• The Journal of Advanced Prosthodontics
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• v.16 no.1
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• pp.25-37
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• 2024

PURPOSE. To investigate the effect of sintering programs and surface treatments on surface properties, phase transformation and flexural strength of monolithic zirconia. MATERIALS AND METHODS. Zirconia specimens were sintered using three distinct sintering programs [classic (C), speed (S), and superspeed (SS)] (n = 56, each). One sample from each group underwent scanning electron microscopy (SEM) and grain size analysis following sintering. Remaining samples were divided into five subgroups (n = 11) based on the surface treatments: control (CL), polish (P), glaze (G), grind + polish (GP), and grind + glaze (GG). One sample from each subgroup underwent SEM analysis. Remaining samples were thermally aged. Monoclinic phase volume, surface roughness, and three-point flexural strength were measured. Monoclinic phase volume and surface roughness were analyzed by Kruskal-Wallis and Dunn tests. Flexural strength was analyzed by two-way ANOVA and Weibull analysis. The relationships among the groups were analyzed using Spearman's correlation analysis. RESULTS. Sintering program, surface treatment, and sintering × surface treatment (P ≤ .010) affected the monoclinic phase volume, whereas the type of surface treatment and sintering × surface treatment affected the surface roughness (P < .001). Type of sintering program or surface treatment did not affect the flexural strength. Weibull analysis revealed no significant differences between the m and σ_o values. Monoclinic phase volume was positively correlated with surface roughness in the SGG and SSP groups. CONCLUSION. After sintering monolithic zirconia in each of the three sintering programs, each of the surface treatments can be used. However, for surface quality and aging resistance, G or GG can be recommended as a surface finishing method.

• Journal of Korean Dental Science
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• v.10 no.2
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• pp.74-81
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• 2017

This report describes two cases of complete arch implant-supported restorations. The first patient had seven dental implants in each arch with monolithic zirconia frameworks. At four weeks' follow-up, the one-piece maxillary framework was fractured, which was re-designed and re-fabricated using laser-sintered cobalt-chrome alloy. The second patient had four implants in the mandible only. A mandibular monolithic zirconia framework and a maxillary conventional complete denture were fabricated and delivered. At five years' follow-up, the patient reported no significant discomfort. Careful consideration and monitoring of the status of antagonistic arches and stress distribution on zirconia frameworks were suggested for complete arch implant-supported fixed restorations.

• The Journal of the Korean dental association
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• v.58 no.7
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• pp.443-447
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• 2020

The esthetic properties of zirconia receive increasing attention as its demand and application escalates. Thus, it is crucial to investigate how zirconia is esthetically different from other dental ceramics. In this study, we evaluated the translucency of zirconia and suggest a method to increase its translucency. We examined the shade of zirconia and offer its distinguishing features. Finally, we analyzed monolithic zirconia restorations to propose esthetic considerations in clinics.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.279-285
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• 2017

Defects due to mandibulectomy often cause hard and soft tissue loss and result in esthetic problems and functional disorders such as mastication, swallowing, and pronunciation. After the mandibular reconstruction, several complications including loss of alveolar bone can cause limitations in maintenance or supporting of removable prosthesis. For these patients, implant-supported fixed restorations have been an appropriate prosthetic restorative method. In this case report, we report the patient who underwent mandibulectomy and mandibular reconstruction owing to oral cancer, and then restored the current dentition functionally and aesthetically by applying zirconia frameworks and monolithic zirconia crowns by computer-aided design and computer-aided manufacturing.

