• 대한치과의사협회지
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• 제56권11호
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• pp.616-621
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• 2018

This clinical case highlights the failure of long length implants, and the prosthodontic procedures necessary to rehabilitate the maxillary dentition of a patient with microstomia. The integrated digital technology of intra-oral scanning, computer-aided design, and three-dimensional printing can provide an alternative method to make conventional impressions for patients with microstomia who cannot insert the appropriate tray in their mouths.

• 한국치위생학회지
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• 제22권6호
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• pp.467-475
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• 2022

Objectives: This study aimed to understand the definitions, types, and principles of computer-aided design/computer-aided manufacturing (CAD/CAM) and scanners due to the introduction of digital workflows. Methods: This study was based on information from the government's law and articles published in academic journals. Results: CAD/CAM is a technology that measures the shape three-dimensionally, saves it as data, designs it into the desired shape, and processes the product. Scanners, which are classified as intraoral and extraoral scanners, measure teeth and the intraoral environment three-dimensionally and convert them into three-dimensional (3D). A 3D printer is a machine that creates a 3D object by layering materials based on a 3D drawing. It can be classified into four types according to the method: extrusion, powder bonding, lamination, and photopolymerization methods. The most used 3D printer methods in dentistry are stereolithograhpy and digital light processing, and they are widely used in prosthetic, surgical, and orthodontic fields. Conclusions: As the dental system is digitized, it is expected that the government will classify the dental hygienist scope of work and the universities will reflect the curriculum; it is necessary to develop excellent dental hygienists, diversify the educational pathways, and establish policies to meet the needs of the increasing number of patients.

• 대한치과교정학회지
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• 제49권6호
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• pp.404-412
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• 2019

Objective: To assess shear bond strength and failure mode (Adhesive Remnant Index, ARI) of orthodontic brackets bonded to polymethylmethacrylate (PMMA) blocks for computer-aided design/manufacture (CAD/CAM) fabrication of temporary restorations, following substrate chemical or mechanical treatment. Methods: Two types of PMMA blocks were tested: $CAD-Temp^{(R)}$ (VITA) and $Telio^{(R)}$ CAD (Ivoclar-Vivadent). The substrate was roughened with 320-grit sandpaper, simulating a fine-grit diamond bur. Two universal adhesives, Scotchbond Universal Adhesive (SU) and Assure Plus (AP), and a conventional adhesive, Transbond XT Primer (XTP; control), were used in combination with Transbond XT Paste to bond the brackets. Six experimental groups were formed: (1) $CAD-Temp^{(R)}/SU$; (2) $CAD-Temp^{(R)}/AP$; (3) $CAD-Temp^{(R)}/XTP$; (4) $Telio^{(R)}$ CAD/SU; (5) $Telio^{(R)}$ CAD/AP; (6) $Telio^{(R)}$ CAD/XTP. Shear bond strength and ARI were assessed. On 1 extra block for each PMMA-based material surfaces were roughened with 180-grit sandpaper, simulating a normal/medium-grit ($100{\mu}m$) diamond bur, and brackets were bonded. Shear bond strengths and ARI scores were compared with those of groups 3, 6. Results: On $CAD-Temp^{(R)}$ significantly higher bracket bond strengths than on $Telio^{(R)}$ CAD were recorded. With XTP significantly lower levels of adhesion were reached than using SU or AP. Roughening with a coarser bur resulted in a significant increase in adhesion. Conclusions: Bracket bonding to CAD/CAM PMMA can be promoted by grinding the substrate with a normal/medium-grit bur or by coating the intact surface with universal adhesives. With appropriate pretreatments, bracket adhesion to CAD/CAM PMMA temporary restorations can be enhanced to clinically satisfactory levels.

• The Journal of Advanced Prosthodontics
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• 제11권6호
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• pp.305-312
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• 2019

PURPOSE. The purpose of this study was to compare computer-aided design/computer-aided manufacturing (CAD/CAM) abutment and prefabricated abutment in Morse taper internal connection type implants after cyclic loading. MATERIALS AND METHODS. The study was conducted with internal type implants of two different manufacturers (Group Os, De). Fourteen assemblies were prepared for each manufacturer group and divided into 2 groups (n=7): prefabricated abutments (Os-P, De-P) and CAD/CAM abutments (Os-C, De-C). The amount of axial displacement and the removal torque values (RTVs) were measured before and after cyclic loading (10⁶ cycles, 3 Hz with 150 N), and the tensile removal force to dislodge the abutments was measured after cyclic loading. A repeated measures ANOVA and a pattern analysis based on the logarithmic regression model were conducted to evaluate the effect of cyclic loading on the axial displacement. The Wilcoxon signed-rank test and the Mann-Whitney test was conducted for comparison of RTV reduction% and tensile removal forces. RESULTS. There was no significant difference between CAD/CAM abutments and prefabricated abutments in axial displacement and tensile removal force; however, significantly greater RTV reduction% after cyclic loading was observed in CAD/CAM abutments. The correlation among the axial displacement, the RTV, and the tensile removal force was not significant. CONCLUSION. The use of CAD/CAM abutment did not significantly affect the amount of axial displacement and tensile removal force, but presented a significantly greater removal torque reduction% than prefabricated abutments. The connection stability due to the friction at the abutment-implant interface of CAD/CAM abutments may not be different from prefabricated abutment.

