• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.231-241
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• 2015

As patients' esthetic expectations increase, there is an increase in demand for cosmetic restorations of anterior and posterior teeth that resemble the natural tooth morphology and color. An example of high-strength all-ceramic systems is zirconia with CAD/CAM application. This case report describes a full-mouth rehabilitation using zirconia all-ceramic crowns supported by upper and lower implants and by a minimal increase in the occlusal vertical dimension in a patient with severe abrasion due to loss of posterior teeth.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.134-141
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• 2019

Purpose: The purpose of this study was to compare the clinical outcomes of lithium disilicate ceramic pressed zirconia prostheses and monolithic zirconia prostheses and to investigate the complications after two years of follow-up in posterior edentulous site. Materials and methods: A total 17 patients (male: 12, female: 5) were treated with 60 posterior fixed implant-supported prostheses (LP. lithium disilicate ceramic pressed zirconia prostheses: n = 30, MZ. monolithic zirconia prostheses: n = 30). After 24-month, clinical examination of Implant survival rate, marginal bone resorption, probing depth, plaque index, bleeding index, calculus and complications were evaluated. Results: There were no failed implants and all implants were normal in function without mobility. Marginal bone resorption was lower in LP group than MZ group at 12-month (P < .05), and 12-month probing depth and calculus deposit in LP group were significantly higher than MZ group (P < .05). Most common complications in MZ were marginal bone resorptions more than 1.5.mm and 2 chipping occurred in LP group. Conclusion: Within the limitations of the present study, lithium disilicate ceramic pressed zirconia is considered as a predictable treatment option as much as monolithic zirconia in posterior fixed implant-supported prostheses.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.25 no.1
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• pp.4-14
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• 2016

Although CAD/CAM technology has been used in dentistry for more than decades, the present CAD/CAM dentistry is still quite inefficient or unesthetic. Zirconia restoration has faced with two contradictory words, 'Efficiency' and 'Esthetics'. One can consider monolithic zirconia restoration to be efficient with CAD/CAM. The monolithic zirconia restoration, however, is rarely esthetic due to the current limitations with zirconia. On the contrary, porcelain build-up is almost indispensible in fabricating esthetic restoration, especially in anterior region. In this article, the current status of monolithic zirconia restoration and clinical cases will be presented.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.252-259
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• 2017

Purpose: The purpose of this study was to compare and analyze the wear of a prosthesis for 6 months after restoration with implant-supported fixed dental prosthesis made of either zirconia or gold. Materials and Methods: This study was conducted on patients requiring implant-supported fixed dental prostheses on first or second molar from January, 2015 to January, 2016. A total of 47 prostheses and antagonists were examined. Occlusal surface was recorded by impression of each prosthesis and antagonist 1 week and 6 months after prosthesis delivery. The digital files were created by impression scan. Occlusal shapes of 1 week and 6 months were compared and wear of prostheses and antagonists was analyzed. The Mann-Whitney test was used to analyzed the result data underwent normality test using SPSS (Version 23.0, IBM Corporation) Results: Mann-Whitney test revealed that there was no statistically significant difference in the median amount of mean vertical wear for 6 months in zirconia ($50.84{\mu}m$) and gold ($42.84{\mu}m$) prostheses (P > 0.05). When the opposing teeth were natural, the median amount of mean vertical wear of zirconia and gold prostheses was $47.72{\mu}m$ and $41.97{\mu}m$, respectively, and the median amount of mean vertical wear of enamel was $47.26{\mu}m$ and $44.59{\mu}m$, respectively. Statistical analysis showed no significant difference (P > 0.05). Conclusion: Despite the short study period and the small number of experimental groups, zirconia and gold showed no significant difference in wear during the first 6 months. Opposing natural enamel also showed no significant difference in the wear.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.210-217
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• 2016

Purpose: The aim of this study was to evaluate the marginal and internal adaptation of monolithic zirconia restoration made without physical model by digital intraoral scanner. Materials and methods: A prospective clinical trial was performed on 11 restorations as a pilot study. The monolithic zirconia restorations were fabricated after digital intraoral impression taking by intraoral scanner (TRIOS, 3shape, Copenhagen, Denmark), computer-aided designing, and milling manufacturing process. Completed zirconia crowns were tried in the patients' mouth and a replica technique was used to acquire the crown-abutment replica. The absolute marginal discrepancy, marginal gap, and internal gap of axial, line angle, and occlusal part were measured after sectioning the replica in the mesiodistal and buccolingual direction. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U test (${\alpha}=.05$). Results: From the adaptation analysis by replica, the statistically significant difference was not found between mesiodistal and buccolingual sections (P>.05), but there was significant difference among the measurement location (P<.01). The amount of absolute marginal discrepancy was larger than those of marginal gap and internal gap (P<.01). Conclusion: Within the limitations of this study, the adaptation accuracy of model-free monolithic zirconia restoration fabricated by intraoral scanner exhibited clinically acceptable result. However, the margin of zirconia crown showed tendency of overcontour and cautious clinical application and follow up is necessary.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.2
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• pp.71-80
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• 2022

