Dental ceramics

Introduction
 Dental ceramics are non-metallic, inorganic materials
primarily containing compounds of oxygen with one or more
metallic or semimetallic elements.

 General composition:
• 1) Glass phase - imparts translucency, refractiveness and a
gloss to the material giving it a life-like appearance.
• 2) Crystal phase - which provide strength to the material1.

10/28/2023 2
• The pursuit for esthetically pleasing tooth colored restorative
material led to the introduction of ceramics in dentistry.

 Additional advantages:
• i. Excellent biocompatibility
• ii. Good color stability
• iii. Chemical durability
• iv. Wear resistance
• v. Ability to be formed into precise shapes

10/28/2023 3
 Disadvantages:
• i. Low tensile strength and high susceptibility to tensile
fracture.
Note- Masticatory loading can cause tensile fracture of the framework and
failure of the restoration.

• ii. Low fracture toughness (i.e. they cannot suppress crack

growth by deforming plastically in areas adjacent to crack tips
that are subjected to tensile stress leading to crack
propagation.)
Note- Even micro-cracks or surface flaws incorporated in the framework
during processing or grinding of the restorative framework are liable to
propagate resulting in the breakdown of the restoration.
10/28/2023 4
• Despite these challenges, the dental ceramic technologies have
evolved rapidly over the last three decades resulting in
significant improvements in fracture toughness and tensile
strength of these materials, and hence have widened their
applications.

• Earlier dental ceramics were used for veneering or masking the

metallic color of the underlying metal substructures [METAL
CERAMIC RESTORATIONS].

• With the evolution of material and advancements in

technologies, dental ceramics are now also used as
substructures of crown restorations [ALL CERAMIC
RESTORATIONS]1.
10/28/2023 5
• Today, all ceramic restorations are the most esthetic
restorations available in dentistry giving the tooth almost a
‘life-like’ appearance and a high degree of esthetic satisfaction
to the patient.

10/28/2023 6
 Methods of strengthening ceramics

• 1) Dispersion strengthening
• 2) Transformation toughening
• 3) Development of residual compressive stress
• 4) Microcrack toughening
• 5) Crack bridging
• 6) Strengthening with metal substructure
• 7) Optimum restoration design
• 8) Enamelling of high strength crystalline ceramics2

10/28/2023 7
 1) Dispersion strengthening

• Dental ceramics that contain glass phase can be strengthened

by dispersing ceramic crystals of high strength and elasticity
such as leucite, lithium disilicate, alumina, magnesia-alumina,
spinell, zirconia in the glass matrix.

• Such high strength crystalline phase within the microstructure

act as obstacles to deflect or re-orient the crack and inhibit
crack propagation.

10/28/2023 8
 2) Transformation toughening

• Applies to Yttrium-stabilized tetragonal zirconia polycrystals (Y-

TZP) ceramics.
• At atmospheric pressure, pure zirconia can assume three
different crystal forms depending upon temperature:
-- Up to 1170⁰ C degree the structure is monoclinic.
-- Between 1170⁰ C degree to 2370⁰ C degree it assumes a
tetragonal crystal.
-- From 2370⁰ C degree up to the melting point it exhibit a
cubic structure.

• Alloying pure zirconia with stabilizing oxides, such as (Y 2O3)

allows the retention of the meta-stable stage tetragonal
structure at room temperature.
10/28/2023 9
• The resultant structure has been
linked to the phemomenon of
transformation toughening accounts
for the high fracture toughness of
yttrium-stabilized tetragonal zirconia
polycrystals (Y-TZP).
• Cracks fails to propagate as the
applied load causes stress
concentration at the crack tip leading
to conversion of tetragonal phase to
monoclinic phase accompanied by 3-
5% volume increase.
• The volumetric expansion induces
compressive stress and put crack into
compression, closing the tip and
retarding its growth, thereby
enhancing the fracture toughness of
the material.
10/28/2023 10
 3) Development of residual compressive stress

• To prevent fracture of ceramic

prosthesis, one must prevent
tensile stresses from occuring .

