• 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.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.13 no.1
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• pp.31-39
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• 2004

For the prosthodontic results which are compatible with esthetics to be fulfilled, the first prerequisite would be periodontal intervention and stability, the second one may be functional competency and the ultimate goal should be ascribed to esthetic considerations. Other words, esthetic dentistry is a whole entity which encompasses the biological stability of the periodontium, physical accuracy of the prosthodontic structure and finally, the beauty which can be found in natural dentition. It also implies the harmonized lip line which reveals the well-balanced tooth morphology and health gum profiles (Red-White Esthetics). Largely, there lie some differences in the input system of the 3-dimentional data from the prepared abutments between respective computer-assisted systems available now. But the manufacturing systems (CAM) are very similar between them, to say, comprise numeric control systems with whole 3-dimensional milling units according to the restorations to be made. Now the author is going to present CAD/CAM Zirconia All Ceramic Restoration on the topics for the Red-White Esthetics, periodontal control and maintenance, treatment for the discolored teeth, post & core build-up works for the devitalized teeth, characteristics of the Zirconium oxide All Ceramics, fabrication procedures, clinical considerations and its application to diverse clinical situations.

• The Journal of Advanced Prosthodontics
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• v.16 no.4
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• pp.231-243
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• 2024

PURPOSE. The objective of the study was to analyze the impact of cement, bonding pretreatment, and ceramic abutment material on the overall color results of CAD-CAM ceramic crowns bonded to titanium-based hybrid abutments. MATERIALS AND METHODS. For single implant restoration of a maxillary lateral incisor a total of 51 CAD-CAM-fabricated monolithic lithium disilicate crowns were fabricated and subsequently bonded onto 24 lithium disilicate Ti-base abutments, 24 zirconia Ti-base abutments and 3 resin abutment replicas as a control group. The 48 copings were cemented with three definitive and one provisional cement on both grit-blasted and non-blasted Ti-bases. The color of each restoration and surrounding artificial gingiva was measured spectrophotometrically at predefined measuring points and the CIELAB (ΔE_ab) color scale values were recorded. RESULTS. The color outcome of ceramic crowns bonded to hybrid abutments and soft tissues was affected differently by cements of different brands. Grit-blasting of Ti-bases prior to cementing CAD-CAM copings affected the color results of allceramic crowns. There was a significant difference (P = .038) for the median ΔE value between blasted and non-blasted reconstructions at the cervical aspect of the crown. Full-ceramic crowns on zirconia Ti-base abutments exhibited significantly lower ΔE values below the threshold of visibility (ΔE 1.8). In all subcategories tested, the use of a highly opaque temporary cement demonstrated the lowest median ΔE for both the crown and the artificial gingiva. CONCLUSION. Various cements, core ceramic materials and airborne particle abrasion prior to bonding can adversely affect the color of Ti-base supported ceramic crowns and peri-implant soft tissue. However, zirconia CAD-CAM copings and an opaque cement can effectively mask this darkening.

• The Journal of Advanced Prosthodontics
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• v.2 no.2
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• pp.33-38
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• 2010

PURPOSE. Marginal fit is a very important factor considering the restoration's long-term success. However, adding porcelain to copings can cause distortion and lead to an inadequate fit which exposes more luting material to the oral environment and causes secondary caries. The purpose of this study was to compare the marginal fit of 2 different all-ceramic crown systems before and after porcelain veneering. This study was also intended to verify the marginal fit of crowns originated from green machining of partially sintered blocks of zirconia (Lava CAD/CAM system) and that of crowns obtained through machining of fully sintered blocks of zirconia (Digident CAD/CAM system). MATERIALS AND METHODS. 20 crowns were made per each system and the marginal fit was evaluated through a light microscope with image processing (Accura 2000) at 50 points that were randomly selected. Each crown was measured twice: the first measurement was done after obtaining a 0.5 mm coping and the second measurement was done after porcelain veneering. The means and standard deviations were calculated and statistical inferences among the 2 groups were made using independent t-test and within the same group through paired t-test. RESULTS. The means and standard deviations of the marginal fit were $61.52{\pm}2.88{\mu}m$ for the Digident CAD/CAM zirconia ceramic crowns before porcelain veneering and $83.15{\pm}3.51{\mu}m$ after porcelain veneering. Lava CAD/CAM zirconia ceramic crowns showed means and standard deviations of $62.22{\pm}1.78{\mu}m$ before porcelain veneering and $82.03{\pm}1.85{\mu}m$ after porcelain veneering. Both groups showed significant differences when analyzing the marginal gaps before and after porcelain veneering within each group. However, no significant differences were found when comparing the marginal gaps of each group before porcelain veneering and after porcelain veneering as well. CONCLUSION. The 2 all-ceramic crown systems showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.

• 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.42 no.4
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• pp.307-312
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• 2020

Application of ceramic materials for fabrication of dental restoration materials has been a focus of interest in the field of esthetic dentistry. The ceramic materials of choice are glass ceramics, spinel, alumina, and zirconia. The development of yttrium tetragonal zirconia polycrystal (YTZP)-based systems is a recent addition to all-ceramic systems that have high strength and are used for crowns and fixed partial dentures. Computer-aided design/computer-aided manufacturing (CAD/CAM)-produced, YTZP-based systems are popular with respect to their esthetic appeal for use in stress-bearing regions. The highly esthetic nature of zirconia and its superior physical properties and biocompatibility have enabled the development of restorative systems that meet the demands of today's patients. Many in vitro trials have been performed on the use of zirconia; however, relatively fewer long-term clinical studies have been published on this subject. The use of zirconia frameworks for long-span fixed partial dentures is currently being evaluated; in the future, more in vivo research and long-term clinical studies are required to provide scientific evidence for drawing solid guidelines. Further clinical and in vitro studies are required to obtain data regarding the long-term clinical use of zirconia-based restorations.

