ceramic-
metal restorations belongs to
this compositional range and
are commonly referred to as
dental porcelains.

• ALL PORCELAIN ARE CERAMICS

BUT ALL CERAMICS ARE NOT
PORCELAIN.
• They are most suitable tooth colored
restorative material used to make
denture teeth, single unit crowns,
fixed partial dentures and labial
veneers.
• It is the most durable esthetic
material, impervious to oral fluids
and biologically compatible.
• In the last few decades there
has been tremendous advances
in the mechanical properties
and methods of fabrication of
these materials.

• Whilst porcelain based

materials are still a major
component of the market there
have been moves to replace
metal cored systems with all
ceramic systems.
 BACKGROUND

Dental ceramics in restorations are essentially

oxide based glass-ceramic systems. They have
three essential features/requirements:

1. Ease of fabrication of complex shapes

2. Sufficient mechanical and corrosion resistance

3. Appropriate aesthetic appeal.

INTRODUCTION
• The history of restorative dentistry
can be traced back as far as ancient
Egyptian times.
• Examples of tooth replacement
prostheses made from gold wire, ox
bone or wood have been found.
• More recent restoratives had a
renaissance about two hundred
years ago when air fired porcelains
and cast gold restorations were
made to restore and replace teeth.
• It seems that in ancient times the
main requirement was to replace
teeth lost as a result of gum disease,
whereas in recent times it is to
restore teeth damaged by decay.
Restorations today are largely
required as a result of trauma,
decay, gum disease and aesthetics.
• The latter being a more recent area
of high demand and one in which
ceramic materials play a large role.
• McLean (1979) provides a concise
history of ceramic use in modern
dentistry.
• The use of ceramics for the
restoration of teeth has been a part
of dentistry's modern period of
evolution.
• This period started in the late
seventeen hundreds but major
advances have mainly come about
this century.
• The demand for aesthetic
restorations led to improvements in
ceramic formulation and firing
techniques.
• The types of ceramic systems have
been largely summarised by McLean.
HISTORY OF DENTAL
CERAMICS

• Dental ceramics were first used

about 225 years ago. The first
application were porcelain
dentures. Interestingly
porcelain is still quite widely
used in dentistry.
CLASSIFICATIONS

• They are classified according

to their
a) FUSION TEMPERATURE
b) USES
c) METHOD OF FIRING
d) APPLICATION
A] According to fusion
temperature:
a] high fusing - 1315*c-1370*c
use in denture teeth,

b] medium fusing - 1090*c-

1260*c
use in crowns and bridges,

c] low fusing - 870*c-1065*c

B] According to uses:
Ceramics have 3 major applications
in dentistry:
a) Ceramics for ceramic-metal
crowns and fixed partial dentures.
b) All-ceramics crowns, inlays,
onlays, and veneers when
aesthetics is a priority.
c) Ceramics denture teeth.
C] According to the
method of firing:

a) Air fired i.e. at atmospheric

pressure.

b) Vacuum fired i.e. at reduced

pressure.
 Elevator model

• Microprocessor based programmable

vacuum furnace for dental ceramics.
D] According to
application:
a) Core porcelain.

b) Dentine or body porcelain.

c) Enamel porcelain.
MODE OF SUPPLY
Porcelain is supplied as a kit
containing:
a) Fine ceramic powders in different
shades:
• Enamel
• Dentine
• Core/ opaquer
b) Special liquid/ distilled water
c) Stains
d) Glaze
Glaze

• It is of two types:

a) Over glaze
b) Self glaze
Over glaze

• These are ceramic powders

containing more glass modifiers
thus lower fusion temperature.
• It may be applied to porcelain
restoration after it has been
fired.
• It imparts an impervious glossy
surface to the restoration.
Self glaze

• All the constituents of porcelain

frit are completely melted to
form a single phase glass.
• Then the porcelain is said to be
self-glazed.
• Its chemical durability is better
than overglaze due to higher
fusion temperture.
COMPOSITION
• Feldspar -60-80%-basic glass
former
• Kaolin -3-5%- binder
• Quartz -15-25%-filler
• Alumina -8-20%-glass former
• Boric oxide -2-7%-glass former & flux
• Oxides of Na, k, & Ca -9-15%-
fluxes(glass modifiers)
• Metallic pigments less than 1%-
coloring agent.
 Feldspar
• It’s a naturally occuring mineral &
is a double silicate of potassium
& aluminium(K20.Al2O3.6SiO2).
• It’s a basic glass former.
• During firing feldspar fuses and
acts as a matrix and binds silica
and kaolin.
Kaolin

• It’s a white clay like material.

• It’s a hydrated aluminium

silicate.

• Acts as a binder, gives opacity

to the mass.
Silica
• Its obtained by grinding pure
quartz.

• It acts as a refractory skeleton

and provides strength and
hardness to porcelain during
fusing.
 Aluminium Oxide
• Replaces some silica in glass
matrix.

• It gives strength and opacity to

the porcelain.

• It alters softening point and

increases the viscosity of
porcelain during firing.
Fluxes and Glass
Modifiers
• These lower the fusion
temperature and increases the
flow of porcelain during firing.