• If during fabrication, a
significant amount of residual
compressive stress is produced
in ceramic structure , a greater
level of offsetting tensile stress
would be needed during oral
function of the prosthesis to
reach the tensile stress
needed to cause fracture.
10/28/2023 11
• The three common methods of inducing residual compressive
stresses in ceramic structure are:

i) Thermal coefficient mismatch

ii) Thermal tempering
iii) Ion exchange method

10/28/2023 12
• i) Thermal co-efficient mismatch - Veneering ceramic is
chosen such that its thermal expansion or contraction co-
efficient is slightly less than the core material.
• In Metal ceramic restorations, the metal and the porcelain
should be selected with a slight mismatch in their co-efficient
of thermal contraction (the metal CTC being higher) so that
the metal contracts slightly more than the porcelain on
cooling from firing temperature to room temperature.

• The mismatch leave the porcelain adjacent to the metal in a

state of residual compression, which effectively protects the
metal ceramic restoration against fracture of the veneering
ceramic.
10/28/2023 13
10/28/2023 14
• ii) Thermal Tempering - Residual compressive stresses can be
generated by rapidly cooling (quenching) the surface of the
ceramic material while it is still hot and in soft molten state.
• Consequently, a skin of rigid glass is produced surrounding
the soft (molten core).
• As the molten core solidifies, it tends to shrink but the outer
skin remains rigid and the pull of the solidifying molten core
as it shrinks creates residual tensile forces in the core and
residual compressive stresses within the outer surface.
• Limitation: it is a technique sensitive process since large
counterbalancing tensile stresses may develop due to
excessive cooling rates.
10/28/2023 15
• iii) Ion exchange method - Involves the placement of a
sodium containing glass article in a bath of molten potassium
nitrate, potassium ions in the bath exchange places with some
sodium ions in the surface of the glass article and remain in
place after cooling .
• Potassium ions are about 35% larger than sodium ions,
diffusion of potassium ions into the place formerly occupied
by sodium ions creates residual compressive stress in the
surface.
• However, the depth of the compression zone is less than
100µm, so this strengthening effect may be lost if the
porcelain or the glass ceramic is ground, worn or eroded by
long term exposure to certain inorganic acids.
10/28/2023 16
10/28/2023 17
 4) Microcrack toughening

• Microcracks produced during fabrication of ceramic can blunt

the advancing crack tip.
• Applicable in case of glass-infiltrated ceramics e.g. In Ceram
alumina.
• Such micro-cracks develop as a result of thermal stresses
formed between the glass matrix and core structure during
cooling due to difference in co-efficient of thermal expansion
between the two .

• Toughness of the material increases

but strength decreases in case of
micro-crack toughening.
10/28/2023 18
 5) Crack bridging

• Involves induction of a second phase crystalline structure

within a castable glass ceramic (e.g. Dicor) by a partial de-
vitrification process known as ‘ceramming’.

• The second phase crystalline structure acts as abandage to

prevent the crack from opening further.

10/28/2023 19
 6) Strengthening with metal substructure

 Metal ceramic systems developed to reinforce ceramics are:

• 1. Noble metal alloy systems (high gold, low gold, gold free).
• 2. Base metal alloy systems (Ni, Cr, Ti)

• In a ceramic that is sub-structurally strengthened by metal,

micro fractures spread if only this strong substructure gets
deformed. The perimeter of thermal dilatation of
substructure material should be higher than porcelain's.
10/28/2023 20
 7) Optimum restoration design

• Restoration design must minimize stress concentrators and

stress raisers: Stress concentrators arise due to presence of
high contact points or traumatic occlusion. Stress raisers are
discontinuities in ceramic restoration that can cause stress
concentration.

• Abrupt changes in contour including any grooves, pits,

notches should be avoided. The internal angles in tooth
preparation should not be sharp but rounded.

10/28/2023 21
 8) Enamelling of high strength crystalline ceramics

 An example:
• High alumina cores with aluminous porcelain veneers. These
laminates are much stronger than regular porcelain, similar to
metal ceramic systems. The bonding at the interface is
chemical in nature and an ionic bond ensures no porosity as
the wetting of the porcelain enamel on alumina core is good.

10/28/2023 22
 Classification of ceramics

 i) Based on fusing temperature

• 1) High Fusing (firing temperature above 1300 degree C)
• 2) Medium Fusing (firing temperature 1101 to 1300 degree C)
• 3) Low Fusing (firing temperature 850 to 1100 degree C)
• 4) Ultra Low Fusing (firing temperature below 850 degree C)3

10/28/2023 23
 ii) Based on composition
• 1. Predominantly glass ceramics
• 2. Particle filled glass ceramics
• 3. Glass infiltrated ceramics
• 4. Polycrystalline ceramics
• 5. Resin matrix ceramics1,4

10/28/2023 24
 1) Predominantly glass ceramics

• Amorphous glass phase pre-dominates over the dispersed

crystal phase.

