• 대한치과보철학회지
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• 제56권2호
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• pp.126-133
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• 2018

Cone beam computerized tomography (CBCT)의 발전은 환자의 해부학적 구조를 3차원적으로 분석할 수 있게 하였다. Surgical guide는 CBCT와 CAD/CAM, 임플란트 진단 소프트웨어의 접목을 통해 미래의 보철물을 계획하고 적합한 위치에 임플란트를 식립할 수 있게 한다. Guided surgery를 통해 해부학적 구조물에 대한 침범을 최소한으로 줄일 수 있고 보다 재현성 있는 치료계획의 설정이 가능하다. 본 증례는 전악 무치악 환자에게 surgical guide를 이용하여 다수의 임플란트를 식립한 증례로 수술시간을 단축시킬 수 있었으며 임시 보철물을 미리 제작함으로써 보다 쉽게 immediate loading을 시행할 수 있었다. 환자는 개선된 안모와 저작기능에 만족하였다.

• The Journal of Advanced Prosthodontics
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• 제10권4호
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• pp.291-299
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• 2018

PURPOSE. To assess the degree of conversion (DC) and light irradiance delivered to light-cured and dual-cured cements by application of different light sources through various types of monolithic computer-aided design and computer-aided manufacturing (CAD/CAM) materials. MATERIALS AND METHODS. RelyX Ultimate Clicker light-cured and dual-cured resin cement specimens with 1.5-mm thicknesses (n=300, 10/group), were placed under four types of crystalline core structure (Vita Enamic, Vita Suprinity, GC Ceresmart, Degudent Prettau Anterior). The specimens were irradiated for 40 seconds with an LED Soft-Start or pulse-delay unit or 20 seconds with a QTH unit. DC ratios were determined by using Fourier transform infrared spectroscopy (FTIR) after curing the specimen at 1 day and 1 month. The data were analyzed using the Mann-Whitney U test (for paired comparison) and the Kruskal-Wallis H test (for multiple comparison), with a significance level of P<.05. RESULTS. DC values were the highest for RelyX Ultimate Clicker light-cure specimens polymerized with the LED Soft-Start unit. The combination of the Vita Suprinity disc and RelyX Ultimate Clicker dual-cure resin cement yielded significantly higher values at both timepoints with all light units (all, P<.05). CONCLUSION. Within the limitations of this study, we conclude that the DC of RelyX Ultimate Clicker dual-cure resin cement was improved significantly by the use of Vita Suprinity and the LED Soft-Start light unit. We strongly recommend the combined use of an LED light unit and dual-cure luting cement for monolithic ceramic restorations.

• 대한치과보철학회지
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• 제58권1호
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• pp.67-76
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• 2020

컴퓨터 지원 설계 제조 기술(CAD/CAM)의 발전에 따라, 완전한 디지털 워크플로우를 구현하기 위한 첫번째 단계인 구내스캐너의 중요성이 높아지기 시작했다. CAD/CAM 이중스캔 기술은 임시 수복물의 외형을 복제하여 최종 수복물에 반영하도록 하는 방법이다. 이 증례에서는 비심미적인 전치부, 중증도의 마모, 수직 고경의 감소를 보이는 67세 남성을 치관 연장술과 수직고경 회복을 동반한 완전구강회복을 통해 치료했다. 임시 수복물은 구내스캐너와 CAD/CAM 이중스캔을 이용해 제작되었다. 적응 기간 후, 최종 단일 구조 지르코니아 수복물을 CAD/CAM 이중스캔을 이용해 임시 수복물을 반영해 제작되었다.

• The Journal of Advanced Prosthodontics
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• 제10권5호
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• pp.335-339
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• 2018

PURPOSE. The purpose of the present study was to compare scanning trueness and precision between an abutment impression and a stone model according to dental computer-aided design/computer-aided manufacturing (CAD/CAM) evaluation standards. MATERIALS AND METHODS. To evaluate trueness, the abutment impression and stone model were scanned to obtain the first 3-dimensional (3-D) stereolithography (STL) file. Next, the abutment impression or stone model was removed from the scanner and re-fixed on the table; scanning was then repeated so that 11 files were obtained for each scan type. To evaluate precision, the abutment impression or stone model was scanned to obtain the first 3-D STL file. Without moving it, scanning was performed 10 more times, so that 11 files were obtained for each scan type. By superimposing the first scanned STL file onto the other STL files one by one, 10 color-difference maps and reports were obtained; i.e., 10 experimental scans per type. The independent t-test was used to compare root mean square (RMS) data between the groups (${\alpha}=.05$). RESULTS. The $RMS{\pm}SD$ values of scanning trueness of the abutment impression and stone model were $22.4{\pm}4.4$ and $17.4{\pm}3.5{\mu}m$, respectively (P<.012). The $RMS{\pm}SD$ values of scanning precision of the abutment impression and stone model were $16.4{\pm}2.9$ and $14.6{\pm}1.6{\mu}m$, respectively (P=.108). CONCLUSION. There was a significant difference in scanning trueness between the abutment impression and stone model, as evaluated according to dental CAD/CAM standards. However, all scans showed high trueness and precision.

