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5. All-Ceramic crowns Flashcards

1
Q

Define all ceramic crown

A

Ceramic FPD without supporting metal framework

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2
Q

Land’s classical jacket crown? (3)

A
  • Obsolete

- feldespathic porcelain fused over platnium foil

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3
Q

Mclean and hughes’ classical jacket crown? (5)

A
  • Obsolete
  • Aluminous porcelain coping (40% Al2O3).
  • Feldspathic veneering porcelain.
  • Opaque coping.
  • Low fracture toughness
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4
Q

Mclean’s classical jacket crown?

A
  • obsolete
  • Aluminous porcelain with platinum foil coping
  • is a variant of MClean and hughes’
  • tougher
  • less esthetic
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5
Q

Why is mclean’s classical jacket crown less esthetic?

A

Decreased light transmission

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6
Q

What is the defining characteristic of current jacket crowns?

A

Reinforced to provide improved toughness and/or esthetics

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7
Q

Material characteristics of dental ceramics? (4)

A
  • Inert
  • Metallic oxides
  • no liberation of ions into the mouth
  • Highly biocompatible
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8
Q

What are the different phases of dental ceramics? (2)

A
  • Vitreous

- Crystalline

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9
Q

What are dental ceramics made of? (2)

A

Vitreous matrix and mineral crystals

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10
Q

What provides the different properties of ceramics?

A

The percentage of vitreous matrix vs mineral crystals

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11
Q

How is the marginal fit of dental ceramics?

A

Good

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12
Q

What are the mechanical properties of dental ceramics? (2)

A
  • Resistance to compression

- Low resistance to flexion

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13
Q

What is flexion?

A

Bending strength

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14
Q

Why do ceramics have low resistance to flexion? (2)

A

They lack the previous state of elastic deformation

- this is improved in high resistance porcelains

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15
Q

Which ceramic is low resistance?

A

Feldspathic porcelain (empress esthetic)

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16
Q

What is the resistance of feldspathic porcelins?

A

70-90 MPa

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17
Q

Which ceramic is moderate resistance?

A

Lithium disilicate (E-max press/ CAD)

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18
Q

What is the resistance of lithium disilicate?

A

360-400 MPa

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19
Q

Which ceramic is high resistance?

A

Zirconia

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20
Q

What is the resistance of zirconia?

A

900 MPa

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21
Q

What materials are classified as vitreous ceramics? (3)

A
  • Feldspathic
  • Leucite
  • Lithium disilicate
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22
Q

What materials are classified as crystalline ceramics? (2)

A
  • Aluminous

- Zirconia based (Y-ZTP)

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23
Q

Whats the manufacturing methods for all ceramic crowns? (3)

A
  • Layered
  • Pressed
  • CAD/CAM
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24
Q

What strength are feldspathich viterous ceramics? (2)

A
  • low strength

- high strength

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25
Q

Which are the glass matrix ceramics? (3)

A
  • Feldspathic
  • Synthetic reinforcemed
  • Glass infiltrated
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26
Q

Which are the glass matrix ceramics with synthetic reinforcement? (3)

A
  • Leucite based
  • Lithium disilicate
  • Fluorapatite-based
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27
Q

Which are the glass matrix ceramics that are glass infiltrated? (3)

A
  • Alumina
  • Alumina & magnesium
  • Alumina & zirconia
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28
Q

What are the different polycrystalline ceramics? (4)

A
  • Alumina
  • Stabilized zirconia
  • Zirconia-toughened alumina
  • Alumina-toughned zirconia
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29
Q

What are the different resin matrix ceramics? (3)

A
  • Resin nanoceramic
  • Glass-ceramic in a resin interpenetrating matrix
  • Zirconia-silica ceramic in a resin interpenetrating matrix
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30
Q

Which are the glass ceramics?

