• The Journal of Advanced Prosthodontics
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• 제15권1호
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• pp.44-54
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• 2023

PURPOSE. To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. MATERIALS AND METHODS. Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients' preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. RESULTS. Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. CONCLUSION. The high survival and success rates, low number of complications, and the high level of patients' acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the "gold standard" MC crowns.

• 대한치과보철학회지
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• 제59권1호
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• pp.97-106
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• 2021

임플란트를 사용한 수복치료에서는 보철물을 위한 이상적인 위치에 임플란트가 식립되어야 한다. 치조골이 부족한 환자의 경우에는 최종 보철물을 위한 적절한 연조직 및 경조직 지지를 얻기 위해서 수술적인 처치를 포함한 구강내 처치를 필요로 하게 된다. CAD-CAM 기술을 활용한 보철물 설계는 위와 같은 수술적 처치의 필요성에 대해 임상가가 사전적으로 평가해볼 수 있는 청사진을 제시해준다. 본 증례에서는 CAD-CAM system을 통해 환자의 치료 전 구내상황, 수술적 처치에 대한 예상, 일련의 임시 보철물을 반영하여 최종 보철물을 계획하고 제작하였다. 최종 보철물을 반영하여 제작한 수술용 가이드를 사용하여 임플란트를 식립함과 동시에 치조골 증대술을 시행하였다. 이후 CAD-CAM을 활용하여, 맞춤형 지대주와 1차 및 2차 잠정 수복물을 디자인하고 제작하였으며, 환자의 구내에서 평가를 거친 2차 잠정 보철물과 동일한 형태의 최종 보철물을 제작하였다. 저작, 발음, 심미 기능에 있어서 환자와 술자 모두 만족할만한 결과를 얻을 수 있었다.

• Restorative Dentistry and Endodontics
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• 제44권3호
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• pp.23.1-23.9
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• 2019

Objectives: The aim of this study was to investigate the microshear bond strength (${\mu}SBS$) of different universal adhesive systems applied to hybrid computer-aided design/computer-aided manufacturing (CAD-CAM) restorative materials repaired with a composite resin. Materials and Methods: Four types of CAD-CAM hybrid block materials-Lava Ultimate (LA), Vita Enamic (VE), CeraSmart (CS), and Shofu Block HC (SH)-were used in this study, in combination with the following four adhesive protocols: 1) control: porcelain primer + total etch adhesive (CO), 2) Single Bond Universal (SB), 3) All Bond Universal (AB), and 4) Clearfil Universal Bond (CU). The ${\mu}SBS$ of the composite resin (Clearfil Majesty Esthetic) was measured and the data were analyzed using two-way analysis of variance and the Tukey test, with the level of significance set at p < 0.05. Results: The CAD-CAM block type and block-adhesive combination had significant effects on the bond strength values (p < 0.05). Significant differences were found between the following pairs of groups: VE/CO and VE/AB, CS/CO and CS/AB, VE/CU and CS/CU, and VE/AB and CS/AB (p < 0.05). Conclusions: The ${\mu}SBS$ values were affected by hybrid block type. All tested universal adhesive treatments can be used as an alternative to the control treatment for repair, except the AB system on VE blocks (the VE/AB group). The ${\mu}SBS$ values showed variation across different adhesive treatments on different hybrid CAD-CAM block types.

• 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.

• 대한치과의사협회지
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• 제52권1호
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• pp.17-26
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• 2014

Computerized 3D virtual dental models are currently available, and their use has started to improve treatment outcomes. The accuracy of digital models has been demonstrated by many studies and various intra-oral scanners are innovated for short scanning time and high precision. Recently, a digital model was combined with a high technology computer-driven system, which was developed for the application of a digital set-up and indirect bonding of lingual attachments. In this section, virtual treatment planning using a virtual set-up program is be introduced, and the clinical applications and accuracy of computer-generated indirect bonding are discussed.

