Cosmetic dentistry using ceramic restorations can easily be underestimated in its complexity, even by clinicians prepared to face the challenges involved. A structured and concise overview designed to overcome the confusion often felt by practitioners was on the agenda of the Society of Dental Ceramics (SDC) immediately after its establishment in 1999.
The organization quickly began preparations to write and publish a white paper that would present all of the treatment guidelines for all-ceramic restoration. With the help of experts from universities, private practices and the dental industry, special reports dealing with variants and new developments were collected and structured by this alliance of experts and published for the first time in German in 2006 as a handbook All-ceramic at a glance.
The handbook soon gained a reputation among dental professionals worldwide as a comprehensive reference work on the subject. Mainly because it is up-to-date in indications and materials and the topics are concisely expressed in a user-friendly manner, it soon attracted international interest. This led to the publication of French, Japanese, Korean and English versions and excerpts in Chinese.
The Third Edition
To address new experiences with all-ceramics and continue to offer guidance internationally in biocompatible and esthetic solutions, the third English edition of All-ceramic at a glance appeared in early 2017 and was presented at the International Dental Show 2017 in Cologne. Supervised by lead authors Van P. Thompson, DDS, PhD, of King’s College London Dental Institute and New York University College of Dentistryand Matthias Kern, DMD, PhD, of University of Kiel In Germany, in collaboration with other experienced co-authors, the manual was revised with additional content and recently re-released by SDC as a hardcover.
The authors have organized the topics into 27 different main chapters with excellent illustrations. Starting with an overview of the uses of ceramics, they then refer to the various indications in dentistry. Guided by clearly defined key points, readers learn about the indications and procedures for inlays, inlays, partial crowns, veneers, anterior partial crowns, anterior and posterior crowns and bridges, and double crowns and implants.
The authors use a standardized scheme to sequentially present planning (material selection, fabrication methods), indication, preparation, impression taking, CAD/CAM capabilities, provisional restoration, insertion, and follow-up care. The procedure for restoring the insert is clearly detailed in a descriptive table. To more effectively illustrate the specific characteristics of ceramic restorations in terms of preparation procedures, veneer thickness, and bridge connector dimensions, the authors refer to easy-to-understand diagrams.
The authors then turn to clinical procedures. Here, they point out the importance of the languid technique. In addition to a step-by-step description of how to perform adhesion, several tables and flow charts provide information on selected cementation techniques depending on the material properties of commercially available ceramic systems. In addition to articulating the differences between dentin adhesives, the flow charts also explain the process of inserting all-ceramic restorations according to the material, the hard dentin substance available, and the dentin adhesive chosen. Thus, the compatibility of the various materials is clearly presented. This overview alone makes restoration using ceramics easier, saves time and demonstrates the usefulness of the manual in everyday practice.
The authors then turn to occlusal facets to restore abraded dentition and raise the bite or as a means of changing occlusal position and performing functional corrections. The suitability of various materials for monolithic (ie, veneerless) crowns and bridges—also in terms of esthetics and anatomical conditions—is clearly defined. In addition, recommendations are given to practitioners on how to avoid chipping of oxide-ceramic coated frameworks. The procedure for single-sided anterior tooth bridges is presented in the guideline, based on clinical success at 10-year follow-up. Implant superstructures and single and double abutment prosthetic options are evaluated in great detail.
In addition, new polymer-doped and zirconia-reinforced composites are introduced, along with their areas of application and available clinical evidence. In addition to relevant literature on the clinical reliability of many treatments, an evidence-based guideline for all-ceramic crowns and bridges provides dentists with the ultimate expertise for long-term restorative success, allowing them to avoid clinical risks and material-related complications. Failure prevention is addressed as well as how to manage failures to ensure the durability of dentistry.
Finally, the product section presents all the current ceramic systems of the various manufacturers individually. A comprehensive bibliographic survey completes the volume.
An overall view
The book can really be considered a handbook of “indications, material selection, techniques for preparation and insertion of all-ceramic restorations”. As such, it has a lot to offer both newcomers and experienced ceramic users. Newcomers will certainly appreciate the esthetic restorations possible with ceramics and develop an interest in this restorative material, while those experienced in the field will find the manual a valuable reference work. By the end of the book, readers will feel fully informed and confident in their memory of the information when prompted.
The next edition is expected to deal even more closely with the coordination of clinical workflows and laboratory procedures for the fabrication of all-ceramic restorations. Ceramic is a demanding material and requires close communication between the dentist and the dental technician, especially when it comes to complex restorations, functional reconstructions and implant prostheses.
Overall, the authors provide factual knowledge in an easy-to-understand format, opening the door to a highly innovative field. This corresponds to multiple versions. The third English edition will undoubtedly contribute to the international standardization of treatment guidelines on clinical and technical procedures with ceramics, and should be expected to ensure widespread, long-term clinical success.
This book benefits clinicians and practitioners regardless of age or experience. It can also be highly recommended for the education of dental students and dentists in training.
All-ceramic at a glance, Third English Edition, by M. Kern, VP Thompson, F. Beuer, R. Frankenberger, RJ Kohal, KH Kunzelmann, P. Pospiech, and B. Reiss, is 190 pages in hardcover. It costs $65.00 plus shipping. For more information, please email info@ag-keramik.de.
Dr. Swaczyna was a general dentist in Krefeld, Germany for 30 years before retiring in 2007. He can be reached at nocavity@googlemail.com.
Relevant Articles
S Mutans also sticks to ceramics
Study Ranks Chairside CAD/CAM Materials for durability
The consumables market will reach $27.6 billion in 2023