• They also absorb or remove

impurities
Coloring Frits
• These are produced by fusing
various metallic oxides with fine
glass and feldspar and then grinding
to powder.
• They are added to dental porcelain
to obtain various shades to match
natural tooth color.
• They are oxides of tin, cobalt,
titanium, iron or gold. Opacity may
be achieved by these oxides.
• These powder are blended with
unpigmented powdered frit to
provide the proper hue and chroma.
• Examples of metallic oxides and
their respective color contributions
to porcelain includes iron or nickel
oxides (brown); copper oxide
(green); titanium oxide (yellowish
brown); mangnese oxide (lavender);
and cobalt oxide (blue).
METHODS OF STRENGTHENING
CERAMICS

1) Introduction of residual
compressive stresses into the
surface of the material.
a) Ion exchange
b) Thermal tempering
c) Thermal compatibility
2) Interruption of crack propogation
through the material
a) Dispersion of crystalline phase
b) Transforming toughening
Introduction of residual
compressive stresses:
Some techniques are:
A] Ion exchange:-
• It is introduced if Na ion having a small
ionic diameter which is a constituent of
glass, is exchanged by K ion.
• Thus there is squeezing of K ion into
smaller space termed as ”STUFFING ”.
• It creates residual compressive stress in
the surface of glass.
• This technique is also called as ‘chemical
tempering’ .
b) thermal tempering:-
• Creates residual surfaces by rapidly
cooling (quenching) the surface of the
object while it is hot and in the softened
(molten) state.
• The rapid cooling produces a skin of rigid
glass surrounding a soft (molten) core.
• As a molten core solidifies , it tends to
shrink, creates a residual tensile stress in
the core thus leaving outer skin in residual
compressive stress.
c) Thermal compatibility:-
• Ceramic in combination with metal
are heated and cooled together.
• Metal thus carrying higher
coefficient of thermal expansion on
cooling contracts more than the
ceramic, leaving the outer skin in
residual compressive stress.
• Interruption of crack propogation:
• This is another method to strengthen
the ceramic by adding a dispersed
phase of a different material that is
of capable hindering a crack from
propogating through the material.
• Two different types of dispersion
used:
• a) Dispersion of crystalline phase.
• b) Transforming toughening.
A) Dispersion of a crystalline phase:
• Tough crystalline material like alumina is
added to toughened and strengthen because
the crack can’t penetrate the alumina
particles as easily as it can propogate the
glass.
• DICOR: utilizes reinforcement when the cast
crown is subjected to heat treatment ,the
mica crystals grows in situ in glass.
• These mica crystals interrupts crack
propogation.eg. Alumina & Zirconia.
 b) Transforming toughening:
• Partially stabilized zirconium [PSZ] is
used here which is capable of
undergoing a change in crystal
structure when placed under stress.
• The refractive index of PSZ is higher
is higher than glass matrix.
• The PSZ scatters the light producing
an opacifying effect.
FABRICATION OF A CERAMIC
RESTORATION

• The porcelain powder is mixed with

the liquid to form a plastic mass
which is condensed to form the
porcelain restoration.
• Then it is fired in the furnace for
sintering.
• When shrinks and flows, so the built
up mass to be supported on the
matrix.
• Description of the steps are as
follows:
• 1) Condensation
• 2) Firing
• 3) Cooling
• 4) Glazing
CONDENSATION

• The powdered particles are closely

packaged in order to reduce the
shrinkage and minimize porosity in
the fired porcelain.
• The process of packing the
powdered particles together and
removing excess water is known as
condensation.
Method of
condensations are:
A) vibration: mild vibrations are used to densely pack
the wet powder upon the underlying matrix.
• The excess water comes to the surface and it is
blotted with a tissues.
B) spatulation: the small spatula is used to apply and
smoothen the wet porcelain.
• This action brings excess water to the surface.
C) brush technique: dry powder is placed by a brush.
• Water is drawn towards the dry powder and the wet
particle are pulled together.
D) ultrasonic: mild vibrations are transmitted
electrically.
• It is important to remember that
the surface tension of the water
is the driving force in
condensation and that the
porcelain must never be
allowed to dry out until
condensation is complete.
FIRING PROCEDURE
• It is carried out fusing the porcelain.
• The process is known as sintering.
• After condensation the compacted
mass supported by the matrix should
be placed on a fire clay tray and
inserted into the muffle of the
ceramic furnace.
• The porcelain should never be
allowed to come directly in contact
with the wall and floor of the muffle.
PORCELAIN FURNACE
• The condensed mass gradually
heated by first placing it in front
of the muffle of a preheated
furnace [approx. 650*c] and
later inserting into the furnace.
• During firing the porcelain
shrinks 30-40% by volume.
• During firing, partial fusion of
particles occur at their point
contact.
• As the temperature is raised the
fused glass gradually flows to
fill up the air spaces.
• As the fused mass is viscous all
the air cannot escape and some
get trapped, giving rise to voids
or porosity.
• Vacuum offset firing is done to
reduce porosity in porcelain.
COOLING
• It is commonly accepted that cooling
must be carried out slowly ad
uniformly.
• If shrinkage is not uniform it causes
cracking and loss of strength.
• Too rapid cooling of outer layers may
result surface crazing or cracking;
this is also called thermal shock.
• Slow cooling is preferred, and is
accomplished by gradual opening of
the porcelain furnace.
GLAZING
• After the porcelain is cleaned it is glaze to
give a smooth and glossy surface, enhance
esthetics and help in hygiene.
• Usually the glazing step is very short,
when the glazing temperature is reached, a
thin glassy film is formed by viscous flow
on the porcelain surface.
• Overglazing is to be avoided, because it
gives the restoration an unnatural shiny
appearance and causes loss of contour
and shade modification.
• Glazing temperature at times vary with the
type and brand of porcelain employed.
PROPERTIES OF FUSED
PORCELAIN
1) STRENGTH: It is a material of good
strength, however, it is brittle and
tends to fracture.
a) Flexure strength: It is a combination
of compressive, tensile, as well as
shear strength.
• Glazed porcelain is stronger than
ground porcelain.
GROUND – 75.8 Mpa [11000 psi]
GLAZED - 141.1 Mpa[20,465 psi]
b) Compressive strength: It has
good compressive strength.
331 Mpa [48,000 psi]
c) Tensile strength: It’s low
because of the avoidable
surface defects like porosities
and microscopic cracks.
34 Mpa [5000 psi]
d) Shear strength: It’s also low.
110 Mpa [16,000 psi]
2) MODULUS OF ELASTICITY: It is
high.
69 Gpa [10*106 psi]
3) SURFACE HARDNESS: Porcelain
is much harder than natural teeth.
460 KHN
4) WEAR RESISTANCE: It is more
resistant to wear than natural
teeth.
Thus, it should not be placed
opposite to natural teeth.
5) THERMAL PROPERTIES:
a) Thermal conductivity: It has
low thermal conductivity.
b) Coefficient of thermal
expansion: It’s close to the
natural teeth.
6.4-7.8*10 /C
6

6) SPECIFIC GRAVITY: 2.242.

