• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.289-295
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• 2020

Improving implant esthetics is very difficult, especially in cases where unaesthetic problems are related to implants in the maxillary anterior dentition. A 69-year old male patient was referred by a prosthodontist for periodic pus discharge and an unaesthetic implant prosthesis (maxillary right lateral incisor). The implant was placed too deeply and showed soft tissue volume deficiency and a long clinical crown. After a clinical and radiographic examination, implant submergence and alveolar ridge augmentation were performed to enhance the aesthetics instead of an explantation. The treatment plan was as follows: extraction the adjacent teeth with tooth mobility, secondary caries, and poor prognosis; placement an additional dental implant with hard and soft tissue grafting; fabrication a fixed bridge using implant abutments. A fixed esthetic prosthesis using implants was fabricated, and the patient was satisfied with the prosthesis. A ridge augmentation with implant submergence may be an alternative for solving the problems of unaesthetic implant restorations in the esthetic zone.

• The Journal of Advanced Prosthodontics
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• v.14 no.1
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• pp.22-31
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• 2022

PURPOSE. The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS. Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS. Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) ㎛ while CAD-cast demonstrated the highest measurements of 29.2 (3.1) ㎛. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION. Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw's preload stability under an aggressive loading situation.

• The Journal of Korean Academy of Prosthodontics
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• v.34 no.2
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• pp.320-334
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• 1996

Dental cast and die materials are essential material using in almost dental prsthodontic procedure and it's most important requirement is accuracy for reqorducing the oral anatomical structures. In this study, 5 abutments A, B, C, D, E were fabricated on the metal master model to simulate the arch form and specimens were poured with 4 cast materials. Inter-abutment distances, A-B, A-C, A-D, A-E, B-C, B-D were calculated using the photo-scanning and the deviations from the metal master model were also evaluated. The results were as follows; 1. The distance between A-B, A-C, A-D, A-E, B-C, B-D of the abutments A, B, C, D, E of each cast material was calculated. And after comparing the deviations between the metal master model. $Fujirock^{(R)}$ showed the lowest value with $0.20{\pm}0.22mm$, and the deviation increased in the order of $Suprastone^{(R)}$, Epoxy $Die^{(R)}$, Die $Keen^{(R)}$. There was significant difference between $Fujirock^{(R)}$ and Epoxy $Die^{(R)}$, Die $Keen^{(R)}$. 2. In each calculation area, the difference in measurements between cast material and metal master model showed singificant difference between A-B and Cross arch measure-ments of A-D, B-D, A-E(p<0.05). 3. The difference in measurements between cast material and metal master model in the A-B area showed $Fujirock^{(R)}$ to be the lowest with $0.05{\pm}0.04$mm and increased in the order of Die $Keen^{(R)}$, $Suprastone^{(R)}$, Epoxy $Dies^{(R)}$. There was significant difference between $Fujirock^{(R)}$ and $Suprastone^{(R)}$, Epoxy $Die^{(R)}$ (p<0.05). 4. The difference in measurements between cast material and metal master model in the B-C area showed $Fujirock^{(R)}$ to bo the lowest with $0.17{\pm}0.11$mm and increased in the order of $Suprastone^{(R)}$, Die $Keen^{(R)}$, Epoxy $Dies^{(R)}$. There was significant difference between $Fujirock^{(R)}$ and Die $Keen^{(R)}$, Epoxy $Die^{(R)}$(p<0.05). 5. The difference in measurements between cast material and metal master model in the B-D area showed $Fujirock^{(R)}$ to bo the lowest with $0.13{\pm}0.07$mm, Epoxy $Dies^{(R)}$and increased in the order of $Suprastone^{(R)}$, Die $Keen^{(R)}$. There was significant difference between $Fuji-rock^{(R)}$ and Die Keen(p<0.05). 6. In this experiment, Epoxy $Dies^{(R)}$ showed mean contraction in every calculation area. And when reconstruction cross arch restorations it is thought that distortion should be considered in every cast material.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.2
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• pp.95-103
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• 2020

Purpose: The purpose of this study was to compare the axial displacement of the hexagonal and conical abutment in internal conical connection implant after screw tightening and cyclic loading. Materials and Methods: Internal conical connection implants were divided into two groups (n = 10): group HEX, hexagonal abutment; and group CON, conical 2-piece abutments. The axial displacement and removal torque values were measured after 30 Ncm torque tightening and 250N loading test of 100,000 cycles. The Student t test with 5% significance level was used to evaluate the data. Results: HEX group demonstrated significantly higher axial displacement values after 30 Ncm tightening in comparison to the CON group (P < 0.05). No significant difference was found in axial displacement after cyclic loading (P = 0.052). Removal torque loss before and after the cyclic loading both revealed no significant difference between groups (P = 0.057 and P = 0.138). Removal torque value decreased after cyclic loading in both groups (P < 0.05). Conclusion: Overall, both abutment with or without hexagon index presented similar biomechanical performance except HEX group demonstrated significantly more axial displacement after applying tightening torque.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.2
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• pp.95-104
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• 2018

