• Restorative Dentistry and Endodontics
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• 제45권4호
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• pp.49.1-49.11
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• 2020

Objectives: The aim of this study was to perform a clinical and radiographic analysis of endodontically treated teeth (ETT) restored with cast metal posts (CMPs) or prefabricated glass fiber posts (GFPs) and crowns. Materials and Methods: Fifty ETT were restored with 25 CMPs and 25 GFPs at a private dental clinic between 2001 and 2016. The restorations consisted of 12 all-ceramic crowns, 31 metal-ceramic crowns, and 7 composite resin crowns. Demographic data, type of teeth, type of post-and-core system, time of placement, crown restorations, the number of proximal contacts, the type of antagonist, and reports of any complications after post-and-core placement were recorded for each patient. Assessments were performed at baseline (radiographic) and follow-up (radiographic and clinical). Data were analyzed by the McNemar test, the Pearson χ² test, and Kaplan-Meier survival curves (α = 0.05). The mean follow-up was 67.6 months. Results: No significant difference was observed for any of the radiographic parameters when the baseline and final radiographs were compared. In the clinical evaluation, anatomical form (p = 0.009) and occlusion (p = 0.001) showed significant differences according to the type of crown restoration; specifically, metal-ceramic and all-ceramic crowns outperformed composite resin crowns. Conclusions: CMPs and GFPs showed favorable results for restoring ETT after 6 years of follow-up. All-ceramic and metal-ceramic crowns showed higher survival rates and better clinical outcomes.

• 대한치과보철학회지
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• 제41권5호
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• pp.582-595
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• 2003

Statement of problem : Most posts are metallic, but in response to the need for a post that possesses optical properties compatible with an all-ceramic crown. an esthetic post has been developed. Although there have been many studies about the esthetic post materials, 3-dimensional finite element studies about the stress distribution of them are in rare. Purpose : The purpose of this study is to investigate comparatively the distribution of stresses of the restored, endodontically treated maxillary incisors with the esthetic post materials and the displacement on the cement layer on simulated occlusal loading by using a 3-dimensional finite element analysis model. Material and method : Four 3-dimensional finite element models were constructed in a view of a maxillary central incisor, a post, a core, and the supporting tissues to investigate the stresses in various esthetic posts and cores and the displacement on the cement layer (Model 1 ; Cast gold post and core, Model 2 ; Glass fiber post with composite core, Model 3 ; Zirconia post with composite core. Model 4 ; Zirconia post with ceramic core). Force of 300N was applied to the incisal edge and the cingulum (centric stop point) with the angle of 135-degree to the long axis of the tooth. Results : 1. The stresses and displacement on the incisal edge were higher than on the cingulum 2. The stresses in dentin were the highest in Model 2 (Glass fiber post with composite core), and the second was Model 3, the third Model 1, and the lowest Model 4. 3. The stresses in post and core were the highest in Model 4 (Zirconia post with ceramic core), and the second was Model 1, the third Model 3, and the lowest Model 2. 4. The displacement on the cement layer was the highest in Model 2 (Glass fiber post with composite core), and the second was Model 3, the third Model 1, and the lowest Model 4. Conclusion : When a functional maximum bite force was applied, the distribution of stresses or the esthetic post and core materials and the displacement on the cement layer were a little different. It seems that restoring extensively damaged incisors with esthetic post and core materials would be decided according to the remaining tooth structure.

• 대한치과보철학회지
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• 제40권3호
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• pp.287-295
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• 2002

Statement of Problem. Endodontically treated teeth frequently required posts and cores to provide retention and resistance form for crowns. In spite of excellent mechanical properties of metal post and core, its metallic color can be detected through all ceramic restorations occasionally. To solve esthetic problems of metal post and core zirconia post system has been introduced recently. Purpose. The purpose of this study was to examine the fracture strength and mode of resin root analogs restored with zirconia, gold and titanium posts with resin, ceramic and metal cores after cementation with metal crowns. Materials and methods. To avoid the morphological variations of natural teeth, 40 root analogs were fabricated with composite resin. Forty resin root analogs were randomly assigned to four groups according to post and core materials: Group A: cast gold post and core and complete cast crowns, as control. Group B: titanium posts (Parapost, Coltent/Whaledent Inc., NJ, USA) and composite resin cores. Group C: zirconia posts (Cosmopost, Ivoclar AG, Schaan/Liechtenstein) and composite resin cores Group D: zirconia posts and heat-pressed ceramic cores (IPS Empress Cosmo Ingots, Ivoclar AG) After thermocycling ($5^{\circ}C{\sim}55^{\circ}C$, 30 sec.), cyclic loading was applied at 3mm below the incisal edge on the palatal surfaces at an angle of 135 degree to the long axis (2Hz, 50N, 50000cycles). Fracture strength was measured by universal testing machine (Instron, High Wycombe, UK) and fracture pattern of restored resin root analogs was also evaluated. Results and conclusion. Within the limitations of this study following results were drawn. 1. Resin root analogs restored with zirconia posts and composite resins demonstrated lowest fracture strength among tested groups. 2. There was no significant difference in the fracture strength between zirconia posts and heat pressed glass ceramic cores and cast gold posts and cores 3. The fracture strength of resin root analogs restored with titanium posts and composite resin cores was lower than that of gold posts and cores. 4. The deep oblique fracture lines were dominantly observed in root analogs restored with cast gold post and core and zirconia post and heat-pressed ceramic core groups.

