dental ceramics. essential aspects for clinical practice
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8/10/2019 Dental Ceramics. Essential Aspects for Clinical Practice
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Csoh HereIre Ser
Ad hGi Hlg
A SerC Rm
cooo h:B Ane, G Bnic, A Fehr,
R Glause, A Hagman, S icklng, oldeegge R Jug, Klaje ,
Loefe, Merk, D PyP Rtaler, D iegethae, M aco
Toa, A Tan, Wc,
Yaman, A Zbi
uessee Push o LtdLondo, Bei Chcago Tokyo ceoa Beiji Istbul Ml
Mocow New De Pri Pue So al Seol Wasaw
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IV
T uos g o picing nl cici o cl oio po o conin goowok W wou sci k o k Wl G (G AG uc B Tin B i AG Dl
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Title of the rignl Gem editn:
Dete Aktee Schwerpke die Kik
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Qessee Pshg C LGron Rd Nw Mlde Suey K 3ABt Bwwqkl ghs se. s ok o y p he o y t e epdd stoed i etievl sysem nstted y y y mes elei mephtcying herwise witt po e esson fhe ublisher
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Mo i oi wll-ok wih i oul xbook How pii i o i i o wou h plo o l liu i o o lo h ioio h qui o o i h i h i obl
o o i book o pill o i opo
iy l i El Ap o liilPi i i quik i l po piii pi ioio h o u oio o i pi. Top o ilu i il ow x pi u ipl oio l bj oio o o-l
x bli lo ib x i o ,poii p-b-p iuio uo poop i o h lui h liil po l i lbl o o pii i wJJ o lu.
Thk o o o i l lii lbooi h, i h b poibl o opl bookh o h o piipl bkou ioio po l o h biio o l i oio i
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VI
Prof Dr Chist op HamereClnc DrcoE-: [email protected]
D Ire SlerSo ConsltE e se@zzkuzh ch
D G lgSo Consl [email protected]
D Crs RmelSeo Conslt crs r e@mkuzh ch
Clnc o Cown d Bdg Poshodotcs,P Poshootics d De Mtes SceceCnr or Dnl Orl Mxlly MdcnUvers o ZrcPsss 1 C8032 ch
A Sute- srn@ocoDet Techcsld C-8707 on S
D Ade o
o@zh ezte keschPrcce or Gene Denst Or Surger,Sooog d OtodocsGross , CH-8754 Nesl
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Sctc Act tal Camc Mata 1
1.1 Copoton nd Co o
De Ce 2
Ps opete ........ 6 Opt l oete 0
Pc Mtd
Mnu oeg Metod 1
22 Mnng 8
3 V
Indn 22 odcos 2
Cln dee
Sepep Cln oede
Fbrcon o Veeers 26
4 Acamc Sl
Indon 8
oo Prer . 9
Cln Suvvl 0
Cln d Lboror oeue
5 vta Atm T 9
5 oen o ov eeh 60
5 Pot 61
het . 6 5 Cln Poede 6
xta Blac 71
6 Inodton 2
62 Poer echg 7
6 Coned Blen ...
6 Atoe Bleng
65 "Ove-he-one" ee Wt enng od 8
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Cnens
VI
Aleam Fxed atal eue 81
eel sdets 82
2 Indcts 82
3 Preara ........................ 844 e nd enl ce
cede 85
5 Clnia Srvvl Rates .................... 90
6 ncuss 91
Bdg ea Reat 93
8 dhesve verss venl eenn .. 9
82 lssc desve ees 9683 ei Cndinig.............. 98
84 ec ndg...................... 100
85 lnc Pcedes 10
Aleam Iat uted eta 13
lnc spects d Idts .... 1
9 dvges ecbutents
15
93 sdvges 5
94 lgc secs 16
95 anufaures 6
dx 125
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cc Asct of ta rc Mars
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Coposon ad Cassfcaono Deal Ceaics
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T w l crics r o coiol l crcs i lgr o o cysls b g o sigic crs i i rg A iio o cs lsocrss opciy ol l crc c oly b s or bricio o sbsrcs or cric soios ik l work y s b r wi rlc cic il
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Cmostio ad Clicio Del Cermics
1.11 Mai Chaceiscs
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.l Copoo a Claifcao of Da Caic
h v sngl-ps mcrosrcur Dm 3 F 3 d 4) cons
Alum/rcon cors or nror posror sgl crowns rcon ror n osor brg rmworks. rocssng
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cc Asct of ta rc Mrs
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12 yscal roperes
1..1 Defiiose eg of er teri i geel deibed ig twovrible erl tregt nd rre toge
lex tren (P o bendig engt i e xi veril lod t teril n ort wito filre (frre) Ierl etg ei e (ll dk-ed i betedo inreig vertl tre ntil i rk or brek ifferent roool e ed fo deteritio of exrl treg eg tree- or
or-oit beding tet) In ee tet, te i vetil lod, or bedig tre i ied to te teile zone (ovex ide) of te erile. Te rfe lit (oing, irork o te teilezoe rl or te reltig exrl tregt
rtre toge or tre reite M i ereof e i fore teril otiing w or rk witnd wiot elrgeent of e rk wen eile fore i liedo te edge of te rk A ile ele illtre inile if ot (w i de t te o of ee of wood t i eier to lit
e wood wt e Cotined eore of e wed teril oore igt or even f beow te initi ring lod n rel ie grd rogtio of te rk i low rogreion, lledbiil rk growt i oe of e reon or te logteire of ll-eri retortion Te iger te tre togeofte tei te loge t ke or terelted flre o or8•e tre togne nd erl treng of vo eri tei re deibed in ble 1 .
To revent nil filre, wek" dentl er teril, gl-eri be tregteed b e of deive eettion )
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2 hyc rop
Table Mtel cic f nt e eal·9•
lxl [MP Ft tg M m]
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1.. actos tht detemie the stengh odetal ceaic resoratios
strng ri rstrtin is dtrd b h rstrutr dnsi nubr f ysls) f t dntl i atrial it sd r Th sn f iii irrks rs uriis
(g du t pssing rrr) in t stuur is issuSu dfts a ld t th dvl rks tht a ritillwkn rsual sal tril
r linl suss h ri trils sd fr dnt strtins ust t fllwing rqins igh xurl strngth igh frat ghss (ivd sli rinfrt =
hig rst ntnt t.
gnit f th rsttur (bs frksps t wlss pssig idall usng idustil uftd
blnks
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cc Ast of ta rc Mars
12 Compion of cheicl nd pyiclpoperte of et d ermi
Metls nd eis respond o stress lods dierentl due to die
enes in the hei struure of he to tel sses Regrdingther heil strute et tos fo nifo rstl ltties btrion though eletron louds etl bonds As these bonds renondieionl (i.e the hve o prefeenti diretio), stress lodng led to shfting of ltie levels ithout loss of ohesionof the tos is ehil prope is esponsible for the terisi elst dutilt ofetls
In he se of eri terils et os fo bonds ih
nonetl tos vi ion ridges Coheson ors due to the oppositehrges of the priles Whe the ltie is defored de o stessptiles ith the se hrge sudden be shied opposite toeh other resultig n the iedite dissolution of the bod hesenertions e responsile fo nother n hrterisi of eriterils: bileess As resul er erils deostrte lileor no esiit or dutilt.
euse he re rittle er els re suseptible to inirostruurl s (irors) fro h rosopi ks
gro One the bonds beteen the tos hve been broen then onl be reoied b ring the teril t ve high epetueshsiolog tepertures in he outh re too lo for hs
ets o the other d e se tpes of rks (proessings et) tend to hel euse ets re ver duile, oundingof the edges of e ours thus desing" e situtio• viue of ther heil sttre ems re ver resistnt to pressre foes bu ulike et, the hve litle resise to esile
stresses.I sur eris re hrdl oprble to ets due to edierenes in their hei nd phsil properties. e to the spei properties of er terils sll teri s n resultn the filure of detl ermi estortio
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.2 hycal Popert
12 Zircoim dioxide !Z0
Zinium ii r irna (Zr) i an i ami Cmarwith thr ram matrial zirnia tigh tlf thrug
urir ual tngth an fratu tugn h uttaningmaral rrti f ziia a b attriut t fllwg fatr at mirttral vl Ziria i a glha (rl alli) rami Zirnia rtal ar vr mall (ati i <04�m) Ziria rtal ar ifrm i a a iz g)
aiti t ig xtrml tab ziium ixi a athr
imrtant fatur atur ugn. fraur tghn f zrium ixi i arl twi a igh a at f alumia. higtrngt f zrnia i aiv thrug a r wn a trafrmati tugig wi i ba xlitati f t a trafmat aai f t rtalli trtur f zirnim ixi. th r ranfati f t traga ha t th mi ha i inu b aig nat tr t a rak iruting n an arimatl 4 rnt ia n th vlum f thzirnium xi rta. Bau f th rultg mi
tr wihn t matia n f th ra ar r tgtrtu rvtig rak gwt (Dgm nd ).
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Refeeces
EdD S JA tm tu n d i ad all
am amwk J Dn R 00 8000, IADR Abtt 088 EdD n JA. tam tu am mr
dpd uig mal J D R 008 :-3, IADR AbtN. 9.
. EdD n A pkrm H Light rnmin hrug rm amwk dndt ltg matri. t J Artil Org 00;6:4AO Abt N P.
. Fi Lhy hr P Gulr L A ami d brdg y t dirt ami mhg (DCM Mar Md V I . M id & w E d i VD H u 998 689
G G Km kf n: E K pp! H Ztl
kud ud Vrbtug V. I Hidg: t V l, 996363.
