• The Journal of Advanced Prosthodontics
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• 제9권5호
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• pp.358-363
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• 2017

PURPOSE. The purpose of this study was to evaluate the reliability of computer-aided replica technique (CART) by calculating its agreement with the replica technique (RT), using statistical agreement analysis. MATERIALS AND METHODS. A prepared metal die and a metal crown were fabricated. The gap between the restoration and abutment was replicated using silicone indicator paste (n = 25). Gap measurements differed in the control (RT) and experimental (CART) groups. In the RT group, the silicone replica was manually sectioned, and the marginal and occlusal gaps were measured using a microscope. In the CART group, the gap was digitized using optical scanning and image superimposition, and the gaps were measured using a software program. The agreement between the measurement techniques was evaluated by using the 95% Bland-Altman limits of agreement and concordance correlation coefficients (CCC). The least acceptable CCC was 0.90. RESULTS. The RT and CART groups showed linear association, with a strong positive correlation in gap measurements, but without significant differences. The 95% limits of agreement between the paired gap measurements were 3.84% and 7.08% of the mean. The lower 95% confidence limits of CCC were 0.9676 and 0.9188 for the marginal and occlusal gap measurements, respectively, and the values were greater than the allowed limit. CONCLUSION. The CART is a reliable digital approach for evaluating the fit accuracy of fixed dental prostheses.

• The Journal of Advanced Prosthodontics
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• 제12권2호
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• pp.100-106
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• 2020

PURPOSE. The purpose of this in vitro study was to evaluate the fitting accuracy of single crowns made from a novel presintered Co-Cr alloy prepared with a computer-aided design and computer-aided manufacturing (CAD/CAM) technique, as compared with crowns manufactured by other digital and the conventional casting technique. Additionally, the influence of oxide layer on the fitting accuracy of specimens was tested. MATERIALS AND METHODS. A total of 40 test specimens made from Co-Cr alloy were investigated according to the fitting accuracy using a replica technique. Four different methods processing different materials were used for the manufacture of the crown copings (milling of presintered (Ceramill Sintron-group_cer_sin) or rigid alloy (Tizian NEM-group_ti_nem), selective laser melting (Ceramill NPL-group_cer_npl), and casting (Girobond NB-group_gir_nb)). The specimens were adapted to a resin model and the outer surfaces were airborne-particle abraded with aluminum oxide. After the veneering process, the fitting accuracy (absolute marginal discrepancy and internal gap) was evaluated by the replica technique in 2 steps, before removing the oxide layer from the intaglio surface of the crowns, and after removing the layer with aluminum oxide airborne-particle abrasion. Statistical analysis was performed by multifactorial analysis of variance (ANOVA) (α=.05). RESULTS. Mean absolute marginal discrepancy ranged between 20 ㎛ (group_cer_npl for specimens of Ceramill NPL) and 43 ㎛ (group_cer_sin for crowns of Ceramill Sintron) with the oxide layer and between 19 ㎛ and 28 ㎛ without the oxide layer. The internal gap varied between 33 ㎛ (group_ti_nem for test samples of Tizian NEM) and 75 ㎛ (group_gir_nb for the base material Girobond NB) with the oxide layer and between 30 ㎛ and 76 ㎛ without the oxide layer. The absolute marginal discrepancy and the internal gap were significantly influenced by the fabrication method used (P<.05). CONCLUSION. Different manufacturing techniques had a significant influence on the fitting accuracy of single crowns made from Co-Cr alloys. However, all tested crowns showed a clinically acceptable absolute marginal discrepancy and internal gap with and without oxide layer and could be recommended under clinical considerations. Especially, the new system Ceramill Sintron showed acceptable values of fitting accuracy so it can be suggested in routine clinical work.

• 대한치과보철학회지
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• 제54권3호
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• pp.210-217
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• 2016

목적: 본 연구의 목적은 실제 환자에서 디지털 구강스캐너로 모형 없이 제작한 보철물의 변연 및 내면 적합도를 평가하는 것이다. 대상 및 방법: 전향적 임상시험으로 시행한 본 예비 연구는 총 11개의 수복물을 대상으로 하였다. 구강스캐너(TRIOS, 3shape, Copenhagen, Denmark)로 디지털 구강인상을 채득한 후, 캐드 디자인 및 밀링 가공 과정을 통해 전부지르코니아 수복물을 제작하였다. 완성된 지르코니아관을 환자 구강 내에 시적하였고, 레플리카 술식으로 보철물-지대치 복제물을 얻었다. 이를 근원심, 협설 방향으로 잘라 변연오차, 변연간극과 축벽부, 선각부, 교합면부의 내면간극을 측정하였다. 통계처리는 Kruskal-Wallis 검정과 Mann-Whitney U 검정을 이용하여 통계적 유의성을 분석하였다(${\alpha}=.05$). 결과: 복제물을 통한 적합도 분석 결과, 근원심, 협설 절편 사이에는 통계적으로 유의한 차이가 없었다(P>.05). 변연간극에 불일치가 있었으며, 변연 오차가 변연간극 보다 컸다(P<.01). 결론: 본 연구의 한계 내에서, 구강스캐너로 모형 없이 제작한 전부지르코니아 수복물의 적합도는 임상적으로 허용할만한 결과를 보였다. 그러나 지르코니아관의 변연부위가 과풍융되는 경향이 있었으므로 주의 깊은 임상 적용 및 추적 연구가 요구된다.

