• The Journal of Korean Academy of Prosthodontics
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• v.43 no.4
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• pp.466-477
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• 2005

Statement of problem : Problem of matching the appearance of porcelain restorations with the patient's natural dentition has always been a concern to dental clinicians. Recently, demands for esthetics, even in restorations requiring strength, has brought a revolution to dentistry and increased use of zirconia. Among the various factors, shade and translucency or the core can significantly affect the overall esthetics of the restoration and should be considered when selecting an all-ceramic system. Purpose : The purpose of this study was to spectrophotometrically evaluate the influence of different zirconia systems and core thickness on the final shade of all-ceramic restorations using the CIEL$^*a^*b^*$ system. Material and Methods: Core specimens (n : 20 per group) of In-Ceram Alumina, In-Ceram Zirconia, Digident CAD/CAM Zirconia, Cercon Zirconia were fabricated 20mm in diameter. 10 specimens of each group were fabricated at core thickness of 0.5mm and 0.7mm. These core specimens were veneered with shade Al & A3 porcelain of the recommended manufacturer. CIEL$^*a^*b^*$ coordinates were recorded for each specimen with a spectrophotometer (Model CM-2600d, Minolta, Japan). Color differences were calculated using the equation ${\Delta}E^*=[({\Delta}L^*)^2+({\Delta}a^*)^2+({\Delta}b^*)^2]^{\frac{1}{2}}$. Results : 1. Specimens of core thickness 0.5mm and 0.7mm did not exhibit clinically perceived color difference. 2. Regarding shade reproducibility, In-Ceram Alumina and In-Ceram Zirconia showed significant difference within each group. 3. Cercon Zirconia group showed the highest $L^*$ value and Digident Zirconia group showed lowest $a^*$ & $b^*$ value. 4. Generally the shade difference between materials was higher in the A3 shade group than in the Al shade group. Conclusion: Within the limitations of this study, there was no color difference after increase in core thickness and every 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 Advanced Prosthodontics
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• v.12 no.3
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• pp.173-180
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• 2020

PURPOSE. This study compared digital (reference point matching) and replica methods for measuring marginal and internal fit of full coverage restorations. MATERIALS AND METHODS. A maxillary left first molar typodent was fixed on to an aluminum base and prepared to receive all-ceramic full coverage restoration. The model was scanned with an intraoral scanner (CEREC Omnicam, Sirona, York, PA, USA). Twelve crowns were fabricated from lithium disilicate blocks (IPS emax CAD, Ivoclar Vivadent) and then crystalized. Marginal and internal fit of each restoration was measured by two examiners using replica and a new digital three-dimensional technique. Reliability between the two methods and two examiners was assessed by correlation and Cronbach's Alpha coefficient (P<.05). A Bland-Altman assessment for agreement was used to compare the two methods. RESULTS. Bland-Altman assessment showed that the mean of difference for marginal, absolute marginal, and axial gap was respectively -1.04 ㎛, -41.9 ㎛, and -29.53 ㎛ with limit of agreement (LOA) between -37.26 to 35.18 ㎛ for marginal, -105.85 to 22.05 ㎛ for absolute marginal and -80.52 to 22.02 ㎛ for axial gap. Positive correlation for repeatability (P<.05) in determining marginal and internal gaps by the two examiners in both techniques was revealed. Reliability of both techniques in all sites of measurements was at least good (0.8 ≤ α < 0.9). CONCLUSION. Both measuring techniques appeared highly reliable for evaluating fit of fixed dental restorations, while reference point matching provided higher values in axial and absolute marginal gap assessment.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.528-534
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• 2008