6 MJ, Aqiln A, DiAld AM Haln DR, tard M,rga MA. Rai rnuy i all-rm m Par Cmta J Prtt D 008849.
. MJ Aqiln A Diz-ld AM Hln DR trd M Vg MA. Raiv uy fix allram ym Par II Cr advn matri J h Dnt 00880-5
8 Kpp HF. am zhzlih Wkt ub R Tr JCiwki H M K M d Crruum Prhtk Vl Qut999:6 660
9 ty tng nd u d ami. AD/CAM in Ehti D ny, EREC 0 Y Any ympim Mman (Ed..hag Qui 996940
0 Mr R Md amih Wrt r tth RuainVrkmg ud uhgt D Zr Z 998:936
Reeences
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e 2 Pocessing e
Ml g
tayerng, re
Th ttng mtrl r y -crm nl rtrtn crmc wr tht b h th r rm by rty rnt rcg mh h ct y rcng hnqu n th mth (by h r mch th
ty crm mtrl lct r th rrtn Th lmnt cmr g mncturg /CM) chg tl ltn nw m bl t rc rmcrtrt m ly tr x crm ml ht r cult c by hn
l-rm g mh th crg ty crmc mrl c b h llng gr
M g
GlceacSlp tng gl nfln l-nltt py-l
ceramc CAM
x CAD/CAM
2. Maa ocessing Meos
211 Lyerig
yrg rcng mth u b rl-nrcrw lyr r rm gl-m Th trtg mrl r rm wr ul by th r mucrr n rg t h trluc
I th rt t, h crmc w mx wth mlng r tll wr t rc ry Th lurry l lyr tth ubtrt (rmwr, rr Th rttn bt yr rng t th ntml im cl trluccy th nurl tth h l crmc m bltt
uty n rr t mk th c n r- -
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21 Maa Prossi Mhds
bl bfo sitig ld ic is cd cmic cd sintd t th qui tmu oximtlC) Thodd gss icls softn d o togth (sint t h ticl intfcs 1 d Dm
)�Sea osideion
As th i btn th tics mus b b to scding hing sinting ust b fomd i vcum nviomth ic must b mod o n nlgd sclg shing is xtnsiv u to %
� wba
Po otio is nvitbl his sults in nig d is of dlmintio
bI
Dm d Suce rutre a fore a ! afr ten
Aft layi, it is rohy % a tha a ii h h th bato i s ye e feret pt ee the ent a sss e it e n pe ei hige.
1
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hte 2 Pocssng Metd
1 6
212 ressg
Th p tnqu w vop o mntu o mnl onl v n own. Th Emp® m th p
o o nmb o m p m hnoog nowo nt mnt. Th tng mtl ull ut (o ltum lt) no gl-a ppl n tom o tl pnt ngot.
Ht-p m oton m ung h lo wpnp ognl n mtl g. T toton tmol n w nv n p m. T on glngot th pl n pll gn (mp®) p
p t 1°C (p ) nto t mol t b b o w Fg )ngot o p-m toon vlbl n v o
t h nlun Th mtl n b po btwo nt mho. t, toon n b p o ull onto tz b u nng ttvl onl t mwok n b p a tn vn b th lng tnq.
Sal onidat ont-png pou g-m toton o optml (o poTh toton l o th ognl No nkg o.
Fg2 Scly e ule wth r yn.
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21 M Prossi Mhds
21 Slip Casing ad Glass filraio
Te metod o slip cstng high-strength lumin cores or glss inltrtion ICerm tecoogy) ws deeoped before e i of
mchning ecniues or industrilly pre-bricted porous ingots7•However pe-fbricted ingot systems he become more popur dueto their superior ulty
Te slp cstig procedre s simil to the lyering echnique.Fine-gned lumn powder s mixed wi modeling luid to produce slip which s pped in yes to specil die to build p e substrucure. The modeed pece is subseuenly sintered (or 2hours 10 °). Siterng does not led to the sio of lumn pcles b
mkes tem become more ighty pcked. Glss inlrton of hisporous substructe s eefoe, peomed i the second sep of heprocede; st lnnum powder is mixed with spec solent ndpplied i ecess to te etel sfce of te substcte 3 epiece is en red fo 4 o·s t 0 o mel te gss picles.Te moten gss s drwn ito the ne pores o te substcture bycplly sucto) yieding hig-stregh gss-inltred lumisubstrcture
_ Sel onidet onhe use of pe-sintered blks ensres epodcble qliyResortions re mied on scle o 1 Io shrnge occurs durng itrion.
_Drawbacks: Suboptml nltion leds to reduced mterl streng
g3 h brw thnu pwd l on o pt m wi pi n le wh b h he cre whte eoe nlon he nd pic ms uy sp rnfrin uy h imroely nleie light brown nd ott i th il w th tly nfr i bow wit e o ee o o r
17
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e 2 Pocessing e
1
22 Mach ing
Maing em e inra mafare eam bla wih
mprove mehanial properie o proue eram reoao oferior ali. he maaring roe ma e mehanalop-miling) or aomae A/AM)
221 Cpy Mllg
n o-milig ela em a rei ompoie replia of he
reorao i fabriae on a maer a A annig ool rae ereplia wh erve a e ea mpae or peion op-milingof e reoraio om a erami blank In-eam blank are mo ommonl ue fo op-milling of l eram reoraion oa
�Sp eialons
der tios
op-milling iole manal fariaon a mehaialaning of a replia of e reoaion
�Drawba he rage o iaion i imieA eaivel age amou of ime i reure for manua proion an meania aning o he reliaA/AM ehiue are reaingl relang o-milg.
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222 Cpte Aded Mang
Cot-i cing CA s sil to cop-ilig th pli f th stotion bc th nt tchnci.
h c is tt i co-i chnig t lic isaed b ia ai el ae wieli ae igti h igti daa th s o pcisio cing f e ea f a iduiall maufaued la
P-sit icoi blnks g Cco ost cool ed f eaided hnng f eai deal esoatoto. As th sjct o potl 22% skg g sei, e t s s ili st b jst peae
sntig shig. pcil sow pckgs ilb o ths2 os
Speial o nsiderat iosRng f inicatio o th pocnl biction pocssOpticl a f a elia f h soio.Th A t st st b jst o copns o sinti iae (iae cto.
rwbaks:A ltv lg ont o ti is o bicio oe eaCACAM tchis icsig pcig coptaided mai.
2 chg
1 9
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e 2 oce e
22 Cmper Aied Desg/CmperAdd Maftrg
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from denely siered pre-siered) ceamic block of viraly allype, b a nmber of oer maerials ianim, syheic maeials)ca also be pocessed. f inered (green) zircoa blocks are ede bocks a is be mled ad sbseqely sinered o ll dsiy he inerg ace ha come w he ysem.
ee basic seps are ivolved in he manacng process wihall CAD/CAM sysem: Daa acqion (opical and mecancal)CAD, and CA of he esorao
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Speil onsde tiosPreinere era b me in a wide rae f materia/AM ytem tat ue preintered "ree r witetae ziia bl are a ew deelpet
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e 3 eeer
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3. tystp: inal Por fo ariaon o Vns
g 14 Aa dtio ll gros rparaion. Bua and intrdtal dtion iom to yild th dd ooth hapBo th hou a t apromal mains shoud at as .5 mm i wid Ia
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g 15 A lat 1 to 5 m o inisal aa rqir. An aproimaty 0 mmdp alaal iih ln mad i aond damo in od to optialyoal h inisal dg
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e 3 eer
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34 Steytep: incal Pocedre fo e abricaon o eee
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ae ry-n
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3 Vers
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34 ysp: incl Pcr f bricon Vns
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IV
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4 Clnil ul
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4 Clic Suvl
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4 ow
44 Cncal ad LaboraoyProcedues
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Goo omuiatio betwee t patiet di ad detal eii i cil o t ltio o optml ortv tril poede fo te dei ad te detal laboato ae dribd tepb-tep t lil tud prtd beow
Fgs i oug won hd n di with th pprn of hr tior h for vrl r. nv ni , t titig o n orowr idl " too ho) n th ifr oo of hr ol opoi ilingotd h T t rown t o-vtl b tooth 12 b ioorov ou o th n w vd nightl. T pol wrrd viibl d o t ptt hg i li. dion o tooth doorionpo th w o o g dolortio o th rginl gingv t too 2.h int wihd to hv mtl-f nt torion.oogph dig li t rt, lgtl rtd d i ull ml r r or trtmnt lnig n ontion uo
44
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Fg 3a 3d h rimin igiw gn ding intil nlttnpt iling mr im gh d h crrcn
drti h tin nd dnti n n lly l nddiu h bli d mtin thtin xn. lgit irin f h mutd in i ubly d in dr cnc dd g th dtl tcnicin th ic c, th dti dditilyxlid tt th gry diln f gngi dby dicln th rt, i immnt c xcd n f
n llcic tn i d
4.4 Cliic nd Lbrtry Pcdr
45
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4 cic Snge n
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icldig ccrt rprdctin t nturl t clr spnd ntmic psitn f t t nd ir drct itrctis tdtcl cmpl ls ply mjr r dntl tcicn msrccil t sttic xpctins f t ptit d dtist wit tcicl limtins f mtrils nd t pint's cil cstrts flwig rcrds ndd f digstc pnig scripti f t sttic xpcttis t ptit
ticultd sud mdl 4) Prtrmnt ptgrps (:
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4.4 Clica and Laboratory Pocedres
Stp-by-stp rocdu
Uing the tudy mode ubmted by he liia te denal tehniianDT makes an addtive wax-up with oeio for tooth poition or
aguatio wo ioe idee ae made om the waup; one se as a referee or toot peaation and the other for fariationo he indiet ovioal (ayli ein ell)
Fo patiet with ih estheti demads it i adviable to do amoup o one or two dieent retoation pooal o the aiento "t o te propoed restoatio or he tea paie enist anenal teiian) to ealuate an diu
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g M-u the ln retrato
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4 n
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4
5 t5c A o-u o oov liv i m o h hin n y o nw ook in oh o w dy h nrddignoi i dvi llywn jor g hv n propod hp o iv pr diniion ofh rooon gol o h r ormn
Trmn lnnig: ooh 2: rown h 11/2 : v
Fi 6 n p diion o h rn ol hd o, iodol/oiv n w pordn h ol orio w rmovdnodon
rn w in o un 1; h px w nor, vrlydiolod rdh. B on h linilion !iul dn, ilp, inrnling w no o hn di no wh o hv h whningrodr A whi opqug omoiw ho o m h o h doo m oo.
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4.4 Clica and Labary Pcedre
Lb
Dnotc wx d hell roviiol
It advale t lae a ual eld n te u ere t e ovol. Ti llo ore e or eer itrorl oitng te relned rovoa Sle nee o te dagtxu e lo de reeree or oo reto
Fig 7a Wa d
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4 cic ows
D
Too aaon an oonaDinstic s el tients e ther isin wi r
tt rng th igntic lnnng tge, n hg nthe e tth she r siti cn stl e e f eterinenr y he t in, ni n tehni
lether r ilicne iresin te efiitivel erebtet th i ten lter nent
Fs 7 7f A slco o osc w- s ror o oth rrn. Th scn ows r slctv cn of cc r th rstortn wtha osat to stuc
s Sa nd 8 h bcal a ncsa ascs f h arans a assss s sl x h tth uny ns n lac th a
rsto. All s n nns ust crlly n.
