• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.2
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• pp.55-63
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• 2019

The aim of this article was to review various methods used to evaluate the accuracy of digital dental models. When evaluating the accuracy of digital models, the errors can be reduced by educating examiners and using artificial landmarks. The accuracy evaluation methods of digital dental models are divided into linear measurement, 2-dimensional cross-sectional analysis, and 3-dimensional best fit measurement. As the technology of scanners develops, many studies have been conducted to compare the accuracy of digital impression and conventional impression. According to improvement of scan technologies and development of 3-dimensional model analysis software, the ability to evaluate the accuracy of digital models is becoming more efficient. In this article, we describe the methods for evaluating the accuracy of a digital model and investigate effective accuracy analysis methods for each situation.

• Journal of Periodontal and Implant Science
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• v.53 no.5
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• pp.388-401
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• 2023

Purpose: This study investigated the accuracy of free-hand implant surgery performed by an experienced operator compared to static guided implant surgery performed by an inexperienced operator on an anterior maxillary dental model arch. Methods: A maxillary dental model with missing teeth (No. 11, 22, and 23) was used for this in vitro study. An intraoral scan was performed on the model, with the resulting digital impression exported as a stereolithography file. Next, a cone-beam computed tomography (CBCT) scan was performed, with the resulting image exported as a Digital Imaging and Communications in Medicine file. Both files were imported into the RealGUIDE 5.0 dental implant planning software. Active Bio implants were selected to place into the model. A single stereolithographic 3-dimensional surgical guide was printed for all cases. Ten clinicians, divided into 2 groups, placed a total of 60 implants in 20 acrylic resin maxillary models. Due to the small sample size, the Mann-Whitney test was used to analyze mean values in the 2 groups. Statistical analyses were performed using SAS version 9.4. Results: The accuracy of implant placement using a surgical guide was significantly higher than that of free-hand implantation. The mean difference between the planned and actual implant positions at the apex was 0.68 mm for the experienced group using the free-hand technique and 0.14 mm for the non-experienced group using the surgical guide technique (P=0.019). At the top of the implant, the mean difference was 1.04 mm for the experienced group using the free-hand technique and 0.52 mm for the non-experienced group using the surgical guide technique (P=0.044). Conclusions: The data from this study will provide valuable insights for future studies, since in vitro studies should be conducted extensively in advance of retrospective or prospective studies to avoid burdening patients unnecessarily.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.3
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• pp.228-238
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• 2020

In order to deliver fixed partial denture to a patient successfully, dentist must take into many considerations beforehand. Patient's occlusal pattern should be fully understood before delivering any type of prosthesis, whether it's canine guidance or group function occlusion. In order to do so, movement of mandible should be recorded precisely. Introduced by Meyers in 1933, functionally generated path technique (FGP) has been successfully used to record mandibular movement with various materials, such as wax, and utilize it in fabricating precise prosthesis. In the following cases, patients showed secondary caries or endodontic-periodontic lesion on maxillary molars. Root canal treatment and subgingival curettage were done for each patient. Since the long term prognosis of each tooth was questionable, lateral force should be minimized. In order to do so, FGP technique was used to record mandibular movements precisely. Instead of using conventional plaster impression, intra-oral scanning of wax tracing was done to fabricate prosthesis efficiently. After delivery of fixed partial denture, favorable outcome was obtained.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.1
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• pp.7-13
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• 2020

Purpose: This study was to evaluate marginal and internal discrepancy of 3-unit fixed dental prostheses (FDP) fabricated by subtractive manufacturing and additive manufacturing. Materials and methods: 3-unit bridge abutments without the maxillary left second premolar were prepared (reference model) and the reference model scan data was obtained using an intraoral scanner. 3-unit fixed dental prostheses were fabricated in the following three ways: Milled 3-unit FDP (MIL), digital light processing (DLP) 3D printed 3-unit FDP (D3P), stereolithography apparatus (SLA) 3D printed 3-unit FDP (S3P). To evaluate the marginal/internal discrepancy and precision of the prosthesis, scan data were superimposed by the triple-scan protocol and the combinations calculator, respectively. Quantitative and qualitative analysis was performed using root mean square (RMS) value and color difference map in 3D analysis program (Geomagic control X). Statistical analysis was performed using the Kruskal-Wallis test (α=.05), MannWhitney U test and Bonferroni correction (α=.05/3=.017). Results: The marginal discrepancy of S3P group was superior to MIL and D3P groups, and MIL and D3P groups were similar. The D3P and S3P groups showed better internal discrepancy than the MIL group, and there was no significant difference between the D3P and S3P groups. The precision was excellent in the order of MIL, S3P, and D3P groups. Conclusion: Within the limitation of this study, the 3-unit fixed dental prostheses fabricated by additive manufacturing showed better marginal and internal discrepancy than the those of fabricated by subtractive manufacturing, but the precision was poor.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.497-507
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• 2021

