High-Strength Ceramics Interdisciplinary Perspectives
Interdisciplinary Perspectives Edited by
Jonathan L. Ferencz, dds Clinical Professor of Prosthodontics New York University College of Dentistry Private Practice in Prosthodontics New York, New York
Nelson R.F.A. Silva, dds, msc, phd Professor Department of Restorative Dentistry Federal University of Minas Gerais Belo Horizonte, Brazil
José Manuel Navarro, dds, ms Private Practice in Periodontics, Prosthodontics, and Implant Dentistry Brånemark Osseointegration Center Spain Las Palmas, Spain
Quintessence Publishing Co, Inc Chicago, Berlin, Tokyo, London, Paris, Milan, Barcelona, Beijing, Istanbul, Moscow, New Delhi, Prague, São Paulo, Seoul, Singapore, and Warsaw
Library of Congress Cataloging-in-Publication Data High-strength ceramics : interdisciplinary perspectives / edited by Jonathan L. Ferencz, Nelson R.F.A. Silva, Jose M. Navarro. p. ; cm. Includes bibliographical references and index. ISBN 978-0-86715-639-3 (hardcover) I. Ferencz, Jonathan L., editor. II. Silva, Nelson R. F. A., editor. III. Navarro, Jose M., editor. [DNLM: 1. Dental Porcelain. 2. Biocompatible Materials. 3. Dental Prosthesis--methods. 4. Esthetics, Dental. 5. Oral Surgical Procedures--methods. 6. Reconstructive Surgical Procedures--methods. WU 190] RK655 617.6’95--dc23 2014007961
5 4 3 2 1
Š 2014 Quintessence Publishing Co Inc Quintessence Publishing Co Inc 4350 Chandler Drive Hanover Park, IL 60133 www.quintpub.com All rights reserved. This book or any part thereof may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise, without prior written permission of the publisher. Editor: Bryn Grisham Design: Ted Pereda Production: Sue Robinson Printed in China
Contents Foreword vii Preface viii Contributors ix
1 2 3 4 5 6
Challenges in Engineering and Testing of Bioceramics 1 Paulo G. Coelho and Timothy G. Bromage
The Role of Industry in Developing New Ceramics
19
George W. Tysowsky and Robert Gottlander
Practice-Based Research on the Effectiveness of Ceramics 33 Van P. Thompson and Kenneth A. Malament
Posterior Partial-Coverage Restorations: Inlays and Onlays 47 Petra C. Guess
Individual Ceramic Crowns for Teeth 63 Estevam A. Bonfante and Stefano Gracis
Ceramic Veneers 101 Susana Morimoto, Marcelo A. Calamita, Christian Coachman, and Galip Gürel
7 8 9 10 11 12 13
Fixed Dental Prostheses for Anterior and Posterior Teeth 119 Irena Sailer
Ceramic Applications to Restore Implants 149 Joerg R. Strub and Michael V. Swain
Cementation Procedures for Ceramics 173 Matthias Kern
Monolithic Zirconia Complete-Arch Reconstructions 189 Esther Grob and Mario Sisera
Successful Ceramic Application on Various Substructures 205 Murilo Calgaro, Victor Clavijo, Rogerio Goulart da Costa, and Willy Clavijo
Ceramic Dental Implants 235 Ralf Kohal and Eric Van Dooren
Digital Workflow in Reconstructive Dentistry 261 Wael Att and Michael Girard
Index 279
Foreword All-ceramic restorations have had a significant impact on dental practice first and foremost because of their mechanical resistance and their esthetic properties. High-strength ceramics are now an integral part of everyday practice. The options for all-ceramic restorations offered to patients have essentially been narrowed down to a small group of materials, and this book discusses those materials and provides detailed clinical protocols that will enable the reader to achieve a higher level of predictability in dental practice. This book also provides an in-depth review of techniques that were traditionally restricted to metal technology: layered or monolithic single restorations, short- and long-span fixed partial dentures, Maryland bridges, implant abutments and restorations, and ceramic implants. The range of applications covered in this text makes it a comprehensive reference on all-ceramic technology. The techniques presented herein represent the wealth of clinical and laboratory experience of the panel of international experts gathered by Dr Ferencz, Dr Silva, and Dr Navarro. This select group of master clinicians and ceramists exemplifies many years of practical knowledge and provides invaluable historical perspectives. What makes this textbook special, however, is that the authors base their discussions on fundamental research of the biologic and mechanical properties of ceramic materials as well as on the accepted consensuses documented by thorough literature reviews. Indeed, the reader will enjoy the evidence-based format of this text presented in a logical and attractive manner and the very effective connection of fundamental knowledge to clinical application. The use of high-strength ceramics as an alternative to porcelain-fused-to-metal restorations has fully matured in response to several factors: patient esthetic demands, the availability of CAD/CAM technology in dentistry, and the high cost of precious metals. Thus, zirconia and lithium disilicate offer specific properties that are illustrated throughout the text to allow an educated choice between these materials, their indications and contraindications, and their respective advantages and disadvantages. The editors should be commended on putting together such a diversified panel of clinicians, dental ceramists, and researchers to produce a major contribution to the field of esthetic dentistry. It will have a definitive impact on the dental community. Gerard J. Chiche, dds Thomas P. Hinman Endowed Professor Director of the Center of Esthetics and Implant Dentistry College of Dental Medicine Georgia Regents University Augusta, Georgia
vii
Preface The inspiration for this book began about a decade ago when New York University (NYU) College of Dentistry built one of the strongest biomaterials teams in the world. Under the leadership of former NYU Dean Michael Alfano, Diane Rekow and Van Thompson were recruited to come to NYU and create a biomaterials research group that focused on answering some basic questions about the behavior of ceramic materials. Corporate support and participation became a hallmark of this successful research endeavor, and many leading academics and researchers around the world wanted to spend time learning and participating in the many ongoing research projects. After a few years, it also became obvious that clinicians and dental laboratory technicians had valuable experiences and ideas to share with the group, because they used these materials on a daily basis. It became apparent that only when we shared our challenges and ideas for improvements could major breakthroughs occur. The idea of writing a textbook that focused on this interdisciplinary collaboration started in the summer of 2011. The three of us believed that a text could be created that focused on the collaboration of biomaterials science, industry, clinical, and dental laboratory perspectives. We envisioned that most chapters could combine perspectives by asking biomaterials experts to work with clinicians to write chapters. We selected many of the same individuals who came to NYU to participate in research projects during this time period. From this idea emerged a text that features contributors from nearly every aspect of dentistry representing 4 continents and nearly 12 countries. This text is intended for dental students, dental technicians, dental faculty, and practicing dentists alike. We believe that to be a successful user of ceramic materials today, one must have an understanding of basic biomaterials. We thoroughly hope that this text introduces readers to new ceramic materials, highquality clinical procedures, and laboratory techniques with an underpinning of biomaterials science. As editors, we are extremely grateful to the contributors who have so graciously lent their time and expertise to this project, to our publishers at Quintessence, and to our families who have encouraged and inspired us along the way.
