ZIRCONIA DENTAL CAPS

Using CAD-CAM Technique

Group 1
Girraj Maheshwari Amisha Chhajlani Raivent Nahar Paridhi Choudhary Srijan Agrawal Vaibhav Tamrakar Karan Kumbhare

What is a Crown?

1. 2.

A crown is a restorative to cap a tooth or dental implant After being fabricated according to required dimensions, bonded to tooth using dental cement Materials involved in making crowns have been evolving We witnessed the fabrication of: Zirconia crowns (Reductive technique) and Chrome-Cobalt Alloy crowns (Additive technique)

What is Zirconia?

Zirconia is a very hard ceramic that is used as a strong base material The zirconia used in dentistry is zirconium oxide which has been stabilized with the addition of yttrium oxide The structure is milled from a block of zirconia in a soft pre-sintered state

Why Zirconia?

Strength- 800 to 1000 Mpa Durability- 10 to 15 years warranty AestheticsNaturally translucent Available in number of shades Metal caps start showing black marks over time

Procedure

Modeling Scanning Milling Sintering Ceramic Layering

Modelling

Impression of teeth (negative) taken by placing a viscous liquid into the mouth. Eg. polyvinyl siloxane. At portions closer to the crown preparation site, impression material of lower viscosity is used to capture greater detail. Then a POP model (positive) is prepared using this mould This model is exact replica of patients teeth

Scanning (CAD-CAM)

3-D Optical Scanner- Light Source + Camera The model of the tooth (or set of teeth) is placed for scanning The system software is used to adjust alignment and set margins (for gums) Light exposure time is adjusted, if any shiny portion is detected on the model by the camera After all parameters are fed, about 13 pictures are taken from different angles

Scanning Contd.

The camera takes pictures using a self-adjusting feature The images are compiled into a single 3-D file The entire process is repeated for rest of the jaw After obtaining 3-D design, surfaces are smoothened digitally (advantage over conventional) Shape is readjusted to create better support, also taking into account sintering shrinkage (about 2025%)

CAD-CAM

When the design is ready, the system sends command for milling CEREC software and Delcam software are in wide use for dental design

Milling

The 3D shape is milled from the pre-sintered ZrO2 blank using hard metal tools. The average milling time for a crown is 35 minutes, for a 3-unit bridge about 75 minutes.

Types of Dental Milling Machine Used

3-Axes and 5-Axes machines are used. 3-Axes machines use X, Y and Zaxis inputs to create the replica of the design given by CAD machine. Machine tools with 3 axes are intended for simple parts or for machining freeform surface with smooth curves that are as flat as possible. The work piece or the tool cannot be tilted: the tools' orientation in space does not change.

Rotary axes in 5-axes Milling Machine

Rotary axes also known as Tilting axes Perform the orientation of the workpiece or tool. Linear axes are mostly responsible for the machining.

Milling

The machine has a magazine capacity of 21 blanks; new blanks can be inserted and finished frameworks removed while milling continues. Different frameworks can be milled automatically, even overnight, because of the automatic tool changer.

Removing of the milled framework

Removal of the Milled Framework from the Holding Device Turbine hand piece to remove the framework due to the lower degree of vibration as compared to other hand pieces! If no turbine is available, fine cross-cut tungsten carbide mills can also be used - rotary speed 20 rpm/min!

Preparation for Sintering

Milled Copings are removed from the zirconia block using a hand piece which is similar to a drill. The coloring of the frame-works also takes place before the sintering process according to the prescribed shade (16 possible shades, keyed to VITA Classic). The zirconia block being porous absorbs the color completely This block is chalk-like in nature and can break easily and is therefore sintered

Sintering

Manual finishing can be carried out before sintering takes place. The fully-automated, monitored sintering process then takes place with no manual handling in a special furnace, the Lava Therm (approx. 11 hours incl. heating and cooling phases).

Sintering

Sintering fuses particles together and the final strength achieved is 850-1000 MPa Milled coping or single-piece framework is tested for fit. Any adjustments are easily made with a rubber bur. Coping or framework is then infiltrated two times for 40 minutes each time in a furnace at 1400C1500C.

Cementation of Restorations

Dental Cements are hard, brittle materials formed by mixing powder and liquid together Before Cementation, restorations should be sandblasted in order to increase surface roughness. Sufficient surface is required for optimal bonding

METAL DENTISTRY
Tooth filling using metal

Criteria

Must not be poisonous or harmful to the body. excellent thermal conductivity. ability to be shaped (malleability). Must not be harmful or irritating to the tissues of the oral cavity.

Alloy Composition
Co-Cr alloy of the following composition is used for making tooth.

Cobalt 61% Chromium 27% Molybdenum 6 % Others 7 %

Process

The CAD-CAM file of the tooth is sent to the machine Cr-Co alloy plates are used as the base plates in the machine on which 20 micron thick powder layer is added. The milling machine compresses and shapes the powder into solid layer.

Another powder layer is added above this layer and the same process repeats until we get the desired crown.

The tooth structure is removed from the base plate using hammer. The base plate can only be used once. To reuse it, it has to be sent to the manufacturer for polishing.

Using Metal alloy over Zirconia

Benefits

it is reasonably durable and easy to work with in aesthetic dentistry

It is relatively inexpensive.

Disadvantages

Metal filling contains mercury, has been known to cause significant harm particularly to ones nervous system as well as damaging ones kidneys and stomach. While ceramic are mercury 100% mercury free For those concerned with environmentally- concious dentistry and to limit their exposure to metal toxins, then ceramic fillings are a viable alternative to filling your cavities.

Ceramic fillings are generally much more resilient and less susceptible to their metal counterparts Metal fillings are, aesthetically speaking, abrasive with placed on the teeth. Ceramic fillings, on the other hand, restore the natural appearance of the tooth filled and are difficult to spot by an unknowing observer