7) DIMENSIONAL STABILITY: Becomes
more stable after firing.
8) CHEMICAL STABILITY: It is
insoluble and impermeable to oral
fluids
• It is also resistant to most solvents
• But contact with hydrofluoric acid
causes etching of the porcelain
surface
ISSUES FACING DENTAL
CERAMICS AS DENTAL
MATERIALS
• The aim of this paper is therefore to
review the role of ceramics in dentistry.
The first consideration is why use
ceramics. The reasons are as follows:

· Biocompatibility

· Aesthetics

· Durability

· Relative ease for customised units.

BIOCOMPATIBILITY

• The biocompatibility issue is essential to

prevent adverse reactions within the
patients.
• The dental ceramics in use today have
relatively low firing temperatures, usually
greater than 900°C and are resistant to
dissolution in the mouth.
• Formulations have been developed with
firing temperatures as low as 640°C,
however, these materials tend to show
considerable surface degradation in the
oral environment and hence are not useful.
AESTHETICS
• Ceramic materials have long
been admired for their aesthetic
qualities.
• The use of dentally coloured
glasses can provide
replacement structures that can
be made to imitate tooth
structure in both colour,
translucency and response to
different lighting sources.
DURABILITY

• According to Griffith, who reported that the

theoretical strength for all solids could
generally be regarded as a constant with a
value approximating E/10.
• The critical problem for all ceramic
materials, not the least those used in
dentistry is the huge difference in
theoretical strength, based on the covalent
nature of their structure, and the usual
strengths found in general use (7000-70000
MPa versus 7-700 MPa).
• Durability is an area that has led to
considerable research for ceramic
systems that can provide individually
constructed restorations, that are
small, unique, inexpensive and will
be subjected to cyclic loading in wet
and sometimes abrasive conditions.
• The advances in industrial ceramics
for such conditions have been
remarkable to say the least, in
recent decades. However, nobody is
going to allow their front teeth to be
restored with a ceramic that is dark
grey, black or opaque white.
• The advances in industrial ceramics have
included improvements in fracture
toughness, wear resistance,
machinability, solubility, hardness and
flexural strength.
• With the exception of hardness, these are
the same improvements that have been
sought in dental ceramics.
• Another major requirement apart from
aesthetics is that the ceramic not be too
hard otherwise abrasive wear of the
opposing natural tooth will be too severe.
METAL CERAMICS
• Porcelain have the disadvantage as
they lack tensile and shear strength.
They can resist only compressive
stresses.
• To overcome this demerit the
porcelain is fused directly to metal.
• The bond between them should be
strong in order to avoid leakage
between the two.
• It has the advantage of a good fit of
metal casting and esthetics of
porcelain.
PORCELAIN PORCELAIN
FUSED METAL FUSED METAL
CROWN- CROWN-
ANTERIOR POSTERIOR
• The alloy should have following properties:
a] coefficient of thermal expansion should be
close or near to that of porcelain.
b] the fusion temperature should be higher
than porcelain so that it should not sag at
firing temp.
c] possess higher modulus of elasticity to
prevent flexing of metal framework and
hence avoid fracture of metal framework
and porcelain.
d] should be capable of bond formation with
porcelain.
e] should not contain copper and silver as
they can stain and discolor porcelain.
f] should have a high proportional limit, to
avoid excess stress on the porcelain.
• Composition of the alloy:
• Should include platinum,
palladium, which increases
their fusion temperature and
reduce the coefficient of
thermal expansion.
• Should also contain zinc, tin,
indium, chromium which form
the surface oxide layer for
chemical bonding of porcelain.
• Composition of ceramics for PFM’s:
• The alkali content of the porcelain is
increased.
• Increase in the quantity of soda and
potash increases the coefficient of
thermal expansion to match that of
the metal to which it is fused, but
increase in alkali content gives a
tendency to devitrify porcelain and
appear cloudy.
• For masking the color of metal,
opacifier are added in the opaquer
porcelain.
PORCELAIN METAL BOND

• Two types of bond falls under

this category.
1] CHEMICAL BONDING.
2] MECHANICAL INTERLOCKING.
• Chemical bonding:
• It’s the primary bonding mechanism
for most metal ceramics.
• Presence of adherent oxide layer is
essential for good bond formation.
• In precious metal alloys tin oxide
and indium oxide are responsible for
the bond and in base metals
chromium oxide does this role.
• In order to have good bonding, the
metal subsurface should be free
from contamination, cleaned by
sandblasting, cleaned in an
ultrasonic cleaner, washed and
dried, it is then oxidized in the
furnace for 5 minutes.
• Mechanical Interlocking:
• Presence of surface roughness on
metal oxide surface can result in
mechanical retention, especially if
undercuts are present, wettability is
important for bonding.
• The opaque porcelain when applied
on the metal framework forms a thin
film by wetting the metal surface.
• Molten porcelain will start to wet the
surface of the metal by ‘Van der
Waal’ forces.
• Bonding using electrodeposition:

