• 대한심미치과학회지
• /
• 제13권1호
• /
• pp.25-30
• /
• 2004

• 대한심미치과학회지
• /
• 제7권1호
• /
• pp.28-31
• /
• 1998

It is difficult to make an artificial central incisor similar to natural tooth. All ceramic porcelain of this patient is not esthetic, and there is gingival recession due to ill-fitted margin. She has class II division 1 occlusion, so upper central incisors is labioversed. Upper light central incisor is well-characterized but the yellowish brown color of dentin is appeared on the incisal third portion of the central incisor. At 1st trial, the shape and characterization of restoration is good but shade is little dark. At 2nd trial, the shape is better but patient complained on black triangle of mid interdental space, so mesiocervical portion of restoration is overcontoured to compromise the black triangle. Completed metal ceramic crown is in harmony with the adjacent central incisor in aspect of shape, shade, and characterization.

• 한국치위생학회지
• /
• 제14권5호
• /
• pp.617-622
• /
• 2014

With the explosive increase of esthetic demands by patients, many dental materials for the esthetic restoration have been introduced. Recently, zirconia based restorations are using for the cases of single crown, bridges, implant prostheses etc. Zirconia have superior mechanical properties and biocompatibility. Owing to the properties of high strength, zirconia has to be manufactured by CAD/CAM system. Dental CAD/CAM system is a futuristic treatment and technical system which makes it possible to produce the precision and uniform prosthesis and also standardize the treatments. This article introduces the characteristics of zirconia, fabrication procedure using CAD/CAM system and procedure for the cementation of zirconia based restoration.

• 대한심미치과학회지
• /
• 제16권2호
• /
• pp.7-18
• /
• 2007

There is now an increased demand for harmony between the peri-implant gingiva and adjacent dentition. In the event of a pending loss of a single tooth in the aesthetic zone with healthy periodontium, expectation for optimal gingival and prosthodontic aesthetics are often very high. Unfortunately, bone resorption is common following the removal of an anterior tooth, compromising the gingival tissue levels for the eventual implant restoration. Also, improper implant placement and inadequate osseous-gingival support potentially deleterious aesthetic result. The creation of an esthetic implant restoration with gingival architecture that harmonizes with the adjacent dentitionis formidable challenge. The predictability of the peri-implant esthetic outcome may ultimately be determined by the patient's own presenting anatomy rather than the clinician's ability to manage state-of-the-art procedures. To more accurately predict the peri-implant esthetic outcome before removing a failing tooth, a considering of diagnostic keys is essential. This presentation addresses the useful diagnostic keys that affect the predictability of peri-implant gingival aesthetics and the overcoming of the risk factors in anterior single-tooth replacement; it also describes a surgical and prosthodontic technique in achieving a long term successful esthetic outcome. Proper diagnosis and understanding of the biological and periodontal variables of failing dentition and their response to surgical and prosthodontic procedures are the essence of predictability. Using a smart protocol that alters the periodontium toward less risk and more favorable assessment of the diagnostic keys before implant placement will provide the most predictable esthetic outcome. Simple diagnostic keys suggested this presentation are useful method to evaluate the overcoming of the risk factors in anterior single implant restoration.

• 대한심미치과학회지
• /
• 제13권1호
• /
• pp.31-39
• /
• 2004

For the prosthodontic results which are compatible with esthetics to be fulfilled, the first prerequisite would be periodontal intervention and stability, the second one may be functional competency and the ultimate goal should be ascribed to esthetic considerations. Other words, esthetic dentistry is a whole entity which encompasses the biological stability of the periodontium, physical accuracy of the prosthodontic structure and finally, the beauty which can be found in natural dentition. It also implies the harmonized lip line which reveals the well-balanced tooth morphology and health gum profiles (Red-White Esthetics). Largely, there lie some differences in the input system of the 3-dimentional data from the prepared abutments between respective computer-assisted systems available now. But the manufacturing systems (CAM) are very similar between them, to say, comprise numeric control systems with whole 3-dimensional milling units according to the restorations to be made. Now the author is going to present CAD/CAM Zirconia All Ceramic Restoration on the topics for the Red-White Esthetics, periodontal control and maintenance, treatment for the discolored teeth, post & core build-up works for the devitalized teeth, characteristics of the Zirconium oxide All Ceramics, fabrication procedures, clinical considerations and its application to diverse clinical situations.

