HYBRID CERAMICS

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 HYBRID CERAMICS
 New Materials That Have Different Names:

Polymer- Resin- Ceramic-

infiltrated matrix like
ceramics ceramics materials

Resin composite CAD/CAM blocks

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 Definition:

• Hybrid ceramic (Polymer infiltrated) is a

material that combines the advantages of
ceramics (esthetics and strength) and
composites (elasticity and minimal wall
thickness of the restoration).

Hybrid
Ceramics Polymers
Ceramics

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• This category comprises materials with an organic
matrix highly filled with ceramic particles.
• The presence of an organic matrix would
theoretically exclude resin-matrix ceramics from
the author ̓classification proposal if the
traditional definition of ceramics was considered
(nonmetallic inorganic materials usually
processed by firing at high temperature to
achieve desirable properties).

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• However, resin-matrix ceramics are being
included because the 2013 version of the ADA
Code on Dental Procedures and Nomenclature
defines the term porcelain/ceramic as:
• (Pressed, fired, polished, or milled materials
containing predominantly inorganic refractory
compounds including porcelains, glasses,
ceramics, and glass-ceramics).

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• Therefore, the materials presented in this
section do fit into this category because they
are composed predominantly (> 50% by wt.)
of refractory inorganic compounds,
irrespective of the presence of a less
predominant organic phase (polymer).

They are also Referred to as Ceramic-Like Materials.

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• This is quite a change with respect to the
former version of the referred code (2012),
which defined porcelain/ceramic as ̋ non-
metal, non-resin, inorganic refractory
compounds processed at high temperatures
(600 ͦC/1,112 ͦF and above) and pressed,
polished, or milled including porcelains, glasses
and glass-ceramics ̏.

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 Composition:

• Vary substantially.
• Hybrid ceramics contains 86% of ceramics and
14% of polymer.
• Ceramic structure includes, 58-63% SiO2, 20-
23% Al2O3, 9-11% Na2O, 4-6% K2O, 0.5-2% B2O3,
% ZrO2 and CaO.
• Resin structure usually is composed of Bis-
GMA, UDMA, Bis-EMA and TEGDMA.

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 Prepared by:

• Primarily, a pre-sintered porous structured

feldspathic ceramics are produced.

• In the second stage, the porous ceramic

structure is filled with resin.
• Prior to the infiltration, silane is added as
bonding agent for chemical bond between the
two structures.

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• Examples:

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 Rationale to develop:

• Obtain a material that more closely simulates

the modulus of elasticity of dentin when
compared to traditional ceramics.

• Develop a material easier to mill and adjust

than glass matrix and polycrystalline ceramics.

• Facilitate repair or modification with

composite resin.

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 Mechanical manufacture of dental restorations:

• They are specifically formulated for CAD/CAM

method.

• Fabrication of dental restorations begins with

scanning, selection of materials and tooth
shade, designing, milling, followed by
finishing, polishing, ends with staining and
glazing.

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 Types of materials:

• Can be divided into several subfamilies

according to their inorganic composition as
follow:

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 1- Resin Nanoceramics

 Eg. Lava Ultimate, 3M ESPE

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• Lava™ Ultimate Restorative, the world’s first
resin nano-ceramic material, designed for
precision, speed and single-appointment
efficiency.

• Because the resin nano-ceramic material is

less brittle than glass ceramic, it resists
chipping and cracking when milled.

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• Lava™ Ultimate provides a restoration with
no post firing step, so the restoration is
finished faster.

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• Besides the benefits of resin nano-ceramic
material that includes:-

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 Composition of the material:-

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Indications:-

Mechanical properties & wear performance:-

•Higher filler loading of ceramic nanofillers reduce the interstitial spacing of filler particles and
improve the physical and mechanical properties of the material.

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 Color and translucency:- (LT & HT)

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 Cementation of restoration:- 3M ESPE offered

 Cementation steps:-
1- Cleaning of restoration
2- Sandblasting
3- Scotchbond primer application
4- RelyX™ Ultimate resin application
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2- Flexible Nanoceramics

 Eg. Cerasmart universal, GC

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 CeraSmart,
The first force absorbing flexible nanoceramic

• It consists of a flexible nanoceramic and resin

matrix with an even distribution of nanoceramic
fillers.
• This specially designed nanoceramic matrix
makes it an ideal high strength and force
absorbing restoration for all indications.
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 Composition:-

 Indications:-

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 Microscopic Picture & Properties:-

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• CeraSmart, a flexible nanoceramic that retains
accurate designed margins without chipping.

