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Fixed Prosthodontics II > L3- Ceramics and Zirconia > Flashcards

L3- Ceramics and Zirconia Flashcards

1
Q

Ceramic applications include:

A
  1. All ceramic crowns, inlays, onlays, veneers and FPDs
  2. Metal-ceramic crowns and FPDs
  3. Implant abutments (and implants)
  4. Denture teeth
  5. Ceramic orthodontic brackets
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2
Q

List the benefits of ceramics:

A
  1. enhanced esthetics (due to absence of metal and improved light transmission)
  2. physiologic gingival response
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3
Q

Why are ceramics most beneficial for teeth with normally colored dentin?

A

dentin coli can affect restoration through the ceramic

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4
Q

We see a physiologic gingival response with ceramics when properly:

A

contoured and highly glazed/polished

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5
Q

____ is the most realistic restoration that looks like a tooth

A

ceramics

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6
Q

Why and how does ceramic look so much like a real tooth?

A
  1. color replcation
  2. refraction
  3. translucency
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7
Q

Describe the color replication of ceramics that makes it look so much like a real tooth:

A

ceramics can be tinted/colored to produce nearly any tooth shade

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8
Q

Describe the refraction of ceramics that makes it look so much like a real tooth:

A

ceramics reflect and absorb light rays simulating enamel

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9
Q

Describe the translucency of ceramics that makes it look so much like a real tooth:

A

type of porcelain (incisal/dentin/opaque)

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10
Q

Important properties of ceramics includes:

A
  1. flexural strength
    2 fracture toughness
  2. shrinkage
  3. thermal insulator
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11
Q

Defined as the strength of a material in bending:

A

flexural strength

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12
Q

Stress on the outermost fibers of a ben test specimen, at failure:

A

flexural strength

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13
Q

Describe the flexural strength of ceramic:

A

brittle!

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14
Q

Defined as the resistance to fracture when a crack is present:

A

fracture toughness

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15
Q

_____ have high fracture toughness due to plasticity at tip of crack, absorbs energy, making crack propagation more difficult

A

Metals

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16
Q

Describe the fracture toughness of ceramics:

A

low fracture toughness - little plasticity

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17
Q

What happens to ceramics as they are fired?

A

they shrink!

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18
Q

Meaning a poor conductor of heat:

A

thermal insulator

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19
Q

Ceramic is a thermal insulator meaning it is:

A

a poor conductor of heat

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20
Q

The coefficient of thermal expansion in ceramic is ___. This means that:

A

low; ceramics do not expand and contract much with heat and cold

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21
Q

CTE:

A

Coefficient of thermal expansion

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22
Q

What is a major limitation of ceramics?

A

They are brittle

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23
Q

A.A. Griffith (1921) suggested that the ___ of glass is due to the presence of microscopic flaws in the bulk of material.

A

low fracture strength

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24
Q

Surface flaws act as ___ and cause widening and propagation of micro cracks through the ceramic material.

A

Stress initiators

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25
Q

Ceramic limitations:

  1. ____ in porcelain propgate cracks
  2. damage from ____ & ____ propagate cracks
  3. these porosities can be ___ or ___
A
  1. porosities
  2. grinding & heat
  3. external or within the material
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26
Q

Why do ceramics fail at lower than expected stress?

A

crack propagation

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27
Q

Crack will propagate through material, or until a particle is met which stops the crack growth:

A

crack propagation

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28
Q

Crack propagation and stress corrosion are both limitations of:

A

ceramic

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29
Q

____ describes how strength is reduced in a moist environment

A

stress corrosion

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30
Q

_____ is reduced in a moist environment

A

strength

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31
Q

A stress-dependent chemical reaction between water vapor and crack tip, causing crack growth and fracture with comparatively little occlusal loading (over long periods)

A

Stress corrosion

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32
Q

Stress corrosion is a ____ reaction between ___ & ___, causing crack growth and fracture with relatively little ____ (over long periods)

A

stress-dependent chemical reaction; water vapor & crack tip; occlusal loading

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33
Q

Ceramic powder/liquid is built up and molded (feldspathic porcelain)

A

sintering

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34
Q

What type of ceramic is produced through sintering?

A

Feldspathic porcelain

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35
Q

Process of heating ceramic powder once molded, (also called firing the ceramic)

A

sintering

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36
Q

The reduction of porosities between particles as the ceramic becomes more rubbery:

A

sintering

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37
Q

Tg:

A

Glass transition temperature

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38
Q

A range of temperatures where porcelain starts to become molten:

A

Glass transition temperature (Tg)

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39
Q

Glass transition temperature describes a transition from:

A

sold to rubbery

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40
Q

What is the typical glass transition temperature range of ceramics?

