• Title/Summary/Keyword: CAD/CAM Zirconia

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Influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with a lingual slot

  • Choi, Kyu-Hyung;Son, KeunBaDa;Lee, Du-Hyeong;Lee, Kyu-Bok
    • The Journal of Advanced Prosthodontics
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    • v.10 no.5
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    • pp.381-387
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    • 2018
  • PURPOSE. Cement-retained implant prostheses can lack proper retrievability during repair, and residual cement can cause peri-implantitis. The purpose of this in vitro study was to evaluate the influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with lingual slots, known as retrievable cement-type slots (RCS). MATERIALS AND METHODS. We fabricated six types of titanium abutments (10 of each type) with two different heights (4 mm and 6 mm), three different convergence angles ($8^{\circ}$, $10^{\circ}$, and $12^{\circ}$), a sloped shoulder margin (0.6 mm depth), a rectangular shape ($6mm{\times}6.5mm$) with rounded edges, and a rectangular ledge ($2mm{\times}1mm$) for the RCS. One monolithic zirconia crown was fabricated for each abutment using a dental computer-aided design/computer-aided manufacturing system. The abutments and crowns were permanently cemented together with dual-curing resin cement, followed by 24 hours in demineralized water at room temperature. Using a custom-made device with a slot driver and torque gauge, we recorded the torque ($N{\cdot}cm$) required to remove the crowns. Statistical analysis was conducted using multiple regression analysis and Mann-Whitney U tests (${\alpha}=.05$). RESULTS. Removal torques significantly decreased as convergence angles increased. Multiple regression analysis showed no significant interaction between the abutment height and the convergence angle (Durbin-Watson ratio: 2.186). CONCLUSION. Within the limitations of this in vitro study, we suggest that the retrievability of cement-retained implant prostheses with RCS can be maintained by adjusting the abutment height and convergence angle, even when they are permanently cemented together.

Full mouth rehabilitation in a patient with peri-implantitis: A case report (Peri-implantitis 환자에서의 전악 재수복 증례)

  • Choi, Nak-Hyun;Cho, Young-Eun;Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.416-424
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    • 2019
  • Peri-implantitis appears in almost 20% of patients who received implant treatment, and increase in its number is inevitable as time goes by. Although it can be treated by both non-surgical and surgical procedures, in cases which include severe bone loss, explantation and rehabilitation may be necessary. Careful treatment planning and considerations to prevent recurrent peri-implantitis should be taken into account. In the following case presented, a patient with chronic periodontitis and peri-implantitis was successfully rehabilitated after removal of several implants. Extraction and explantation of multiple teeth and implants were followed by full mouth reconstruction with fixed implant prostheses on the mandible and implant retained overdenture on the maxilla. Surgical and prosthetic measures to prevent recurrent peri-implantitis were taken into consideration.

Dental application of glass-ceramic materials for aesthetic restoration (심미수복을 위한 글라스-세라믹 재료의 치과 응용)

  • Bae, Tae Sung
    • The Journal of the Korean dental association
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    • v.58 no.7
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    • pp.435-442
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    • 2020
  • Porcelain is the first ceramic material to be introduced into dentistry. Porcelain jacket crown was introduced by Dr. Charles H Land in 1886, which was an excellent aesthetic dental restoration but has not been widely used due to high firing shrinkage and low tensile strength. Then metal-ceramic system, which combines the esthetic properties of ceramics and the mechanical properties of metals, was introduced and nowadays it is still used in dental clinical field. However, the metal-ceramic system has shown some problems, such as increased lightness by reflection of light at opaque layer, shadow beneath the gingival line due to the block-out of light by metal coping, exposure of metal in margin part, bond failure between metal and porcelain, oxidation of metal coping during firing the porcelain, etc. Recently, along with the advance of fabrication methods of dental ceramics, the all-ceramic restorations with high esthetic and mechanical properties has increased and gradually replaced metal-ceramic restorations. Especially, CAD/CAM technology has opened a new era in fabricating the dental ceramic restorations. This overview will take a look at the past, present and future possibility of the dental ceramic materials.

