Table Of Content

Advanced Ceramics for Dentistry Advanced Ceramics for Dentistry James Zhijian Shen and Tomaž Kosmacˇ AMSTERDAM • BOSTON • HEIDELBERG • LONDON NEW YORK • OXFORD • PARIS • SAN DIEGO SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Butterworth-Heinemann is an imprint of Elsevier Butterworth-Heinemann is an imprint of Elsevier 225 Wyman Street, Waltham, MA 02451, USA First edition 2014 Copyright © 2014 Elsevier Inc. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. Permissions may be sought directly from Elsevier’s Science & Technology Rights Department in Oxford, UK: phone (+44) (0) 1865 843830; fax (+44) (0) 1865 853333; email: [email protected]. Alternatively you can submit your request online by visiting the Elsevier web site at http://elsevier.com/locate/permissions, and selecting Obtaining permission to use Elsevier material. Every effort has been made to contact the copyright holders. If permission has not been granted, please contact Elsevier immediately. Notice No responsibility is assumed by the publisher for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is availabe from the Library of Congress ISBN: 978-0-12-394619-5 For information on all Butterworth-Heinemann publications visit our website at books.elsevier.com Printed and bound in United States of America 14 15 16 17 10 9 8 7 6 5 4 3 2 1 List of Contributors Erik Adolfsson Ceramic Materials, Swerea IVF, Box 104, SE-431 22 Mölndal, Sweden Matts Andersson Chalmers University of Technology, SE-412 96 Göteborg, Sweden Thomas Beikler Department of Operative and Preventive Dentistry and Periodontics, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany Dag Henrik Bergsjö Chalmers University of Technology, SE-412 96 Göteborg, Sweden Johan Carlson Fraunhofer-Chalmers Research Centre for Industrial Mathematics, Chalmers Science Park, SE-412 88 Göteborg, Sweden Haifeng Chen Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, China Saverio Giovanni Condo Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy Robert Danzer Institut für Struktur- und Funktionskeramik, Montanuniversität Leoben, 8700 Leoben, Austria Jenny Fäldt Nobel Biocare AB, P.O. Box 5190, SE-402 26 Göteborg, Sweden Boštjan Jančar Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia Tomaž Kosmač Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia Danjela Kuscer Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia Yihong Liu Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China Tanja Lube Institut für Struktur- und Funktionskeramik, Montanuniversität Leoben, 8700 Leoben, Austria Karel Maca Department of Ceramics and Polymers, Brno University of Technology, Czech Republic Corrado Piconi Orthopedics Institute, Sacred Heart Catholic University, Rome, Italy Belinda Reinhardt Department of Operative and Preventive Dentistry and Periodontics, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany Simon Jegou Saint-Jean a David Salamon CEITEC-Central European Institute of Technology, Brno University of Technology, Technická 3058/10, 61600 Brno, Czech Republic Rikard Söderberg Chalmers University of Technology, SE-412 96 Göteborg, Sweden xi xii List of Contributors Peter Schüpbach Schupbach Ltd, Service and Research Laboratory, Zugerstraße 64, CH-8810 Horgen, Switzerland James Zhijian Shen Berzelii Center EXSELENT on Porous Materials, and Department of Materials and Environmental Chemistry, Arrhenius Laboratory, Stockholm University, SE-106 91, Stockholm, Sweden Martin Stefanic Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia Saso Sturm Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia Martin Trunec Department of Ceramics and Polymers, Brno University of Technology, Czech Republic Xinzhi Wang Department of Prosthedontics, Peking University School and Hospital of Stomatology, 100081 Beijing, China Jing Zhao Department of Prosthedontics, Peking University School and Hospital of Stomatology, 100081 Beijing, China; Department of Materials and Environmental Chemistry, Arrhenius Laboratory, Stockholm University, Stockholm SE-106 91, Sweden Preface Nowadays, you are likely to find references to the topics covered in this book, in two types of publication: reference books about bioceramics or dental ceramics; or about dental materials. However, whilst books covering the sub- ject of bioceramics might provide indepth coverage of the topic, books in the latter category will more likely present ceramics in an over simplified manner. In a way, neither type reflects the current status of the field, particularly the actions that are rapidly being taken for future developments. This is because the majority of ceramics currently in use in restorative dentistry are regarded neither as bio-oriented nor as being developed for dental purposes only, at least not at the moment of introduction into the field of dentistry. It was during close collaboration with dental practitioners and the dental industry that the editors of this book recognized a dissymmetry of knowledge concerning ceramics and the demands for ceramics. They felt a similar knowledge gap existed between ceramics and, in general, the practical demands of ceramics, in the fields of materials science and engineering. Advanced ceramics for dentistry appears to be such a topic. The original motivation for this book was to integrate two topics (advanced ceramics and the demand for advanced ceramics