• The Journal of Advanced Prosthodontics
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• v.13 no.5
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• pp.269-280
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• 2021

PURPOSE. The objective of this study was to evaluate the effect of thickness reduction and fatigue on the failure load of monolithic zirconia crowns. MATERIALS AND METHODS. 140 CAD-CAM fabricated crowns (3Y-TZP, inCorisTZI, Dentsply-Sirona) with different ceramic thicknesses (2.0, 1.5, 1.0, 0.8, 0.5 mm, respectively, named G2, G1.5, G1, G0.8, and G0.5) were investigated. Dies of a mandibular first molar were made of composite resin. The zirconia crowns were luted with a resin composite cement (RelyX Unicem 2 Automix, 3M ESPE). Half of the specimens (n = 14 per group) were mouth-motion-fatigued (1.2 million cycles, 1.6 Hz, 200 N/ 5 - 55℃, groups named G2-F, G1.5-F, G1-F, G0.8-F, and G0.5-F). Single-load to failure was performed using a universal testing-machine. Fracture modes were analyzed. Data were statistically analyzed using a Weibull 2-parameter distribution (90% CI) to determine the characteristic strength and Weibull modulus differences among the groups. RESULTS. Three crowns (21%) of G0.8 and five crowns (36%) of G0.5 showed cracks after fatigue. Characteristic strength was the highest for G2, followed by G1.5. Intermediate values were observed for G1 and G1-F, followed by significantly lower values for G0.8, G0.8-F, and G0.5, and the lowest for G0.5-F. Weibull modulus was the lowest for G0.8, intermediate for G0.8-F and G0.5, and significantly higher for the remaining groups. Fatigue only affected G0.5-F. CONCLUSION. Reduced crown thickness lead to reduced characteristic strength, even under failure loads that exceed physiological chewing forces. Fatigue significantly reduced the failure load of 0.5 mm monolithic 3Y-TZP crowns.

• The Journal of Advanced Prosthodontics
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• v.15 no.3
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• pp.114-125
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• 2023

PURPOSE. The aim of the study was to evaluate the optical properties of new generation (3Y-TZP) monolithic zirconia (MZ) with different abutment types and resin cement shades. MATERIALS AND METHODS. A1/LT MZ specimens were prepared (10 × 12 × 1 mm, N = 30) and divided into 3 groups according to cement shades as transparent (Tr), yellow (Y) and opaque (O). Abutment specimens were obtained from 4 different materials including zirconia (Group Z), hybrid (Group H), titanium (Group T) and anodized yellow titanium (Group AT). MZ and abutment specimens were then cemented. L^*, a^*, and b^* parameters were obtained from MZ, MZ + abutment, and MZ + abutment + cement. ∆E₀₀₁^* (between MZ and MZ + abutment), ∆E₀₀₂^* (between MZ and MZ + abutment + cement) and ∆E₀₀₃^* (between MZ + abutment and MZ + abutment + cement) values were calculated. Statistical analyses included 2-way ANOVA, Bonferroni, and Paired Sample t-Tests (P < .05). RESULTS. Abutment types and resin cements had significant effect on L^*, a^*, b^*, ∆E₀₀₁^*, ∆E₀₀₂^*, and ∆E₀₀₃^* values (P < .001). Without cementation, whereas zirconia abutment resulted in the least discoloration (∆E₀₀₁^* = 0.68), titanium abutment caused the most discoloration (∆E₀₀₁^* = 4.99). The least ∆E₀₀₂^* = 0.68 value was seen using zirconia abutment after cementation with yellow shaded cement. Opaque shaded cement caused the most color change (∆E₀₀₃^* = 5.24). Cement application increased the L^* values in all groups. CONCLUSION. The least color change with/without cement was observed in crown configurations created with zirconia abutments. Zirconia and hybrid abutments produced significantly lower ∆E₀₀₂^* and ∆E₀₀₃^* values in combination with yellow shaded cement. The usage of opaque shaded cement in titanium/anodized titanium groups may enable the clinically unacceptable ∆E₀₀^* value to reach the acceptable level.

• The Journal of Advanced Prosthodontics
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• v.14 no.3
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• pp.173-181
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• 2022

