Selecting criteria in All-Ceramic restoration

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Selecting criteria in All-Ceramic restoration

• ???????
• ???
• ???

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Ceramic.

• ?? ???? ??? ??
• ??? ???? keramos(??,??)
• ???? ?? ??? ?? Sanskrit?? ? ??

3
history

• 100??? 1889? C.H.Land? Porcelain jacket crown?
  ???? ?? ??? ????? ?????.
• 1889? Land ?? ??? Porcelain jacket crown
• ?, ?? ??? Porcelain jacket crown
• 1950? Porcelain fused to metal crown
• 1965? McLean aluminous porcelain jacket crown
• 1976? McLean twin foil porcelain crown
• 1978? Shoher ??? ?? Porcelain crown

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• 1980? ??? ??? castable ??? ?? new-ceramic? ??
  all-ceramic crown? ??
• 1983? Sozio? shrink-free ceramic ceramic crown?
  ????

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Composition

• 80? ??(feldspar), 15? ??(quartz), 4?
  ???(kaolin)? ?????.

??? ??? ??? ?? ??? ??? ??(??? ??)? ?? ?? ??? ??
??? ????? ??. ?? ??? ???? ???? ??? ???? ???
?????.
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Requirements of dental porcelain

• 1.low fusing temperature
• 2.high viscosity(firing???? ????? ???? ?)
• 3.glazing? ? ??? ?.

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? ?

• 1.high compressive strength
• 2.high abrasion resistance
• 3.smooth surface(low plaque retention)
• 4.color, translucency? ???? ??
• 5.insoluble
• 6.low thermal expansion or contraction,
  conductivity

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? ?

• 1.low tensile and shear strength(brittle)
• 2.abrade natural teeth
• 3.marginal fit difficult
• 4.require much tooth reduction
• 5.require laboratory skill
• 6.expensive to patient

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Application in dentistry

• 1. Ceramometal crown
• 2. All ceramic restoration
• -In ceram, Empress, OPC, CAD-CAM
• Inlay, onlay, Laminate.
• 3. denture teeth

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All ceramic restoration

• 1.aluminous core? ??? ?? ?
• Hi-ceram, Alceram, Inceram
• 2.aluminous core? ??? ?? ???
• Optec, Dicor, Empress
• 3.Zirconia core? ??? ?

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CAD/CAM system

• ADENSE (Dental Graphics, Korea)
• ALKOM (CAD-CAM technologie,
  Luxembourg)BellaDent (BellaDent,
  Germany)CADIM (Advance Comp., Japan)CERADENT
  (Universit?en, Germany)Cercon smart ceramics
  (Degussa dental, Germany)KaVo Everest System
  (Kavo, Germany)LAVA-System (3M/ESPE,
  Germany)LICORA - CAD/CAM allceramic I, II
  (Girrbach Dental GmbH, Germany)Procera
  (Procera/Novel Biocare, Sweden) 
• DCS (DCS Dental, Germany)DECIM (DECIM
  AB, Ivoclar, Lichtenstein)Decsy (Olympus,
  Nissan, Shizuoka, Japan)DentiCAD (Bego,
  Germany)Digident (Girrbach, Germany)

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(No Transcript)
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Core and veneer material.
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1. Alumina core? ??? all ceramic restoration

• Hi-Ceram, Alceram? ??, alumina core? alumina
  oxide? ??? ????? ??? (Hi-Ceram? 60.7, Alceram?
  61.1) ?????.

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Hi-Ceram

• aluminous core???? alumina??? ?? ? ??? ??????
  ????, ???? core? ???????? ?? ??.

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Alceram

• 1983? Sozio?? ??? epoxy ????? ceramic? ?? ????,
  ??? ???? ???? core? ???? Cerestore? ??, core
  material? ??? ????, ??? ???? ???.
  