in restorative dentistry) into a single, comprehensive resource. We were encouraged by the favorable responses received during a successful symposium on “Advanced Ceramics and Ceramic Processes for Dentistry,” which we organized together with Horst Fisher, Leif Hermansson, and Jenny Fäldt in association with the 12th Conference of the European Ceramic Society that was held in Stockholm in June 2011. This book is still materials-oriented, but with a strong focus on the latest applications of advanced ceramics for solving the problems encountered in restorative dentistry. By highlighting existing problems and emphasizing new needs, we hope this book can, besides facilitating a better understanding of state-of-the-art solutions in both ceramics and dentistry, encourage interdisciplinary efforts for developing new concepts, materials, and technologies for the future. We realized the challenge at the very beginning of this initiative, when selecting activities across disciplines. Accordingly, efforts were made to create a balance between dental demands and materials demands, between fundamentals and practice, between coverage and depth, and between the current status of the field and future development. It would not have been possible to write a book with such broad coverage without the understanding and collaboration of all the individual authors involved. We sincerely appreciate the time and effort they have dedicated to this work. We would like to acknowledge the JECS Trust for the financial support that made it possible to arrange the topical symposium “Advanced xiii xiv Preface Ceramics and Ceramic Processes for Dentistry.” It was during this multidisciplinary symposium that most of the topics in this book were discussed. We would also like to thank Professor Daniel van Steenberghe for encouraging discussions and for suggesting topics, particularly those that relate to dental implants. One of us (Shen) would like to take this opportunity to acknowledge Professor Matts Andersson (the inventor of Procera®) and Professor Hailan Feng (School and Hospital of Stomatology, Peking University) for their inspir- ing discussions and close collaborations over the years. James Zhijian Shen Tomaž Kosmač Chapter 1 Introduction James Zhijian Shen* and Tomaž Kosmač† *Berzelii Center EXSELENT on Porous Materials; and Department of Materials and Environmental Chemistry, Arrhenius Laboratory, Stockholm University, Sweden; †Jožef Stefan Institute, Ljubljana, Slovenia Ceramic materials are currently used in two categories of application for restorative dentistry, namely, all-ceramic fixed-partial dentures (FPDs) and implantable components. While the former mainly demand integrated and balanced properties of mechanical and aesthetic origins, the latter also rely a great deal on the bio- oriented properties of materials. Innovations in ceramics and ceramic processes are vital to ensure reliable and affordable dental-restoration solutions with aes- thetically pleasing outcomes. A broad range of issues is challenging researchers and engineers in the ceramics community. These include developing bioactive surfaces on otherwise inert but load-bearing ceramics for implants; combining inherently chemically stable and physically stiff ceramics into highly coherent laminate composites for prosthetic crowns and bridges; improving the optical translucency of load- bearing ceramics for the manufacture of fully anatomic restorations (without the need for aesthetic veneering porcelain); and integrating feasible techniques for producing (in cost-effective and material-saving ways) long-lasting, individual- ized ceramic components with biocompatibility, complexity, and high precision. The development of advanced ceramics for dentistry is a topic of practice-motivated science that requires a multidisciplinary approach, and calls for collaborations across the disciplines of materials science, product design, mechanical engineering, imaging technologies, biology, chemistry, and clinical technologies for the development of new concepts, new materials, and new technologies. This is a never-ending journey, pursuing optimized clinical solutions through better understanding, better materials, and better processes to satisfy the increasing demands of patients, dentists, and social and environmental concerns. In general, patients are looking for affordable treatments by applying long- lasting prostheses that can restore or enhance their natural appearance and ful- fill all the necessary functions. Dentists would prefer to achieve the above goals through less invasive, less painful, more comfortable, and quicker procedures. In addition, social and environmental concerns place strong demands on green and material-saving approaches. Advanced Ceramics for Dentistry. DOI: http://dx.doi.org/10.1016/B978-0-12-394619-5.00001-8 © 22001144 Elsevier Inc. All rights reserved. 