• The Journal of Advanced Prosthodontics
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• 제10권1호
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• pp.18-24
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• 2018

PURPOSE. In literature, many studies compare survival rates of different types of FPDs. Most of them compared restorations, which originated from one university, but from different clinicians. Data about restoration survival rates by only one experienced dentist are very rare. The aim of this study was to evaluate the survival rate of all-ceramic FPDs without the blurring effects of different clinicians. MATERIALS AND METHODS. 153 veneered-zirconia FPDs were observed for follow-up. 22 patients received 131 single crowns and 22 bridges. Because of the different bridge lengths, one unit was defined as a restored or replaced tooth. In total, 201 units were included. Only the restorations performed by the same clinician and produced in the same dental laboratory from 2011 to 2016 were included. Considered factors were defined as "type of unit", "type of abutment", "intraoral region", and "vitality". Modified UHPHS criteria were used for evaluation. Statistical analysis was performed using cox-regression. RESULTS. 189 units (94.0%) showed no kind of failure. 5 chippings (2.4%) could be corrected by intraoral polishing. 4 units (1.9%) exhibited spontaneous decementation. These polishable and recementable restorations are still in clinical use. Chippings or decementations, which lead to total failure, did not occur. One unit was completely fractured (0.5 %). Biological failures (caries, periodontitis or periimplantitis) did not occur. The statistical analysis of the factors did not reveal any significant differences. CONCLUSION. Modern all-ceramic FPDs seem to be an appropriate therapy not only for single restorations but for complex occlusal rehabilitations.

• The Journal of Advanced Prosthodontics
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• 제12권6호
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• pp.329-337
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• 2020

PURPOSE. To verify the influence of computer-aided design/computer-aided manufacturing (CAD/CAM) implant-supported prostheses manufactured with cobalt-chromium (Co-Cr) and zirconia (Zr), and whether ceramic application, spark erosion, and simulation of masticatory cycles modify biomechanical parameters (marginal fit, screw-loosening torque, and strain) on the implant-supported system. MATERIALS AND METHODS. Ten full-arch fixed frameworks were manufactured by a CAD/CAM milling system with Co-Cr and Zr (n=5/group). The marginal fit between the abutment and frameworks was measured as stated by single-screw test. Screw-loosening torque evaluated screw stability, and strain analysis was explored on the implant-supported system. All analyses were performed at 3 distinct times: after framework manufacturing; after ceramic application in both materials' frameworks; and after the spark erosion in Co-Cr frameworks. Afterward, stability analysis was re-evaluated after 106 mechanical cycles (2 Hz/150-N) for both materials. Statistical analyses were performed by Kruskal-Wallis and Dunn tests (α=.05). RESULTS. No difference between the two materials was found for marginal fit, screwloosening torque, and strain after framework manufacturing (P>.05). Ceramic application did not affect the variables (P>.05). Spark erosion optimized marginal fit and strain medians for Co-Cr frameworks (P<.05). Screw-loosening torque was significantly reduced by masticatory simulation (P<.05) regardless of the framework materials. CONCLUSION. Co-Cr and Zr frameworks presented similar biomechanical behavior. Ceramic application had no effect on the biomechanical behavior of either material. Spark erosion was an effective technique to improve Co-Cr biomechanical behavior on the implant-supported system. Screw-loosening torque was reduced for both materials after masticatory simulation.

• 대한치과기공학회지
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• 제29권2호
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• pp.119-128
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• 2007

Although there are many different ways that restorations can be made, it can be said that the biocompatibility of abutment and crown is very important in this experiment. When placed in the actual oral cavity, the differences were obvious. Compared to In-ceram Aluminium, the structure that is obtained after firing reveals a particularly homogeneous distribution of the crystal and glass phase. The In-ceram aluminium system had many problems, such as having weak tensile strength, and having low bonding strength due to the shrinking that occurs after firing. Because of the opaque finish of the metal frame, the two may look similar from the outside, but it is evident that there are differences between using a metal frame and In-ceram. VITA VM9 has been designed as a special ceramic featuring a fine structure or stabilized Zro2 substructures, and so the VITA VM9 excels in its light refraction and reflection behavior, which is similar to natural teeth. It also has outstanding chemical balance, which presents advantages such as considerably reduced accumulation of plaque on the ceramic surface.? This ultimately results in easier care and cleaning for the patient.