A

540-610 degrees Celsius

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41
Q

It is important to note that the glass transition temperatures of ceramics is:

A

BELOW the ceramic melting point

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42
Q

The glass transition temperature of ceramic is a range of temperature where porcelain started to become:

A

molten

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43
Q

During firing (sintering), the space between the particles shrinks until the particles:

A

fuse together, resulting in dense/hard ceramic

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44
Q

Relies on external pressure to sinter and shape the ceramic at high temperature:

A

heat pressing

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45
Q

Heat pressing relates on ____ to sinter and shape the ceramic at high temperature

A

external pressure

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46
Q

During heat pressing, the restoration is made from a ____ (____)

A

wax pattern (lost wax technique)

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47
Q

Heat pressing is also known as:

A

high temperature injection molding

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48
Q

CAD:

A

computer aided design

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49
Q

CAM:

A

Computer aided manufacture

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50
Q

Involves an already densely sintered material such as silicate, glass ceramics, & resin-based ceramics:

A

hard milling (CAD/CAM)

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51
Q

Involves partially sintered material such as zirconia, lithium discilicate (e. max) & the sintering is to be completed in oven AFTER manufacture:

A

soft milling (CAD/CAM)

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52
Q

What type of milling involves sintering AFTER the manufacture?

A

soft milling

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53
Q

What materials are used with hard milling?

A
  1. silicate
  2. glass ceramics
  3. resin-based ceramics

(already densely sintered material)

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54
Q

What materials are used with soft milling?

A
  1. zirconia
  2. lithium distillate (e. max)

(partially sintered material)

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55
Q

For CAD/CAM, ___ are used for the milling process

A

blocks

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56
Q

What has improved esthetics with CAD/CAM?

A
  1. newer multi-shade blocks
  2. a stain and glaze via furnace
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57
Q

List the types of blocks available for CAD/CAM

A
  1. glass ceramics
  2. zirconia
  3. resin-ceramics
  4. resin
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58
Q

Classify the following blocks:
- Vita Mark 2
- IPS Emax CAD
- Celtra Duo Ultra

A

Glass ceramics

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59
Q

Classify the following blocks:
- IPS Emax ZirCAD
- 3M Chairside Zirconia
- CEREC Zirconia

A

Zirconia

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60
Q

Classify the following blocks:
- Cerasmart
- Vita Enamic

A

Resin-ceramics

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61
Q

Classify the following blocks:
- Tell blocks

A

Resin

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62
Q

CAD/CAM systems include:

A
  1. Itero
  2. E4D
  3. Trios
  4. Planmeca
  5. Carestream
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63
Q

T/F: More CAD/CAM systems come to the market every year

A

True

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64
Q

Ceramics that are predominately glass are considered:

A

veneers

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65
Q

Ceramics that are particle filled glass ceramics are considered:

A

Emax

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66
Q

Type of ceramics that have the most translucent optical properties:

A

Veneers (predominately glass)

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67
Q

What is considered the weakest material?

A

Veneers (predominately glass)

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68
Q

Feldspathic porcelain is an example of:

A

Veneers (predominately glass)

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69
Q

Can you etch with Veneers (predominately glass)?

A

Yes!

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70
Q

Type of ceramics that have less translucency than veneers but not the leas amount of translucency

A

Particle filled glass ceramic (eMax)

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71
Q

Particle filled glass ceramic (eMax) has a ____ strength

A

increased (compared to veneers but less than polycrystalline ceramic zirconia)

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72
Q

Can you etch Particle filled glass ceramic (eMax)?

A

Yes!

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73
Q

Lithium disilicate is an example of:

A

Particle filled glass ceramic (eMax)

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74
Q

Type of ceramic with the LOWEST translucency:

A

Polycrystalline ceramic (zirconia)

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75
Q

Polycrystalline ceramic (zirconia) has the ____ strength

76
Q

Alumina and zirconia are examples of:

A

Polycrystalline ceramic (zirconia)

77
Q

Can you etch Polycrystalline ceramic (zirconia)?