• A layer of pure gold is deposited

onto the cast metal, followed by a
short ‘flashing’ deposition of tin.
• This method has been successfully
used for metal, and alloys such as
cobalt- chromium, stainless steel,
palladium- silver, high and low gold
content alloys and titanium.
• The advantage of this method are:
1] Bonding is improved because of
improved wetting of the metal by the
porcelain and the reduced porosity
at the porcelain metal interface,
2] The electrodeposited layer acts as
a barrier between the metal casting
and porcelain to inhibit ion
penetration by the metal.
3] The gold color of the oxide film
improves the vitality and esthetics of
the porcelain, when compared to the
normal dark oxides which require
thick opaque layers of porcelain to
mask it.
4] The deposited layer acts as a buffer zone
to absorb stresses caused by differentials
in the coefficient of the thermal expansion
between porcelain and metal during
cooling.
TECHNICAL ASPECTS OF METAL
CERAMICS RESTORTAIONS

• A clean metal surface is essential

for good bonding. Impurities from the
fingers can be a possible
contaminant. The surface may be
cleaned adequately by finishing with
ceramics bonding stones or sintered
diamonds.
• Final texturing is done with an
alumina air-abrasive by process of
sandblasting. This aid in mechanical
bonding of porcelain.
• The alloy such as olympia
(J.F.Jelenko & Company, Armonk,
NY) a gold-palladium, silver alloy, is
heated in the porcelain furnace to a
temperature of 1038*C[1900*F] to
burn off impurities and degas it.
• Degassing is necessary for all gold
porcelain systems. In many alloy
systems, degassing also serves to
form an oxide layer on alloy surface
which helps in bonding.
• The next step is the application
of an opaquer. The opaquer
porcelain is condensed with a
thickness of approx. 0.3mm and
fired.
• The opaquer helps to mask the
color of the underlying metal.
The porcelain is then build up
and fired as mentioned
previously.
TYPES OF METAL CERAMICS ALLOYS
A.CAST METAL CERAMIC ALLOYS
1. Noble Metal Alloy Systems:
a. High gold-gold platinum palladium.
b. Low gold- gold palladium silver.
c. Gold free-palladium silver.
2. Base Metal Alloy Systems:
a. Nickel chromium alloys.
b. Cobalt chromium alloys. [rarely used
in ceramic bonding]
B.FOIL COPING:
1. Bonded Platinum Foil Coping.
2. Swaged Gold Alloy Foil Coping.
A. CAST METAL CERAMIC ALLOYS:

Noble Metal Alloy Systems:

a. High gold-gold platinum palladium:
• Au-88%
• Pt,Pd-varying amounts and small
amounts.
b. Low gold- gold palladium silver:
• Au- 39 to 77%
• Pd- 35%
• Ag upto 22%
c. Gold free-palladium silver:
• These are palladium based alloys.
• Possess good high temperature
strength.
• Their main drawback is the
discoloration of some porcelains
caused to the high silver contents
(yellow, green, or brown).
• Recently non- greening porcelains
have been introduced to overcome
this.
Base Metal Alloy Systems:
a. Nickel chromium alloys:
• Ni- upto 80%.
• Cr- 13 to 22%.
• Be- upto 2%.
b. Cobalt chromium alloys:
• Co- 55 to 68%.
• Cr- upto 25 to 27%.
Allergic reactions

