• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.27.1-27.12
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• 2019

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

• The Journal of Advanced Prosthodontics
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• v.11 no.3
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• pp.179-186
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• 2019

PURPOSE. The purpose of this study was to compare two novel impression methods and a conventional impression method for edentulous jaws using 3-dimensional (3D) analysis software. MATERIALS AND METHODS. Five edentulous patients (four men and one woman; mean age: 62.7 years) were included. Three impression techniques were used: conventional impression method (CI; control), simple modified closed-mouth impression method with a novel tray (SI), and digital impression method using an intraoral scanner (DI). Subsequently, a gypsum model was made, scanned, and superimposed using 3D analysis software. Mean area displacement was measured using CI method to evaluate differences in the impression surfaces as compared to those values obtained using SI and DI methods. The values were confirmed at two to five areas to determine the differences. CI and SI were compared at all areas, while CI and DI were compared at the supporting areas. Kruskal-Wallis test was performed for all data. Statistical significance was considered at P value <.05. RESULTS. In the comparison of the CI and SI methods, the greatest difference was observed in the mandibular vestibule without statistical significance (P>.05); the difference was < 0.14 mm in the maxilla. The difference in the edentulous supporting areas between the CI and DI methods was not significant (P>.05). CONCLUSION. The CI, SI, and DI methods were effective in making impressions of the supporting areas in edentulous patients. The SI method showed clinically applicability.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.1
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• pp.29-40
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• 2020

Purpose: The purpose of this study was to compare the accuracy of impression taking method using the encoded healing abutment, scan body and pick-up impression coping with different implant angulations. Materials and Methods: Master model was fabricated by 3D printer and three implants were placed into the model with 0°, 10° and 20° mesial angulation. The abutments were secured to each implants and master model was scanned to make a reference model. Group P model was fabricated using pick-up impression copings and model was scanned after securing the abutments. Encoded healing abutment (Group E) and scan body (Group S) were secured on the master model and digital impression was taken using intraoral scanner 15 times each. Each STL files of test groups were superimposed with reference model using best fit alignment and root mean square (RMS) value was analyzed. Results: The RMS values were lowest in Group P, followed by Group S and Group E. Group P showed significant difference with Group S and E (P < 0.05) while there was no significant difference between Group S and E. Correlation between implant angulation and RMS value was significant in Group E (P < 0.05). Conclusion: The pick-up impression coping method showed higher accuracy and there was no significant difference in accuracy between the healing abutment and the scan body. The clinical use of the encoded healing abutment is possible, but it should be used with caution in the case of angulated implant.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.11
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• pp.693-700
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• 2020

This study compared the accuracy and reliability of definitive casts fabricated from a digital impression and conventional impression technique. A master model with the prepared upper full-arch tooth was used. Samples of ten plaster models and ten polyurethane models were duplicated using a selected standard master model. Six linear measurements were recorded between the landmarks, directly on each of the stone models and the polyurethane models on two occasions by a double examiner. The Wilcoxon signed-rank test, interclass correlation coefficient (ICC), measurement error (MSE), and limit of agreement (LoA) were used for statistical analysis. The ICC ranged from 0.76 to 0.99 when comparing the stone models and polyurethane models. The mean difference between the stone models and polyurethane models ranged from 0.09mm to 0.20mm, suggesting that stone models might be slightly larger than polyurethane models. Based on this study, the accuracy of the polyurethane models in evaluating the performance of an oral scanner and subtractive technology was acceptable. Further studies will be needed on patient subjects under clinical conditions that may involve missing or malpositioned teeth and fixed dental prostheses because this study was limited to use a standard master model and duplicated sample models in a laboratory setting.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.330-337
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• 2018

In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.2
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• pp.169-175
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• 2020

Traditionally, gingival retraction has been performed to obtain customized abutment impressions with subgingival margins of the implant supported prosthesis. However, gingival retraction may have side effects such as gingival recession and bleed, leading to an inaccurate impression. In order to prevent these problems, in this case, the new technique has been introduced; a customized abutment which is designed for superimposition is used. Before the connection of the abutment to the implant fixture, pre-scanned shape data are stored, and then the optical impression without gingival retraction is obtained after connecting to the fixture. The suprastructure is fabricated by superimposing the two data. This technique showed the clinical efficacy of fabricating the implant supported prosthesis with subgingival margin, which satisfied the aesthetics, convenience, and clinically acceptable marginal and internal fit.

• The Journal of Advanced Prosthodontics
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• v.10 no.5
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• pp.354-360
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• 2018

PURPOSE. To compare and analyze trueness and precision of provisional crowns made using stereolithography apparatus and subtractive technology. MATERIALS AND METHODS. Digital impressions were made using a master model and an intraoral scanner and the crowns were designed with CAD software; in total, 22 crowns were produced. After superimposing CAD design data and scan data using a 3D program, quantitative and qualitative data were obtained for analysis of trueness and precision. Statistical analysis was performed using normality test combined with Levene test for equal variance analysis and independent sample t-test. Type 1 error was set at 0.05. RESULTS. Trueness for the outer and inner surfaces of the SLA crown (SLAC) were $49.6{\pm}9.3{\mu}m$ and $22.5{\pm}5.1{\mu}m$, respectively, and those of the subtractive crown (SUBC) were $31.8{\pm}7.5{\mu}m$ and $14.6{\pm}1.2{\mu}m$, respectively. Precision values for the outer and inner surfaces of the SLAC were $18.7{\pm}6.2{\mu}m$ and $26.9{\pm}8.5{\mu}m$, and those of the SUBC were $25.4{\pm}3.1{\mu}m$ and $13.8{\pm}0.6{\mu}m$, respectively. Trueness values for the outer and inner surfaces of the SLAC and SUBC showed statistically significant differences (P<.001). Precision for the inner surface showed significance (P<.03), whereas that for the outer surface showed no significance (P<.58). CONCLUSION. The study demonstrates that provisional crowns produced by subtractive technology are superior to crowns fabricated by stereolithography in terms of accuracy.

