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

• Transactions of Materials Processing
• /
• v.7 no.3
• /
• pp.246-259
• /
• 1998

This paper describes a research work of developing a computer-aided design and manufacturing of irregular shaped sheet metal product for blanking or piercing and bending operations. An approach to the system is based on the knowledge-based rules. Knowledge for the system is formulated from plasticity theories experimental results and the empirical knowledge of field experts, This system has been written in AutoLISp on the AutoCAD and in customer tool kit on the SmartCAM with a personal computer and is composed of nine modules which are input and shape treatment, flat pattern-layout, pro-processor module. Based on the knowledge-based rules, the system is designed by considering several factors, such as material and thickness of product complexities of blank geometry and punch profile sheet metal to give flat pattern and automatically account for the adjustment of bending allowances to match tooling requirements by checking dimensions and generating NC data automatically according to drawings of die-layout module. Results carried out in each module will provide efficiencies to the designer and the manufacturer of blanking or piercing and bending die in this field.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.4
• /
• pp.431-441
• /
• 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.

• The Journal of Advanced Prosthodontics
• /
• v.11 no.2
• /
• pp.120-127
• /
• 2019

PURPOSE. To determine wear amount of single molar crowns, made from four different restoratives, and opposing natural teeth through computerized fabrication techniques using 3D image alignment. MATERIALS AND METHODS. A total of 24 single crowns (N = 24 patients, age range: 18 - 50) were made from lithium disilicate (IPS E-max CAD), lithium silicate and zirconia based (Vita Suprinity CAD), resin matrix ceramic material (Cerasmart, GC), and dual matrix (Vita Enamic CAD) blocks. After digital impressions (Cerec 3D Bluecam, DentsplySirona), the crowns were designed and manufactured (Cerec 3, DentsplySirona). A dualcuring resin cement was used for cementation (Variolink Esthetic DC, Ivoclar). Then, measurement and recording of crowns and the opposing enamel surfaces with the intraoral scanner were made as well as at the third and sixth month follow-ups. All measurements were superimposed with a software (David-Laserscanner, V3.10.4). Volume loss due to wear was calculated from baseline to follow-up periods with Siemens Unigraphics NX 10 software. Statistical analysis was accomplished by Repeated Measures for ANOVA (SPSS 21) at = .05 significance level. RESULTS. After 6 months, insignificant differences of the glass matrix and resin matrix materials for restoration/enamel wear were observed (P>.05). While there were no significant differences between the glass matrix groups (P>.05), significant differences between the resin matrix group materials (P<.05) were obtained. Although Cerasmart and Enamic were both resin matrix based, they exhibited different wear characteristics. CONCLUSION. Glass matrix materials showed less wear both on their own and opposing enamel surfaces than resin matrix ceramic materials.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.4
• /
• pp.275-284
• /
• 2016

PURPOSE. The aim of this study was to evaluate the influence of different surface treatment methods on the microtensile bond strength of resin cement to resin nanoceramic (RNC). MATERIALS AND METHODS. RNC onlays (Lava Ultimate) (n=30) were treated using air abrasion with and without a universal adhesive, or HF etching followed by a universal adhesive with and without a silane coupling agent, or tribological silica coating with and without a universal adhesive, and divided into 6 groups. Onlays were luted with resin cement to dentin surfaces. A microtensile bond strength test was performed and evaluated by one-way ANOVA and Tukey HSD test (${\alpha}$=.05). A nanoscratch test, field emission scanning electron microscopy, and energy dispersive X-ray spectroscopy were used for micromorphologic analysis (${\alpha}$=.05). The roughness and elemental proportion were evaluated by Kruskal-Wallis test and Mann-Whitney U test. RESULTS. Tribological silica coating showed the highest roughness, followed by air abrasion and HF etching. After HF etching, the RNC surface presented a decrease in oxygen, silicon, and zirconium ratio with increasing carbon ratio. Air abrasion with universal adhesive showed the highest bond strength followed by tribological silica coating with universal adhesive. HF etching with universal adhesive showed the lowest bond strength. CONCLUSION. An improved understanding of the effect of surface treatment of RNC could enhance the durability of resin bonding when used for indirect restorations. When using RNC for restoration, effective and systemic surface roughening methods and an appropriate adhesive are required.