PURPOSE. This analysis aimed to evaluate the intaglio surface trueness, antagonist's wear volume loss, and fracture resistance of full-contour crowns of (Y, Nb)-stabilized fully-sintered zirconia (FSZ), 4 mol% or 5 mol% yttria-stabilized partially sintered zirconia (4YZ or 5YZ) with high-speed sintering. MATERIALS AND METHODS. A total of 42 zirconia crowns were separated into three groups: FSZ, 4YZ, and 5YZ (n = 14). The intaglio surface trueness of the crowns was evaluated at the inner surface, occlusal, margin, and axial areas and reported as root-mean-square, positive and negative average deviation. Half of the specimens were aged for 120,000 cycles in the chewing simulator, and the wear volume loss of antagonist was measured. Before and after chewing, the fracture load was measured for each group. The trueness values were analyzed with Welch's ANOVA, and the wear volume loss with the Kruskal-Wallis tests. Effect of the zirconia type and aging on fracture resistance of crowns was tested using two-way ANOVA. RESULTS. The intaglio surface trueness measured at four different areas of the crown was less than 50 ㎛, regardless of the type of zirconia. No significant P in wear volume loss of antagonists were detected among the groups (P > .05). Both the type of zirconia and aging showed statistically significant effects on fracture resistance (P < .05). CONCLUSION. The full-contour crowns of FSZ as well as 4YZ or 5YZ with high-speed sintering were clinically acceptable, in terms of intaglio surface trueness, antagonist's wear volume loss, and fracture resistance after simulated mastication.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.423-431
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• 2017

PURPOSE. The goal of this study was to evaluate the fracture resistances of various monolithic crowns fabricated by computer-aided design and computer-aided manufacturing (CAD/CAM) with different thickness. MATERIALS AND METHODS. Test dies were fabricated as mandibular molar forms with occlusal reductions using CAD/CAM. With different occlusal thickness (1.0 or 1.5 mm), a polymer-infiltrated ceramic network (Enamic, EN), and zirconia-reinforced lithium silicate (Suprinity, SU and Celtra-Duo, CD) were used to fabricate molar crowns. Lithium disilicate (e.max CAD, EM) crowns (occlusal: 1.5 mm) were fabricated as control. Seventy crowns (n=10 per group) were bonded to abutments and stored in water for 24 hours. A universal testing machine was used to apply load to crown until fracture. The fractured specimens were examined with a scanning electron microscopy. RESULTS. The type of ceramics and the occlusal thickness showed a significant interaction. With a recommended thickness (1.5 mm), the SU revealed the mean load similar to the EM, higher compared with those of the EN and CD. The fracture loads in a reduced thickness (1.0 mm) were similar among the SU, CD, and EN. The mean fracture load of the SU and CD enhanced significantly when the occlusal thickness increased, whereas that of the EN did not. CONCLUSION. The fracture loads of monolithic crowns were differently influenced by the changes in occlusal thickness, depending on the type of ceramics. Within the limitations of this study, all the tested crowns withstood the physiological masticatory loads both at the recommended and reduced occlusal thickness.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.9.1-9.6
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• 2018

The objective of this case report is to introduce a simple technique for simultaneously taking a closed-mouth impression and functionally generated path (FGP) for a full coverage crown restoration. A monolithic zirconia crown was the restoration of choice. An alginate impression of the abutment tooth was taken to fabricate a custom-made closed-mouth impression tray covering the abutment tooth and the adjacent teeth. The tray had an FGP table and an abutment tray in cameo and intaglio surfaces, respectively. The impression was taken with silicone impression material after adjusting the abutment tray and inscribing the FGP using self-curing acrylic resins. Plaster casts were made from the impression, and a zirconia crown was fabricated. The crown was cemented to the abutment tooth with minimal adjustments. This simple technique resulted in a well-fitting crown that accounted for mandibular movements. Using the custom closed-mouth impression tray incorporating an FGP table simultaneously aids in fabricating an accurately fitting restoration that incorporates harmonious mandibular movements using a single impression capture.

• The Journal of Advanced Prosthodontics
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• v.8 no.1
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• pp.43-52
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• 2016

PURPOSE. This study was conducted to evaluate the effects of full-coverage all-ceramic zirconia, lithium disilicate glass-ceramic, leucite glass-ceramic, or stainless steel crowns on antagonistic primary tooth wear. MATERIALS AND METHODS. There were four study groups: the stainless steel (Steel) group, the leucite glass-ceramic (Leucite) group, the lithium disilicate glass-ceramic (Lithium) group, and the monolithic zirconia (Zirconia) group. Ten flat crown specimens were prepared per group; opposing teeth were prepared using primary canines. A wear test was conducted over 100,000 chewing cycles using a dual-axis chewing simulator and a 50 N masticating force, and wear losses of antagonistic teeth and restorative materials were calculated using a three-dimensional profiling system and an electronic scale, respectively. Statistical significance was determined using One-way ANOVA and Tukey's test (P<.05). RESULTS. The Leucite group ($2.670{\pm}1.471mm^3$) showed the greatest amount of antagonist tooth wear, followed by in decreasing order by the Lithium ($2.042{\pm}0.696mm^3$), Zirconia ($1.426{\pm}0.477mm^3$), and Steel groups ($0.397{\pm}0.192mm^3$). Mean volume losses in the Leucite and Lithium groups were significantly greater than in the Steel group (P<.05). No significant difference was observed between mean volume losses in the Zirconia and Steel groups (P>.05). CONCLUSION. Leucite glass-ceramic and lithium disilicate glass-ceramic cause more primary tooth wear than stainless steel or zirconia.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.72-81
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• 2024