A

Feldspathic

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31
Q

Which are the glass ceramic with fillers? (3)

A
  • Leucite reinforced
  • lithium disilicate
  • glass infiltrated
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32
Q

Which are the glass-free ceramics, polycrystalline? (2)

A
  • Alumina

- Zirconia

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33
Q

What are the high strength feldspathic porcelains? (2)

A
  • Leucite reinforced

- Lithium disilicate

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34
Q

What was the first all ceramic crown?

A

Low strength feldspathic porcelains

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35
Q

What are low strength feldspathic porcelins composed of? (3)

A
  • Feldspar
  • Quartz
  • Kaolin
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36
Q

What is the purpose of the feldspar in low strength feldspathic porcelains?

A

Translucency

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37
Q

Quartz in low strength feldspathic porcelains?

A

Crystalline phase

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38
Q

What is the purpose of the kaolin in low strength feldspathic porcelains?

A

Plasticity

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39
Q

Low strength feldspathic porcelains have an important ___ phase

A

Glass

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40
Q

Main use of low strength feldspathic porcelains?

A

Veneering porcelain

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41
Q

Pro’s of low strength feldspathic porcelains?

A

Esthetics

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42
Q

Con’s of low strengh feldspathic porcelains

A

High fragility

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43
Q

When do you use leucite high strength feldspathic porcelains?

A

For high esthetic demand

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44
Q

What are Leucite reinforced high strength feldspathic porcelains made of?

A

Leucite microcrystals

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45
Q

What is the fracture strength of leucite reinforced high strength feldspathic porcelains?

A

120Mpa

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46
Q

What is the resistance of lithium disilicate reinforced high strength feldspathic porcelains?

A

360-400MPa

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47
Q

What are lithium disilicate reinforced high strength feldspathic porcelains made of?

A

reinforced with a higher percentage of lithium disilicate

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48
Q

Example of leucite-reinforced high strength feldspathic porcelain?

A

IPS empress II

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49
Q

IPS empress II?

A

Leucite-reinforced high strength feldspathic porcelain

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50
Q

Examples of lithium disilicate-reinforced high strength feldspathic porcelain? (3)

A
  • IPS e.max CAD
  • IPS e.max Press
  • IPS e.max Press Multi
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51
Q

IPS e.max CAD?

A

Lithium disilicate-reinforced high strength feldspathic porcelain

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52
Q

IPS e.max Press?

A

Lithium disilicate-reinforced high strength feldspathic porcelain

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53
Q

IPS e.max Press Multi

A

Lithium disilicate-reinforced high strength feldspathic porcelain

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54
Q

Properties of IPS e.max Press? (2)

A

◦ Varies from HT (high translucency) to HO (high opacity).

◦ 400MPa

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55
Q

IPS e.max Press strength?

A

400 MPa

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56
Q

Properties of IPS e.max CAD?

A

◦ Varies from HT (high translucency) to HO (high opacity).
◦ Typical blue initial color.
◦ Gives the option for monolithic restorations
◦ Resistance of 360Mpa

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57
Q

What is the composition of aluminous porcelains?

A

Aluminum oxide instead of quartz

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58
Q

What are the mechanical properties of aluminous porcelains ?

A

Good

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59
Q

How is the translucency of aluminous porcelains ?

A

Low

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60
Q

What are aluminous porcelains used for?

A

Full cast crown copings

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61
Q

Porosity of aluminum oxides?

A

high

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62
Q

Is aluminous porcelain used often? Why or why not?

A

Diminished use due to the better properties and survival

of LDS and Zr

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63
Q

What is the chemical composition of zirconia based porcelains?

A

ZrO2

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64
Q

What are the three phases of zirconia based porcelains?

A
  • tetragonal
  • monoclinic
  • cubic
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65
Q

Which is the third stable phase that was developed of zirconia based porcelains

A

Cubic

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66
Q

What is the composition of zirconia-based porcelains?

A
  • 95% zirconium oxide

- 5% yttrium oxide

67
Q

What is the chemical composition of yttrium oxide?

68
Q

What is Y-TZP?

A

Yttrium stabilized tetragonal zirconia pollycrystals

69
Q

Where can you find Y-TZP ?

