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(Dental Porcelain (1
Dental Material II Lecture # 13

Last lecture, we've talked about Metals. It has some relation with Ceramic. To make crown, we use porcelain to cover metal crown, right? Today we talk about ceramic or Dental Porcelain. Ceramic is the general term. So we will specifically talk about Dental Porcelain. Dental Porcelain that we are going to talk about has many advantages; 1. Very esthetic material. Available in many shades that similar to dentin shade and .. 2. It is biocompatible which do not cause any irritation. 3. Porcelain is a hard material so it is very strong especially in compressive strength but in the same time the tensile or shear is weak especially in thin section. For another example is amalgam or enamel. So in thin section they are very weak. 4. It has high wear resistance. 5. It resistant toward stain.

And the problems are, 1. Since it has very high wear resistance and very high compressive strength, it cause abrasion or wear of natural teeth. If we have upper opposing crown and a natural tooth, it can cause some wear to enamel. Because it is very hard. 2. Porcelain is brittle material. It has low tensile strength but high compressive strength. Like enamel, like amalgam, Glass Ionmer Cement but GIC has moderate compressive strength not high.
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3. It is difficult to re-polish if we want to adjust it with bur because sometime when we have place the crown or bridge and it has very high force. You need to reduce it with the bur. It becomes a little bit rough so you have to re-polish it because it is a hard material. So these are the advantages and disadvantages of Porcelain but still the advantages outnumber the disadvantages so it is a good material to be used. Previously it used to be use acrylic. But in comparison, Porcelain is a much better material. So these are examples of bridge; a) Three-unit bridge with the metal tooth here which are extracted we call it Pontac. So these 2 crown will fit on to both side of the extracted tooth. For example Lateral Incisor has been extracted, Central and Canine will be prepared, a part of tooth structure will be removed. A crown will fit the Central and Canine, in the middle it will be the Lateral Incisor replacing the extracted Lateral Incisor. So we call the part of extracted tooth a Pontic and these two crowns that fit on the prepared teeth are called a ----? They support the Pontic, they'll support the structure that replace the extracted tooth. This is three unit of bridges, can be four, five unit of bridges; whatever and it can be a single crown or multiple single crown. It doesn't matter. So from the inside there is metal core to provide strength and support and on top of it Porcelain will be layered to provide appearance and strength. So we have strength from metal and we have strength and aesthetic from Porcelain, right?

Sometime the whole bridges are made up of Porcelain but the central part of Porcelain it should be very strong because it has no metal support. This type of Ceramic or Porcelain is reinforced to make it stronger, ok? But in Posterior teeth, the best choice is metal and porcelain together.
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In anterior teeth, teeth are not subjected to high force like posterior teeth, full porcelain crown can be made but this porcelain should be reinforced Porcelain. A strong porcelain because there is no metal supporting it. So there are two type of Porcelain bridges. So, for aesthetic purpose, full porcelain crown can be made; there is no metal. It has even better appearance and more natural appearance but this will be reinforced Porcelain and we'll talk about it in a few minutes. The main composition for Dental Porcelain is: a) Silica b ) Feldspar which is a binder that bind all component together c) Clay; either present in very small amount or not present at all because it weaken the material. So, we mainly will talk about Silica and Feldspar. Just now we talked about what Feldspar mean. In addition, there are pigment added which are different metal oxides that give different shade and different colors. Either Iron, Copper, Titannium or Cobalt. So each material will give different color and for each color they give a different shade; Grey, yellowish, whiter shade etc. When they manipulate the powder, they add Sugar or Starch just to manipulate the powder so these components can be mixed easily together with the material. SO the basic components are Silica, Feldspar, Pigment for shade and for easy manipulation starch or sugar added. So when these components are placed together, they put them in oven and under very high temperature to fuse them together. Once they have fuse it together, they will put it in cold water; very cold water. So, it will become solid like a block and then they grind it to make very fine particles.

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SO we will get a porcelain powder, the powder is sold to the lab and we get in form of powder in container; different shade. So when it is sold as powder in different container, different shade, what does technician do when he get your impression and pour it into a model? He pour the powder and mix it with distilled water and start to place it on your gypsum model to make the shape of the crown. SO we will just melt the powder and place it layer by layer on top of the metal crown or the model. Component mixed together Put under high temperature Cooled down Grind it Put into container Sold into laboratory Porcelain can be classified in many ways; a) According to the temperature which the component was fused. Some type of porcelain need very high temperature to make denture teeth. Other type of porcelain fuse at low temperature; they call it Low-fusing temperature and this are the one that we use to make crown and bridges. i- High Fusing ii- Low- fusing b) According to the esthetic role; Body porcelain give shade of enamel, some of them are opaque, some of them are more translucent or more transparent to give shiny appearance; they call it Glaze Porcelain. SO this is another way to classify porcelain. i- Body Porcelain : Give dentin appearence; more yellowish.There're some that give enamel look. ii- Opaque : To shade color of metal so that the metal will not be seen.