• 대한치과보철학회지
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• 제59권3호
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• pp.319-332
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• 2021

심미적인 도재 재료와 레진 시멘트의 비약적인 발전으로 임상에서 금속도재관에서 전부도재관으로의 전환이 활발히 이루어지고 있으며, 도재 수복물 제작 시 그에 적합한 형태와 기술을 이용하여야 그 장점을 최대화할 수 있다. 최근 법랑질을 최대한 보존하고 접착 효율을 높이는 최소 침습적 치아 삭제법을 적용하여 치은 연상 변연을 가진 심미적인 도재 부분피 개관 수복방법이 소개되었는데, 이를 통해 치질 삭제의 최소화, 시멘트 제거의 용이성 등 여러 장점들을 얻을 수 있다고 보고된다. 또한 이 제작법은 치은 압배사의 삽입이 불필요하여 치은 압배사 삽입에 소요되는 시간을 절약할 수 있으며 환자의 불편감도 감소시킬 수 있다. 더 나아가 치은 열구액이나 혈액의 개입 없이 명확하게 변연을 채득할 수 있어 더 정확한 수복물 제작이 가능하다고 보고된다. 본 증례에서는 각각 해당 치아 부위에 부분적인 결함이 있는 환자에서 통상적인 전부피개관이 아닌 접착치의학 개념에 따른 최소 침습적 치아 삭제법을 적용한 치은 연상 변연 도재 부분피개관으로 다양한 제작 방법을 활용하여 수복함으로써 불필요한 치아 삭제를 방지하고 잔존 치질을 최대한 보존할 수 있었다. 치료 후 환자와 술자 모두 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.555-565
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• 2006

The purpose of the present study is to evaluate the biological stability of the zirconia/alumina composite abutment by histologic and radiographic examination in clinical cases. 17 partially edentulous patients (5 men and 12 women, mean age 47) were treated with 37 implants. The implants were placed following the standard two-stage protocol. After a healing period of 3 to 6 months, zirconia/alumina composite abutments were connected. All radiographs were taken using paralleling technique with individually fabricated impression bite block, following insertion of the prosthesis and at the 3-, 6-, 12 month re-examinations. After processing the obtained images, the osseous level was calculated using the digital image in the mesial and distal aspect in each implant. An ANOVA and t-test were used to test for difference between the baseline and 3-, 6-, 12 months re-examinations, and for difference between maxilla and mandible. Differences at P <0.05 were considered statistically significant. For histologic examination, sample was obtained from the palatal gingiva which implant functioned for 12 months. Sections were examined under a light microscope under various magnifications. Clinically, no abutment fracture or crack as well as periimplantitis was observed during the period of study. The mean bone level reduction(${\pm}standard$ deviation) was 0.34 rom(${\pm}\;0.26$) at 3-months, 0.4 2mm(${\pm}\;0.30$) at 6-months, 0.62 mm(${\pm}\;0.28$) at 12-months respectively. No statistically significant difference was found between baseline and 3-, 6-, 12-months re-examinations (p > 0.05). The mean bone level reduction in maxilla was 0.33(${\pm}0.25$) at 3-months, 0.36(${\pm}0.33$) at 6-months, 0.56(${\pm}0.26$) at 12-months. And the mean bone level reduction in mandible was 0.35(${\pm}0.27$) at 3-months, 0,49(${\pm}0.27$) at 6-months, 0.68(${\pm}0.30$) at 12-months. No statistical difference in bone level reduction between implants placed in the maxilla and mandible. Histologically, the height of the junctional epithelium was about 2.09 mm. And the width was about 0.51 mm. Scattered fibroblasts and inflammatory cells, and dense collagen network with few vascular structures characterized the portion of connective tissue. The inflammatory cell infiltration was observed just beneath the apical end of junctional epithelium and the area of direct in contact with zirconia/alumina abutment. These results suggest the zirconia/alumina composite abutment can be used in variable intraoral condition, in posterior segment as well as anterior segment without adverse effects.

• 한국세라믹학회지
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• 제41권1호
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• pp.69-75
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• 2004

인공치아용 3Y-TZP와 (Y,Nb)-TZP/$Al_2O_3$ 복합체를 유사 구강분위기인 인공타액 하에서 500-3000N의 하중 조건으로 $10^6$ 횟수까지 헤르찌안 반복하중 피로특성을 조사하였다. 500N의 하중에서 $5{\times}10^5$까지 반복피로 실험결과, 강도 저하 및 균열 현상은 관찰되지 않았다. 피로특성은 SY-TZP가 (T,Nb)-TZP/$Al_2O_3$ 복합체보다 상전이에 의한 응역회복 때문에 우수하였다. 하중값이 증가함에 따라 링 균열에서 방사상 균열로 전이되었을 때 급격한 강도 저하 현상이 발생하였다. 강도 저하 현상은 유사 구강 분위기하에서 반복 하중 접촉 시 발생한 균열을 통해 침투한 인공타액의 화학적 침식으로 더욱 가속화 되었다.

• The Journal of Advanced Prosthodontics
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• 제7권2호
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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.