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Implant-supported fixed prostheses with high-performance polymer (PEKK) abutments in partial edentulous patients: A case report (부분 무치악 환자에서 고기능성 폴리머(PEKK) 지대주를 이용한 임플란트 고정성 보철물 수복 증례)

  • Ha, Seung-Ryong
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.71-78
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    • 2021
  • Implant treatment, which was first attempted in fully edentulous patients, is now widely used in partially edentulous, and a single tooth missing patients. Moreover, implant treatment has become an essential treatment modality in modern dentistry. The material of fabricating implant prostheses has also become more diverse than before, one of which is the use of high-performance polymers. The frequency of using high-performance polymers, which have been used in the medical field, is also increased in the dental field compared to the past. In the first case, a PEKK abutment and a PFG crown (cement-screw-retaining type) were fabricated in the lower left second premolar, and in the second case, a PEKK abutment and a monolithic zirconia crown (cement-screw-retaining type) were fabricated in the missing upper left first molar, and in the third case two PEKK abutments and a splinted PFM crowns (cement-screw-retaining type) were fabricated and connected to the upper right first and second molar implants. Through these procedures the patients obtained esthetically and functionally satisfactory results after 4 years of follow-up.

Posterior rehabilitation considering mandibular movement with digital facebow transfer and virtual articulator: A case report (디지털 안궁이전과 가상교합기를 이용하여 하악의 운동을 고려한 구치부 수복 증례)

  • Kim, Min-Beom;Kwon, Ho-Beom;Lim, Young-Jun;Kim, Myung-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.431-441
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    • 2022
  • The digital facebow device records the trajectory of the mandibular movement where it is then reflected on the computer-aided design software, leading to an improvement on treatment outcomes of prosthetic restorations. In this clinical case, using a digital technology, an implant placement and prosthetic restoration were done in a patient who has lost maxillary and mandibular molars. Following an intraoral scan, a surgical stent for implant surgery was fabricated based on digital diagnostic wax-up, and implants were installed. After six months of sufficient osseointegration, customized abutments and the first temporary prostheses were delivered. Then two months later, at an abutment level, an intraoral scan and digital facebow transfer device were used to mount the intraoral scan data on a virtual articulator, and record the mandibular movements. Once the second temporary prostheses were fabricated and delivered on a basis of the mandibular movement, the definitive zirconia prostheses were designed and delivered based on a stabilized occlusion that was duplicated via double scan technique.

Influence of crown-to-implant ratio of short vs long implants on implant stability and marginal bone loss in the mandibular single molar implant (하악 구치 단일임플란트 수복에서 임플란트 길이에 따른 치관-임플란트 비율이 임플란트안정성 및 변연골소실에 주는 영향)

  • Baek, Yeon-Wha;Kim, Bongju;Kim, Myung-Joo;Kwon, Ho-Beom;Lim, Young-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.280-289
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    • 2018
  • Purpose: The purpose of this randomized clinical trial is to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and peri-implant marginal bone loss (MBL). Materials and Methods: 46 patients with single tooth missing in the posterior molar region of the mandible were included in this study. 19 implants (CMI IS-III $active^{(R)}$ long implant) of 5.0 mm diameter and 10 mm length were installed for the control group, while 27 implants (CMI IS-III $active^{(R)}$ short implant) of 5.5 mm diameter and 6.6, 7.3 or 8.5 mm length were placed for the experimental group. Each implant was inserted and immediately loaded using the digitally pre-fabricated surgical template and provisional restoration. The CAD-CAM monolithic zirconia crown was fabricated at 3 months after the surgery as a definitive restoration. The ISQ value and the MBL was measured at 48 weeks after the surgery. The correlation between the C/I ratio, MBL, and secondary implant stability was analyzed. Results: Successful results in terms of ISQ and MBL were achieved with both groups. There was no significant difference between the groups in terms of ISQ values and MBL at 48 weeks after the surgery (P > 0.05). No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the MBL (P > 0.05). Conclusion: The influence of C/I ratio in both groups was not shown on the stability nor the marginal bone loss in implants supporting single crown of the mandible. Short implant could be a preferable alternative option in the reduced bone height mandible under the limited condition despite its higher C/I ratio.