• 대한치과보철학회지
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• 제47권1호
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• pp.53-60
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• 2009

연구목적: 오늘날 심미적 요구의 증가로 치아색 포스트 코어에 대한 많은 관심이 모아지고 있으며 다양한 연구가 진행 중이다. 현재 화이버 포스트 (ParaPost fiber White, Coltene Whaledent, Cuyahoga Falls, USA), 지르코니아 포스트 (CosmoPost, Ivoclar Vivadent, Schann, Germany) 등에 관한 논문은 다소 나와 있으나 요즘 여러 분야에서 관심을 받고 있는 CAD/CAM (computer-aided design/computer-aided manufacturing) 방식으로 지르코니아를 가공한 절삭형 지르코니아 포스트 코어에 대한 연구는 많지 않은 실정이다. 이 연구의 목적은 CAD/CAM을 이용한 지르코니아를 비롯하여 근관치료된 치아에서 사용된 세 가지 다른 치아색 포스트 코어에 대해 미세누출 (microleakage)을 비교해 보는 것이다. 연구 재료 및 방법: 발치된 건전한 상악 절치 27개를 채택하여 백악법랑질경계 (CEJ)에서 절단하여 근관치료를 시행하고, 세군 (각 9개)으로 나누었다. 각군들은 화이버 포스트와 콤포짓트 레진 코어 (1군), 지르코니아 포스트와 열가압형 세라믹 코어 (2군), CAD/CAM 절삭형 지르코니아 포스트 코어 (3군)로 수복하였다. $5-55^{\circ}C$ 1000회 열순환 처리 (thermocycling)를 시행하고, 2% 메틸렌 블루로 $37^{\circ}C$에서 24시간 염색하였다. 치아장축과 평행하게 순설방향으로 절단하여 미세누출을 현미경과 컴퓨터 프로그램을 사용하여 분석을 하였다. 데이터는 one-way ANOVA와 Scheffe's multiple range test (${\alpha}=0.05$)로 분석하였다. 결과: 모든 군에서 미세누출을 보였으며, 지르코니아 포스트와 열가압형 세라믹 코어군 (2군)에서 치근계면 입구에서는 다소 많은 미세누출을 보였으나 포스트 끝에 이르러서는 거의 미세누출이 없는 결과를 보였다. 화이버 포스트와 콤포짓트 레진 코어군 (1군)과CAD/CAM 절삭형 지르코니아 포스트 코어군 (3군)에서는 부위별로 균등한 미세누출을 보였다. 결론: 화이버 포스트와 콤포짓트 레진 코어군, 지르코니아 포스트와 열가압형 세라믹 코어군, CAD/CAM 절삭형 지르코니아 포스트 코어군 모두에서 미세누출을 보였고, 이 중에서 지르코니아 포스트와 열가압형 세라믹 코어군이 좀 더 큰 미세누출에 대한 저항성을 보였으며 화이버 포스트와 콤포짓트 레진 코어군, CAD/CAM 절삭형 지르코니아 포스트 코어군은 유사한 양상을 보였으나, 각 실험군 간에 통계적으로 유의한 차이는 인정되지 않았다. (P>.05)

• 대한치과기공학회지
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• 제43권1호
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• pp.6-12
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• 2021

Purpose: This study aimed to compare the shear bond strength between zirconia cores and veneer ceramics as per the sand blasting and liner treatments. Methods: The following 4 groups of zirconia-veneering ceramic specimens were prepared: (1) Group I, untreated; (2) Group II, with 110 ㎛ aluminium oxide (Al2O3) sandblasting; (3) Group III, with liner (IPS e.max ZirLiner; Ivoclar Vivadent); and (4) Group IV, with 110 ㎛ Al2O3 sand blasting and liner. Surface roughness was measured for all the prepared specimens, and the surface morphology was observed using a scanning electron microscope. All the samples (n=40) were fixed with measuring jigs, and shear bond strengths were obtained using a universal testing machine with a crosshead speed of 0.5 mm/min. The shear bond strength data were analyzed using one-way analysis of variance and t-test. The post hoc comparison was performed using the Tukey's test (α=0.05). Results: A significant difference in the surface roughness was observed between the specimens of groups I and II (p<0.05). Surface treatment with liner and sandblasting showed higher shear bond strength between zirconia core and veneering ceramic (p<0.05). Conclusion: The sand blasting and liner treatment increased the shear bond strength between zirconia core and veneering ceramic.