• 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.

• The Journal of Advanced Prosthodontics
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• 제11권6호
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• pp.331-340
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• 2019

PURPOSE. The purpose of this study is to assess the accuracy of three intraoral scanners along the complete dental arch and evaluate the feasibility of the assessment methodology for further in vivo analysis. MATERIALS AND METHODS. A specific measurement pattern was fabricated and measured using a coordinate measuring machine for the assessment of control distances and angles. Afterwards, the pattern was placed and fixed in replica of an upper jaw for their subsequent scans (10 times) using 3 intraoral scanners, namely iTero Element1, Trios 3, and True Definition. 4 reference distances and 5 angles were measured and compared with the controls. Trueness and precision were assessed for each IOS: trueness, as the deviation of the measures from the control ones, while precision, as the dispersion of measurements in each reference parameter. These measurements were carried out using software for analyzing 3-dimensional data. Data analysis software was used for statistical and measurements analysis (α=.05). RESULTS. Significant differences (P<.05) were found depending on the intraoral scanner used. Best trueness values were achieved with iTero Element1 (mean from 10 ± 7 ㎛ to 91 ± 63 ㎛) while the worst values were obtained with Trios3 (mean from 42 ± 23 ㎛ to 174 ± 77 ㎛). Trueness analysis in angle measurements, as well as precision analysis, did not show conclusive results. CONCLUSION. iTero Element1 was more accurate than the current versions of Trios3 and True Definition. Importantly, the proposed methodology is considered reliable for analyzing accuracy in any dental arch length and valid for assessing both trueness and precision in an in vivo study.

• 치위생과학회지
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• 제15권1호
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• pp.54-59
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• 2015

본 연구는 시중에 널리 사용되는 치과용 지르코니아 코어를 이용하여 서로 다른 형태의 지대치를 대상으로 작업모형을 제작한 후, 치과용 스캐너를 통해 3차원 디지털 모형을 전환한 데이터를 토대로 지르코니아 코어를 제작하였으며, 각 실험군별 변연 적합도를 측정하여 비교분석하고자 하였다. 이와 같은 결과로 형태가 다른 지대치가 CAD/CAM system으로 치과 보철물 제작 시 적합도의 영향여부를 비교하였다. 제한된 조건 하에서 수행된 본 연구에서 다름과 같은 결과를 보였다. 지대치의 형태가 다른 작업모형으로 제작된 지르코니아 코어의 변연 적합도는 큰 차이가 없었다(p>0.05). 작업모형의 부위를 4등분으로 나누어 측정한 변연 적합도 또한 통계적으로 유의한 차이를 보이지 않았다. 결론적으로 3종류의 다른 지대치 모두 유사한 지르코니아 코어의 변연 적합도를 보였으며, 측정된 결과는 선행연구에 비추어 볼 때 임상적으로 허용 가능한 수치($100{\sim}120{\mu}m$)를 초과하는 실험군은 없었다. 이와 같은 결과를 토대로 다른 형태의 지대치를 사용하여 제작되었더라도 지르코니아 코어의 변연 적합도에 큰 영향을 주지 않을 것으로 생각된다.

• 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.

• 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.

• 치위생과학회지
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• 제18권1호
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• pp.42-49
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• 2018

The computer-aided design/computer-aided manufacturing (CAD/CAM) system was introduced to shorten the production time of all-ceramic restorations and the number of patient visits. Among these types of ceramic for dental CAD/CAM, they have been processed into inlay, onlay, and crown shapes using leucite-reinforced glass-ceramics to improve strength. The purpose of this study was to observe the mechanical properties and microstructure of leucite-reinforced glass-ceramics for dental CAD/CAM. Two types of leucite-reinforced glass-ceramic blocks (IPS Empress CAD, Rosetta BM) were prepared with diameter of 13 mm and thickness of 1 mm. Biaxial flexural testing was conducted using a piston-on-three-ball method at a crosshead speed of 0.5 mm/min. Weibull statistics were used for the analysis of biaxial flexural strength. Fracture toughness was obtained using an indentation fracture method. Specimens were observed by field emission scanning electron microscopy to examine the microstructure of the leucite crystalline phase after acid etching with 0.5% hydrofluoric acid aqueous solution for 1 minute. The results of strength testing showed that IPS Empress CAD had a mean value of $158.1{\pm}8.6MPa$ and Rosetta BM of $172.3{\pm}8.3MPa$. The fracture toughness results showed that IPS Empress CAD had a mean value of $1.28{\pm}0.19MPa{\cdot}m^{1/2}$ and Rosetta BM of $1.38{\pm}0.12MPa{\cdot}m^{1/2}$. The Rosetta BM sample exhibited higher strength and fracture toughness. Moreover, the crystalline phase size and ratio were increased in the Rosetta BM sample. The above results are expected to elucidate the basic mechanical properties and crystal structure characteristics of IPS Empress CAD and Rosetta BM. Additionally, they will help develop leucite-reinforced glass-ceramic materials for CAD/CAM.