1 2 Advanced Ceramics for Dentistry The purpose of this book is to provide an overview of the recent progress made in this multidisciplinary field with a focus on the challenges presented to future concepts as well as current and emerging technologies. It is not our inten- tion to provide a history of the application of ceramics in dentistry, or to an indepth review of the ceramic materials and processes currently in use in dentistry, although we will cover most of the ceramics and ceramic components used for today’s dental restorations. This is why the book is entitled Advanced Ceramics for Dentistry rather than Advanced Ceramics in Dentistry. It is our aim to cover the topics of current focus and those of future interest. We hope that in this way the developers and manufacturers of ceramics will gain a better understanding of the exact demands of dental practices, while dentists and dental technicians will become more aware of the limitations and the potential of ceramics and ceramic processes in this field. In other words, by emphasizing the needs and exposing the problems, we hope this book will inspire a new way of thinking and encourage interdisciplinary efforts, rather than just be used as one more reference source. Because we had in mind potential readers from two different disciplines: materials science and dentistry (who have essentially different educational backgrounds), the first thing we did was to balance the selected topics and opti- mize their presentation. Efforts were made to establish a good structure for the sequence of covered topics in order to avoid the obvious risks of disordering and disintegration that can easily happen when handling a broad range of interdisciplinary topics. The book’s topics can thus be divided into seven groups: 1. Teeth as natural materials (Chapter 2). In this chapter, we look at teeth as natural materials. The development; formation; composition; microstructure; optical and mechanical properties; common defects; and damage to human teeth are reviewed. This knowledge set forms the basis of restorative dentistry for designing preventive treatments in order to maintain tissue integrity and to replace damaged tissues with synthetic materials (e.g. ceramics that mimic the natural appearance and performance of teeth). 2. Dental prostheses and dental implants and their clinical failures (Chapter 3–5). In these chapters, the common problems and difficulties encountered in restorative dentistry are described, including tooth defects and edentulism, as well as the clinical failures of dental prostheses. Despite the fact that there are no omnipotent prostheses, some general guidelines for prostheses selec- tion are given. This is essential for readers with a materials background, and is designed to help them get an understanding of the real-world problems that can be encountered. We hope it will also refresh the existing knowledge of readers with a dental background, and also present problems in such a way that their counterparts in another field can easily understand them. Chapter | 1 Introduction 3 3. Advanced ceramics, their processes and mechanical properties (Chapters 6–9). In these chapters, detailed descriptions are given to answer the general questions that readers with a dental background might have about advanced ceramics. How are they prepared? What are the relationships between their properties and microstructures? How can their microstructures and properties be characterized? The main focus is on their mechanical properties. This is essential materials knowledge used for dealing with ceramics, and is presented in a way that is easy to follow for readers with a dental background, but is still of interest to readers with a materials background when linked to clear application demands. 4. Interfaces between tissues and ceramics (Chapter 10). This chapter stands alone. The information presented here is about the interface between tissues and ceramics, and is also the interface of two disciplines: dentistry and materials. In order to understand this chapter, knowledge and skills from both disciplines are required. 5. Advanced ceramics currently in use in dentistry (Chapters 11–14). These chapters review the ceramics currently used in dentistry. An effort is made to not only describe where and how these ceramics are used, but also to explain why certain ceramics are chosen for specific purposes and what problems are typically encountered. Accordingly, the means of improving the mechanical, bio-, and aesthetic properties of ceramics as bulk, porous bodies, or surface-active layers are presented. We hope the knowledge and philosophy presented in this part will pave the way towards ceramics by design. 6. Industrial-scale production of customized ceramic prostheses (Chapter 15). The current, highly flexible production processes used for customized dental prostheses are reviewed in this chapter. These include digitaliza- tion, computer-aided design, and milling. Quality issues are also addressed, including prospects for further improvements: adapting new ceramic materials, and using new materials processes and highly digital treatment processes. 7. Concepts for the future (Chapters 16–18). These chapters address material and process demands for solving the problems encountered in current practice that indicate the direc- tion of future development. In the near future, minimization of process- ing defects will continuously appear as a major task for improving the performance and reliability of dental prostheses. In the longer-term, biomimetic materials and related processes will be topics of general importance. Current subtractive manufacturing processes, which gener- ate huge material waste, have encouraged the development of more sus- tainable, material-saving, and cost-effective concepts (e.g. rapid additive manufacturing processes).