• The Journal of Advanced Prosthodontics
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• 제8권2호
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• pp.158-166
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• 2016

PURPOSE. The aim of this study was to determine the fracture resistance and the mode of fracture of endodontically treated teeth restored with different fiber posts and all-ceramic crowns. MATERIALS AND METHODS. Two glass fiber reinforced post systems in two different sizes and polyethylene fiber ribbon in two different thicknesses (n=10) were used. The specimens, restored with all-ceramic crowns, were subjected to a compressive load (in N) delivered at a 130-degree angle to the long axis until a fracture could be noted. The results were analyzed statistically with a One-Way ANOVA test (P<.05). RESULTS. Statistically significant differences were observed between the mean fracture resistance values of Postec, Snowlight, and Kerr Connect thin specimens (P<.0095). The Postec results (395.70 N) were found to be significantly higher than the others. No statistical difference was observed among the thick specimens (P<.2657). The mean fracture resistance values of the Snowlight thick samples were found to be higher than those of the Snowlight thin samples. The specimens were always fractured around the cemento-enamel junction at the palatinal side. No post fracture was observed for the thin Snowlight and Kerr Connect specimens or for the thick Postec and Kerr Connect specimens. Among the common failure types of the specimens, the worst was observed to be the root fracture failure. The highest post dislodgement failure result (80%) was obtained from the thin Kerr Connect specimen. CONCLUSION. In terms of optimizing fracture resistance, the fiber post size selection should be done according to the forces applied to the restored teeth.

• 대한심미치과학회지
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• 제13권1호
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• pp.31-39
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• 2004

For the prosthodontic results which are compatible with esthetics to be fulfilled, the first prerequisite would be periodontal intervention and stability, the second one may be functional competency and the ultimate goal should be ascribed to esthetic considerations. Other words, esthetic dentistry is a whole entity which encompasses the biological stability of the periodontium, physical accuracy of the prosthodontic structure and finally, the beauty which can be found in natural dentition. It also implies the harmonized lip line which reveals the well-balanced tooth morphology and health gum profiles (Red-White Esthetics). Largely, there lie some differences in the input system of the 3-dimentional data from the prepared abutments between respective computer-assisted systems available now. But the manufacturing systems (CAM) are very similar between them, to say, comprise numeric control systems with whole 3-dimensional milling units according to the restorations to be made. Now the author is going to present CAD/CAM Zirconia All Ceramic Restoration on the topics for the Red-White Esthetics, periodontal control and maintenance, treatment for the discolored teeth, post & core build-up works for the devitalized teeth, characteristics of the Zirconium oxide All Ceramics, fabrication procedures, clinical considerations and its application to diverse clinical situations.

• 대한치과보철학회지
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• 제47권2호
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• pp.199-205
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• 2009

연구목적: 지르코니아 코어의 표면처리가 비니어링 세라믹과 전단결합강도에 미치는 영향을 알아보고자 한다. 연구 재료 및 방법: 지르코니아 블록(IPS e. max ZirCAD; Ivoclar vivadent, N=40, n=10, $10mm{\times}10mm{\times}3mm$)를 제조사의 지시에 따라 소성한 후 세척하였다. 대조군, 샌드블라스팅(4기압하 $50{\mu}m$ 알루미늄옥사이드) 처리군, 라이너(Zirliner; Ivoclar vivadent) 처리군, 샌드블라스팅과 라이너 처리군 네 개의 군으로 나누어 각 각 표면처리한 후 3 mm 두께로 세라믹(IPS e. max Ceram; Ivoclar vivadent)을 축조한다. 인스트론 만능시험기로 전단결합강도를 측정한 후, 일원변량 분산분석(One way ANOVA)과 $Scheff{\acute{e}}$검정법(P<.05)를 시행하였다. 결과: 지르코니아 코어와 세라믹 간 평균 전단결합강도는 샌드블라스팅과 라이너 동시 처리군에서 가장 높게 나타났으며, 지르코니아 코어에 샌드블라스팅과 라이너 단독 표면처리는 결합력에 통계적으로 유의한 차이를 보이지 않았으나(P>.05), 샌드블라스팅과 라이너 동시 표면처리는 두 재료 간 결합력에 통계적으로 유의한 차이를 보였다(P<.05). 결론: 지르코니아 코어에 샌드블라스팅과 라이너 동시 처리시 전단결합강도의 증가를 보였다.