All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient's inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient's requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.2
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• pp.222-230
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• 2022

Digital technology is gradually expanding its field and has a great influence on various fields of dentistry. Recently in digital dentistry, the importance of superimposing various 3-dimensional (3D) image data is emerging, in order to utilize gathered data effectively for diagnosis and prosthesis fabrication. Integrating data from facial scans, intraoral scans, and mandibular movement recordings can create a virtual patient. A virtual patient is formed by integrating digital 3D diagnostic data such as intraoral and extraoral soft tissues, residual dentition, and dynamic occlusion, and the results of prosthetic treatment can be evaluated virtually. The patients in this case report were a 37-year-old female whose chief complaint is that the appearance of the existing prosthesis was distorted and a 55-year-old female patient whose anterior prosthesis needed to be refabricated after the endodontic treatment. 3D facial scans were obtained from each patient, and the patient's mandibular movements were recorded using ARCUS Digma 2 (KaVo Dental GmbH, Biberach an der Riss, Germany). The collected data were integrated on computer-aided design (CAD) software (Exocad dental CAD; exocad GmbH, Darmstadt, Germany) and transferred to a virtual articulator to create a digital virtual patient. The temporary fixed prostheses were designed, restored, and evaluated, and it was reflected into the final restorations. With the aid of the virtual dental patient, accuracy and predictability could be increased throughout treatment, simplifying the occlusal adjustment and clinical evaluation with improved esthetic outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.1-8
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• 2017

Purpose: The purpose of this study is to compare the accuracy of the CT guided implant template that was produced by using an intraoral scanner according to the edentulous distance. Materials and methods: Five maxillary casts were fabricated using radiopaque acrylic resin with the second premolars, first molars, and second molars missing. Then a virtual cast was acquired by scanning each resin cast. Implant treatment was planned on the missing sites by superimposing the presurgical CT DICOM file and the virtual cast. Then the implants were placed using a surgical template followed by postsurgical CT scan. The distance and angle of the platform and apex between the presurgical implant and postsurgical implant were measured using the X, Y, and Z axis of the superimposed presurgical CT and postsurgical CT via software followed by statistical analysis using Kruskall-Wallis test and Mann-Whitney test. Results: The implant placement angle error increased towards the second molars but there was no statistically significant difference. The implant placement distance error at the platform and apex also increased towards the second molars and there was a statistically significant error at the second molars. Conclusion: Although the placement angle had no statistically significant difference between the presurgical implant and postsurgical implant, the placement distance at the platform and apex showed a larger error and a statistically significant difference at the second molar implant.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.2
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• pp.104-115
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• 2018

Purpose: The purpose of this study is to evaluate the image acquisition ability of intraoral scanners by analyzing the comprehensiveness of scanned images from standardized model, and to identify problems of the model. Materials and Methods: Cast models and 3D-printed models were prepared according to international standards set by ISO12836 and ANSI/ADA no. 132, which were then scanned by model scanner and two different intraoral scanners (TRIOS3 and CS3500). The image acquisition performance of the scanners was classified into three grades, and the study was repeated with varying surface conditions of the models. Results: Model scanner produced the most accurate images in all models. Meanwhile, CS3500 showed good image reproducibility for angled structures and TRIOS3 showed good image reproducibility for rounded structures. As for model ingredients, improved plaster model best reproduced scan images regardless of the type of scanner used. When limited to 3D-printed model, powdered surface condition resulted in higher image quality. Conclusion: When scanning structures beyond FOV (field of view) in standardized models (following ISO12836 and ANSI/ADA 132), lack of reference points to help distinguish different faces confuses the scanning and matching process, resulting in inaccurate display of images. These results imply the need to develop a new standard model not confined to simple pattern repetition and symmetric structure.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.146-152
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• 2021

Accurate transfer of the maxillo-mandibular relationship to an articulator (i.e., mounting) is critical in prosthetic treatment procedures. In the current study, a PubMed search was performed to review the influencing factors for the maxillo-mandibular relationship's accuracy. The search included digital mounting as well as conventional gypsum cast mounting. The results showed that a greater amount of displacement was introduced during positioning the maxillary and mandibular models to interocclusal records rather than the dimensional change of registration material. Most intraoral scanners resulted in an accurate reproduction of the maxillo-mandibular relationship for posterior quadrant scanning; however, the accuracy was declined as the scan area increased to a complete arch scan. The digital mounting accuracy was also influenced by the image processing algorithms and software versions, especially for complete arch scans.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.27.1-27.12
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• 2019

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.