• The Journal of Advanced Prosthodontics
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• 제7권2호
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• pp.122-128
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• 2015

PURPOSE. To assess the marginal and internal gaps of the copings fabricated by computer-aided milling and direct metal laser sintering (DMLS) systems in comparison to casting method. MATERIALS AND METHODS. Ten metal copings were fabricated by casting, computer-aided milling, and DMLS. Seven mesiodistal and labiolingual positions were then measured, and each of these were divided into the categories; marginal gap (MG), cervical gap (CG), axial wall at internal gap (AG), and incisal edge at internal gap (IG). Evaluation was performed by a silicone replica technique. A digital microscope was used for measurement of silicone layer. Statistical analyses included one-way and repeated measure ANOVA to test the difference between the fabrication methods and categories of measured points (${\alpha}$=.05), respectively. RESULTS. The mean gap differed significantly with fabrication methods (P<.001). Casting produced the narrowest gap in each of the four measured positions, whereas CG, AG, and IG proved narrower in computer-aided milling than in DMLS. Thus, with the exception of MG, all positions exhibited a significant difference between computer-aided milling and DMLS (P<.05). CONCLUSION. Although the gap was found to vary with fabrication methods, the marginal and internal gaps of the copings fabricated by computer-aided milling and DMLS fell within the range of clinical acceptance (< $120{\mu}m$). However, the statistically significant difference to conventional casting indicates that the gaps in computer-aided milling and DMLS fabricated restorations still need to be further reduced.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.80-85
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• 2024

Background: This study aimed to compare and evaluate the marginal fit of nanocomposite computer-aided design/computer-aided manufacturing (CAD/CAM) inlays. Three types of nanocomposite CAD/CAM blocks (HASEM, VITA Enamic, and Lava Ultimate) were used as materials. Methods: Class II disto-occlusal inlay restorations were prepared on a typodont mandibular right first molar using diamond rotary instruments. The inlays were fabricated using CAD/CAM technology and evaluated using the silicone replica technique to measure marginal gaps at five locations on each inlay. The data were analyzed by two-way analysis of variance and Tukey post hoc tests (α=0.05). Results: There were no significant differences in the marginal gaps based on the type of nanocomposite CAD/CAM inlay used (p=0.209). However, there was a significant difference in the marginal gaps between the measurement regions. The gingival region consistently exhibited a larger marginal gap than the axial and occlusal regions (p<0.001). Conclusion: Within the limitations of this in vitro study, the measurement location significantly influenced the marginal fit of class II disto-occlusal inlay restorations. However, there were no significant differences in the marginal gaps among the different types of CAD/CAM blocks. Furthermore, the overall mean marginal fits of the class II disto-occlusal inlay restorations made with the three types of nanocomposite CAD/CAM blocks were within the clinically acceptable range.

• 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.

• The Journal of Advanced Prosthodontics
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• 제10권5호
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• pp.347-353
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• 2018

PURPOSE. The purpose of this study was to evaluate the marginal discrepancy of heat-pressed ceramic veneers manufactured using a CAD/CAM system. MATERIALS AND METHODS. The ceramic veneers for the abutment of a maxillary left central incisor were designed using a CAD/CAM software program. Ten veneers using a microstereolithography apparatus (AM group), ten veneers using a five-axis milling machine (SM group), and ten veneers using a traditional free-hand wax technique (TW group) were prepared according to the respective manufacturing method. The ceramic veneers were also fabricated using a heat-press technique, and a silicone replica was used to measure their marginal discrepancy. The marginal discrepancies were measured using a digital microscope (${\times}160$ magnification). The data were analyzed using a nonparametric Kruskal-Wallis H test. Finally, post-hoc comparisons were conducted using Bonferroni-corrected Mann-Whitney U tests (${\alpha}=.05$). RESULTS. The $mean{\pm}SD$ of the total marginal discrepancy was $99.68{\pm}28.01{\mu}m$ for the AM group, $76.60{\pm}28.76{\mu}m$ for the SM group, and $83.08{\pm}39.74{\mu}m$ for the TW group. There were significant differences in the total marginal discrepancies of the ceramic veneers (P<.05). CONCLUSION. The SM group showed a better fit than the AM and TW groups. However, all values were within the clinical tolerance. Therefore, CAD/CAM manufacturing methods can replace the traditional free-hand wax technique.

