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Thursday, June 6
Friday, June 7
Saturday, June 8
Sunday, June 9

Session I: The Creation of Optimal Ceramic Esthetics


Integration of Esthetic Dentistry in Routine and Complex Prosthodontics


Kenneth A. Malament
Friday, June 7
10:45 am - 11:45 am
Grand Ballroom (Salon G-K)

Dentistry that is esthetic to the patient is an important clinical objective. Ceramics are the most consistently predictable esthetic dental material. Metal-ceramics are the “state of the art” for complex implant prosthodontics, but single-phase or monolithic all-ceramic materials have become increasingly popular for esthetic restorations because they do not chip like bi-layered ceramic materials, ensuring more long-term success. The lithium disilicate e.max and zirconia monolayered all-ceramic material is changing dentistry and the expectation for long-term ceramic survival. Ultimately, crown performance is a complex set of interactions between crown material and geometry, the characteristics of the support structure of the cement and crown, and the clinical loading history. This presentation will provide a comprehensive look at failure modes and effects in bilayered all-ceramic crown-cement-tooth systems, tying together the influences on resistance to fracture initiation and propagation of ceramic material properties and thickness; crown/tooth geometry; cement modulus and layer thickness; damage induced by shaping, fabrication, clinical adjustments, and sandblasting; and fatigue in the wet intraoral environment. Original research will be presented that studied the clinical behavior of over 5,000 all-ceramic restorations, including life history and fracture rates over a period of 20 years. Factors such as tooth position, preparation, luting procedures, and sex were shown to be significant to long-term ceramic success. At the conclusion of this lecture, participants will understand the factors and concerns surrounding esthetic procedures, the problems and controversies that exist with modern dental materials, the clinical factors that impact long-term survival of dental ceramic materials, and the science of dental ceramic materials, with a look to the future.


Kenneth A. Malament, DDS, MSCD, received his dental degree from the New York University College of Dentistry and a specialty certificate from the Boston University School of Graduate Dentistry. He is a clinical professor at Tufts University and a course director in the postgraduate Department of Prosthodontics. He is a past president of the American Board of Prosthodontics, the Greater New York Academy of Prosthodontics, the Northeastern Gnathological Society, and the Northeast Prosthodontic Society. He is also an active member of the International College of Prosthodontists, the American Academy of Fixed Prosthodontics, the American Academy of Esthetic Dentistry, and the Academy of Osseointegration. Dr Malament was on the research and development teams for two different wellknown ceramic products and developed instrumentation used in clinical practice. He maintains a full-time private practice limited to prosthodontics in Boston that includes a dental laboratory with master dental technologists.