Best Top Full Contour Monolithic Zirconia Dental Crown Dentist Clinic in East Delhi India.
Monolithic zirconia full-coverage restorations have begun a revolution that just may lead to the demise of the PFM teeth caps from dentistry. There are numerous advantages & benefits of monolithic CAD CAM metal free zirconia dental crowns. They can be prepared just like the preferred posterior full-coverage preparation. Full-shoulder, chamfer, or even knife-edge finish lines are acceptable for monolithic or full contour zirconia teeth caps or crowns.
In tight occlusal areas, like second molars, as little as 0.5 mm of occlusal reduction is adequate for strength and block-out of underlying tooth structure. Three, four, and even six-unit bridges may be fabricated using monolithic full contour zirconia, as long as the connectors are developed using the suggested guidelines.
The development of full-contour monolithic zirconia (MZ) crowns promises an end to the heartbreak of fractured aesthetic porcelain on posterior crowns and bridges. MZ crowns can be prepared just like conventional PFM crowns using either a butt shoulder, a chamfer, or a knife-edge finish line. MZ crowns may be fabricated with as little as 0.5-mm of occlusal reduction, and most importantly, MZ crowns can be cemented using the clinician’s choice of favourite conventional cement.
The only difference between monolithic full contour zirconia crowns and a conventional porcelain fused to metal teeth caps, that can be summed up in one word is – unbreakable.
Nowadays, monolithic zirconia caps have become popular because of their high flexural strength, natural tooth colour, less wear on the antagonists, and minimum tooth preparation.
For the patients with compromised occlusion or parafunction, monolithic zirconia crowns may be fabricated with as little as 0.5 mm of occlusal reduction. It is possible to produce CAD/CAM-milled monolithic zirconia restorations with the new digital impression technologies.
The colour of the restoration is homogeneous and there is no need for concern about opaque show-through during adjustment of the occlusion. It is also easy to shape and polish the material using porcelain-polishing materials.
Zirconia has been considered an opaque material compared to other all ceramics, but more aesthetic alternative to porcelain fused to metals (PFMs) or cast gold restorations, in the areas with limited occlusal spaces. The translucency of monolithic zirconia should be improved to make it a restorative option in the anterior region as well. The cementation is either adhesive or conventional.
Benefits & advantages of Monolithic Full Contour Zirconia —
Soft-Tissue Response to Monolithic Zirconia
The soft-tissue response to monolith zirconia dental crowns has been very encouraging. They promote a soft-tissue response very similar to porcelain veneers; the tissue stays pink and stippled and healthy. The high biocompatibility of zirconia is evidenced by the success rate when using zirconia medical implants for procedures such as hip replacement. Advantageous clinical properties—such as reduced bacterial adhesion, ease of manipulation, high strength, and perishability, along with superior resistance to fracture—combine to make MZ crowns the ideal choice for posterior full-coverage restorations.
Highly polished ovate pontics are easily cleaned and maintained, and the resistance MZ restorations show to bacterial adhesion encourages a healthy response from surrounding soft tissues.
The ease of shaping and polishing MZ restorations provides a nature-mimicking environment that contributes to the health of soft tissues surrounding these crowns and bridges.
Because the MZ crowns are tooth-coloured, finish lines may be either supragingival or subgingival. Very often the length of the clinical crown determines the position of the finish line. A short clinical crown may require a subgingival finish line in order to have a significant ferrule for retention of the MZ restoration.
Monolithic Zirconia Crowns for Implant Restoration.
Full-contour monolithic zirconia caps is ideal for the restoration of dental implants on posterior teeth. The natural opacity of the material combined with the full depth of colour hides even the darkest metal abutments without having a grey cast. If space is a problem, the MZ crown or bridge can be fabricated to a thickness of 0.5 mm and will still be resistant to breakage and will not demonstrate the opaque show-through of the metal so often seen on occlusally thin PFM restorations.
Marginal adaptation
The marginal fit of monolithic zirconia teeth crowns is exceptional. The restorations are milled in a CAD/CAM process that produces a precise marginal fit. Whether the restorations are produced from a conventional impression and scanned at the dental laboratory or from a dental office-generated digital image, the finish margin fit of the final restorations is excellent.
