• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.95-98
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• 2017

Due to hypodontia, poor oral hygiene, and significantly more prevalent periodontal disease, patients with Down syndrome show higher incidence of edentulism. Oral rehabilitation of such patients is imperative but challenging as high rates of prosthesis failure are reported due to malocclusion, high masticatory force, and parafunctional habits. As CAD/CAM(Computer-Aided Design and Computer Aided Manufacturing) is the recent trend in prosthodontics, this report discusses the application of CAD/CAM in a Down syndrome patient. A 25-year-old patient with Down syndrome was presented to the Department of Pediatric Dentistry, Yonsei University Dental Hospital for oral examination. 5 maxillary teeth were missing, 3 were fully impacted, and 4 had grade III mobility. The patient underwent general anesthesia for extraction of impacted and mobile teeth, implant surgery, and final impression for prosthesis. Afterwards, CAD/CAM was used to design and manufacture a 10-unit zirconia bridge. However the bridge was fractured after 18 months due to the patient's bruxism and high masticatory force. Final impression taking, bite registration, cast fabrication, cast scanning, and prosthesis designing were not needed as CAD/CAM data remained. Previous CAD/CAM design was used to remanufacture the zirconia bridge. Down syndrome patients have malocclusion, high masticatory force, and parafunctional habits which increase the possibility of prosthesis fracture. CAD/CAM is beneficial for Down syndrome patients as previous digital records can be utilized for prosthesis repair or remake. In detail, application of CAD/CAM in remanufacturing decreases patient's discomfort of impression taking, shortens and simplifies dental laboratory procedures, and reduces clinician's effort of taking detailed final impressions or accurate bite registration. In conclusion, oral rehabilitation using CAD/CAM provides not only satisfactory levels of comfort, stability, and esthetics, but also easier repair or remake compared to conventional prostheses.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.258-263
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• 2017

Purpose: In this study, the retrospective radiographic study is executed to evaluate amount of bone loss of various conditions in patients using customized abutment for 4 years of follow-up. Materials and methods: The subjects of this study were implant fixed dental prosthesis using CAD/CAM customized abutments. CAD/CAM customized abutment and fixed dental prosthesis were manufactured by the Prosthodontics Department of Chosun University Dental Hospital from August 1, 2011 to July 31, 2012. Radiological assessments were performed on the patients who were treated by the fixed prosthodontics. After each treatment, a retrospective study was performed for a total of 4 years at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years. Results: As a result of the study, the customized abutment using CAD/CAM showed less bone loss than the results of existing research. There was no statistically significant differences at alveolar bone loss between splinting group and non-splinting group (respectively 0.27 mm, 0.5 mm). Also, there were statistically significant differences at alveolar bone loss in mx. anterior, mx. posterior, mn. anterior and mn. posterior part (respectively 1.37 mm, 0.39 mm, 0.00 mm, 0.30 mm). Conclusion: The customized abutment using CAD/CAM showed less bone loss than the results of existing research, there were statistically significant differences at alveolar bone loss in implant positions.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.18-25
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• 2017

Purpose: The aim of this study was to evaluate the effect of two types of coloring agents and the number of application on the color of zirconia. Materials and methods: Monolithic zirconia specimens ($15.7mm{\times}15.7mm{\times}2.0mm$) (n = 33) was prepared and divided into 11 groups. Each experimental group was coded as a1-a5, w1-w5 according to the type of coloring agent and number of application. Specimens with no coloring agent applied were set as control group. The color difference of specimen was measured by using double-beam spectrophotometer, and calculated color difference (${{\Delta}E^*}_{ab}$), translucency parameter (TP). All data was analyzed with two-way ANOVA, multiple comparison $Sch{\acute{e}}ffe$ test, Pearson correlation and linear regression analysis. Results: As the number of application increased, values of $CIE\;L^*$ was decreased, but values of $CIE\;b^*$ was increased in both coloring agents. However, there was no significant difference on values of translucency parameter. The color difference range of each group was ${0.87{\Delta}E^*}_{ab}$ to ${9.43{\Delta}E^*}_{ab}$. Conclusion: In this study, type of coloring agent and the number of application did not affect the color difference of zirconia.

