• The Journal of Advanced Prosthodontics
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• v.7 no.2
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• pp.151-159
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• 2015

PURPOSE. To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS. A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non- quantitatively. RESULTS. All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION. The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented.

• The Journal of Advanced Prosthodontics
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• v.14 no.5
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• pp.273-284
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• 2022

PURPOSE. Computer-aided design and manufacturing (CAD-CAM) of implant abutments has been shown to result in surface contamination from site-specific milling and fabrication processes. If not removed, these contaminants can have a potentially adverse effect and may trigger inflammatory responses of the peri-implant tissues. The aim of the present study was to evaluate the bacterial disinfection and cleaning efficacy of ultrasonic reprocessing in approved disinfectants to reduce the microbial load of CAD-CAM abutments. MATERIALS AND METHODS. Four different types of custom implant abutments (total N = 32) with eight specimens in each test group (type I to IV) were CAD-CAM manufactured. In two separate contamination experiments, specimens were contaminated with heparinized sheep blood alone and with heparinized sheep blood and the test bacterium Enterococcus faecium. Abutments in the test group were processed according to a three-stage ultrasonic protocol and assessed qualitatively and quantitatively by determination of residual protein. Ultrasonicated specimens contaminated with sheep blood and E. faecium were additionally eluted and the dilutions were incubated on agar plates for seven days. The determined bacterial counts were expressed as colony-forming units (CFU). RESULTS. Ultrasonic reprocessing resulted in a substantial decrease in residual bacterial protein to less than 80 ㎍ and a reduction in microbiota of more than 7 log levels of CFU for all abutment types, exceeding the effect required for disinfection. CONCLUSION. A three-stage ultrasonic cleaning and disinfection protocol results in effective bacterial decontamination. The procedure is reproducible and complies with the standardized reprocessing and disinfection specifications for one- or two-piece CAD-CAM implant abutments.

• 기계와재료
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• v.1 no.2 s.2
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• pp.52-63
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• 1989

• The Journal of Advanced Prosthodontics
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• v.10 no.3
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• pp.245-251
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• 2018

PURPOSE. To evaluate the accuracy of a model made using the computer-aided design/computer-aided manufacture (CAD/CAM) milling method and 3D printing method and to confirm its applicability as a work model for dental prosthesis production. MATERIALS AND METHODS. First, a natural tooth model (ANA-4, Frasaco, Germany) was scanned using an oral scanner. The obtained scan data were then used as a CAD reference model (CRM), to produce a total of 10 models each, either using the milling method or the 3D printing method. The 20 models were then scanned using a desktop scanner and the CAD test model was formed. The accuracy of the two groups was compared using dedicated software to calculate the root mean square (RMS) value after superimposing CRM and CAD test model (CTM). RESULTS. The RMS value ($152{\pm}52{\mu}m$) of the model manufactured by the milling method was significantly higher than the RMS value ($52{\pm}9{\mu}m$) of the model produced by the 3D printing method. CONCLUSION. The accuracy of the 3D printing method is superior to that of the milling method, but at present, both methods are limited in their application as a work model for prosthesis manufacture.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.40.1-40.10
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• 2018

Objectives: This study evaluated the microtensile bond strength (${\mu}TBS$) of polymer-ceramic and indirect composite resin with 3 classes of resin cements. Materials and Methods: Two computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated polymer-ceramics (Enamic [ENA; Vita] and Lava Ultimate [LAV; 3M ESPE]) and a laboratory indirect composite resin (Gradia [GRA; GC Corp.]) were equally divided into 6 groups (n = 18) with 3 classes of resin cements: Variolink N (VAR; Vivadent), RelyX U200 (RXU; 3M ESPE), and Panavia F2 (PAN; Kuraray). The ${\mu}TBS$ values were compared between groups by 2-way analysis of variance and the post hoc Tamhane test (${\alpha}=0.05$). Results: Restorative materials and resin cements significantly influenced ${\mu}TBS$ (p < 0.05). In the GRA group, the highest ${\mu}TBS$ was found with RXU ($27.40{\pm}5.39N$) and the lowest with VAR ($13.54{\pm}6.04N$) (p < 0.05). Similar trends were observed in the ENA group. In the LAV group, the highest ${\mu}TBS$ was observed with VAR ($27.45{\pm}5.84N$) and the lowest with PAN ($10.67{\pm}4.37N$) (p < 0.05). PAN had comparable results to those of ENA and GRA, whereas the ${\mu}TBS$ values were significantly lower with LAV (p = 0.001). The highest bond strength of RXU was found with GRA ($27.40{\pm}5.39N$, p = 0.001). PAN showed the lowest ${\mu}TBS$ with LAV ($10.67{\pm}4.37N$; p < 0.001). Conclusions: When applied according to the manufacturers' recommendations, the ${\mu}TBS$ of polymer-ceramic CAD/CAM materials and indirect composites is influenced by the luting cements.