• The Journal of Advanced Prosthodontics
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• v.11 no.6
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• pp.324-330
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• 2019

PURPOSE. The aim of the study was to evaluate and compare the fracture resistance and modes of fracture of monolithic zirconia crowns with two preparation designs. MATERIALS AND METHODS. Forty human maxillary first premolar teeth were extracted for orthodontic purposes and divided into two main groups (n=20): Group A: monolithic traditional zirconia; Group B: monolithic translucent zirconia. The groups were further subdivided into two subgroups (n=10): (A1, B1) shoulder margin design; (A2, B2) feather-edge margin design. Teeth were prepared with either a 1 mm shoulder margin design or a feather-edge margin design. The prepared teeth were scanned using a digital intraoral scanner. The crowns were cemented using self-adhesive resin cement. All cemented teeth were stored in water for 7 days and thermocycling was done before testing. All samples were subjected to compressive axial loading until fracture. The fractographic analysis was done to assess the modes of fracture of the tested samples. RESULTS. The highest mean values of fracture resistance were recorded in kilo-newton and were in the order of subgroup A1 (2.903); subgroup A2 (2.3); subgroup B1 (1.854) and subgroup B2 (1.523). One-way ANOVA showed a statistically significant difference among the 4 subgroups. Concerning modes of fracture, the majority of samples in subgroups A1 and B1 were fracture of restoration and/or tooth, while in subgroups A2 and B2, the majority of samples fractured through the central fossa. CONCLUSION. Even though all the tested crowns fractured at a higher level than the maximum occlusal forces, the shoulder margin design was better than the feather-edge margin design and the monolithic traditional zirconia was better than the monolithic translucent zirconia in terms of fracture strength.

• The Journal of Advanced Prosthodontics
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• v.11 no.2
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• pp.120-127
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• 2019

PURPOSE. To determine wear amount of single molar crowns, made from four different restoratives, and opposing natural teeth through computerized fabrication techniques using 3D image alignment. MATERIALS AND METHODS. A total of 24 single crowns (N = 24 patients, age range: 18 - 50) were made from lithium disilicate (IPS E-max CAD), lithium silicate and zirconia based (Vita Suprinity CAD), resin matrix ceramic material (Cerasmart, GC), and dual matrix (Vita Enamic CAD) blocks. After digital impressions (Cerec 3D Bluecam, DentsplySirona), the crowns were designed and manufactured (Cerec 3, DentsplySirona). A dualcuring resin cement was used for cementation (Variolink Esthetic DC, Ivoclar). Then, measurement and recording of crowns and the opposing enamel surfaces with the intraoral scanner were made as well as at the third and sixth month follow-ups. All measurements were superimposed with a software (David-Laserscanner, V3.10.4). Volume loss due to wear was calculated from baseline to follow-up periods with Siemens Unigraphics NX 10 software. Statistical analysis was accomplished by Repeated Measures for ANOVA (SPSS 21) at = .05 significance level. RESULTS. After 6 months, insignificant differences of the glass matrix and resin matrix materials for restoration/enamel wear were observed (P>.05). While there were no significant differences between the glass matrix groups (P>.05), significant differences between the resin matrix group materials (P<.05) were obtained. Although Cerasmart and Enamic were both resin matrix based, they exhibited different wear characteristics. CONCLUSION. Glass matrix materials showed less wear both on their own and opposing enamel surfaces than resin matrix ceramic materials.

• The korean journal of orthodontics
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• v.52 no.1
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• pp.20-28
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• 2022

Objective: Although, digital models have recently been used in orthodontic clinics, physical models are still needed for a multitude of reasons. The purpose of this study was to assess whether the printed models can replace the plaster models by evaluating their accuracy in reproducing intermaxillary relationships and by appraising the clinicians' ability to measure the printed models. Methods: Twenty sets of patients' plaster models with well-established occlusal relationships were selected. Models were scanned using an intraoral scanner (Trios 3, 3Shape Dental System) by a single operator. Printed models were made with ZMD-1000B light-curing resin using the stereolithography method 3-dimensional printer. Validity, reliability, and reproducibility were evaluated using measurements obtained by three operators. Results: In evaluation of validity, all items showed no significant differences between measurements taken from plaster and printed models. In evaluation for reliability, significant differences were found in the distance between the gingival zeniths of #23-#33 (DZL_3) for the plaster models and at #17-#43 (DZCM_1) for the printed models. In evaluation for reproducibility, the plaster models showed significant differences between operators at midline, and printed models showed significant differences at 7 measurements including #17-#47 (DZR_7). Conclusions: The validity and reliability of intermaxillary relationships as determined by the printed model were clinically acceptable, but the evaluation of reproducibility revealed significant inter-operator differences. To use printed models as substitutes for plaster models, additional studies on their accuracies in measuring intermaxillary relationship are required.