• Nickel based alloys can

potentially cause allergic
reactions or eczematous
reactions to the underlying
soft tissues on which it is
applied.
Foil Coping
Bonded Platinum Foil Coping:
• This method of bonding porcelain to metal
is the use of tin oxide coating on platinum
foil.
• The method consist of bonding aluminous
porcelain to platinum foil coping.
• Attachment of the porcelain is secured by
electroplating the foil with a thin layer of
tin and then oxidizing it in a furnace.
• The objective of this type of restoration is
to improve esthetics.
• Swaged Gold Alloy Foil Coping.
• A laminated gold alloy foil
(Renaissance-Unikorn Ltd, Tel Aviv,
Isreal) supplied in fluted shape is
also used as an alternative to the
cast metal coping.
• The foil is swaged onto the die and
flames sintered to form a coping.
• An “interfacial alloy” powder is applied
and fired and the coping is then
veneered with porcelain
• Creep or Sag:
• When temperature of some high noble
alloys approaches 980*C they undergo
creep.
• It can be reduced if metal has the proper
composition so that a dispersion
strengthening effect occurs at high
temperature.
• It has been reduced in some of the
commercial alloys, but it apparently
cannot be eliminated.
• The solidus temperature of base
metal alloys, such as nickel-
chromium, is higher than that of
gold alloys; hence, base metal
alloys are less susceptible to
sag than are gold-based alloys.
Classification of bond
failure in metal ceramic
• Given by O’Brain[1977]
1) Metal-Porcelain:
2) Metal Oxide-Porcelain:
3) Metal-Metal Oxide:
4) Metal Oxide-Metal Oxide:
5) Cohesive within Metal:
6) Cohesive within Porcelain:
1) Metal Porcelain:
• Fracture leaves a clean
surface of metal.
• Seen when metal surface is
devoid of oxides.
• May also be due to
contaminated or porous metal
surface.
2) Metal Oxide-Porcelain:
• Porcelain fractures at metal
oxide surface, leaving oxide
firmly attached to metal.
• Seen more often in base metal
alloys.
3) Metal-Metal Oxide:
• Metal oxide breaks away from
the metal and is left attached
to porcelain.
• Seen commonly in base metal
alloys systems due to over
production of chromium and
nickel oxides.
4) Metal Oxide-Metal Oxide:
• Fracture occurs through the
metal oxide.
• Results from overproduction of
oxides causing sandwich effect
between metal and porcelain.
5) Cohesive within Metal:
• More common in bridges where
the joint area breaks.
• Rarely seen in single crowns.
6) Cohesive within Porcelain:
• Tensile failure within porcelain.
• Bond strength exceeds strength
of porcelain.
• Seen in high gold content
alloys.
 Failure of Ceramic
Dental Restorations
• The clinical observations tend to show
catastrophic mechanical failure. There
are reports that ceramic restorations
such as inlays and crowns fail due to
occlusal (biting together) injury not
unlike that of a small spherical
indentation.
• This has led to at least one group using
a small spherical indenter of 2
millimetres diameter as a testing
devices to produce similar failures in
vitro.
• Perhaps the most important
consideration to note are the
possible driving forces associated
with stresses formed from elastic
components within the field of the
initial crack.
• Another consideration is the choice
of indenter to produce a failure. In
general, the contacts between teeth
are the same as small spherical
indenters, changing with age and
wear to broader, flatter contacts.
• The cusps of teeth are naturally
rounded. As teeth become worn they
tend to exhibit small milled facets and
so the contacts can become much
broader.
• A spherical indenter rather than a
sharp indenter is therefore the system
of choice when measuring the
behaviour of the ceramic system in
question.
 DENTAL CERAMICS
&
ITS RECENT
ADVANCEMENTS
ALL-CERAMIC RESTORATIONS
• Materials for all ceramics restoration use a
wide variety of crystalline phases as
reinforcing agents and contain up to 99% by
volume of crystalline phase.
• The nature, amount, and particle size
distribution of the crystalline phase directly
influence the mechanical and optical
properties of material.
• This has led to a series of differing ceramic
structures available for dentistry, with some
examples described below.
• THE FELSPATHIC PORCELAIN
• THE CASTABLE GLASSES
• THE ALUMINA JACKET CROWNS
• PURE ALUMINA CORE-HEAT
CURED AFTER PRESSING
• THE GLASS-INFILTERATED
ALUMINA SYSTEM FOR CORE
 THE FELSPATHIC
PORCELAINS
• Several summaries for the composition
of dental porcelain have been written.
• They cover the composition of
felspathic porcelain as a veneering
porcelain in all-ceramic and metal-
ceramic crowns.
• They describe a history of modifying
the basic Potash Feldspar-Quartz-
Kaolinite mix by the removal of mullite
and free quartz, while increasing
sodium oxide and alkaline earth oxides
as bivalent glass modifiers, to improve
translucent properties while trying to
maintain strength.
• Fluxing agents have also been added
to lower the melting temperatures
and make them easier to handle in
the dental laboratory.
• These materials are now
substantially glassy and Binns (1983)
describes their classification as a
porcelain as “somewhat of a
misnomer”.
• The K2O content was also varied to
accommodate the need to match the
coefficient of thermal expansion for
metal alloys used in dental metal-
ceramic techniques.
• The increase in K2O content allowed a
greater proportion of leucite crystals
(coefficient of thermal exp. 27 x 10-
6/°C) which led to the overall
coefficient of thermal expansion rising
to something in the order of 13.5 - 15.5
x 10-6/°C.
• The felspathic porcelains used in all-
ceramic systems have coefficients of
thermal expansion ranging from 5.5 -
7.5 x 10-6/°C when used over castable
glass and alumina based core
materials, to 16 x 10-6/°C when used
over the newer pressed leucite
systems.
The Leucite Systems
• Leucite has been widely used as a
constituent of dental ceramics to
modify the coefficient of thermal
expansion.
• This is most important where the
ceramic is to be fused or baked onto
metal.
• The recent introduction of the
pressed leucite reinforced ceramic
system, IPS Empress, has leucite in
a different role.
• This material relies on an increased
volume of fine leucite particles to
increase flexural strength.
• Leucite is used as a reinforcing phase in
amounts varying from 35% to 55%.
• Ceramic ingots are pressed between 1150*
and 1180*c (under a pressure of 0.3 to 0.4
Mpa) into a refractory mold made by the
lost wax technique.
• The temperature is held for about 20
minutes in a specially designed automatic
press furnace.
• The final microstructure of these heat
pressed ceramics consists of leucite
crystals, 1 to 5 micron, dispersed in glassy
matrix.
• Similar versions using finely
dispersed leucite grains to increase
toughness, strength and modify wear
patterns and rates to make them
similar to enamel wear rates are
now available for metal-ceramic
restorations.
 THE CASTABLE
GLASSES
• The development of glass ceramics by
the Corning Glass Works in the late
1950's has led to the creation of a
dental ceramic system based on the
strengthening of glass with various
forms of mica.
• The Dicor® crown system uses the lost
wax system to produce a glass casting
of the restoration.
• The casting is then heat treated or
“cerammed”, during which tetra
silicic fluromica crystals are
formed to increase the strength
and toughness of the glass
ceramic.
• This procedure is designed to take
place within the economic
confines of a commercial dental
laboratory.
• A second dental version was
developed to be used for CAD/CAM
dental procedures.
• This cerammed glass is provided in an
already heat treated state from the
manufacturer. In this latter technique
an optical scan of a prepared tooth is
loaded into a computer and a milling
system is used to produce the
restoration.
• The restoration is then “bonded” to the
remaining tooth structure using a
dental BisGMA based composite resin.
THE ALUMINA BASED SYSTEMS
THE ALUMINA JACKET CROWNS

• The modern Aluminous Jacket Crown,

probably more commonly known as the
Porcelain Jacket Crown (PJC) was
popularised in the mid 1960’s by McLean.
• This report also points out the importance
for the use of alumina in dental ceramics
and how it modifies the flaw systems at
the surface and within the ceramic.
• The aluminous porcelains reported by
McLean are also very prone to strength
degradation when they contain porosity.
PURE ALUMINA CORE-HEAT
CURED AFTER PRESSING