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 Adhesive Cementation:-
• (PRIOR TO USE, CarEFully Read The InsTrUctions for Use).

• The material could be sandblasted with 25-50µm

alumina (0.2MPa). Or acid etched with HF (5%) for
60 seconds.
• Followed by, silane application.
• Cementation could be done using traditional resin
cement technique.
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3- Nanohybrid composite

Eg.1- Grandio blocs,

VOCO

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 Composition:-

• Grandio Blocs provide a new solution for

practitioners and labs that are looking to
streamline their CAD/CAM processes and deliver
high-quality restorations.
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 Their unique nano-ceramic resin hybrid
makeup allows for:-
• - Excellent polishability,
• - Enabling finer milling,
• - Greater accuracy of fit and esthetics

Compared to pure ceramic CAD/CAM blocks.

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They also,
•- Eliminate the firing process
•- Allow for intraoral repairs, saving time and money.
•- Offer physical properties that mimic natural teeth
with enhanced color stability and low water
absorption.
•- Are antagonistically friendly with opposing teeth.
•- And can be processed using any conventional
milling unit.
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 Grandio Blocs are available in:-
• Two sizes

• Two translucencies and multiple shades.

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 Indications:-

 Adhesive cementation:-
• Cementation of Grandio blocs is always carried
out using a bonded-in cementation system.
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• Bifix QM, in combination with Futurabond U
and Ceramic Bond, is the system of choice for
ensuring that the highest standards are met.

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 Eg. Rebilda Post GT, VOCO

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• Rebilda Post GT, is said to offer enhanced
physical properties and capabilities.

• Core build-ups of endodontically treated teeth

often employ the use of a root post to provide
the basis for a stable build-up.

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• However, it is common for situations to arise
which limit the possibilities for using
conventional root posts such as atypical root
anatomies (e.g. overly curved root canals,
pronounced conicity, etc.).
• Rebilda Post GT: is a bundled glass fiber-
reinforced resin post.
• a first of its kind consisting of multiple
diametrically smaller (0.3 mm) posts.
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 Advantages of Rebilda Post GT:-
• 1- These bundles of finer posts, vary in number
depending on require post size.
• 2- Offer enhanced physical properties and capabilities
that enable its use when the above situations arise.
• 3- Additionally, they are said to eliminate the need to
mechanically prepare the root, preserving healthy
tooth structure while minimizing trauma to the tooth.

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• 4- Has high radiopacity, flexural strength,
fracture resistance, and elasticity similar to
dentin;

• which allow it to be the solution whether it is

for routine, everyday post and core
procedures or the more difficult yet common
place atypical root canal anatomies.

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• 5- After Rebilda Post GT is seated within the
root canal;
• The bundled posts are designed to
intentionally spread out to increase the
surface area they can offer to the core build-
up restoration. This in turn creates greater
adhesion and retention values to the build-up
restoration.

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• 6- The system is compatible with all core
build-up materials.

• Rebilda Post GT is translucent and comes in

four different traditionally sized posts: 0.8 mm
(4), 1.0 mm (6), 1.2 mm (9) and 1.4 mm (12).
• The system can be ordered as a complete kit
that also contains the adhesive resin.
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 3- Glass-ceramics in a resin
interpenetrating polymer network
 Eg. Enamic, Vita

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• It is Typically Composed of A dual Network:-

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 Ceramic network Polymer network
• A feldspathic ceramic network • Resin network (14% by weight-
(86% by weight - 75% by 25% by volume).
volume).
• Usually composed of UDMA
• The specific composition of the and TEGDMA.
ceramic part is:
58-63% SiO2, 20-23% Al2O3,
9-11% Na2O, 4-6% K2O
0.5-2% B2O3, and <1% Zr2O
and CaO
This material is referred to as hybrid ceramic
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• In a dual-network structure, the dominant
ceramic network is strengthened by a polymer
network.