• 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 Technologic Dentistry
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• v.42 no.3
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• pp.228-233
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• 2020

Purpose: This study aimed to assess and compare the marginal fit of ceramic-based hybrid resin restoration (HYB) and zirconia restoration (ZIR) for dental computer-aided design/computer-aided manufacturing systems. Methods: A stainless steel master model was produced. The impression was first made with silicone, and then stone working models were produced. A total of twenty restorations were fabricated with two different materials: ZIR and HYB. The silicone film thickness of the marginal gap was measured using a digital microscope; digital photos were taken at a magnification of ×160, and then analyzed using a measurement software. The values of the result were evaluated with the independent-sample t-test (α=0.05). All statistical analyses were performed with a statistical software. Results: The mean values for the marginal gap was 37.14±2.96 ㎛ for HYB, compared with 40.37±5.26 ㎛ for ZIR. No significant difference was found between ZIR and HYB (p=0.107). Conclusion: As a result, the marginal fit of the restoration fabricated using the hybrid resin was better than that of the restoration fabricated using zirconia. Also, the marginal fit of all groups was below the clinical acceptable range of 120 ㎛. Thus, HYB for dental CAD/CAM system in this study is expected to be suitable for clinical use in dentistry.

• 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 Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.39-45
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• 2024

The residual alveolar ridge below the denture base undergoes physiologic changes over time, which results in the existing dentures becoming less accurate with the residual alveolar ridge. In addition, changes of the occlusal plane, decreasing in vertical dimension and loss of denture retention and facial support can occur. Consequently, denture relining may be required to accommodate these changes and ensure an ongoing close fit. Relining a denture can be performed directly on the chairside using autopolymerizing relining materials or indirectly in the laboratory using heat-cured relining materials. A direct relining method is not only simple but also time and cost effective. However, irritation or burning sensation of the mucosa can occur, and poor bonding of the relining material to the denture base can be cited as disadvantages. The indirect relining method exhibits relatively high bonding strength between the relining material and the denture base, but the patient might experience discomfort during relining process period. This report will examine the characteristics of relining materials, including those used in the relining of CAD-CAM dentures, and explore the clinical considerations for relining procedures.

• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.36-45
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• 2021

Purpose. To investigate the fracture resistance of monolithic CAD-CAM all-ceramic surveyed crowns with two different occlusal rest seat designs. Materials and Methods. Two maxillary first premolar were prepared for all-ceramic surveyed crowns with wide (2/3rd of buccolingual width of an unprepared tooth) or narrow (1/3rd of buccolingual width of an unprepared tooth) disto-occlusal rest seat (ORS) designs. Eighty monolithic CAD-CAM all-ceramic surveyed crowns were prepared and divided into 4 groups - Group CR, Composite resin material as a control; Group LDS, Lithium disilicate based material; Group ZIPS, zirconia-material (IPS ZirCAD); and Group ZLHT, zirconia- material (CeramillZolidht+). Crowns were cemented on an epoxy resin die with adhesive resin cement. The fracture resistance of crowns was tested with the universal machine. Univariate regression analysis was used. Results. The mean ± standard deviation of maximum failure force values varied from 3476.10 ± 285.97 N for the narrow ORS subgroup of group ZIPS to 687.89 ± 167.63 N for the wide ORS subgroup of group CR. The mean ± standard deviation of maximum force was 1075 ± 77.0 N for group CR, 1309.3 ± 283.9 N for group LDS, 3476.1 ± 285.97 N for group ZIPS, and 2666.7 ± 228.21 N for group ZLHT, with narrow occlusal rest seat design. The results of the intergroup comparison showed significant differences in fracture strength with various material groups and occlusal rest seat designs (P<.001). Conclusion. The zirconia-based all-ceramic surveyed crowns fractured at more than double the load of Lithium disilicate based crowns. The crowns with narrow base occlusal rest seat design had statistically significantly higher fracture resistance than surveyed crowns with wide occlusal rest seat design. The use of narrow occlusal rest seat design in CAD-CAM all ceramic surveyed crowns provides higher fracture resistance, and therefore narrow occlusal rest design can be used for providing esthetics with high strength.