• The Nobel Biocare company from Sweden

have introduced two systems that
essentially use a system of pressing
alumina onto a metal die, removing the
pressed shape from the die and then
sintering it.
• One system is used to make alumina
profiles that are then used as cores to build
up ceramic superstructures for single tooth
implants, CeraOne®,& the second is to
make cores for conventional crowns, a
process known as Procera®.
• Unlike the other dental ceramic
materials, there is no glassy
phase present between the
particles.
• Feldspathic veneering
porcelains such as Vitadur
Alpha@ & Duceram® are then
fired onto this alumina core to
provide the colour and form for
the restoration.
• This heat pressing is also called
as ‘high temperature injection
molding’.
• Heat pressing classically helps
avoid large pores and promotes
good dispersion of the
crystalline phase within the
glassy matrix.
• The mechanical properties of
many ceramics systems are
maximized with high density
and small crystal size.
Lithium Disilicate-Based Materials
• These materials contain lithium
disilicate[Li2Si2O5] as a major crystalline
phase.
• They are heat pressed in the 890*to 920*C
temperature range, using the same
equipment for leucite based ceramics.
• The heat pressed restoration is later
veneered with ceramics of matching
thermal expansion.
• The final microstructure consist of
prismatic lithium disilicate crystals(0.5 to
5 microns long) dispersed in glossy matrix.
• The main advantage of these ceramics is
their good flexural strength(350 Mpa) and
fracture toughness (3.2 Mpa).
Lithium Phosphate-Based ceramics

• This ceramic contains lithium phosphate

(Li3PO4) as a major crystalline phase which
can be heat pressed on to a zirconia
endodontic post.
• The heating temperature is about 900*C
where pressing can be done in a
conventional heat pressing furnace.
• The glossy matrix consist of spherical
lithium phosphate crystals uniformly
dispersed.
• The main advantage of this ceramics is good
aesthetics and high strength (but higher
opacity) and the short processing time.
GLASS-INFILTERATED
ALUMINA SYSTEM FOR CORE

• During the 1980’s, Dr. Michael Sadoun and

Vita Zahnfabrik, developed a slip casting
system using fine grained alumina.
• The cast alumina was sintered and then
infiltrated with a Lanthana based glass.
• This provided a glass infiltrated alumina
core (In-Ceram®) on which a felspathic
ceramic could be baked to provide the
functional form and aesthetic component
of the restoration.
• The system also has the greatest
versatility for dental use of any
metal free ceramic restorative.
• In-Ceram has the highest flexural
strength and fracture toughness of
all the currently available dental
ceramic systems available to most
commercial dental laboratories.
• The driving force for these
developments has been the immense
difference in reliability between metal-
ceramic systems and all-ceramic
systems and a public perception that
metal-free restorations are more
aesthetic.
• The disadvantages of the metal
ceramic systems include radiopacity,
long processing time some questions
centring around metal biocompatibility
and lack of natural aesthetics;
important features in today's consumer
conscious dental market.
Spinel-and Zirconia-Based Materials

• Two modified ceramic composition for this

technique have been recently introduced.
• One contain a magnesium spinel(MgAl2O4)
as the major crystalline phase with traces
of alpha alumina,which improves the
translucency of the final restoration.
• The second material contains tetragonal
zirconia and alumina.
• The spinel bound ceramic has a lower
modulus of rupture than the alumina based
materials, whereas the zirconia-based
material has a reported flexural strength
neighbouring 600 Mpa.
CAD/CAM

• CAD-CAM (computer assisted design-

computer assisted machining)
technology is used to produce
restorations in one office visit.
• Its was first introduced in germany
in 1986.
• After the tooth is prepared, the
preparation is optically scanned and
the images is computerized.
• The restoration is designed with the
aid of the computer, as shown in the
figure.
• The restoration is then machined
from ceramic blocks by a computer-
controlled milling machine.
• The milling process takes only a few
minutes.
• Although convenient, the CAD-CAM
system is very expensive and its
marginal accuracy is poor, with gap
value of 100 to 150 microns. Bonding
of the restoration with resin cements
may help compensate for some of
the problems of poor marginal fit.
• The disadvantages of this technique
include the need for costly equipments, the
lack of computer-controlled processing
support for occlusal adjustments, and the
technique-sensitive nature of surface
imaging that is required for the prepared
teeth.
• The advantages includes negligible
porosity levels in the CAD-CAM core
ceramics, the freedom from making an
impression, reduced assistant time with
impression procedures, the need for only a
single appointment (with ceram system),
and good patient acceptance.
ALL CERAMIC CERCON BRIDGE
• ALL CERAMIC- • ALL CERAMIC
IN CERON, PROCERA
PFM CROWN
• ALL CERAMIC- • ALL CERAMIC-
IN-CERON, FULL PROCERA
METAL CROWN (UPPER &
LOWER)
• ALL CERAMIC- • ALL CERAMIC-
PROCERA PROCERA
(UPPER) (LOWER)
CROWN POST LARGE
CROWN LARGE
OPTICAL PROPERTIES
OF DENTAL CERAMICS
• Color matching is a critical problem in
replacing portion of natural teeth.
• Porcelain, being partially amorphous in
structure, does not resemble crystalline
enamel completely.
• As a result, various kinds of light are
reflected and absorbed in different
manners by he tooth tissue and porcelain,
and restorations viewed from an angle may
not appear the same as they do when
viewed from the front.
• The cementing medium is an important
factor in the final appearance of an all
ceramic restorations.
• Because of its opacity, an all ceramic
restoration may be cemented with a wide
range of luting agents, but not with resin-
modified GIC.
• However, more translucent all ceramic
restoration such as a leucite-reinforced
heat pressed crown or veneer, or a
machined inlay or veneer, usually requires
the use of translucent resin luting agents
that are available in different shades.
• The range of colors of natural teeth is
much greater than the range available in a
kit of premixed porcelain, modifier
porcelains are also supplied for
adjustments.
• These modifiers are strongly pigmented
porcelain to the opaque and body porcelain
usually supplied in blue, yellow, pink,
orange, brown gray.
• The dental technician may add the
modifier to the opaque and the body
porcelain during the building of the crown.
• Extrinsic surface staining is another
method of changing the color of a dental
porcelain crown, involves the application
of highly pigmented glazes.
• The main disadvantage of surface staining
are a lowered durability and the reduction
of translucency.
Translucency
• It’s another critical property of dental
ceramics.
• The translucency of opaque, dentin
(body), and enamel (incisal) porcelain
varies considerably.
• Opaque porcelain have very low
translucency, allows them to mask metal
subsurface structure.
• Dentin porcelain translucency value
ranges between 18%-38%.
• Enamel porcelain have the highest values
of translucency, ranging from between
45%-50%.
• The translucency of material for all
ceramic restoration varies with
nature of reinforcing crystalline
phase.
• Alumina- and zirconia-based systems
are opaque, whereas leucite-
reinforced systems are more
translucent.
• The translucency of spinel-based
systems is comparable with that of
lithium disilicate-based systems and
intermediate between alumina-based
and leucite-reinforced systems.
• Dental enamel is fluorescent under
ultraviolet light, uranium oxide had
been added to produce fluorescence
with porcelain.
• However, because of the low but
detectable radioactivity of uranium,
newer formulations contain are earth
oxides (cerium oxide) to produce
fluorescence.
Chemical Attack Of Dental
Ceramic By Acidulated
Phosphate Fluoride
• Topical fluorides are routinely used
for caries control. The effect of such
agents on the surface of ceramics
restorations has been studied.
• Acidulated phosphate fluoride (APF) ,
one of the most commonly used
fluoride gels, is known to etch glass,
probably by selective leaching of
sodium ions, thereby disrupting the
silica network.
• Within 4 minutes a 1.23% APF or 8%
stannous fluoride can produce a
rough porcelain surface, when come
in contact.
• A 30 minutes exposure to 1.23% APF can
attack the glass phase of gingival (body)
porcelain and can produce surface crazing.
• A 300 minutes exposure can produce a
generalized severe degradation of
porcelain surface, which could further lead
to staining, plaque accumulation, and
severe breakdown of structure.
• A lower concentration of 0.4% stannous
fluoride, or 2% sodium fluoride, has no
significant effect on the ceramic surface.
• Dentist should be aware of long term
clinical effect of fluorides on ceramic and
composite restoration [because of their
glass filler particles] and avoid the use of
APF gels when composites and ceramics
are present.
• APF should not be used on
glazed surface of porcelain, if
used, the surface of the
restoration should be protected
with petroleum jelly, cocoa
butter, or wax.
TYPES OF DENTAL
RESTORATIONS
• The types of restorations involved include:

• SIMPLE FELDSPATIC VENEER

• PORCELAIN JACKET CROWNS AND BRIDGES

• METAL-CERAMICS CROWNS AND BRIDGES

• INLAYS AND ONLAYS

• IMPLANT SUPERSTRUCTURES.
SIMPLE FELDSPATIC
VENEER

• The simple veneers are essentially

an enamel replacement used
mainly for aesthetic reasons on
anterior teeth.
• They are approximately 0.5 mm
thick and are glued or “bonded” to
the tooth using a dental composite
resin.
• They are very reliant on the
mechanical integrity of the
supporting tooth to provide enough
stiffness to prevent loads flexing the
restored tooth and exceeding the
critical strain limit of the ceramic
veneer.
• In general, dentists are not aware of
the flexibility range for teeth and
these restorations are often
inappropriately used.
PORCELAIN VENEERS
 PORCELAIN JACKET
CROWNS AND BRIDGES
• Porcelain Jacket Crowns are a more
extensive restoration.
• These are used to replace virtually all the
enamel component and some dentine.
• This means that they are almost always
supported by dentine in a vital tooth, or cast
gold in a non-vital tooth.
• They are at least 1 mm thick and depending
on the system used are either made from a
single material, as found in Dicor and IPS
Empress crowns or are bilaminar such as In-
Ceram® and Procera Crowns.
• In-Ceram® and Procera® use
variations of alumina as a toughened
and high strength underlying core to
support feldspathic veneering
porcelain which gives the final shape
and aesthetic attributes required for
the restoration.
• In-Ceram® and Procera® are also the
only systems that can be used to
construct three unit bridges, where
missing tooth is replaced using the
adjacent teeth as abutments.
 METAL-CERAMICS
CROWNS AND BRIDGES
• Metal-ceramic restorations as described
earlier use an alloy, originally based on gold,
to form a tough and rigid base for the
veneering ceramic.
• This ceramic usually contains leucite as a
coefficient of thermal expansion modifier to
reduce stress between the metal and ceramic
during the firing process.
• The modern versions are now using finer and
denser dispersions of leucite to improve
mechanical properties for wear and flexural
strength.
INLAYS AND ONLAYS

• Inlays and onlays are made from

a variety of the systems
mentioned above, with no real
preference, although systems
containing dispersions of
leucite seem to be gaining
ground.
INLAYS
IMPLANT
SUPERSTRUCTURES

• Implant superstructures can be

made using the metal-ceramic
systems or the alumina based
ceramic systems.
IMPLANTS
Ceramics in Modern
Dentistry

• Current applications of
ceramics in dentistry include
• 1) Fillings
• 2) Crowns & Veneers
• 3) Implants
• 4) Dental Brackets
Fillings
• Traditionally filling have been made
from silver/tin/mercury amalgams.
• However, resin based filling materials
are rapidly gaining in popularity for
health and aesthetic reasons.

• These resins are usually filled with

35-85% ceramic fillers such as
silicate glasses, colloidal silica or
quartz.
• Despite the advantages of using
ceramic filled resins, these
materials may be susceptible to
wear when applied to chewing
surfaces.
• For this reason, all-ceramic inlays,
onlays and crowns are also gaining
in popularity.
• CAD-CAM systems are also
becoming more popular allow
dentists to machine dental ceramic
blanks to suit individual patients
and fir them in the same visit.
Materials that are suitable for
this application include:

• Leucite reinforced feldspathic

porcelain.
• Alumina with continuously
interconnected porosity, infiltrated
with lanthanum aluminosilicate
glass, after machining to provide
translucency.
• Glass infiltrated porous spinel.

