• 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.

• The Journal of Advanced Prosthodontics
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• 제12권6호
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• pp.329-337
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• 2020

PURPOSE. To verify the influence of computer-aided design/computer-aided manufacturing (CAD/CAM) implant-supported prostheses manufactured with cobalt-chromium (Co-Cr) and zirconia (Zr), and whether ceramic application, spark erosion, and simulation of masticatory cycles modify biomechanical parameters (marginal fit, screw-loosening torque, and strain) on the implant-supported system. MATERIALS AND METHODS. Ten full-arch fixed frameworks were manufactured by a CAD/CAM milling system with Co-Cr and Zr (n=5/group). The marginal fit between the abutment and frameworks was measured as stated by single-screw test. Screw-loosening torque evaluated screw stability, and strain analysis was explored on the implant-supported system. All analyses were performed at 3 distinct times: after framework manufacturing; after ceramic application in both materials' frameworks; and after the spark erosion in Co-Cr frameworks. Afterward, stability analysis was re-evaluated after 106 mechanical cycles (2 Hz/150-N) for both materials. Statistical analyses were performed by Kruskal-Wallis and Dunn tests (α=.05). RESULTS. No difference between the two materials was found for marginal fit, screwloosening torque, and strain after framework manufacturing (P>.05). Ceramic application did not affect the variables (P>.05). Spark erosion optimized marginal fit and strain medians for Co-Cr frameworks (P<.05). Screw-loosening torque was significantly reduced by masticatory simulation (P<.05) regardless of the framework materials. CONCLUSION. Co-Cr and Zr frameworks presented similar biomechanical behavior. Ceramic application had no effect on the biomechanical behavior of either material. Spark erosion was an effective technique to improve Co-Cr biomechanical behavior on the implant-supported system. Screw-loosening torque was reduced for both materials after masticatory simulation.

• The Journal of Advanced Prosthodontics
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• 제8권4호
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• pp.329-332
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• 2016

Fabricating a surveyed prosthesis beneath an existing partial removable dental prosthesis (PRDP) is a challenging and time-consuming procedure. The computer-aided design/computer-assisted manufacturing (CAD/CAM) technology was applied to fabricate a retrofitted, surveyed zirconia prosthesis to an existing PRDP. CAD/CAM technology enabled precise and easy replication of the contour of the planned surveyed crown on the existing abutment tooth. This technology ensured excellent adaptation and fit of newly fabricated crown to the existing PRDP with minimal adjustments. In this case report, a seventy-year-old male patient presented with fractured existing surveyed crown. Because the existing PRDP was serviceable, new crown was fabricated to the existing PRDP.

• 구강회복응용과학지
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• 제36권2호
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• pp.128-137
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• 2020

지난 30년동안, CAD/CAM 시스템을 이용한 수복 시스템은 눈부시게 발전하였다. 구치부 수복에서 널리 쓰이던 것과는 달리, 환자와 임상가의 심미적인 요구를 충족해야 하는 전치부 수복 증례에서는 CAD/CAM 시스템을 이용하는데 다소 한계가 있었다. 단일 색조를 가지는 CAD/CAM 수복물에 다양한 색조를 부여하기 위해, A2 lithium disilicate (LS2) 블록에 staining kit를 이용하여 색조 개별화를 시행하여 다양한 색조를 표현하는 예비실험을 시행하였다. 색조 개별화를 진행한 시편을 spectrophotometer를 이용하여 CIE L^*a^*b^* 값을 측정한 후, 임상에서 널리 사용되고 있는 shade guide와 비교하였다. 예비 실험 결과를 바탕으로 2명의 환자의 전치부 수복시, 치아의 부위별 색조 재현과 표면 특성의 개별화를 진행한 증례를 소개한다. 수복물의 해부학적 형태는 CAD/CAM 시스템에서 '복사 및 붙여넣기 기능'과 '거울상 획득 기능'을 이용하여 디자인하였으며, 이 연구에서 소개하는 모든 임상 및 수복물의 기공과정은 진료실 내에서만 이루어졌다.

