Elsevier

Dental Materials

Volume 27, Issue 1, January 2011, Pages 83-96
Dental Materials

From porcelain-fused-to-metal to zirconia: Clinical and experimental considerations

https://doi.org/10.1016/j.dental.2010.10.024Get rights and content

Abstract

Objective

The interest of dental research in metal-free restorations has been rising in the last 20 years following the introduction of innovative all-ceramic materials in the daily practice. In particular, high strength ceramics and related CAD/CAM techniques have widely increased the clinical indications of metal-free prostheses, showing more favourable mechanical characteristics compared to the early ceramic materials.

The purpose of the present paper is providing a brief review on the all-ceramic dental materials, evaluating pros and cons in the light of the most recent scientific results and of the authors’ clinical experience.

Materials

A structured review of the literature was given on the basis of medical and engineering papers published in the last decades on the use of dental ceramics and zirconia in particular. The experimental and clinical findings of the most relevant researches were reported.

Results

Zirconia is one of the most promising restorative materials, because it yields very favourable mechanical properties and reasonable esthetic. Several in vitro and in vivo investigations reported suitable strength and mechanical performances of zirconia, compatible with clinical serviceability as a framework material for both single crowns and short-span fixed partial dentures. However, clinical results are not comparable, at the moment, with conventional metal–ceramic restorations, neither is there sufficient long-term data for validating the clinical potential of zirconia in the long run.

Significance

The use of zirconia frameworks for long-span fixed partial dentures or for implant-supported restorations is currently under evaluation and further in vivo, long-term clinical studies will be needed to provide scientific evidence for drawing solid guidelines.

Section snippets

Introduction to the review

In the last decades, since the development of porcelain-fused-to-metal (PFM) procedures in the early sixties, metal–ceramic restorations have represented the “gold standard” for years in prosthetic dentistry, thanks to their good mechanical properties and to somewhat satisfactory esthetic results, along with a clinically acceptable quality of their marginal and internal adaptation [1], [2], [3], [4], [5], [6], [7]. The predictability and consistency of positive clinical results, validated by

Glass- and alumina-based dental ceramics

An ideal all-ceramic dental material should exhibit excellent esthetic characteristics, like translucency, natural tooth color, outstanding light transmission and, at the same time, optimal mechanical properties, like flexural strength (σ), fracture toughness and limited crack propagation at the functional and parafunctional load conditions, in order to ensure lifetime serviceability. Unfortunately, today, none of the available dental ceramics fulfills all of these requirements at the same

Summary

The trend toward an increasingly extended use of all-ceramic SCs and FPDs is an undeniable reality in Fixed Prosthodontics. After the development era, dental ceramics introduced in the last 20 years exhibit different, favorable and promising esthetic and mechanical properties. At the moment, there is no one ceramic material that equally excels in all of these characteristics. The choice of one specific typology of ceramic, rather than on the latest fashion, should be based on a careful

References (160)

  • L. Xiao-Ping et al.

    Strength and fracture toughness of MgO-modified glass infiltrated alumina for CAD/CAM

    Dent Mater

    (2002)
  • E.A. McLaren et al.

    Survival of In-Ceram crowns in a private practice: a prospective clinical trial

    J Prosthet Dent

    (2000)
  • W.C. Wagner et al.

    Biaxial flexural strength and indentation fracture toughness of three new dental core ceramics

    J Prosthet Dent

    (1996)
  • D.R. Haselton et al.

    Clinical assessment of high-strength all-ceramic crowns

    J Prosthet Dent

    (2000)
  • B.S. Segal

    Retrospective assessment of 546 all-ceramic anterior and posterior crowns in a general practice

    J Prosthet Dent

    (2001)
  • I. Denry et al.

    State of the art of zirconia for dental applications

    Dent Mater

    (2008)
  • M. Guazzato et al.

    Strength, fracture toughness and microstructure of a selection of all-ceramic materials. Part II. Zirconia-based dental ceramics

    Dent Mater

    (2004)
  • M. Guazzato et al.

    Strength, reliability and mode of fracture of bilayered porcelain/zirconia (Y-TZP) dental ceramics

    Biomaterials

    (2004)
  • A. Sundh et al.

    Fracture resistance of all-ceramic zirconia bridges with differing phase stabilizers and quality of sintering

    Dent Mater

    (2006)
  • J. Fischer et al.

    Impact of thermal properties of veneering ceramics on the fracture load of layered Ce-TZP/A nanocomposite frameworks

    Dent Mater

    (2009)
  • J. Fischer et al.

