Aesthetic dentistry using ceramic restorations can easily be underestimated in its complexity, even by clinicians prepared to address the challenges involved. A structured and yet concise overview designed to overcome the confusion frequently felt by practitioners was on the agenda of the Society for Dental Ceramics (SDC) soon after it was founded in 1999.
The organization quickly began preparations to write and publish a white paper that would present the entire treatment guidelines on all-ceramic restoration. With the help of experts from universities, private practices, and the dental industry, specialist reports dealing with variations and new developments were compiled and structured by that alliance of experts and first published in German in 2006 as the handbook All-Ceramics at a Glance.
The handbook soon acquired a reputation among dental professionals worldwide as an accomplished work of reference on the subject. Mainly due to being up-to-date on indications and materials and having topics expressed concisely in a user-friendly way, it soon attracted international interest. This led to editions in French, Japanese, Korean, and English, and excerpts in Chinese being published.
The Third Edition
To deal with new experiences regarding all-ceramics and continuing to offer orientation internationally on biologically compatible and aesthetic solutions, the third English edition of All-Ceramics at a Glance appeared at the beginning of 2017 and was presented at the International Dental Show 2017 in Cologne. Overseen by lead authors Van P. Thompson, DDS, PhD, of the King’s College London Dental Institute and New York University College of Dentistry, and Matthias Kern, DMD, PhD, of the University of Kiel in Germany, in cooperation with other experienced co-authors, the handbook has been revised with additional content, and it has been newly re-released by the SDC as a hardcover.
The authors have organized the topics into 27 different main chapters featuring excellent images. Starting with an overview on the uses of ceramics, they then address the various indications in dentistry. Guided by clearly defined key points, readers learn about the indications and procedures for inlays, onlays, 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 (choice of materials, fabrication methods), indication, preparation, impression taking, possibilities for CAD/CAM use, provisional restoration, insertion, and follow-up care. The procedure for an inlay restoration is clearly laid out in detail in a descriptive table. To more effectively illustrate the special characteristics of ceramic restorations in terms of preparation procedures, veneer thickness, and bridge connector dimensions, the authors refer to easily understandable diagrams.
The authors next turn to clinical procedures. Here, they point out the importance of the luting technique. In addition to a step-by-step description of how to perform adhesion, several tables and flowcharts provide information on selected cementation techniques depending on the material properties of the commercially available ceramic systems. Apart from spelling out the differences among dentin adhesives, the flowcharts also explain the procedure for inserting all-ceramic restorations according to the material, available hard tooth-substance, and dentin adhesive chosen. Thus, the compatibility of the various materials is also clearly presented. This overview alone makes restoration using ceramic easier, saves time, and proves the usefulness of the handbook in daily practice.
Subsequently, the authors address occlusal veneers in restoring abraded dentition and bite raising or as a means of changing the occlusal position and performing functional corrections. The suitability of various materials for monolithic (ie, veneer-free) crowns and bridges—also in terms of aesthetics and anatomic conditions—is clearly defined. Moreover, practitioners are given recommendations on how to avoid the chipping of veneered oxide-ceramic frameworks. The procedure for single-wing anterior- tooth adhesive bridges is presented in the guideline, based on clinical success in 10-year follow-ups. Implant-borne superstructures and the prosthetic options with single and double abutments are assessed in great detail.
In addition, new compound materials with polymer doping and zirconia reinforcement are introduced, along with their areas of application and available clinical evidence. Besides relevant literature on the clinical reliability of many treatments, an evidence-based guideline for all-ceramic crowns and bridges offers dentists the ultimate know-how for long-term restoration success, enabling them to avoid clinical risks and materials-related complications. Prevention of failure is addressed as well as how to manage failures to ensure dentistry that lasts.
Finally, the products section individually presents all of the current ceramic systems by the different manufacturers. A comprehensive literature survey completes the volume.
An Overall View
The book can truly be regarded as a manual of “indications, material selection, preparation, and insertion techniques of all-ceramic restorations.” As such, it has much to offer newcomers and experienced ceramic users alike. Newcomers will certainly appreciate the aesthetic restorations possible with ceramics and develop an interest in this restorative material, while those experienced in the field will find the manual to be a valuable work of reference. By the end of the book, readers will feel completely up to date and confident in their memory of the information when required.
The next edition can be expected to deal even more closely with the coordination of clinical workflows and lab procedures in the fabrication of all-ceramic restorations. Ceramic is a demanding material and requires close communication between the dentist and the dental technician, especially when dealing with complex restorations, functional reconstructions, and implant prosthetics.
In general, the authors provide well-founded knowledge in an easily comprehensible form, opening the door to a highly innovative field. This accounts for the multiple editions. The third English edition will undoubtedly contribute to internationally standardizing treatment guidelines on clinical and technical procedures with ceramic, and it should be expected to ensure widespread, long-term clinical success.
This book benefits clinicians and practitioners regardless of age or experience. It also can be highly recommended for the education of dental students and for dentists in training.
All-Ceramics at a Glance, Third English Edition, by M. Kern, V. P. Thompson, F. Beuer, R. Frankenberger, R. J. Kohal, K.H. Kunzelmann, P. Pospiech, and B. Reiss, is 190 pages in hardcover. It costs $65.00 plus shipping. For more information, 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.
Related Articles
S Mutans Sticks to Ceramics, Too
Study Ranks Chairside CAD/CAM Materials for Toughness
Consumables Market to Reach $27.6 Billion in 2023