Fs9a nd 9b h nstc o- nst wax-u s nw rn st as t ovsol soon
5
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4.4 Clica and Labrary Pcedre
ab
ratmnt w-The retment wx- ee ube ftin. Whe n e
ree merl i ue te n be me r tth he cnt gu O). ice the ilicne iex frm the wxuhw etly hw mh e i vilble r te retrt, therere nlent urie in e ei erin e. hentrrll ee tretmet w-u inee e eletin reortve eil.
Fg lOa Te h u eered y he eeal a e ee, an he cal hape f he eeh y he aal rde
b
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4 cic Snge n
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Fs and 1 Ty- the tretmen w-p, wc ws prere by e ent tehic n he mse st cdi t te preiminry sti w
b
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F 1 1 a hde yses shud e permed t n pm h empee5500°K, especly when teiesti s be de. he te mninr le e s n ie tie f y shde yss R liht lity testcrds re ls helpl
5
F 1 b Detemnn f e stmp shdes ls require r brictn lcermc resttis.
1 t s vey elpf te the sde nlysiswth e p [me fumn zcni e. npe n t stn the pin intrrly s neede
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4.4 Clica an Labrry Pcr
Shae eeo ai
a
.
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t
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F 1 1 f Ognl a l by o ra manuaur.
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53
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4 cic Snge n
54
Disposable gloves Colo ings etc Colo makes Colo cas Ceek eacos Mt mo Camea
Seecon o ceamc materia
Factos at eteine te choice o ceamic mateias se o theestoation ae: egio stmp sae space equements a bie sit
ato Region: ateioAll-ceamic estoatos (with o without ceamic coes aepefeable te ateio egion becase of te ligt tasmissionpopees o ceamic mateials. Stump sae:
te abutme toot is seveely iscoloe A4 >B4 eamout of colo vaiato possible wit all-ceamic estoatios isgeaty limite.
Space eqiemets a coeeioce alumia zicoia all-eamic estoation so be place a mnimum coe hckness o 04 mm sol beobsee. thewise tee is a igh sk of cemc facte. Bie siuatio
Conveional pocela-seometal cowns sol be se paies with eteme bite poblems
Bct ae ty-in and coleton of e etoratonGoig om the biscut bae t-n to the compee estoatio by aiagnostic waxp an a eatment wax-p as pove to be a sccessl cocept patients with hg esthetic ems.
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c
Den ake -n
4.4 Clica and Laborory Pocedre
Figs 1 1f Te loe de fom ewa- i a eul oo or he ayeide ade deero crcal fo alceramc reoraio ecae me eie o pedc he nl reu.
Fig 1 c be ryi o eeer adrcona cow a e ea ofce.
55
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4 cic Snge n
Cmpd ra
F d 1 oeted retortio iroi row o ooth 2, veeer 360deeeo ooh , veeer or ooh 2 odie prepooio
Fg 1 The oiog key e. terRei, G, UA bried y the ealecncan ae poble o e orcorec eheic poio o he eoraondu eenaio. Howee it abouel eetil o e o expore oe ri oiohe bodi roedre or dee e
o cerac aera ecrbe sepyep i Chper
gs 1 d 1b ro l ew an e ae placee o e reoraohe ue o ceac aeial wi deren opical a ecaca propere copeaed o p de etio d irregularie i oo edio.
56
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Refeeces
Beek KW. ollamshe Kostaonn as HCrm 5aeSte. ts Zatl Z 992476166.
2. Bn! A a WH Survva rate o monoerm an eam-oeCAD/CAeeae aero ws over 25 yers. Er al S 20041 12(2 97204.
. B! A a WH A up to 5-year al evalao o posero nCerm CA/CA ore rowns 1 J osoon 2002;15(545156
Cheu S Apelmy veson to e loevy a uses o le of sne n exoon esortos J Det 991 9) 160 6
5 EeofD HorstemperT Rte EJ, Spekea H Ylm Asvn onvton eestt Emprs Kone ts Zatl Z2000553260
6. Epstn H, Borh R, Kersha otm l rslts o l
vaoeam a sseam vu ows ose Det2000;(550534.
7 Esaf D Dav A Dv S Caama J. A ew ppoa o esortve etsry arat erm restoaos usn CEREC CA/CA. CompeCo Eu Det 1999;20(6):5550
. ae Reeman A yer a evao o eutereoe ss-erm rowns A retospetve sty. nessene lnt2002;(50510
9 Fae Aqo A Coo Clnl eeee wl Ceam rowns 5yr foowp l J eoonts Rsoatve D200222(6525533.
0 Hakson JA, Cptta E. v yes al e wth uteeor oe rown system. t eroons Resatve Det1994; 1(2 153.
. Hs A. Zum Sn e klnse Bewu ltatoseamsheereoe. Ds Zaz Z 1995;50:674676.
2. Kesey W r, Cave! T Bkenau R Brmeer WW Wwern a A. -year al suy o astae erm owns Am J Det1995;(5)259262
Kersbam aszy CKp S eyer ewelzet n Rskoatoealyse von feszenem Zesa. ts Zatl Z 991 46202
ren A, Whte S Suva oCm Crowns n rvt a A
osptv lnl l. Post De 2000326222 5. r , Rhtr EJ Ke H Spe H. Klse Bn Ko
n as Doraskamk. ts Zartl Z 9924761064.6. u EB. aors uen suess o porela jake resoatos. J Prs
theDe 9 6 1 1 :7374.7. A Aesso ysek-nraek 1 ausson ve-yea ln
evauon oPoeA!Ceram ows. J Prosthe De 99;0(4)450456. mn P Anersson B oer Al-Ceam rowns ollowe for 5 to 05
yea Aospetve lnl suy osoont 200 ;504509
Refeences
57
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4 cic Snge n
58
19. Pjetsson BE Saer Zwhe ele F A sseatc revew ohe srvval a colcato aes o acerc a el-ceac esorions ae an osevaon eo of at least 3 ers Par Sle crowns lnOra p Res 20078Spl.3)73
20. Prster L Knsce Laetehre volleraschen Koe as
n-ea. Qessez 199;8 1639646 Scott R, aao S Dla A clncal evalao of -e crows
J rosoo 1995;8(4)32033 Sea S eoseive assesse o 56 allei aero and ostior
crows n a nal aic J rost Dn 2001 85654455023 S G, Lanto R, llbr lca evauaion o allceaic owns
Dco eral racc Poshet Dent 9998 3277282. Se G Lantto R Ganbeg A, Snds BO Ter A. ca exa
nao of lecte-renfoced lss-cec crows (Eress) n eneal pacce A erospecve sd Poshodot 19992(2)22128.
2. Sorese A ho Fasc o WT. S Epess crown sse
ree-ear clnca ta esls. Cafet sso 1998;26(2 3 0136.26 Sde S, Lehne C Bobec U Screr P. S-e rests of lecteren
orce asscerac cowns c ecae Dei eveica998328
27. Weaver JD Joso G Bales DJ. ana adaaion of casae ceaiccrows J Prosht t 199 66:74775
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5 Nvl bum Th
60
A mb of aitioal fato m oi wh plaig tpoti aiitatio of o-vita tth. Apat fom ooiptamt a biomaial fato iatig matal ltoa tooth ppaato ti fato a alo ial to tatmt
u a of ufu oato o ootialy tat
tth potly ag fom 70 to 95p, pig o ow thitia o a f• Lakag o batia ito h oba oo aal la to otamato of th oo aal lum Batial miolaag a qt piapial -iftio a wl aoay ai a ubqut lo of ttio of t toatoa mao a o oot fai
iolakag o i p o vaio fato iluig: typ of oot aal llig matial/mt th a
quay ofllig typ a quality of th poviioa toato typ a quality of th tiv toato
o m to a ha ab o ahiv otally ompl algbt ft typ of m aiv gialy it vl o
ag qualiy Zi popat mt fo amp, pov to b giaty o to gla oom mt a ompoi mt pt ui' al 8
51 Biechancs f Nvta eeth
mo tootl tuu lot toug ay o mov to at aa fo ooti tatmt o to ppa th tth o toatioh gat th tt o fomato of t maig toot utuuig tioal atvity. ot plamt qui th aitioalmoval o i, th fh waig t ooth u o a poto o tgt h ooth pio to pothti toato b atit mly v to a h ttio o th ow a o a toamit t fo pla o thm o t maiig tooth tu.
Fom a bomhaial pot of viw th toot po a o ompi
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an inmgenes ystem Biing ce ae aneed m themechanically stnge cmpnents te system t the eake systemcmpnent nde ecesie tan, the ekes pat te ytem ite s ace and that is sally te dentin.
51 .1 Ro of rul Eft
All stdie inestigatng the le te amnt tt scteenelped by a crn e1le eec n all-ceramc estans haes a csed slely n c lted th zinc hpate cements95•Wth these lting agent thee i n chemical adhein beeen the
cement and the th pt he esistance cn lted ih zinchsphate cement cclsal ces as nd be gncantly hghe in etatins it a 2mm ele6• Stdie ealaing the le erle deign n adhesi cementatin ar n aaiabe Diagram!).
entin
Core
2 oss
; "'' " "'" "V
C
�···-· .. . .
I u
e
hee is cently n denitie ane t the citical qein hthe nt the placement a p is still necsary adeqatece eentin in lig e adanced adhese technlgies aailable tday. n tdes n hi bject ae cac and mst aeplaged by the pbem p cmpaability. Cnseenly theeae nly geneal gidelines aid e dentit in making e decisin ehe nt t place a pst in an enddntically ·eated th.
hee ae descbed be
52 Poss
Dagm 1
6
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5 Nnvit bumt th
62
Inito For rttio o or i oowi iunt tooh uur
oritio Aililty o qt toot trt to rt or Vry rrow or ortou too root So root qu l o roo l fllig ripil ptoogi
ruit or pot n or plt u roo l pprtio tqu
Coplt ling o t roo l yt uig o-llilig tril No or inil pour o t ro l lig to t orl ity
opitio Lo o rio o t rtotion Cri Toot rtur
21 Pst Gemery
T u o ti pot (rw pot i o ro butir tr gn l to inr itnion tr t oul to root rt• Pi pot yt work by pi rin to witrw (tg-k wit no ti rtion oor
Cylinril pot i goo rtto by n o io but
ty r too wi to i t pl rgo, wr t root uulybo or row (Dagam2) Conl pot on t otr or uitb gotry but poor rtnto y lo tn towg wn o i ppli Dagra 3 Cyliro-o potwr tror, lop to obn tg o t twoor ybri pot r oil in pil rgio n yril i orol rgo.