    Impact of thermal misfit on shear strength of veneering ceramic/zirconia composites

    Dent Mater

    (2009)
  • K.B. May et al.

    Precision of fit: the Procera AllCeram crown

    J. Prosthet. Dent.

    (1998)
  • V. Lughi et al.

    Low temperature degradation–aging- of zirconia: a critical review of the relevant aspects in dentistry

    Dent Mater

    (2010)
  • P. Torricelli et al.

    Biological glass coating on ceramic materials: in vitro evaluation using primary osteoblast cultures from healthy and osteopenic rat bone

    Biomaterials

    (2001)
  • C.H. Lohmann et al.

    Ceramic and PMMA particles differentially affect osteoblast phenotype

    Biomaterials

    (2002)
  • C. Piconi et al.

    Zirconia as a ceramic biomaterial

    Biomaterials

    (1999)
  • A. Sundh et al.

    Fracture resistance of yttrium oxide partially-stabilized zirconia all-ceramic bridges after veneering and mechanical fatigue testing

    Dent Mater

    (2005)
  • J. Chevalier et al.

    Critical effect of cubic phase on aging in 3 mol% yttria-stabilized zirconia ceramics for hip replacement prosthesis

    Biomaterials

    (2004)
  • B.A. Cottom et al.

    Fracture toughness of nanocrystalline ZrO2–3 mol% Y2O3 determined by Vickers indentation

    Scr Mater

    (1996)
  • H. Lüthy et al.

    Strength and reliability of four-unit all-ceramic posterior bridges

    Dent Mater

    (2005)
  • B. Taskonak et al.

    Analysis of subcritical crack growth in dental ceramics using fracture mechanics and fractography

    Dent Mater

    (2008)
  • J.R. Kelly et al.

    Stabilized zirconia as a structural ceramic: an overview

    Dent Mater

    (2008)
  • J. Chevalier

    What future for zirconia as a biomaterial?

    Biomaterials

    (2006)
  • B. Basu et al.

    Microstructure-toughness-wear relationship of tetragonal zirconia ceramics

    J Eur Ceram Soc

    (2004)
  • B. Basu et al.

    Influence of humidity on the fretting wear of self-mated tetragonal zirconia ceramics

    Acta Mater

    (2000)
  • T. Kosmac et al.

    The effect of surface grinding and sandblasting on flexural strength and reliability of Y-TZP zirconia ceramic

    Dent Mater

    (1999)
  • T.R. Walton

    A 10-year longitudinal study of fixed prosthodontics: clinical characteristics and outcome of single-unit metal–ceramic crowns

    Int J Prosthodont

    (1999)
  • F.M. Spear

    The metal-free practice: myth? Reality? Desirable goal?

    J Esthet Restor Dent

    (2001)
  • B. Reitemeier et al.

    Metal–ceramic failure in noble metal crowns: 7-year results of a prospective clinical trial in private practices

    Int J Prosthodont

    (2006)
  • B.E. Pjetursson et al.

    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 I: single crowns

    Clin Oral Implants Res

    (2007)
  • I. Sailer et al.

    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

    Clin Oral Implants Res

    (2007)
  • F. Wettstein et al.

    Clinical study of the internal gaps of zirconia and metal frameworks for fixed partial dentures

    Eur J Oral Sci

    (2008)
  • N.V. Raptis et al.

    Optical behavior of current ceramic systems

    Int J Periodontics Restorative Dent

    (2006)
  • T.E. Donovan

    Factors essential for successful all-ceramic restorations

    J Am Dent Assoc

    (2008)
  • L.W. McLean et al.

    The reinforcement of dental porcelain with ceramic oxides

    Br Dent J

    (1965)
  • A.V. Ritter et al.

    Ceramic restorations for posterior teeth: guidelines for the clinician

    J Esthet Dent

    (1999)
  • M. Fradeani et al.

    An 11-year clinical evaluation of leucite-reinforced glass–ceramic crowns: a retrospective study

    Quintessence Int

    (2002)
  • M. Fradeani

    Six-year follow-up with Empress veneers

    Int J Periodontics Restorative Dent

    (1998)
  • M. Fradeani et al.

    Porcelain laminate veneers: 6- to 12-year clinical evaluation—a retrospective study

    Int J Periodontics Restorative Dent

    (2005)
  • D. Layton et al.

    An up to 16-year prospective study of 304 porcelain veneers

    Int J Prosthodont

    (2007)
  • Cited by (0)

    View full text