SITI FATIMAH BINTI MOHD KAMAL 2ND YEAR DENTISTRY

METAL-CERAMIC RESTORATION
Also called porcelain fused to metal restoration (PFM). It consists of a ceramic layer bonded to a thin cast metal coping that fits over the tooth preparation. Metal-ceramic restoration combines the strength and accurate fit of a cast restoration with the cosmetic effect of a ceramic crown. The metal substructure made Metal-ceramic restoration have greater strength than restorations made of ceramic alone.

Metal-ceramic restoration can be used in a wide variety including the replacement of missing teeth with fixed-partial denture.

PREPARATION STEP
The tooth preparation is also combine of deep reduction facially and shallower reduction lingually. There may be a wing on each proximal surface where the deep reduction ends and the shallower proximal reduction begins. A uniform reduction of approximately 1.2mm is needed over the facial surface of anterior metal ceramic crown.

ARMAMENTARIUM

1. Lab knife with no:25 blade. 2.Silicone putty. 3. Round End tapered diamond. 4. Small wheel diamond 5. Long needle diamond. 6. Radial fissure bur (rounded shoulder) 7. Modified binangle chisel.

ANTERIOR METAL-CERAMIC CROWN PREPARATION PROPERTIES :

FACIAL MARGIN
# Deep Chamfer # Shoulder with bevel # Shoulder # Radial shoulder

STEP NO. 2 Incisal reduction (2mm) using round-end tapered diamond.

STEP NO. 1 Placement of depth orientation grooves (1.2mm) The Labial grooves are cut in two sets. 1. One set parallel with the gingival half of labial surface. 2. One set parallel with the incisal half of labial surface.

STEP NO. 3 Labial reduction (incisal half) using roundend tapered diamond.

STEP NO. 4 Labial reduction (gingival half) using roundend tapered diamond.

STEP NO. 5 Lingual reduction (0.7-1mm) using small wheel diamond.

STEP NO. 8 Smoothening the sharp angles.

STEP NO. 6 Initial proximal reduction using long needle diamond.

STEP NO. 7 Lingual axial reduction using round-end tapered diamond.

POSTERIOR METAL-CERAMIC RESTORATION

STEP NO. 1 Occlusal reduction followed by functional cusp bevel. STEP NO. 3 Facial reduction-occlusal half.

STEP NO. 4 Facial reduction gingival half.

STEP NO. 2 Depth orientation grooves.

STEP NO. 5 Proximal axial reduction.

STEP NO. 8 Gingival bevel.

STEP NO. 6 Lingual axial reduction.

STEP NO. 7 Axial finishing.

Indications of Metal Ceramic:

The metal ceramic crown is indicated on teeth that require complete coverage, where significant esthetic demands are the placed on the dentist. Ex:-anterior teeth. Extensive tooth destruction as a result of caries, trauma of existing previous restorations that precludes the use of more conservative restoration. For superior retention & strength. An endodontically treated teeth in conjunction with a suitable structure. Ex:-post & core If all ceramic crown is contraindicated

Contraindications of Metal Ceramic and Complete Ceramic Crowns:

Contraindications for the metal-ceramic crown, as for all fixed restoration, include patients with active caries of untreated periodontal disease. In young patients with large pulp chambers. Intact buccal wall. When more conservative retainer is technically feasible.

Advantages:

The metal-ceramic restoration combines to a large degree the strength of cast metal with the esthetics of an all ceramic crown. Retentive qualities are excellent because all axial walls are included in the preparation. Natural appearance can be closely matched by good technique and if desired through characterization of the restoration with internally /externally applied stains. In addition, the required preparation often is much less demanding than for partial-coverage retainers.

Disadvantages:

Removal of substantial tooth structure. Subject to fracture because porcelain is brittle. Difficult to obtain accurate occlusion is glazed porcelain. Expensive. Inferior esthetics compared to all ceramic crown.