• The Journal of Advanced Prosthodontics
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• v.8 no.1
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• pp.30-36
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• 2016

PURPOSE. The aim of this study was to evaluate the fracture resistance and fracture behavior of monolithic zirconia crowns in accordance with the preparation design and aging simulation method. MATERIALS AND METHODS. An upper first molar was prepared sequentially with three different preparation designs: shoulderless preparation, 0.4 mm chamfer and 0.8 mm chamfer preparation. For each preparation design, 30 monolithic zirconia crowns were fabricated. After cementation on Cr-Co alloy dies, the following artificial aging procedures were performed: (1) thermal cycling and mechanical loading (TCML): 5000 cycles of thermal cycling $5^{\circ}C-55^{\circ}C$ and chewing simulation (1,200,000 cycles, 50 N); (2) Low Temperature Degradation simulation (LTD): autoclave treatment at $137^{\circ}C$, 2 bar for 3 hours and chewing simulation; and (3) no pre-treatment (control group). After artificial aging, the crowns were loaded until fracture. RESULTS. The mean values of fracture resistance varied between 3414 N (LTD; 0.8 mm chamfer preparation) and 5712 N (control group; shoulderless preparation). Two-way ANOVA analysis showed a significantly higher fracture loads for the shoulderless preparation, whereas no difference was found between the chamfer preparations. In contrast to TCML, after LTD simulation the fracture strength of monolithic zirconia crowns decreased significantly. CONCLUSION. The monolithic crowns tested in this study showed generally high fracture load values. Preparation design and LTD simulation had a significant influence on the fracture strength of monolithic zirconia crowns.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.3
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• pp.318-327
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• 2019

The purpose of this study was to identify which combination of zirconia crowns and cements is most similar in color to the maxillary primary incisors by varying the color of zirconia crowns, crown thickness, and shade of cements. Prefabricated zirconia crowns in 3 shades and crowns fabricated using 6 types of zirconia blocks were used in this study. These were filled with A2-shade or translucent-shade resin cement and the $L^*$, $a^*$, and $b^*$ values were calculated using a spectrophotometer. The color differences between the natural teeth and the zirconia crowns were assessed. The shade of the final restoration was more similar to that of the natural teeth using A2-shade than translucent-shade resin cement. Application of A2-shade cement to a 0.5-mm-thick crown fabricated from a smile series 2 zirconia block resulted in the color most similar to that of the natural teeth. A2-shade resin cement is recommended for zirconia crown restoration in anterior primary teeth compared to TR-shade resin cement for more esthetic restoration. Since restorations with Nu-smile zirconia crowns were not esthetically favorable in terms of shade, improvement of the shade characteristics of the product or development of a new kind of zirconia crown is required.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.2
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• pp.94-100
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• 2010

Purpose: The purpose of this study was to compare the fracture strength of the zirconia ceramic crowns according to tooth position. Material and methods: After 10 metal dies were made for each group, the zirconia ceramic crowns were fabricated using CAD/CAM system ($Lava^{TM}$ All-Ceramic System) and each crown was cemented on each metal die with resin cement (Rely $X^{TM}$ Unicem). The cemented zirconia ceramic crowns mounted on the testing jig were inclined with 30 degrees to the long axis of the tooth and the universal testing machine was used to measure the fracture strength. Results: 1. The fracture strength of the zirconia ceramic crown in the lower 1st molar (2963 N) had the highest and that in the lower central incisor (1035 N) had the lowest. 2. The fracture strength of zirconia ceramic crown was higher than that of the IPS Empress crowns in all tooth position. 3. The fracture mode of the crowns was similar. Most of fracture lines began at the loading area and extended through proximal surface perpendicular to the long axis of the crowns. 4. There were no significant differences on the fracture strength of the zirconia ceramic crowns according to tooth position except in premolar group. Conclusion: Within the limitations of this study, the results suggested that strength of zirconia ceramic crown is satisfactory for clinical use.

• 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.3
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• pp.208-216
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• 2017

PURPOSE. The aim of this study was to compare the precision of optical impression (Trios, 3Shape) versus that of conventional impression (Imprint IV, 3M-ESPE) with three different margins (shoulder, chamfer, and knife-edge) on Frasaco teeth. MATERIALS AND METHODS. The sample comprised of 60 zirconia half-crowns, divided into six groups according to the type of impression and margin. Scanning electron microscopy enabled us to analyze the gap between the zirconia crowns and the Frasaco teeth, using ImageJ software, based on eight reproducible and standardized measuring points. RESULTS. No statistically significant difference was found between conventional impressions and optical impressions, except for two of the eight points. A statistically significant difference was observed between the three margin types; the chamfer and knife-edge finishing lines appeared to offer better adaptation results than the shoulder margin. CONCLUSION. Zirconia crowns created from optical impression and those created from conventional impression present similar adaptation. While offering identical results, the former have many advantages. In view of our findings, we believe the chamfer margin should be favored.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.41-56
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• 2018

