• The Journal of Korean Academy of Prosthodontics
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• v.39 no.6
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• pp.641-658
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• 2001

All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at $55^{\circ}$ at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at ${\times}50$ power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram($112{\mu}m$) exhibited significantly greater marginal discrepancy than In Ceram ($97{\mu}m$), and IPS Empress 2 ($94{\mu}m$) at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and accept able marginal fit values to allow clinical application.

• Journal of Korean society of Dental Hygiene
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• v.14 no.4
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• pp.447-452
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• 2014

With the increase of esthetic demands, most patients want to have restorations which are not only functional but also esthetic. For the esthetic restoration, many ceramic systems have been introduced and applied in dentistry. Among those ceramic restorations, IPS e.max system composed of lithium disilicate glass ceramic is one of the most commonly used systems because it has strength and esthetic characteristics. IPS e.max system is divided into IPS e.max Press and IPS e.max CAD according to the manufacturing methods. IPS e.max Press is fabricated through heat-pressed technique with ceramic ingot, which is very simple. The restorations which are made using IPS e.max system can apply to 3 units restoration for the anterior teeth and premolar, and single posterior tooth restoration. Cementation is one of the most important clinic procedure for the longevity of the restorations. All ceramics are bonded by resin cements, it is classified into three groups including adhesive, self-adhesive, and conventional. Variolink N, which is an adhesive resin cement and manufactured by same company with IPS e.max, is recommended for the bonding of IPS e.max restoration. Conventional and self-adhesive resin cement is also available. The aim of this review article is to provide the understanding of material properties, production procedure and clinical application of IPS e.max system.

• The Journal of Advanced Prosthodontics
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• v.8 no.6
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• pp.489-493
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• 2016

PURPOSE. This in-vitro study aimed to evaluate the fracture resistances and failure modes of endodontically treated mandibular premolars restored with endocrowns and conventional post-core retained crowns. MATERIALS AND METHODS. Thirty mandibular premolars were assigned into three groups (n=10): GI, intact teeth; GE, teeth with endocrowns; GC, teeth with conventional post-core supported crowns. Except for the teeth in group GI, all specimens were cut to 1.5 mm above the cementoenamel junction and endodontically treated. Both endocrowns and conventional crowns were fabricated from lithium-disilicate blocks using a CEREC 3D CAD/CAM unit. All specimens were subjected to thermocycling and then to $45^{\circ}$ oblique compressive load until fracture occurred. The fracture resistance and failure mode of each specimen were recorded. Data were analyzed with one-way ANOVA and LSD Post Hoc Test (${\alpha}=.05$). RESULTS. The fracture resistances of GE and GC were significantly lower than that of GI (P<.01), while no significant difference was found between GE and GC (P=.702). As of the failure mode, most of the specimens in GE and GC were unfavorable while a higher occurrence of favorable failure mode was presented in GI. CONCLUSION. For the restoration of mandibular premolar, endocrown shows no advantage in fracture resistance when compared with the conventional method. Both of the two methods cannot rehabilitate endodontically treated teeth with the same fracture resistances that intact mandibular premolars have.

• Journal of Technologic Dentistry
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• v.39 no.3
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• pp.137-143
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• 2017

Purpose: The purpose of this study is to analyze the fitness of heat - pressed ceramic laminate veneers fabricated using the additive manufacturing. Methods: Impression was replicated by using light body silicone and heavy body silicone on the custom tray, and it was fabricated using Type IV Stone. The test specimens were prepared by using a dental scanner, a laminating veneer using a dental design program, and a specimen with a 3D printer. The control specimens were prepared by the lost wax technique and heat - pressed to fabricate the specimens. The data of the specimens were measured by the RMS value of the internal fitness a using a 3-dimensional measurement program. Results: The Stereolithography laminate veneer group was measured at $78.10(4.09){\mu}m$ and the LWV group was measured at $31.50(5.10){\mu}m$. There is a significant difference between the two groups (p<0.001) Conclusion : Evaluation of fitness laminate veneers was fabricated by additive manufacturing showed the difference statistically significantly and clinically acceptable result.

