F

ull veener crown

METAL CERAMIC RESTORATIONS

Introduction :
A metal ceramic restoration is composed of a metal casting or coping
which fits over a tooth preparation and ceramic that is fused to the coping.The coping
may be a little more than a thimble or it may be clearly recognizable as a cast crown
with some portion cut away. These cut away contours will be replaced by porcelain
that will mask / hide the metal underneath. Therefore metal ceramic restorations
combine the strength and accuracy of the metal with esthetics of porcelain.

History :
It was introduced to dentistry nearly 4 decades ago. The different names used were :

Ceramco crown (one of the first brands of porcelain for fabricating the crown).

Porcelain veneer crown (PVC)

Porcelain fused to gold (PFG)

Porcelain fused to metal (PFM) (1970s 80s)

Ceramo metal restoration the state of science:

Developments in the field of metal ceramics have led to numerous
improvements, some answers, but as in most scientific endeavours, more questions.

109

F
ull veener crown
Knowledge of the science and appreciation of the art are necessary to realize the full
potential of the constantly evolving restoration.
Physics, chemistry, engineering and material science have all helped to rationalize our
approach to ceramo-metal restorations.
The scientific base of the technical procedures can be divided into smaller topics as
dealt below:
The substructure
The ceramic
The Bond
THE SUB-STRUCTURE
Requirements to be fulfilled:

The substructure should strengthen the restoration to resist failure, which could
result from poor tensile, shear and impact strength of the veneer (i.e.) porcelain.

It should provide good marginal fit

Should not interfere with esthetics

Option available: metal alloys

Metallurgical Properties of an ideal alloy for a ceramic sub-structure:

1) High modulus of elasticity:
Modulus of elasticity reflects the rigidity of the material within its elastic
range. Greater the MOE, the less a given thickness of material will flex when loaded.
The brittle ceramic demands a rigid substructure. Any deformation, even if elastic,
110

F
ull veener crown
generates destructive stresses in the ceramic veneer. However, as the restoration cools,
the alloy should be able to deform a small amount to relieve the stress produced by
thermal contraction of porcelain. High MOE does not allow alloy to relieve stress,
which would remain in porcelain and cause crazing.
2) High yield strength:
The yield strength reflects the resistance of the material to permanent
deformation. If the sub-structure permanently deforms, the restoration will fail. In
addition, yield strength is critical to the ability of a material to about energy,
especially in materials, which have a high MOE.
3) Fine grain structure:
Important to the mechanical stability of the marginal area, corrosion
resistance and hardness.
4) Sag resistance:
Alloy should resist deformation at firing temp of ceramic
5) Castability:
Alloy should be easy to handle and cast. Accuracy of fit of a casting is a
must. One can compensate for poor mech. prep by intelligent structural design, but
there is no compensation for ill-fitting restorations.
6) Bond potential:
The alloy must allow good wetting, provide a suitable bond and be
thermally compatible with the veneer material.Alloys vary in technique sensitivity
because of difference in casting temp, casting shrinkage, specific gravity, surface,

111

F
ull veener crown
tension, investment compatibility, soldering capability, resistance to overheating and
gas absorption.
Predictability with respect to alloy choice therefore is still very much dependent on
individual experience, expectation and expertise.
Design of the Metal Sub-structure:
Regardless of alloy selected, intelligent design is critical to success. The
sub-structure should satisfy both biologic and mechanical demands. Mechanical
demands dictate that it should be as thick as possible esthetics dictate that it should be
as thin as possible. Framework design in sinple words should be so that there is
adequate embrasure space to allow gingival health, and adequate thickness of
porcelain to allow for esthetics and yet maintain resistance to deformation.

Principles in Design:
1. Rigidity of support

4.

Marginal integrity

2. Control of tensile and compressive

5.

Esthetics, form and function

6.

Access for maintenance

forces
3. Shear resistance

1. Rigidity of Support:
The metal substrate must be firm and unyielding to preserve precise abutment metal
form when the porcelain is being fired (sintered).
Distortion of this form will lead to:
a) Tensile strains within porcelain and
112

F
ull veener crown
b) Potential porcelain fracture while seating restorations, compromising marginal
integrity and fit.
In addition to sintering forces, the metal substrate for bridges should
withstand functional and parafunctional forces of occlusion without fatigue or
deflection beyond the limits of porcelain or metal.
Mechanical engineering principles govern basic design concepts. The law
of beams applies here, ie. Assuming a vertical vector of force, metal substructures
will alter their resistance in the following manner:
a)

Doubling the height of metal produces 8 times the resistance of deflection as it

is inversely proportional to the cube of the change in size.

b)

Doubling the width of the metal produces twice the resistance it is directly
proportional to change.

c)

Doubling the length of the pontic space increases the deflection by eight times
because the change in dimension is inversely proportional to the cube.
Structural integrity is most efficiently controlled by manipulation of vertical
dimension in connectors.
Sound conceptual geometric forms still require skill and judgmental

alterations for diverse situations.

2 .Control of compressive and tensile forces:

Dental porcelain is a brittle material with low fracture toughness. Tensile
and shear forces are easily achieved under many circumstances, which may fracture
porcelain; though porcelains resistance to breakage from compression is great.
113

F
ull veener crown
Therefore design forms endeavor to emphasize metal support wherever force is
applied to the porcelain preferably perpendicular to the major force vector.
The thickness of porcelain veneer demands careful control another
problem in tensile and compressive forces. Correctly applied, thin porcelain is
stronger near the metal-porcelain interface due to the mismatched coefficient of therm
expansion designed by manufacturers to produce compression of porcelain at the
interface. The temptation to keep metal thin and to thicken the porcelain for optimal
optical quality is a constant threat to the integrity of the dual system.
Porcelain that exceeds 1.5-2.0 mm thickness develops more fracture when shear
forces are applied. These fractures probably follow the flaw mechanisms, enhanced by
tension or lack of compression in the thickened porcelain. Another way of viewing
this problem is to provide metal designs that permit porcelain to shrink on metal
rather than on itself, for it will surely produce flaws. Thick porcelain (> 2mm) violates
the basic concept of manufactured metal porcelain composite.