Purpose: Marginal fit is one of the important components for the successful prosthodontic restoration. Poor fitting margin of the restoration causes hypersensitivity, secondary caries, and plaque accumulation, which later result in prosthodontic failure. CAD/CAM zirconia all-ceramic restorations, such as $LAVA^{(R)}$ (3M ESPE, St.Paul, MN) and $EVEREST^{(R)}$ (KaVo Dental GmbH, Biberach, Germany) systems were recently introduced in Korea. It is clinically meaningful to evaluate the changes of the marginal fit of the CAD/CAM zirconia systems before and after build-up. The purposes of this study are to compare the marginal fit of the two CAD/CAM all-ceramic systems with that of the ceramometal restoration, before and after porcelain build-up Material and methods: A maxillary first premolar dentiform tooth was prepared with 2.0 mm occlusal reduction, 1.0 mm axial reduction, chamfer margin, and 6 degree taperness in the axial wall. The prepared dentiform die was duplicated into the metal abutment die. The metal die was placed in the dental study model, and the full arch impressions of the model were made. Twenty four copings of 3 groups which were $LAVA^{(R)}$, $EVEREST^{(R)}$, and ceramometal restorations were fabricated. Each coping was cemented on the metal die with color-mixed Fit-checker $II^{(R)}$ (GC Cor., Tokyo, Japan). The marginal opening of each coping was measured with $Microhiscope^{(R)}$ system (HIROX KH-1000 ING-Plus, Seoul, Korea. X300 magnification). After porcelain build-up, the marginal openings of $LAVA^{(R)}$, $EVEREST^{(R)}$,and ceramometal restorations were also evaluated in the same method. Statistical analysis was done with paired t-test and one-way ANOVA test. Results: In coping states, the mean marginal opening for $EVEREST^{(R)}$ restorations was $52.00{\pm}11.94\;{\mu}m$ for $LAVA^{(R)}$ restorations $56.97{\pm}10.00\;{\mu}m$, and for ceramometal restorations $97.38{\pm}18.54\;{\mu}m$. After porcelain build-up, the mean marginal opening for $EVEREST^{(R)}$ restorations was $61.69{\pm}19.33\;{\mu}m$, for $LAVA^{(R)}$ restorations $70.81{\pm}12.99\;{\mu}m$, and for ceramometal restorations $1115.25{\pm}23.86\;{\mu}m$. Conclusion: 1. $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations in comparison with ceramometal restorations showed better marginal fit, which had significant differences (P < 0.05) in coping state and also after porcelain build-up . 2. The mean marginal opening values between $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations did not showed significant differences after porcelain build-up as well as in coping state (P > .05). 3. $EVEREST^{(R)}$, $LAVA^{(R)}$ and ceramometal restorations showed a little increased marginal opening after porcelain build-up, but did not show any statistical significance (P > .05).

• The Journal of Advanced Prosthodontics
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• v.4 no.3
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• pp.162-169
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• 2012

PURPOSE. Fracture of the veneering material of zirconia restorations frequently occurs in clinical situations. The purpose of this in vitro study was to compare the fracture strengths of zirconia crowns veneered with various ceramic materials by various techniques. MATERIALS AND METHODS. A 1.2 mm, $360^{\circ}$ chamfer preparation and occlusal reduction of 2 mm were performed on a first mandibular molar, and 45 model dies were fabricated in a titanium alloy by CAD/CAM system. Forty-five zirconia copings were fabricated and divided into three groups. In the first group (LT) zirconia copings were veneered with feldspathic porcelain by the layering technique. In the second group (HT) the glass ceramic was heat-pressed on the zirconia coping, and for the third group (ST) a CAD/CAM-fabricated high-strength anatomically shaped veneering cap was sintered onto the zirconia coping. All crowns were cemented onto their titanium dies with Rely $X^{TM}$ Unicem (3M ESPE) and loaded with a universal testing machine (Instron 5583) until failure. The mean fracture values were compared by an one-way ANOVA and a multiple comparison post-hoc test (${\alpha}$= 0.05). Scanning electron microscope was used to investigate the fractured interface. RESULTS. Mean fracture load and standard deviation was $4263.8{\pm}1110.8$ N for Group LT, $5070.8{\pm}1016.4$ for Group HT and $6242.0{\pm}1759.5$ N for Group ST. The values of Group ST were significantly higher than those of the other groups. CONCLUSION. Zirconia crowns veneered with CAD/CAM generated glass ceramics by the sintering technique are superior to those veneered with feldspathic porcelain by the layering technique or veneered with glass ceramics by the heat-pressing technique in terms of fracture strength.