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Dogrms nd
522 Pst Mateals
Various ypes o maeas ae use o anufacre ena poss cung meas, ceramics ber-enforce aerias. For bioogic reasons, e oy meas suiabe for use as ena poss ae go a aiu he no-precious eas are subec o coosion. The mechnicapefomace of ea poss s goo, even wen heir iaeer is sma
Zrcoia hr 2 is he oy ceraic pos maeria
avaiabe Fg 1) Zirconia poss ave high eura srengh b, iea ceraics hey are very brie. To acheve sucie acue resisance he iaeer of ceraic poss us be sighy arger han ha ofmea poss. Mea an ceamic poss can be use or eher irec onrec resoaos
he ien ypes of fiber poss F 2 iffer i a number oways Gass or carbon ibers are ebee in a resin coposie orepoxy resi marx. he number an aee of renforcig fibers
aries o one manuacurer o anoher The ecaica properieso he ieren ypes o be poss vay accoringy. he mouus oeasicy o he various syses ages wiey fro oughy 0 o30 Pa. ie a synhec maeras, ber poss are suscepibe ohuiiy a faigue Therefore, he echanica aa pove by hemaufacurers appy ony o bran-new ber poss ber poss aresuiabe for rec resoaos ony.
52 Poss
63
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5 Nv bum h
64
Fig 1 t f zci t
3 Eshecs
acre srace a
o-vita teeh may beome isooe e o the esene of metai substanes in oo in mateias boo eaatio ots o
eae u oteins Mea osts ae aso sai to have a eatveet o tooth oo a ths o the aeaae of osthootiestoatios Esthets may theeoe, be aeabe fo esthetayemai estoatos
53.1 la of Non-vtal th
he os an os of beahi non-via teeth must be aey osiee befoe stati suh a eamet ne istit avanta ofon-ita eahi is tha if suessfu, t may o one e neessay to a a own o th o-vita tooth i o o obtai thesie estheti esu. I ostheti ehabiaion is sti equie,eah wi make th abutment moe osey math the oiiaooth shae ths eatin moe otima oitions o the faiatioof an a-eami own by a enta tehiian St it is imoa toea in min that beahn oes not ihte isooe ooth oots
whih oe show thouh the iniva
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he ma isavanage fnn-vita beaching is the risk f resrin athe r sace. Hygen erxie te mst cmmny use beacing agen eneaes entin an can cause extea rt resrti byvie f its aciic H• t is herefre crcial t ense that the rt
ig is reuce y 1 t2 mm bew te cementename ncins the rt llig ane cannt cmetely revent the iffusin feaching maerias gass inmer cement is neee fr aitinasealng he incience f cervical rt resrti was shw ticrease when 0% yrgen erxie is use r wen therm-cataytic bleaching s erfrme. herefe it is generay recmmene that intea eaching be efrme usg sim erbrate mxewith water frmi t merate staing r with 3% yrge erx
ie f severey isclre teeth It is nt aways ssbe t eiminateth iscatin he success f bleacing varies eeig n hecause fisclratin nike b an rtein egraatin ructsmalic rcts ae very esistan blachig
As, te cr sability f te beaching est is nt always assure.isclratin rease resumaby ccrs e t eakag thrgh therestratin margs• The mre extesive te restrati f te aectetth, the greaer the chances hat cr igments r actera w beabe t enetae the margins an cause a ease f sclain.
Aer beachng the nng stregth f resrative materias te th is temraily rece ue t he resence fresiua erxie r xygen tima ahesi s achieve wees aer beachig. Tis ime ase can e se t ceck fr cl stabiliy a tay cacium hyrxe i rer uer the acic H at the rsace t revent resrtin.
53 tec
65
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Chapte 5 Nv bte Tet
Fg i otit ooio hd A3l.
66
52 Efets f Psts t Clr
o-toot-colo po a ai to ak h toot a t magialgiga look gay a to pai ttc. T colo tabty o fou
po matia taium, cabo b, gla b a icoia, aoaqu cooit ct aia aay Dal S acompot co tc C Sa A a a oCAD camc cowCER wa cy itigat by ou goup Slr l,
ar)W i ot or ay ifc btw aiou typ o
pot matial wt ga to colo cag i t root gio ow,th ic btw t it pot tial w igiicat
3 and 4 typ of po atial uc th coo of cow (Fg d 6 W ou hat cow colo i igicatly ak o titau a cabo b pot co by a caic lay ti ha 5 wa i o igca ic w caic lay i tic ha m. aly apl o t crowagi, w th lay thick i o l ta m
ig on ot oosieoe shde l
g in osnd o h ER on(d A3.
g6 Zoni otnd o th onhd A31.
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54 lnl Poere
5 Cncal Pcede
raation Cair
Rubb amDnin boning agntanava C mntSt of rior omoitolmration lam.
Toothoa a y toothra a traigh a o root analrar th ot ana uing ril of aroriat z lavingat la mm of guta ra lngRin t ana wih oim hyohlorit oltion (aoion an y wit ar oint 7In t o into th rar ana to th rfrn lngthto hk fo t
hk raioga ifnar
7 A pp po is ud to dy o.
8 Te pos is insee to te eeeneleng o e o ft.
67
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Chapte 5 Nv bue h
Po Tiiu po nb wih 0 �A Zrconi po coniio wih ler Porceli Acivor Clel SE BN ry rier :
ein Boin I eel eh i eqire, ppy 37% phophoic ci or
0eco hen ow o ry cely pper poin he cl. Mix D Prier A n B Ar Bon o o . Apply lo
in he cal wh bruh leve o or 60 eco Sueqenlyow o ry. Reove exce prie o he cl ui
orben ppe poin Fi
ee Pvi
Mix cee ( o xin pMx wh pl or 30eco o o hooeeouperp he po wh imon orcep n we he lower 3 o o he po wih ceen g1 0Ine he po io he cnl Fg 1)Reove exce ceeApply Clerl SE B o he ene ein enelce llow o ake eec low o n low o hrenor 60 ecoBuil p he coe wih hyri copoie eril (i .
g 9 Apion o prier. g 10 Weng the pos wi cee
68
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Reeences
1 1 Vew o e insered st berecre uildp.
1 iew the ie mte re.
Refeence
. Bcha W Dre P er eschler E Pshley DH.
cee eclly ee ee rese ss. J E9920-08.
2 CU V Res A G Ars G he eec ese ell eac ee sh res cpse Ope D00I 66)59760
3. ra I a bla s a mlas Am DAss 1997;8 a ssu)5155.
. ra Rse I bl H bhlz A H I. c ear resp a ese ess 58 bleae pulless ee. De ral 988 1-6
5. ss Z zas ae ur peey c hyre
lech es J E 1989; 15(86-6.6 Gel Gl uerm E. fec mlee eeer rs
e cmesse s f ey ree pserr ee J rsheDe 19656
7 Glcer K Ebelseer K Gezllers Blee e ebe zhe Qssz 99;5957
8. Hll D, krb J E ara blea cl r res E 199; 18 158
9. Is Br K 999 Iec a eh esrus eface c er pss l rsh 9969 136
10. lse Y H s as D. Ees f ee ree
a efbae sre ps rshe De 1987;577-17
69
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Cape 5 N-v/ be ee
70
1 Rotti I Zyd D, Lewti I Brge . Et o dieret proeve se teris o drog oide ege durig irool ehig i iro Edodo 2 1 : 17.
2. Rotstei I Fredma S Mo elso J Soe M Ba I Hisologiaeto o leagded ete oo resoto dogs. Jdodo 1 17):36.
. Soaa MS odiges JA Pieta LA to o eage o omposie restoaio ae oa leag Qitessee l 20012-1
See JA gea MJ errle desg ad aue restae oedodoally teaed ee Prostet De 10656
. Stadee to M oloom P. The des rew omprte steslyi wi oe dodo dowel desg. J Orl Rei 1.
6. de T, Pl A Behig o too diolotio edyedodo eles. J dodot 6 12212.
7. Weige R Axma- D s Progoss o oeo oot aetme reosdered Edod e auol 1 ( I: 1-.
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Capte 6 Exte Be
72
6 nrodcon
Beh ene e eolorizto whiei of meri.
Blehi ent e i entl ppion eove tooh iooto by oxizi hromoei moleule. Vtl tooth blehi iitiie om on-vil blehin n i perfoe on the exte tooh e.
6.12 lag Agts
Hyroe peoxie HBk own ito oxye pryroxyl ril u . Crbmie peroxie N-C-N
Ret wit wter to fo re (6.6 p hyroe peroxe(3 .4 p.
613 Mas f At
Free u il ue thoh the or ube of thenterprimi emel throuh the ei. eryroxyl i( bre ow he le k hromoeni molele reponblefo tooth ootion o mler nturte oubleboe moleule re hter in oo er fher oion the moee reoverte into npiente yrophil urte rbon ompon.
6.14 Idats fr Extral lag Dioorto of he enmel e-relte tooth iootion Mil to oerte etyline tin.
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62 ow lecn
65 Cntaats
Stain that an b mov by man of ossional toot laning Aaga stains
Waing Sia aution i avis in atint with laky llingshynstiv tt lag ul avt ano os ntn
62 owe ecng
ow laing i an in-o o fo sing higlyonntat baing agnt Lgt-avat atalyts a otims to otntat th baing aton. ow blang anly o to win a ingl isoo toot o on iaa of a toot. Gnaly mltil sssions a qui. owblaing out ontain abam an yogn oxi at onntaions o to %• T ay of ng ligt-aivation ootntaion o ow blahing ha n vaaby si aliaion of ig-intnsity gt alo abo t is of ovhaing
t l
621 Pwe Bleahng Prere
Clan t t wt an abaiv olihing ast n a ub .(Th uo o asng h tt wt alohol o thng tnam wih hosoi ai fo tis uo i now obolt.
Dtn a omnt t unt sha of t th (otog t h togh wth t ha gi. olat tt wit a ubb Aly th blaing agnt fo aoxa ly 5 mints an wi
o with a oton swab soak in 3 % hyogn oxi; at foa tota o to 6 tim Ligt aiva h blaing agnt aoingo h anufats insttons Wang ak autions oavoi ovating!
