• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.209-223
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• 2013

This study was to evaluate the stress distributions of prefabricated, customized abutments and fixtures according to their material and shape by three-dimensional finite element analysis. And to investigate the fatigue life and fracture characteristics. Mandibular models were fabricated by reconstruction of the CT scan of patients with normal occlusion. A total of six finite element models were designed, a load of 100 N was applied on the buccal cusps vertically, and 30 degree obliquely. 10 specimens each were fabricated for the more clinically widely used 4 type abutments and were loaded according to ISO 14801. Differences in stress distribution patterns were not found according to the materials of the abutments and fixtures. But a slight difference in the stress level was detected. Customized abutment groups showed lower crown stress levels. One-piece zirconia implant showed the lowest bone stress levels. In the fatigue test, highest values were measured in group 7. Prefabricated abutments showed less variation of fatigue life (P<0.05). Use of customized abutments can improve the fracture resistance of restorations. Especially, use of customized zirconia abutments reinforced by titanium screw connecting parts is recommended.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.4
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• pp.321-327
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• 2020

Purpose: The purpose of this study was to measure and compare the strain value exerted on the cervical area using different screw tightening protocols in implant-supported, screw-retained 3-unit prostheses. Materials and methods: Strain gauges were attached to four implants: two external and two internal. Thereafter, two study model were designed each type using acrylic resin. CAD-CAM was used to design hex and nonhex abutments for each group (EH, ENH, IH, and INH group) and Screw-cement-retained prostheses were also designed using a nonprecious base metal. Abutment was fixed with 10 Ncm torque, and the prosthesis was cemented. Screws were fixed with 30 Ncm torque using different three protocols. After 5 min, the strain gauge level was measured, and group analysis was performed (α=.05). Results: External group showed significantly lower strain values than internal group and the EH group showed significantly lower strain values than the ENH group (P<.05). There was no difference in strain value based on the types of screw tightening protocols in same group (P>.05). The IH group exhibited significantly higher strain values than the INH group and the IH group showed a significant difference in strain values based on the types of screw tightening protocols used (P<.05). Conclusion: There was no significant effect on the external type in the implant-supported, screw-retained prostheses. However, strain values were high in the internal type, and the types of screw tightening protocol significantly affected these implants.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.1
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• pp.46-55
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• 2018

Oral rehabilitation of a patient having severe periodontitis with alveolar bone resorption and periodontal inflammation presents a challenge to clinicians. However, if appropriate implant placement according to the bone shape is selected, unnecessary bone grafting or soft tissue surgery can be minimized. In recent years, using cone beam CT and software, it has become possible to operate the planned position with the surgical guide made with 3D printing technology. This case was a 70 years old female patient who required total extraction of teeth due to severe periodontitis and performed a full-mouth rehabilitation with an implant - supported fixed prosthesis. During the surgery, the implant was placed in a flapless manner through a surgical guide. Immediate loading of the temporary prosthesis made by CAD/CAM method before surgery was done. Since then, we have produced customized abutments and zirconia prostheses, and have reported satisfactory aesthetic and functional recovery.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.234-243
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• 2015

Developing of digital technique, it is possible to fabricate implant prostheses for edentulous area using intraoral 3-dimentional information throughout implant diagnosis and treatment process. It is being changed that from the method using CAD/CAM, producing prostheses by model scanning after conventional impression and model processing, to the method of fabricating implant provisional restorations and customized abutments by digital impression after connecting digital impression copings (scanbody) and implant fixtures without models. But, this digital method has not been actively used for implant prostheses not yet. Specially, it is short of intraoral digital impression cases for immediate provisional restorations of the maxillary anterior implants. The gingival contour impression of maxillary anterior area is very important for esthetic restorations. Accordingly, in this case report, the using a digital impression coping (scanbody) and digital impression by CEREC Omnicam (Sirona, Bensheim, Germany) or Trios (3shape, Copenhagen, Denmark) were introduced for immediate provisional restorations in 3 cases needed a single implant restoration in maxillary anterior area. The clinical results were satisfactory on the convenience and accuracy of digital impression technique and the good esthetics of final restorations.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.299-306
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• 2017

In this case report, immediate loading of an implant-supported single-tooth prosthesis through complete digital workflow. A patient presented for restoration of missing a single tooth in the mandibular first molar. The digital impression was made with intraoral scanner and implant was placed using surgical guide pre-fabricated with pre-operative computed tomography (CT) and scan data. After 1 week later, prefabricated customized abutment and provisional restoration were connected for immediate loading. After 8 weeks later, abutment level impression was taken by intraoral scanner. At 3 months later from implant installation, monolithic zirconia crown were fabricated. This clinical report presents satisfying result in accuracy and patient satisfaction. A completely modeless digital procedure met expectations regarding precision, esthetics, and functionality.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.71-78
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• 2021

