|Year : 2020 | Volume
| Issue : 1 | Page : 34-37
Chairside ceramic repair
Vimal Bharathi Bolloju1, P Parameswar Naishadham2, A Gautam Kumar3, Sandhya Jadhav4, M Praveen3
1 Department of Prosthodontics, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India
2 Department of Oral Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India
3 Department of Prosthodontics, Panineeya Institute of Dental Sciences, Hyderabad, Telangana, India
4 Department of Orthodontics, KNR University of Health Sciences, Warangal, Telangana, India
|Date of Submission||28-Sep-2019|
|Date of Acceptance||30-Sep-2019|
|Date of Web Publication||24-Jan-2020|
Vimal Bharathi Bolloju
Department of Prosthodontics, Panineeya Mahavidyalaya Institute of Dental Sciences, Kamala Nagar, Hyderabad - 500 060, Telangana
Source of Support: None, Conflict of Interest: None
Metal–ceramic restorations are used for fixed restorations very commonly, and sometimes, failure of these may need a removal and making a new restoration. It may destroy the abutment. Three categories of repair techniques are available for fractured metal–ceramic restorations, of which the treatment is chosen depending on the clinical acceptability. If the defects are small, these can be repaired intraorally with a ceramic repair kit without remaking the restoration. This article presents one such case report.
Keywords: Bond failure, ceramic repair, ceramic repair kit
|How to cite this article:|
Bolloju VB, Naishadham P P, Kumar A G, Jadhav S, Praveen M. Chairside ceramic repair. J Oral Res Rev 2020;12:34-7
| Introduction|| |
Metal–ceramic restorations are the common restorations for the replacement of missing teeth. These restorations are durable and have long-term clinical success. At times, there may be smaller metal to ceramic bonding failures due to various causes. The ceramic's brittle nature renders fractures occasionally. This case report explains the causes for failure of metal–ceramic bonding and technique for intraoral chairside clinical repair of the same.
Metal–ceramic bond strength depends on (1) molecular bonding between the oxide layer and on the metal substrate to the porcelain, (2) mechanical bonding by creating surface roughness by sandblasting, and (3) compression bonding which is created by thermal contraction, wherein the coefficient of thermal expansion of the substrate metal is slightly more than that of the porcelain.
The bond failures between the porcelain and metal can be seen as porcelain delamination due to incompatible materials, over or under oxidation, and contamination. Delamination of porcelain can be due to loss of the bonding of the oxide layer that is poorly adherent to the metal or was too thick. This type of failure is seen between the metal and oxide layers. Incompatibility in terms of the coefficients of thermal expansion of the metal and porcelain is too great and also causes cracking of the ceramic veneer. Over or underoxidation can lead to the formation of an oxide layer that is either too thick or weak. The contamination of the substrate also may lead to debonding causing fracture of porcelain which affects the esthetics and causes a clinical problem. Fabrication of new prosthesis requires its removal that may destroy the abutment teeth. Therefore, it is preferable to repair the fractured prosthesis which increases the durability of the prosthesis and also offers the patient and the clinician a treatment that is economical.
The various techniques used for repair of fractured ceramic restorations (facings) include re-bonding of the fractured chip to the fixed restoration, bonding a porcelain veneer to the fractured porcelain, or using a resin-based composite (RBC) to restore the fractured porcelain, among which easier, faster, and less expensive technique is the use of RBCs.,
The intraoral technique that was implemented to repair the fractured porcelain restoration was using a RBC.,
| Case Report|| |
A 27-year-old male patient reported to the department of prosthodontics with chipped metal–ceramic restoration on the retainer of maxillary left lateral incisor of a four-unit anterior fixed partial denture. The bonding failure was seen at the margin showing the metal underneath [Figure 1]. As the defect was small and the fixed partial denture was recently fabricated, the treatment decided was to repair the ceramic intraorally using a ceramic repair kit. The ceramic repair kit (IVOCLAR) consists of a silane coupling agent (Monobond Plus), bonding agent (Heliobond), opaque to masque the metal (IPS Empress), and composite in different shades (TETRIC EVOCERAM).
The repair procedure included removal of any unsupported ceramic, and the metal was abraded slightly using medium grit diamond point. Then, the area was isolated and silane coupling agent was applied on the metal and air-dried for 1 min. It was followed by the application of bonding agent which was light cured [Figure 2]. Over this, a layer of opaque material was applied and light cured for 20 s [Figure 3]. The selected shade of the repair material was applied on the opaque layer and light cured [Figure 4]. After the material was cured, it was finished using a fine grit diamond point and was polished with polishing discs [Figure 5]. The patient was satisfied with the result, as the repair was done chairside without refabricating the fixed partial denture and the esthetic outcome was satisfactory [Figure 6].
| Discussion|| |
According to the literature available, the anterior porcelain-fused-to-metal fixed partial dentures are subjected to shear stresses that lead to fracture of porcelain, commonly in clinical practice.
After dental caries, the second greatest cause for replacement of restorations is failure of ceramics. The other causes for fracture of ceramics include trauma, inadequate occlusal adjustment, parafunctional habits, flexural fatigue of the metal substructure, incompatibility of the coefficient of thermal expansion between the ceramic and the metal structure, failures in the adhesive bonding, inadequate tooth reduction during dental preparation, porosities in the ceramic, and inappropriate coping design. The treatment of choice for smaller defects is to utilize intraoral repair systems as they are convenient, effective, less time consuming, restore the esthetics and function, inexpensive, and does not necessitate fabrication of new prosthesis. The intraoral repair systems act by increasing the surface area mechanically, decreasing the surface tension, and enhancing the adhesion between the porous metal–ceramic surface and the resin, thus improving the bond between the metal substructure and the resin,,, and durability of the prosthesis. The bond between the composite and ceramic surface is contributed by the silane coupling agent while enhancing the wettability of the ceramic surface. The penetration of monomers into the composite surface is contributed by the bonding agent. Therefore, composite resins with their greater viscosity are suitable for the repair of fractured ceramics in such clinical scenarios.
| Conclusion|| |
Although metal–ceramic restorations are widely used in indirect restorations, these materials can also fail at times. These bonding failures if small can be repaired intraorally without remaking the whole fixed partial dentures using a ceramic repair kit.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]