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iii- Glaze : Give shiny appearance on teeth surface just like our normal teeth; always surrounded by saliva that gives shiny appearance. So when porcelain is added, it'll be added in layer: Resemble dentin, and then followed by enamel layer so we can get a natural appearance because natural tooth is formed by pulp then layer of dentin then layer of enamel. So we get a natural look of the restoration. Some dental porcelain also called Stain porcelain so they can be used to place a stain to make a tooth look more natural because natural teeth are not perfectly clean and white. Usually natural tooth will have some stain especially in cervical area which are replicated by certain type of porcelain to get natural appearance. It is better to get natural appearance like whitish, grayish teeth. To get more natural appearance, porcelain are available to provide the stain. Once the technician has mix the powder with water, they put a layer of porcelain on top of the metal or a die; a replica of one tooth.It is a model of one tooth. Usually you make an impression, then you send to the lab and you get a replica of one tooth; a die. On top of that the technician adds a layer of porcelain and makes it solidify. Then he will add another layer. SO what does the technician do after adding the first layer? He put it into an oven. 1- Under vacuum: To minimize voids or pores; to make it stronger. After that, he should allow to cold slowly. Now, while it come out from oven and cooling, it will shrink a little bit. That's why the technician add a little bit more than necessary to compensate the shrinkage as the material cools down.

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Now, once the layer solidify, he's going to add wax layer until it reach the natural quality or size of the tooth. So layer by layer of addition of porcelain. So this is a comparison between 2 type of porcelain; one is not vacuum and another one is vacuum inside the oven.

Which one is without vacuum? The one on the left. It is obvious. There are too many pores. So without vacuum, there'll be prominent presence of pores. The presence of pores will weaken the porcelain so it is more susceptible to vacuum. Then, of course we add a layer dentin porcelain and put it inside the furnace and out again and then enamel and then out again. This process of glazing the porcelain is called Firing. They place it inside the oven under high temperature, under vacuum and cool it down and then another layer before firing. They are using high temperature to make the material solid. At the end, to give shiny smooth surface, they add a layer of glazing porcelain. Glazing Porcelain will also close up any pores or deformities on porcelain surface. They gave us a nice, even surface; no irregularities, no imperfection, no voids and shiny. Just like natural tooth surface. So, basically these are the steps they made dental porcelain. Question : What is the difference in composition of Glaze Porcelain?
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Answer : It just the same unless it's pigment. Question : How about the particle size? Answer : Yes, it is. Look, it's gonna be different. The smaller the particle size, the better the surface finishing. Ok, lets start to take about properties. We have talked a little bit about properties. 1. It is a brittle material in thin section. So, that's why when we make Porcelain fused with metal; a crown that made up by metal inside and porcelain on top, the thickness of porcelain should be at least 1.5 mm. Let say 1.425 mm. The cusp or tip of the cusp, porcelain thickness should be at least 2.0 mm. Why? Because of the higher occlusal load. So, the material need to be a little bit thicker. So the metal could be 0.5 mm or 0.3 mm is acceptable but the porcelain should be at least 1.0 1.5 mm. While at the tip of the cusp, incisal edge and functioning cusp, porcelain thickness should be at least 2.0 mm; where there's occlusal load or occlusal contact between upper and lower teeth. This will provide us with enough thickness of porcelain and prevent fracture. 2. Porcelain has low thermal conductivity and good thermal insulator. 3. Porcelain is hard material. Harder than enamel so it could cause wear to opposing tooth. 4. Static fatigue Now, with time; over the years, after continuous function performance inside the oral cavity, some failure may occur due to residual bond within the material itself; Between Silica and Oxidase.

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So, with time fatigue may occur in porcelain. That's why in some cases you will find tipping of porcelain. A piece of porcelain is gone; it's fractured due to fatigue. Fatigue : Failure of material due to continuous force application over a long period of time. Mainly, fracture of ceramic occur through crack propagation. Crack start in weak area and continuous until it reach the surface. That's why a piece of porcelain pulled of the crown.

So this is a crack that propagate until it reach the surface from the weak area. So any weak spot will be spot where crack occur. Usually in Porcelain-fuse-to-Metal is made in these area which porcelain bond to the metal. Sometimes the bond is not very strong; under stress it will Porcelain not be able to handle stress very well, it is not binding to the metal well, so crack will occur until it reaching the surface. It will propagate inside the material surface may break off. That's why they try to reinforce the material to prevent crack or to stop crack from propagating to the surface. An example is they start to reinforce by using Alumina (Aluminium; Al2O3). They place a part of Alumina and act as crack stopper. They will stop the crack from propagate into the whole thickness of porcelain.

