Reference: - Shillingberg, Fundamentals of fixed prosthodontics 3rd edition Chapter 25

What are Metal-Ceramic restorations?? Advantages?? Bonding porcelain to metal Alloys for metal-ceramic restorations Metal framework design Metal surface treatment

Esthetic Superior casting fit Not subjected to discoloration Withstand loading under function

Four mechanisms: 1- mechanical entrapment 2- compressive forces 3- Van der Waals forces 4- chemical bonding

Finishing stones or disks Air abrasion Also increase surface area for chemical

bonding

Coefficient of thermal expansion for the metal

coping should be slightly higher than that of porcelain

Porcelain will draw toward the metal when

cools after firing

Affinity based on attraction of charged

molecules Minor forces

Formation of oxide layer on the surface of

metal Gold alloys have trace elements like iron, tin and indium that form oxides when fired in air These oxides bonds to similar oxides in the porcelain Base metal alloys readily form chromium oxides that bonds to porcelain

Properties:
Coefficient of thermal expansion:

- Should be slightly higher than that of porcelain but not by more than 1 x 10-6 0 c.
Melting range:

- Should be 170-280 0 c higher than that of porcelain

Modulus of elasticity

- Measure of rigidity - Alloys with higher modulus of elasticity have higher rigidity and are more suitable for long span bridges - High noble alloys have lower rigidity than base metal alloys

Yield strength - Alloy used should have adequate Yield

strength not less than stresses caused by biting forces

Hardness - Alloy must be hard enough in order to resist

wear - Alloys with high hardness values are difficult to adjust and finished - Alloys with hardness values exceeding that for enamel (around 350) will cause abrasion for opposing teeth

Corrosion resistance: - Corrosion can lead to roughening of the

surface of metal, weakening of the restoration, and discoloration of the adjacent soft tissues - Noble metals are added to an alloy to reduce its tendency to corrode

Strain (cm/cm)

Gold Platinum Palladium Ruthenium Rhodium Osmium iridium

Contains more than 60% noble metal Contains more than 40% gold Excellent corrosion resistance Low rigidity (inadequate for long span FPDs) Relatively low melting range Poor sag deformation resistance upon firing

of porcelain High cost

Corrosion resistance varies according to the

composition Relatively high strength and hardness Contains higher % of silver which can cause greening discoloration of porcelain

Harder Stronger More rigid (suitable for long span FPDs ) High melting range Greater casting shrinkage Less burnishable than noble metals Poor corrosion resistance Nickel and beryllium can cause allergic

reactions

Titanium alloys - Excellent biocompatibility and corrosion -

resistance due to TIO2 layer Less expensive than noble metals Light weight High melting point and tendency to oxidize creates problems in technique Special casting machines should be used

Metal coping must allow the porcelain to

remain in compression Any tensile stresses in the porcelain must be minimized

- Thickness of metal - Occlusal and proximal contacts - Extension of veneered area - Design of the facial margin

Uniform thickness

of porcelain supported by metal for better stress distribution and appearance - Deficiencies or extra space should be compensated by the metal coping

- Minimum thickness

of porcelain is 0.7 mm for strength and esthetic - Thickness of porcelain should not exceed 2 mms
Sharp angles and

undercuts should be avoided

Outer junction between metal

and porcelain should be at right angle

Metal coping should be rigid - Noble metal coping should be at least 0.3-0.5

mm thick - Base metal alloys should be at least 0.2 mm thick - The thickness of metal coping may vary according to the preparation in order to achieve uniform thickness of porcelain

Occlusal contacts should occur on metal if possible - Porcelain cause more abrasion for opposing enamel than metal Porcelain metal junction should be placed 1-1.5 mm from occlusal contacts

Porcelain metal junction should not be

placed on metal-ceramic junction

Proximal contacts should not be placed on junction between metal and porcelain to avoid plaque accumulation. Usually proximal contacts are placed on porcelain - Esthetic - Better stress distribution

Depends on: Patient wishes Opposing occlusal restorations Presence or absence of bruxism Retention requirements

Metal margins: - Better accuracy but - Esthetic?? - Extending preparation subgingivally??

Porcelain margins: - Esthetic - No need to extend preparation subgingivally - Accuracy?? - Technique sensitive?? - Shoulder porcelains:

Stronger aluminous porcelain with 30-80 0 c higher fusing temperature than dentin porcelain

Wax pattern should be made to the full

anatomic contour of the restoration The area to be veneered with porcelain is cut back Wax should not be thinned to less than 0.5 mm This will ensure: - Uniform thickness of porcelain - Smooth continuation of contours between metal and porcelain

Wax Pattern should fulfill the following

criteria: 1- conform to the normal anatomic form 2- centric stops should be at least 1.5 mm from junction between porcelain and metal 3- surfaces of veneered areas should be smooth and rounded 4- pontics and connectors of adequate size and design

1- Checking the metal framework on the die 2- Checking the metal framework in the patient mouth

Check the internal surface of the metal for

defects and the die for any damage

Fitting: ideally the casting should touch the

die only in the marginal region

Temporary restoration is removed and

preparation is cleaned from any cements

Try-in procedure usually does not require

anasthesia
The metal framework should be seated

without force

Precaution!! - Upright position - Dry crown and dry fingers - Gauze - Finger behind the crown

Check the internal surface for nodules or

casting blebs

Check for retained temporary cement Check for overextended margins Check the internal surface for internal

discrepancies

Internal discrepancies can be detected using

disclosing waxes, aerosol sprays, chloroform and rouge, fit checker or by sandblasting - Areas of metal-tooth contact will appear inside the crown as shiny spots devoid of the material used - These areas can be relieved using carbide burs

Acceptable margin should not be

overextended, underextended, too thick or open

Margin is considered open if a sharp explorer

tip50 micrometer can be inserted in between

The crown should be checked for tendency to

pivot when rocked Causes: - High spot in the fitting surface - Too much die spacer