• Highly esthetic ceramics that mimic the optical properties of

enamel and dentin due to presence of high glass content in
them.

• Manufacturers can alter the percentages of fillers, crystalline

particles in them to control optical effects such as
opalescence, color or opacity.

10/28/2023 25
• Chemically these are mostly feldspathic porcelains
(K2O.Al2O3.6SiO2) and were the very first material used for all
the ceramic crown restorations.

• These crowns exhibited excellent esthetics but exhibited high

incidences of fracture due to poor strength and low fracture
toughness.

• Now their use is limited as veneering materials over high

strength core substructure or copings.

10/28/2023 26
 2) Particle filled glass ceramics

• Includes:
 1) Aluminous Porcelain: The glass matrix is heavily filled with
crystalline particles which are added mechanically during
manufacturing as powder.
• Mc Lean and Hughes (1965) developed an alumina reinforced porcelain
core material (Aluminous porcelain) consisting of a glass matrix filled with
40-50% crystalline alumina by weight and reported significant
improvement in fracture resistance of the crown.

 2) Glass Ceramics: Crystalline particles are precipitated within

the glass by special heat treatment (ceramming) to induce
partial de-vitrification. They include:
(i) Leucite reinforced glass ceramics
(ii) Lithium disilicate based glass ceramics
10/28/2023 27
 Leucite reinforced glass ceramic
• - IPS Empress (Ivoclar Vivadent )
• - Contains 35% by volume of leucite crystals
• - Flexural strength = 112 Mpa
• - Used for anterior single unit crowns and anterior laminate
veneers
 Lithium disilicate based glass ceramics
• (1) - IPS Empress 2 (Ivoclar vivadent)
• - Contain 65 to 70% lithium disilicate crystals
• - Flexural strength = 400 Mpa
• - Suitable for anterior 3 unit FPDs and posterior crowns.
10/28/2023 28
• (2) IPS e. max press (Ivoclar Vivadent)
• - Lithium disilicate based glass ceramic introduced in 2005
• - Are supplied as polychromatic ingots and thus have
improved esthetics.
• - Suitable for anterior three unit FPDs and posterior crowns.

10/28/2023 29
 3) Glass infiltrated ceramics

 Includes :
• 1) In Ceram alumina (alumina based)
• 2) In Ceram spinell (spinell based)
• 3) In Ceram zirconia ( zirconia based)

• All three are processed by a special processing technique

called slip casting technique.

• Slip casting technique employs an alternative approach to

achieve high core crystalline content in the final ceramic
prosthesis.

10/28/2023 30
 In-Ceram Alumina (Vita Zahnfabrik)
• - Introduced in 1989 and consists of alumina crystalline
infrastructure infiltrated with lanthanum glass.
• - First all ceramic system available for single unit crown
restorations (anterior as well as posterior) and 3-unit anterior
FPDs
• - Feldspathic porcelain is used to veneer the produced
copings.
• - Flexural strength = 600 Mpa
• - Not used in esthetic zones because it does not allow fully
allow light transmission.
 .
10/28/2023 31
 In - Ceram Spinell (Vita Zahnfabrik)
• - Introduced in 1994 to overcome the opacity of In-Ceram
Alumina.
• - Slip contains a mixture of magnesia and alumina (spinell-
MgAl2O3) to improve the translucency of the material.
• - Flexural strength = 250 Mpa
• - In Ceram spinell in indicated for anterior crowns because of
its low flexural strength

10/28/2023 32
 In - Ceram Zirconia (Vita Zahnfabrik)
• - Modification of In-ceram Alumina system with the addition
of 35% of partially stabilized zirconia oxide to the slip to
increase the strength of the ceramics.
• - Flexural strength = 700 Mpa
• - Material is considered opaque and has poor translucency
limiting it use for posterior crowns and posterior 3 unit FPDs.