• The Journal of Advanced Prosthodontics
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• v.5 no.2
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• pp.98-103
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• 2013

PURPOSE. To evaluate the effects of hydrofluoric acid etching and Er,Cr:YSGG laser irradiation on the shear bond strength of resin cement to lithium disilicate ceramic. MATERIALS AND METHODS. Fifty-five ceramic blocks ($5mm{\times}5mm{\times}2mm$) were fabricated and embedded in acrylic resin. Their surfaces were finished with 1000-grit silicon carbide paper. The blocks were assigned to five groups: 1) 9.5% hydrofluoric-acid etching for 60 s; 2-4), 1.5-, 2.5-, and 6-W Er,Cr:YSGG laser applications for 60 seconds, respectively; and 5) no treatment (control). One specimen from each group was examined using scanning electron microscopy. Ceramic primer (Rely X ceramic primer) and adhesive (Adper Single Bond) were applied to the ceramic surfaces, followed by resin cement to bond the composite cylinders, and light curing. Bonded specimens were stored in distilled water at $37^{\circ}C$ for 24 hours. Shear bond strengths were determined by a universal testing machine at 1 mm/min crosshead speed. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests (${\alpha}$=0.05). RESULTS. Adhesion was significantly stronger in Group 2 ($3.88{\pm}1.94$ MPa) and Group 3 ($3.65{\pm}1.87$ MPa) than in Control group ($1.95{\pm}1.06$ MPa), in which bonding values were lowest (P<.01). No significant difference was observed between Group 4 ($3.59{\pm}1.19$ MPa) and Control group. Shear bond strength was highest in Group 1 ($8.42{\pm}1.86$ MPa; P<.01). CONCLUSION. Er,Cr:YSGG laser irradiation at 1.5 and 2.5 W increased shear bond strengths between ceramic and resin cement compared with untreated ceramic surfaces. Irradiation at 6 W may not be an efficient ceramic surface treatment technique.

• The Journal of Advanced Prosthodontics
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• v.11 no.1
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• pp.16-22
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• 2019

PURPOSE. The purpose of this study was to compare the translucency and color changes of ceramic laminate veneers of different composition following glazing process. MATERIALS AND METHODS. $10mm{\times}10mm$ square specimens of 0.6 mm and 1.0 mm thicknesses were fabricated with IPS e.max Press (EM) and IPS e.max ZirPress (ZP) (n=10 per group). The color coordinates (CIE $L^*$ $a^*$ $b^*$) of the specimens were recorded with a colorimeter before and after glazing. The color changes and translucency parameter (TP) were calculated. For the comparisons with the composition and thicknesses between the 'not glazed' and 'glazed' groups, statistical analyses were done through paired T-test, independent two-sample T-test, and multiple regression analysis using SPSS 18.0 (P<.05). RESULTS. The TP of 0.6 mm EM was higher than that of 0.6 mm ZP. Total color difference (${\Delta}E^*$) between bare and glazed specimens of 1.0 mm EM was greater than that of 1.0 mm ZP with statistical significance. Following glazing, specimens from all groups showed statistically significant amount of decrease in $L^*$ and $a^*$, and statistically significant increase in $b^*$. The result of multiple regression analysis of EM and ZP showed that ${\Delta}L^*$ improved ${\Delta}E^*$. CONCLUSION. Within the limitations of present study, we conclude that translucency and color of ceramic laminate veneers change significantly after glazing process, and the nature and amount of changes vary with different compositions.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.48.1-48.13
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• 2018

Objectives: To analyze the influence of thickness and incisal extension of indirect veneers on the stress and strain generated in maxillary canine teeth. Materials and Methods: A 3-dimensional maxillary canine model was validated with an in vitro strain gauge and exported to computer-assisted engineering software. Materials were considered homogeneous, isotropic, and elastic. Each canine tooth was then subjected to a 0.3 and 0.8 mm reduction on the facial surface, in preparations with and without incisal covering, and restored with a lithium disilicate veneer. A 50 N load was applied at $45^{\circ}$ to the long axis of the tooth, on the incisal third of the palatal surface of the crown. Results: The results showed a mean of $218.16{\mu}strain$ of stress in the in vitro experiment, and $210.63{\mu}strain$ in finite element analysis (FEA). The stress concentration on prepared teeth was higher at the palatal root surface, with a mean value of 11.02 MPa and varying less than 3% between the preparation designs. The veneers concentrated higher stresses at the incisal third of the facial surface, with a mean of 3.88 MPa and a 40% increase in less-thick veneers. The incisal cover generated a new stress concentration area, with values over 48.18 MPa. Conclusions: The mathematical model for a maxillary canine tooth was validated using FEA. The thickness (0.3 or 0.8 mm) and the incisal covering showed no difference for the tooth structure. However, the incisal covering was harmful for the veneer, of which the greatest thickness was beneficial.