• The Journal of Advanced Prosthodontics
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• v.11 no.1
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• pp.41-47
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• 2019

PURPOSE. Surface finishing of a zirconia restoration is essential after clinical adjustment. Herein, we investigated the effects of a surface finishing protocol for monolithic zirconia on final roughness and bacterial adherence. MATERIALS AND METHODS. Forty-eight disk-shaped monolithic zirconia specimens were fabricated and divided into four groups (n = 12) based on initial surface treatment, finishing, and polishing protocols: diamond bur+polishing bur (DP group), diamond bur+stone grinding bur+polishing bur (DSP group), no diamond bur+polishing bur (NP group), and no diamond bur+stone grinding bur+polishing bur (NSP group). Initial and final surface roughness was measured with a profilometer, and shown using scanning electron microscope. Bacterial adhesion was evaluated by quantifying Streptococcus mutans in the biofilm. Kruskal-Wallis and Mann-Whitney U tests were used to compare results among groups, and two-way analysis of variance was used to evaluate the effects of grinding burs on final roughness (${\alpha}=.05$). RESULTS. The DP group had the highest final Ra value, followed by the DSP, NP, and NSP groups. Use of the stone grinding bur as a coarse-finishing step significantly decreased final Ra values when a diamond bur was used (P<.001). Omission of the stone grinding bur increased biofilm formation on specimen surfaces. Combining a stone grinding bur with silicone polishing burs produced the smallest final biofilm values, regardless of the use of a diamond bur in initial surface treatment. CONCLUSION. Coarse finishing of monolithic zirconia with a stone grinding bur significantly decreased final Ra values and bacterial biofilm formation when surfaces had been roughened by a diamond bur.

• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.394-401
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• 2017

PURPOSE. The purpose of this study was to compare the optical properties of pre-colored dental monolithic zirconia ceramics of various thicknesses sintered in a microwave and those in a conventional furnace. MATERIALS AND METHODS. A2-shade of pre-colored monolithic zirconia ceramic specimens ($22.0mm{\times}22.0mm$) in 3 thickness groups of 0.5, 1.0, and 1.5 mm were divided into 2 subgroups according to the sintering methods (n=9): microwave and conventional sintering. A spectrophotometer was used to obtain CIELab color coordinates, and translucency parameters and CIEDE2000 color differences (${\Delta}E_{00}$) were measured. The relative amount of monoclinic phase ($X_m$) was estimated with x-ray diffraction. The surface topography was analyzed by atomic force microscope and scanning electron microscope. Statistical analyses were conducted with two-way ANOVA (${\alpha}=.05$). RESULTS. There were small interaction effects on CIE $L^*$, $a^*$, and TP between sintering method and thickness (P<.001): $L^*$ (partial eta squared ${{\eta}_p}^2=0.115$), $a^*$ (${{\eta}_p}^2=0.136$), and TP (${{\eta}_p}^2=0.206$), although higher $b^*$ values were noted for microwave sintering regardless of thickness. Color differences between two sintering methods ranged from 0.52 to 0.96 ${\Delta}E_{00}$ units. The $X_m$ values ranged from 7.03% to 9.89% for conventional sintering, and from 7.31% to 9.17% for microwave sintering. The microwave-sintered specimen demonstrated a smoother surface and a more uniform grain structure compared to the conventionally-sintered specimen. CONCLUSION. With reduced processing time, microwave-sintered pre-colored dental monolithic zirconia ceramics can exhibit similar color perception and translucency to those by conventional sintering.

• The Journal of Advanced Prosthodontics
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• v.8 no.1
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• pp.37-42
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• 2016

PURPOSE. This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics. MATERIALS AND METHODS. One-hundred sixty-five monolithic zirconia specimens ($16.3mm{\times}16.3mm{\times}2.0mm$) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (${\Delta}E^*{^_{ab}}$) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison $Scheff{\acute{e}}$ test (${\alpha}=.05$). RESULTS. There were significant differences in CIE $L^*$ between Subgroup 0 and other subgroups in all groups. CIE $a^*$ increased (0.52<$R^2$<0.73), while CIE $b^*$ decreased (0.00<$R^2$<0.74) in all groups with increasing thickness reduction. Perceptible color differences (${\Delta}E^*{^_{ab}}$>3.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups ($R^2$>0.89, P<.001). CONCLUSION. Increasing thickness reduction reduces lightness and increases a reddish, bluish appearance, and translucency of monolithic zirconia ceramics.