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In-Ceram alumina

• Alumina? glass? ?? ??? ?? 2?? ?? ????.
• Alumina ???? ??? ?? ?? ?? slip?? ???, ??? ??????
  ???, ??? ??? ?? ???? ??, compact?? ??.
• Flexible strength 450Mpa
• Single crown, 3unit anterior bridge, 6unit
  anterior bridge

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In-ceram spinell

• Aluminum oxide??? magnesium aluminate spinel?
  ???? ???? ??
• ?? ?? ??, ???? ??? ????, ?? ????? ?? ??? ??, ??
  ??, ??? ??? ???
• ??? ??? single crown

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2. Alumina core? ??? ?? ?? all ceramic restoration

• Optec, Dicor, Empress? ????, ???? ??? ???? ????.

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Optec

• ???? ceramic??, core?? ???? ??, body incisal
  porcelain??? ??? ???? ? ??.
• Porcelain? ?? ???? ?? ???? ???
• ??? ??????? ???? porcelain? ??, ???? ??? ????.

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Dicor

• Castable glass ceramic(1980??? ??)
• ???? ??? ???? glass? ceramming?? ??? ?????? ?? ?
  55vol(tetrasilicic fluoromica)? ??? ????, ????
  ???? ??? ????? ?? ? ??, ??? shading porcelain?
  ???? crown??.

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Empress

• Leucite? ? ??? glass? ???? ????? ??? lost wax???
  ?? ??? ?????? ???.
• Staining tech. layering tech.

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Zirconia

• ZrO2 ???? ?? ???? ?? ???? ? ??? ???.
• CAD / CAM ?? ?? ??? ??, ??? ??? ?? ?? ?? ??
  computer? ?? ???? ??? ?? ??? ??
• ????
• ?? ???, ????, ??? ?? ? ???
• Digident(Digident Ltd, Nesher, Israel),
  Gercon(Dentsply), Procera

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All-Cermic? ???

• 1.metal-free(???)
• 2.???? ??? ???(PJC? ??)
• 3.??? ?? ???
• 4.????? ??

• 1.?????? ??.
• (??? ?? 1.0-1.5mm
• ???? ?? 1.5-2.0mm
• ???? 16mm2)
• 2.????? ??????? ??

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All-Cermic? ???

• 1.??? ???? ???? ??
• 2.???(??? ? ???)
• 3.3-unit bridge? ????? ???(?????? In-ceram
  zirconia? ??)
• 4.metal allergy.

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All-Ceramic? ???

• 1.??? ??? long bridge
• 2.single crown??? ??? ??? ? ? ?? ??, ? ??? ? ???
  ???? ?? ??, ???? ?? ??
• 3.bruxism?? clenching?? ???? ??? ?? ??

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All-ceramic? ????
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All-ceramic? metal ceramic? ? ??? ??
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All ceramic crown? ?? ??? ????

• ??? ??? ???? ??? ??, ????? ??? ???? ??, ?? ?????
  ??? ??? ??? ?? ??? ????. (??? ??? ?? ???, ??
  ????? ???? anterior guidance? ??? ?? ??? ???. )

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??? ?? ? ?? ??? ??? ???

• Hi-Ceram?? Alceram? ?? ??? alumina core? ??? ??
  crown? Optec, Dicor, Empress? ?? ?? ?? ??? ????.
• ?? ??? ?????? ???? ??, ?? ??? ??? ?? ??? ??? ??
  ? ?? ??? ????, ? ??? ? ??? ??? ?? ?????? ??, ??
  ??? ?? ??? ?? ? ?? ???? ??? ? ? ??.

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Preparation Guideline
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Preparation Guideline

• 1.Crown preparation? ??? ?? ??? ??? ?? ?? ??? ?
  ?? ??? ??.
• 2.???? ?? prep? crown? labiogingival ??? stress
  ??? ?????, ??? ???? labiogingival ??? ????
  half-moon fracture? ????.
• 3.? 1mm ??? shoulder? ????? ???? ?? ?? ???? flat
  seat? ???? gingival finish line?? ????.
• 4.Incisal edge? flat?? ?? linguogingival ???? ??
  ????? ????? shearing? ????.

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Preparation Guidline

• 5.preparation? ?? sharp angle? stress
  concentration points? ?? ???? ?? ??? ?? ??? ??
  round?? ?? ??.
• 6.???? ???? stress? ??? ????? ??? ???? ?????.
• 7. ???? ???? ?? 1/5??? ??? ??? ????? ???.