• The Journal of Advanced Prosthodontics
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• v.11 no.4
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• pp.215-222
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• 2019

PURPOSE. To evaluate the polishing effect on roughness and color change of pressed and layering ceramics after immersion in coffee solution. MATERIALS AND METHODS. 88 ceramic discs ($1.0mm{\times}10.0mm$) were manufactured - 44 nano-fluorapatite layering ceramics (IPS e.max Ceram. Group C) and 44 pressed lithium disilicate ceramic discs (IPS e. max Press - Group P). Each group was divided into 4 subgroups according to surface treatments: (G) Glaze, (S) Shofu polishing system (Shofu Inc.), (E) Edenta AG polishing System, (KG) $30-{\mu}m$ diamond granulation tip. Surface roughness (Ra) and color change (${\Delta}E$) measurings after the surface treatments were performed, before and 12 days after the immersion in coffee solution. A samples' qualitative analysis was conducted with a scanning electron microscopy (SEM). Data were statistically-treated with one-way-ANOVA and Duncan's tests, apart from paired t-test and Pearson's correlation test (${\alpha}=5%$). RESULTS. The decrescent order, both for surface roughness (Ra) and ${\Delta}E$ for both ceramics were: KG > E > S > G (P<.05). With exception for PG and CG subgroups, which did not present statistical difference between them, all other pressed ceramics subgroups presented smaller Ra values and greater ${\Delta}E$ values than the layering ceramics subgroups (P<.05). CONCLUSION. Although mechanical polishing systems presented intermediate Ra values, their colors were considered clinically acceptable. There is a strong correlation between the surface roughness and the color change of tested ceramics.

• Journal of Technologic Dentistry
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• v.43 no.4
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• pp.168-174
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• 2021

Purpose: This study was conducted to investigate alloys spectrophotometrically including yttrium of nickel-chromium (Ni-Cr) alloys, which are used as substitutes for the regulation of beryllium and provide helpful improvements in Ni-Cr alloys. Methods: Four groups of specimens (ZN, ZY, SN and EM) were prepared for analysis. Color parameters were measured with a spectrophotometer, and color difference (∆E^*) was calculated. The t-test and one-way analysis of variance test were used to determine significant difference, and the Tukey test was used to identify where the differences were. To measure the spectroscopic reflectivity, the spectroscopic reflectance was measured and converted into CIE L^*, a^*, b^* color system. Results: The ∆E^* value of each metal ceramic group after opaque firing of Ni-Cr alloy with and without yttrium was <2, and the total group color difference (∆E^*) was below 1 in the dentin ceramic all experimental group. However, the a^* and b^* values of the metal ceramic groups were higher than that in the lithium disilicate all ceramic group, and the chroma was higher than the natural tooth. The brightness of all experimental groups was similar to that of the shade guide sample. Conclusion: Yttrium added to Ni-Cr alloys showed similar CIE L^*, a^*, b^* values to Ni-Cr alloys that did not contain yttrium, indicating that yttrium had no effect on color in metallic ceramic systems.

• The Journal of Advanced Prosthodontics
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• v.15 no.1
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• pp.33-43
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• 2023

PURPOSE. This study investigated the physical and mechanical changes in the titanium base of three different hybrid abutment materials after cyclic loading by estimating the post-load reverse torque value (RTV), compressive side fulcrum wear pattern of titanium base, and surface roughness. MATERIALS AND METHODS. A total of 24 dental implants were divided into three groups (n = 8 each): Group Z, LD, and P used zirconia, lithium disilicate, and polyetheretherketone, respectively, for hybrid abutment fabrication. RTV was evaluated after cyclic loading with 50 N for 1.2 × 10⁶ chewing cycles. The compressive sides of the titanium bases were analyzed using a scanning electron microscope, and the roughness of the affected areas was measured using an optical profilometer after loading. Datasets were analyzed using Kruskal-Wallis test followed by Mann-Whitney tests with the Bonferroni correction (α = .05). RESULTS. Twenty-three samples passed the test; one LD sample fractured after 770,474 cycles. Post-load RTV varied significantly depending on the hybridabutment material (P = .020). Group P had a significantly higher median of post-load RTVs than group Z (16.5 and 14.3 Ncm, respectively). Groups LD and P showed minor signs of wear, and group Z showed a more pronounced wear pattern. While evaluating compressive side affected area roughness of titanium bases, lower medians were shown in group LD (Ra 0.16 and Rq 0.22 ㎛) and group P (Ra 0.16 and Rq 0.23 ㎛) than in group Z (Ra 0.26 and Rq 0.34 ㎛); significant differences were found only among the unaffected surface and group Z. CONCLUSION. The hybrid abutment material influences the post-load RTV. Group Z had a more pronounced wear pattern on the compressive side of titanium base; however, the surface roughness was not statistically different among the hybridabutment groups.