• The Journal of Advanced Prosthodontics
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• 제10권5호
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• pp.381-387
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• 2018

PURPOSE. Cement-retained implant prostheses can lack proper retrievability during repair, and residual cement can cause peri-implantitis. The purpose of this in vitro study was to evaluate the influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with lingual slots, known as retrievable cement-type slots (RCS). MATERIALS AND METHODS. We fabricated six types of titanium abutments (10 of each type) with two different heights (4 mm and 6 mm), three different convergence angles ($8^{\circ}$, $10^{\circ}$, and $12^{\circ}$), a sloped shoulder margin (0.6 mm depth), a rectangular shape ($6mm{\times}6.5mm$) with rounded edges, and a rectangular ledge ($2mm{\times}1mm$) for the RCS. One monolithic zirconia crown was fabricated for each abutment using a dental computer-aided design/computer-aided manufacturing system. The abutments and crowns were permanently cemented together with dual-curing resin cement, followed by 24 hours in demineralized water at room temperature. Using a custom-made device with a slot driver and torque gauge, we recorded the torque ($N{\cdot}cm$) required to remove the crowns. Statistical analysis was conducted using multiple regression analysis and Mann-Whitney U tests (${\alpha}=.05$). RESULTS. Removal torques significantly decreased as convergence angles increased. Multiple regression analysis showed no significant interaction between the abutment height and the convergence angle (Durbin-Watson ratio: 2.186). CONCLUSION. Within the limitations of this in vitro study, we suggest that the retrievability of cement-retained implant prostheses with RCS can be maintained by adjusting the abutment height and convergence angle, even when they are permanently cemented together.

• 대한치과보철학회지
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• 제57권4호
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• pp.490-494
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• 2019

국소의치 장착자에서 2차 우식 등의 문제가 발생하여 지대치 치료 후 크라운 재수복이 필요한 경우가 있다. 기존 국소의치가 잘 기능하고 있고 환자가 여러 가지 원인으로 국소의치를 새로 제작할 수 없을 경우에는 기존 국소의치에 맞도록 지대치 보철물을 제작해야 한다. 그러나 이 과정은 기술적으로 난이도가 높고, 기공과정이 복잡하다. 국소의치를 지지하는 지대치에 합병증이 발생하기 전의 원본 모형이 있고 참고점이 될 수 있는 다른 치아들을 포함하고 있다면, CAD/CAM을 이용하여 retrofitting 보철물을 매우 간단하고 효율적으로 제작할 수 있다. 본 증례는 지대치의 포스트, 코어 및 보철물이 복합적으로 탈락하여 내원한 환자에서, computer-aided design and computer-aided manufacturing (CAD/CAM)을 이용해 기존 국소의치에 맞는 보철물을 제작하였고 높은 적합도와 조정 과정의 최소화 등 만족스러운 결과를 얻어 이를 보고하는 바이다.

• 대한치과교정학회지
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• 제49권2호
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• pp.73-80
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• 2019