• With both networks fully integrated with one

another, VITA ENAMIC combines the positive
characteristics of both materials (ceramics &
composites).

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Product benefits/features:-
• Range of indications:- Inlays, onlays, veneers, crowns, and
implant supported crowns.
• Enormous load capacity:- Following bonding with tooth
substance, VITA ENAMIC is immensely strong and guarantees
an excellent distribution of masticatory force.
• Its polymer network offers outstanding absorption of
intraoral load.
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• Excellent reliability:- that offers an integrated crack-
stop function.
• Restorations that are gentle on oral substance:- due
to high load capacity with absorption of masticatory
forces, high elasticity, and enabling minimally-
invasive treatment.
• Precise and accurate restorations 
• Fast and efficient fabrication
• Natural results that match the tooth shade
• Cost effective.
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 Indications:-

 Designation/ size:-

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 Product data/ forms:-
• Vita Enamic, is available in three variations, several
translucency levels, and multiple shades:-

Translucency Levels:-
• T (Translucent)
• HT (High Translucent)
Variations:-
• ST (Super Translucent)

Vita Enamic, Vita Enamic,

Vita Enamic
multiColor IS

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 Adhesive cementation:-
• Done using light- or dual-curing resin cements.
• The restoration could be etched with VITA CERAMICS
ETCH and silanized prior to cementation.

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 4- Zirconia-silica in a resin
interpenetrating polymer network
 Eg. 1- Block Hc, Shofu

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 Composition:-

• This unique hybrid ceramic CAD/CAM

material ensuring; high aesthetics, with
exceptional natural light transmission as well
as high flexural strength and durability.
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Features/ benefits:-

Indications:-
•Minimally invasive inlays, onlays, cosmetic veneers, full crowns for
anterior and posterior teeth, and implant-supported restorations .

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 Forms:-
• Block & Disk shape specimens
• In one-Layer or two-Layers
• With different shades and translucencies.

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 Adhesive cementation:-
• HC Primer, an innovative bonding system
infiltrating the polymer matrix and ensuring
very high bond strengths is recommended in
combination with ResiCem resin cement.

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 Eg. 2- Paradigm MZ-100 block, 3M ESPE

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Composition:-

•3M™ Paradigm™ MZ100 Block for CEREC® is a strong, wear-

resistant, and esthetic mill block that provides a fast and easy-to-use
alternative to porcelain blocks for CEREC restorations.
•Paradigm MZ100 blocks are made under optimized process
conditions that assure thorough cure and a high degree of
crosslinking.
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• This process contributes to excellent physical
properties and clinical performance.

• Paradigm MZ100 blocks are designed for use

in the CEREC system, and are mounted on a
mandrel for use in CEREC machines.
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 Key product features:-

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• Paradigm MZ100 material is radiopaque.
• Available in 6 different shades: A1, A2, A3,
A3.5, B3 and Bleach and in 5 different sizes (I8,
I10, I12, I14, V5-12).

 Indications for Use:-

• Inlays, onlays, veneers, and full crown
restorations.
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 Adhesive cementation:-
• Paradigm MZ100 restorations are bonded to tooth
structure with an adhesive resin cement such as
3M™ RelyX™ ARC Adhesive Resin Cement.
• Steps include:- Roughening the bonding surface
with a diamond. air abrasion improves bond. Then
Apply 3M™ Scotchbond™ Ceramic Primer. Dry for
5 seconds and Apply Cement.

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Other hybrid ceramic materials:-

 Eg. 1- KZR-CAD HR

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 Composition:-
• Is shown in the previous figure.
 KZR-CAD HR, has an outstanding strength and
durability. At the same time, it also has
excellent processability and polishability and
fluoride sustained release.
• It is also less likely to wear natural teeth and
maintains glaze.
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 Indications:-
• Indirect single tooth restorations.