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Journal Reading
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Relative translucency of six all-ceramic system
core material

• JPD
  July 2002
• ?? all-ceramic system? ??? ??
• ?? 6?? all-ceramic system? 13mm ??? 0.49mm ???
  ??? ??
• Standard- Vitadur Alpha opaque dentin
• (IPS Empress dentin, IPS Empress 2 dentin,
  In-Ceram alumina core, In-Ceram spinell core,
  In-Ceram zirconia, ProCera alceramic core.)
• Transparent 0.0, opaque 1.0

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? ?

• Vitadur Alpha 0.60 0.03
• Empress (0.5 mm) 0.64 0.01
• In-Ceram Spinell 0.67 0.02
• Empress 2 (0.5 mm) 0.68 0.02
• Empress (0.8 mm) 0.72 0.01
• Procera 0.72 0.01
• Empress 2 (0.8 mm) 0.74 0.01
• In-Ceram Alumina 0.87 0.01
• In-Ceram Zirconia 1.00 0.01

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? ?

• Vitadur Alpha dentin (standard) gt In-Ceram
  Spinell gt Empress, Procera, Empress 2 gt In-Ceram
  Alumina gt In-Ceram Zirconia
• 
  (J Prosthet Dent
  2002884-9.)

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• Retrospective assesment of 546 all-ceramic
  anterior and posterior crowns in a general
  practice
• 
  JPD 200185544-50.

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Retrospective assesment of 546 all-ceramic
anterior and posterior crowns in a general
practice

• Aluminous porcelain? ???? ??? ?? ????? ?????? ??
  ??? ??? ??.
• ?? ??? ??? ? ??? ???? alumina core, all-ceramic
  crown? ??? ???? ?????.
• 6??? ??? ??? ??,546?? In-Ceram crown(???177,
  ???369)? vitremer? ??????, ???? 99.1??(???
  ????? 2?, ????? 3?)

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Retrospective assesment of 546 all-ceramic
anterior and posterior crowns in a general
practice

• ?? Procera AllCeram core? ? ?? alumina??? ??
  ????? ? ?? ??? In ceram core?? ?? ??????, ???
  ?????(194.20-37.65kg)In ceram(218.80-36.12kg)?
  ???? ? ??? ??? ?????.
• ????????? In ceram? ? ??(CAD/CAM? ???)-crown
  marginal gap? ?? ??? ??? 5075um??? ?.

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Retrospective assesment of 546 all-ceramic
anterior and posterior crowns in a general
practice

• ??
• 1.??? ?? ??, veneering porcelain? ??? ?? ???
  core??, ??? ?? ??, ???? ?? ??? ??? ????.
• 2.all-ceramic crown? ?????? ??? ???? ??? ??? ?
  ???? ?????.
• 3.????? ??? alumina core? ??? all-ceramic crown?
  ??? ???? ceramometal crown? ???? ????? ??? ??? ?
  ??.

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Clinical evaluation of all-ceramic crown(Dicor)
in general practice
JPD 199981277-84
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Clinical evaluation of all-ceramic crowns(Dicor)
in general practice

• 46?? ????? 98??Dicor crown? ??????, ????? GIC,
  ZPC, resin cement? ?????(????? 1.410.9?)
• 98????, 82? ??????. ????????, 51? ????. 14??
  crown?? ??? ?????? ?? 2?? ??? ??? ??? ??? ?? ???.
  ??? ? ?? ????? ??? ??????? ?????. ??? 83?? 55??
  ????? ????. ???? ???? ??? ????? ???.

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Clinical evaluation of all-ceramic crowns(Dicor)
in general practice

• ????? ????? ?? ???? ???? ???(12)? ??? ?? ??
  ????. ???, ?? ???? ?????? ?? ???? all-ceramic? ??
  ????? ????? ?????. ?, ?? ???, Dicor? ?? ????
  clenching?? ???? ??? ?? ?????? ??? ?? ??.