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Adjusting the occlusion
When adjusting the occlusion on an zirconia teeth caps, there is no need for concern about opaque or metal show-through because the colour of the restoration is homogeneous throughout the restoration. Shape and contour adjustments are easily accomplished using a diamond or small green stone and any conventional extraoral ceramic polishing kit. The restorations are very strong, and occlusal adjustments can be made before the unit is cemented, allowing for final polishing of the restoration in the laboratory, rather than in the patient’s mouth.
Resistant to fracture
Because the restoration is so resistant to fracture, conservative preparation is encouraged; because the restoration is homogeneous in nature, there is no aesthetic ceramic component to fracture during occlusal loading. Research has found MZ crowns are less abrasive to opposing natural dentition than most other full-coverage restorations. The tissue response to MZ is very favourable. Resistance to bacterial colonization helps keep the soft tissue surrounding MZ restorations much healthier-looking at re-care visits.
Require less time to fabricate
Perhaps the greatest advantage of MZ crowns is the fact that they require less time to fabricate. As the impression is scanned for fabrication of the crown or a digitial impression is taken sometimes – it removes all the intermediately steps as we do in conventional PFM crowns.
Wear of opposing tooth structure
Wear means “loss of material from a surface”. Wear of tooth material is related to several factors, such as mechanical contact, surface roughness, grain size, fracture toughness, occlusal load, temperature, chemical reactions, environment and lubrication. Surface conditions is one of the most crucial factors, therefore, different kinds of surface treatments should be applied on the restorative materials in order to prevent damage of natural antagonist teeth.
There are two common surface treatment techniques for monolithic zirconia, such as polishing (manual/machine) or glazing (glass coating/firing) to improve the aesthetic appearance of the restoration and to obtain smooth surface texture. Diamond points, rubber wheels and abrasive pastes are used in polishing procedures. Glazing is performed by firing a thin coating of glass on the surface or by firing the restoration up to temperature required for glazing.
The wear ability of monolithic zirconia — can be clearly observed that polished zirconia had the lowest wear on the antagonists compared to glazed zirconia. This result was attributed to the fact that glazed zirconia loses the thin glaze after a short period of clinical function, with the result of appearance of the rough and more abrasive surface of zirconia. It was also stated that glazed layer is easily removed by chairside occlusal adjustments.
Surface roughness
Preparing a smooth surface for ceramic restorations is considered as an important step because increased surface roughness associated with improper surface treatment can increase wear rate of the opposing natural teeth and can compromise the clinical performance of the restorations.
Polished surfaces of monolithic zirconia were smoother than glazed surfaces. It was stated that polished zirconia showed a lower surface roughness than glazed and ground zirconia. These differences may be due to the different polishing (machine or manual) and glazing (glass coating, firing) techniques, or different study protocols. It was known that machine polishing results in a significantly higher surface gloss of ceramics than manual polishing with tools for intraoral polishing.
Fracture strength
Fracture of zirconia showed the highest strength when luted with adhesive resin or glass-ionomer cements, compared to lithium disilicate and feldspathic ceramics. Similar results were obtained with monolithic zirconia crown with a thickness of 1 mm was found equal to metal-ceramic crowns. It was also reported that strength of monolithic zirconia was higher than veneered zirconia, lithium disilicate and metal-ceramics.
Optical properties
The creation of acceptable aesthetic result with monolithic zirconia restorations is challenging because they are mono-layered restorations. Application of colouring liquids, surface characterization, glazing and polishing of zirconia are the procedures to look like natural teeth. Significantly improved colour adaptation to adjacent teeth is accomplished with colouring of the monolithic zirconia structures, followed by individual colour characterizations achieved by surface painting.
The colouring liquids with different colour intensities are applied with a paintbrush prior to sintering.
The translucency of the monolithic zirconia restoration is also essential for optimized aesthetic outcome. However, an increase in crystalline content and framework thickness in order to achieve high strength would generally result in lower translucency. Zirconia has higher contrast ratio compared to glass ceramics, and can be clinically applied with a minimum thickness of 0.4 mm.
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