• 한국산학기술학회논문지
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• 제16권10호
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• pp.6611-6617
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• 2015

본 연구는 수작업으로 제작된 metal coping과 CAD/CAM(Computer Aided Design/Computer Aided Manufacturing)으로 제작된 지르코니아 coping을 제작하여 변연과 내면 적합도를 비교 분석하고자 하였다. 모형은 우레탄 모형재를 사용하여 knife, chamfer변연 두 종류의 지대치를 제작하였다. 수작업과 CAD/CAM으로 제작된 보철물의 변연 적합도를 실리콘 리플리카 테크닉방법을 사용하여 측정하였다. 적합도 측정은 현미경의 CCD카메라로 캡쳐하였다. 이때 지대치와 보철물의 거리는 이미지분석 소프트웨어에서 거리 조정이 된 상태에서 실시하였다. 측정부위는 marginal opening을 MO, marginal gap을 MG, internal gap을 IG, Axial gap을 AG, occlusal gap을 OG로 하였다. 제작법과 변연 형태에 따른 비교분석을 위해 이원배치분산분석을 실시하였으며 서로 다른 평균값들의 비교 분석을 위해서 일원배치분산분석과 Scheffe's 사후 검정을 실시하였다. 그 결과 CAD/CAM의 OG와 knife 변연의 MO을 제외하고는 < $120{\mu}m$ 적합도를 나타냈다. CAD/CAM으로 제작된 coping은 chamfer 변연 MO에서 높은 적합도를 보였으나 MG에서는 knife변연이 chamfer변연 보다 더 좋은 적합도를 보였다. AG의 내면 적합도는 가장 좋은 값을 나타내었다(< $38{\mu}m$).

• 치위생과학회지
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• 제14권3호
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• pp.349-355
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• 2014

본 연구는 최근 치의학계 전반적으로 치과용 캐드캠 시스템의 사용이 증가함에 따라 새로운 재료의 개발도 활발히 이루어지고 있는 현실을 반영하였다. 최근 새롭게 개발된 고정성 보철물의 제작 재료인 연질금속재료를 이용하여 제작된 고정성 보철물의 변연 간격을 평가하여 봄으로써 신재료의 임상적 허용 가능성을 변연 간격을 기준으로 가늠하여보고자 하였으며, 나아가서는 치과의사, 치과위생사 및 치과기공사 등 해당 분야 임상가들에게 참고자료를 제시하고자 하였다. 연구 결과에 따르면 연질금속블록을 가공하여 제작된 집단이 전통적인 방식에 의해 제작된 집단보다 우수한 변연간격을 보였으나, 통계적으로 유의하지 않았다. 또한 연질금속블록을 가공하여 제작된 보철물들의 변연 간격이 임상적 허용 수치로 제시되고 있는 $120{\mu}m$를 넘지 않는 것으로 보아 변연 간격을 기준으로 하였을 때 임상적으로 허용이 가능할 것으로 생각된다.

• 대한치과기공학회지
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• 제46권1호
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• pp.1-7
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• 2024

Purpose: The goal of this study was to determine the clinical acceptability of various cement space settings for the marginal and internal fit of a zirconia core manufactured using additive manufacturing. Methods: The maxillary right incisor served as the master model. After scanning the maxillary right incisor with a dental 3D (three-dimensional) scanner, the stereo lithography file was created using different cement space settings of 40, 120, and 200 ㎛ using computer-aided design software (Dental System 2018; 3Shape). The marginal and internal fit of the 3 groups were determined using the silicon replica technique. Measurement points were divided into the following three categories: margin, axial wall, and incisal. To ensure more accurate measurements, these three measurement points were divided into 8 points. The Shapiro-Wilk, one-way ANOVA, and Tukey's honestly significant difference test (for all tests α=0.05) were the statistical analyses that were included in the study. Results: The CS (cement space)-200 group had better marginal and internal fit than the CS-40 and CS-120 groups, and there were statistically significant differences at the marginal and incisal points, except for the axial wall points. CS-200 group, both marginal and internal fit were within 120 ㎛, which is the clinically acceptable value. Conclusion: This study suggests that a 200 ㎛ cement space setting is ideal for optimal marginal and internal fit of 3D-printed ceramic crowns.