• Journal of dental hygiene science
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• v.13 no.3
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• pp.290-295
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• 2013

The purpose of this study was to investigate the shear bond strength between various commercial all-ceramic system core and veneering ceramics, and evaluate the clinical stability by comparing the conventional metal ceramic system. The test samples were divided into three groups: Ni-Cr alloy (metal bond), yttria-stabilized, tetragonal zirconia polycrystal (Y-TZP) (zirconia bond), lithium disilicate (lithium disilicate bond). The veneering porcelain recommended by the manufacturer for each type of material was fired to the core. After firing, the specimens were subjected to shear force in a universal testing machine. Load was applied at a crosshead speed of 0.50 mm/min until failure. Average shear strengths (mega pascal) were analyzed with a one-way analysis of variance and the Tukey test (${\alpha}$=0.05). The mean shear bond strength${\pm}$SD in MPa was $44.79{\pm}2.31$ in the Ni-Cr alloy group, $28.32{\pm}4.41$ in the Y-TZP group, $15.91{\pm}1.39$ in the Lithium disilicate group. The ANOVA showed a significant difference among groups (p<0.05). None of the all-ceramic system core and veneering ceramics could attain the high bond strength values of the metal ceramic combination.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.35.1-35.7
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• 2018

Background: After the resection at the mandibular site involving oral cancer, free vascularized fibular graft, a type of vascularized autograft, is often used for the mandibular reconstruction. Titanium mesh (T-mesh) and particulate cancellous bone and marrow (PCBM), however, a type of non-vascularized autograft, can also be used for the reconstruction. With the T-mesh applied even in the chin and angle areas, an aesthetic contour with adequate strength and stable fixation can be achieved, and the pores of the mesh will allow the rapid revascularization of the bone graft site. Especially, this technique does not require microvascular training; as such, the surgery time can be shortened. This advantage allows older patients to undergo the reconstructive surgery. Case presentation: Reported in this article are two cases of mandibular reconstruction using the ready-made type and custom-made type T-mesh, respectively, after mandibular resection. We had operated double blind peer-review process. A 79-year-old female patient visited the authors' clinic with gingival swelling and pain on the left mandibular region. After wide excision and segmental mandibulectomy, a pectoralis major myocutaneous flap was used to cover the intraoral defect. Fourteen months postoperatively, reconstruction using a ready-made type T-mesh (Striker-Leibinger, Freibrug, Germany) and iliac PCBM was done to repair the mandible left body defect. Another 62-year-old female patient visited the authors' clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular squamous cell carcinoma (SCC), reconstruction was done with a reconstruction plate and a right fibula free flap. Sixteen months postoperatively, reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair the mandibular defect after the failure of the fibula free flap. The CAD-CAM T-mesh was made prior to the operation. Conclusions: In both cases, sufficient new-bone formation was observed in terms of volume and strength. In the CAD-CAM custom-made type T-mesh case, especially, it was much easier to fix screws onto the adjacent mandible, and after the removal of the mesh, the appearance of both patients improved, and the neo-mandibular body showed adequate bony volume for implant or prosthetic restoration.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.3
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• pp.228-238
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• 2020

In order to deliver fixed partial denture to a patient successfully, dentist must take into many considerations beforehand. Patient's occlusal pattern should be fully understood before delivering any type of prosthesis, whether it's canine guidance or group function occlusion. In order to do so, movement of mandible should be recorded precisely. Introduced by Meyers in 1933, functionally generated path technique (FGP) has been successfully used to record mandibular movement with various materials, such as wax, and utilize it in fabricating precise prosthesis. In the following cases, patients showed secondary caries or endodontic-periodontic lesion on maxillary molars. Root canal treatment and subgingival curettage were done for each patient. Since the long term prognosis of each tooth was questionable, lateral force should be minimized. In order to do so, FGP technique was used to record mandibular movements precisely. Instead of using conventional plaster impression, intra-oral scanning of wax tracing was done to fabricate prosthesis efficiently. After delivery of fixed partial denture, favorable outcome was obtained.