• The Journal of Advanced Prosthodontics
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• 제3권2호
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• pp.57-62
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• 2011

MATERIALS AND METHODS. Ceramics have a long history in fixed prosthodontics for achieving optimal esthetics and various materials have been used to improve ceramic core strength. However, there is a lack of information on how color is affected by fabrication procedure. The purpose of this study was to evaluate the effects of various dentin ceramic thicknesses and repeated firings on the color of zirconium oxide all-ceramic system (LavaTM) fabricated using CAD/CAM technology. MATERIALS AND METHODS. Thirty disc-shaped cores, 12 mm in diameter with a 1 mm thickness were fabricated from zirconium oxide based all ceramic systems ($Lava^{TM}$, 3M ESPE, St Paul, MN, USA) and divided into three groups (n = 10) according to veneering with dentin ceramic thicknesses: as 0.5, 1, or 1.5 mm. Repeated firings (3, 5, 7, or 9) were performed, and the color of the specimens was compared with the color after the initial firing. Color differences among ceramic specimens were measured using a spectrophotometer (VITA Easyshade, VITA Zahnfabrik, Bad $S{\ddot{a}}ckingen$, Germany) and data were expressed in CIELAB system coordinates. A repeated measures ANOVA and Bonferroni post hoc test were used to analyze the data (n = 10, ${\alpha}=.05$). RESULTS. $L^{\ast}a^{\ast}b^{\ast}$ values of the ceramic systems were affected by the number of firings (3, 5, 7, or 9 firings) (P<.001) and ceramic thickness (0.5, 1, or 1.5 mm) (P<.001). Significant interactions were present in $L^{\ast}a^{\ast}b^{\ast}$ values between the number of firings and ceramic thickness (P<.001). An increase in number of firings resulted in significant increase in $L^{\ast}$ values for both 0.5 mm and 1.5 mm thicknesses (P<.01, P=.013); however it decreased for 1 mm thickness (P<.01). The $a^{\ast}$ values increased for 1 mm and 1.5 mm thicknesses (P<.01), while it decreased for 0.5 mm specimens. The $b^{\ast}$ values increased significantly for all thicknesses (P<.01, P=.022). As the dentin ceramic thickness increased, significant reductions in $L^{\ast}$ values (P<.01) were recorded. There were significant increases in both $a^{\ast}$ and $b^{\ast}$ values (P<.01) as the dentin ceramic thickness increased. CONCLUSION. The number of firings and dentin ceramic thickness have a definite effect on the final color of all ceramic system tested. The mean ${\Delta}E$ value increased as the dentin ceramic thicknesses increased for zirconium-oxide based all ceramic specimens tested. However, the mean ${\Delta}E$ values were less than 3.7${\Delta}E$ units which is rated as a match in the oral environment.

• The Journal of Advanced Prosthodontics
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• 제5권4호
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• pp.485-493
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• 2013

PURPOSE. To evaluate the effects of surface treatments on shear bond strength (SBS) between microwave and conventionally sintered zirconia core/veneers. MATERIALS AND METHODS. 96 disc shaped Noritake Alliance zirconia specimens were fabricated using YenaDent CAM unit and were divided in 2 groups with respect to microwave or conventional methods (n=48/group). Surface roughness (Ra) evaluation was made with a profilometer on randomly selected microwave (n=10) and conventionally sintered (n=10) cores. Specimens were then assessed into 4 subgroups according to surface treatments applied (n=12/group). Groups for microwave (M) and conventionally (C) sintered core specimens were as follows; $M_C$,$C_C$: untreated (control group), $M_1,C_1:Al_2O_3$ sandblasting, $M_2,C_2$:liner, $M_3,C_3:Al_2O_3$ sandblasting followed by liner. Veneer ceramic was fired on zirconia cores and specimens were thermocycled (6000 cycles between $5^{\circ}-55^{\circ}C$). All specimens were subjected to SBS test using a universal testing machine at 0.5 mm/min, failure were evaluated under an optical microscope. Data were statistically analyzed using Shapiro Wilk, Levene, Post-hoc Tukey HSD and Student's t tests, Two-Way-Variance- Analysis and One-Way-Variance-Analysis (${\alpha}$=.05). RESULTS. Conventionally sintered specimens ($1.06{\pm}0.32{\mu}m$) showed rougher surfaces compared to microwave sintered ones ($0.76{\pm}0.32{\mu}m$)(P=.046), however, no correlation was found between SBS and surface roughness (r=-0.109, P=.658). The statistical comparison of the shear bond strengths of $C_3$ and $C_1$ group (P=.015); $C_C$ and $M_C$ group (P=.004) and $C_3$ and $M_3$ group presented statistically higher (P=.005) values. While adhesive failure was not seen in any of the groups, cohesive and combined patterns were seen in all groups. CONCLUSION. Based on the results of this in-vitro study, $Al_2O_{3-}$ sandblasting followed by liner application on conventionally sintered zirconia cores may be preferred to enhance bond strength.