Hybrid Ceramics in Dentistry

Hybrid Ceramics in Dentistry: A Literature Review
G. Jorquera, E. Mahn, J. P. Sanchez, S. Berrera, M. J. Prado, Vanessa

Bernasconi Stange
Department of Oral Rehabilitation, Universidad de los Andes, Santiago, Chile
ABSTRACT:
The scientific and technological development of dental materials
grows exponentially, every year new materials are placed on the
market with the aim of giving dentists new clinical alternatives for the
treatment of their patients. This added to that all new materials are
focused on the application of new technologies such as cad-cam
systems. Hybrid ceramics seek to combine the optical and mechanical
properties of ceramics and composite resins, two of the most used
materials in restorative dentistry.
This review article aims to ensure that clinical dentists know and can
choose the best treatment option for their clinical cases.
Key words: Ceramics blocs, dental ceramics, hybrid ceramics, resin
blocs
INTRODUCTION:
The continuous development of new materials for computer-aided
design/computer-aided manufacturing (CAD/CAM) systems has
allowed to increase the variety of alternatives for the clinician to
rehabilitate their patients. As is known, CAD/CAM technology has
permitted to reduce the number of clinical sessions and fabrication
time of dental restorations, as well as allowing the use of new
materials with better mechanical and optical properties. The first
CAD/ CAM restoration was fabricated in 1985 with the CEREC 1 unit
and was made with a prefabricated ceramic block. Since then, the
technique has evolved, being more economic, quick, and precise.[1]
Ceramics and composites are some of the materials available for
definitive machined restorations. Ceramics have excellent mechanical
and optical properties, as well as biocompatibility; however, they are
fragile, rigid, and hard to repair. On the other hand, composites are
easy to manipulate and repair, more flexible, and less abrasive on the
antagonist tooth, but their poor wear resistance and difficulty to
obtain good polish put them in a disadvantage compared to
ceramics.[2] Conventional ceramics produce highly esthetic
restorations; however, some studies have identified a higher
incidence of failure of these materials, possibly caused by their
rigidness and abrasive effect on the antagonist tooth.[3] Machinable
composite blocks suffer high material wear levels, loss of superficial
gloss, and color instability, as well as low resistance to fracture.[3]
Some authors suggest associating the elastic modulus of composites,
being similar to that of dentine, with feldspathic ceramic, being
similar to enamel, adding esthetic properties while searching for the
ideal restorative material.[4] To fulfill this objective, materials that
intend to simulate mechanical and optical properties of a natural
tooth have been developed, hybrid ceramics. This mixed structure
would reduce fragility and superficial hardness of the material,
allowing for an easier milling in a shorter time and promising better
clinical results.[5] As a part of these new hybrid materials, we can find
Vita Enamic (VE) (Vita Zahnfabrik), a polymerinfiltrated ceramic-
network; Lava Ultimate (LU) (3M ESPE), a resin nanoceramic; and
Cerasmart (GC Dental Products), a hybrid ceramic with nanofiller
particles.[1] Up to date, there is a lack of scientific evidence regarding
hybrid ceramics. In fact, to this moment, there are no randomized
cohort clinical studies that evaluate the clinical performance,
properties, or indications of these materials. It is for this reason that
the present review has the objective of organizing the available
evidence in relation to these new materials and tries to comprehend
their optical and mechanical properties to orientate material
selection for the clinician. In this review, 18 in vitro studies were
included, comparing three types of hybrid ceramics (VE, LU, and
Cerasmart) against conventional materials, in relation to their optical
and mechanical properties.

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Hybrid Ceramics in Dentistry: A Literature Review

G. Jorquera, E. Mahn, J. P. Sanchez, S. Berrera, M. J. Prado, Vanessa

Department of Oral Rehabilitation, Universidad de los Andes, Santiago, Chile

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