A

zirconia-based porcelains

70
Q

What kind of structure do zirconia-based porcelains have?

A

Totally crystalline structure

71
Q

When does transformation toughening occur?

A

In zirconia-based porcelains

72
Q

What are the phases of zirconia related to?

A

Transition related to temperature rise

73
Q

Properties of partially stabilized zirconia Y-TZP? (3)

A
  • high tensile strength
  • fracture toughness
  • most used in dental restorations
74
Q

What chemicals can stabilize zirconia in zirconia-based porcelain? (2)

A
  • Magnesium calcium

- Cerium

75
Q

What are the stages of zirconia-based porcelains transformation toughening? (3)

A
  • Crack initiation
  • Early stage of crack propagation
  • later stage of crack propagation
76
Q

What is in the crack initiation stage of zirconia-based porcelains transformation toughening?

A

A crack exists and all the particles are tetragonal

77
Q

What is in the early stage of crack propagation of zirconia-based porcelains transformation toughening?

A

The tip of the crack is in the process zone surrounded by tetragonal particles transforming into monoclinic particles

The crack is surrounded by already transformed monoclinic particles

78
Q

What is in the later stage of crack propagation of zirconia-based porcelains transformation toughening?

A

The crack is bigger

The tip of the crack is in the process zone surrounded by tetragonal particles transforming into monoclinic particles

The crack is surrounded by already transformed monoclinic particles

79
Q

Examples of zirconia porcelains?

A

Lava Esthetic, Plus, Frame (3M Espe).

  • Katana
  • Zirkonzahn
80
Q

Zirconia porcelain properties? (2)

A
  • Very tough.

* Very opaque

81
Q

What are the properties of layered zirconia porcelains? (3)

A
  • Aging (low temperature degradation).
  • Chipping in 15% of the cases after 24 months.
  • 25% of fractures and chipping after 31 months.
82
Q

Which is the newly developed zirconia porcelains?

A

Monolithic zirconia

83
Q

Properties of monolithic zirconia? (4)

A
  • Stability structure
  • High Biocompatibility
  • No chipping complications
  • Mono-blocks previously stratified
84
Q

Reduction of monolithic zirconia porcelains?

A
  • Tooth structure reduction between 0.5 and 1.5mm max.

- 0.5 mm chamfer line [0.3 to 0.8 mm]

85
Q

Examples of monolithic zirconia porcelains?

A
  • Lava Plus

- Lava Esthetic

86
Q

Which examples of all ceramic crowns are layered over the investment cast? (4)

A
  • In-Ceram® Spinell.
  • Mirage® II Fiber.
  • Optec-HSP®.
  • Fortress®.
87
Q

What is another name for the pressed technique?

88
Q

What are the steps in the pressed technique? (2)

A

• 1º- Waxing of the framework or of the whole restoration,
by MILLING a block of WAX.
• 2º- Pressing the material into the space left by the melted
wax.

89
Q

What is the advantage of the pressed technique?

A

Increases toughness by reducing porosity

90
Q

Examples of the pressed technique? (2)

A
  • IPS® Empress.

- IPS® e.max Press

91
Q

What is the lab procedure for CADCAM all ceramic crowns? (4)

A
  • Scanning
  • Design CAD
  • Manufacturing methods
  • Manufacturing final shape
92
Q

What are the manufactiing methods for CADCAM all ceramic crowns?

A
  • Milling
  • Pressed
  • Sintered
93
Q

What are the different manufcating final shapes for CADCAM all ceramic crowns?

A
  • Monolithic, full contour
  • Cut-back technique
  • Core + veneering
94
Q

CADCAM all ceramic crowns monolithic full contour ? (4)

A

◦ All the volume of the restoration in one piece.
◦ Stains to individualize and for characterizations.
◦ LDS for posterior teeth should be prepared this way.
◦ Zirconia restorations should be made in full-contour to reduce the chipping

95
Q

Zirconia all ceramic restorations should be made in ____ to reduce the chipping

A

full contour

96
Q

All ceramic posterior teeth should be prepared this way…

A

Full contour monolithic

with LDS

97
Q

CADCAM all ceramic crowns cutback manfucating?