10/28/2023 33
 4) Polycrystalline ceramics

• Polycrystalline ceramics are those in which there in no glassy

component and the entire structure is made up of densely
packed atoms arranged into regular crystalline arrays.
• They are much tougher and stronger than glass based
ceramics and are suitable for anterior as well as posterior
crowns.
• They are usually made from alumina or zirconia oxides.
• These are generally used as core material for all ceramic
crown restoration which can be layered with more esthetic
veneering ceramic or in cases where esthetic demand is not
too high these can also be used as monolithic crown material.
10/28/2023 34
 Alumina
• Alumina exhibits the highest resistance to hydrolysis compared to other
ceramic materials, low thermal conductivity and high flexural strength (>
500 MPa). The alumina blocks (consisting of 99.5% Al2O3) are initially
manufactured partially sintered which allows easy processing-milling.
• Shrinkage, which occurs during the subsequent sintering process, can be
exactly calculated, so precision-fit structures are obtained. Since grinding
does not cause phase transformation in the structure, restorations can be
reshaped in the sintered condition, with no need of subsequent
regenerative firing.

10/28/2023 35
 Zirconia
• Zirconia was discovered by the German chemist Martin Heinrich Klaproth
in 1789. Pure zirconia is a polymorphic material that occurs in three
crystallographic structures depended on the material’s temperature.
• This phenomenon is known as allotropy since different structures have
the same chemical composition but a different atomic arrangement. When
cooling down from the molten state, following phases can be observed:
cubic (c) from 2680°C, the melting point, to 2370°C; tetragonal (t) from
2370°C to 1170°C; and monoclinic (m) from 1170°C to room temperature.
• Alloying pure zirconia with stabilizing oxides, such as (Y2O3) allows the
retention of tetragonal structure at room temperature thus improves
fracture toughness of the material.

10/28/2023 36
 5) Resin matrix ceramics

• 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 authors’ classification proposal if the
traditional definition of ceramics was considered: “nonmetallic
inorganic materials usually processed by firing at a high temperature
to achieve desirable properties.”

• However, resin-matrix ceramics are being included because the ADA

Code on dental procedures and nomenclature in 2013 defined the
term porcelain/ceramic as “pressed, fired, polished, or milled
materials containing predominantly inorganic refractory compounds
—including porcelains, glasses, ceramics, and glass-ceramics.”
10/28/2023 37
 Despite the controversies associated with the definition, the
manufacturers’ rationale to develop resin-matrix ceramic
materials was to:

• (1) obtain a material that more closely simulates the modulus

of elasticity of dentin when compared to traditional ceramics.

• (2) develop a material easier to mill and adjust than glass-

matrix ceramics (eg, synthetic ceramics of the lithium
disilicate family) or polycrystalline ceramics, and

• (3) facilitate repair or modification with composite resin.

10/28/2023 38
• Resin-matrix ceramic composition varies substantially, but
they are specifically formulated for CAD/ CAM.

 Currently, the resin-matrix ceramic materials can be divided

into several subfamilies, according to their inorganic
composition, as follows:
• i. Resin nanoceramic (eg, Lava Ultimate, 3M ESPE)
• ii. Glass ceramic in a resin interpenetrating matrix (eg, Enamic, Vita)
• iii. Zirconia-silica ceramic in a resin interpenetrating matrix

10/28/2023 39
 iii) Based on processing methods
• 1) Powder/liquid builded ceramics
• 2) Castable ceramics
• 3) Slip casting ceramics
• 4) Hot - pressed ceramics
• 5) CAD/CAM ceramics1,5

10/28/2023 40
 1) Powder/liquid building ceramics

• Conventional processing method in which the ceramic

powder is mixed with manufacturer’s modeling liquid or de-
ionized water and the resultant powder/liquid ceramic slurry
is build on a ceramic or metal core with a brush or a spatula.

• Slurry is condensed by vibration to remove excess liquid,

which rises to the surface and is blotted away by an absorbent
tissue.

• Voids should be removed carefully as it decreases the overall

strength of the restoration.

10/28/2023 41
• Ceramic build up is vacuum fired at a selected temperature,
which removes the moisture and further condenses the
ceramic through a process called “sintering’’.

• During sintering, fusion occurs at the particle points of

contact, which results in densification by viscous flow when
the ceramic or the glass particles reach their firing
temperature.

• Typically, a restoration is over-contoured by 25% to allow for

densification or shrinkage during the firing cycle.