• 대한치과보철학회지
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• 제58권1호
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• pp.42-49
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• 2020

무치악 환자에게서 의치의 제작은 통상적이고 전통적인 방법을 따를 경우 최종 의치 장착까지 여러 단계를 거쳐야 하며 이로 인한 환자의 잦은 내원이 불가피하다. 또한 기공 과정 상에서 나타나는 중합수축에 의한 오차나, 의치의 파절이나 분실 시 빠른 재제작의 어려움 등의 단점이 존재하였다. 하지만 최근 치과 분야에서 computer-aided design and computer-aided manufacturing (CAD/CAM) System이 사용되기 시작하였고, 의치 제작에까지 그 영역을 넓히기 시작하였다. CAD/CAM System을 이용하여 의치를 제작하면 첫 번째 내원 시에 인상채득과 악간관계의 기록, 인공치의 선택 등이 동시에 이루어지고 두 번째 내원 시 의치의 장착이 가능하기 때문에 환자의 내원 횟수와 진료시간을 감소시킬 수 있다. 또한 3D-Printing 기술을 이용하기 때문에 중합수축에 의한 기공 오차를 감소시킬 수 있다. 현재 상용화 되어 있는 CAD/CAM System을 사용한 의치로는 DENTCA CAD/CAM denture (DENTCA Inc., Los Angeles, CA, USA)가 있다. 본 증례에서는 상, 하악 완전 무치악 환자에게서 conventional 한 방법과 DENTCA CAD/CAM Denture System을 사용하는 방법을 동시에 사용하여 두 쌍의 총의치로 수복함으로써 발음, 저작, 연하 등의 기능적인 측면뿐만 아니라 심미적인 측면에서도 양호한 결과를 얻었기에 이를 보고하고자 한다.

• 구강회복응용과학지
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• 제39권3호
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• pp.158-167
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• 2023

최근 치의학 분야에서 디지털 기술이 발달함에 따라 computer-aided design-computer-aided manufacturing (CAD/CAM)을 이용한 의치 제작 진료 단계의 변화를 가져왔다. CAD/CAM 기술을 이용한 의치 제작 방식은 제작기간과 내원 간격의 단축으로 임상적인 효율성과 편리함을 제공함과 동시에 기공을 단순화하여 오류 발생을 감소시켰다. 본 증례는 복잡한 병력과 신체적 장애를 가진 환자에게 기존의 임시의치를 디지털 방식으로 복제 및 출력하여 개인 트레이로 활용하였고, 부가중합형 실리콘 인상재로 채득한 최종 인상체에는 수직고경과 중심위, 상악 전치부의 각도 및 길이에 대한 정보가 포함되어 있으며 이를 통해 제작 기간과 내원 간격을 단축하여 환자의 만족도를 높일 수 있었다. 최종 의치는 밀링 방식 및 monolithic disc를 이용하여 제작하였고, 적절한 안정과 유지, 지지를 보여 기능적, 심미적으로 만족스러운 결과를 얻을 수 있었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권4호
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• pp.197-199
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• 2013

Three-dimensional (3D) computed tomography image models are helpful in reproducing the maxillofacial area; however, they do not necessarily provide an accurate representation of dental occlusion and the state of the teeth. Recent efforts have focused on improvement of dental imaging by replacement of computed tomography with other detailed digital images. Unfortunately, despite the advantages of medical simulation software in dentofacial analysis, diagnosis, and surgical simulation, it lacks adequate registration tools. Following up on our previous report on orthognathic simulation surgery using computer-aided design/computer-aided manufacturing (CAD/CAM) software, we recently used the registration functions of a CAD/CAM platform in conjunction with surgical simulation software. Therefore, we would like to introduce a new technique, which involves use of the registration functions of CAD/CAM software followed by transfer of the images into medical simulation software. This technique may be applicable when using various registration function tools from different software platforms.

• 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.

• 대한치과보철학회지
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• 제57권4호
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• pp.495-505
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• 2019

본 증례는 다수의 치아 상실과 심한 치아 마모로 인해 교합 고경(occlusal vertical dimension)의 감소 및 수복 공간 부족을 보이는 환자에 대한 computer-aided design and computer-aided manufacturing (CAD/CAM) 기술을 활용한 완전 구강 회복 치료이다. 진단 단계에서 교합 고경에 대한 여러 분석을 통해 교합 고경 증가를 통한 완전 구강 회복을 계획하였다. 새롭게 설정된 교합 고경을 반영한 임시 수복물을 환자에게 적용하여 적응시키고, 이중 스캔 방법을 통해 임시 수복물의 정보를 최종 수복물에 옮긴 후, 3D 프린팅을 통해 금속 코핑을 제작하여 최종 고정성 금속 도재 수복물을 완성하였다. 이후 전자 서베잉과 3D 프린팅을 통해 가철성 국소의치 금속 구조물을 제작, 최종 가철성 국소의치로 환자치료를 완료하였다. 이러한 디지털 기술을 활용한 완전 구강 회복 치료로 환자는 기능적, 심미적으로 만족하였고, 술자는 임상적으로 받아들일 만한 치료결과로 판단하였다.