A

◦ Milling of cervical 2/3s of the crown.

◦ The rest is veneered with feldspathic porcelain

98
Q

CADCAM all ceramic crowns Milled coping + veneering porcelain manufacturing?

A

For maximum esthetic results

99
Q

What is the fracture toughness of ISO 6872?

A

Minimum of 100MPa

100
Q

What is the fracture toughness of PFM?

A

400-600MPa

101
Q

What is the gold standard of fracture toughness?

A

400-600 PFM

102
Q

What is the compressive strength of feldspathic porcelain?

103
Q

What is the bending strength of feldspathic porcelain?

104
Q

What is the bending strength of feldspathic porcelain when veneered over framework?

105
Q

What is the bending strength of lithium disilicate when CAM?

106
Q

What is the bending strength of lithium disilicate when pressed?

107
Q

What is the bending strength of zirconia?

A

700-900 MPa

108
Q

The minimum acceptable marginal fit?

A

100 microns

109
Q

The explorer cannot detect marginal fit misfits lower than…

A

100 microns

110
Q

All ceramic crowns: What material do you choose for an anterior crown if it has a light color and enough prosthetic space?

A

High strength feldspathic porcelains

111
Q

All ceramic crowns: What material do you choose for an anterior crown if it has a dark color?

A 
Lithium disilicate, choosing a low translucency (LT) or
medium opacity (MO)
112
Q

All ceramic crowns: What material do you choose for an anterior crown if it has unfavorable occlusion/space

A

Monolithic LDS or Zr

113
Q

All ceramic crowns: why would you select HIGH TRANSLUCENCY HT (3)

A
  • The underneath colour of the tooth is good.
  • No more than 1 grade of colour modification.
  • Multiple anterior restorations with the same colour of the substrate
114
Q

All ceramic crowns: why would you select LT or MO materials? (3)

A

• Dark substrate of the preparation
• Colour modification of more than 1 grade
• Multiple restorations with different conditions of the
substrate

115
Q

When do you select feldspathic porcelain for anterior veneers? (3)

A
  • Small modifications of the shape.
  • Slight modifications of the color.
  • No more than 2mm lengthening of the incisal border.
116
Q

When do you select LDS core and veneered porcelain for anterior veneers? (3)

A
  • Important color changes: 2 to 3 grades.
  • Important changes of the shape and length.
  • Overbite, bruxism.
117
Q

When do you select LDS for anterior veneers? (3)

A
  • Important color changes: 2 to 3 grades.
  • Important changes of the shape and length.
  • Overbite, bruxism.
118
Q

When is a posterior unitary crown a good option?

A

Premolars and posteriot restorations

119
Q

In posterior unitary crown it is important to respect the..

A

volumes in order to give to the

restoration the needed strength against mechanical loads

120
Q

What volume does an LDS with a veneered layer, posterior unitary crown need

121
Q

How can you get a better result with a zirconia with a veneered layer, posterior unitary crown

A
  • rounded shoulder FL
  • contact points in Zr and enough volume of the
    functional cusps
122
Q

When do we choose monolithic Zr restorations, posterior unitary crown ?

A

when the prosthetic space is

limited, less abrasive when correctly polished

123
Q

What materials can you use for anterior bridges?

A
  • LDS

- Zirconia

124
Q

What is important to know about LDS in anterior bridges?

A

Maximum 3 pieces and not further than the premolar

125
Q

What material do you use if the anterior bridge is light color and there is enough prosthetic space?

A

LDS, e-max press for its better mechanical properties

126
Q

What material do you use for the anterior bridge, if it has a dark color or unfavorable prosthetic space?

A

zirconia based porcelain or PFM

127
Q

What is the contraindication of anterior bridges?

A

unfavorable occlusion and low prosthetic space

128
Q

What is important to know about anterior bridges and connector volume?

