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Fixed Prosthodontics II > L3: Ceramics & Zirconia > Flashcards

L3: Ceramics & Zirconia Flashcards

1
Q

Ceramic applications include:

A
  1. all ceramic crowns, inlays, onlay, veneers & FPDs
  2. metal-ceramic crowns & FPDs
  3. implant abutments (and implants)
  4. denture teeth
  5. ceramic ortho brackets
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2
Q

List the benefits of ceramics:

A
  1. enhanced esthetics
  2. physiologic gingival response
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3
Q

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

A

Dentin color can affect restorations through the ceramic

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4
Q

We see a physiologic gingival response with ceramics when properly:

A

contoured & 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 replication
  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 include:

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

Defined as the strength of a material bending:

A

flexural strength

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12
Q

Stress on the outermost fibers of a bent 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:

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 the 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 material

A

low fracture strength

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24
Q

Surface flaws act as _____ and cause widening and propagation of microcracks 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

A 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 & 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 & 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 produce through sintering?

A

feldspathic porcelain

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35
Q

Process of heating ceramic powder once molded:

A

sintering

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36
Q

Also called “firing” the ceramic:

A

sintering

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37
Q

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

A

Sintering

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38
Q

Tg:

A

Glass transition temperature

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39
Q

A range of temperature where porcelain starts to become molten:

A

Glass transition temperature (Tg)

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40
Q

Glass transition temperature describes a transition from:

A

solid to rubbery

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41
Q

What is the typical glass transition temperature range of ceramics?

A

540 - 610 degrees celcius

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42
Q

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

A

BELOW the ceramic melting point

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43
Q

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

A

molten

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44
Q

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

A

fuse together, resulting in dense/hard ceramic

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45
Q

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

A

heat pressing

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46
Q

Heat pressing replies on _____ to sinter and shape the ceramic at high temperature

A

external pressure

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47
Q

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

A

wax pattern (lost wax technique)

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48
Q

Heat pressing is also known as:

A

High temperature injection molding

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49
Q

CAD:

A

Computer aided design

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50
Q

CAM:

A

Computer aided manufacture

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51
Q

Involves a densely sintered material such as silicate, glass ceramics, and resin-based ceramics:

A

Hard milling (CAD/CAM)

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52
Q

Involves a partially sintered material such as zirconia, and lithium discillicate (e.Max) and the sintering is to be completed in oven AFTER manufacture:

A

Soft milling (CAD/CAM)

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53
Q

What type of milling involves sintering after the manufacture?

A

soft milling

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54
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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55
Q

What materials are used with soft milling?

A
  1. zirconia
  2. lithium discilicate (e.Max)

(partially sintered material)

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56
Q

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

A

blocks

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57
Q

What have improved esthetics with CAD/CAM?

A
  1. Newer multishade blocks
  2. a stain & glaze via furnace
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58
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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59
Q

Classify the following blocks:

-vita mark 2
-IPS Emax CAD
-Celtra duo ultra

A

Glass ceramics

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60
Q

Classify the following blocks:

-IPS Emax ZirCAD
-3M Chairside zirconia
-CEREC zirconia

A

Zirconia

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61
Q

Classify the following blocks:

-Cerasmart
-Vita enamic

A

Resin-ceramics

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62
Q

Classify the following blocks:

-telio blocks

A

Resin

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63
Q

CAD/CAM systems include:

A
  1. Itero
  2. E4D
  3. Trios
  4. Planmeca
  5. Carestream
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64
Q

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

A

True

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65
Q

Ceramics that are predominately glass are considered:

A

veneers

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66
Q

Particle filled glass ceramics are considered:

A

eMax

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67
Q

Type of ceramics that have the most translucent optical properties:

A

Veneers (predominately glass)

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68
Q

What is considered the WEAKEST material?

A

Veneers (predominately glass)

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69
Q

Feldspathic porcelain is an example of:

A

Veneers (predominately glass)

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70
Q

Can you etch with Veneers (predominately glass)?

A

Yes

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71
Q

Type of ceramics that has less translucency than veneers but not the least amount of translucency:

A

Particle filled glass ceramic (eMax)

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72
Q

Particle filled glass ceramic (eMax) has a _____ strength

A

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

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73
Q

Can you etch with Particle filled glass ceramic (eMax)?

A

Yes

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74
Q

Lithium discilicate is an example of:

A

Particle filled glass ceramic (eMax)

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75
Q

Type of ceramic with the LOWEST translucency:

A

Polycrystalline ceramic (zirconia)

76
Q

Polycrystalline ceramic (zirconia) has the ____ strength

A

highest

77
Q

Alumina & zirconia are examples of:

A

Polycrystalline ceramic (zirconia)

78
Q

Can you etch Polycrystalline ceramic (zirconia)?