Although low translucency 3 mol% yttria stabilized tetragonal zirconia polycrystal has excellent mechanical properties, it has limited application as a monolithic prosthesis. To improve these optical limitations, translucent zirconia has improved esthetics due to an increase in the cubic phase; however, it is accompanied by a decrease in mechanical properties simultaneously. Lithium disilicate has improved its mechanical properties through crystal size reduction and various heat treatment methods; therefore, its clinical application range is continuously increasing. Translucent zirconia shows a wide distribution of physical properties depending on the yttria content and lithium disilicate according to the size and density of crystal grains. As a result, the indications for translucent zirconia and lithium disilicate are increasing. Therefore, in this literature review, we intend to examine the rationale behind the material selection criteria in clinical situations and considerations for designing fixed dental prostheses including pontic, in particular, by summarizing recent studies.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.218-224
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• 2017

The implant-supported fixed dental prosthesis in irradiated maxilla needs meticulous treatment planning due to low bone healing capacity. All-on-4 concept implantation can reduce the number of implants to be placed avoiding bone grafting procedure. Conventionally, prefabricated angled abutments for tilted implants have been used. However, in this case, it was replaced with computer-aided design and computer-aided manufacturing (CAD/CAM) abutment. This case report described all-on-4 concept implantation and fabrication of CAD/CAM zirconia fixed dental prostheses using CAD/CAM titanium abutments.

• Journal of dental hygiene science
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• v.12 no.2
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• pp.123-129
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• 2012

The aim of study was to compare the color parameters and mean color difference of porcelain specimens by different veneering technique in order to examine the effect of veneering technique on esthetics of yttria-stabilized tetragonal zirconia polycrystalline(Y-TZP) all ceramic restoration. Three groups of square-shaped core ceramic specimens(14mm in diameter and 0.3, 0.5, 0.7 mm) and two groups of veneering ceramic specimen were prepared for analysis. Color parameter($L^*,a^*,b^*$) and color difference of zirconia core squares and core-veneer specimens were measured with ShadeEye $NCC^{(R)}$ spectrophotometer, respectively. Mean color difference(${\Delta}E^*$)were calculated using color difference formula. Two-way analysis of variance(ANOVA) combined with a Tukey multiple-range test were used to analysis the data(${\alpha}=0.05$). ${\Delta}E^*$ values were not significantly affected by core thickness and veneering porcelain(p=0.083). The color differences(${\Delta}E^*$) of core-veneer specimens with 0.5, 0.7 mm-A1,A2,A3.5 shade were mostly below 3.7 which was within the clinically acceptable range, while color differences between 0.3 mm-A1,A2 showed more than 3.7. All-ceramic system has color characteristics that clinicians have to consider when selecting materials. Also, manufacturers of different porcelain systems must make every effort to achieve color reproducibility.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.3
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• pp.246-251
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• 2014

In case of prosthesis fabrication by CAD/CAM, location, area and contour of occlusal contacts can be adjusted so more functional occlusion can be acquired. Also, errors in a manufacturing process is reduced compared to cast metal prostheses and porcelain fused metal prostheses fabricated by conventional methods such as casting and porcelain build up. Therefore, prostheses by CAD/CAM show superior occlusion accuracy. Recently, virtual articulator function has been introduced to CAD/CAM system, which reproduces mandibular movement against maxilla. Thus, it is possible to consider occlusal interference in anterior/lateral movement as well as closing movement. There have been many studies on the marginal and internal fit of prostheses using zirconia but the occlusal fit of zirconia crown fabricated by CAD/CAM has not been researched as much. In this case report, 7 zirconia crowns were designed and fabricated by CAD/CAM for total 5 patients. The models of zirconia crowns before and after occlusal adjustment during intraoral try-in were scanned for occlusal contacts, which were compared to evaluate accuracy of prostheses and understand patterns of occlusal adjustment. Most of the occlusal adjustments were done on functional cusps and slopes of zirconia crown, and the magnitude of occlusal adjustment ranged from $15{\mu}m$ to $60{\mu}m$. In the zirconia crown fabricated with CAD/CAM systems, the occlusal adjustment is a necessary procedure, so additional procedures will be needed for compensating reduced mechanical properties.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.47-51
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• 2013

With the introduction of dental implants, restoration of missing teeth with conventional fixed or removable partial dentures is being replaced with implants. Especially, with young patients, not only longevity but also esthetic factors need to be considered. Implant restorations provide long-term success functionally but, esthetic complications such as, marginal exposure due to gingival recession, loss of the papilla and dark color of metal abutments may occur. Recently, zirconia restorations with CAD/CAM technology provide functional, biocompatible and esthetic restorations possible. All-ceramic restorations using the pressed ceramic technique show better fracture toughness values than those of the conventional porcelain veneering technique. Pressed ceramic technique creates the veneer design in wax and the lost wax technique is used to create the restoration. The final contour of the restoration may be controlled during wax-up. A 22-year old female patient was restored with dental implants and zirconia restorations using the pressed ceramic technique presenting short-term but optimistic prognosis.