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Chairside computer-aided design/computer-aided manufacturing (CAD/CAM)-based restoration of anterior teeth with customized shade and surface characterization: a report of 2 cases

CAD/CAM을 이용한 전치부 수복시 색조 및 표면 특성의 개별화를 시행한 증례

  • Kim, Hyun-Jung (Department of Conservative Dentistry, Kyung Hee University Dental Hospital) ;
  • Jang, Ji-Hyun (Department of Conservative Dentistry, School of Dentistry, Kyung Hee University) ;
  • Ryu, Gil-Joo (GoodWill Dental Hospital) ;
  • Choi, Kyoung-Kyu (Department of Conservative Dentistry, School of Dentistry, Kyung Hee University) ;
  • Kim, Duck-Su (Department of Conservative Dentistry, School of Dentistry, Kyung Hee University)
  • Received : 2020.02.26
  • Accepted : 2020.05.01
  • Published : 2020.06.30

Abstract

Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L*a*b* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from 'copy and paste technique' and 'mirror image acquisition technique'. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.

지난 30년동안, CAD/CAM 시스템을 이용한 수복 시스템은 눈부시게 발전하였다. 구치부 수복에서 널리 쓰이던 것과는 달리, 환자와 임상가의 심미적인 요구를 충족해야 하는 전치부 수복 증례에서는 CAD/CAM 시스템을 이용하는데 다소 한계가 있었다. 단일 색조를 가지는 CAD/CAM 수복물에 다양한 색조를 부여하기 위해, A2 lithium disilicate (LS2) 블록에 staining kit를 이용하여 색조 개별화를 시행하여 다양한 색조를 표현하는 예비실험을 시행하였다. 색조 개별화를 진행한 시편을 spectrophotometer를 이용하여 CIE L*a*b* 값을 측정한 후, 임상에서 널리 사용되고 있는 shade guide와 비교하였다. 예비 실험 결과를 바탕으로 2명의 환자의 전치부 수복시, 치아의 부위별 색조 재현과 표면 특성의 개별화를 진행한 증례를 소개한다. 수복물의 해부학적 형태는 CAD/CAM 시스템에서 '복사 및 붙여넣기 기능'과 '거울상 획득 기능'을 이용하여 디자인하였으며, 이 연구에서 소개하는 모든 임상 및 수복물의 기공과정은 진료실 내에서만 이루어졌다.

Keywords

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