Dental Ceramics

Question 1

key point about ceramic

Answer 1

all porcelain is ceramic but not all ceramic is porcelain

Question 2

decorative ceramics contain

Answer 2

kaolin - this is a clay
hydrated aluminium silicate that is opaque which is important for appearance of final product

Question 3

how to dental ceramics differ from decorative ceramics

Answer 3

dental ceramics need to be translucent so kaolin is removed & replaced with feldspar & silica

Question 4

feldspar

Answer 4

potassium & sodium alumina silicate
acts as a flux
lowers fusion & softening temp of glass
is lowest fusing component & flows during firing forming a solid mass around the other components

Question 5

conventional dental ceramics

Answer 5

feldspathic ceramics form leucite when heated to 1150-1500o
leucite = potassium aluminium silicate
this forms glass phase of ceramic & gives powder of known physical & thermal properties
no further chemical reaction is required during fabrication of restoration
powder melts together to form crown

Question 6

fabrication of crown

Answer 6

heating leads to sintering
ceramic particles begin to fuse into a single mass
during this material contracts by about 20%

Question 7

aesthetics of conventional dental ceramics (CDCs)

Answer 7

colour stable
smooth surface
less staining compared to others
optical properties

Question 8

optical properties (5)

Answer 8

reflectance - how much light is reflected from a surface / optical element
translucency - allows light to pass diffusely
opacity - does not allow light to pass diffusely
transparency - allows light fully through so objects behind can be distinctly seen
opalescence - colourless / white like an opal or changing colour like an opal

Question 9

chemical stability of CDC

Answer 9

very stable
unaffected by wide range of pH in mouth
do not take up staining from food / drink
good biocompatibility

Question 10

thermal properties of CDC

Answer 10

similar to tooth substance
TEC similar to dentine so results in low stresses to restoration in mouth
thermal diffusivity is low (protective of remaining tooth)

Question 11

dimensional stability of CDC

Answer 11

once fully fired it is very stable
during fabrication shrinkage can be a problem (20%)

Question 12

mechanical properties of CDC

Answer 12

high compressive strength
high hardness - must be glazed to prevent abrasion of opposing teeth

low tensile strength
low flexural strength
low fracture toughness
these lead to failure on loading

Question 13

problems with CDC

Answer 13

static fatigue - time dependent decrease in strength even in absence of applied load (due to hydrolysis of SiO)
surface microcracks - can occur during manufacture, finishing or occlusal wear
slow crack growth - cyclic fatigue under occlusal forces in wet environment over time

Question 14

where should CDC be used

Answer 14

low stress areas i.e.
- only anterior crowns
- not in all ptx
- too brittle for use elsewhere

Question 15

to overcome problems with CDC

Answer 15

1. produce a strong coping resistant to fracture & cover in conventional porcelain i.e. porcelain fused alloys
2. cast or press a block of harder ceramic
3. mill a laboratory prepared block of ceramic

Question 16

alumina core

Answer 16

reinforces feldspathic ceramics
prevent cracks propagating through the material causing fracture
aluminous porcelain is opaque & can only be used as a core material so is veneered with conventional feldspathic porcelain to produce final crown
not strong enough for posterior use

Question 17

zirconia

Answer 17

zirconia powder does not sinter unless heated over 1600o
pure zirconia can crack on cooling

Question 18

yttria stabilisation of zirconia

Answer 18

increase yttria increases translucency but decreases physical properties
if crack begins yttria presence can cause slight expansion of material to close it; due to
zirconia = monoclinic crystal but yttria = tetragonal crystal structure
this means it is hard, strong (1000MPa flexural strength) and tough so can be used a bridge framework

Question 19

fabrication of zirconia crown

Answer 19

imp taken of prep and sent to lab where model is cast and scanned digitally
zirconia crown then veneered with feldspathic porcelain to produce final restoration

Question 20

problems with zirconia cored crowns

Answer 20

expensive equipment required
potential for veneering crown to debond from core
inert fitting surface so cannot etch or bond
BUT
once you have equipment they are cheaper to make
fit is generally excellent

Question 21

milled core crowns & bridges

Answer 21

zirconia
lithium disilicate
precious metal
non precious metal
titanium
composite
ceramics all have surface sintered layer for best aesthetics

Question 22

fabrication of a milled crown

Answer 22

scan in mouth
design on CAD machine
mill
polish
cement

Question 23

cast & pressed ceramics process

Answer 23

more like casting a metal restoration
waxed up
invested
cast from heated ingot of ceramic (1100o)
no sintering occurs as ceramic ingot is already fully condensed prior to fitting
once devested & cleaned restoration is heated to improve crystal structure producing crack inhibiting crystals
process called ceraming
cast crown can be stained
often cut back labially & veneered with appropriate feldspathic porcelains

Question 24

ceramic used in cast & pressed ceramics

Answer 24

lithium disilicate glass
leucite reinforced glass

Question 25

ceraming

Answer 25

2 stage process
1. crystal formation - max no of crystal nuclei are formed
2. crystal growth - to maximise crystal properties

Question 26

cast & pressed ceramics

Answer 26

strong
good flexural strength 350MPa
lithium disilicate glasses have needle-like crystals which makes crack propagation very difficult

Question 27

adv of different crown types

Answer 27

• monolithic block crowns milled from single block of material are strongest
• zirconia based are stronger than LiDiSi
• LiDiSi have better translucency and so aesthetics
• crowns with layered porcelain rather than just stained monolithic block have better aesthetics
• layered crowns more likely to chip due to stresses

Question 28

sintered v milled

Answer 28

for same material milled crown will be stronger than sintered

Question 29

what to use in posterior teeth

Answer 29

monolithic zirconia
can be used for single crowns & shorter span bridges

Question 30

what to use in anterior teeth

Answer 30

aesthetics paramount
LiDiSi
can probably use as far back as 1st premolar

Question 31

what to use for anterior bridgework

Answer 31

short span with no parafunction - use LiDiSi
longer span or heavier occlusion - use zirconia cored with zirconia where occlusal contacts meet

Question 32

luting crowns

Answer 32

zirconia & LiDiSi can be cemented with conventional or resin cements
both crowns have intrinsic strength & do not rely on being bonded to tooth substance to prevent #
silica containing (LiDiSi) ceramics can be etched with hydrofluoric acid to produce retentive surface
this now etched surface can be bonded to using silane coupling agent and in turn be bonded to tooth using app bonding agent & resin cement
zirconia cored can be air abraded to create retentive surface