3.Shear resistance:
Proper metal substructures enhance the inherent shear resistance of the
fused porcelain and help withstand intraoral forces.
Three major areas deserve attention.
1.

Incisal cosness the metal support limits porcelain to 2.0 mm in this area.

2.

Posterior porcelain cusps- the metal support maintains porcelain cusp integrity
by limiting shearing forces and increasing compressive resistance.

3.

Proximal posterior porcelain margins

114

F
ull veener crown

The proximal metal structure provides superior support to preclude

fracture in this crucial area while using porcelain occlusals.

4.

Marginal Integrity:

The finished restoration must:

1.

Seal the denuded tooth from bacterial invasion.

2.

Allow minimal cement dissolution

3.

Reproduce a normal emergence profile

Full metal margins permit superior marginal adaptation. Cosmetic veneering materials
fused (porcelain) introduce problems in controlling marginal integrity.
2 aspects here require examination:
1.

Seating of finished restoration during cementation

2.

Avoiding metal creep (lifting of metal margin during porcelain sintering and
shrinkage)
These problems could be limited if the need to hide the metal were less

demanding.
Metal collar enhances control of gingival contour, and the emergence
profile dictated by the wax up is preserved in its original form when metal collars
are used.
Margin Design and casting seating:
Bevel is considered as a geometric form that enhances marginal seal
(Kashani et al 1981). Burnishable, ductile gold alloys are used over marginal bevels
of (slip-joint) inlay and onlays. The stiffness of metal-ceramic alloys precludes that
possibility. Bevelled cutting tool permits considerable vertical variation as it is guided
115

F
ull veener crown
around the tooth while still preserving horizontal linearity of margin; this is an
important quality of the beveled margin.
Rosner (1963) notes four functions of the bevel in castings. These are:
1.

Reduction of inherent defects in casting and cementation.

2.

Protection of enamel rods at the margins

3.

Allowance for burnishing

4.

Development of circumferential retention.

The question of shoulder/bevel centers around the open margin quality and

quantity of the cemented cast restoration.(Best seal is from featheredge and parallel
bevel preparations consistent with geometric considerations). (Gavelis et al 1981).
The best seating during cementation was produced with a 90 full shoulder
and poorer was with 90 shoulders with parallel bevel. This is explained on the basis
that shoulder preparations have poor seal prior to cementation, facilitating cement
escape marginally.(To clarify controversy, Mc Lean and Wilson (1980) presented
mathematical evidence indicating that levels must be in the region of 70-80 for an
improvement in marginal seal and cement dissolution. Overextended margins can be
kept till final polishing and then trimmed prior to cementing. The full shoulder does
not allow this liberty). The casting should be milled to a knife-edge at the margin,
after which porcelain is fixed to the exact line. If metal over extension is left for
reduction after firing, the reduction of metal may produce a metal collar and opaque
line.
Creep problem during sintering:

116

F
ull veener crown
Chamfer produces the most distortion during shrinkage of porcelain
Shilling burg et al.Supported by Taucher & Nicholls (1980)
It was concluded that porcelain application and firing does not
mechanically distort the facial margin as the layered porcelain precludes metal
creep. Sintering shrinkage and potential creep is countered by incremental layering of
porcelain.
Opaque layers for good wetting with min. thickness.
1st Body build up away from the margin.
2nd complete the undercontoured cervical area.
Avoiding extremely long firing cycles can control creep. Varying the alloy
comp. also helps in controlling creep by inducing a dispersion strengthening effect.
These principles of design are incorporated in various stages of fabricating
metal ceramic restorations in the form of the following features. (Shillingburg)
1. Thickness of metal :
Rigid copings give strength and longevity to restorations. If restorations flex under
occlusal loads, tensile stresses occur in porcelain which would lead to its shearing.
Rigidity is required to avoid flexure.
Noble metal copings should be 3-5 mm thick and base metal compings; 2 mm (as
their yield strength and melting temp are high).
The coping should have an evenly flowing convex contour of veneering area. This
helps stress distribution unlike sharp angles and undercuts. Which increase stress.
The outer junc. of porcelain to metal should be at 90-135. If acute, the metalporcelain interface may produce porcelain crazing and if it is beveled, the porcelain
117

F
ull veener crown
will and in a feather edge through which the oxidized metal or opaque will show. The
veneered porcelain should be kept at a minimum thickness and should still be
compatible with good esthetics.
Kelatively thin porcelain of uniform thickness and supported by rigid metal is the
strongest. The absolute min thickness of porcelain is .7 mm and the desirable
thickness is 1.0 mm.
2. Occlusal and Proximal contacts :
Contacts should be placed on metal wherever possible because:

Contacts can be precisely located.

The area covered by ceramic can be more precisely controlled.

Metal causes less wear on opposing teeth than ceramic.

Glazed porcelain removes 40 times as much opposing tooth structure as

gold. (Jacobi et al) The contacts should occur well away from the porcelain metal
junction line.
Contact near the junction can cause metal flow and subsequent porcelain
fracture. The porcelain metal junc. should be 1.0 mm from occlusal contacts at the
position of maximum intercuspation.
In anteriors :
To avoid / minimize stress from the lower incisor contacts on the lingual
surface of max. ant. Restorations, the metal ceramic junc. should be placed away from
the vicinity of the contacts.

118

F
ull veener crown
When the vertical overlap is inadequate, the junc. is placed far enough
gingivally for the contact to occur on porcelain.
One more thing worth mentioning is the placement f porcelain metal junc. Too close
to incisal edge. This destroys the incisal transluscency and fracture of porcelain
increases.
Extent of veneered area :
As the occlusal contacts occur in metal, the porcelain coverage is as follows:
On max premolars and molars Porcelain extends over the facial cusp tip
and about half way down the lingual incline of facial cusp. A rounded ledge of metal
under the facial cusp support the porcelain so that the ceramic metal junc. is kept
away from the occlusal contacts. This design is more resistant to fracture than when
porcelain extends to central groove or covers the entire surface.
Variants for maxillary teeth :
1.