• The Journal of Advanced Prosthodontics
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• v.13 no.6
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• pp.373-384
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• 2021

PURPOSE. This study aimed to compare the marginal and internal fit of 3-unit monolithic zirconia restorations that were designed by using the data obtained with the aid of intraoral and laboratory scanners. MATERIALS AND METHODS. For the fabrication of 3-unit monolithic zirconia restorations using impressions taken from the maxillary master cast, plaster cast was created and scanned in laboratory scanners (InEos X5 and D900L). The main cast was also scanned with different intraoral scanners (Omnicam [OMNI], Primescan [PS], Trios 3 [T3], Trios 4 [T4]) (n = 12 per group). Zirconia fixed partial dentures were virtually designed, produced from presintered block, and subsequently sintered. Marginal and internal discrepancy values (in ㎛) were measured by using silicone replica method under stereomicroscope. Data were statistically analyzed by using 1-way ANOVA and Kruskal Wallis tests (P<.05). RESULTS. In terms of marginal adaptation, the measurements on the canine tooth indicated better performance with intraoral scanners than those in laboratory scanners, but there was no difference among intraoral scanners (P<.05). In the premolar tooth, PS had the lowest marginal (86.9 ± 19.2 ㎛) and axial (92.4 ± 14.8 ㎛), and T4 had the lowest axio-occlusal (89.4 ± 15.6 ㎛) and occlusal (89.1 ± 13.9 ㎛) discrepancy value. In both canine and premolar teeth, the D900L was found to be the most marginally and internally inconsistent scanner. CONCLUSION. Within the limits of the study, marginal and internal discrepancy values were generally lower in intraoral scanners than in laboratory scanners. Marginal discrepancy values of scanners were clinically acceptable (< 120 ㎛), except D900L.

• The Journal of Advanced Prosthodontics
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• v.16 no.1
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• pp.12-24
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• 2024

PURPOSE. This study aimed to evaluate the maximum vertical wear, volume wear, and surface characteristic of antagonist enamel, opposing monolithic zirconia or lithium disilicate crowns. MATERIALS AND METHODS. The study comprised 24 participants (n = 12), who were randomly allocated to receive either a 5 mol% Y-TZP or a lithium disilicate crown in positions which would oppose the natural first molar tooth. The contralateral first molar along with its antagonist was considered as the enamel opposing natural enamel control. Data collection was performed using an intraoral scanner and polyvinylsiloxane impression. The means of the maximum vertical loss and the volume loss at the occlusal contact areas of the crowns and the various natural antagonists were measured by 3D comparison software. A scanning electron microscope was subsequently used to assess the wear characteristics. RESULTS. The one-year results from 22 participants (n = 11) indicated no significant differences when comparing the zirconia crown's antagonist enamel (40.28 ± 9.11 ㎛, 0.04 ± 0.02 mm³) and the natural enamel wear (38.91 ± 7.09 ㎛, 0.04 ± 0.02 mm³) (P > .05). Also, there is no significant differences between lithium disilicate crown's antagonist enamel (47.81 ± 9.41 ㎛, 0.04 ± 0.02 mm³) and the natural enamel wear (39.11 ± 7.90 ㎛, 0.04 ± 0.02 mm³) (P > .05). CONCLUSION. While some studies suggested that monolithic zirconia caused less wear on opposing enamel than lithium disilicate, this study found similar wear levels to enamel for both materials compared to natural teeth.

• The Journal of Advanced Prosthodontics
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• v.8 no.4
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• pp.329-332
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• 2016

Fabricating a surveyed prosthesis beneath an existing partial removable dental prosthesis (PRDP) is a challenging and time-consuming procedure. The computer-aided design/computer-assisted manufacturing (CAD/CAM) technology was applied to fabricate a retrofitted, surveyed zirconia prosthesis to an existing PRDP. CAD/CAM technology enabled precise and easy replication of the contour of the planned surveyed crown on the existing abutment tooth. This technology ensured excellent adaptation and fit of newly fabricated crown to the existing PRDP with minimal adjustments. In this case report, a seventy-year-old male patient presented with fractured existing surveyed crown. Because the existing PRDP was serviceable, new crown was fabricated to the existing PRDP.