• The Journal of Advanced Prosthodontics
• /
• v.10 no.4
• /
• pp.328-334
• /
• 2018

PURPOSE. To evaluate the reproducibility of scan-based abutments using a blue light model scanner. MATERIALS AND METHODS. A wax cast abutment die was fabricated, and a silicone impression was prepared using a silicone material. Nine study dies were constructed using the prepared duplicable silicone, and the first was used as a reference. These dies were classified into three groups and scanned using a blue light model scanner. The first three-dimensional (3D) data set was obtained by scanning eight dies separately in the first group. The second 3D data set was acquired when four dies were placed together in the scanner and scanned twice in the second group. Finally, the third 3D data set was obtained when eight dies were placed together in the scanner and scanned once. These data were then used to define the data value using third-dimension software. All the data were then analyzed using the non-parametric Kruskal-Wallis H test (${\alpha}=.05$) and the post-hoc Mann-Whitney U-test with Bonferroni's correction (${\alpha}=.017$). RESULTS. The means and standard deviations of the eight dies together were larger than those of the four dies together and of the individual die. Moreover, significant differences were observed among the three groups (P<.05). CONCLUSION. With larger numbers of abutments scanned together, the scan becomes more inaccurate and loses reproducibility. Therefore, scans of smaller numbers of abutments are recommended to ensure better results.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.4
• /
• pp.416-424
• /
• 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.

• Journal of Technologic Dentistry
• /
• v.42 no.4
• /
• pp.326-333
• /
• 2020

Purpose: The purpose of this study was to evaluate the effects of various zirconia surface treatment methods on shear bond strength with resin cements. Methods: We prepared 120 cylindrical zirconia specimens (⌀10 mm×10 mm) using computer-aided design/computer-aided manufacturing (CAD/CAM). Each specimen was randomly subjected to one of four surface treatment conditions: (1) no treatment (control), (2) airborne-particle abrasion with 50 ㎛ of Al2O3 (A50), (3) airborne-particle abrasion with 125 ㎛ of Al2O3 (A125), and (4) ZrO2 slurry (ZA). Using a polytetrafluoroethylene mold (⌀6 mm×3 mm), we applied three resin cements (Panavia F 2.0, Super-Bond C&B, and Variolink N) to each specimen. The shear bond strength tests were performed in a universal testing machine. The surfaces of representative specimens of each group were evaluated under scanning electron microscope. We used one-way analysis of variance (ANOVA), two-way ANOVA, and post hoc Tukey honest significant difference test to analyze the data. Results: In the surface treatment method, the A50 group showed the highest bond strength, followed by A125, ZA, and control groups; however, no significant difference was observed between A50 and A125, A125 and ZA, and ZA and control (p>0.05). Among the resin cements, Super-Bond C&B showed the highest shear bond strength, followed by Panavia F 2.0 and Variolink N (p<0.05). Conclusion: Within the limitations of this study, application of airborne-particle abrasion and ZrO2 slurry improved the shear bond strength of resin cement on zirconia.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.3
• /
• pp.291-297
• /
• 2016

Patients with $Sj{\ddot{o}}gren^{\prime}s$ syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a $Sj{\ddot{o}}gren^{\prime}s$ syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.1
• /
• pp.80-90
• /
• 2022

With the development of digital dentistry, it is being applied in various ways of dental treatment. This case report presents the definitive prosthesis designed in advance with a re-established vertical dimension and the digital technology, which determined the amount of tooth preparation, in order to preserve as much tooth structure as possible in a patient with pathological wear of the posterior teeth and loss of vertical dimension. For accurate tooth preparation, the guides of the occlusal and axial surfaces were digitally and additively manufactured. Then, aesthetics and anterior guidance were established at the provisional stage. The information of the provisional restoration was delivered to the definitive stage by double scanning. The digital technology, including the virtual planning and the guided tooth removal, produced the definitive restorations satisfactory to both the patient and clinician.