• 대한심미치과학회지
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• 제25권2호
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• pp.79-87
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• 2016

당일수복 보철물 제작을 위해 디지털 프로세스 사용은 필수적이다. 이러한 디지털 프로세스는 구강스캔, 컴퓨터를 이용한 보철물을 디자인 과정(CAD)과 보철물을 가공하는 과정(CAM)을 포함한다. 지르코니아의 굴곡강도는 900Mpa로 리튬디실리케이트의 400MPa보다 더 단단하지만, 리튬디실리케이트를 이용한 보철물 기공시간이 지르코니아와 비교하여 더 짧기에 당일수복 보철물 제작시 리튬디실리케이트 사용이 선호되었다. 하지만, TZI C 와 LUXEN Enamel 와 같은 새로운 소재의 지르코니아가 출시되고, 새로운 소결방식이 개발되어 지르코니아 기공시간을 단축시킬수 있게 되었고, 높은 투명도의 풀지르코니아 크라운을 짧은 시간 안에 제작할 수 있게 되었다. 이러한 발전은 당일 풀지르코니아 보철수복을 현실로 이끌고 있다.

• The Journal of Advanced Prosthodontics
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• 제10권4호
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• pp.300-307
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• 2018

PURPOSE. To investigate the fatigue and fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic molar crowns on dental implants and human teeth. MATERIALS AND METHODS. Molar crowns (n=48; n=8/group) were fabricated of a lithium-disilicate-strengthened lithium aluminosilicate glass ceramic (N). Surfaces were polished (P) or glazed (G). Crowns were tested on human teeth (T) and implant-abutment analogues (I) simulating a chairside (C, crown bonded to abutment) or labside (L, screw channel) procedure for implant groups. Polished/glazed lithium disilicate (E) crowns (n=16) served as reference. Combined thermal cycling and mechanical loading (TC: $3000{\times}5^{\circ}C/3000{\times}55^{\circ}C$; ML: $1.2{\time}10^6$ cycles, 50 N) with antagonistic human molars (groups T) and steatite spheres (groups I) was performed under a chewing simulator. TCML crowns were then analyzed for failures (optical microscopy, SEM) and fracture force was determined. Data were statistically analyzed (Kolmogorow-Smirnov, one-way-ANOVA, post-hoc Bonferroni, ${\alpha}=.05$). RESULTS. All crowns survived TCML and showed small traces of wear. In human teeth groups, fracture forces of N crowns varied between $1214{\pm}293N$ (NPT) and $1324{\pm}498N$ (NGT), differing significantly ($P{\leq}.003$) from the polished reference EPT ($2044{\pm}302N$). Fracture forces in implant groups varied between $934{\pm}154N$ (NGI_L) and $1782{\pm}153N$ (NPI_C), providing higher values for the respective chairside crowns. Differences between polishing and glazing were not significant ($P{\geq}.066$) between crowns of identical materials and abutment support. CONCLUSION. Fracture resistance was influenced by the ceramic material, and partly by the tooth or implant situation and the clinical procedure (chairside/labside). Type of surface finish (polishing/glazing) had no significant influence. Clinical survival of the new glass ceramic may be comparable to lithium disilicate.

• Restorative Dentistry and Endodontics
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• 제43권4호
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• pp.38.1-38.9
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• 2018

The restoration of endodontically treated teeth (ETT) with more than one cusp missing and thin remaining walls is challenging for the general practitioner. The use of posts combined with full coverage restorations is a well-established approach, yet not following the minimal invasive principles of adhesive dentistry. Endocrowns are indirect monoblock restorations that use the pulp chamber of the ETT for retention. In this study the fabrication of 4 endocrowns and their clinical performance will be discussed. Two clinical cases include computer-aided design/computer-aided manufacturing manufactured molar endocrowns (one feldspathic ceramic and one hybrid composite-ceramic restoration) and the other two are dental laboratory manufactured resin composite premolar endocrown restorations. The modified United States Public Health Service criteria were used to assess the clinical behavior of the restorations at different follow up periods. Endocrown restorations present a satisfactory clinical alternative, either by the use of resin composite or glass ceramic and hybrid materials. Specific guidelines with minimal alterations should be followed for an endocrown restoration to be successful. Due to limited evidence regarding the long term evaluation of this restorative technique, a careful selection of cases should be applied.