• 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 Advanced Prosthodontics
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• v.12 no.6
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• pp.344-350
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• 2020

PURPOSE. Recently introduced hybrid and reinforced glass ceramic computer-aided design/computer-aided manufacturing (CAD/CAM) materials have been used for full-coverage restorations. However; the effect of adjustment and type of materials on internal and marginal adaptation are unknown. This study aimed to evaluate and compare the marginal and internal adaptations of crowns made of three different CAD/CAM materials before and after adjustment. MATERIALS AND METHODS. One acrylic resin maxillary first molar was prepared and served as the master die. Thirty-six restorations were fabricated using CAD/CAM system (CEREC Omnicam, MCXL) with three materials including lithium disilicate (IPS e.max CAD), zirconia-reinforced lithium silicate (Suprinity), and hybrid ceramic (Enamic). Internal and marginal adaptations were evaluated with the reference point matching technique before and after adjustment. The data were analyzed using mixed ANOVA considering α=.05 as the significance level. RESULTS. The effect of adjustment and its interaction with the restoration material were significant for marginal, absolute marginal, and occlusal discrepancies (P<.05). Before adjustment, Suprinity had lower marginal discrepancies than IPS e.max CAD (P=.18) and Enamic (P=.021); though no significant differences existed after adjustment. CONCLUSION. Within the limitations of this study, crowns fabricated from IPS e.max CAD and Suprinity resulted in slightly better adaptation compared with Enamic crowns before adjustment. However, marginal, axial, and occlusal discrepancies were similar among all materials after the adjustment.

• The Journal of Advanced Prosthodontics
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• v.14 no.2
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• pp.96-107
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• 2022

PURPOSE. Microstructural and physico-mechanical characterization of highly translucent zirconia, prepared by milling technology (CAD-CAM) and repeated firing cycles, was the main aim of this in vitro study. MATERIALS AND METHODS. Two groups of samples of two commercial highly-translucent yttria-stabilized dental zirconia, VITA YZ-HT^White (Group A) and Zolid HT + White (Group B), with dimensions according to the ISO 6872 "Dentistry - Ceramic materials", were prepared. The specimens of each group were divided into two subgroups. The specimens of the first subgroups (Group A₁ and Group B₁) were merely the sintered specimens. The specimens of the second subgroups (Group A₂ and Group B₂) were subjected to 4 heat treatment cycles. The microstructural features (microstructure, density, grain size, crystalline phases, and crystallite size) and four mechanical properties (flexural strength, modulus of elasticity, Vickers hardness, and fracture toughness) of the subgroups (i.e. before and after heat treatment) were compared. The statistical significance between the subgroups (A₁/A₂, and B₁/B₂) was evaluated by the t-test. In all tests, P values smaller than 5% were considered statistically significant. RESULTS. A homogenous microstructure, with no residual porosity and grains sized between 500 and 450 nm for group A and B, respectively, was observed. Crystalline yttria-stabilized tetragonal zirconia was exclusively registered in the X-ray diffractograms. The mechanical properties decreased after the heat treatment procedure, but the differences were not statistically significant. CONCLUSION. The produced zirconia ceramic materials can be safely (i.e., according to the ISO 6872) used in extensive fixed prosthetic restorations, such as substructure ceramics for three-unit prostheses involving the molar restoration and substructure ceramics for prostheses involving four or more units. Consequently, milling technology is an effective manufacturing technology for producing zirconia substructures for dental fixed all-ceramic prosthetic restorations.

• Journal of Technologic Dentistry
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• v.34 no.2
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• pp.95-103
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• 2012

Purpose: Fracture strength of all-ceramic 3-unit fixed partial dentures manufactured by CAD/CAM and copy-milling systems were evaluated. Methods: Zirconia cores were made by milling the pre-sintered zirconia block by CAD/CAM or copy milling method followed by subsequent sintering. By building-up the corresponding porcelains on the core, all-ceramic bridges were fabricated, and those were evaluated in comparison with PFM fixed partial denture. Results: During the flexural test of the 3-unit PFM bridge, the porcelain started to chip or break at 507.28(${\pm}62.82$)kgf and the metal framework did not break until the maximum load level of 800kgf which was set in the testing instrument of this study. However, among all-ceramic restoration test groups, Everest(EV) group showed a peeling off or breakage of the porcelain from 365.64(${\pm}64.96$)kgf and the core was broken at 491.77(${\pm}55.62$)kgf. Those values of Zirkonzahn(ZR) were 431.03(${\pm}58.47$)kgf and 602.74(${\pm}48.44$)kgf, respectively. The break strength of the porcelain of PFM(PM) group was significantly higher than that of EV (p<0.05) group and there was no significant difference when comparing to that of ZR (p>0.05). ZR group showed higher break strength than that of EV group however there was no significant difference (p>0.05). The break strength of cores were in the increasing order of EV < ZR < PM (p<0.05). Conclusion: We could find that even though the PM group fractured at much higher value than all-ceramic cores, the breakage values of the porcelain of PM group with crack formation or delamination, which will be regarded as clinical failure, was significantly higher than that of EV group and not significantly higher than that of ZR group at p-values of 0.05. The break strength of ZR group was higher than that of EV group at an insignificant level(p>0.05).