• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.1
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• pp.81-92
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• 2014

It is so hard to obtain optimal anterior esthetics in the implant prosthesis. This is not only because of hard and soft tissue problem such as alveolar bone resorption and interdental papilla loss but also because of prosthetic limitation related to marginal exposure of metal abutment and metal ceramics and low transillumination. In this case, guided soft tissue healing is obtained using a long term provisional restoration with soft and hard tissue augmentation or immediate implantation. Then, this healed tissue is transferred to final master model using a customized impression coping and the implant is restored with a customized zirconia abutment and a all ceramics. This case presents satisfying result esthetically and functionally.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.146-151
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• 2016

In patients with fully edentulous maxilla, fabrication of implant-supported overdenture can be a viable treatment option, when a minimum of six implants were strategically placed. Among several attachment systems used for implant-supported overdentures, milled-bars prevent rotational movement of denture, thus showing great stability, and have the advantage of splinting multiple implants with each other. In this case report, a milled-bar supported overdenture was fabricated for a patient suffering from condition of fully edentulous maxilla with severe ridge resorption in the anterior residual ridge. Seven implants composed of three different systems were effectively utilized by CAD/CAM customized abutment and cement-retained milled bar.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.67-73
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• 2012

Fixed dental prostheses such as inlay, onlay, crown, and bridge fabricated by CAD/CAM technique combined with digital impressions is getting popular due to the recent rapid progress of digital impression taking system. For the scope of implant prosthesis, however, digital intra-oral scan hasn't been actively utilized for the fabrication of superstructures. In this case report, 6 cases of titanium-milled custom abutment based on the iTero intra-oral scan data were introduced, five of them were restored with screw-type prosthesis after cementation (SCRP) and the clinical results were satisfactory on restoring the function and esthetics.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.157-166
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• 2018

Purpose: This study was aimed to compare the consistency between the custom abutment design and the output in two CAD software programs. Materials and Methods: Customized abutments were designed by using 3Shape Dental System CAD software and Delta9 CAD software on a plaster model with implants (CRM STL file). After milling of the designed abutments, the abutments were scanned with a contact method scanner (Test STL file). We overlaid the Test STL file with each CRM STL file by using inspection software, and then compared the milling reproducibility by measuring the output error of the specimens from each CAD software program. Results: The Delta9 showed better milling reproducibility than 3Shape when comparing the milling errors obtained with a full scan of all specimens (P < .05) and also when comparing the axial wall region specifically according to the axial angle. With 0.9 mm marginal radius, the Delta9 showed better consistency between the design and the output than 3Shape (P < .05). While, anti-rotation form had no significant difference in error between the two systems. When cumulative errors were compared, the Delta9 showed better milling reproducibility in almost cases (P < .05). Conclusion: Delta9 showed a significantly smaller error for most of the abutment design options. This means that it is possible to facilitate generation of printouts with reliable reproducibility and high precision with respect to the planned design.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.276-283
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• 2013

Purpose: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. Materials and methods: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (${\alpha}=.05$). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. Results: The pre-loading reverse torque values were $26.0{\pm}0.30Ncm$ (ready-made abutment; Transfer abutment) and $26.3{\pm}0.32Ncm$ (CAD-CAM custom-made abutment; CustomFit abutment) and $24.7{\pm}0.67Ncm$ (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. Conclusion: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.2
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• pp.88-96
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• 2017

Purpose: The purpose of this study is to assess the relationship between the time spent designing custom abutments and repeated learning using dental implant computer aided design (CAD) software. Materials and Methods: The design of customized abutments was performed four stages using the 3DS CAD software and the EXO CAD software, and measured repeatedly three times by each stage. Learning effect by repetition was presented with the learning curve, and the significance of the reduction in the total time and the time at each stage spent on designing was evaluated using the Friedman test and the Wilcoxon signed rank test. The difference in the design time between groups was analyzed using the repeated measure two-way ANOVA. Statistical analysis was performed using the SPSS statistics software (P < 0.05). Results: Repeated learning of the customized abutment design displayed a significant difference according to the number of repetition and the stage (P < 0.001). The difference in the time spent designing was found to be significant (P < 0.001), and that between the CAD software programs was also significant (P = 0.006). Conclusion: Repeated learning of CAD software shortened the time spent designing. While less design time on average was spent with the 3DS CAD than with the EXO CAD, the EXO CAD showed better results in terms of learning rate according to learning effect.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.243-248
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• 2012

Purpose: The purpose of this study is to compare the removal torque between prefabricated and customized implant abutment screw. Materials and methods: Three types of implant system (Osstem, Astra, Zimmer) were used. For each system, prefabricated abutment screw (control group) and customized abutment screw (test group) were used to connect the fixture and the abutment (n = 6). Digital torque gauze was used to control the tightening torque and the screws were tightened under each manufacturer's recommendation. 10 minutes after the connection the same tightening torque was applied, and 5 minutes after the second connection, the removal torque was measured. This procedure was repeated 10 times. In the cyclic loading test, 10 minutes after the first connection to the 6 groups (n = 3), the same tightening torque was applied, and a total of 1,000,000 time loading was applied at 30 degree angle to long axis with 50 N load. Repeated measures of ANOVA test (${\alpha}$=.05) was used as statistics to evaluate the effect of repeated loading number on the removal torque. Independent t-test was used to evaluate the difference in removal torque after cyclic loading. Results: The removal torque significantly decreased as the number of loading repetition increased (P<.05). In the 10 time repetition test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Also in the cyclic loading test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Conclusion: Within the limitation of this study, there was no significant difference in the removal torque between the prefabricated abutment screw and customized abutment screws.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.263-273
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• 2016

In the implant prosthetic procedure, the soft tissue reaction was varied with the material and surface treatment of the abutment. It may be the cause of the peri-implantitis, and hence it can affect the long-term prognosis of the implant prosthesis. Titania and zirconia abutment presented superior biocompatibility and stable soft tissue reaction, while gold alloy abutment showed unfavorable reaction sometimes. A soft tissue reaction can be differed by the surface characteristics even in the same material type. Because rougher surface induces a bacterial attachment, the part contacting a soft tissue should have smooth surface. Additional surface treatment can enhance the cellular response without increasing bacterial attachment. Repeated removal and insertion of the abutment and the shape of the abutment may affect the soft tissue reaction, also. Ultrasonic cleaning and argon plasma cleaning are effective way to clean the retained micro-dust on the customized abutment.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.4
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• pp.260-266
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• 2023

The concept of 'Implant Supracrestal Complex (ISC)' was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant. Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the long-term stability of the implant.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.299-306
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• 2017

In this case report, immediate loading of an implant-supported single-tooth prosthesis through complete digital workflow. A patient presented for restoration of missing a single tooth in the mandibular first molar. The digital impression was made with intraoral scanner and implant was placed using surgical guide pre-fabricated with pre-operative computed tomography (CT) and scan data. After 1 week later, prefabricated customized abutment and provisional restoration were connected for immediate loading. After 8 weeks later, abutment level impression was taken by intraoral scanner. At 3 months later from implant installation, monolithic zirconia crown were fabricated. This clinical report presents satisfying result in accuracy and patient satisfaction. A completely modeless digital procedure met expectations regarding precision, esthetics, and functionality.