 Adhesive cementation steps:-

• Alumina sandblasting, washing with phosphoric
acid after trial, surface treatment (silane coupling
agent). Followed by tooth surface treatment,
cement application, pressing down and light-
curing.
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 Eg. 2- BRILLIANT Crios

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 Composition:-

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 Properties:-
 1- High Performance – Made Brilliant
• Excellent mechanical properties.
• High flexural strength for resistant restorations
• Tooth-like modulus of elasticity for a shock-absorbing
effect and pleasant bite feeling.
• Two translucencies with a total of 13 shades, offer a
broad spectrum for aesthetic single-tooth
restorations.
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 2- Tooth-Like Behavior
• Tooth like aesthetics
• High wear resistance and low abrasion on antagonist
 3- Efficient Handling
• No firing process required
• Can be modified and repaired
• Exceptional grinding precision for more freedom of
preparation
• Effortless polishing for fast gloss.
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 4- Reliable Luting System
• Secure bonding due to ONE COAT 7 UNIVERSAL
• Suitable luting material for every situation.
 Depending on the indication, light-curing or dual-
curing resin cements are suitable. Self-adhesive resin
cements are also suitable.
 After fabrication of the restoration, the luting area to
be bonded is sandblasted to enlarge the surface area
and to create mechanical retention.

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 Indications:- Single-tooth restorations as:-

 Sizes:-
• It is available in two sizes.

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 Eg. 3- Katana Avencia and Katana Zirconia
 Eg. 4- Nacera hybrid

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Microscopic Pictures:

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Mechanical properties:

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Abbreviations:
LU Lava Ultimate PM Paradigm CS CeraSmart
SB Shofu Block HC KA Katana Avencia VE Vita Enamic

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Indications, Method of fabrication, and Etchability for adhesive cementation:

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 Framework (F)
Clinical indications
Fabrication
Material method
Monolithic (M)
Veneer (V)
Etch-
able Partial Full-
Venee crown:- FPD Implant
cover. abut.
r rest. (A)/(P)

Lava Ultimate CAD/CAM M No

[[

CeraSmart, GC CAD/CAM M Yes

Grandio blocs CAD/CAM M

Vita Enamic CAD/CAM M Yes

Block Hc CAD/CAM M No

Brilliant Crios CAD/CAM M No

Paradigm MZ-100 CAD/CAM M

KZR-CAD HR CAD/CAM M
Kantana Avencia CAD/CAM M

Nacera Hybrid CAD/CAM M

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 Advantages and Disadvantages:
Advantages
• Mechanical properties are
higher than composites.
• A crack occurred in the
ceramic phase could be
prevented by the polymer
structure of the material.
• Chemical structures of the
hybrid ceramics provide
occlusal forces to spread from
contact points to a wide area
and reduce the stress.
Disadvantages
• Due to the low hardness of
the hybrid ceramics, the
amount of material lost by
wear over time is more than
traditional ceramics.
• Due to the low hardness of
the hybrid ceramics, the
clinical indications is limited
to single tooth restorations as
inlays, onlays, veneers, and
single crowns.
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 Advantages
Disadvantages
• The occlusal load • Couldn’t be used for fixed
compensation capacity of partial dentures or implant
hybrid ceramic is higher abutments.
than traditional ceramics.
• Hardness value of hybrid • More water sorption and
ceramics were lower than susceptibility to
silica-based ceramics, discoloration than the
therefore hybrid ceramics ceramic restorations.
cause less wear than
traditional ceramics.

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Finally, it is likely that a number of new materials
to be introduced for dental esthetic restorations
will fit into the resin-matrix ceramics category.

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Thank you

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 Ceramics Composites
High esthetics Less esthetics

High color stability Less color stability

High wear resistance Less wear resistance (due to ↨ hardness)

Can cause wear to opposing teeth No wear to opposing teeth

Low elastic modulus (↨force absorption Higher elastic modulus (↨force absorption
capacity) capacity)

Low fatigue resistance Higher fatigue resistance

Fragile and brittle under bite pressure Not brittle

Ceramics + Composites = Hybrid Ceramics

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 Hybrid Ceramics
1- Better absorb & distribute the stresses
2- A crack occurred in the ceramic phase could be prevented by
the polymer structure of the material.
3- Has (↨hardness), with more force absorption capacity,
better use for dental implants due to less stress concentration at
implant-bone interface and less bone resorption.

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  CAD/CAM
• Advantages:-
- Less time required
- Doesn̓t require a lot of human resources
- Produce a restoration with good quality

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• Indirect Composites

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4

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