Abstract
The evolution of computerized systems for the production of dental restorations associated to the development of novel microstructures for ceramic materials has caused an important change in the clinical workflow for dentists and technicians, as well as in the treatment options offered to patients. New microstructures have also been developed by the industry in order to offer ceramic and composite materials with optimized properties, i.e., good mechanical properties, appropriate wear behavior and acceptable aesthetic characteristics. The objective of this literature review is to discuss the main advantages and disadvantages of the new ceramic systems and processing methods. The manuscript is divided in five parts: I) monolithic zirconia restorations; II) multilayered dental prostheses; III) new glass-ceramics; IV) polymer infiltrated ceramics; and V) novel processing technologies. Dental ceramics and processing technologies have evolved significantly in the past ten years, with most of the evolution being related to new microstructures and CAD-CAM methods. In addition, a trend towards the use of monolithic restorations has changed the way clinicians produce all-ceramic dental prostheses, since the more aesthetic multilayered restorations unfortunately are more prone to chipping or delamination. Composite materials processed via CAD-CAM have become an interesting option, as they have intermediate properties between ceramics and polymers and are more easily milled and polished.
Highlights
The evolution of computerized systems for the production of dental restorations associated to the development of novel microstructures for ceramic materials has caused an important change in the clinical workflow for dentists and technicians, as well as in the treatment options offered to patients
By offering monolithic prostheses, clinicians are able to overcome one of the major problems associated to multilayered restorations, which is the fracture of the low-strength veneering layer, usually made of a feldspathic dental ceramic
The CAD-on technique involves the production of a stronger veneering layer based on lithium disilicate glass-ceramics sintered onto the zirconia framework using a fusion glass solder, and the rapid layer uses CAD-CAM technology to mill the veneering layer that is afterwards cemented onto the zirconia framework
Summary
The evolution of computerized systems for the production of dental restorations associated to the development of novel microstructures for ceramic materials has caused an important change in the clinical workflow for dentists and technicians, as well as in the treatment options offered to patients. The CAD-on technique involves the production of a stronger veneering layer based on lithium disilicate glass-ceramics sintered onto the zirconia framework using a fusion glass solder, and the rapid layer uses CAD-CAM (computer-aided design and computer-aided manufacturing) technology to mill the veneering layer that is afterwards cemented onto the zirconia framework These new processing methods are relatively new and still need more clinical trials to prove their efficacy in relation to the traditional processing routes. New microstructures have been developed by the industry in order to offer ceramic and composite materials with optimized properties, i.e., good mechanical properties, appropriate wear behavior and acceptable aesthetic characteristics Examples of these novel microstructures are lithium silicate glass-ceramics reinforced with zirconia and a composite constituted of a polymer-infiltrated ceramic. The manuscript is divided in five parts: 1) monolithic zirconia restorations; 2) multilayered dental prostheses; 3) new glass-ceramics; 4) polymer infiltrated ceramics; and 5) novel processing technologies
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