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On the right, this is an example of porcelain which has crack at one end. This is Alumina particle which able to stop the crack from propagating to the surface. So this is an example of Reinforced porcelain with Alumina particles. What the Alumina particles do? It prevent propagation of crack from reaching the surface. Crack Stoppers. So there're another method to make the material stronger and prevent fracture or propagation of crack. Technician firing the material. When the technician put it into oven, the temperature is high. As it cools down, which layer will be smoother? The outer layer. It will cool down slowly, at a latter stage it will shrink a little bit. With shrink, it will compensate stress of the material. It will become stronger resist fracture more. Another method is chemically. They change the composition a little bit; like we said before by adding Alumina, right? Another method is alloy strengthening. They change some composition of the alloy. Porcelain is made up of sodium. One of example is Pottasium. So what do they do? They soak the porcelain into solution of Pottasium. Pottasium and Sodium is + 1, right? But potassium is larger. Then what happen? Pottasium will do inside the material and replace Sodium.

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Since Pottasium is larger, it will put forces on the rest of material thus form compression add higher strength. Again, there are 2 ways to strengthen Porcelain; a) Thermal strengthening b) Ion strenghthening PORCELAIN SHADE As I said, Porcelain shade are available by incorporating pigment or oxide.

These are shade that available in the market. They come in different container and shade. Some are available with brushes to apply and mix porcelain. It is mixed with distilled water to make a paste to be incorporated or added to the metal core.

So these are 2 example of restoration; B: Porcelain-fused-to-metal crown A: All-ceramic crown

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From inside to outside. So it end with core porcelain that has darker shade, followed by porcelain that resemble most superficial dentin and then Porcelain that resemble to enamel in term of translucency; it has natural shade of enamel. Enamel is responsible for the shade of the tooth because enamel will react with reflection of light. So different shade of enamel are available. So when we have a metal core inside, an opaque layer should be placed to cover the dark color of metal. On top of it, dentin and enamel porcelain is added. So within the crown, there's color of metal that needed to be covered; add opaque porcelain. Here (A), opaque layer is not need to be added. So in term of natural appearance, (A) looks more natural. No metal underneath, no need to place opaque layer. So which is stronger? Metal-reinforced porcelain is stronger. That's why (B) is suitable for posterior while (A) is suitable for anterior. Now, there's new type of porcelain that they made all-porcelain can be at posterior part of the mouth. One of them is called Zirconia. 'suddenly a student interrupt with question which I couldnt hear' Answer: Pontac can be made with metal core covered with porcelain or completely porcelain. You can choose either one for esthetic reason and cost factor because stronger porcelain is more expensive because the manufacturing process is more expensive. Again, way to strengthen porcelain is by adding Alumina. This alumina can be in form of particle or they can added in form of sheet of Alumina (but sheet must be used in the palatal surface). Why? Because it is not esthetic. It is too white. This will add support and strength. So, they add particle of Alumina or sheet (make it stronger) place between layer in palatal surface or labial surface or they made a core of Alumina then they put Porcelain on top of it.
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What is core? It's like metal core, the same.On top of it they will place layer of porcelain to resemble natural teeth. This will add strength and prevent crack formation. So Alumina is used as: -Crack stopper -in form of particle or sheet (unaesthetic) - Alumina core On top of it, they will place porcelain, just like a base as supporting layer. Now, there are examples of these reinforced ceramic. One of them is In-Cerum. There are many of them; different type of porcelain with different composition and they are all reinforced. They become stronger to overcome the brittleness of Porcelain of low fracture strength. So, as I said they mix Alumina powder with water, they painted to build this core , put in an oven and on top they start adding layer. Before they add layer of porcelain, they have to make sure the core has even surface. So they add a layer of glass, they painted on top of this core just to avoid any void. (similar technique with glaze) Metal Core painted with Alumina Silica Oven (high temperature) harden Metal-core will be: -no void -Good, strong surface On top, they add dentin porcelain and enamel porcelain. Example of In-Cerum a) Alumina In-Cerum - 400 500 mPa flexural strength
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-contain Mg; slightly weaken material but better esthetic; less opaque. (may be suitable in anterior part of the mouth) b) Zirconia (the strongest In-Cerum) - 800 mPa flexural strength; suitable for restoration in premolar area. - Full-porcelain crown; no metal needed. # Different type of porcelain can be used according to it's purposes.

----------------------Lecture ends here and Dr. Hanan discussed the exam's questions. Alhamdulillah, hope this will be helpful. Do refer the slides and study well. Written by : Nurul Kauthar Mohamad Khari

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