73
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Chapter Extel Bleacing
7
Subqly appy ll l gl h h lui u i an f h na a ni,wih i igniany iiih by h bahig pu h iga barn8. Dpning h l f whiig, h pru ay
pa a ab h if ary. a pa phgapi r Rraiv an l b pr ui a a
h a h whnig Thi allw f a bna h liiain xyg ainig in h al rur af blahing, h prving bn rgh f ahiv h bah al an ni•
63 Combned leac hing
i blahing a h i wh iiial i- aiiblahig i fllw by ubqn a- bahng Ti pur an b ra vrly il h ailiz h
l f i baing Hwv i hav ay avaag vr a- bahng xp f h iial alrain whni
6.4 At-h ome leaching
hi an aly i al r a nighguar blaing uhga lahing. a- blahig, h pai appli ail blahg ag h ing a ay. I h liar,0% aa prxi ha n ib a a iv a afbaig agn. I igia wiing wr illabl w ya af lahig' u ray faiaf nighguar blahig hu av g rvi Si avhw ha 5% f h blahig gl ai i h vi 2 ha applia, a ha 4% i ill pr 6 hu ar applia
n
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.4 Ahe each
641 A-hom lag Prodr
ooy poee (Figs I 3 e tuy (o he ie impeio poie y
te entit le tin ppoximtely 0. m lye o loo teil
o he li tooh ufe to ee e eevoi o not blokot the iil ee oll fe now oe lote ivl min e .5ti oft ty tel to vmfo exile
fo-le ty ee o t ty oul ollow he li iv ontou
ovelppin e o i mi lihly o peve lekeo te el
F Sud with -ut i fgl vis la th uf
The ra llw he val
F Te cu a id d heede roued.
75
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Capte 6 Exte Be
76
haii p Fg 4 9) Clan h h wih a abaiv plhi pa in a bb p Din an m h a paph h
h wih h a i Aap ay f pimal vi pa wi iin n w h ay a l
bahin ym nui f :
Fi b an h h wih hpa an na Dip ab f whinin l in vi f aySa ay v h ly p h ay aain h h
Rmv wih a hbh a wabRain fm ain an inki wi ay i i pla mvin h ay, lan wiha bh a waSbqy in h wih a ll linlan ay wi a b an waAv mk a f a will ai h niain f am pa l b nf ab pnal i vb iv a inva iain.
T pai l b awa w alva ympm .. by apply nizin .
Th pain hl b i wih n whini f nwk f amn. Fi wk whn l i iniially appli 2
f i . If n i f l i applivih f 8 h Fqnly plain blahi aina k f i •
Th pain hl f a fllw-p vii a wk. h a n pbm vi blahn an b in Th ain am i nally 2wk f mil m
a aini' an p 6 mnh f aylin ain Th blain l l b a an mn. Raiv amn l n b pfm i a a l
mh a h whni. Thi allw m f ha bna h limiain y main in h al a blain h mpvin bn f a
iv h bah aml an ni·
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g Tooh ceann
g 6 abs el ae dsesed o he.eseos
g 8 Vew of he se a.
64 Ahoe leac
g 5 reeae phoahc recrdwh reeence shade
g 7 xcess el s subsequenly remed.
g 9 oseae ooaphc recodwh eerece sade.
77
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Capte 6 Exe Be
78
65 "Ovetheconte TeehWheng
ver-the-onter (T teet witein systes are freely availableon te aret. The aufaturers roise their ustoers witeeeth
1 OTC Bleaching Kits
beahn ts eerally onsist of an aii oral ris aeti
ai or itri ai, a reabriae tay tat a only be aate to alie eree 3 to 6 % hyroen eroxie bleahi el a aabasive toothaste Beause of the oor t of the ay, he bleahel eas, is swaow a is qily inativate by saliva ln aiio the roeure is very abrasive. Te se of sh is aot beeoee
Wite in g Strips
Wteni sris ae trasarent selfahesive stris of astablelasti tat ave bee oate on oe se with bleain aen Theyare enerally wo for 30iutes a ay twie aily for a erio of2 wees Te ost oonly use bleai aent is 6 % hyoeneroxe. Whtei stris roue eonstrable teeh whiteiees, an te sie eets en to i an reversible The osteeiveess raio of witein stris is atraive to osers.
.3 t Whiig oothpasts
Toothastes o ot have a bleain eet beause yroe eroie an arbaie eoe are ioatible wt te oter ireients i these outs. At bes they wor toh oabrasion oroealin eets
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654 Whteng Chewg Gus
T acti igrint i witing cwng gm a icl iltby lia. Ftmo, witni agt a aiy inatat
by alia roia
Reeence
A See , Mais BA Coran MA, eons R, topes MA. Ciial ealuaon f wo in-oe beag prots Ope Dent 20028(5:488495
2. Caall V es AF Gain M Abrosano GM e ee o eapse eollowg beang on enae bon sengt f resn oposite Oper Dent200I ;266:597602
Da Costa lo C Da Cosa CC oia M aga et of oe beaigan song on argnal gngia epiel ifeat: A soog styi woen Oa Paol Me 00 8:4480
4 Del ei , Bar w DN Paatanaso A Ciil ealaion of a obineinoe an aeoe beang syse. JA Dent Asso 004 3556
635. Fugao JO Nora Fug, O, Mas A Mr IA. Plp eaion o ilbeag. Oer De 2004294363-68.
6 Gerla W, ibb R age! PA Iial olo ange a eento wta yrogen eoie beag srip. A J Dent 2002 5( I :7.
7. Leona H Haywoo VB llps C is atos fo eeopng ootsenstiy a gigial irtaion assoate wi igguad a beangQuntessene lt 992885254
Lewnsein l ue N Cua N Caras H et of feren peroebeag egiens an sbsequent loaon on e aness o anena an eni. J Poste De 00494334.
9 Lu K a L ber M. e o lg eegy on xid oot beaig . A DenAsso 200435940;Quiz 2.0 Mats A, Coan MA, e G, Carson e eay an safet o a
0% aaie peroe leang gel Quinessee I 998;299555-563.I I Mas A, aiao U Blaan Su FA, e GJ. l o eaato
obeang ge se n weng eet J A DeAsso 999;02:227235.
2 Mats A Wag Jiang er GJ tene a-e eaig f eraylnesine teet w een oentatos o arbae eoieQuntessene It 00;9:645655
Refeences
79
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Chaper xte Beacing
80
1 Paathaaso asal S Pe R gel G Cia evauaio ofyo eroe -oe wtei sysem Coed C et002;24):4z 48
4 Rosesi SF, ost W Romz ial ral o ey y o h bh . Qt lt
9927:14.1. pyd M edgo Pai C, rjo M pyrdes M. Ee o
wteig gs o dt bod. Eet e 202:221. Sw May N Wlder D r, Heya HO Baye C Twyea
a evauo of oot wteig usg a-oe eag syste. Eset e 19991):342.
17 Taares M Slt Newa Si V et Capio E Goodso Mgt ages oo wtei wi erode D sso0014:1-
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Chapte 7 ea e Pa ee
82
71 Genea Cean
Th i fo th vlont of llcrc b riy
rivn by th fc th th thic rlt of ll-cric rtorton tht of tlcrc rtorion Cric rl ov vnt of ttr biocoiility low thrl conctviy. Rn th hyicl ori of vilbl cicri C 1 l-itr cric ih-trnthcric r th oy itb cit fo t icio of llcric b. Ytiu-tbi ico i iclry intrtin trl tht incily i u th rwork for bo
otrior trior -cric bri.
72 Incatnwi o th low cc trn of crc til x tl t wth cic fwork cn oly b c in ronwh no xciv occlu oc cn b xc Th fibiliy ollcric ix ti ntur rtortion i ri by th folowin fctor ( w char : Exc occlul foc tior otior toto
Sn hr-it or li-uni ot of c rquir for th totio (frwork ion Stu h
Th t tic l r obti wi l-iltr cricowi o thr uror oicl rot A th uror thtcl of l-it cric o thir tlcncy thrc of tr i c y th h of th lyi
butnt Thfor butnt blow -lt crc
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on
oul ely e ei-ooe Hg-eg ei e oeoque l-ei so ey e le o ove isoloe be bee, b ll o oleely Coequely e e of eee e oes o e e eei ee of i
eg e eoio s of gls-ei esoo
/
or (3 to 4 u Lo 5 o oe
I
No olufoe
ro
I
Exeve olfoe
Mete Meer
Dagm Deon proe or the hoie of ie pr dere ler ertr
83
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Chapter 7 A-eram Fied P/ Denues
84
3 h Pepaan
T toot rrio uilin or llcric bri r th
to or ll-cric crow see Chape Th rlll o tbtnt th trt in th rortio ut turly b ctT ont o vrticl clrnc i otr iortnt ctor Mcniclly t connctor r th ri wk oint of ny cc ixrtil tu Bic rrch ow tht h nitil crc ht ltitly to th filr of l-cic x il tu vribly trt t t connctor in th inivl rion Conncor wtrqrt wr clcut o h t (Daam !)
T rin intl o CA/CAM ll-cic tl ur i lily infior t tt of t-crc x rtiltur bt wl win t clincly cctb n•
·
•
r
Coer d.{·
................
Dgrm
I
Rd u
Dgrm
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4 ena aoar and enal Oce Pere
74 Dental Labay ad DentaOffice cede
Two procss r nly us or th bricton o zrconimwoks o prtl dnturs
W t irst rocs (.. Ccon Smrt Crmics Ddntnu Gmny), th dn tchnicin rs mtr modl toict ix ptil dntur rmwork ccorin to connton lot wx tchniu Th wx m i thn rmod om thmstr mod nd cnnd y th systms scnn. CM ni
thn tomticly mill th mwok om prsintd n"ziconi bock. Grn zirconi s poros nd sot tn nsly sintd zrconi. Consqnty, th millin im inicntly hortnd smll wr o th millin bs occurs Moror it s lso osibl o mk dumnt by hnd whn ziconi is st in thrn s frmwork is ubsqunly pcd in th sintnuc nd d 10C or 6 our T sintrin procss ldsto 20% shrnk nd dnsicton o th mtril In ordr o mtcth dimnions of oriinl wokin dis th mwork mill
rom th rn mtrl must b orsd ccordinly to compnt or h sintrn shrink
scond pocss DCS Alscw wtlnd ss thm wxp nd scnnn procdus bt mills t mwork romnly sint ircon lnk
T CDC sytms llow t ur to brict crmic xprtl dntr rmwork wtot in to pyclly modl wpttrn On CDCM systm Procr hs mcnicl cnn
tt cn th pr utmnt, t dcnt tth, t s co h connctor nd t opposin rch• scn t r hn tnsmittd to computr Th bortory tcnicin cn thn diillydsn th mwork on-scrn Whn ishd th ditizd dt rtrnsrrd lctoniclly to millin cnr Th milin cntr bricts h zirconi mwork nd snds it o t dnl lbort ohr procsin nd nrn.