Porcelain coverage of mesial marginal ridge upto the middle of the triangular
ridge.

2.

Complete coverage for those who demand absolute esthetics.

On mand first premolars : complete porcelain coverage on occlusal

surface. Mand. Second premolars and molars Bruxism, occlusal restorations on

opp arch and patients whishes dictate extent of ceramic.

The distal half of premolars and molars can be uneven to allow more occlusal contacts
in metal.

119

F
ull veener crown
Metal collar of 2 mm on facial and 3 mm on lingual can be used so that the
tooth preparation is more conservative through the greater portion of crown is to be
covered with porcelain, it should be waxed to full contour and then cut back to insure
a uniform thickness of porcelain and correct contours.
Thimble copings result in unsupported, fracture prone porcelain. Anterior
metal ceramic restorations with guidance in lateral excursions and protrusion on
porcelain teeth will abrade opposing teeth eventually will require restorations.
The collar of exposed metal on the lingual should be at least 3.0 mm wide
incisogingivally. Proximal contacts for anteriors should be in porcelain which should
be facilitated by adequate tooth reduction.
The porcelain metal junc is placed lingual to the proximal contact areas so that:

Proximal porcelain has greater depth and translucency and hence better esthetics.

Optimumstress distribution

Facial margins :
For many years, the conventional facial margin for metal ceramic crown was a
narrow metal collar.
It had the following disadvantages :

unesthetic display of metal

The need to create subgingival finish lines which in turn caused gingival
inflammation and recession.

120

F
ull veener crown

When porcelain was veneered right upto the metal collar to avoid metal display,
the restorations would get overcontoured at the margin or would give a thin,
fracture prone porcelain or an undetected open margin.

These unesthetic facial margins led to the thought of an all porcelain margin, facially.
This can be either even with the gingival or slightly supragingival which had a
positive influence on gingival health. Various techniques were devised for fabrication
of all-porcelain facial margins.
1.

Use of patient fail to support the margin while firing

2.

Use of refractory die to support margins while firing

3.

direct-lift tech ii) correction porcelain was added to the margin after a fullcontour buildup of the crown. The porcelain was condensed by compression and
fired to produce the final margin.

4.

In 1979, Vryonis described a technique which required tooth preparation with

90 shoulder and a metal coping that terminated at the gingivo-axial line angle.
Opaque porcelain was applied to the metal coping and the shoulder on the

die. After obtaining a satisfactory margin, dentin and enamel were added to complete
the crown. Previously, dentin and enamel blends were used to create margins.
However, the margins of conventional porcelain tend to round or slump
during subsequent firings because the fusion temp are identical.
To overcome this, manufacturers created special shoulder porcelains
containing aluminous porcelain that fuse at temp 30-80C higher than dentin or
enamel porcelains.

121

F
ull veener crown
Therefore the shoulder porcelains allow repeated firings with no effect on
completed margins and are also stronger in flexure than conventional porcelains,
making margins more resistant to fracture.
Studies with shoulder porcelains and direct lift tech have shown consistent
level of marginal adaptation with mean marginal openings of 15-23 m and 8-11m.
Demonstration of acceptable margins with a wide assortment of techniques,
porcelains and binders indicate that the quality of margins is directly related to the
skill of the ceramist.
When talented ceramists are absent, all-porcelain facial margins are
contra-indicated.
Alloys used for PFMs : (ADA classification)
1.

High Noble

2.

Noble

3.

Predominantly base metal alloys

1.

High Noble : (> 60% Noble metal content with atleast 40% Gold)
Gold Pt Pd.
Gold Pt Ag
Gold Pd

2.

Noble : (at 25% Noble metal)

Pd Ag
High Palladium

3.

Predominantly base metal (< 25% Noble metal content)

122

F
ull veener crown
Ni-Cr
Ni-Cr-Be
Co-Cr
It is important that metal has a thermal coefficient of expansion and
melting temp that is compatible with the porcelain, when used in restorations.
Regarding coefficient of thermal expansion () a diff of 1.7 x 10-6c can
shear the band between metal and ceramic. The optimum diff between the coefficients
of metal and ceramic should be no greater than 1 x 10 -6C. Conventional gold alloys
have a coefficient of therm exp equal to 14 x 10-6C and conventional porcelain; 2-4
x 10-6C.
Therefore the coefficient of thermal expn of porcelain was increased to 7-8
x 10-6C by addition of alkaline like Li Carbonate and at the same time, the of
metal was lowered to 7-8 x 10-6C by adding Pt or Pd.
Regarding melting temp the melting range of alloy should be 170-180C
(300 500F) higher than the porcelain.
A similar melting range would obviously result in distortional or melting
of coping during firing.
The greater the diff, the fewer the problems that are encountered.
Melting temp of noble alloys = 12-60C (23007)
And they are subjected to creep when temp = 980F
Porcelain S fuse at a temp = 980F
123

F
ull veener crown
Therefore the alloys are modified to possess high fusion temp.
Development of Alloys :
As gold became very expensive in late 1970s, alloys with little or no gold were
developed.
A logical transition was the use of RPD alloys which had advantages like : Low cost,
Increased strength and hardness
High fusion temp
Resistance to distortion during firing
But they had certain disadvantages are well; when used in a metal-cer.system :

Excessive oxide for motion

Difficulty in finishing and polishing

Questionable biocompatibility
Ni, Be

Ni Contact dermatitis
Be Dust is carcinogenic
Hazardous to personnel
Another alternative in cost cutting was to use Cu or cobalt to modify

traditional alloys. But these elements caused dark oxide formation and poor high
temperature strength.
Subsequently small amounts of gold and silver replaced cobalt or copper.
Silver containing alloys have disadvantage of greening.
Choice of an alloy :
Depends on a variety of factors :

124

F
ull veener crown
Cost

Rigidity

Castability

Ease of finishing and polishing

Corrosion resistance

Compatibility with specific porcelains

Personal preference

No alloy system is without disadvantages financial or technical and so, no system is

without disadvantages financial or technical and so, no system is superior in all
aspects.

