An engineering perspective of ceramics applied in dental reconstructions

Abstract

The demands for dental materials continue to grow, driven by the desire to reach a better performance than currently achieved by the available materials. In the dental restorative ceramic field, the structures evolved from the metal-ceramic systems to highly translucent multilayered zirconia, aiming not only for tailored mechanical properties but also for the aesthetics to mimic natural teeth. Ceramics are widely used in prosthetic dentistry due to their attractive clinical properties, including high strength, biocompatibility, chemical stability, and a good combination of optical properties. Metal-ceramics type has always been the golden standard of dental reconstruction. However, this system lacks aesthetic aspects. For this reason, efforts are made to develop materials that met both the mechanical features necessary for the safe performance of the restoration as well as the aesthetic aspects, aiming for a beautiful smile. In this field, glass and high-strength core ceramics have been highly investigated for applications in dental restoration due to their excellent combination of mechanical properties and translucency. However, since these are recent materials when compared with the metal-ceramic system, many studies are still required to guarantee the quality and longevity of these systems. Therefore, a background on available dental materials properties is a starting point to provoke a discussion on the development of potential alternatives to rehabilitate lost hard and soft tissue structures with ceramic-based tooth and implant-supported reconstructions. This review aims to bring the most recent materials research of the two major categories of ceramic restorations: ceramic-metal system and all-ceramic restorations. The practical aspects are herein presented regarding the evolution and development of materials, technologies applications, strength, color, and aesthetics. A trend was observed to use high-strength core ceramics type due to their ability to be manufactured by CAD/CAM technology. In addition, the impacts of COVID-19 on the market of dental restorative ceramics are presented.

Criterios para la elección de biomateriales protésicos según sus propiedades fisicoquímicas para los sectores anterior y posterior. Una revisión exhaustiva

“…For the selection of zirconium material, the following conditions must be met: over 18 years of age, harmonic occlusal relations, gingival, periodontal and periapical health, as well as good oral health ( [3][4][5][6] ).…”

“…The progression of the development of all-ceramic materials continues, and clinicians are constantly searching for the ideal material that can be used in different clinical applications 2 . It is common to find patients who have suffered the loss of one or more teeth, resulting in a large number of esthetic and functional sequelae that affect the individual's health and masticatory function 3 , 4 .…”

Evaluation of short- and long-term bond strength of zirconia after different surface treatments

“…New ceramics have been developed to meet the functional and aesthetic requirements of dentistry [1]. Its main characteristics include translucency, biocompatibility, high mechanical resistance, and color mimetics to obtain high aesthetic results [2]. Zirconium oxide ceramics (ZrO 2 , 3 rd generation) have been widely used in prosthetic dentistry, and the clinical success of restorations depends not only on esthetic or functional results but also on bond durability between dental tissues and prosthetic substrates [3][4][5][6].…”

Brittle dental ceramics: A challenge in dentistry

“…periods. 12 Additionally, rigorous testing methodologies must be established to assess the long-term performance and durability of these materials before introducing them into clinical practice. Fatigue cycling, including accelerated life tests and the measurement of stress-life curves (S-N), are fundamental concepts in the field of biomaterials that should be encouraged to predict the fatigue life of dental ceramics.…”

“…[2][3][4][5][6][7] For instance, grinding the inner surface of ceramic restorations can markedly reduce their mechanical fatigue behavior. 7,12 Moreover, inner surface treatments are the primary factor influencing the mechanical behavior. Promoting maximum adhesion between the materials/ substrates is a must to induce a better mechanical behavior.…”