• 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.

• The Journal of Advanced Prosthodontics
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• v.15 no.1
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• pp.44-54
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• 2023

PURPOSE. To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. MATERIALS AND METHODS. Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients' preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. RESULTS. Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. CONCLUSION. The high survival and success rates, low number of complications, and the high level of patients' acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the "gold standard" MC crowns.

• The Journal of Advanced Prosthodontics
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• v.14 no.2
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• pp.78-87
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• 2022

PURPOSE. This study aimed to compare the effect of different surface treatments and luting agent types on the shear bond strength of two ceramics to commercially pure titanium (Cp Ti). MATERIALS AND METHODS. A total of 160 Cp Ti specimens were divided into 4 subgroups (n = 40) according to surface treatments received (control, 50 ㎛ airborne-particle abrasion, 110 ㎛ airborne-particle abrasion, and tribochemical coating). The cementation surfaces of titanium and all-ceramic specimens were treated with a universal primer. Two cubic all-ceramic discs (lithium disilicate ceramic (LDC) and zirconia-reinforced lithium silicate ceramic (ZLC)) were cemented to titanium using two types of resin-based luting agents: self-cure and dual-cure (n = 10). After cementation, all specimens were subjected to 5000 cycles of thermal aging. A shear bond strength (SBS) test was conducted, and the failure mode was determined using a scanning electron microscope. Data were analyzed using three-way ANOVA, and the Tukey-HSD test was used for post hoc comparisons (P < .05). RESULTS. Significant differences were found among the groups based on surface treatment, resin-based luting agent, and ceramic type (P < .05). Among the surface treatments, 50 ㎛ air-abrasion showed the highest SBS, while the control group showed the lowest. SBS was higher for dual-cure resin-based luting agent than self-cure luting agent. ZLC showed better SBS values than LDC. CONCLUSION. The cementation of ZLC with dual-cure resin-based luting agent showed better bonding effectiveness to commercially pure titanium treated with 50 ㎛ airborne-particle abrasion.

• The Journal of the Korean dental association
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• v.56 no.3
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• pp.159-166
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• 2018

The zirconia-reinforced lithium silicate ceramic material is a material in which lithium silicate glass contains about 10% by weight of zirconia oxide (zirconia oxide). This material has both the advantages of glass ceramics and zirconia, and it is attracting attention as a CADCAM material for single tooth restoration. ZLS materials have improved strength compared to widely used e.max (lithium disilicate ceramic) materials. It can be used for single crown restoration and ensuring a thickness of 1.5 mm is very important for reliable treatment. In the case of Celtra Duo, heat treatment may be helpful in terms of strength and abrasion resistance. Hydrofluoric acid treatment is helpful for bonding and hydrofluoric acid for a short time may not help to improve the bonding strength. Although zirconia-reinforced lithium silicate ceramic materials have been continuously conducted and published in the laboratory, reliable clinical studies are still lacking. Additional clinical studies will be a very important part of establishing a scientific basis.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.2
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• pp.149-159
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• 2006

Statement of problem. Porcelain repair mainly involves replacement with composite resin, but the bond strength between composite resin and all-ceramic coping materials has not been studies extensively. Purpose. The objective of this study was to investigate the influence of composite resin and ceramic etching pattern on shear bond strength of Empress2 ceramic and observe the change of microstructure of ceramic according to etching methods. Material and methods. Eighty-five cylinder shape ceramic specimens (diameter 5mm, IPS Empress 2 core materials) embeded by acrylic resin were used for this study. The ceramic were specimens divided into sixteen experimental groups with 5 specimens in each group and were etched with phosphoric acid(37%, 65%) & hydrofluoric acid (4%, 9%) according to different etching times(30s, 60s, 120s 180s). All etched ceramic surfaces were examined morphologically using SEM(scanning electron microscopy). Etched surfaces of ceramic specimens were coated with silane (Monobond-S) & adhesive(Heliobond) and built up composite resin using Teflon mold. Accomplished specimens were tested under shear loading until fracture on universal testing machine at a crosshead speed 1mm/min; the maximum load at fracture(kg) was recorded. Shear bond strength data were analyzed with one way ANOVA and Duncan tests.(P<.05) Results. Maximum shear bond strength was $30.07{\pm}2.41(kg)$ when the ceramic was etched with 4% hydrofluoric acid at 120s. No significant difference was found between phosphoric etchant group and control group with respect to shear bond strength. Conclusion. Empress 2 ceramic surface was not etched by phosphoric acid, but etched by hydrofluoric acid.