The Ceramic:
Dental Porcelain is generally categorized into 3 classes:
High fusing
Medium
Low-fusing

High & Med fusing are nearly same in composition and microstructure but
are considerably different from low fusing porcelains.
High fusing porcelains are used primarily for denture teeth and medium
fusing porcelains for pontics (tru-pontics) Denture teeth are built up by layering
several different shades of porcelain. Each layer is chemically and microstructurally
similar. These porcelains are true porcelains as defined by a ceramic engineer. They
are composed of mixtures of raw minerals mined from earth such as natural feldspars
(clay like minerals composed of oxides of Si, A1, Na & K) and quartz (Sio 2). The are
125

F
ull veener crown
powdered, mixed together and heated. Above 2000C, multiple chemical reaction
between the oxides result in the formation of a molten oxide liquid which glues the
reacting and unreacted particles together. Cooling this solid liquid composite results in
a solid piece of true porcelain.
Microscopic examination reveals a composite physical structure made up
of a host of small crystalline particles within an amorphous matrix. This structure is
physically and chemically stable at low temp but the reactions will begin again if
reheated. As the internal chemical reactions can be started and stopped by cycling the
temperature, the physical properties of true porcelains are unstable upon repeated
episodes of heating and cooling.
Medium fusing porcelains differ from high-fusing porcelains only in their
proportion of reactive oxides. They require less heat to fuse the particles together and
can be more easily self-glazed at a lower temp than the high-fusing porcelains.
Due to instability of high and med. Fusing porcelains upon repeated episodes of reheating, they are used for situations where they need only be ground and may be
glazed once and mounted in metal or plastic bases.
Low-fusing porcelains:
In veneering a metal sub-structure for a metal-ceramic restoration,
porcelain powder is fused at relatively high temp., directly onto the metal.
The porcelain must be chemically and physically stable through the numerous bakes
until the desired form is established.
This is accomplished by producing a glassy material that is chemically
similar but microstructurally different from the high and med fusing porcelains.
126

F
ull veener crown
Low-fusing porcelains are produced by first mixing raw minerals similar
to those used in high-fusing porcelains, but with a relatively high proportion of
sodium and potassium K and Na help break down the Si-O network (and are therefore
called glass modifiers). This results in 2 favourable consequences:
1)

Softening temp of glass is reduced

2)

The coefficient of thermal expn is increased.

These oxides readily react with SiO & Al 2O3 at high temp to produce

liquid glass. Unlike high fusing porcelains, the components are nearly completely
dissolved via chemical reaction so that the material, when cooled, shows a nearly
homogeneous microstructure of amorphous glass, which can be powdered, remixed
and refixed without further chemical (and consequently physical) change.
Layering & Fusing to metal simply involve a coalescence of particles at
elevated temp of the particles. This homogeneous glass can be modified by
manufacturers by small additions of oxides that will impart colour to glass without
significantly changing its properties. Glass can be made opaque by adding small
percentages of nearly insoluble oxides Tio2, Zro2. As they are white or yellow white,
they create colour shades. Due to their insolubility, they interrupt light transmission
and have no appreciable effect on fusion temp. range of glass.
Different blends of low-fusing porcelains have been used for metal
ceramic restorations. They play different roles in the fabrication.
Opaque porcelains: Composed of low fusing glass and insoluble oxides.
The density of oxides is greater than that of the glass matrix eg. Oxides of Ti, Sn, Zr,

127

F
ull veener crown
In, Ce. They cause incident light to scatter and reflect rather than transmit through the
porcelain.
Therefore the opaque porcelain applied as a first ceramic coat serves 2 functions:
1)

Mask the colour fo alloy

2)

Responsible for metal-ceramic bond

Body porcelains : Basic low fusing glass with various concentrations of colorant
oxides.
There are generally 3 body porcelains:
Those with no colouring oxides

Incisal (enamel) porcelains

Those with small amount

Gingival (Dentin) shades

Modifiers

Of colourants esp yellow.

Those with colorants ranging

Across the color spectrum including white and gray

These 3 body porcelains have the same chemical and physical properties
and can be intermixed freely. They are layered and fused over the opaque porcelain to
build tooth contour and esthetics by diffusing and softening the opaque colour.
Stains and Glazes: Composed of glasses with a lower proportion of silica and
alumina than body porcelains.
The relatively higher content of oxides of Na & K, plus colorant oxides
gives these glasses a considerable fluidity at temp

around 1600-1700C. These

porcelains are balanced for nearly equal thermal expn. with body and opaque
porcelains but they should be intermixed with caution due to their high fluidity.
128

F
ull veener crown
They are used to create a glassy veneer and to impart superficial
characterization to a fused ceramo-metal restoration just prior to cementation.
To achieve consistently successful ceramo metal restorations, the strengths
and weaknesses of the veneer member must be understood inorder to minimize
potential ceramic failure.
Probably, the most imp mech property in terms of potential failure is the
relative weakness of ceramic under tensile stress.
Though the theoretical strength value of vitreous

materials based on

intermolecular bonds is in the order of 1 x 107 psi, these values are approached only in
very fine glass fibres free of flaws and protected from conditions that would enhance
flaw generation.
Flaws in ceramics are basically microcracks (10 -6m) predictability with
respect to ceramic, hinges on an understanding of the implication, generation,
prevention and control of these extremely small flaws.