Purpose: This study aimed to assess the marginal and internal fit of 3-unit monolithic zirconia fixed partial dentures (FPDs) fabricated via computer-aided design and computer-aided manufacturing (CAD/CAM) from solid working casts and removable die system. Materials and Methods: The tooth preparation protocol for a zirconia crown was executed on the mandibular right first premolar and mandibular right first molar, with the creation of a reference cast featuring an absent mandibular right second premolar. The reference cast was duplicated using polyvinyl siloxane impression, from which 20 working casts were fabricated following typical dental laboratory procedures. For comparative analysis, 10 FPDs were produced from a removable die system (RD group) and the remaining 10 FPDs from the solid working casts (S group). The casts were digitized using a dental desktop scanner to establish virtual casts and design the FPDs using CAD. The definitive 3-unit monolithic zirconia FPDs were fabricated via a CAM milling process. The seated FPDs on the reference cast underwent digital evaluation for marginal and internal fit. The Mann-Whitney U test was applied for statistical comparison between the two groups (α = 0.05). Results: The RD group showed significantly higher discrepancies in fit for both premolars and molars compared to the S group (P < 0.05), particularly in terms of marginal and occlusal gaps. Color mapping also highlighted more significant deviations in the RD group, especially in the marginal and occlusal regions. Conclusion: The study found that the discrepancies in marginal and occlusal fits of 3-unit monolithic zirconia FPDs were primarily associated with those fabricated using the removable die system. This indicates the significant impact of the fabrication method on the accuracy of FPDs.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.107-115
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• 2021

Excessive pathological attrition over the entire dentition can cause decreased masticatory function, and pathological problems of the temporomandibular joint and the muscular nervous system. In this case, 71 year-old male patient with severe attrition and fracture across the entire tooth was treated by full mouth rehabilitation for regaining space of restoration. In order to determine the appropriate vertical dimension of the patient's occlusion, facial appearance, aesthetics, restoration space were evaluated, and provisional restoration of the raised vertical dimension was made. After 4 months of evaluation, the entire restoration of monolithic zirconia crown using CAD-CAM was completed. Through the above process, satisfactory aesthetic and functional results were obtained.

• The Journal of Advanced Prosthodontics
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• v.8 no.6
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• pp.439-448
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• 2016

PURPOSE. The purposes of this study are to evaluate the internal and marginal adaptation of two widely used CAD/CAM systems and to study the effect of porcelain press veneering process on the prosthesis adaptation. MATERIALS AND METHODS. Molar of a lower jaw typodont resin model was prepared by adjusting a 1.0 mm circumferential chamfer, an occlusal reduction of 2.0 mm, and a $5^{\circ}$ convergence angle and was duplicated as an abrasion-resistant master die. The monolithic crowns and copings were fabricated with two different CAD/CAM system-Ceramil and Zirkonzahn systems. Two kinds of non-destructive analysis methods are used in this study. First, weight technique was used to determine the overall fitting accuracy. And, to evaluate internal and marginal fit of specific part, replica technique procedures were performed. RESULTS. The silicone weight for the cement space of monolithic crowns and copings manufactured with Ceramil system was significantly higher than that from Zirkonzahn system. This gap might cause the differences in the silicone weight because the prostheses were manufactured according to the recommendation of each system. Marginal discrepancies of copings made with Ceramil system were between 106 and $117{\mu}m$ and those from Zirkonzahn system were between 111 and $115{\mu}m$. Marginal discrepancies of copings made with Ceramil system were between 101 and $131{\mu}m$ and those from Zirkonzahn system were between 116 and $131{\mu}m$. CONCLUSION. Marginal discrepancy was relatively lower in Ceramil system and internal gap was smaller in Zirkonzahn system. There were significant differences in the internal gap of monolithic crown and coping among the 2 CAD/CAM systems. Marginal discrepancy produced from the 2 CAD/CAM systems were within a reported clinically acceptable range of marginal discrepancy.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.71-78
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• 2021

Implant treatment, which was first attempted in fully edentulous patients, is now widely used in partially edentulous, and a single tooth missing patients. Moreover, implant treatment has become an essential treatment modality in modern dentistry. The material of fabricating implant prostheses has also become more diverse than before, one of which is the use of high-performance polymers. The frequency of using high-performance polymers, which have been used in the medical field, is also increased in the dental field compared to the past. In the first case, a PEKK abutment and a PFG crown (cement-screw-retaining type) were fabricated in the lower left second premolar, and in the second case, a PEKK abutment and a monolithic zirconia crown (cement-screw-retaining type) were fabricated in the missing upper left first molar, and in the third case two PEKK abutments and a splinted PFM crowns (cement-screw-retaining type) were fabricated and connected to the upper right first and second molar implants. Through these procedures the patients obtained esthetically and functionally satisfactory results after 4 years of follow-up.