Purpose: The purpose of this study is to analyze the factors affecting the longevity of failed prosthesis and the success rate of the prosthesis based on the data evaluated with the newly developed Korean Academy of Prosthodontics (KAP) criteria. Materials and methods: Evaluation was performed in the restored prosthesis for patients who visited the prosthodontics department of the 13 dental university hospitals and general hospitals. The status of the prosthesis was classified into four categories: Good, Fair, Bad, Worst. The success was recorded if only the category was classified in 'good'. The mean duration of failed prostheses and the success rate through Kaplan-Meier method were analyzed. Results: A total of 1,804 cases of prosthesis were evaluated: 810 cases of fixed dental prostheses (FDP), 519 cases of Removable Dental Prostheses (RDP), and 475 cases of implant prosthesis. The mean duration of failed FDP was $11.41{\pm}0.30years$ and the median was 10 years. The mean duration of failed RDP was $8.18{\pm}0.29years$ and the median was 7 years. The mean duration of failed implant prosthesis was $7.99{\pm}0.30years$ and the median was 7 years. The factors related to the failure were as follows: number of units, abutments, abutments treated with root canal, and plaque index in FDPs; treated and opposing dentition in RDPs; the number of implants, duration of use, and plaque index in implant prostheses. Conclusion: The average duration of failed prosthesis was 11.41 years for FDPs, 8.18 years for RDPs, and 7.99 years for implant prosthesis, according to the evaluation with newly developed KAP criteria.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.79-87
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• 2021

The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient's visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an 'A.I. abutment matching algorithm' the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner's advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.1
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• pp.50-59
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• 2015

It is hard to restore and manage anterior teeth esthetically and functionally; because of peri-implantitis, not only hard and soft tissue problem such as alveolar bone resorption and interdental papilla loss but also esthetic problem caused by metal abutment exposure can occur. This case presents patients using customized abutment made of Co-Cr alloy that can be made by conventional casting and compensate the shortcomings of prefabricated titanium abutments, and cement-retained prosthesis.

• The Journal of Advanced Prosthodontics
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• v.9 no.4
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• pp.244-251
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• 2017

PURPOSE. The purpose of this study was to determine fracture resistance and failure modes of three-unit fixed dental prostheses (FDPs) made of lithium disilicate pressed on zirconia (LZ), monolithic lithium disilicate (ML), and monolithic zirconia (MZ). MATERIALS AND METHODS. Co-Cr alloy three-unit metal FDPs model with maxillary first premolar and first molar abutments was fabricated. Three different FDPs groups, LZ, ML, and MZ, were prepared (n = 5 per group). The three-unit FDPs designs were identical for all specimens and cemented with resin cement on the prepared metal model. The region of pontic in FDPs was given 50,000 times of cyclic preloading at 2 Hz via dental chewing simulator and received a static load until fracture with universal testing machine fixed at $10^{\circ}$. The fracture resistance and mode of failure were recorded. Statistical analyses were performed using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni's correction (${\alpha}=0.05/3=0.017$). RESULTS. A significant difference in fracture resistance was found between LZ ($4943.87{\pm}1243.70N$) and ML ($2872.61{\pm}658.78N$) groups, as well as between ML and MZ ($4948.02{\pm}974.51N$) groups (P<.05), but no significant difference was found between LZ and MZ groups (P>.05). With regard to fracture pattern, there were three cases of veneer chipping and two interfacial fractures in LZ group, and complete fracture was observed in all the specimens of ML and MZ groups. CONCLUSION. Compared to monolithic lithium disilicate FDPs, monolithic zirconia FDPs and lithium disilicate glass ceramics pressed on zirconia-based FDPs showed superior fracture resistance while they manifested comparable fracture resistances.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.2
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• pp.110-119
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• 2022

When restoration for partially edentulous patients, abutments are not always in favorable positions for making removable partial dentures. Because of these situations, patients are sometimes unsatisfied with the stability and support of their removable partial prostheses. In this regard, removable partial denture using a few implant surveyed crown prostheses can be a good alternative. It can be expected to increase stability and support of removable partial dentures by strategically placing a small number of implants and restoring with implant-supported surveyed crowns. In these cases, the patients who had unilateral residual teeth on mandible were treated with two implant surveyed crowns in the tactical place to have bilateral distribution. After definitive removable partial prosthesis, the patients showed satisfaction with the masticatory function and comfort of using removable dentures.

• Journal of Technologic Dentistry
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• v.45 no.3
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• pp.67-73
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• 2023

Purpose: This in vitro study aimed to evaluate the clinical acceptability of precision of fit of the support thickness of Co-Cr alloy copings fabricated using selective laser melting (SLM). Methods: Thirty dental stone models of maxillary left molar abutments were manufactured, images were taken using a scanner, and a computer-aided design program was used to design the form of a conventional metal ceramic crown coping. Overall, 30 single copings were made from Co-Cr alloy using SLM and divided into three support radius groups (0.1, 0.25, and 0.35 mm) of 10 for each. Digitized data were superimposed with three-dimensional inspection software to quantitatively obtain the machinability of a ceramic crown coping, and visual differences were confirmed using a color map. The root mean square values of the ceramic crown coping group were statistically analyzed using one-way analysis of variance (α=0.05). Results: The precision of fit was superior with 0.25 mm compared with 0.1 mm and 0.35 mm, and the results exhibited significant differences (p<0.05). All specimens showed that various support thicknesses did not exceed the clinically permitted value of 120 ㎛, which mean that more than 0.1 mm and 0.35 mm of support radius for SLM was adequate. Conclusion: The support thickness of Co-Cr alloy restoration fabricated using SLM is shown to affect the adaptation.