The common causes of these microcracks are :

1)

Mismatch in the co-efficient of thermal expn of the sub-structure and the

veneer. This was common during earlier stages of development when
interchange of metal-ceramic systems caused failure. Now that the ceramics
are better matched to metals, some interchange of one manufacturers metal
with anothers porcelain is possible.

129

F
ull veener crown
2)

Another potential cause is the heat generated while grinding and adjusting
porcelain. This can cause differences in expansion in diff. areas of porcelain
which lead to micrcracks. Staticfatigue?

(3)

The inevitable abrasion and corrosion in the oral environment.

(4)

Static loads :
If the load places ceramic under continuous tensile stress, the potential solvent
effect of the mouth is greatly enhanced.
One risks static load failure of this type whenever a ceramometal restoration is
forced place.
A forced-fit places a constant stress on the ceramic, which, given time and
moisture, can fail, even though the stress generated is below the reported
tensile stress of the porcelain used.
Therefore the ceramo-metal restoration should have a passive fit that
minimizes the risk of development of static load on cementation and thus the
time-delay failures.

(5)

Bubbles and voids in ceramic decrease strength and translucency

Appliacation of opaque, proper condensation and strict adherence to
manufactures instructions regarding firing cycles help in producing a dense,
porosity free restoration.

The Bond:
Bond between metal and ceramic has been explained by 4 mechanisms.
1. Mechanical entrapment
2. Compressive forces
130

F
ull veener crown
3. Van der Waals forces
4. Chemical bonding
Mech. Entrapment: is ceramic interlocking within incroabrasions on the metal
surface. Finishing the surface of metal coping with noncontaminating discs or stones
and air abrasion has proved to give a better bond.
Air abrasion increases wettability of metal with ceramic, provide
mechanical interlocking and increases surface area for chemical bonding. Platinum
spheres (3-6 m diameter) used as bonding agent increase bond strength significantly.
Compressive forces :
The slight difference in the coefficient of thermal expansion cause
porcelain to draw toward the metal coping when the restoration cools after firing.
Vander waals forces : Comprise an affinity based on mutual attraction of changed
molecules. They are a minor force and not as significant as once thought. Though it is
only a minor contribution to overall bond strength, it is significant in the initiation of
the most imp. Mechanism, the chemical bond.
Chemical bond:
Indicated by the formation of an oxide layer on the metal and by bond
strength that is increased by fixing in an oxidizing atmosphere.
When fixed in air, the trace elements in gold alloy - such as Fe, Sn, Ga, In
migrate to the surface and form oxides. They subsequently bond to similar oxides in
the opaque layer of porcelain gold alloy containing significant amount of Fe and Sn
creates a significantly stronger bond than a pure gold alloy.

131

F
ull veener crown
The bond strength of true adhesion is such that failure or fracture will
occur in porcelain rather than at the porcelain metal interface.
Base metal alloys readily form chromium oxides that bond to porcelain
without the addition of any trace elements.
The intervening link between the metal alloy and the glass is a layer of
metal oxide which need be only a monolayer in thickness to be effective.
Nonoxidisable, purely noble alloys do not bond chemically eg. Au-Pt-Pd
will cleanly

lift from the surface of porelain, with no evidence of attachment.

Addition of oxidisable elements eg. In, Sn establishes the potential for oxidation and
consequent adhesion to glass. Glass is a powerful solvent for metal oxides and
digestion of relatively large conc. of interfacial metal oxides can lead to changes
(generally lowering) in coefficient of therm expn of the interfacial glass. Such a
change can cause internal tensile stresses upon thermal cycling and facilitate fracture.
ie) Excessive metal oxide diminishes bond strength by interposing an oxide layer. So
thick that fracture can easily proceed through it.
Also, the diffusion of dissolved oxides through porcelain can also lead to
graying or show-through of darkened glass. Eg. Greening in silver alloys.

Therefore care should taken to minimize oxidation.

Factors affecting the bond :
As the factors contributing to the bond are better comprehended than before, the
factors affecting the bond are now clearer.

132

F
ull veener crown
As the factors contributing to the bond are better comprehended than before, the
factors affecting the bond are now clearer.
1)

Most metal alloys need an initial oxidation prior to ceramic firing (exception
Pd-Cu-Ga) high palladium alloy freedom plus).
This was also called conditioning bake or degassing.
(Degassing wrong term) Gases come out of metal only at higher temp ie)
from molten metal and not during firing ceramic.
An optimum thickness of oxide layer is essential for a strong metal-ceramic
interfacial bond. Be has been added to some Ni-Cr systems to control the
thickness of oxide layer.
Some systems are provided with a bonding agent that contains some elements
contained in porcelain (eg. Al, Sn, Si) bonding agents may increase or decrease
the width of interaction zone between metal and ceramic. Manufacturer will
indicate whether a bonding agent is necessary or beneficial.

2)

Air borne particle abrasion with Al2O3, is routinely performed to provide

mechanical bond.
Recent research shows that controlled amounts of mech. Surface

roughening that yields greater notch depth for irregularities, increases the metal
ceramic bond strength than coarse roughening.
Ceramic bond-strength was analysed using finite element analysis (eg:
tests like pull-shear, three point bending, foxu point bending). But the problem was
that the stress varied with position along the metal ceramic interface and simulation of
loads that could cause clinical failure was difficult.
133

F
ull veener crown
To avoid these problems, OBrien proposed a different approach, focusing
on the mode of failure of metal ceramic specimens or restorations, though the method
of microscopic measurement. Ii) Adhesive / cohesive failure can occur at six is not
specified. Possible sites or combinations of those sites.
Adhesive failure :
1.

Porcelain-metal interface.

2.

Metal oxide-metal

3.

Porcelain-metal oxide

Cohesive failure :
1. Porcelain porelain
2. Metal oxide metal oxide
3. Metal-metal (very rare)
Other techniques being used to evaluate the metal ceramic interfacial bond were:

X-ray spectrometry

Three point bending test in ISO standard 9693.