85
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Chapte 7 ea e Pa ee
onia canot b ol onvntionally o y la iicona fawok cannot b paat an connct. iconafawok, tfo qi tiuo in plain T folowin n appy o al ytm an tcn o fabi
cation of iona famwo fo patal nt
Minimu amwo wal tikn 4mm Millin of famwo mt b pon wil coolin wit
wat (to pvnt t foation of micocack amwo i anblat wi 5 to ain oi
ptil at a pu of to 4 ba an a itanc of appoimaly 5
amwo i clan n ultaoun ba iin i pfo a C Din n t bi ou poiion on n wi to
pvnt al t N: ta conctivity o iconai ow.
Rin conncto in t minim onncto wit to pvnt patial ntu fa i 9mm fo tnit b an fo fonit bi8• Futo t connco ol
av a la ai of uvatu a t iniva mbau D-rm 2) uin o fabiaton of icona famwo aow t am a to fo mal amwok
ik tal patial n but zcona fawok a t n o tat bqunt in autnt an b maa n Fnal cntaion may b a out aivy o onvntionally htr T aopaciy of ionia amwok alo linicaly ul a i allow fo aioloia ontol o
u 1 throh
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4 nt nd nl Oc Pc
Four-t zrco fxed prtl etre(eeth 14---7)
Fg l t diph in n xi t wth psi A l- unit xd pildn tth 7xx4 w zn w lnd
g w ft xtn t . Fg th 7 d 4 w ppd t t t th fu-nit
Fg dnt wxup id th dtl tnin i d t thin tht n unti.
87
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e 7 e e ere
g 5 Te le dex ed hekhe wx de the lned rett nd ign
g 8 Sde een ere dig e iter nd ere ebed te te n lle rwn
88
g 6 Vew e deney nteed rnewr te he b tue hnt gn.
ig 7 e eted rtil ene rmewre z ew i kd d gn dng ty-n
g eu t ly lier wheeleig e ri rmewh e it eie t determne e thhe nd le.
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4 en r nd Denl ce Pcere
s la nd l ccus nd sl ews f he she xed prl enure.
1 h ie rc ramew hee se nex densey snere ne{ secn ewr ws mcued rdmnsrn pupss h s fr is cl vs irt i.
F 1 r- th fnshd rc de.In trms of shpe d cl, the restortionles we wh he sndin nlenn
F 3 phc c h xd pl nu n w lss mr . h zri rmw ppes s dque srcue
89
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Chapte 7 ea e Pa ee
90
75 Clincal Survval Rates
A emati eview o te terate wa eet perorme to aete inia viva ate o aeami xe patia ene ooweo a minimm peio o3 ear Atog te eut wee enouagng te aue ate o aeami xe pia entue wa gnia ge ta tat o oventioa mea-eami ixe paiaente. Speifa te annua aiue ate o a-eami bigewa 4% ompae wit a anua aiue ate o o 0% o meaeam bige o e eami amewok uie wee abi
ae ung eite ga-eami (Empe II o gaintateeam mateia Jn-eam umina, n-eam Zonia i i apatia eevant at to note a neite o tee two mateiabeong o te a o ig-tengt eami oneuent it i notpobe o ae te ane o e o a-eami xe paiaentue wit amewo mae o oia bae on tee ata
ee-ea oow-up tie o a-eami xe paia etuewi ioa amewok ave no et been pbie i te iteate. e ionia xe atia ente uie eibe in ak o
poer peete a mpoia it i a omiig ign o nia tabit at no amewok aue ave been epoe to ate. Te ataom o ii orm ti impeion Famewo ate avenot oe in an o o 3 patient wit a toa o4 ionia xeparta enue wo wee oowe o a peo o3 ear oweveone patient ate e ionia xe paia entue in an ewingaient b bitng o a toe i i oo 38 mot ae te epaa entue aement.
mm oe an onue tat xe artia etue wit ionia amewo ave met tabii expetation wit ega o witaig oa oe in e poteio egion uing maiatounion oweve te ou be ue wt etaint in patebeae o te ong-term ata ae avaabe.
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Regdg otent ues nd oos, oe a syexet te sme tye of eets tt o wt et-em estotons to o a-em ed tl denes wt on fmewoks
oogCesPeodottsDeone atooges
Teoot fte
ud- ateaewo fueVeeeng feLoss of eteto
stetDsooton
Gnga eesson
76 Conclusos
e fxed ta detues w zo fmewos ae anteestg nd osng ete o oento met-exed aa detues lg of te tese ese effots ts
ed, te deeoents nd moements a be eeted netse oemets d adete og-t foow-u dta beoebe, one oe tt -eam xed aa denues wt o fmwoks w ome u tat to mta-emxed deues n te osteo ego
Coc
9
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Cape 7 e e / ee
92
Refeences
1 Bsm CE Splma HP Rnr HP. Cmpurassisd gnrai f a
cramc cws ad id pata dnures In J Cmpu D 00I 4()43-6
Fh A, ggr B thy H, Scumacr M l 0, Scrr P ISOZmnvalati ud kiisch ntrsuchng v ZirdsauauActa Md nt Hv 10 0
3 azza M Qach L, Aay M, Swai M Ilunc sac ad atratm t ural rng YTZP dta caic. J nt 00(1)8.
. Klly JR, Tsk JA Srsn JA. Fl f all-crac d aa dursi vir ad in viv Aalyss and mdig J Dn s 15( 6): 153-1 58.
5. Ksmac , Oa C Jvnkar P Fudk Marn . c sacgrdng and sandastng n xural segt and alty fYZ ircia cramc Dt Mat 15(646-33
6 Ksmac T; Oa C Jvnk P udk Mar Sngth ad rlaiysac ad YTZP dna cracs Bd Mat Rs 0003()304313
LTra D. Margal nd ntr Passgnauigt cmpurgtzt gfig vllkraschr Bcngrs DitatUviy Zric 003
8. Lthy Fisr F, Ll , Scumacr M ackr LJ nrl .Srengt and ialty ffut all-cac psr idgs. D Ma
005 0):303. O W, N Asavic KJ. nuc f cctr dsig act
praiiy crac dparal dnturs. J t Rs 008):63610 c S Wicann M Nk E, Psc P Ciical t f a-camic
r-ni ixd paral dnturs, gnrad wth h drt CAD/CAMsystms u J Oral Sci 005 I 13( 1
1 1 Sal , Pjrsn E, Zwahln M, Hmm CHF A sysatc rvw urva and cmpicat as alcramc and mtacmic crct ar a vat rid a la 3 yar. at d dntaprst. Cln Oa Imp! 00 18Sppl.)86-6.
1. S CFJ M, Cgkuk S d , Stu . Magal adaa
i f r-ni xd paral dts csrctd prsd camic syss Br D J 00 6:660
13. Lag NP Purssn BE Ta K Bragg Egg M Zwa M. A systmaic vw f surva and cmpcatn as xd parial dtsDs aftr an sratn d at last 5 yas Ci Ora Ilans s00; 16):6363
14 Tisct J Na G Mautsc W Spka H Anusavc J Marga aumnaad zircnaasd d aia durs ducd y aAD/CAM sysm Opr Dt 001 6()36
1. Zzma N Mail , Ly H. Th Pcra Alcam acramic sym cical and cical aay apcts us a nw a
cramc sys. Scw Matsscr Zahmd I 08)80-8.
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93
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8 Bonding of ric Rtortons
94
8 Adhesve vessCovetoal Cemeao
Adheve bndn cruc he clncl ucce l-cercrer. In h cne ur r cr y rle Frcre renh Ree crlee rlucece
11 Fratre StregthAdheve bnd ncree he rcure renh ll-cercrer e i i udy he ctre renh ll-ceccrwn lued by dheve bndn w und be ju h h ecerc cw' F cerc wh lw erl rehhe renhen ec dheve dn reu n ncnrveen n-e clncl ernce
Ccl ude hve dered h the ul re dhe
ely bnded lcerc rern re cnly hher hnhe cvennlly ceeed rern·•9
Th uerr clnc ernce rbule n nly reduced re rcue ccurrence bu reduced re eenn l One cc rereue r clnc ucce rer cndn e cerc rer d he urce r bndn The ue cndnn ncree he bndn urce re n de ve echcl reenn nd ehnce he
quy cecl culn beween he ceened cnen Thebdn cedure r l-cerc nd de cerc de due drence n her cn ( har 7 ad7). Teneed dheve bd de cec dued due hehh er ren A clnc eerence wh hee cerc l revely hr ee cuenly re ude denrnwheher r cnvennl ceen nd dhee bndn reu crble uvvl re Mrever he chce ceenye r de cerc nuenced by her n cr
reenn he rern
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8 Adhi dig ru Coioa Cma
812 Reeio
CA o retoton ro dene inered or preinere eriblok reul i ower r o inern t tn n eri
reoion ite b ering or preing tenique iotdie ow te rgn nd ern g in CACA-geerted ll-eri row re lrger tn oe o poreli-ed-toel rown'. Ceri reorion ereoe ve lower reeion.Conequetl, onventionl eenttio o eri retortio equentl eult in o o etention were deve bondig i otee ti prole
813 Molekge
e degree orginl integrit i deterined b e ize o te rginl gp d te trengt o e bod etween te luting ge ndte retoton or toot epetivel Mirolekge t rown rginproote te penetton nd pge o bteri to e pp Tibteril invon e to lo o oot vilit urter potentiopito o gnl lekge re eondr ie, peiodo
probe, nd o o eeti due to rgin diolortio Intro tde ve own tt e ot o iro lekge i ignintl lower n retorion bonded wit opoie eet opred wit toe ued wit onventiol zin oxide popteeent In ptu, onventionl eenttio led to igerlo o rgil itegrit o CACAMgenered leriretortio t o eteri reorio
814 rnslceny
e otil nd oo rteriti o te luting teri e ten etei o rnlent eri ore tn te e te oqueeri Cpr 23) oneqentl te ue o oe opqeeent e.g., popte eent led o tronger inree in teopit o gl-ei opre wit o luin erInverel te ue o rluent opoie nree e tnluen
o ll-eri teril (inluing roi) An eplio or i
95
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8 Bonding of ric Rtortons
96
e tt e eet pves te gt trug e er er. Te se vet eet r tg -errestrts s terere trte r estet ress
8.2 Cassfcaton of AdhesveCeets
8..1 Compoitio
Te pst res pse eets s s te se stt pste g ters:
Mtr xte spe A g ete Bs-GMA -vssy tvs su s eee g etrte TEGMA res ute ete MA es er tr ste S Cug get: gt-ure se-g r -ure.
e sze rg ers eee te trx re respse r te e terss res psteeets. ue t te ress rete erees ter
essg te pse ppetes res pste eetser r tse res ste gs s s: Ctst reut ger rg te er sze reut er tess Reue er tet ve ty Opg tves: reue see.
st ses esve s equre t eve
eee es pste eets et Aesve esu esves pste ees e: 2-rxet ete HEMA 4-etxet et Pspte ers 10-erxe ge
pspte MP
es pste eets tg esve pste erss s e use t eet er ters tt e
ete re t et Aesve pspte ers rerequre t eve te eessr es ese e ters•
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8.2 aiao Adh Cm
822 Chacscs o sn ComposCm
Rei ooe ement are inoluble n ai. A own below
teir il rerit ow wie rge o rou-eiibi lt. uig time 2 to 7 minue Fil kne: <25 Flerl tregt 70 o l72M 2 Moulu o elatiit: 2 to . 1 P Wter olubilit 0 to 001 Pl reion: Moete
ly X Uc E, Sd Gmy)Dul-urng unierl rein emen Power
Gl ower ilaizeittorSili ilzeSubtitute riiieCium roxe
Pero omoPigen.
uMetrlte ooi i eterDietarlteAetteStabilzer
ittor.