78
Q

Ceramic classification:

  1. Predominately glass
  2. Particle filled glass ceramic
  3. Polycrystalline ceramic
A
  1. Veneers
  2. Emax
  3. Zirconia
79
Q

Ceramic classification:

  1. Highest translucency
  2. Intermediate translucency
  3. Lowest translucency
A
  1. Veneers
  2. Emax
  3. Zirconia
80
Q

Ceramic classification:

Can etch:
CANNOT etch:

A

can etch: veneers & max

cannot etch: zirconia

81
Q

Ceramic classification :

  1. Highest strength
  2. Intermediate strength
  3. Lowest strength
A
  1. Zirconia
  2. Emax
  3. Veneers
82
Q

Give an example of each of the following:

  1. Veneers
  2. Emax
  3. Zirconia:
A
  1. Feldspathic porcelain
  2. Lithium disilicate
  3. Alumina
83
Q

The most beautiful, colorful, and the most realistic false representation of natural tooth we have:

84
Q

What are the negatives of ceramics?

A

brittle and fracture prone

85
Q

List some methods to strengthen ceramics:

A
  1. resin bonding
  2. reinforcement of the crystalline structure of ceramic
  3. transformation toughening
86
Q

T/F: You can use resin bonding to bond tooth to ceramic with the etchable ceramics

87
Q

When resin bonding to strengthen ceramics, use of a ______ enhances bond strength

A

Silane coupling agent

88
Q

When resin bonding to strengthen ceramics, a resin cement used is either:

A

light cured or dual cured

89
Q

Reinforcement of the crystalline structure of the ceramic to provide more strength involves the ____ phase which adds higher strength and fracture resistance

A

dispersed crystalline phase

90
Q

Lithium disilicate is an example of what method to strengthen ceramics?

A

Reinforcement of the crystalline structure of the ceramic

91
Q

Transformation toughening of ceramic to increase the strength involves:

A

stress induced transformation

92
Q

What form of ceramic strengthening is unique to zirconia?

A

transformation toughening

93
Q

In this process of strengthening ceramic, compressive forces at crack tip retard crack propagation:

A

Transformation toughening

94
Q

How does porcelain break?

A
  1. flexure
  2. improper loading (askew occlusion)
95
Q

Resin bonding is a high strength cementation procedure , so bonding ceramics will ____ the ability of the ceramic to flex. Therefore it ____.

A

decrease; adds strength

96
Q

Resin bonding with etchable glass ceramics provides a ___ in glass ceramic ceramic crown strength

A

50% increase

97
Q

When resin-bonding etchable glass ceramics, HF etched ceramic surface provides:

98
Q

When resin-bonding etchable glass ceramics, the ____ (bifunctional monomers) forms a chemical bond

A

silane coupling agent

99
Q

When resin-bonding etchable glass ceramics, etched enamel/dentin provides a:

A

adhesive layer

100
Q

When resin-bonding etchable glass ceramics, what layer is formed between the etched ceramic surface and the adhesive layer?

A

silane layer

101
Q

How does resin cement work to strengthen ceramics?

A

The movement of the resin cement into the dentin tubules forms microtags and moves into the porcelain spaces forming a matrix with great retention

102
Q

Layer that contains resin microstags within the interlobular dentin and surrounding collagen fibers:

A

Hybrid layers

(created by resin bonding to ceramic)

103
Q

A very thin sheet of porcelain as thin as 0.3 to 0.5 mm (minimal thickness)

104
Q

What is the minimal thickness of veneers?

A

0.3 to 0.5 mm

105
Q

This tooth preparation is specific and aimed at providing esthetics and physical support to this entity:

106
Q

Veneers should not be used under:

A

heavy occlusal loads

107
Q

How are veneers bonded to the tooth?

A

resin bonded to the enamel

108
Q

Possibly the MOST esthetic dental restoration:

109
Q

Veneers can be so thin that the:

A

underlying tooth color can affect the optical properties

110
Q

T/F: With crystalline reinforcement of ceramics cracks never begin

A

False- small cracks begin but then have a harder time causing catastrophic failure

111
Q

By adding crystalline aspects to the ceramic, ____ is much more difficult

A

crack propagation

112
Q

Flexural strength of:
A) enamel
B) feldspathic porcelain
C) leucite reinforced ceramic
D) E. Max

A

A)300 MPa
B) 60-70 MPa (much lower)
C) 120-160 MPa
D) 360-500 MPa

113
Q

An additional method to strengthen feldspathic porcelain is to:

A

add a metal substructure

114
Q

What material is ONLY used for veneers?

A

feldspathic porcelain

115
Q

Leucite reinforced ceramic:

116
Q

Would you use leucite reinforced ceramic on a posterior crown?

117
Q

Would you use leucite reinforced ceramic on an onlay/inlay?

