• The Journal of Advanced Prosthodontics
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• v.8 no.3
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• pp.194-200
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• 2016

PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.

• The Journal of the Korea Contents Association
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• v.18 no.10
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• pp.361-367
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• 2018

The purpose of this study was to evaluate the influence of hydrofluoric acid etching treatment on the bonding strength of yttria-stabilized tetragonal zirconia polycrystal(Y-TZP). Four groups of zirconia-resin cement specimens were prepared; 1) ZGS group (zirconia, no treatment), 2) ZGSH group (zirconia, hydrofluoric acid etching treatment) 3) H-ZGS group (Hybrid zirconia, no treatment) 4) H-ZGSH group (Hybrid zirconia, hydrofluoric acid etching treatment). The shear bond strength between zirconia and porcelain was measured using a Instron Universal Testing Machine(Model DBBP-500, Instron Corporation, Kyonggi, Korea). Data were statistically analyzed using independent t-test and two-way ANOVA(${\alpha}=0.05$). The ceramic-resin cement bonding strength was affected by hydrofluoric acid etching treatment(p<0.05). Digital microscope examination of the fracture surface showed mixed failures with adhesive and cohesive types in hydrofluoric acid etching treatment with treated zirconia and hybrid zirconia groups.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.317-325
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• 1995

This study was performed to investigate the mean life expectancy of dental prosthetic restorations. The author has examined 352 dental prosthesis clinically and radiologically, and decided the success(survival) and failure(mortality) of the dental prosthesis. The dental prosthesis which had been treated in the Seoul National University Dental Hospital, two private clinics in Seoul, one university dental hospital, and two private clinics in local province were included in this study. The survival analysis using product limit estimator was used and the mean life expectancy of each type of dental prosthesis was calculated. The results were as follows : 1. The life expectancies were 10.5 years in gold crown and bridge, 8.5 years in porcelain fused to metal crown and bridge, 8.3 years in nonprecious metal crown and bridge, 8.1 years in removal partial denture, and 7.7 years in full denture. 2. The causes of mortality were in the order of dental caries(24.6%), fracture of dental prosthesis(19.2%), periodontal problems(18.6%), chronic chewing difficulty and dysfunction due to dental prosthesis(15.0%), excessive exposure of abutments due to the marginal defect of dental prosthesis(14.4%), abnormal occlusion due to severe attrition of artificial teeth in dentures(3.0%), periapical problems(2.4%), perforation of dental prosthesis(1.8%), and loose contacts with neighboring tooth(1.2%). 3. Among survival cases, 66.5% showed normal chewing ability and 31.9% showed partial chewing ability. However, 1.6% of them complained loss of chewing ability. 4. Among failure cases, 6.6% showed normal chewing ability and 38.9% showed partial chewing ability. However, 54.5% of them complained loss of chewing ability.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.183-192
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• 2008

Modern dental reconstructions do not only aim at restoring the patient's mastication, but rather at improving general well-being and quality of life, especially in terms of esthetics. The media, the internet, advertising, and many other facts of society contribute to an increased cosmetic awareness. A 35-year-old male patient presented with as follows: 1) the porcelain fracture of ceramo-metal restoration on #11 and #23, 2) the inclination of incisal plane to horizontal reference plane, 3) the dental midline deviation to facial midline, and 4) the lack of symmetry on upper anterior dentition. The patient requested an aesthetic improvement using fixed prosthodontics including implant-supported restorations. In the upper anterior region, one of the goals of the conventional as well as implant prosthesis is to achieve restorations with the dental attractiveness and beauty in the respect of dental, dentofacial, and facial compositions. This case report presents geometrically improvement of dental esthetics using conventional and implant prosthesis with soft and hard tissue augmentation.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.1
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• pp.80-86
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• 2011

When a tooth adjacent to implant has coronal damages caused by severe dental caries or fracture, the clinical crown lengthening by forced eruption makes it possible to get esthetic restoration due to the prevention of alveolar crestal bone resorption and loss of interdental papilla. A 54-years-old male patient wanted prosthetic treatment because his anterior 3 unit bridges had fallen out. A right maxillary central incisor showed mild dental caries but a right maxillary canine lost most clinical crowns. Forced eruption combined with a gingival fiberotomy of a right maxillary canine was performed for 1 month after the dental implant had been simultaneously placed with bone grafts on a right maxillary lateral incisor. About 5 months after implant placement, 2nd surgical operation was performed. The provisional restorations were adjusted to make esthetic gingival contour for 8 weeks. The porcelain fused gold restorations were fabricated and set. The patient was satisfied with the final restorations in esthetic and functional aspect.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.4
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• pp.781-792
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• 1997

This study was peformed to evaluate the dynamic fatigue characteristics of the dental ceramics for all-ceramic crown. A feldspathic porcelain of VMK68. glass ceramic of IPS-Empress, and glass infiltrated alumina ceramic of In-Ceram were used. Disc specimens were prepared to the final dimensions of 12 mm in diameter and 1 mm in thickness. The biaxial flexure test was conducted using a ball-on-three-ball method. 240 specimens were tested in $37^{\circ}C$ water by testing 20 samples at each of four loading rates:0.05, 0.2, 1, and 5mm/min. 60 specimens were tested in a moisture-free environment by testing 20 samples at 5mm/min. The inert strength of VMK68 was 80.25MPa, and the fatigue parameters were n=29.1, ${\sigma}_{fo}=52.90MPa$. The inert strength of IPS-Empress was 104.76MPa, and the fatigue parameters were n=32.46, ${\sigma}_{fo}=67.52MPa$. The inert strength of In-Ceram was 429.33MPa, and the fatigue parameters were n=31.46, ${\sigma}_{fo}=258.36MPa$. 10-year failure stresses of VMK68, IPS-Empress, and In-Ceram were 20.3MPa, 24.8MPa, and 93.6MPa, respectively. Failure strength and fatigue life showed the highest value in In-Ceram, and then, IPS-Empress and VMK68.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.6
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• pp.800-805
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• 2000

