Dental Ceramics Christoph Hämmerle Irena Sailer Andrea Thoma Gianni Hälg Ana Suter Christian Ramel In cooperation with: B Annen, G Benic, A Fehér, R Glauser, A Hagmann, S Hickling, C Holderegger, R Jung, H Klajnert, O Loeffel, S Merki, D Pally, P Ruhstaller, D Siegenthaler, M Stanco, D Thoma, A Trottmann, S Windisch, D Yaman, A Zembic Essential Aspects for Clinical Practice Quintessence Publishing Co Ltd London, Berlin, Chicago, Tokyo, Barcelona, Beijing, Istanbul, Milan, Moscow, New Delhi, Paris, Prague, São Paulo, Seoul and Warsaw
Most dentists offices are well-stocked with scientific journals and textbooks. However, practising dentists often find it hard to wade through the plethora of dental literature in order to locate the information they require or to find the advice they need in a reasonable amount of time. This book focuses specifically on current issues in contemporary ceramic dentistry. Dental Ceramics Essential Aspects for Clinical Practice is designed as a quick reference guide. It provides practising dentists the specific information they need to manufacture ceramic restorations for their patients. Topics covered include ceramic veneers, single crowns, fixed partial dentures, and implant restorations. Related subjects, such as restoration of non-vital teeth and external bleaching, are also described. The text is concise and clear, providing step-by-step instructions and numerous photographs and diagrams to further elucidate the clinical procedures. Dental Ceramics is a valuable resource for practising dentists as well as for dental students. Thanks to the efforts of dedicated dental clinicians, laboratory technicians and researchers, it has been possible to compile a book that conveys the core principles, background information and procedures relevant to the fabrication of dental ceramic restorations in a readily comprehensible and attractive format, making this book a valuable reference source for dental practice. Preface Christoph Hämmerle V
Authors Prof Dr Christoph Hämmerle Clinic Director E-mail: sekkbtm@zzmk.uzh.ch Dr Irena Sailer E-mail: irena.sailer@zzmk.uzh.ch Dr Gianni Hälg E-mail: gianni.haelg@zzmk.uzh.ch Dr Christian Ramel E-mail: christian.ramel@zzmk.uzh.ch Clinic for Crown and Bridge Prosthodontics, Partial Prosthodontics and Dental Materials Science Center for Dental, Oral and Maxillary Medicine University of Zurich Plattenstrasse 11, CH-8032 Zürich Ana Suter E-mail: suterana@hotmail.com Dental Technician Haslihalde 17, CH-8707 Uetikon am See Dr Andrea Thoma E-mail: info@zahnaerzteamkreis.ch Practice for General Dentistry, Oral Surgery, Stomatology and Orthodontics Grosszaun 11, CH-8754 Netstal VI
1 Scientific Aspects of Dental Ceramic Materials... 1 1.1 Composition and Classification of Dental Ceramics... 2 1.2 Physical Properties... 6 1.3 Optical Properties... 10 Contents 2 Processing Methods... 13 2.1 Manual Processing Methods... 14 2.2 Machining... 18 3 Veneers... 23 3.1 Indications... 24 3.2 Contraindications... 24 3.3 Clinical Guidelines... 25 3.4 Step-by-step: Clinical Procedures for the Fabrication of Veneers... 26 4 All-ceramic Single Crowns... 37 4.1 Indications... 38 4.2 Tooth Preparation... 39 4.3 Clinical Survival... 40 4.4 Clinical and Laboratory Procedures... 44 5 Non-vital Abutment Teeth... 59 5.1 Biomechanics of Non-vital Teeth... 60 5.2 Posts... 61 5.3 Esthetics... 64 5.4 Clinical Procedures... 67 6 External Bleaching... 71 6.1 Introduction... 72 6.2 Power Bleaching... 73 6.3 Combined Bleaching... 74 6.4 At-home Bleaching... 74 6.5 Over-the-counter Teeth Whitening Products... 78 VII
Contents 7 All-ceramic Fixed Partial Dentures... 81 7.1 General Considerations... 82 7.2 Indications... 82 7.3 Tooth Preparation... 84 7.4 Dental Laboratory and Dental Office Procedure... 85 7.5 Clinical Survival Rates... 90 7.6 Conclusions... 91 8 Bonding of Ceramic Restorations... 93 8.1 Adhesive versus Conventional Cementation... 94 8.2 Classification of Adhesive Cements... 96 8.3 Dentin Conditioning... 98 8.4 Ceramic Conditioning... 100 8.5 Clinical Procedures...101 9 All-ceramic Implant Supported Restorations... 113 9.1 Clinical Aspects and Indications... 114 9.2 Advantages of Ceramic Abutments... 115 9.3 Disadvantages... 115 9.4 Biologic Aspects... 116 9.5 Manufacturers... 116 10 Index... 125 VIII