viii
Running A Head
Contributors Wael Att, DDS, Dr Med Dent, PhD
Willy Clavijo, CDT
Professor and Director of Postgraduate Studies Department of Prosthodontics School of Dentistry Albert-Ludwigs University Freiburg, Germany
Dental Technician Curitiba, Brazil
Estevam A. Bonfante, DDS, MSc, PhD Assistant Professor Department of Prosthodontics Bauru College of Dentistry University of São Paulo Bauru, Brazil
Timothy G. Bromage, PhD Professor and Director of Hard Tissue Research Unit Department of Biomaterials and Biomimetics New York University College of Dentistry New York, New York
Marcelo A. Calamita, DDS, MSD, PhD Private Practice São Paulo, Brazil
Murilo Calgaro, CDT Dental Technician Curitiba, Brazil
Victor Clavijo, DDS, MS, PhD Professor Advanced Program in Implantology and Restorative Dentistry Implante/Perio Institute São Paulo, Brazil
Christian Coachman, DDS, CDT Private Practice in Esthetics São Paulo, Brazil
Paulo G. Coelho, DDS, PhD Associate Professor of Biomaterials and Biomimetics Director for Research Department of Periodontology and Implant Dentistry New York University College of Dentistry New York, New York Affiliated Faculty Division of Engineering New York University Abu Dhabi Abu Dhabi, United Arab Emirates
Jonathan L. Ferencz, DDS Clinical Professor of Prosthodontics New York University College of Dentistry Private Practice in Prosthodontics New York, New York
Michael Girard, RDT President and CEO Modern Dental USA Troy, Michigan
Robert Gottlander, DDS Vice President of Global Prosthetic Solutions Henry Schein Melville, New York
ix
Rogerio Goulart da Costa, DDS, MS
Matthias Kern, DMD, PhD
Professor of Dental Prosthodontics Department of Prosthetic Dentistry Federal Institute for Education, Science and Technology of Paraná Curitiba, Brazil
Professor and Chair Department of Prosthodontics, Propaedeutics and Dental Materials School of Dentistry Christian-Albrechts University at Kiel Kiel, Germany
Stefano Gracis, DMD, MSD Private Practice in Prosthodontics Milan, Italy
Arteco Dental Technology Zürich, Switzerland
Professor Department of Prosthodontics School of Dentistry University Medical Center Freiburg Freiburg, Germany
Petra C. Guess, DDS, Dr Med Dent, PhD
Kenneth A. Malament, DDS, MScD
Associate Professor Department of Prosthodontics School of Dentistry University Medical Center Freiburg Freiburg, Germany
Clinical Professor Tufts University School of Dental Medicine Boston, Massachusetts
Esther Grob, CDT
Galip Gürel, DDS, MSD Visiting Professor New York University College of Dentistry New York, New York Private Practice Istanbul, Turkey
x
Ralf Kohal, DMD, Dr Med Dent, PhD
Susana Morimoto, DDS, MSD, PhD Professor of Graduate Program School of Dentistry Ibirapuera University São Paulo, Brazil
José Manuel Navarro, DDS, MS Private Practice in Periodontics, Prosthodontics, and Implant Dentistry Brånemark Osseointegration Center Spain Las Palmas, Spain
Irena Sailer, Prof Dr Med Dent
Michael V. Swain, BSc, PhD
Chair Division of Fixed Prosthodontics and Biomaterials University Center for Dental Medicine University of Geneva Geneva, Switzerland
Professor of Biomaterials Faculty of Dentistry University of Sydney Sydney, Australia
Nelson R.F.A. Silva, DDS, MSc, PhD Professor Department of Restorative Dentistry Federal University of Minas Gerais Belo Horizonte, Brazil
Professor Department of Biomaterials, Biomimetics, and Biophotonics King’s College London Dental Institute Guys Hospital London, England
Mario Sisera, CDT
George W. Tysowsky, DDS, MPH
Arteco Dental Technology ZĂźrich, Switzerland
Vice President of Technology Ivoclar Vivadent Amherst, New York
Joerg R. Strub, DMD, Dr Med Dent, Dr hc, PhD Professor and Chair Department of Prosthodontics Associate Dean for Clinical Affairs School of Dentistry University Medical Center Freiburg Freiburg, Germany
Van P. Thompson, DDS, PhD
Eric Van Dooren, DDS Private Practice Antwerp, Belgium
xi