Current ceramic materials offer preferred optical properties for highly esthetic restorations. The inherent brittleness of some ceramic materials, specific treatment modalities, and certain clinical situations require resin bonding of the completed ceramic restoration to the supporting tooth structures for long-term clinical success. This article presents a literature review on the resin bond to dental ceramics. A PubMed database search was conducted for in vitro studies pertaining to the resin bond to ceramic materials. The search was limited to peer-reviewed articles published in English between 1966 and 2001. Although the resin bond to silica-based ceramics is well researched and documented, few in vitro studies on the resin bond to high-strength ceramic materials were identified. Available data suggest that resin bonding to these materials is less predictable and requires substantially different bonding methods than to silica-based ceramics. Further in vitro studies, as well as controlled clinical trials, are needed.

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Resin-ceramic bonding: a review of the literature.

Statement of problem Developments in ceramic core materials such as lithium disilicate, aluminum oxide, and zirconium oxide have allowed more widespread application of all-ceramic restorations over the past 10 years. With a plethora of ceramic materials and systems currently available for use, an overview of the scientific literature on the efficacy of this treatment therapy is indicated. Purpose This article reviews the current literature covering all-ceramic materials and systems, with respect to survival, material properties, marginal and internal fit, cementation and bonding, and color and esthetics, and provides clinical recommendations for their use. Material and methods A comprehensive review of the literature was completed seeking evidence for the treatment of teeth with all-ceramic restorations. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed with a focus on evidence-based research articles published between 1996 and 2006. A hand search of relevant dental journals was also completed. Randomized controlled trials, nonrandomized controlled studies, longitudinal experimental clinical studies, longitudinal prospective studies, and longitudinal retrospective studies were reviewed. The last search was conducted on June 12, 2007. Data supporting the clinical application of all-ceramic materials and systems was sought. Results The literature demonstrates that multiple all-ceramic materials and systems are currently available for clinical use, and there is not a single universal material or system for all clinical situations. The successful application is dependent upon the clinician to match the materials, manufacturing techniques, and cementation or bonding procedures, with the individual clinical situation. Conclusions Within the scope of this systematic review, there is no evidence to support the universal application of a single ceramic material and system for all clinical situations. Additional longitudinal clinical studies are required to advance the development of ceramic materials and systems.

Current ceramic materials and systems with clinical recommendations: A systematic review

In this article, we review the recent history of the development of dental CAD/CAM systems for the fabrication of crowns and fixed partial dentures (FPDs), based on our 20 years of experience in this field. The current status of commercial dental CAD/CAM systems developed around the world is evaluated, with particular focus on the field of ceramic crowns and FPDs. Finally, we discuss the future perspectives applicable to dental CAD/CAM. The use of dental CAD/CAM systems is promising not only in the field of crowns and FPDs but also in other fields of dentistry, even if the contribution is presently limited. CAD/CAM technology will contribute to patients' health and QOL in the aging society.

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A review of dental CAD/CAM: current status and future perspectives from 20 years of experience.

Objectives: The objective of this systematic review was to assess the 5-year survival rates and incidences of complications of all-ceramic fixed dental prostheses (FDPs) and to compare them with those of metal‐ceramic FDPs. Methods: An electronic MEDLINE and Dental Global Publication Research System search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on all-ceramic and metal‐ceramic reconstructions with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by three reviewers. Failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions. Results: The search provided 3473 titles for single crowns and FDPs and resulted in 100

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A systematic review of the survival and complication rates of all‐ceramic and metal–ceramic reconstructions after an observation period of at least 3 years. Part II: fixed dental prostheses.

https://pure.rug.nl/ws/files/6673928/OzcanM-Effectstrength-2003.pdf

Effect of surface conditioning methods on the bond strength of luting cement to ceramics

A method of manufacturing an all-ceramic crown composed of a coping of dense-sintered, high-purity alumina with dental porcelain is described. This method takes the sintering shrinkage of alumina into consideration and makes it possible to produce individual dental copings in dense-sintered, high-purity alumina, which is a biocompatible implant material. The alumina used has density, grain size, and flexural strength within the limits of the values required in ISO 6474-1981, 'Implants for surgery, ceramic materials based on alumina'.