• Restorative Dentistry and Endodontics
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• v.42 no.1
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• pp.9-18
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• 2017

Objectives: This study evaluated color differences (${\Delta}Es$) and translucency parameter changes (${\Delta}TPs$) of various computer-aided design/computer-aided manufacturing (CAD/CAM) blocks after immersion in coffee. Materials and Methods: Eight CAD/CAM blocks and four restorative composite resins were evaluated. The CIE $L^{\ast}a^{\ast}b^{\ast}$ values of 2.0 mm thick disk-shaped specimens were measured using the spectrophotometer on white and black backgrounds (n = 6). The ${\Delta}Es$ and ${\Delta}TPs$ of one day, one week, and one month immersion in coffee or water were calculated. The values of each material were analyzed by two-way ANOVA and Tukey's multiple comparisons (${\alpha}=0.05$). The ${\Delta}Es$ after prophylaxis paste polishing of 1 month coffee immersion specimens, water sorption and solubility were also evaluated. Results: After one month in coffee, ${\Delta}Es$ of CAD/CAM composite resin blocks and restorative composites ranged from 1.6 to 3.7 and from 2.1 to 7.9, respectively, and ${\Delta}TPs$ decreased. The ANOVA of ${\Delta}Es$ and ${\Delta}TPs$ revealed significant differences in two main factors, immersion periods and media, and their interaction except for ${\Delta}Es$ of TEL (Telio CAD, Ivoclar Vivadent). The ${\Delta}Es$ significantly decreased after prophylaxis polishing except GRA (Gradia Block, GC). There was no significant correlation between ${\Delta}Es$ and water sorption or solubility in water. Conclusions: The ${\Delta}Es$ of CAD/CAM blocks after immersion in coffee varied among products and were comparable to those of restorative composite resins. The discoloration of CAD/CAM composite resin blocks could be effectively removed with prophylaxis paste polishing, while that of some restorative composites could not be removed.

• The Journal of the Korea Contents Association
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• v.18 no.12
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• pp.639-645
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• 2018

The objective of this research was to compare the precision of scanning the digital abutment impression and gypsum model according to 3-dimensional superimposing different skills. There were made with the abutment impression and gypsum model of a maxillary 1st premolar, blue light scanner scanned to obtain the stereolithography (STL) file. After the same process was performed 10 more times without moving them on the scanner table about the abutment impression and gypsum model, respectively (n=11, per types). By superimposing the date of scanning the abutment impression and gypsum model used with no control and best-fit-alignment skills, 10 color-difference maps and root mean square (RMS) data were obtained. The independent t-test was performed to compare RMS data between the each other groups (${\alpha}=0.05$). In the scanning abutment impressions, $RMS{\pm}SD$ of no control, best-fit-alignment showed $6.86{\pm}0.94$, $5.04{\pm}0.24$. in the scanning gypsum model, $4.98{\pm}1.16$, $3.39{\pm}0.07$, all groups showed a significant difference (P<0.001). Trough the this study's result, not only best-fit-alignment but no control is used with digital dental computer-aided design/computer-aided manufacturing (CAD/CAM) research and clinical part.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.3
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• pp.263-270
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• 2019

Current trends in restorative dentistry focus on improving the esthetics and keeping the sound dental tissues as long as possible. The aims of this case report were to describe the successful outcome of cubic-phase zirconia laminate veneers for a patient with isolated microdontia by using a digital workflow, and to describe their clinical implications. A 15-year-old female who had isolated microdontia in combination with spacing visited Ajou University Dental Hospital for esthetic treatment. In this case, 6 maxillary anterior teeth were restored with cubic-phase zirconia laminate veneers without tooth structure removal by using a digital impression, computer-aided design (CAD) software, and computer-aided manufacturing (CAM) procedures. At 6-month follow-up, no distinct mechanical and biological complications were detected and the prostheses exhibited satisfactory esthetics and functions. Due to its favorable tissue responses and enhanced translucency, cubic-phase zirconia can be a suitable strategy for a noninvasive esthetic approach.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.43-54
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• 2021

Based on rapid improvement in digital fields, many advanced digital technologies are utilized in prosthodontic treatment. Especially, intraoral scanners and 3D printing technology are commonly used, and facial scanning technology is recently being attempted to be part of these digital routines. This case report aims to introduce a digital procedure using the intraoral scanner, facial scanner, and 3D printing technology to create definitive restorations, which are esthetic and harmonious with patient's face. From thoroughly evaluated full-mouth provisional restoration which was manufactured and fitted conventionally, definitive prostheses were fabricated using various digital technique. Stable occlusion with functionally and aesthetically satisfying results were achieved.