Implant treatment, which was first attempted in fully edentulous patients, is now widely used in partially edentulous, and a single tooth missing patients. Moreover, implant treatment has become an essential treatment modality in modern dentistry. The material of fabricating implant prostheses has also become more diverse than before, one of which is the use of high-performance polymers. The frequency of using high-performance polymers, which have been used in the medical field, is also increased in the dental field compared to the past. In the first case, a PEKK abutment and a PFG crown (cement-screw-retaining type) were fabricated in the lower left second premolar, and in the second case, a PEKK abutment and a monolithic zirconia crown (cement-screw-retaining type) were fabricated in the missing upper left first molar, and in the third case two PEKK abutments and a splinted PFM crowns (cement-screw-retaining type) were fabricated and connected to the upper right first and second molar implants. Through these procedures the patients obtained esthetically and functionally satisfactory results after 4 years of follow-up.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.160-170
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• 2019

The anterior guidance is one of the important factors in prosthodontic treatment of anterior teeth. The lingual surface shape of anterior restorations is so critical that small errors of treatment procedure can cause discomfort of the patient and disharmony of the dentition. If the anterior restorations are achieved harmonious anterior guidance through the fabrication and adjustment of provisional restorations, it is important to accurately reproduce the lingual surface shape of provisional restorations as the final prosthesis. In this case report, it was used the modified Dahl principle and copy-milled technique of computer-aided design/computer-aided manufacturing (CAD/CAM) system for systematic diagnosis and treatment. Therefore, we tried to reconstruct the restoration shape more precisely by setting the appropriate anterior guidance and superimposing the digital image of the abutment teeth and the provisional restorations. Thus, by promoting functional and esthetic recovery, this case report demonstrates satisfying results to both the patients and dentist.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.431-441
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• 2022

The digital facebow device records the trajectory of the mandibular movement where it is then reflected on the computer-aided design software, leading to an improvement on treatment outcomes of prosthetic restorations. In this clinical case, using a digital technology, an implant placement and prosthetic restoration were done in a patient who has lost maxillary and mandibular molars. Following an intraoral scan, a surgical stent for implant surgery was fabricated based on digital diagnostic wax-up, and implants were installed. After six months of sufficient osseointegration, customized abutments and the first temporary prostheses were delivered. Then two months later, at an abutment level, an intraoral scan and digital facebow transfer device were used to mount the intraoral scan data on a virtual articulator, and record the mandibular movements. Once the second temporary prostheses were fabricated and delivered on a basis of the mandibular movement, the definitive zirconia prostheses were designed and delivered based on a stabilized occlusion that was duplicated via double scan technique.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.47-51
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• 2013

With the introduction of dental implants, restoration of missing teeth with conventional fixed or removable partial dentures is being replaced with implants. Especially, with young patients, not only longevity but also esthetic factors need to be considered. Implant restorations provide long-term success functionally but, esthetic complications such as, marginal exposure due to gingival recession, loss of the papilla and dark color of metal abutments may occur. Recently, zirconia restorations with CAD/CAM technology provide functional, biocompatible and esthetic restorations possible. All-ceramic restorations using the pressed ceramic technique show better fracture toughness values than those of the conventional porcelain veneering technique. Pressed ceramic technique creates the veneer design in wax and the lost wax technique is used to create the restoration. The final contour of the restoration may be controlled during wax-up. A 22-year old female patient was restored with dental implants and zirconia restorations using the pressed ceramic technique presenting short-term but optimistic prognosis.

• Journal of Technologic Dentistry
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• v.38 no.3
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• pp.111-117
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• 2016

Purpose: The present study was performed to investigate the effect of abutment inclined angle on the marginal fit of zirconia all-ceramic crown. Methods: The Ti abutments with 3 different inclined angle($2^{\circ}$, $4^{\circ}$ and $6^{\circ}$) were fabricated. The zirconia copings were fabricated for each abutment by using dental CAD/CAM system. The manufactured zirconia copings were duplicated through silicone replica technique, and a replicated specimen was sectioned in the center of bucco-lingual and mesio-distal axial to measure the marginal fit by using a stereo microscope. The results were analyzed using a one-way ANOVA with SPSS 22.0 for Windows(${\alpha}=0.05$). Results: On the bucco-lingual axial, marginal fit was the RL3($41.5{\pm}3.4{\mu}m$), RL2($44.3{\pm}4.3{\mu}m$) and RL1($47.5{\pm}5.7{\mu}m$), respectively. On the mesio-distal axial, marginal fit was the RL3($41.1{\pm}3.7{\mu}m$), RL2($45.7{\pm}5.3{\mu}m$) and RL1($46.2{\pm}4.5{\mu}m$), respectively. One-way ANOVA showed statistically significant difference between groups for marginal fit(p<0.05). Conclusion: For marginal fit of the abutments inclined angle, RL3 specimen was superior. The abutment inclined angle had influence on marginal fit of the zirconia copings. The marginal fit of each group were within clinically acceptable range.