A

NOOOOO

79
Q

Ceramic classification:

  1. predominately glass
  2. particle filled glass ceramic
  3. polycrystalline ceramic
A
  1. veneers
  2. eMax
  3. zirconia
80
Q

Ceramic classification:

  1. Highest translucency
  2. Intermediate translucency
  3. Lowest translucency
A
  1. veneers
  2. eMax
  3. zirconia
81
Q

Ceramic classification:

Can etch:

Cannot etch:

A

Can etch: veneers & eMac

Cannot etch: zirconia

82
Q

Ceramic classification:

  1. Highest strength
  2. Intermediate strength
  3. Lowest strength
A
  1. zirconia
  2. eMax
  3. veneers
83
Q

Give an example of each of the following:

  1. Veneers
  2. eMax
  3. Zirconia
A
  1. Feldspathic porcelain
  2. Lithium discilicate
  3. Alumina
84
Q

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

A

Ceramics

85
Q

What are the negatives of ceramics?

A

Brittle & fracture prone

86
Q

List some methods to strengthen ceramics:

A
  1. resin bonding
  2. reinforcement of crystalline structure of the ceramic
  3. transformation toughening
87
Q

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

A

true

88
Q

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

A

silane coupling agent

89
Q

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

A

light-cured or dual-cured

90
Q

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

A

dispersed crystalline phase

91
Q

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

A

reinforcement of the crystalline structure of the ceramic

92
Q

Transformation toughening of ceramic to increase the strength involves:

A

A stress induced transformation

93
Q

What form of ceramic strengthening is unique to zirconia:

A

Transformation toughening

94
Q

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

A

Transformation toughening

95
Q

How does porcelain break?

A
  1. flexure
  2. improper loading (askew occlusion)
96
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

97
Q

Resin bonding with etchable glass ceramics provides a _____% increase in glass ceramic crown strength

A

50%

98
Q

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

A

retention

99
Q

When resin bonding etchable glass ceramics, the _____ (bifunctional monomers) forms a chemical bone

A

silane coupling agent

100
Q

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

A

adhesive layer

101
Q

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

A

silane layer

102
Q

How does resin cement work to strengthen ceramics?

A

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

103
Q

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

A

Hybrid layer

(created by resin bonding to ceramic)

104
Q

A very thin “sheet” of porcelain as the as 0.3 to 0.5 mm (minimum thickness):

A

Veneers

105
Q

What is the minimum thickness of veneers?

A

0.3-0.5mm

106
Q

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

A

veneers

107
Q

Veneers should not be used under:

A

Heavy occlusal loads

108
Q

How are veneers bonded to the tooth?

A

Resin bonded to the enamel

109
Q

Possibly the MOST esthetic dental restoration:

A

veneers

110
Q

Veneers can be so thin that:

A

the underlying tooth color can affect optimal properties

111
Q

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

A

Crack propagation

112
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

113
Q

What is the flexural strength?

a) enamel
b) feldspathic porcelain
c) leucite reinforced ceramic (empress)
d) e.Max

A

a) 300 MPa
b) 60-70 MPa (much lower)
c) 120-160 MPa
d) 360-500 MPa

114
Q

An additional method to strengthen Feldspathic porcelain is to:

A

add a metal substructure

115
Q

What material is ONLY used for veneers?

A

Feldspathic porcelain

116
Q

Leucite reinforced ceramic:

A

Empress

117
Q

Would you use leucite reinforced ceramic (empress) on a posterior crown?

A

No

118
Q

Would you use leucite reinforced ceramic (empress) on a posterior inlay/onlay?

A

maybe- only where occlusal force is low

119
Q

Would resin bonding help strengthen leucite reinforced ceramic (empress)?

A

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

120
Q

Indications for leucite reinforced ceramic (empress):

A

anterior crowns & veneers

121
Q

IPS empress esthetic & Ivoclar are examples of:

A

Leucite reinforced glass ceramic

122
Q

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

A

Lithium discilicate ceramic (e.Max)

(360-500 Mpa)

123
Q

Lithium discilicate (e.Max) is used for:

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

(due to its increased strength)

124
Q

Can you use resin bonding on Lithium discilicate ceramic (E.Max)?

A

Yes- can use resin bonding AND other cements like RMGI

125
Q

Should you use e.Max for a posterior three-unit bridge?

A

No- due to increased fracture of material

126
Q

In the following image, we see a posterior three-unit FDP made of Lithium discilicate ceramic (e.Max). What went wrong to result in this?

A

You should not use e.Max for a posterior three-unit bridge due to increased fracture risk

127
Q

Zirconia has a _____ structure

A

polycrystalline

128
Q

The polycrystalline structure that comprises zirconia comprises:

A
  1. increased strength
  2. a surface that is not abrasive (like porcelain) & therefore is gentle on opposing dentition
129
Q

What provides these properties of zirconia?

-increased strength
-a surface that is not abrasive (like porcelain) & therefore is gentle on opposing dentition

A

the polycrystalline structure

130
Q

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

A

Both statements true

131
Q

What will resin bonding do for zirconia?