• Journal of Technologic Dentistry
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• v.45 no.3
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• pp.67-73
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• 2023

Purpose: This in vitro study aimed to evaluate the clinical acceptability of precision of fit of the support thickness of Co-Cr alloy copings fabricated using selective laser melting (SLM). Methods: Thirty dental stone models of maxillary left molar abutments were manufactured, images were taken using a scanner, and a computer-aided design program was used to design the form of a conventional metal ceramic crown coping. Overall, 30 single copings were made from Co-Cr alloy using SLM and divided into three support radius groups (0.1, 0.25, and 0.35 mm) of 10 for each. Digitized data were superimposed with three-dimensional inspection software to quantitatively obtain the machinability of a ceramic crown coping, and visual differences were confirmed using a color map. The root mean square values of the ceramic crown coping group were statistically analyzed using one-way analysis of variance (α=0.05). Results: The precision of fit was superior with 0.25 mm compared with 0.1 mm and 0.35 mm, and the results exhibited significant differences (p<0.05). All specimens showed that various support thicknesses did not exceed the clinically permitted value of 120 ㎛, which mean that more than 0.1 mm and 0.35 mm of support radius for SLM was adequate. Conclusion: The support thickness of Co-Cr alloy restoration fabricated using SLM is shown to affect the adaptation.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.1
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• pp.20-34
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• 2003

Novel methods producing supplementary and prosthetic material by cutting or discharge processing via computer design have been proposed as alternatives for traditional casting methods and are being utilized for commercial purposes. The CAD/CAM system used in dentistry can be classified into three-dimensional input of target values, restoration design, and material processing. The marginal fidelity in production of In-Ceram core has important clinical implications and is a key consideration issue in CAD/CAM production as well. Through this research, the author arrived at the following conclusion aaer conducting comparison analysis of marginal fidelities between the In-Ceram core produced via CAD/CAM and that produced through the traditional method ; 1. In the cases of mesial, distal, and lingual margins, the core margins via CAD/CAM produced lower values than those via the traditional method, but the differences were found to be statistically insignificant. 2. In the case of labial flange, the core margins via CAD/CAM produced lower values than those via the traditional method and the differences were found to be statistically significant. (p<0.05) 3. In comparision with overall marginal fidelity, the core margins via CAD/CAM produced lower values than those via the traditional method, but the differences were found to be statistically insignificant. 4. Among the core margins produced via the traditional method did not have statistically significant differences but fir those produced via CAD/CAM had statistically significant differences between labial and lingual sides and between labial and mesial sides. (p <0.05).

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.3
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• pp.445-457
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• 1997

Poor marginal fidelity resulting in a large marginal gap increases plaque accumulation, gingival inflammation and dental caries. The purpose of this study was to evaluate the marginal fit of three different cervical finishing methods of prepared teeth. A stereomicroscope was used to measure the space between the margin of restoration and the finishing line of prepared tooth. The results were statistically analyzed using the ANOVA and Multiple Range Test(Tukey's HSD). The results were as follows : 1. There were no significant differences concerning the types of tooth and positon (P>0.05), whereas the differences were statistically significant in case of cervical finishing methods (P<0.05). 2. There were statistically significant differences between before and after cementation (P<0.05). 3. In comparison according to variable margins after cementation, the gap discrepancies were increased in $130^{\circ}$ shoulder margin, chamfer margin and $90^{\circ}$ shoulder margin in ascending order, and there were significant differences between $90^{\circ}$ shoulder margin and chamfer, $130^{\circ}$ shoulder margin 4. In comparison according to variable margins, the gap discrepancies were increased in chamfer margin, $130^{\circ}$ shoulder margin and $90^{\circ}$ shoulder margin in ascending order, and there were significant differences between $90^{\circ}$ shoulder margin and chamfer, $130^{\circ}$ shoulder margin. 5. This study demonstrated a better marginal fit with all-ceramic crowns fabricated on chamfer and $130^{\circ}$ shoulder margin compared with $90^{\circ}$ shoulder margin.