• Korean Journal of Materials Research
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• v.22 no.2
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• pp.61-65
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• 2012

A $Li_2O-2SiO_2$ ($LS_2$) glass was investigated as a lithium-ion conducting oxide glass, which is applicable to a fast ionic conductor even at low temperature due to its high mechanical strength and chemical stability. The $Li_2O-2SiO_2$ glass is likely to be broken into small pieces when quenched; thus, it is difficult to fabricate a specifically sized sample. The production of properly sized glass samples is necessary for device applications. In this study, we applied spark plasma sintering (SPS) to fabricate $LS_2$ glass samples which have a particular size as well as high transparency. The sintered samples, $15mm\phi{\times}2mmT$ in size, ($LS_2$-s) were produced by SPS between $480^{\circ}C$ and $500^{\circ}C$ at 45MPa for 3~5mim, after which the thermal and dielectric properties of the $LS_2$-s samples were compared with those of quenched glass ($LS_2$-q) samples. Thermal behavior, crystalline structure, and electrical conductivity of both samples were analyzed by differential scanning calorimetry (DSC), X-ray diffraction (XRD) and an impedance/gain-phase analyzer, respectively. The results showed that the $LS_2$-s had an amorphous structure, like the $LS_2$-q sample, and that both samples took on the lithium disilicate structure after the heat treatment at $800^{\circ}C$. We observed similar dielectric peaks in both of the samples between room temperature and $700^{\circ}C$. The DC activation energies of the $LS_2$-q and $LS_2$-s samples were $0.48{\pm}0.05eV$ and $0.66{\pm}0.04eV$, while the AC activation energies were $0.48{\pm}0.05eV$ and $0.68{\pm}0.04eV$, respectively.

• Journal of the Korean Ceramic Society
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• v.27 no.4
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• pp.521-528
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• 1990

Li2O.2SiO2 glass-ceramics were made from the melt by the nucleation and growth treatment. The optimum nucleation temperature and time were determined from DTA curves of as-quenched and thermally treated glasses, and found to be 44$0^{\circ}C$ and 3hrs. The optical microscopic technique was also used to support this result. The volume fractions of crystals present in the partially crystallized specimens were measured using the optical microscopy and the amorphous X-ray scattering methods. The degree of crystallization increased with increasing the crystallization temperature and time. The crystalline phase identified by X-ray diffraction was lithium disilicate. As the crystallinity increased up to 95%, the transmittance of glass-ceramics was decreased linearly. It was also found that for the same heat treatment condition (575$^{\circ}C$, 30min), a thicker specimen showed higher transmittance, presumably due to less crystallinity.

• The Journal of the Korean dental association
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• v.58 no.7
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• pp.413-434
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• 2020

Recently, there are much improvement in optical and mechanical properties of dental ceramic materials coupled with improved fabrication techniques, which have caused a considerable shift in the preference of the dentists to ceramic restorations. Because the chemical composition and microstructure of all-ceramic materials are different by the type, correct choice of cement type and surface treatment procedure, and cementation strategy is essential for the success of ceramic restorations with adequate retention and decreased incidence of complications. This manuscript reviews on the most often prescribed and some newly developed ceramic materials, and the selection criteria and usage guidelines of cement materials that are used in conjunction with various ceramic materials. This manuscript emphasizes that continuous updating the information of newly developed ceramic and cement materials and application techniques by the dentists and dental staffs are demanding in response to the constantly improving ceramic and cement materials and corresponding application protocol changes.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.4
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• pp.313-320
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• 2020

Purpose: The purpose of this study was to evaluate the machining precision and the marginal and internal fit of single restorations fabricated with three types of lithium disilicate ceramic blocks and to evaluate the correlation. Materials and methods: Single restorations were designed using a CAD software program. The crown designed model file was extracted from the CAD software program. Three types of lithium disilicate blocks (Rosetta; HASS, IPS e.max CAD; Ivoclar vivadent, VITA Suprinity; VITA) were milled using a milling machine. For the fabrication of the crown scanned model file, the intaglio surface of the restoration was digitized using a contact scanner. Then, using the three-dimensional inspection software (Geomagic control X; 3D Systems), the process of the overlap of the crown designed model and the scanned model and 3-dimensional analysis was conducted. In addition, the marginal and internal fit of the crowns was evaluated by a silicone replication method. The difference among three types of single ceramic crown was analyzed using a Kruskal-Wallis H test, and Spearman correlation analysis was performed to analyze the correlation between machining precision and fitness (α=.05). Results: There was a significant difference in the machining precision and the marginal and internal fit according to the type of ceramic block (P<.001). In addition, the machining precision and the marginal and internal fit were positively correlated (P<.001). Conclusion: The marginal fit of crowns fabricated according to the types of ceramic blocks was within the clinically acceptable range (< 120 ㎛), so it can be regarded as appropriate machining precision applicable to all clinical as aspects in terms of the marginal fit.