10/28/2023 42
 Examples of ceramic systems processed by this method:
• ✓ Duceram LFC (Dentsply)
• ✓ Finesse low fusing (Dentsply)
• ✓ IPS e.max Ceram (Ivoclar-Vivadent)
• ✓ IPS Eris (Ivoclar – Vivadent )
• ✓ Lava Ceram (3M ESPE)
• ✓ Vita D (Vita Zahnfabrik)
• ✓ Vitadur Alpha ( Vita Zahnfabrik)
• ✓ Vita N (Vita Zahnfabrik)

10/28/2023 43
 2) Castable ceramics

 Produced by lost wax pattern

casting technique.
 Examples include:
-Mica based (Dicor)
-Lithium disilicate based ceramics
-Hydroxyapatite based (Cearlpearl)

 Dicor was the first commercially

used castable glass ceramic
available for dental purpose.
-Contains 55%vol of tetra silic
fluoramica crystals.
-Cast in vitreous state and later
subjected to ceramming process to
induce partial de-vitrification.
10/28/2023 44
 3) Slip casting ceramics

• Involves condensation of an aqueous porcelain slip on a

refractory die.
• The porosity of the refractory die helps in condensation by
absorption of water from the slip by capillary action.
• The framework is then removed from the mould by partial
sintering in which the refractory die shrinks more than the
condensed slip facilitating easy removal.

10/28/2023 45
• The resulting partially sintered ceramic is very weak and
porous which is then glass infiltrated .
• Glass infiltration is the process by which molten glass is drawn
into the pores by capillary action at high temperature.
• Materials processed by this technique tend to have fewer
defects from processing, and exhibit higher toughness than
the conventional feldspathic porcelain.

10/28/2023 46
 Examples include:
• I) In-Ceram Alumina (Vita Zahnfabrik)
• II) In - Ceram Spinell (Vita Zahnfabrik)
• III) In – Ceram Zirconia (Vita Zahnfabrik)

10/28/2023 47
 4) Hot-pressed/ injection moulded ceramic

• Involves utilizing the lost wax technique to form moulds for

pressable dental ceramics.

• Pressable ceramics are available as glass - ceramic ingots

which are supplied from manufacturers.

10/28/2023 48
• The ingots are heated to a high temperature where they
become a highly viscous liquid, and then pressed slowly into
the formed mold.

10/28/2023 49
 Examples include:
• 1) IPS Empress (Ivoclar Vivadent )
• 2) IPS Empress 2 (Ivoclar vivadent)
• 3) IPS e. max press (Ivoclar Vivadent)

10/28/2023 50
 5) CAD - CAM ceramics

 CAD - CAM ceramic restorations are manufactured in two

ways:
• i) Dry pressed and sintered
• ii) Machined

10/28/2023 51
 i) Dry pressed and sintered method
• In dry pressing and sintering method, a standard die made from
the impression taken by the dentist is digitized using a specially
designed mechanical scanning device and a computer that turns
the shape of the die into digitized data.
• This data is then used to fabricate an oversized die to which
alumina and zirconia is dry pressed to create an oversized green
ware (unfired ceramic).
• The pressed oversize greenware is then removed from the die
and sintered, thus shrinking to the correct size and creating a
hard core to which feldspathic porcelain can be veneered.
• Examples include: Nobel Procera system (Nobel Biocare) for
polycrystalline alumina and Procera Forte system (Nobel Biocare) for
polycrystalline zirconia.
10/28/2023 52
 ii) Machined ceramics
• After tooth preparation, an optical impression is taken for the
preparation by a special scanner and the image is transferred
to the system’s software.

• The software designs the restorations and sends the data to

computer controlled milling machine that grinds the ceramic
block according to the desired shape.

• Restorations are milled from blocks of ceramic materials

which are made from their respective ceramic powders by
mixing them with a binder and pressing them into mould.

10/28/2023 53
• The blocks are then milled either in green state (unfired
state), partially sintered state or fully sintered state to yield
the CAD-CAM designed restorations.

• Restorations manufactured from green ware and partially

sintered blocks are then fully sintered and after that a
veneering ceramic is applied on to it to yield desired esthetics.