Objective: The purpose of this study was to compare the static (SFF) and kinetic frictional forces (KFF) of a computer-aided design and computer-aided manufacturing lingual bracket (CAD/CAM-LB) with those of conventional LB (Con-LB) and Con-LB with narrow bracket width (Con-LB-NBW) under 3 tooth displacement conditions. Methods: The samples were divided into 9 groups according to combinations of 3 LB types (CAD/CAM-LB [Incognito], Con-LB [7th Generation, 7G], and Con-LB-NBW [STb]) with 3 displacement conditions (no displacement [control], maxillary right lateral incisor with 1-mm palatal displacement [MXLI-PD], and maxillary right canine with 1-mm gingival displacement [MXC-GD]; n = 6/group). While drawing a 0.016-inch copper or super-elastic nickel-titanium archwire with 0.5 mm/min for 5 minutes in a chamber maintained at $36.5^{\circ}C$, SFF and KFF were measured. The Kruskal-Wallis method with Bonferroni correction was performed. Results: The Incognito group demonstrated the highest SFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD, Stb-MXC-GD] < [7G-MXC-GD, 7G-MXLI-PD, 7G-control] < [Incognito-MXLI-PD, Incognito-control, Incognito-MXC-GD]; p < 0.001). However, there were no significant differences in SFF among the 3 displacement conditions within each bracket group. Within each displacement condition, the Incognito group demonstrated the highest KFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD] < Stb-MXC-GD < 7G-MXLI-PD < [7G-control, 7G-MXC-GD] < [7G-MXC-GD, Incognito-MXLI-PD, Incognito-control] < [Incognito-control, Incognito-MXC-GD]; p < 0.001). MXC-GD exhibited higher KFFs than MXLI-PD in the same bracket group. Conclusions: The slot design and ligation method of the CAD/CAM-LB system should be modified to reduce SFF and KFF during the leveling/alignment stage.

• The Journal of Advanced Prosthodontics
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• 제11권2호
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• pp.128-137
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• 2019

PURPOSE. The aim of this study was to compare the effect of different finishing and polishing techniques on water absorption, water solubility, and microhardness of ceramic or glass-polymer based computer-aided design and computer-aided manufacturing (CAD/CAM) materials following thermocycling. MATERIALS AND METHODS. 150 disc-shaped specimens were prepared from three different hybrid materials and divided into five subgroups according to the applied surface polishing techniques. All specimens were subjected up to #4000 grit SiC paper grinding. No additional polishing has been done to the control group (Group I). Other polishing procedures were as follows: Group II: two-stage diamond impregnated polishing discs; Group III: yellow colored rubber based silicone discs; Group IV: diamond polishing paste; and Group V: Aluminum oxide polishing discs. Subsequently, 5000-cycles of thermocycling were applied. The analyses were conducted after 24 hours, 7 days, and 30 days of water immersion. Water absorption and water solubility results were analyzed by two-way ANOVA and Tukey post-hoc tests. Besides, microhardness data were compared by Kruskal-Wallis and MannWhitney U tests (P<.05). RESULTS. Surface polishing procedures had significant effects on water absorption and solubility and surface microhardness of resin ceramics (P<.05). Group IV exhibited the lowest water absorption and the highest microhardness values (P<.05). Immersion periods had no effect on the microhardness of hybrid ceramic materials (P>.05). CONCLUSION. Surface finishing and polishing procedures might negatively affect physical properties of hybrid ceramic materials. Nevertheless, immersion periods do not affect the microhardness of the materials. Final polishing by using diamond polishing paste can be recommended for all CAD/CAM materials.

• The Journal of Advanced Prosthodontics
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• 제12권6호
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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.

• 대한치위생과학회지
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• 제5권1호
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• pp.13-19
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• 2022

Background: In this study, zirconia copings were fabricated by setting clinically acceptable inner values for prostheses using computer-aided design/computer-aided manufacturing (CAD/CAM). The processed copings were evaluated for the marginal and internal fit of each abutment shape with a CAD program using the silicone replica technique. Methods A total of 20 copings was produced by selecting models commonly used in clinical practice. After injecting the sample, the minimum thickness, internal adhesion interval, and distance to the margin line were set to 0.5, 0.05, and 1.00 mm using a dental CAD program, respectively. It was measured using a 2D section function in a three-way program of the silicon replication technology. Although the positions and number of measurements of the anterior and posterior regions differed, nine parts of each pre-tube were designated and measured by referring to a previous study to compare the two samples. Results As a result, the average margin of the mesial, distal, and buccal (labial) surfaces was 59.90 ㎛ in the anterior region and 60.40 ㎛ in the posterior region. The mean axial wall margin was 67.25 ㎛ in the anterior region and 69.25 ㎛ in the posterior region. In occlusion, the anterior teeth (77.70 ㎛), posterior teeth (77.60 ㎛), and both anterior and posterior regions were within the clinically acceptable range. Conclusion The edge and inner fit of zirconia coping manufactured using the CAD/CAM system showed clinically applicable results. To reduce errors and increase accuracy, materials and machine errors that affect the manufacture of prosthetics should be investigated. Based on our results, the completeness of prosthetics could increase if the inner value and characteristics of the material are adjusted when applied in clinical practice.