• The Journal of Advanced Prosthodontics
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• v.6 no.2
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• pp.71-78
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• 2014

PURPOSE. The objective of this study was to evaluate the clinical acceptability of all-ceramic crowns fabricated by the digital veneering method vis-$\grave{a}$-vis the traditional method. MATERIALS AND METHODS. Zirconia specimens manufactures by two different manufacturing method, conventional vs digital veneering, with three different thickness (0.3 mm, 0.5 mm, 0.7 mm) were prepared for analysis. Color measurement was performed using a spectrophotometer for the prepared specimens. The differences in shade in relation to the build-up method were calculated by quantifying ${\Delta}E^*$ (mean color difference), with the use of color difference equations representing the distance from the measured values $L^*$, $a^*$, and $b^*$, to the three-dimensional space of two colors. Two-way analysis of variance (ANOVA) combined with a Tukey multiple-range test was used to analyze the data (${\alpha}$=0.05). RESULTS. In comparing means and standard deviations of $L^*$, $a^*$*, and $b^*$ color values there was no significant difference by the manufacturing method and zirconia core thickness according to a two-way ANOVA. The color differences between two manufacturing methods were in a clinically acceptable range less than or equal to 3.7 in all the specimens. CONCLUSION. Based on the results of this study, a carefully consideration is necessary while selecting upper porcelain materials, even if it is performed on a small scale. However, because the color reproducibility of the digital veneering system was within the clinically acceptable range when comparing with conventional layering system, it was possible to estimate the possibility of successful aesthetic prostheses in the latest technology.

• Journal of Technologic Dentistry
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• v.33 no.3
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• pp.203-210
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• 2011

Purpose: The purpose of this study was to compare color correspondence of different sizes of Vita Mark II$^{(R)}$ and TriLuxe$^{(R)}$ Feldspar blocks. Methods: The three commercially available shades(1M2, 2M2, 3M2) of Mark II & TriLuxe blocks for the CEREC$^{(R)}$ CAD/CAM system were examined. For each of three colors, three different sizes were tested, 5 blocks each. The measurements were made using a spectrophotometer equipped with an integrating sphere using the CIE $L^*$, $a^*$, $b^*$ colorimetric system. Results: The $L^*$, $a^*$, $b^*$ value of Vita Mark II$^{(R)}$ ceramic block showed significantly higher than TriLuxe$^{(R)}$ ceramic block(p<0.05). In comparing the Vita Mark II$^{(R)}$ specimen of the three different shade, color differences between materials(${\Delta}E^*$) showed the lowest value of 2.09, and the highest was 2.24. ${\Delta}E^*$ values of the materials of Vita Mark II$^{(R)}$ were higher than 2. As the size of ceramic block differed, the color correspondence of Vita Mark II$^{(R)}$ showed statistically significant difference but, this result is clinically acceptable. Conclusion: All the different sizes of the different shades of Vita TriLuxe$^{(R)}$ blocks for the CEREC$^{(R)}$ system showed the high degree of color correspondence necessary in industrially prefabricated CAD/CAM blocks. The results of the present study suggested that it would be necessary to establish the reproducible and constant color specification system for an esthetic restoration.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.470-478
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• 2008

Statement of problem: Use of all-ceramic prostheses fabricated with CAD/CAM systems is increasing in the dentistry. Marginal fidelity in production of all-ceramic restoration has important clinical implications and is a key consideration issue in CAD/CAM production as well. Purpose: The objective of this study was to analyse marginal fidelities of $Procera^{(R)}$ Allceram Crown. Material and methods: On 56 patients treated with $Procera^{(R)}$ system Allceram Crown at Dankook Dental Hospital, marginal discrepancies of 101 abutments were measured by stereomicroscope at coping and final restoration stages. Paired t-test and one-way analysis of variance on marginal discrepancy data were conducted to determine the presence of significant differences between measurement and measuring point stages. Results: Marginal discrepancies of final restoration ($45.82{\pm}30.84\;{\mu}m$) were lower than alumina coping ($53.84{\pm}38.83\;{\mu}m$). Furthermore, the differences were found to be statistically significant at 95% confidence level. Anterior marginal discrepancies were lower than posterior marginal discrepancies, but they were not statistically significant. Lingual marginal discrepancies were higher than other measurement sites, and the differences were found to be statistically significant at 95% confidence level. Conclusion: Within the conditions of this study, marginal fidelities of $Procera^{(R)}$ Allceram Crown were acceptable, and after porcelain build-up, marginal fitness improved over alumina coping. More careful scanning is needed for better results.