10/28/2023 54
10/28/2023 55
 Examples of materials available for CAD-CAM technology:
 - Silica based ceramics e.g. IPS e.max CAD (Ivoclar vivadent) and VITABLOCKS
Triluxe Forte (VITA Zahnfabrik)
 - In Ceram AL Block (VITA) & In Coris AL (Sirona) are alumunium oxide blocks
available in market
 - Zirconia oxide blocks available in the market include Lava (3M ESPE), Vita In
Ceram YZ cubes (VITA Zahnfabrik), Cercon (Degudent/DENSTSPLY Ceramaco)

 Examples of systems available for the machining of ceramic

blocks:
• ✓ Procera
• ✓ CEREC in LAB
• ✓ Cercon
• ✓ Lava
• ✓ E4D
10/28/2023 56
 Metal Ceramic Restorations

• High propensity to tensile fracture of porcelain jacket crowns

(PJC) in early 1900’s led to rigorous research works and
developments looking for ways in which the ceramic
restorations could be reinforced to enhance their physical
properties, hence durability.
• Two parallel streams of developments:
• 1) All ceramic restorations – High strength ceramic core
copings (e.g. Alumina core ceramics/ Yttria-stabilized Zirconia)
to serve as a foundation upon which the feldspathic glass
porcelain is veneered to attain the desired esthetics.
• 2) Metal ceramic restorations – Uses metal substructure
upon which the porcelain veneer is bonded to resemble
natural tooth in appearance6.
10/28/2023 57
• Nevertheless, both these technologies are to some extent
identical in capitalizing the basic concept that a strong rigid
substructure beneath the low strength porcelain veneer could
resist flexure and hence development of tensile stress within
the porcelain veneer, thereby preventing its fracture.

10/28/2023 58
 Advantages of metal ceramic restorations over all-ceramic
restorations 6:
• i) Higher fracture resistance
• ii) Lesser amount of tooth reduction required
• iii) Simplicity in fabrication techniques
• iv) Cost effectiveness

10/28/2023 59
 Disadvantages:
• i) Diminished esthetics – All ceramic restorations offer a
greater potential for success in matching the appearance of
adjacent tooth especially when a relative higher degree of
translucency is desired.

• ii) Dark line visible at the facial margin of metal ceramic crown
is a significant esthetic concern in cases where a higher smile
line is present or when gingival recession has occurred.

• iii) Metal allergy- Metal ceramic crowns have potential for

metal allergy especially when nickel containing alloys are
used6.
10/28/2023 60
 Structurally, a metal ceramic
crown is a composite entity
consisting of two distinct
components:
• I. A metal sub-structure
• II. Porcelain veneer

• The bond between the two is

both chemical and mechanical in
nature.
• A surface oxide layer on the
metal substructure helps to form
chemical bond with the porcelain
veneer .
10/28/2023 61
• Control of oxide layer thickness on metal substructure is
important to avoid problems of porcelain de-bonding. Too
thick an oxide layer can result in ceramic de-bonding.

• The thickness of the metal substructure for a single crown

restoration can vary from 0.2 to 0.5 mm, depending upon the
type of casting alloy used and the amount of tooth structure
removed by the dentist6.

10/28/2023 62
 Besides, the alloy used for fabrication of metal substructure
need to possess certain specific criteria to form stable bond
with the porcelain veneer:
 1) They must have the ability to form a thin film of surface oxide which
does not fall off the metal and hence produce chemical bonding with
porcelain.
 2) They should be formulated so that their Coefficient of Thermal
Contraction should be slightly greater (average contraction coefficient
difference of 0.5 x 10-6 /K or less between 600 degree Celsius and room
temperature) than that of the porcelain veneer.
 3) Their melting range should be considerably higher than the sintering
temperature of the porcelain that veneers it.
 4) They must have a high sag resistance and should not distort as a result
of repetitive firing of the porcelain veneer overlying it6.
10/28/2023
• First alloys used for fabrication of metal ceramic copings were
all high noble metal alloys (Au-Pt-Pd, Au-Pd-Ag, Au-Pd) with
iron , indium and tin used for hardening, and to create
superficial oxide layer to which ceramic can be bonded.
• The high gold content of these alloys made such restorations
quite expensive and so to deal with it, high palladium low gold
alloys (Pd-Ag, Pd-Cu-Ga) were introduced as an affordable
alternative.
• These high palladium low gold alloys have the additional
advantage of having higher modulus of elasticity allowing for
thinner copings to be made. These alloy contain either gallium
or indium or both to promote chemical bonding with
porcelain6. 64
• A common problem encountered with the Pd-Ag alloys is their
tendency to discolor porcelain veneer due to diffusion of
silver compounds into porcelain appearing as greenish hue.

• The base metal alloys (Ni-Cr, Ni-Cr-Be) used for all metal
crowns can also be used for fabricating metal copings of
metal-ceramic crowns.

• Amongst the two, Ni-Cr-Be alloys are generally regarded as

possessing superior qualities and have been more popular.