• 대한치과보철학회지
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• 제35권4호
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• pp.742-766
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• 1997

The purpose of this study was to determine the effect of finish line design, amount of incisal reduction, and loading condition on the stress distribution in anterior all-ceramic crowns. Three-dimensional finite element models of an incisor all-ceramic crown with 3 different finish line designs : 1) shoulder with sharp line angle 2) shoulder with rounded line angle 3) chamfer : and 2 different incisal reductions : 2mm and 4mm were developed. 300 N force with the direction of 45 degree to the long axis of the tooth was applied at 3 different positions : A) incisal 1/3, B) incisal edge, C) cervical 1/5. Stresses developed in ceramic and cement were analyzed using three-dimensional finite element method. The results were as follows : 1. Stresses were concentrated in the margin region, which were primarily compressive in the labial and tensile in the lingual. 2. Stresses were larger in the area near line angle than on the crown surface of the margin region. In case of shoulder with sharp line angle, stresses were highly concentrated in the porcelain near line angle. 3. At the interface between porcelain and cement and at the porcelain above the margin on crown surface, stresses were the highest in chamfer, and decreased in shoulder with sharp line angle and shoulder with rounded line angle, respectively. 4. At the interface between cement and abutment on crown surface, stresses were the highest in shoulder with sharp line angle, and decreased in shoulder with rounded line angle and chamfer, respectively. 5. The amount of incisal reduction had little influence on the stress distribution in all-ceramic crowns. 6. When load was applied at the incisal edge, higher stresses were developed in the margin region and the incisal edge than under the other loading conditions. 7. When load was applied at the cervical 1/5, stresses were very low as a whole.

• 대한치과보철학회지
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• 제43권5호
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• pp.611-621
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• 2005

State of problem: Zirconia all-ceramic restoration fabricated with CAM system is on an increasing trend in dentistry. However, evaluation of the marginal and internal fits of zirconia bridge seldomly have been reported. Purpose: This study was to evaluate the at of margin and internal surface in posterior 3-unit zirconia bridge framework fabricated with CAM system(DeguDent, Germany). Material and Method: Preparations of secondary premolar and secondary molar on artificial resin model were performed for fabrication of 3-unit posterior bridge framework. Fits of 5 zirconia bridge framework were compared with 5 precious ceramo-metal alloy framework(V-GnathosPlus, Metalor, Switzerland), and prepared margins were designed to chamfer and shoulder finishing line. Each framework was cemented to epoxy resin model with reinforced glass ionomer(FujiCEM, GC Co., Japan), embedded in acrylic resin and sectioned in two planes, mesio-distal and buccolingual. Samples were divided into six pieces by sectioning and had two pieces of each surface(i.e mesial, distal, buccal and lingual surface) per abutment, so there were eight measuring points in each abutment. External gap was measured at the margin and internal gaps were measured at the margin, axial and occlusal surface. Gaps were observed under the measuring microscope(Compact measuring microscope STM5; Olympus, Japan) at a magnification of $\times100$. T-test were used to determine the statistic significance of the different gaps between zirconia and metal framework. Results and Conclusion: 1. External and internal marginal gaps of zirconia and metal framework were in clinically acceptable range. External marginal gaps were not different significantly between zirconia$(81.9{\mu}m)$ and metal $(81.3{\mu}m)$ framework and internal marginal gaps of zirconia $(44.6{\mu}m)$ were smaller than those of metal framework $(58.6{\mu}m)$. 2. Internal axial gaps of zirconia framework$(96.7{\mu}m)$ were larger than those of metal frame-work$(78.1{\mu}m)$ significantly and adversely, internal occlusal gaps of zirconia frame-work$(89.4{\mu}m)$ were smaller than those of metal framework $(104.9{\mu}m)$ significantly. 3. There were no significant differences in external and internal marginal gaps between chamfer and shoulder finish line when zirconia frameworks were fabricated.

• 대한치과보철학회지
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• 제49권1호
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• pp.65-72
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• 2011

연구 목적: 이 연구의 목적은 티타늄 지대주와 비귀금속 보철물이 접촉한 경우를 가정하여 이종 금속간 접촉에 의한 갈바닉 부식으로 인해 발생하는 표면 거칠기 변화를 비교, 평가하고자 하였다. 연구 재료 및 방법: 성분과 조성이 다른 3종의 Ni-Cr합금 (T3, Bella bond plus, Tilite)과 cp 티타늄 Grade 2를 이용하여 $13{\times}13{\times}1.5\;mm$의 크기로 시편을 각 군당 6개씩 제작하였다. 연마과정 후 절연 테이프로 직경 6 mm만을 노출시켜 potentiostat (Parastat 2273A)를 이용하여 동전위 분극 시험과 갈바닉 부식 시험을 시행하였으며, 표면 거칠기 측정기(Surftester SV-3000)를 이용하여 부식 전 후 거칠기를 평가하였다. 측정값을 paired t-test와 One-way ANOVA로 분석하였다. 결과: 티타늄과 접촉한 모든 Ni-Cr 시편의 표면 거칠기는 통계적으로 유의하게 증가하였다. 증가량은 베릴륨을 포함한 T3합금 ($0.016{\pm}.007\;{\mu}m$)이 가장 컸으며, 베릴륨을 포함하지 않은 Bella bond plus ($0.012{\pm}.003\;{\mu}m$), 티타늄을 첨가한 Tilite ($0.012{\pm}.002\;{\mu}m$)는 큰 차이를 보이지 않았다. 금속 종류에 따른 거칠기 증가는 유의한 차이를 보이지 않았다. 결론: 티타늄과 접촉한 비귀금속 합금은 갈바닉 부식에 의해 표면 거칠기가 증가하였다.