A

Maybe- only where occlusal force is low

118
Q

Would resin bonding help strengthen leucite reinforced ceramic?

A

Yes- it can be etched and therefore retention and strength is increased with resin bonding

119
Q

Indications for leucite reinforced ceramic (empress)

A

anterior crowns & veneers

120
Q

IPS, Empress, Esthetic, and Ivoclar are all examples of:

A

leucite reinforced glass ceramic

121
Q

Material that’s flexural strength is stronger than enamel alone:

A

Lithium disilicate ceramic (E. Max) (360-500 MPa)

122
Q

Lithium Discilicate (E. Max) is used for:

A
  1. veneers
  2. anterior crowns
  3. posterior crowns
  4. anterior bridges (particular cases)
  5. inlays & only with low occlusal forces

(due to its increased strength)

123
Q

Can you use resin bonding on lithium discilicate ceramic (E. max)?

A

Yes - can use resin bonding AND other cements like RMGI

124
Q

Can you use E. Max for a posterior 3-unit bridge?

A

No due to increased fracture of material

125
Q

In the following image, we see a posterior 3 unit FDP made from lithium disilicate ceramic (E. Max)… What went wrong to result in this?

A

You should NOT use E. max for a posterior bridge

(due to increased fracture risk)

126
Q

Zirconia has a ____ structure:

A

polycrystalline

127
Q

The polycrystalline structure of zirconia provides:

A
  1. increased strength
  2. a surface that is not abrasive (like porcelain) and therefore is gentle on opposing dentition
128
Q

What provides these properties of zirconia?

  • increased strength
  • a surface that is not abrasive (like porcelain) and therefore is gentle on opposing dentition
A

The polycrystalline structure of zirconia

129
Q

T/F: Resin bonding will NOT increase the strength of zirconia. Resin bonding will increase the retention of zirconia.

A

Both statements true

130
Q

What will resin bonding do for zirconia?

A

Increase the retention! (but not the strength)

131
Q

This material needs the internal restoration surface to be roughened since it cannot be etched:

132
Q

T/F: Zirconia contains glass etch

133
Q

Zirconia needs the internal restoration surface to be roughened since it cannot be etched. How might this be accomplished?

A
  1. Air abrasion
  2. Diamond bur
134
Q

What is needed for increased bonding of zirconia with resin cement?

A

bonding primer

135
Q

T/F: A bonding primer is needed for increased bonding of zirconia with resin cement

136
Q

The original zirconia crown was from ___ 10 years ago

137
Q

The original zirconia produced was a ___ zirconia crown called ___

A

3Y; Bruxir

138
Q

Describe the first zirconia produced (3Y zirconia aka Bruxir):

A
  1. horrible translucency esthetics
  2. poorly defined occlusal anatomy
139
Q

What was the flexural strength of 3Y Bruxir?

140
Q

3Y Bruxir:

A

Zirconia (the original one!)

141
Q

T/F: Because of 3Y Bruxir zirconia strength, any cement can be used

142
Q

What has to be done to a 3Y Bruxir Zirconia crown in order to fit?

A

crown has to “fired” and will shrink to fit; will shrink it about 25%

143
Q

How are zirconia crowns so strong?

A

transformational toughening

144
Q

____ is unique to zirconia

A

stress induced transformation

145
Q

With stress induced transformation ____ forces at crack tip retard the crack propogation

A

compressive forces

146
Q

Describe what happens following crack initiation of zirconia:

A

Crack initiation –> tensile stress at crack tip causes a tetragonal to monoclinic shape change

147
Q

Describe the shape change with crack initiation of zirconia?

A

tetragonal –> monoclinic shape change

(transformational toughening)

148
Q

What leads to crack closure associated with the compresses stresses in the vicinity of the crack tip (zirconia transformational toughening)

A

volume increase associated with the compressive stresses

149
Q

To make zirconia more translucent we can add ___. What does this result in?

A

Yttria; decreased strength

150
Q

Adding Yttria to zirconia results in:

A
  1. increased translucency
  2. decreased strength
151
Q

What type of zirconia is being described?

  • 100% tetragonal phase
  • 0% cubic phase
  • HIGHEST mechanical properties (1200 MPa)
  • LOWEST translucency
A

3Y zirconia

152
Q

What type of zirconia is being described?

  • 75% tetragonal phase
  • 25% cubic phase
  • HIGH mechanical properties (850 MPa)
  • HIGHER translucency
A

4Y zirconia

153
Q

What type of zirconia is being described?