10/28/2023 65
• Beryllium containing Ni-Cr alloys have more fluidity which
improves castability. Besides, addition of Beryllium to Ni-Cr
alloys lessens the tendency of these alloys to form thick oxide
layer on the surface at high temperature and thus aids in the
formation of stable bond with porcelain.

• Titanium alloys: Titanium oxidizes quite readily and a thick

non-adherent oxide layer can form under repetitive porcelain
firing compromising the bond strength. A 6-year follow up
showed higher risk of metal ceramic failures with titanium
alloys as compared to other alloys6.

10/28/2023 66
 The porcelain veneer of the
Metal-Ceramic crowns in general
consists of 4 distinct layers each
having some specific function
but fused together as a single
mass. These layers include:

• 1) Opaque porcelain- have uniform

thickness of 0.2 to 0.3mm and serves
to mask the color of the metal
substructure.
• - serve to establish the porcelain –
metal bond and initiate the
development of selected porcelain
shade.

10/28/2023 67
• 2) Dentin body – contains pigmented
metal oxides and imparts color to
porcelain veneers.

• 3) Enamel porcelain – placed in areas

where translucency is desire
especially in the incisal and inter-
proximal areas.

• 4) Glazes - Glazes are colorless low

fusing porcelain and they serve to fill
the small surface porosities and
irregularities when fired and imparts
glossy surface to the natural tooth6.

10/28/2023 68
• For more accurate shade duplication, the combined thickness
of the dentin body and the enamel porcelain range from a
minimum of 0.5 to 1.0 mm (in the gingival third) to a
maximum of 1.5 mm to 2.0 mm (incisal and occlusal third)
depending upon the level of characterization in the natural
tooth to be produced.

• However, the thickness should never exceed 2.0 mm to

minimize the potential for fracture6.

10/28/2023 69
10/28/2023 70
 Copy Milling Technology
• Employs CAM systems to produce
ceramic cores or substructures
for FPDs
• A wax pattern of the restoration
is made on the die which is
scanned and the replica is milled
out of the ceramic blank.

 Commerical systems available:

 1) Celay (Mikrona AG,
Spreitenbach,Switzerland)
 2) Cercon (Degudent, Dentsply)
has both CAD-CAM and copy
milling system.
 3) Ceramill system
10/28/2023 71
 Differences between CAD-CAM & Copy milling systems:
 CAD- CAM
• Scans preparation
• Restoration designed virtually
• Restoration milled from virtual pattern

 Copy-milling
• Scans pattern
• Restoration designed manually.
• Restoration milled from scanned replica of the pattern

10/28/2023 72
 Luting of Ceramic Restorations

• Cementation for all-ceramic restorations can be Adhesive or

non-adhesive.
• Adhesive cementation involves the use of agents that
promote bonding of the restorative material to the substrate.
It is a combination of adhesive chemical bonding and
micromechanical interlocking.
• Non-adhesive/ conventional cementation involves the use of
a luting agent to fill the space between the restoration and
the natural tooth and relies solely on micromechanical
retention.
• Though its not critical to use adhesive cementation in all
ceramic restoration cases, however, adhesive cementation
have demonstrated reduced micro-leakage at crown margins.73
10/28/2023
 Indications for either type of cementation (adhesive or non-
adhesive) are dictated by three factors:

• 1) Available preparation resistance and resistance form e.g.

short, tapered preparations will benefit from adhesive
cementation.

• 2) Field control at the time of cementation - Use of bonding

agents used in adhesive cementation require additional steps
and meticulous isolation, which may not be feasible in every
clinical situations.

10/28/2023 74
• 3) Composition and type of ceramic used
• i) Predominantly glass ceramics such as feldspathic porcelains must be
adhesively cemented as they have low mechanical strength and adhesive
cementation to the underlying tooth increase the restoration’s resistance
to fracture.
• ii) Particle filled glass ceramics also demand adhesive cementation to
improve their strength
• iii) Glass-infiltrated ceramics are cemented conventionally with
conventional luting agents such as resin modified GIC since in them
etching glass with HF acid does not appear to increase the retention of
resin cements.
• iv) Polycrystalline ceramics are also cemented conventionally1.

10/28/2023 75
 Steps in adhesive cementation:-
• 1) The intaglio surface of the ceramic restoration is etched
with a solution of HF acid in concentrations between 5 and
10%, for approximately 1 minute, after that it is rinsed
thoroughly with water and air dried.