Panav® Kraray
Sel-urig omoite rei -GM oorlte merlte ein grou
97
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8 Bonding of ric Rtortons
98
Vol k !Vvn Sc hnul-cing cste ceet Mti is-M uethne diethcle iethene glc
dethcye File Biu glss ebiu ide B-l sicte
gss seidl e des (en e sze: 0.7 .
8.23 Rqrt
The ide" esin csite ceet sld ee te llwing clinicl equieents
High tslcenc d ecc eies (g cessie segth n e-l stegt) igh bd stgth w slbili Sutble scsi e cet still itin w
bt) Ese hndling Rdicity.
8.3 Denn Conioing
8.31 P-trat of h t aftrpepaao
e tth etin e cut denti shld be tected : Mechncl ces niuti te te iessin-
ing etc) Ceics detl teils c ctei iclge el stesses cld het. ge ducts e lble the cnditiing eshl eed detn. These cn be dided it tw gs ccding t tei
de cti
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83 Di Codiioig
izig g
Obliete dentinl tbles b mens of ogltion neosis(e.g.,COH o eiition ofC+- O nd oteins
e litio of g dildede ime eg Glm o not fe te dentin bod sength of dhesies.
Slig g Coege of dentn nd obtetion of dentil bules is
eed ogh lition of ime nd onding gent ese te bonding stegt befoe desie emetion Single-omonen (one-ottle ssems do not iee deue
seling•
Te seleted od must be omible with he luing ementnomiblit leds o dese in bod sength (sme le
Otiml dentin deson n onl e hieed we e bondinggent s lied to es eed dentin' o his eson he dlbonding enue is still used tod'8 Consideg the hemil diffeees in emens it is imotn o se te oet bonding sstemto sel te oot fte etion. I, t tis time it is still une
whih emi mteil (nd tus wi te of ement wil be sed,the eed dentin soud ol be desensitized with gltdildehdeoinig rme lum s etionr mesue
8 entn Cononn
efoe ementton, e denin s onditioned with the oite tomonen(s odg o the mnuftes nsttions Gss-ems: Snt Css (ol
Oide emis (igh-stengt emis Clel SE ond(u ED Pime (Ku
ft t of mnt o b utilizd is kown t the tim of tooh eion, te oesondig bondig ssem be used to sel thedenti oding to e dul onding tnique
99
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8 Bonding of ic Rtortons
00
84 Ceac Codog
eml ods etwee esn omosite nd lssemis e
eved mens o oi moleles, o eme sine ileonds wit silites in te lss mt o he emi mteil (ioi sstne o the oe sde, nd olmeies wi the onmti o te omoste esi o he ote.
ode to e hemill tve the sile moleles mst ehdolzed to silno. Disitios e mde etween one d twoomoent sstems inle-omonet sles, wih e moe eqntl sed iil tie e led dolzd. he ei
tion dte mst e stt oseved s te eome itive wit timelse ote he id mst e le. Disd iod. e se o lss-inlted emis, etin one does ot
iv sit se oein eo thse mis mste sdlsted with 50 to 100 m Al 25 . Altho emionditioin does ot inse od stet, t does imove wettilt' Gss-inltte ems sold e emented with hoste moome-sed eme see Chapter
Ode ems ontn ew o no silies e ot e
snied i te sme mne s ss-ems New esi omositeements e.., vi 21 oin dhesve oshe moomeeMP tht on o oides hs m t ossle to ieveemi oin o oide ems wt o wtot te se o djive ondn ent oweve ton o ntveond et does imove te lotem stilit o od d istheeoe, eommende As w mets, te imove emlod mst e eve eite mens o sli oti Roe
sstem, Mnesot UA nd sseqe slitio o wihot siloi sn seil desive snes wi desive oshtemoomes.
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85 lncal Procere
85 Cncal Prceres
85.1 Ition n RomnMti
Cton BondQGceramc ch
95% ydrooric acdSizon
Sync
IMonoond S
Giniltrated Sandatin leril S od m , 2 ar or Peerm
de ceaic Sandatin leril S ond!al, zoi m , 2 ar or Pie
SizonIearl relain ctvatr
852 Stp-by-p Po
. Gsscermic
-y-t c aiv ati caicw (C® i i y wy xl.
Fig 1 e earaton vial tooh i ciclar wit 1 mm wiehoder ad onded ee enu mmm o o oot tctre. eaue the mp ade deal te toot e reored in ranuent eam dheve bondi reae the ratretreh eramc retoration or hi reaon, aeive ondhod erorme wih due dilence hin etrat cord INo.hod e aced beoe aeve lt whenever ble
CntVronk
Pnv 21
Pnv 1
1
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C 8 Bonding of Cric Rortons
Fg
rssd ad s-r d co oopa coor adasluccy sd o ach ocal caac-rscs of h aja-c h oad poso wsof h crow
Fgs b h a sufac of cow s ch wh % hydrofluoc ac foaml rad'" ocla ch a U fo 60scods. ! los ad pocas ms wor. hyroorc acd s h rsd of wh rug war To mochg cpas h crow s ulrasocally clad acoho or 4 us Aa-y ca cd aa wh a war ac posphoc ac for scos.
02
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85 Clcl Prcr
F and Scig c crgp d 3D ews f dlly cd mieglsscric. Sigific se re lgm ms ls clly isib.
5 h ner sre f h cdd cd cw sld he tpp wh wi dpss r rgh c w ires 4 d c b pmly dfr cm.
Sl prmd mp g rd® Sil rMb S. ! Cop bl w
eent s im
p
rav !) h slnized wshd w mpeely fee of i (sr, lhl, . sl-v vp r m ig g is ppld irlsrc of h crw d h crw issed i dr pe.
103
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e 8 Bonding of eic Reortons
7 8 A di big ag Sya rmr, adiv a on ag Ci, USAI ld o ad h arig h maurr' iui. in cot o d nt v h odi a l ily gly pprnc
-
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.
F Oa os ad ctlys s o thsm ad !daly raa) a a a raio o ad alid h rwwi a u.
4
9 Var II !la Vva i uld i o i w ad hg vcosi n n fu h. o rc thoccrrc o cro, h mo hig-y l ad mr gly viu yuld u whv ibl Vo-li I a b aud ba + aaly)r ly lighud a Wh lug aai rw wi i
lyrs of crmcil th dual ci vint shol u n orr o sr come cr oth h d ay r iahi, raa uld bu.
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1 1 Ar o pm o crown, c ct cauy rmwith fam plt and dnal lyr
ul b appi t cwari i o t rt xy hb-to (, b f uri i t opi y po yg . Poyia i th iiat or mu o bcca paatal, and ical ufaand a w a-cui aiant iu. Auh i k u rouhy24 h f mt t ur th p-r cai , h cmn md imdialy.
85 Clncal Pcr
gs 12 14 Hadn iua m i carll md w n x
p
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o r r alwhl tly mapati th ia. h tratio or i subsequent
y ro, whh bi out o atioa m ru. h a o rw aly arfullnd (g wth our l. Raiooia otro o m dffuldu w aioacy
05
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8 Bonding of ic Rtortons
Od acTis poee i illutrte be on se exe (ziron ronpleet
g 1 nl sn fe te pept f ld steted wn ntt 11 the d ld eemved wi ndangig e r Iis ra i w cdd i pept. heve n esthet estn theltshde stmp hd t e veed wth qe n. e se f nsenlsem mtel w tndedas a thk a ami wda rqir r n. A theent wshed nmel estt z ws seeed. e wn s wel sthe pxml nd lsl nts weenpeed f ft efe ementt ewn was dgs wi al
Fgs 16 16b l d dl vews e defve znw.
1
Fg 17 nnn elet phwn he ndlsted sfe f e ziria ai Saasig ds ag e d sura e iaes s h s s des th ethedlssems.
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g 18 lel Bnd s twmpnent n sem ht cnssts sel-etcn pe n hesve nen. Bth cmet cn e esve phphe nmers neede tceve chemc ndn c. hepme lne s sfcent ceetn c cecs. t cts s dentn cnd-ne nd lne ctvt
g 1 efre cementt e cncemc pecte wt CefPrcel Actvtr pecl e thmst e ctvted wh lerfl E Bnd
pme efe ppctn shn s e eed.
ig One prcel ctvt the ed
85 Clncl Pcere
ig 0 ne d f me ds-ee t wel he mn
07
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C 8 Bonding of Cic Rtortons
1
g The two q fo o emsioie liu hat ust e ixe wel wh aush
Fg h atiate silae is applie tothe e sufae of the wn aloweto ea fo 5 seos. Te sps s enbow o wi ea of opesse ai .
g The ixue soul hoe a hove auifo oo osstey.
Fig h ea sufae of owow oos oiy. Wag: the exteal sfae o e cow moy also look oily aee sippey
g 26 7 enn conitonng : pie ED me o Ceo) is ispese ino aoerwel of the ixig oy a aplie o e epae tooth wth a ush Piig ime seos D m/0 nd f . otioig wi ln mmnd whnemetig Ige esi oposie ui ps
108
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85 lnl Pere
ig ad b Pv T Oyr; the ste e e t 1 1n ple t he r th bsh.