• Glass infiltrated porous zirconia.

Crowns and Veneers
• Porcelain fused to metal (PFM)
materials constitute about 75% all
crowns in a market consuming about
30 million crowns in the USA alone.
• The porcelain used is a feldspathic
porcelain.
• The porcelain contains varying
amounts of crystallised leucite.
• The amount of crystallised leucite
influences properties such as
strength and thermal expansion.
• Thermal expansion is critical in the
manufacture PFM implants to avoid
cracking of the ceramic, which could
lead to failure during manufacture or in
operation.

• PFM materials are also used for veneers

to cover damaged front teeth and
crowns, although ceramic cores are
being used in some crowns.
• All ceramic crowns are normally coated
with porcelain so that colour and
translucency can be matched.
Dental Implants
• Dental implants are used as an alternative
to bridges where a tooth has been lost or
removed.
• These are also made of PFM, where a
biocompatible metal post made out a
material such as titanium is anchored into
the jaw bone and the porcelain crown is
affixed to the post.

• The metal post may also be coated with

hydroxyapatite to aid bone bonding and
rapid osseointegration.
• Bioglass posts are sometimes used for this
purpose for the same reason.
IMPLANTS
Orthodontic Brackets

• The most recent use for ceramics in

dentistry is orthodontic brackets.
• The development and demand for
these items has been driven solely
by aesthetics.
• Polycrystalline alumina is the
material of choice in this
application.
 Case
Presentation
Tetracycline Treatment
• The young lady in the adjacent photo
expressed a desire of treating her severely
stained teeth. She too received
tetracycline treatments as a youngster...
for an extended time. All of her teeth had a
"stain band" (see photo's for detail).
• Her primary goal was to have the "whitest
of white" teeth. It was determined that her
teeth would respond to a "customized"
application of teeth whitening procedures.
• Different Patients - Different
Teeth Whitening
• No two patients will respond
identically to a particular teeth
whitening procedure. They uses
any combination of BriteSmile,
Zoom, Crest Whitening Strips,
Rembrandt and laser teeth
whitening methods that will be
effective for the individual
patient.
• Tetracycline Bleaching - Cosmetic Dentistry

• During the patient's consult with dentist she

learned that additional procedures could help
her address some other cosmetic concerns.
• She had gaps between her upper teeth and
also had teeth that were too narrow.
• Crowns that were placed by another dentist
were too dark. Lastly, gumline symmetry was
not balanced.
• It was decided by the patient that she would
not only acquire and ultra bright smile but
undergo some popular cosmetic procedures
incorporating the use of porcelain materials
to match the whiteness achieved on her
natural teeth.
• The first step, before selecting the
porcelain materials, was to achieve the
highest degree of whiteness for all of her
teeth.
• Laser teeth whitening procedures was
used first to obtain the shade of whiteness
desired by the patient. Her teeth
responded well to the laser treatments.
• Porcelain crowns were recommended to
widen the narrow appearance of her smile.
thereby closing up the apparent gaps in
her upper teeth.
• Dentist was able to help the patient
understand that the net effect would be an
even broader, natural looking and whiter
smile which would certainly enhance her
attractiveness.
Precision Dental
Ceramics

• Matching the color of the new porcelain materials to

the patient's new whiteness level of her lower teeth
was no small task... requiring close coordination
between the patient, Dentist and his ceramist.

• This extra effort had a very dramatic impact on this

reconstructive effort, as can be seen in this second
photo. The patient overwhelmingly achieved her
primary goal of having the "whitest of white" teeth.
• No unsightly stains. The gum
reshaping and recontouring
produced a symmetrical gum line
that was desired by the patient.
Precision ceramics produced a smile
line (the arc of the lower biting edge
of the upper teeth) that established
the final "harmony" of her smile (the
pictures tell the story).

• Review the photos below for closer

detail
 GENERAL DISCUSSION

• Despite the substantial improvements

in the mechanical properties of dental
ceramics there is still an unacceptable
degree of failure of these materials in
service.
• These failures often arise because of
the dentists and technicians attempts
to achieve aesthetic design,
particularly of complex multi-tooth
bridges.
• There is still considerable scope for the
further improvement of dental ceramics
but not without very careful consideration
of the aesthetics and simplicity of
fabrication.
• Other failure mechanisms are due to
impact failure from opposing teeth or high
localised stresses due to hard particulates
caught between the teeth, poor adhesion
between the ceramic and the underlying
tooth or metal support.
• There is still considerable
scope for the improvement of
properties and microstructures
of dental ceramics including a
more critical attempt to mimic
the structure developed by
nature.
CONCLUSION
• The mechanical properties of these
materials have shown a significant
improvement during the last few
decades with a move towards the all
ceramic crown for the more severely
loaded posterior application.
• Some of the unique recent
developments such as the simple net
shape forming of high strength and
high toughness interpenetrating
networks of alumina and a lanthana
glass ceramics have a wider
application than just dental
applications.
REFERENCES
• Note: References for this article are
available by referring to the original
text.

• Primary author: J.G. Ironside and M.V.

Swain

• Source: Journal of the Australasian

Ceramic Society, Vol. 34 no. 2, pp. 78-
91 (1998).
• www.azom.com
• Craig’s Restorative Dental
Material-12th edition.
• Phillip’s Science of Dental
Materials-11th edition.
• John J Mannipalli.
• www.santamonicacosmetic-
implantdentist.com/te...
PHOTOGRAPHS OF SOME
DENTAL PORCELAIN
LABS.