Lenz et al analysis etc.

The fracture mechanics approach is the most recent.

Predictability with respect to bond strength still needs research.
There are many treatment variables, numerous alloy and little standardization with
respect to testing.

134

F
ull veener crown
Research efforts continue so that eventually the techniques will become predictable by
having a scientific than an empiric base.
The Art : (Technique of ceramo-metal)
Design of coping

Single unit
Bridge
Splint

Metal preparation / Alloy treatment:

The investment on the cast framework is removed by air borne particle abrasion steam
and ultrasonic cleaning prior to treatment.
The surfaces of a coping that are to porcelain must be properly finished to assure a
strong bond and an esthetic restoration.
Metal finishing :
After sprue removal, the veneering area is finished using clean, noncontaminating stones and discs. Instruments used on other types of metal will
contaminate the veneering area.

Rough finishing can be done using Al2O3 stones.

Finishing the surface in one direction and using light pressure will help
avoid trapping debris between folds of metal, which is a problem when using high
content alloys with high elongation values.
The thickness of the sub-structure should be checked from time to time
and it should be atleast .3mm thick for noble alloys and .2 mm for basemetal. Cervical
collars can be thinned to a knife edge (.1mm).
135

F
ull veener crown
The demarcation between the surfaces to be and those not to be veneered
should be distinct with an external angle of 90 and rounded internal angle.
The surfaces not to be veneered are brought to a rubber wheel finish prior
to ceramic firing.
The metal-ceramic junction is delineated with stone or tungsten-carbide
bur and the veneering surface is air abraded with alumina (fine-grit).
The next step is to clean the alloy before oxidation.

Cleaning :
Grindin debris, oil and finger grease are some common contaminants that need to be
removed as they might interfere with wetting of metal by porcelain.
Ultrasonic cleansing (5 min), Rinsing with 92% alcohol and steam are the
various methods out of which steam has been found to be very effective.
Oxidising :
Metal surface treatments are unique for each porcelain alloy combination
and manufacturers recommendations should be followed.
Heat treatment of noble alloys causes the trace quantities of Dn, Ga, In and Zn in the
alloys to form oxides that enhance bonding with porcelain.
Base metal alloys, on the other hand oxidize readily and so oxidation has
to be carefully controlled. Following oxidation, most of these alloys are needed to be
air-abraded with alumina to minimize the thickness of oxide layer.
Some systems do not need the work to be held in the furnace for oxidation,
as they undergo continuous oxide formation.
136

F
ull veener crown

Although tech differ, base metal alloys are now not subjected to oxidation.
For noble alloys, the oxidation procedure includes inserting the
substructure into the furnace and raising temp above the firing temp of porcelain.
Oxidation is only one of the fune of this initial firing. It also helps to
release the H2 gas trapped on the alloy surface during casting which would otherwise
weaken the metal-ceramic bond.
Obtaining an optimum thickness of oxide layer is the final step in alloy preparation to
receive a ceramic veneer.

Build up is a skill that requires a great deal practice to develop. This is a brief
description for familiarization.

Porcelain Addition :
The casting is now ready for the actual placement of porcelain.
Dental porcelain is usually received from the manufacturer in powder form, which is
mixed either with water or a water based, glycerin containing liquid to form a paste of
a workable consitency.

Manufacturers specify the alloy systems with which their porcelain is compatible.
Usually compatibility refers to the relative coefficients of thermal expansion.
The shade selected clinically determines which powders to combine.

Opaque porcelain application:

137

F
ull veener crown
Opaque porcelain is applied first to mask the metal, to give the restoration
its basic shade and to initiate the porcelain- metal bond.
A small amount of opaque powder is dispensed on a glass slab or palette
and mixed with some modeling liquid.
The coping / framework is held with tweezers and moistened with some of
the liquid.
A small bead of opaque is picked with the tip of brush and applied to the
coping as a wash. Light vibration is used to spread it thinly and evenly. Moving a
serrated instrument back and forth over the handle of the tweezer will create the
necessary vibration. Excess moisture that comes to the surface can be blotted off with
a clean tissue. These steps help in proper condensation of porcelain. No attempt is
made to thoroughly mask the metal with this initial application.
It is intended to completely wet the metal and penetrate the striations created by
finishing.
Any excess opaque on the unveneered surface removed with a short, stiff dry brush.
The coping is placed on the saggertray, dried and fixed under vaccum to a specific
temp. The vaccum is then broken and the coping is held at the temp under air for 1
min.
The second application of opaque is then applied and this should mask the metal.
After firing the second layer, the total thickness of opaque should not
exceed .3 mm thick and should fulfil the following:

Should be a relatively smooth layer, masking the colour of the framework.

Have an eggshell appearance

138

F
ull veener crown

No excess on any external or internal surfaces of the restoration.

Body and Incisal Porcelains :

When a satisfactory opaque layer has been fired, the body and incisal porcelains are
applied.
Several porcelains are used in a restoration.
Eg. Opacious Dentins are used where less transluscency is required (eg. Gingival area
of pontic, incisal mamelons etc.)
Special neck powders can be applied on the cervical 1/3rd and incisal
powders to the incisal edge to simulate natural enamel.
Generally, the restoration is built to the anatomic contour, when it is
acceptable, a cut-back similar to that made during the waxing stage will allow for a
veneer of the more transluscent incisal porcelain.
Dispense the required powders on a glass slab or palette.
Wet the previously fixed opaque with a small amount of liquid. Place a
small bead of neck powder on the cervical portion of the neneering surface Gentle
patting with a brush and light tapping in the cast will produce adequate vibration
during preliminary stage of condensation. A tissue is held close for removal of excess
surface moisture.

Blotting consistently from lingual aspect is recommended and will result in

superior esthetics.