• 치위생과학회지
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• 제12권4호
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• pp.368-374
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• 2012

제한된 조건 하에서 수행된 본 연구에서 다음과 같은 결론을 얻었다. 1. 치과용 캐드캠을 이용하여 제작된 지르코니아 코어의 변연 및 내면 적합도보다 전통적인 방식을 이용하여 제작한 금속 코어가 모든 부위에서 우수하였다(p<.001). 2. 두 그룹 모두에서 적합도가 가장 미흡한 부분은 절단부였고, 축벽부가 가장 우수한 것으로 확인되었다. 본 연구 결과를 볼 때 아직까지는 치과용 캐드캠을 이용하여 보철물을 제작하는 것이 기존의 기공 방식을 이용하여 제작된 보철물의 적합도만큼 만족스럽지는 못하였으나 임상적 허용 범위 안에 존재하였다는 점에서 치과용 캐드캠은 임상적으로 사용이 가능한 것으로 판단된다. 앞으로 기계가 개선되고 가공 방식이 지금보다 발전한다면 기존의 기공 방식을 이용하여 제작되는 보철물의 완성도를 능가할 것으로 생각된다.

• 대한심미치과학회지
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• 제23권2호
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• pp.86-94
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• 2014

In recent years, perhaps the biggest driver in new material development is the desire to improve crown and bridge esthetics compared to the traditional PFM or all-metal restorations. As such, zirconia, leucite-containing glass ceramic and lithium disilicate glass ceramic have become prominent in the dental practice. Each material type performs differently regarding strength, toughness, ease of machining and the final preparation of the material prior to placement. For example, glass ceramic are typically weaker materials which limits its use to single-unit restorations. On the other hand, zirconia has a high fracture toughness which enables multi-unit restorations. This material requires a long sintering procedure which excludes its use for fast chair side production. Developed hybrid material of CAD/CAM is contained nano ceramic elements. This new material, called a Resin Nano Ceramic is unique in durability and function. The material is not a resin or composite. It is also not a pure ceramic. The material is a mixture of both and consists of ceramic. Like a composite, the material is not brittle and is fracture resistant. Like a glass ceramic, the material has excellent polish retention for lasting esthetics. The material is easily machined chair side or in a dental lab, polishes quickly to an esthetic finish and if necessary, can be useful restoratives.

• 구강생물연구
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• 제42권4호
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• pp.262-268
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• 2018

In a situation where a vertical dimension has to be increased, the normal occlusion, function and aesthetics should be restored after taking into consideration the neuromuscular system and temporomandibular join. In order to do this, the provisional prosthesis should be made according to the patient's information. Moreover, the period of adjustment should be made through the provisional prosthesis modification, if necessary. The patient is then transferred to the final prosthesis to obtain results that are satisfactory. In the modern-day world, provisional prosthesis are replicated using three dimensional scanning and computer aided design/computer aided manufacturing (CAD/CAM) then made into final prosthesis. The adaptability of stomatognathic system can be judged by the PMMA provisional restoration. Functional and aesthetical aspect can be obtained. The adjustment period can be shortened by an intraoral correction and proper wear between provisional restorations. By using the CAD/CAM technology that transfers the information right into the final prosthesis.

• 대한치과보철학회지
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• 제52권4호
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• pp.352-358
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• 2014

최근 지르코니아와 CAD/CAM을 이용하는 심미적인 임플란트 보철치료 방법들이 많이 소개되고 있다. 그러나 이러한 방법들은 치은부위와 교합면부위에서 한계점들을 가지고 있다. 이에 본 증례에서는 지르코니아와 CAD/CAM 시스템을 이용하여 고정체 1 mm 상부에서부터 형성되는 점막하지르코니아 임플란트 보철물을 제작하고 이를 타이타늄 지대주와 접착하여 시멘트 나사 유지형 보철물을 제작하였다. 임상적으로 심미적이고 기능적면에서 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• 구강회복응용과학지
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• 제40권2호
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• pp.100-106
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• 2024

조기 교정치료의 개입은 종종 성장하는 치열을 정상 교합으로 유도하는 것에서부터 시작된다. 유치의 상실로 인한 맹출 실패를 예방하는 가장 간단한 방법은 밴드 및 루프와 같은 공간 유지장치를 부착하는 것이다. 밴드 및 루프 공간 유지장치는 밴드의 픽업 인상 과정을 거쳐야 하며, 시멘트 소실과 탈회, 인접치의 locking과 같은 문제들을 갖고 있다. 이러한 문제를 해결하기 위해서 CAD/CAM을 이용한 band가 필요 없는 공간유지장치가 개발되었다. 본 증례는 밴드 없이 CAD/CAM을 이용하여 하악 제2소구치가 성공적으로 맹출할 수 있었기에 이를 보고하는 바이다.