• 대한치과보철학회지
• /
• 제59권4호
• /
• pp.451-458
• /
• 2021

현재 치과치료의 다양한 분야에서 디지털 기술이 활용되고 있다. 특히 전치부 심미수복에 있어 기존의 전통적인 수복방식은 안모 정보를 담을 수 없고 환자가 치료 결과를 예상하기 어려운 반면 디지털 디자인을 통한 심미수복의 경우 보철물 디자인의 시각화 및 환자 피드백 반영의 용이성, 치료 결과에 대한 예지성을 얻기 쉽다. 본 증례는 전치부 외상 환자에게서 디지털 방식을 이용하여 예상되는 치료 결과를 환자가 치료 전 확인하고 피드백을 반영하여 진행하였다. 2D 디지털 스마일 디자인 방식은 환자의 안모 및 미소정보로 2차원 평면상에서 디자인이 이루어져 적용에 다소 제한되는 점이 있었으나 본 증례에서는 3차원 가상환자를 만들어 진행하였기에 디자인된 보철물에 대하여 다양한 각도에서 확인 및 수정이 가능하였다. 본 증례를 통하여 디지털 방식을 이용한 심미 수복시 환자 및 기공사와의 원활한 소통, 치료결과에 대한 높은 만족도를 얻어낼 수 있었다.

• 대한심미치과학회지
• /
• 제28권2호
• /
• pp.95-115
• /
• 2019

심미보철치료를 성공하기 위해서는 crown part심미(White Esthetic)와 Tissue part 심미(Pink Esthetic)을 반드시 잘 컨트롤해야 한다. 임상적으로 White esthetic은 치과기공사의 영역이고 Pink esthetic은 치과의사의 영역이지만 상대방 영역에 대한 깊은 이해을 통해 더 성공적인 결과를 만들어 낼 수 있다. 이 논문에서는 이러한 과정에 대해 간략히 서술해 보고자 한다.

• 대한심미치과학회지
• /
• 제24권1호
• /
• pp.13-24
• /
• 2015

임플란트와 주변 연조직에 대한 술식들이 발전함에 따라 임플란트를 통해 저작 기능 뿐 아니라 심미성의 회복도 가능하게 되었다. 최근에는 심미적인 면이 가장 중요한 상악 전치부에도 임플란트를 이용한 수복이 많이 이용되고 있다. 하지만 상악 전치부를 주변 조직과 조화되게끔 임플란트로 재건하는 것은 치과의사에게 여전히 어려운 일이다. 이를 위해서는 경조직의 재건, 연조직의 재건, 그리고 주변 조직과 어울리는 보철물의 제작이 이루어져야 한다. 본 증례에서는 이전의 여러 차례 수술로 인하여 상악 전치부 상실부위의 연조직, 경조직 손실이 심한 상태로 내원한 환자에서 연조직 증강술과 골이식을 시행하고 임시수복물을 통해 심미성을 개선시킨 임플란트 증례가 있어 보고하고자 한다.

• 대한치과보철학회지
• /
• 제61권1호
• /
• pp.26-32
• /
• 2023

활동이 많은 소아 청소년 시기에는 치아의 외상이 흔하게 발생한다. 그 중 탈구로 인해 유착이 일어날 경우 임상검사를 통한 진단이 중요하며 성인이 된 후 심미적인 보철 수복을 위해서는 진단에 따른 치료가 중요하다. 본 증례는 외상으로 인해 유착된 치아를 치관절제술과 임플란트 식립을 통한 상악 전치부 심미 보철 수복 증례이다. 치관절제술 후 치관을 이용하여 보철 수복을 위한 공간 유지를 시행하였다. 성인이 된 후 guide surgery를 이용하여 정교한 임플란트 식립과 심미적인 보철 수복을 가능하게 하였으며, 상악 전치부임을 고려하여 원발성 안정성(primary stability) 확인 후 즉시 부하(immediate loading)를 시행하였다. 연조직 지지를 위해 임시치아의 윤곽 변화를 주며 임시치아를 교체하였고 digital wax-up 하여 최종 보철물을 수복하였다.

• 대한심미치과학회지
• /
• 제10권1호
• /
• pp.30-45
• /
• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.