139

F
ull veener crown
Facial surface should not be blotted because the small pigment particles might be
removed.
After placing the neck powder and sculpting it, build the veneer to
anatomic contour with body porcelain, using adjacent and opposing teeth as guide.
When contact is anticipated between the wet build-up and stone-cast, the cast can be
coated with a small amount of cyanoacrylate resin to seal the surface and prevent
absorption of moisture from the build up.

To compensate for firing shrinkage, slightly overbuild the porcelain.

A typical meta-ceram ant crown will shrink 0.6 mm at the incisal edge and
5 mm midfacially.
Depending on the desired appearance, make a cut-back for the more
translucent incisal powder.
Some manufactures recommend carrying the incisal veneer all the way to
the cervical portion, while others limit it to the incisal third.
Almost an infinite variety of possibilities exist and only with experience
can the dentist predict the finished products appearance.
The cut-back should be made from incisal to cervical to minimize the
chance of damaging the incisal portion of the build up.
Apply the incisal powder and overbuild the restoration in the same manner
as for the body porcelain.

140

F
ull veener crown
The opposing cast should be marked with green or red markers and the
articulator is closed to check for occlusal contacts. The marks transferred onto
ceramic bun off without residue.
DO NOT USE BLUE, BLACK pigments as markers as they contain metal
oxides and carbon that discolour porcelain.
Moisten the proximal contact areas before removing the completed build
up from the cast to reduce the risk of fracturing that portion of the buildup.
Place the work on a sagger tray, inspect for any excess on the unveneered
area and remove if any, and dry it for 6-10 min in front of the open muffle and then
proceed with the firing.
After the bake allow the cooling rate recommended by manufacture,
otherwise residual stresses result in porcelain fracture during function.
Critically evaluate this first bake (low bisquebake). If any fissures are
found, grind before adding the second layer.
Remove all excess with ceramic bound stones and use a flexible diamond
disk to shape the embrasures. (Moist disk lasts longer).
Prior to the second corrective bake (patch bake), ultrasonically clean the
restoration to remove grinding debris.
Place the second body and incisal layers on the slightly moistened first
bake. Multiple bakes may be needed for an extensive prosthesis.
The number of bakes should be as low as possible as multiple fixing leads
to devitrification which causes loss of transluscency and decrease in the restoration
fracture resistance.
141

F
ull veener crown
Porcelain Surface treatment :
Once the desired contours and occlusion have been achieved, the
restoration must receive a surface treatment. Three commonly used treatments
include:
1)

Natural or autoglaze

2)

Applied overglaze

3)

Polishing

Autoglaze :
Porcelain has the ability to glaze itself when held at its fusing range under
air for 1-4 min. Many ceramists prefer this treatment as they feel that it preserves the
surface texture and character of the porcelain.

Applied over glaze :

It is a low-fusing clear porcelain that is painted on the surface and fired at
a temp. lower than the fusing temp of dentin and enamel porcelains.
Porcelain loses its ability to form a natural glaze after multiple firings, an
applied overglaze may be indicated on large restorations that have required numerous
corrections.
Polishing :
Traditionally, polished porcelain has been regarded as a rougher surface
than the glazed porcelain.

142

F
ull veener crown
Recent qualitative and quantitative studies indicate that an acceptable surface
can be obtained by using a commercially available polishing system.
Jacobi et al showed polished porcelain to be less destructive of tooth structure in the
opposing arch than glazed porcelain.
Polishing lends itself to use on relatively small areas of adjustments such
as proximal contacts and limited areas of occlusal contact.

All Porcelain margins :

Most patients object to the grayness at the margin associated with metal
ceramic restorations. Sub-gingival margins are best avoided.
When esthetics is of prime importance, a collarless metal-ceramic crown
should be considered.
Collarless crowns have a facial margin of porcelain and lingual and
proximal margins of metal.
Advantages :
o Good esthetics
o Easy plaque removal
Disadvantages :

Inferior marginal adaptation as compared to cast restoration

Susceptibility to fracture during handling

Time consuming and therefore expensive

Indications :
143

F
ull veener crown
Wherever superior esthetics are needed.

Contraindications :
1.

Conditions where an extremely smooth, 1 mm wide shoulder cannot be

prepared.

2.

Skill of the technician

Arame-work design for labial margin :

Various designs with different facial framework reduction have been suggested.
In general, the more the metal reduce, the better the esthetics.
Removal of upto 2 mm of labial framework has been shown not to decrease the
fracture resistance of restoration

Methods of fabrication :
1)

Platinum foil matrix

2)

Direct lift or cyanoacrylate resin

3)

Porcelain wax

Patient foil matrix tech :

Patient foil is burnished onto the facial portion where the porcelain margin
is to be placed. Place the coping onto the casting and stabilize the foil with stickywax.
Lift the coping along with the foil and spot weld them. After the porcelain build-up,
staining and glazing, the foil is removed prior to cementation.
144

F
ull veener crown
Direct-Lift : Die is coated with cyanoacylate resin and special shoulder porcelain is
condensed onto the die at the facial margin of the opaqued coping. The coping, along
with the shoulder porcelain is teared out of the die and fired.

Porcelain wax Technique :

A mixture of body porcelain and wax (6 : 1 by weight) is applied to the die
for the final adaptation of the porcelain labial margin.
The technique involves application of the porcelain wax to the cervical
shoulder of the opaqued coping and firing in the conventional manner.
Metal-ceramic restorations with excellent appearance and good mech prop
are obtainable if the techniques of metal preparation, framework design, porcelain
manipulation, drying and fixing are carefully followed.

145

F
ull veener crown
Full veener crown

DEFINITION

According to the Glossary of Prosthodontic terms 7

Full veneer crown is described as A restoration that covers all the coronal tooth
surfaces (Mesial, Distal, Facial, Lingual and Occlusal)

PORCELAIN FUSED TO METAL CROWN

Indications
On teeth that require complete coverage and where significant aesthetic demands
are placed
If all ceramic crown is contraindicated . . . . . . . .

