Recent Advances in Materials for All-Ceramic Restorations

The past 3 years of research on materials for all-ceramic veneers, inlays, onlays, single-unit crowns, and multi-unit restorations are reviewed in this article. The primary changes in the field were the proliferation of zirconia-based frameworks and computer-aided fabrication of prostheses, and a trend toward more clinically relevant in vitro test methods. This article includes an overview of ceramic fabrication methods, suggestions for critical assessment of material property data, and a summary of clinical longevity for prostheses constructed of various materials.

Ceramic materials are best able to mimic the appearance of natural teeth; however, two obstacles have limited the use of ceramics in the fabrication of dental prostheses: (1) brittleness leading to a lack of mechanical reliability, and (2) greater effort and time required for processing in comparison with metal alloys and dental composites. Recent advances in ceramic processing methods have simplified the work of the dental technician and have allowed greater quality control for ceramic materials, which has increased their mechanical reliability. As a result, the proportion of restorative treatments using all-ceramic prostheses is rapidly growing.

Several authors previously reviewed progress in the field of dental ceramics . This article reviews the research literature and commercial changes over the past 3 years since the last review in this field. The recent developments in dental ceramic technology can be categorized into three primary trends:

  • There has been a rapid diversification of equipment and materials available for computer-aided design/computer-aided manufacturing (CAD-CAM) of ceramic prostheses.

  • The availability of CAD-CAM processing permitted the use of polycrystalline zirconia coping and framework materials. The relatively high stiffness and good mechanical reliability of partially stabilized zirconia allows thinner core layers, longer bridge spans, and the use of all-ceramic fixed partial dentures (FPDs) in posterior locations.

  • Basic science researchers are increasingly using clinically relevant specimen geometry, surface finish, and mechanical loading in their in vitro studies. This implies that in vitro results will more accurately predict clinical performance of ceramic prostheses; however, clinicians still need to be cautious in extrapolating from the laboratory to the clinical case.

Methods of ceramic fabrication

A recent review of the literature included a taxonomy of dental ceramics, in which materials were categorized according to their composition and indications . The following sections are categorized by method of fabrication. This complements the previous review and reflects the recent diversification of CAD-CAM systems ( Table 1 ). Ceramics having similar composition may be fabricated by different laboratory techniques, and each method of forming results in a different distribution of flaws, opportunity for depth of translucency, and accuracy of fit. These differences should be important to the clinician because they persist beyond the walls of the dental laboratory and affect clinical performance.

Table 1
Methods of forming ceramics for all-ceramic prostheses
Fabrication method Commercial examples Composition
Powder condensation Duceram LFC (Dentsply) a Glass
Finesse Low Fusing (Dentsply) a Leucite-glass
IPS e.max Ceram (Ivoclar-Vivadent) b Fluoroapatite-glass
IPS Eris (Ivoclar-Vivadent) b Fluoroapatite-glass
LAVA Ceram (3M ESPE) c Leucite-glass
Vita D (Vita Zahnfabrik) d Leucite-glass
Vitadur Alpha (Vita Zahnfabrik) d Leucite-glass
Vitadur N (Vita Zahnfabrik) d Alumina-glass
Slip casting In-Ceram Alumina (Vita Zahnfabrik) d Glass-alumina
In-Ceram Spinell (Vita Zahnfabrik) d Glass-alumina-spinel
In-Ceram Zirconia (Vita Zahnfabrik) d Glass-alumina-PS zirconia
Hot pressing Finesse All-Ceramic (Dentsply) a Leucite-glass
Fortress Pressable (Mirage Dental Systems) e Leucite-glass
IPS Empress (Ivoclar-Vivadent) b Lleucite-glass
IPS Empress 2 (Ivoclar-Vivadent) b Lithium disilicate-glass
IPS e.max Press (Ivoclar-Vivadent) b Lithium disilicate-glass
IPS e.max ZirPress (Ivoclar-Vivadent) b Fluoroapatite-glass
OPC (Pentron Clinical Technologies) f Leucite-glass
Presintered Cercon (Dentsply) a Partially stabilized zirconia
DC-Zirkon (DCS) g Partially stabilized zirconia
Everest ZS-Blanks (Kavo) h Partially stabilized zirconia
IPS e.max ZirCAD (Ivoclar-Vivadent) b Partially stabilized zirconia
LAVA Frame (3M ESPE) c Partially stabilized zirconia
Procera AllCeram (Nobel Biocare) i Alumina
Procera AllZirkon (Nobel Biocare) i Partially stabilized zirconia
Vita YZ (Vita Zahnfabrik) d Partially stabilized zirconia
Densely sintered Denzir (Cad.esthetics) j Partially stabilized zirconia
Digiceram L (Digident) k Leucite-glass
Digizon (Digident) k Partially stabilized zirconia
Everest G-Blanks (Kavo) h Leucite-glass
Everest ZH-Blanks (Kavo) h Partially stabilized zirconia
IPS e.max CAD (Ivoclar-Vivadent) b Lithium disilicate-glass
ProCAD (Ivoclar-Vivadent) b Leucite-glass
Vitablocs Mark II (Vita Zahnfabrik) d Leucite-glass
Vitablocs TriLuxe (Vita Zahnfabrik) d Leucite-glass
ZirKon (Cynovad) l Partially stabilized zirconia
Glass infiltrated In-Ceram Alumina (Vita Zahnfabrik) d Glass-alumina
In-Ceram Spinell (Vita Zahnfabrik) d Glass-alumina-spinel
In-Ceram Zirconia (Vita Zahnfabrik) d Glass-alumina-PS zirconia
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Jun 15, 2016 | Posted by in Dental Materials | Comments Off on Recent Advances in Materials for All-Ceramic Restorations
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