In an effort to facilitate fabrication procedure of all ceramic crowns, a novel preparation method for all ceramic crown using alumina tape was developed. The alumina tape having a uniform thickness was cast by using Doctor blade method. The physical properties of newly introduced alumina tape has biaxial flexure strength of $500\sim600MPa$. The value of toughness is $3.18\sim3,28MPa.m^{1/2}$ which corelates with fracture and the linear shrinkage rate of the alumina tape is 0.44% during core production. The marginal fitness of the alumina tape all-ceramic restoration with $90{!`}$shoulder margin had average marginal discrepancy at $78.3{\S}$ > and average marginal gap at $44.4{\S}$ >. At the marginal preparation of $135{!`}$deep chamfer, the average marginal discrepancy at $82.1{\S}$ > and the average marginal gap at $40.2{\S}$ > had been reported. This fabrication procedure of all ceramic crowns with alumina tapes is easier and less technical sensitive for dental technicians. After restoration with new all ceramic crowns we followed the patients 2 years later, there were no complications as porcelain fractures or periodontal disease. We had good esthetic clinical results with new all ceramic crowns.

• The Journal of Advanced Prosthodontics
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• v.5 no.2
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• pp.187-197
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• 2013

PURPOSE. The purpose of this study was to evaluate various core designs on stress distribution within zirconia crowns. MATERIALS AND METHODS. Three-dimensional finite element models, representing mandibular molars, comprising a prepared tooth, cement layer, zirconia core, and veneer porcelain were designed by computer software. The shoulder (1 mm in width) variations in core were incremental increases of 1 mm, 2 mm and 3 mm in proximal and lingual height, and buccal height respectively. To simulate masticatory force, loads of 280 N were applied from three directions (vertical, at a $45^{\circ}$ angle, and horizontal). To simulate maximum bite force, a load of 700 N was applied vertically to the crowns. Maximum principal stress (MPS) was determined for each model, loading condition, and position. RESULTS. In the maximum bite force simulation test, the MPSs on all crowns observed around the shoulder region and loading points. The compressive stresses were located in the shoulder region of the veneer-zirconia interface and at the occlusal region. In the test simulating masticatory force, the MPS was concentrated around the loading points, and the compressive stresses were located at the 3 mm height lingual shoulder region, when the load was applied horizontally. MPS increased in the shoulder region as the shoulder height increased. CONCLUSION. This study suggested that reinforced shoulder play an essential role in the success of the zirconia restoration, and veneer fracture due to occlusal loading can be prevented by proper core design, such as shoulder.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.312-319
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• 2009

Statement of problem: Delamination of veneering porcelain from underlying ceramic substructures has been reported for zirconia-ceramic restorations. Colored zirconia cores for esthetics have been reported that their bond strength with veneered porcelain is weaker compared to white zirconia cores. Purpose: This study aimed to investigate the shear bond strength by manufacturing the veneering porcelain on the colored zirconia core, using the layering technique and heat-pressing technique, and to evaluate the clinical stability by comparing the result of this with that of conventional metal ceramic system. Material and methods: A Metal ceramic (MC) system was tested as a control group. The tested systems were Katana zirconia with CZR (ZB) and Katana Zirconia with NobelRondo Press (ZP). Thirty specimens, 10 for each system and control, were fabricated. Specimen disks, 3 mm high and 12 mm diameter, were fabricated with the lost-wax technique (MC) and the CAD-CAM (ZB and ZP). MC and ZB specimens were prepared using opaque and dentin veneering ceramics, veneered, 3 mm high and 2.8 mm in diameter, over the cores. ZP specimens were prepared using heat pressing ingots, 3 mm high and 2.8mm in diameter. The shear bond strength test was performed in a Shear bond test machine. Load was applied at a cross-head speed of 0.50 mm/min until failure. Mean shear bond strengths (MPa) were analyzed with the One-way ANOVA. After the shear bond test, fracture surfaces were examined by SEM. Results: The mean shear bond strengths (SD) in MPa were MC control 29.14 (2.26); ZB 29.48 (2.30); and ZP 29.51 (2.32). The shear bond strengths of the tested systems were not significantly different (P > .05). All groups presented cohesive and adhesive failures, and showed predominance of cohesive failures in ceramic veneers. Conclusion: 1. The shear bond strengths of the tested groups were not significantly different from the control group (P >.05). 2. There was no significant different between the layering technique and the heat pressing technique in the veneering methods on the colored zirconia core. 3. All groups presented cohesive and adhesive failures, and showed predominance of cohesive failures in ceramic veneers.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.126-132
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• 2009

Injuries of permanent teeth by trauma occur frequently in childhood and adolescence. Crown fractures are as frequent as 25-76% and especially maxillary incisors are prone to fractures. There have been numerous efforts to achieve both aesthetically and functionally satisfying restoration. When a mature tooth is fractured, porcelain crown or laminate veneer could be a choice of prosthodontic treatment. However, in a case of immature permanent incisor fracture, prosthodontic treatment is more complicated due to the immaturity of the tooth. Moreover, if endodontic treatment is accompanied with the prosthodontic treatment, the treatment period is prolonged. In the past, restoration using an orthodontic band, a ready-made crown, or glass ionomer cement did not exhibit esthetically satisfying result. As restorational materials have been improved, now more esthetic restoration is possible by reattaching fractured fragments or light-curing composite resin restoration. We reports cases of patients with fractured maxillary incisors and their successful treatment results through reattachment of fractured fragments and composite resin restoration.