• 대한치과보철학회지
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• 제62권1호
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• pp.20-27
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• 2024

고기능성 폴리머 중 하나인 Polyetherketoneketone (PEKK)는 좋은 생체적합성과 우수한 물성을 가져 치과 영역을 포함한 다양한 분야에서 사용되고 있다. 이러한 PEKK를 프레임워크로 하는 임플란트 지지 고정성 보철물에 관한 성공적인 증례들이 많이 보고되어 왔으나, 보고된 증례에 대한 장기간의 관찰과 합병증에 관한 고찰은 부족한 상태이다. 이에 본 증례보고에서는 PEKK 프레임워크를 composite resin, lithium disilicate crown, high-impact polymethyl methacrylate PMMA로 각각 veneering하여 임플란트 지지 고정성 보철 수복을 한 세 가지 증례와 각각의 6년간의 경과관찰 결과를 소개하고 이를 고찰해 보고하고자 한다.

• 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.

• The Journal of Advanced Prosthodontics
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• 제11권1호
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• pp.55-64
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• 2019

PURPOSE. The accuracy of denture bases was compared among injection molding, milling, and rapid prototyping (RP) fabricating method. MATERIALS AND METHODS. The maxillary edentulous master cast was fabricated and round shaped four notches were formed. The cast was duplicated to ten casts and scanned. In the injection molding method, designed denture bases were milled from a wax block and fabricated using SR Ivocap injection system. Denture bases were milled from a pre-polymerized block in the milling method. In the RP method, denture bases were printed and post-cured. The intaglio surface of the base was scanned and surface matching software was used to measure inaccuracy. Measurements were performed between four notches and two points in the mid-palatal suture to evaluate inaccuracy. The palatine rugae resolution was evaluated. One-way analysis of variance was used for statistical analysis at ${\alpha}=.05$. RESULTS. No statistically significant differences in distances among four notches (P>.05). The accuracy of the injection molding method was lower than those of the other methods in two points of the mid-palatal suture significantly (P<.05). The degree of palatine rugae resolution was significantly higher in the injection molding method than that in other methods (P<.05). CONCLUSION. The overall accuracy of the denture base is higher in milling and RP method than the injection molding method. The degree of fine reproducibility is higher in the injection molding method than the milling or RP method.

• 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.

• 대한치과보철학회지
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• 제56권2호
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• pp.173-178
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• 2018

직접식 금속 레이저 소결 방식 시스템은 기공 오차 및 주조 결함 없이 제작 비용 및 제조 시간 단축을 장점으로 전악 임플란트 지지 고정성 보철물 제작에 유용하다. 본 증례에서는 직접식 금속 레이저 소결 방식과 치과용 캐드캠으로 제작된 단일구조 지르코니아 크라운을 사용하여 무치악 상악에서 임플란트 지지 고정성 치과 보철물의 성공적인 결과를 보고하고 임상적 의의를 평가하였다. 51세의 건강한 중년 여성이 상악 전 치아의 동요도를 주소로 서울대학교 치과병원에 내원하였다. 모든 상악 치아 발치 후 직접식 금속 레이저 소결 기술 및 캐드캠 단일구조 지르코니아 크라운을 사용하여 코발트-크롬 프레임을 포함하는 임플란트 지지 고정성 치과 보철물을 제작하였다. 최종 수복물 장착 6개월 후, 기계적 및 생물학적 합병증은 발견되지 않았고 보철물은 기능 및 심미적으로 만족스러운 결과를 보였다. 직접식 금속 레이저 소결 시스템을 이용하여 추가적인 기공 작업 없이 임플란트 지지 고정성 보철물을 제작하여 제조 시간을 단축하고 신뢰할 수 있는 정확도와 적합성을 얻었다.

• 대한치과보철학회지
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• 제62권2호
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• pp.131-139
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• 2024

무치악 환자에서 임플란트를 이용한 보철치료는 임플란트 고정성 보철, 임플란트 융합 국소 의치, 하이브리드 보철물, 임플란트 유지 및 지지 피개의치 등의 다양한 방법이 있다. 본 증례에서는 중등도 이상의 만성 치주염에 이환 되어 전악 발치가 필요한 환자에서 computer guided surgery를 이용하여 계획된 위치에 임플란트를 식립하였다. 상악은 불량한 골질로 초기고정력이 충분하지 않아 지연 부하를 시행하였고 골 유착 기간 동안 임시 의치를 사용하였다. 하악은 안정적인 초기 고정을 얻어 즉시 부하를 이용하여 환자의 불편감을 감소시켰다. 임플란트 일차 안정은 즉시 부하를 얻기 위해 가장 중요한 요소로 여겨지기 때문에 수술 전 반드시 임상적, 방사선학적 평가를 통해 잔존 치조골 양 및 골질을 파악해야 한다.

• The Journal of Advanced Prosthodontics
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• 제10권4호
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• pp.328-334
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• 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.