A

Require more volume of the connector to avoid fractures

129
Q

What is the better option for posterior bridges when the material is full ceramic?

130
Q

What type of zirconia can you use in posterior bridges? (2)

A

Monolithic or veneered

131
Q

What type of connectors are needed for zirconia in posterior bridges?

A
  • 9mmsquared connectors

- 12mm squared if central connector

132
Q

List the all ceramic crowna in order of higher esthetics/cost (4)

A
  • Veneered zirconia
  • lithium disilicate
  • monolithic Zr
  • PFM
133
Q

What is the thickness of all ceramic PFM crown?

134
Q

What is the thickness of all ceramic monolithic Zr crown?

135
Q

What is the thickness of all ceramic LDS crown?

136
Q

What is the thickness of all ceramic Veneered Zr crown?

137
Q

What do we need to consider when selecting all ceramic crowns?

A
  • Color of the substrate
  • Type of occlusion
  • prothetic space
138
Q

What are the maximum esthetic concern indications for all ceramic crowns? (6)

A
  • tooth fractures
  • caries and restorations at anterior teeth
  • color alterations
  • diasthemas
  • tooth malformation
  • malposition
139
Q

What are the maximum esthetic concern contraindications for all ceramic crowns? (3)

A
  • parafunctional habits
  • limited prosthetic space
  • periodontal disease
140
Q

What are the maximum esthetic concern contraindications for all ceramic crowns for patients with limited prosthetic space? (3)

A
  • overbite
  • crossbite
  • edge-to-edge occlusion
141
Q

What preparation size is needed for all cermaic crowns 3M laval plus zirconia?

A

0.5mm or more

142
Q

What preparation size is needed for all cermaic crowns 3M lava esthetic zirconia?

A

0.8mm or more

143
Q

What preparation size is needed for all cermaic crowns IPS e.max

A

1.5mm or more

144
Q

What is an example of 3Y-TZP zirconia?

A

3M laval plus high-translucency

145
Q

What minimal wall thickness is needed for material stability of of 3Y-TZP zirconia anteriorly?

146
Q

What minimal wall thickness is needed for material stability of of 3Y-TZP zirconia posteriorly?

147
Q

What minimal wall thickness is needed for material stability of of 4Y-TZP zirconia anteriorly?

148
Q

What minimal wall thickness is needed for material stability of of 4Y-TZP zirconia posteriorly?

149
Q

What is an example of 4Y-TZP zirconia

A

3M chairside zirconia

150
Q

What is an example of 5Y-TZP full contour zirconia

A

3M™ Lava™ Esthetic Fluorescent Full-Contour

Zirconia

151
Q

What is an example of lithium disilicate? (2)

A
  • IPS e-max CAD

- ivoclar vivadent

152
Q

What minimal wall thickness is needed for material stability of of 5Y-TZP zirconia posteriorly?

153
Q

What minimal wall thickness is needed for material stability of 5Y-TZP zirconia anteriorly?

154
Q

What minimal wall thickness is needed for material stability of LDS anteriorly?

155
Q

What minimal wall thickness is needed for material stability of LDS posteriorly?

156
Q

What minimal wall thickness is needed for material stability of 3Y-TZP zirconia plus veneering porcelain anteriorly?

157
Q

What minimal wall thickness is needed for material stability of 3Y-TZP zirconia plus veneering porcelain posteriorly?

158
Q

Example of 3Y-TZP zirconia plus veneering porcelain?

A

3M™ Lava™ Frame Zirconia

159
Q

What minimal wall thickness is needed for material stability of PFM posteriorly?

160
Q

What minimal wall thickness is needed for material stability of PFM anteriorly?

161
Q

What abutment height is needed for all ceramic crowns if conventional cementation is desired?

162
Q

Which angles are not read correctly by scanning machines?

163
Q

Allceramic crowns: material favorable in the posterior region?

A
  • monolithic

- high strength ceramics

164
Q

Allceramic crowns: material favorable in the anterior region?

A

layered/hand veneered ceramics

Prostho 3 (11 decks)

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