Effects of Surface Treatments of The Zirconium-Based Ceramic on the Bond Strength of Resin Cement (지르코니움 세라믹에서 표면 처리 방법이 레진 시멘트의 접착력에 미치는 영향)

  • Park, Kyung-Seok;Shin, Soo-Youn;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.3
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    • pp.221-230
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    • 2006
  • Recently, the need for esthetic results has increased the interest for all-ceramic crown prosthesis. Furthermore, the development of zirconium core via CAD/CAM system has allowed the all ceramic restorations to be applied to almost all fixed prosthesis situations. But, the increased strength has been reported to increase in proportion with the bond strength of cement, and recently, the tribochemical system which increases the bond strength through, silica coating and silanization has been introduced. The purpose of this study was to compare the $Rocatec^{TM}$ system and $CoJet^{TM}$ system with the traditional acid etching and silanization method of the irconium based ceramic. The surface character was observed via SEM(X2000), and the bond strength with the resin cement were measured. 50 In-Ceram Zirconia (Adens, Korea) discs were fabricated and embedded in resin, group 1 was treated with glass-bead blasting and cleaning, group 2 was treated with 20% HF for 10 minutes and silanized, group 3 was treated with the $Rocatec^{TM}$ system, and group 4 was treated with the $CoJet^{TM}$ system. Each group was comprised of 10 specimens. The specimens were cemented to a $3mm{\times}5mm$ resin block with Super-Bond C&B. The shear bond strength was measured with the $Instron^{(R)}$ 8871 at a crosshead speed of 0.5mm/min. The results were as follows. 1. According to SEM results, there were little difference between group 1 & group 2, but in group 3 and 4, silica coating was detected and there was increase in surface roughness. 2. The shear bond strength decreased in the order of group 3(46.28MPa), group 4(42.04MPa), group 2(31.56MPa), and group 1(27.46MPa). 3. There was significant differnce between group 1&2 and group 3&4(p<0.05). From the results above, it can be considered that the conventional method of acid etching and silane treatment cannot increase the bond strength with resin cements, and that by applying the tribochemical system of $Rocatec^{TM}$ system and $CoJet^{TM}$ system, we can achieve a stronger all ceramic restoration. Further studies on surface treatments to increase the bond strength are thought to be needed.

Full mouth rehabilitation through re-establishment of occlusal plane in partially edentulous patient with reduced vertical dimension accompanied by loss of posterior occlusal support (구치부 교합지지 상실과 수직고경 감소를 동반한 부분 무치악 환자에서 교합평면 회복을 통한 완전구강회복 증례)

  • Cho, Young Eun;Leesungbok, Richard;Lee, Suk Won;Choi, Joseph June Sirk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.3
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    • pp.263-275
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    • 2022
  • The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

Prosthetic rehabilitation with digital implant planning for a minimally invasive surgery approach (디지털 임플란트 플래닝을 통한 최소침습 보철수복 증례)

  • Jeong, Areum;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.3
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    • pp.283-292
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    • 2022
  • For fixed prosthetic treatment using implants, implants must be placed in a suitable location for prosthetic treatment. During surgery, minimally invasive prosthetic restoration is possible using a flapless method using a surgical guide. The patient in this case was an 86-year-old male patient who wanted treatment due to discomfort when using conventional dentures. Due to systemic disease, the patient had difficulty using removable local dentures, so full dentures for the maxilla and fixed implants for the mandible were restored. Because there is a high risk of bleeding due to systemic disease, the implant was placed in a flapless method using a surgical guide. Finally, prostheses were fabricated with maxillary full denture and mandibular screw-retained zirconia, and this report shows satisfactory esthetic and functional recovery.