Advantages

Superior esthetics as compared to cast metal crowns

Posterior porcelain fused to metal crown preparation

Lab knife with no. 25 blade

Silicone putty with accelerator

Handpiece

Flat ended tapered diamond

Short needle diamond

Torpedo diamond

Torpedo bur
146

F
ull veener crown

Radial fissure bur

Biangle chisel

PREPARATION
Silicone putty is adapted to the facial , lingual, and occlusal surfaces of the tooth to be
prepared.
Occlusal reduction

Round end tapered diamond is used to give depth orientation grooves. In the
areas of ceramic coverage reduction should be 1.5 to 2mm
Depth orientation grooves for functional cusp bevel is provided on the lingual
inclines of the maxillary lingual cusps and facial inclines of the mandibular
facial cusps. they provide a uniform bulk of restorative material. the depth is 1.5
mm if covered by metal and 2mm if veneered by porcelain.

Axial reduction
Cut three vertical grooves in the occlusal portion of the facial surface.
These are placed with full diameter of the instrument fading out in the area where the
facial surface is most curved. Now align the bur along the gingival component and
place atleast 2 more grooves near the line angles of the tooth. the tip of diamond
should be supragingival at this time. Now remove the facial surface with the flat end
tapered diamond. If facial reduction is less than1.2mm for a base metal crown or
1.4mm for a noble metal ceramic crown . . . . . . . . .

147

F
ull veener crown
At the lingual most extension of the proximal contact the transition from a
deeper facial reduction to the relative shallower lingual reduction results in vertical
wall or wing of tooth structure.

The facial silicone and midsaggital silicone putty index shows uniform
reduction on the facial surface and occlusogingivally.

All Ceramic Crown

INDICATIONS

In areas with a high esthetic requirement where a more conservative restoration

will be inadequate.

CONTRAINDICATIONS

Where a more conservative restoration can be used

Not indicated in molar tooth because of increased occlusal load and reduced
aesthetic demand.

ADVANTAGES

Superior aesthetics

DISADVANTAGES

Reduced strength

Proximal and lingual reduction are less conservative

Not effective as retainers for fixed partial dentures

148

F
ull veener crown

Wear has been observed on the natural teeth opposing all ceramic restoration

If inadequate tooth preparation goes uncorrected can result in fracture.

All ceramic crown tooth preparation

A combination of facial and lingual index is made by adapting silicone putty to the
facial, lingual ,and occlusal surface of the posterior teeth.

This will provide an accurate reference for both facial and lingual reduction

OCCLUSAL REDUCTION

Use large round end tapered diamond to place depth orientation grooves on the
occlusal surface.

The final occlusal preparation should be between 1.5mm to 2mm.

Remove the tooth structure remaining between the grooves following inclined
planes of occlusal surface.

Use the same round ended tapered diamond to produce depth orientation grooves
for the functional cusp bevel

Create the functional cusp bevel to insure that the facial incline of the facial cusp
will have the same porcelain thickness as the lingual incline..

Check the occlusal reduction by asking the patient to bite on a 1.5mm leaf of
thickness gauge
149

F
ull veener crown

Make depth orientation grooves on the facial and lingual surfaces to insure that
adequate reduction of tooth with a minimum thickness of 1mm at gingival finish
line

1.5mm at slightly less at mid-crown

Remove the remaining tooth structure between the grooves with the help of large
round end tapered diamond so that shoulder with a rounded internal line angle
can be formed.

Now use this short needle diamond to begin the proximal axial reduction.

As more space is created the needle diamond can be brushed across to produce
more reduction.

Use round end tapered diamond to blend the proximal axial reduction and
shoulder of facial and lingual surfaces.

Finishing of preparation- round end tapered diamond bur..

COMMON ERRORS IN TOOTH PREPARATION

Insufficient occlusal reduction

Lack of uniform reduction on buccal surface comprising esthetics

Minimal axial reduction on the buccal and lingual surfaces

Over reduction of teeth and violation of biologic width

Excessive taper of proximal surfaces

Variable shoulder width

150

F
ull veener crown

Undercuts on the distolingual surface of the preparation Rough tooth preparations.

CONCLUSION
The removal of all morphologic form of the tooth is a radical treatment
and restoring it properly can be difficult.
The full veneer crown is a restoration that replaces lost tooth structure and
imparts some measure of structural support to the tooth.
Hence, one must be able to judge correctly the type of restoration required
for each individual tooth and try to follow the guidelines for the respective tooth
preparation.

151

F
ull veener crown

References

Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby

Shillingburg(1981) Fundamentals of Fixed Prosthodontics 2nd edition
Quintessence

Tylman (1989) Theory and Practice of Fixed Prosthodontics. 8th edition

Ishiyaku EuroAmerica Inc

Shillingburg (1987) Fundamentals of Tooth Preparation for Cast metal and

Porcelain restoration. Quintessence Pub. Co.

C.J.Goodacre designing tooth preparation for optimal success.DCNA

2004;48:359-385.

F.M.Blair ,R.W.Wassell , J.G.Steele Preparation of full veneer crowns. BDJ

2002;192:561-571

Herbert T. Shillingburg, Sumiya Hobo, Donald W. Fisher. Preparation design

and margin distortion in Porcelain-fused-to-metal restorations. JPD 1973; 29:
276-284
152

F
ull veener crown

W.A.Kent , H.T.Shillinberg ,M.G.Duncanson. Taper of clinical preparation for

cast restoration. Quintessence international 1988;19:339-345

David L. Koth Full crown restoration and gingival inflamation in a

controlled population.JPD 1982;48:681-685

P. J. B. Leempoel, L. M. Leemens, P. A. Snoek, M.A.Vant Hoff The

Convergence Angle Of Tooth Preparation For Complete Crowns. JPD
1987;58:414-416

J.R.Gavelis ,J.D.Morency ,E.D.Riley ,R.B.Sozio- The effect of various finish

line preparations on the marginal seal and occlusal seat of full crown
preparation. JPD 1981;45:138-145

153