A new all-ceramic crown: A dense-sintered, high-purity alumina coping with porcelain

Statement of problem. Esthetic demands of patients and practitioners for an all-ceramic crown in both anterior and posterior regions of the dental arches has prompted the development of the Procera AllCeram crown. Long-term clinical trials that evaluate the strength and naturalness of the Procera AllCeram crown are lacking. Purpose. This prospective study was initiated to evaluate the clinical performance of 100 Procera AllCeram crowns after 5 years in service. Material and methods. One hundred Procera AllCeram crowns were fabricated for 58 patients (20 men and 38 women). Patients were treated by 4 general dental practitioners. Crown placement involved both the anterior and posterior regions of the dental arches. Crowns were examined at baseline and once a year during the 5 years that followed and evaluated at each appointment with the California Dental Association's quality assessment system. Results. Of the 97 crowns remaining in the study after 5 years, only 3 crowns had experienced a fracture through the veneering porcelain and the aluminum oxide coping material. Two additional crowns were replaced as a result of fractures of only the veneering porcelain. One crown was replaced as a result of recurrent caries. All remaining crowns were ranked as either excellent or acceptable for surface/color, anatomic form, and marginal integrity. Conclusion. The 5-year clinical observations and ranking with the California Dental Association's quality assessment criteria supported the conclusion that Procera AllCeram crowns may be used in all areas of the mouth. (J Prosthet Dent 1998;80:450-6.)

Five-year clinical evaluation of Procera AllCeram crowns ☆ ☆☆ ★ ★★ ♢ ♢♢

The present invention relates to a method of manufacturing artificial tooth restorations for natural teeth or implants comprising a ceramic densely sintered high strength individual core (B) with dental porcelain (A) by powder metallurgical manufacturing methods. The inner surface (I) of the core (B), which will fit against one or more prepared tooth surfaces (P) or artificial abutments is manufactured by forming a ceramic powder mixture against a surface of a body at which said surface is manufactured by registering the surfaces of the prepared teeth or artificial abutments and their mutual relationship with a three dimensional optical or mechanical reading method directly in the mouth or on a model in e.g. plaster after which the registered surfaces are reproduced in an enlarged size e.g. with a computer controlled milling machine at which the enlargement is calculated from the shrinkage of the ceramic material during sintering to full density and considering the gap for cement.

Method of manufacturing ceramic tooth restorations

Statement of problem The fit of a dental restoration depends on quality throughout the entire manufacturing process. There is difficulty in assessing the surface topography of an object with a complex form, such as teeth, since there is no exact reference form. Purpose The purpose of this study was to determine the repeatability and relative accuracy of 2 dental surface digitization devices. A computer-aided design (CAD) technique was used for evaluation to calculate and present the deviations 3-dimensionally. Material and methods Ten dies of teeth prepared for complete crowns were fabricated in presintered yttria-stabilized tetragonal zirconia (Y-TZP). The surfaces were digitized 3 times each with an optical or mechanical digitizer. The number of points in the point clouds from each reading were calculated and used as the CAD reference model (CRM). Alignments were performed by registration software that works by minimizing a distance criterion. In color-difference maps, the distribution of the discrepancies between the surfaces in the CRM and the 3-dimensional surface models was identified and located. Results The repeatability of both scanners was within 10 μm, based on SD and absolute mean values. The qualitative evaluation resulted in an even distribution of the deviations in the optical digitizer, whereas the dominating part of the surfaces in the mechanical digitizer showed no deviations. The relative accuracy of the 2 surface digitization devices was within ± 6 μm, based on median values. Conclusion The repeatability of the optical digitizer was comparable with the mechanical digitization device, and the relative accuracy was similar.

A three-dimensional evaluation of a laser scanner and a touch-probe scanner.

Procera Sandvik AB is now manufacturing a densely sintered high-purity alumina core for an all-ceramic crown designed for anterior and posterior restorations. Whereas the material holds promise on the basis of in vitro strength tests, the ability to alter the surface and use conventional bonded resin cements has not been reported previously in the literature. Samples of the core were treated by means of one of four methods routinely used for all ceramic restorations, and then a commercially available resin cement was bonded to the surface. A shear bond test of the adhesion showed that the highest shear bond strengths of 11.99 +/- 3.12 MPa were obtained with air abrasion at 80 psi and 50-microm alumina particles.

Agneta Odén

Papers

A new all-ceramic crown: A dense-sintered, high-purity alumina coping with porcelain

Five-year clinical evaluation of Procera AllCeram crowns ☆ ☆☆ ★ ★★ ♢ ♢♢

Method of manufacturing ceramic tooth restorations

A three-dimensional evaluation of a laser scanner and a touch-probe scanner.

Shear bond strength of a resin cement to densely sintered high-purity alumina with various surface conditions.