Fig 9 nn elet pshn the n eee zn p}n Pv tt. e h tet fIre ller re n e emen elyerbe.
Fg 1 Oxyr pe rn her rn e re r7 te. Th see t b e sply ye s t te eent rn resn ben. he Oxyr s sbseenyrse th e ll eentree e thrhly reve sle. ntl t lebese the eent s qe
Fg 0 fe hekn the n f ppeft exess ee s eve fm pellet
09
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8 Bonding of ric Rtortons
l l 0
Refeencesl Abet , -Mow OM Mgil io mico ekge ooce
Cem cow wit o cemen t J Pooon 20041(55255
2 ce K illi' Science of Den Meil PildeSnde, 200 :45 I 8
. etcnge P SJ, , Sche P. D cion o etin bondng get: ct o o egth. m J Den 1(: 15.
4. tz M, S , M J Lg . n ito euio o e bondegth of en to eney need ighuty zionum oxie cemc eog-te oge em cycg J. Potet Den 004;1(45-.
5 uitie H, Ntnon D. c of ionome e o cemc ece tote. Den Re 1;:15 Act No 0.
ue J emig GJ Non D Mi PM. ee techologeneeed to uo cemic? emet o e cuen eidence J Ae
et 0024 )22 EeloD, Soene J igt tnmiion tog cemc fmewok nd
cement comtion J Den Re 2008 I ctNo I 8 Fei M, Mocc F, Mon PN, Kg G n o ekge o eioe
ocei cown. J de Den I (:24.. XH Ke M. Mgl icecie lege of cemc cow:
lence of lng get gig condo n J Potodon 00(: 0-1 .
l 0. Hefe MJ Auio SA Dz-Ao AM Heo DR, Stnfo MVg MA. Rele lcency o cemc yem P I oemtei. J Poet Det 0088-
1 1 Jee M Set J, ollie D cedoceln en-bod -eeecown n cte ece Comend Con uc Det8 104
I 2 Juge , Nico , Pilli K, Lmn Lo fge o comomeeet como of thee ig cemen. t J Pohoont 18 5585.
1. Ke, . (00) Kiiche Meile Zze, 5.14. Ke M, omon VP. ong o g ilte m cec: Ae
e metod nd the dbility. J Pohe Det 5:0-4.15. Mgne P, Dougl \H. Poce eee Denn oig otimion d
omimec ecoey of e cw. lt J Phoont 1 (): 1 1-12 .
1 Mlmen Soc SS Sil o Dco gl cemc del etoo oe 1 ye P ll ec of lting gen n oo o oo-utecoe cte J Poet et 200 18(5):5 15
1 M PM e inece o cement on te mecicl efomce o e cemic Poceedng ohe 5h lnetion Symoim on Cemic Meicine. iocemic 5 2
18. Pl SJ, Sche P. he d oig echnue: moied metho omoe dheie uting oceue ln Peodon Re De 1):5545.
1 Roene SF, G PK n e Sly RA Zimmem MH Segth o detl glcemc e fce coting. Det Mte 1;(4-
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20 Sgen G Mg d el it fu dfee ye ceic inlye uig v udy c Odtl Snd 199(1 28
2 . Sub JR, idt SM Ft tg e d e y. J hdt 1998 09
T Feege R eji I ge S Ple D, l R, L .
Sgletle deive ee eee embe e lyeivv evdee. J Det 0043(8 -1
3. V Dije JW Hgud-Aeg Of AL Fed cei ily: A iye fllw. J De 8(319-5.
ite S Fuichi R Kyme SM Mclege gh de e cwcemet J dd 199 1 )9-.
2 i R Kvi E Mcell RJ et gidg, plihg degig e e teg higheit dtic ci Pthd 999( 0
R
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p 9 ic Imp/n Sppod Rsoaions
91 Clica Aspecs adIndcatons
Natura-ooking impant-spported restorations pay a majo roe inthe esthetic success of prosthodotc treatmes i he aterior regioTwo factos crcial to esthetic sccess are: Sotisse morphoogy m ad esthetics of the restoration
Prefabricaed titanium abutmets have severa esthetic imitaios As their roud shape dos not coespod to he aua ooth
anaomy, the correc contou emegece proe) mus be estabished by th crown that is by deep subucosa pacee ohe
crown magms Because the sagt soder ofthese stadardized abutes
does not foow the scaoped contour ofthe srrounding soft tissues the remova of excess ceme ca be dicut The gray metaic coor of the abutmes may show thoug e
soft tissues resuing n gay discooration of the gingiva
In order to resove these probems individuaizabe custom abtmentsmade ofamna ceramics were deveoped i the eay 199s•9•
The few avaiabe studies on the perfoace of amia ceamicabutmes show that good ongerm esuts are achieved whe theseabutmens are paced i te aterior ad pemoar region I onesudy the cinica sccess rae for amia ceamic impant abtmentswas 93% ae 1 to 3 yea of sevice2 I a second study the 5-year
sccess rate for aceramic fxed paia deures sppoed by a
na ceamic abtmets was 97% Abtment fracte was identiedas the ai cause o impat faiur both sudies.The itrodctio of zicoia abtments shod redce the isk o
abutm racur by virt of thir superior matria propties hn viro fracture oad of mpatsupported a-ceramic crows withzircoia abutms was fod to b 700 compard wih ony 8 Nfor those with amina abtmens •
Unfounatey cinica data on zrcoia abets ae st scarceI the ony ogterm stdy pbshed to date oe of te zirconia
abutmes studied had factured aer years of service i the anteor
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el egi Bse te ville eviece e c t estcclue tt te sccessl lcee ceic btes i eei em eg is ssile
9.2 Advatages o Cea cAbtmens el cl
e wite ei-ike cl ceac bets is esei
clly iel ll-cemic esttisGigivl ecessi cses ewe estetic lems. Csmizbity
e se te iivulize cstm bet eselestt ee s te eegece le s eemie by te utme tecw gis c be sce cm e citecte te sig s tissesCe emv ecess ceme is ssble.
Cecti mlt gult is ssile wit smeesicts (iium lye ckess
e ssiity veeeig llws seic eility e mtbtet ceci exibts g cccy t
(ue isil eicti) icity e bet ets igic mtig.
93 Disadvatages• Hige isk cte e t te mtei eies cemic
mteils ( Capr 2• Miiu lye tickesses st be bseve• e scew ccess le iits custzility• Te btmet scew is te wekest k i te system e etl ty ceues e teclicy emg
tmecsig
• Hig cst
93 iaaag
1 5
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Chate Aeam lant ed Retoao
6
94 Bologc Apc
T mopoloy o piimpnt of tiu oundn tnium
mnts is wl doumd nd lnl p to h mopholoy ofth piodonim hv bn did
A sottissu oll o vn (bioloi) width nomlly osound titnium btmnt ond tooth. hi ol of tthmn onsi o ly ountionl pthlium (ppoimtly 2 mmovyin ly o olos onntiv tisu ( 1 5 to 1 . mmTh mi moholoi di i th, wth utmnts th olln ibr plll to t implnt s wh in ntt tth
thy td villy ino th oot mntmAiml stdis hv sow tt t moholoy oft pimplntmuo rond lum nd zio mi umnt i ompblto ht ound titnim btmts mi butmnts nd titnimbtmnt n, tfo, lid biololly qivlnt
9. Manufacrr
Bu thi y olo o ld o inivl diootio itnimutmns qutly nbl to mt hh sthti pttononquntly it mk littl n o mtli btmnt thbstt o llmi stotions A wid n o mtmn md by vio mnfu i now vill fo thpothodontit nd dnl thniin stotv m) to oo omh btmn n t dily vd sw-tind) o
ppd wih n ll-m ow (mntd In th ltt bumnt s ppd s in noml tooth ppio nlly mostintd o inltd mi mnt mut ppd uinwoold instmnsltd mnu Stmnn (Bsl wtzlnd): synOt Vt Zhfi
In-Cm Nobl Bo Adp Po Zioi d Alumin
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BEGO Beme Ge) Cemc coe mtes det Mhem, Gem): CCON Bce Bomet Imt Iovo (Fod USA) Ze Wohwed ch Swed
Aa
CeAdt tmets e mde o dese steed e m d ce coed wth Bek e Ptfo m Noe Boce) fo estotos he eo d emo eo
he efcted cdc tmet eses 1 mm hehd 6 mm dmete
Oa/-Ceam em
he sOct tmets e fcted tm d hecemc ks Vt hk.
he cec ks (dmete 9mm heh: 5mm) e mde ofICem co. The e octo d scew se of theks e e-tted to ese otm t he o-rted o the k c e es woked wh d whee. Ae cstomed sh the det techc the s tted wth sec ss t ICem co ss owde to cheve f
me steth d hdess em ks e sed fo esthetcse-tooth ecemets he eo d oseo eo. Thesestctes c e ethe cemeted o scew-eted (cse sceweted estoto).
ca Ana a Zcona A
esotos fom these two mtes c e desed twomethods he coveto wx- teche o CAD Wh the wx
echqe he met des s dvd modeed dmechc sced.Wth the AD tece the tmet s desed o-scee wth
m cde mes 15 mm dmete d 15 mm heh Noe Boce mkes o dscos wh ed to e ofdcto d the m d co tets c e sed ooth cows d des the osteo eo (cse : cemeted se-tooth estoto)
9.5 Manuaur
7
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p 9 ic Imp/n Suppord sains
Fg 1 Wup yi.
8
ib
Zbut ion utnt ytm dvlopd by old Wownd t ytm wi t ont ioy of lini •
butmnt dind fo u wt nm ytmWP P nd N. T dim of utmn n om6 to l dpndin on wi plto i ud; l pltfom it of 14 . ny djutn t my n d outt dnl lotoy uin w-oold tuin In w tbln nno b individuzd did tom-md opymild butmn n b odd diy om t mnutu (oldWownd.
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References
1 Aaao Begl Gla PO ie The mcol ahe a
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5 Ge , Se 1 ohlwe A Se S, Sibli M, Scre P xemetaoia ae o imla-oe gleoo eoaio eeicy emag egio Foye eu ofa oeie licl uy l Pohoo 2 1)2829
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9 Peiio V, ge A Allcemic imla aume eei iaoJ te De 998)55
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I I . Yim M, Fe , M eo io acue eiace ofmlauo aeamc eoio J Pe De 239 :3331
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