• This step provides an increased surface area, micromechanical retention

and a clean surface.

10/28/2023 76
• 2) A silane coupling agent is applied to the etched ceramic
surface and left to dry.
• ✓ Application of silane coupling agent with bifunctional group provide a
chemical link between the luting resin composite and ceramic.

• ✓ A silane group at one end chemically bonds to the hydrolyzed silicon

dioxide at the ceramic surface and a methacrylate group at the other
end copolymerizes with adhesive resin.

10/28/2023 77
• 3) Simultaneously a dentin bonding agent is applied to the
prepared tooth surface.

• 4) For cementation, a light cured luting composite is preferred

as it provide longer working time compared with dual cured
or chemically cured materials and also, their color stability is
superior compared to dual cure or chemically cured
materials1.

10/28/2023 78
 Porcelain Denture Teeth

• Porcelain teeth are made with high fusing porcelains.

• Two or more porcelains of different translucencies for each

tooth are packed into metal molds and fired on large trays in
high temperature ovens.

10/28/2023 79
 The retention of porcelain teeth on the denture base is by
mechanical interlocking:
• - Anterior teeth have projecting metal pins that get
embedded in the denture base resin during processing.
• - Posterior teeth on the other hand are designed with holes
(diatoric spaces) in the underside into which the denture resin
flows.

10/28/2023 80
 Advantages of Porcelain denture teeth:

• i. Porcelain denture teeth are more natural looking than

acrylic teeth.
• ii. They have excellent biocompatibility and are more resistant
to wear.

• iii. Porcelain denture teeth also have the advantage of being

the only type of denture teeth that allow the denture to be
rebased.

10/28/2023 81
 Disdavantages:
• i. They are brittle and make a clicking sound during contact.

• ii. They require a greater inter-ridge distance as they cannot

be ground as thin as acrylic teeth in the ridge-lap areas
without destroying the diatoric channels or pins that provide
their only means of retention.
• iii. The higher density increases their weight1.

10/28/2023 82
 Conclusions
• Nevertheless, even with all its advantages, in the esthetically driven
modern society, Metal Ceramic Restorations fall just short of All Ceramic
Restorations when it comes to restoration of esthetics of the prepared
tooth especially in the anterior regions of the arch.

• An All Ceramic Crown offers a greater potential for success in matching

the appearance of the adjacent natural tooth especially when a relatively
higher degree of translucency is desired.

• Moreover, with the introduction of Zirconia and Alumina based high

strength core ceramics that could be veneered with feldspathic porcelain
to give the desired esthetic outcome coupled with the recent
advancements in ceramic processing techniques such as CAD-CAM, the All
Ceramic Crown restorations have come in their own way to challenge the
Metal Ceramic Crown Restorations, especially in demanding clinical
situations and this trend is expected to rise further in future.
10/28/2023 83
 References
• 1) Anusavice, Sheen & Rawls. Phillip’s Science of Dental Materials. First
South Asian edition. Elsevier publishers
• 2) Crowns and extra-coronal restorations: Material Selection. R.W. Wassell,
W.G. Walls, J.G. Steele. British Dental Journal 2002; Vol 2002; Vol 192; 199-
211
• 3) McLean JW, Hughes TH. The reinforcement of dental porcelain with
ceramic oxides. British Dental Journal 1965 Sept 21; 119(6):251-67
• 4) Shenoy A, Shenoy N. Dental Ceramics: An update. Journal of
Conservative Dentistry, Oct-Dec 2010 Vol 13, Issue 4
• 5) Christensen GJ. The confusing array of tooth colored crowns. J Am.
Dent. Assoc.2003:134:1253-1255
• 6) Naylor W.P. Introduction to Metal Ceramic Technology, Quintessence
Publishing Co,Inc,2nd edition

10/28/2023 84
• Thanks

10/28/2023 85
 Ceramics used in dentistry

• Fillings
• Veneering metal frameworks
• All ceramic restorations
• Denture teeth
• Implants
• Orthodontic brackets

10/28/2023 86
10/28/2023 87
 Thermal compatibility
 Relies on difference in α
 E.g.:
• Low expansion glaze can be under compression from the
greater compression of the underlying ceramic.
• Ceramo-metal system
• Crystalline inclusions having slight greater α than glassy
matrix placing it under tangantial compressive stress (leucite
crystals).

10/28/2023 88
10/28/2023 89