  • 50% tetragonal phase
    -50% cubic phase
  • LOWEST mechanical properties (650 MPa)
  • HIGHEST translucency
A

5y zirconia

154
Q

In zirconia, ____ phase helps with fracture toughness, while ____ phase helps with translucency

A

tetragonal = toughness
cubic= translucency (cuteness)

155
Q

What formulation of zirconia is a 50/50 ratio of the tetragonal phase with the cubic phase?

156
Q

PFZ:

A

porcelain fuzed to zirconia

157
Q

What is the purpose of a PFZ?

A

improve esthetics with the porcelain shell on tope of the zirconia core for strength

158
Q

Monolithic options of zirconia are not very ___ but do not ____.

A

Esthetics; fracture easily

159
Q

PFZ crowns initially had failures, mostly in the:

160
Q

List some reasons PFZ crowns failed? Specifically the porcelain aspect that would fail:

A
  1. lack of porcelain support in zirconia substructure
  2. OCCLUSION
  3. Bond between zirconia and porcelain would not be able to overcome the difference in coefficient of thermal expansion between the zirconia core and the veneering porcelain
161
Q

If a patient comes in with a dark tooth (dentin) needing a crown, what may be a good option?

A

PFZ because the zirconia core can be used to mask the dark dentin

162
Q

T/F: Because zirconia is NOT brittle, any cement technique can be used

163
Q

Zirconia copings can be as thin as ___ because zirconia is strong

164
Q

A _____ zirconia crown preparation can be very conservative similar to gold or PFM crown preps

A

monolithic zirconia

165
Q

Describe the effects of zirconia on the opposing teeth:

A

wear friendly

166
Q

What type of finish lines can be used for zirconia crown preps?

A

chamfer or shoulder

167
Q

Zirconia still needs appropriate ____ and ____ to survive in the oral cavity

A

thickness & occlusion

168
Q

If you want the MOST esthetic anterior restoration what material would you choose?

  1. veneer
  2. crown
A
  1. feldspathic porcelain
  2. E. Max or Empress
169
Q

If you want the MOST esthetic posterior restoration, what material would you use?

  1. Crown
A

Emax or 5Y zirconia

170
Q

If you have a bruxing patient, what posterior restoration material would you use?

A

3Y zirconia or Gold

171
Q

What is the most realistic anterior tooth replacement option?

A

Feldspathic porcelain veneer resin bonded

172
Q

Anterior teeth:

  1. ____ occlusal forces
  2. ____ strength requirement
  3. ____ esthetic requirement
A
  1. lower
  2. less
  3. higher
173
Q

Posterior teeth

  1. ____ occlusal forces
  2. ____ strength requirement
  3. ____ esthetic requirement
A
  1. higher
    2 higher
  2. less
174
Q

If the patient is NOT a grinder, what type of restoration material would we use in the posterior?

A

E. max or Zirconia

175
Q

Your patient is bruxer/clencher and needs a bridge.

  1. Best treatment option:
  2. Middle treatment option:
  3. Not a great option:
A
  1. Monolithic zirconia or PFM
  2. monolithic material with buccal porcelain
  3. fully veneered porcelain
176
Q

When should you adjust glass ceramic veneers?

A

Only adjust AFTER seated and bonded with resin cement (too fragile to adjust outside the mouth) and the internal surface should NOT be adjusted if possible

177
Q

When should you adjust E. Max (lithium disilicate)?

A

adjustment outside the mouth is acceptable and the internal surface should not be adjusted if possible

178
Q

When should you adjust zirconia?

A

Adjustment outside the mouth is acceptable; internal surface needs either air abrasion or diamond bur roughening prior to cementingA

179
Q

After adjustments of ceramics with bur, what is the order for polishing?

A
  1. coarse polisher
  2. fine polisher
  3. felt wheel or burns with fine diamond polishing paste
180
Q

T/F: Resin cements do not require a moisture free environment

A

False- They DO require a moisture free environment

181
Q

MDP:

A

Methacryloyloxydecyl dihydrogen phosphate

182
Q

Placed on zirconia to enhance the chemical bond to cements containing resin

A

Primer containing MDP (used with resin cements)

183
Q

Which of the following are contraindicated in LOW strength ceramics?

A) RMGI
B) Resin cements
C) Resin cements with MDP primer

184
Q

Why is an RMGI cement contraindicated with low strength ceramics?

A

Because the water absorption with the setting of the cement leads to slight expansion and possible fracture of ceramic at thin margin area

(however because zirconia is a strong ceramic it can be used with zirconia)

Fixed Prosthodontics II (5 decks)

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