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

As in many other industries, production stages are increasingly becoming automated in dental technology. As the price of dental laboratory work has become a major factor in treatment planning and therapy, automation could enable more competitive production in high-wage areas like Western Europe and the USA. Advances in computer technology now enable cost-effective production of individual pieces. Dental restorations produced with computer assistance have become more common in recent years. Most dental companies have access to CAD/CAM procedures, either in the dental practice, the dental laboratory or in the form of production centres. The many benefits associated with CAD/CAM generated dental restorations include: the access to new, almost defect-free, industrially prefabricated and controlled materials; an increase in quality and reproducibility and also data storage commensurate with a standardised chain of production; an improvement in precision and planning, as well as an increase in efficiency. As a result of continual developments in computer hardware and software, new methods of production and new treatment concepts are to be expected, which will enable an additional reduction in costs. Dentists, who will be confronted with these techniques in the future, require certain basic knowledge if they are to benefit from these new procedures. This article gives an overview of CAD/CAM-technologies and systems available for dentistry today.

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Digital dentistry: an overview of recent developments for CAD/CAM generated restorations

Color stability of dental composite resin materials for crown and bridge veneers

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.

High-strength all-ceramic systems for fixed partial dentures (FPDs) are available for replacing a missing tooth. New core/framework materials have been developed and have evolved in the last decade. With the advancement of CAD/CAM technology, various fabrication techniques have been developed for fabricating improved, consistent, and predictable restorations in terms of strength, marginal fit, and esthetics and for managing core/framework materials that could not otherwise be managed. This article reviews the evolution and development of materials and technologies for all-ceramic FPDs through data published between 1966 and 2004 in the English language. Peer-reviewed articles were identified through a MEDLINE search and a hand search of relevant textbooks and annual publications. The available information suggests that clinical data on the success of these restorations are limited, and that the results of long-term clinical studies are critical to the assessment of these restorations to provide more specific guidelines for usage.

Contemporary materials and technologies for all-ceramic fixed partial dentures: a review of the literature.

The in vitro marginal fit of three all-ceramic crown systems (In-Ceram, Procera, and IPS Empress) was compared. All crown systems were significantly different from each other at P = 0.05. In-Ceram exhibited the greatest marginal discrepancy (161 microns), followed by Procera (83 microns), and IPS Empress (63 microns). There were no significant differences among the various stages of the crown fabrication: core fabrication, porcelain veneering, and glazing. The facial and lingual margins exhibited significantly larger marginal discrepancies than the mesial and distal margins.

A comparison of the marginal fit of In-Ceram, IPS Empress, and Procera crowns.

PURPOSE The study compared the flexural strength of In-Ceram alumina and In-Ceram zirconia systems. The probability of failure of the two glass-infiltrated ceramic core materials was analyzed with and without lamination with Vitadur-alpha porcelain. MATERIALS AND METHODS Ten uniform beams of core materials as well as 10 beams of laminated core materials were fabricated for In-Ceram alumina and In-Ceram zirconia. The samples were subjected to three-point bending tests. Flexural strength for both ceramic core materials was determined with and without their porcelain laminations. The strength data were analyzed using the Weibull method. Modes of failure for both systems were determined using scanning electron micrography. RESULTS The strength of the In-Ceram zirconia system was significantly higher than In-Ceram alumina when comparing their core materials with and without porcelain lamination. The failure mode for both systems was predominantly transgranular fracture of alumina platelets. CONCLUSION In-Ceram zirconia demonstrated higher flexural strength than In-Ceram alumina.

Flexural strength of In-Ceram alumina and In-Ceram zirconia core materials.

The irradiance in the wavelength of 450 to 500 nm of nine visible light-curing units was measured at 120 V input voltage. The highest irradiance was more than 20 times that of the lowest. Irradiance was also measured at 90 to 130 V input. Irradiance and depth of cure at lower input voltages were also examined.

https://jada.ada.org/article/S0002-8177(87)53016-1/pdf

Irradiance of visible light-curing units and voltage variation effects

Effect of finishing on color and gloss of composites with different fillers.

JL he success of the currently available esthetic restorative dental materials de­pends on proper shade matching. As clin­ical assessments of color match are per­formed visually, the dental practitioner should be aware of his or her own de­ficiencies in color perception and dis­crimination. At the 1981 ADA annual ses­sion, color vision testing was included in the Health Assessment Program. This re­port gives the results of this testing and the possible clinical effects of abnormal color vision.

Wayne T. Wozniak

Papers

A comparison of the marginal fit of In-Ceram, IPS Empress, and Procera crowns.

Flexural strength of In-Ceram alumina and In-Ceram zirconia core materials.

Irradiance of visible light-curing units and voltage variation effects

Effect of finishing on color and gloss of composites with different fillers.

Color vision in dentistry: a survey.