The purpose of this study was to provide clinical recommendations for restoration with selection of the most similar zirconia crown by 3-dimensional analysis of the shape of the maxillary primary central and lateral incisors in Korean individuals and prefabricated zirconia crowns. The average shape of the sound maxillary primary central and lateral incisors in 300 children was reproduced by 3-dimensional scanning. Zirconia crowns of 4 manufacturers (NuSmile $ZR^{(R)}$ Crown, Cheng $Crowns^{(R)}$, Kinder $Krowns^{(R)}$, and EZ $Pedo^{(R)}$ Crown) were scanned 3-dimensionally, and coordinates for comparison of the shape were measured to evaluate the similarity between the teeth and crowns. The most similar crowns were selected by comparing the mesiodistal length, crown height, crown shape ratio, distance between the same coordinates of a tooth and crown, the radius of curvature of the labial surface, and the volume. As a result of analysis, Cheng $Crowns^{(R)}$ size 3 and NuSmile $ZR^{(R)}$ Crown size 2 were the most similar crowns in the maxillary primary central and lateral incisors, respectively. Scanning the inner surface of the crowns and evaluating the amount of tooth reduction required suggested that an overall lesser amount of tooth reduction compared to that presented by the manufacturer's guidelines should be performed.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.2
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• pp.127-134
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• 2019

The aim of this study was to evaluate the compomer cement and resin cement as an orthodontic band cement on zirconia crown. A total of 30 specimens were prepared. Preformed stainless steel crowns and zirconia crowns of upper right second primary molar were used. Orthodontic bands were cemented on stainless steel crowns (Group I, n = 10) and zirconia crowns (Group II, n = 10) with compomer cement. The other bands were cemented on zirconia crowns with resin cement (Group III, n = 10). The tensile loads were applied to band to measure the bond strength. The mean of bond strengths of group I, II and III were 0.79 MPa, 1.09 MPa and 1.56 MPa respectively. Bond strength of group II is significantly higher than group I. There was no significant difference between group II and III. Compomer cement and resin cement containing functional monomers showed favorable bond strength of orthodontic bands.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.26-31
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• 2017

Purpose: This study was to assess clinically the success rates and technical complications of cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks. Materials and methods: 75 (single crowns: 51, splinted crowns: 24) cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks which were restored in 67 patients were investigated for the evaluation of the success rates and technical complications. All restorations were cemented with temporary cement. Age, gender, restoration position, opposing teeth, restoration type were assessed as possible factors affecting technical complications. Results: During the mean observation period of 22.2 months, cumulative success rates of all restorations were 66.9 (73.2 - 60.6)%. Retention loss was found in 16 restorations (single crowns: 14, splinted crowns: 2), abutment screw loosening and veneer porcelain fracture were found in each 2 single crowns, respectively. According to a Kaplan-Meier survival analysis of single crowns and splinted crowns, the cumulative success rates were 58.9 (66.6 - 51.2)%, 87.5 (96.1 - 78.9)%, respectively. There was a statistically significant difference. The other possible factors did not have a significant effect on the technical complications. Conclusion: Retention loss was the most frequent technical complication. Abutment screw loosening and veneer porcelain fracture were found rarely in single crowns only. Age, gender, restoration position, and antagonist did not have significant effect on the technical complications. Splinted crowns had a higher success rate than single crowns.

• Journal of dental hygiene science
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• v.18 no.3
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• pp.194-200
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• 2018

Early childhood caries is a widespread condition that requires attention; however, its treatment remains a challenge in terms of child behavior management. This study describes the usefulness of customized zirconia crowns for the restoration of deciduous teeth through the evaluation of some cases. Three cases are described: a 29-month-old girl who presented with severe early childhood caries affecting anterior tooth, a 50-month-old boy who presented with extensive caries of his anterior tooth, and 70-month-old girl who presented with extensive caries of his primary posterior dentition. These prefabricated, zirconium-based ceramic crowns ($Nusmile^{TM}$ NuSmile) are available in various sizes, shapes and colors. Before the treatment, radiographs and intraoral photographs were taken to evaluate the appropriateness of treatment. Our findings indicate that customized zirconia crowns may be appropriate for restoring the deciduous teeth. Further long-term clinical studies are required to clarify the usefulness of this restorative method.

• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.36-45
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• 2021

Purpose. To investigate the fracture resistance of monolithic CAD-CAM all-ceramic surveyed crowns with two different occlusal rest seat designs. Materials and Methods. Two maxillary first premolar were prepared for all-ceramic surveyed crowns with wide (2/3rd of buccolingual width of an unprepared tooth) or narrow (1/3rd of buccolingual width of an unprepared tooth) disto-occlusal rest seat (ORS) designs. Eighty monolithic CAD-CAM all-ceramic surveyed crowns were prepared and divided into 4 groups - Group CR, Composite resin material as a control; Group LDS, Lithium disilicate based material; Group ZIPS, zirconia-material (IPS ZirCAD); and Group ZLHT, zirconia- material (CeramillZolidht+). Crowns were cemented on an epoxy resin die with adhesive resin cement. The fracture resistance of crowns was tested with the universal machine. Univariate regression analysis was used. Results. The mean ± standard deviation of maximum failure force values varied from 3476.10 ± 285.97 N for the narrow ORS subgroup of group ZIPS to 687.89 ± 167.63 N for the wide ORS subgroup of group CR. The mean ± standard deviation of maximum force was 1075 ± 77.0 N for group CR, 1309.3 ± 283.9 N for group LDS, 3476.1 ± 285.97 N for group ZIPS, and 2666.7 ± 228.21 N for group ZLHT, with narrow occlusal rest seat design. The results of the intergroup comparison showed significant differences in fracture strength with various material groups and occlusal rest seat designs (P<.001). Conclusion. The zirconia-based all-ceramic surveyed crowns fractured at more than double the load of Lithium disilicate based crowns. The crowns with narrow base occlusal rest seat design had statistically significantly higher fracture resistance than surveyed crowns with wide occlusal rest seat design. The use of narrow occlusal rest seat design in CAD-CAM all ceramic surveyed crowns provides higher fracture resistance, and therefore narrow occlusal rest design can be used for providing esthetics with high strength.