A

Increase the retention! But NOT strength

132
Q

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

A

Zirconia

133
Q

T/F: Zirconia contains glass etch

A

False

134
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
135
Q

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

A

A bonding primer

136
Q

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

A

True

137
Q

The original zirconia crown was from ______ 10 years ago

A

Glidewell

138
Q

The original zirconia produced was a ____ zirconia crown called _____

A

3Y; Bruxir

139
Q

Describe the first zirconia produced (3Y Bruxir):

A
  1. horrible translucency esthetics
  2. poorly defined occlusal anatomy
140
Q

What was the flexural strength of 3Y Bruxir zirconia?

A

1200 Mpa

141
Q

3Y Bruxir:

A

Zirconia (the original one)

142
Q

T/F: Because of 3Y Bruxir zirconia’s strength, any cement can be used

A

True

143
Q

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

A

Crown has to be “fired” and will shrink it about 25%

144
Q

How are zirconia crowns so strong?

A

Transformational toughening

145
Q

_____ is unique to zirconia

A

stress induced transformation

146
Q

with stress induced transformation, ____ forces at crack tip retard the crack propagation

A

compressive forces

147
Q

Describe what happens crack initiation of zirconia:

A

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

148
Q

Describe the shape change seen with crack initiation of zirconia:

A

tetragonal to monoclinic chape change

(transformational toughening)

149
Q

What leads to crack closure associated with the compressive stresses in the vicinity of the crack tip

(zirconia transformational toughening)

A

volume increase associated with compressive stresses

150
Q

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

A

Yttria; decreased strength, increased translucency

151
Q

Adding yttria to zirconia results in:

A
  1. increased translucency
  2. decreased strength
152
Q

What type of zirconia is being described?

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

A

3Y Zirconia

153
Q

What type of zirconia is being described?

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

A

4Y Zirconia

154
Q

What type of zirconia is being described?

-50% tetragonal phase
-50% cubic phase
-LOWEST mechanic properties (650 MPa)
-HIGHEST translucency

A

5Y Zirconia

155
Q

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

A

tetragonal (toughness); cubic (translucency/cuteness)

156
Q

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

A

5Y

157
Q

PFZ:

A

Porcelain fused to zirconia

158
Q

What is the purpose of a PFZ?

A

improve aesthetics with porcelain shell on top of zirconia core for strength

159
Q

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

A

esthetic; fracture easily

160
Q

PFZ initially had failures, mostly in the:

A

posterior

161
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
162
Q

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

A

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

163
Q

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

A

True

164
Q

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

A

0.4 mm

165
Q

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

A

monolithic zirconia

166
Q

Describe the effects of zirconia on opposing teeth:

A

wear friendly

167
Q

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

A

chamfer or shoulder

168
Q

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

A

thickness & occlusion

169
Q

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

  1. veneer:
  2. crown:
A
  1. feldspathic porcelain
  2. e.Max or Empress
170
Q

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

  1. Crown:
A
  1. e.Max, or 5Y zirconia
171
Q

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

A

3Y zirconia or gold

172
Q

What is the MOST realistic anterior tooth replacement option?

A

Feldspathic porcelain veneer, resin bonded

173
Q

Anterior teeth:

  1. ____ occlusal forces
  2. ____ strength requirement
  3. ____ esthetic requirement
A
  1. Lower
  2. Less
  3. Higher
174
Q

Posterior teeth:

  1. ____ occlusal forces
  2. ____ strength requirement
  3. ____ esthetic requirement
A
  1. higher
  2. higher
  3. less
175
Q

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

A

E.max or zirconia

176
Q

Your patient is a bruxer/clencher and needs a bridge:

  1. Best treatment option:
  2. Middle treatment option:
  3. NOT a great option:
A
  1. monolithic zirconia (3Y) or PFM
  2. monolithic material with buccal porcelain
  3. fully veneered porcelain
177
Q

When should you adjust glass ceramic veneers?

A

Only adjust AFTER seated & bonded with resin cement

(too fragile to adjust outside the mouth)

(internal surface should not be adjusted if possible)

178
Q

When should you adjust e.Max (lithium discilicate)?

A

Adjustment outside the mouth is acceptable

(internal surface should not be adjusted if possible)

179
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 cementation

180
Q

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

A
  1. coarse polisher
  2. fine polisher
  3. felt wheel or brush with fine diamond polishing paste
181
Q

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

A

False- they DO require a MOISTURE FREE environment

182
Q

MDP:

A

Methacryloyloxydecyl dihydrogen phosphate

183
Q

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

A

Primer containing MDP (used with resin cements)

184
Q

Which of the following are contraindicated in LOW strength ceramics?

a) RMGI
b) resin cements
c) resin cements with MDP primer

A

a) RMGI

185
Q

Why is an RMGI cement contraindicated with low strength ceramics?

A

because the water absorption with the setting of 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)

186
Q
A

Fixed Prosthodontics II (15 decks)

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