• Journal of the Korean Academy of Esthetic Dentistry
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• v.22 no.1
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• pp.30-46
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• 2013

Porcelain fused to metal crown has been used mostly over the last 50 years for restorations in dentistry. However, the patients' awareness of aesthetic aspect, biocompatibility and the problems such as an allergy to metals led to the growing interest in the 'metal free restoration'. In particular, the price of the precious metals that have been mainly used to date has risen drastically, which made them impossible to play their role as oral restorative materials anymore, and in addition, the PFM restoration has intrinsic problems of chipping and fracture. Therefore, the CAD/CAM has been drawing more attention than ever due to the popular needs for the material that is more aesthetic and stronger for restoration of the molar implant. Considerations in carrying out the full zirconia restoration are as follows: 1) strength, 2) combination work, 3) light penetrability, 4) treatment of cracks, 5) the color reproducibility of the block, 6) the abrasivity of antagonistic tooth, 7) low temperature degradation. In this presentation, the color reproducibility of the block will be discussed. One of the biggest reasons for avoiding the full zirconia restoration is that it is difficult to reproduce the natural color compared to the conventional PFM restoration. Thus, many clinicians show reluctance due to the exposure of the ugly block when the coloring on the surface is removed after occlusal adjustment. From the experience of using blocks by Zirkonzahn for more than 4 years, it is considered that these problems can be addressed to some degrees. Accordingly, how to make restorations that are well in harmony with surrounding prosthesis or natural teeth will be discussed.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.324-329
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• 2012

Excessive tooth wear causes loss of tooth structure, disharmony of occlusal plane, functional and esthetic problems. Although the decrease of occlusal vertical dimension may be compensated by growth of alveolar bone, if the length of tooth is not enough for the retention of restoration, minimum increase of occlusal vertical dimension is required without discomfort of the patient. In this case, 33-year-old woman drinks more than 1 liter of soft drinks a day and has bruxism in night time, visited in Seoul National University Dental Hospital with chief complaint of generalized tooth wear and related esthetic and functional problems. It was considered as a loss of occlusal vertical dimension based on the accelerated tooth wear caused by erosion and bruxism and facial appearance, phonetic, esthetic, functional evaluations. It was planned to raise occlusal vertical dimension by provisional restoration two times for patient's adaptation, 3 mm and 2 mm each, total 5 mm. Confirming no discomfort and clinical symptom during total 16 weeks after restoration with provisional fixed restoration, it was restored with porcelain fused to gold crown and bridge. Because the patient was young woman, anterior teeth were restored with collarless porcelain fused to gold crown. This case presents that satisfactory esthetic and functional result by full mouth rehabilitation with increase of occlusal vertical dimension.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.298-306
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• 2008

STATEMENT OF PROBLEM: Effect of surface treatment of ceramic under loading does not appear to have been investigated. PURPOSE: The aim of this study was to investigate the effect of surface treatment of esthetic ceramic, which is performed to increase the bonding strength, on the fracture stress under controlled cyclic loading condition. MATERIAL AND METHODS: Sixty 1.0 mm-thick specimens were made from Mark II Vitablocs (Vita Zahnfabrik, Germany) and divided into 3 groups: polished (control), sandblasted, and etched. Specimens of each group were bonded to a dentin analog material base including micro-channels to facilitate the flow of water to the bonding interface. Bonded ceramics were cyclically loaded with a flat-end piston in the water (500,000 cycles, 15Hz). Following completion of cyclic loading, specimens were examined for subsurface crack formation and subsequent stress was determined and loaded to next specimen by the staircase method according to the crack existence. RESULTS: There were significant differences of mean fatigue limit in the sandblasted (222.86 ${\pm}$ 23.42 N) and etched group (222.86 ${\pm}$ 14.16 N) when compared to polished group (251.43 ${\pm}$ 10.6 N) (P<.05; Wald-type pair-wise comparison and post hoc Bonferroni test). Of cracked specimens, surface treated group showed longer crack propagation after 24 hours. All failures originated from the radial cracking without cone crack. Fracture resistance of this study was very low and comparable to failure load in the oral cavity. CONCLUSION: Well controlled cyclic loading could induce clinically relevant cracks and fracture resistance of Mark II ceramic was relatively low applicable only to anterior restorations. Surface treatment of inner surface of feldspathic porcelain in the matsicatory area could influence lifetime of restorations.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.2
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• pp.147-163
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• 1990

Although dental porcelain demonstrates lasting esthetic results, it suffers from inherent brittle fractures. Various techniques and materials for intraoral porcelain repair has been suggested. This study investigated the in vitro shear strength of three porcelain repair systems according to aspects of the porcelain fractures. The purpose of this study was to evaluate the shear bond strength of three porcelain repair systems(All-bond, Clearfil, Scotchprime) according to fractured surface of porcelain - fused - to - metal restorations. For this study specimens were divided into five groups : group 1 represented fracture occurred at body porcelain layer, group 2 represented fracture occurred at opaque porcelain layer, group 3 represented fracture including 1/3 of metal exposure, group 4 represented fracture including 2/3 of metal exposure, and group 5 represented all metal surface was exposed. Specimens were stored in double deionized water(24Hr, $37^{\circ}C$) and thermocycling was performed(24Hr, 1080cycles), and subjected to a shear force parallel to the repair resin and porcelain interface by use of an University Testing Machine. The results of this study were obtained as follows : 1. In group 1 and 2, bond strength was relatively high, and bond strength showing reducing tendency as exposure of metal was increased. 2. In group 1, bond strength was relatively high, and no significant differences in porcelain repair system. 3. In group 2, 3 and 4, All-bond and Clearfil provided significantly higher bond strength than scotchprime. 4. In group 5, bond strength was the lowest among all groups and especially in case if Scotchprime. 5. Cohesive failure was observed in group 1 and 2, adhesive failure was observed in group 5, and cohesive / adhesive failures were observed in group 3 and 4.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.1
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• pp.49-57
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• 2004

Statement of problem : The increased awareness of esthetics in dentistry has brought the esthetic consideration in prosthetic restorations . Dental ceramics offer better esthetics for use of prosthetic restorations. Unfortunately, dental ceramic materials are not always the most suitable candidate materials since their inherently brittle nature. In recent years, basic research in ceramic science has led to the recognition or several approaches to strengthen and to enhance esthetics of ceramics. Several all ceramic systems use ceramic core and porcelain build up structures . Ceramic cores influence to strength of all ceramic crowns . So the strength of ceramic cores is important to all ceramic crowns. Purpose : The purpose of this study is to estimate the flexural strength of ceramic cores in some all ceramic systems. Material and method : A biaxial flexure test was conducted on three groups(Cergo, Empress 2, In-Ceram). Each group consisted of 30 discs of nearly identical dimension with a 0.5mm, 1.0mm, 1.5mm thickness and 12mm in diameter. The fracture load was recorded by Instron. Analysis of valiance(ANOVA) and Tukey's tests were performed using SAS statistical software. Results : 1.5mm thickness of specimens were significantly stronger than 0.5mm and 1.0mm thickness of specimens in Cergo and In-Ceram. But each sepecimen group of Empress 2 was no significantly strength by thickness. In order of In-Ceram, Empress 2 and Cergo has significantly stronger strength in the same thickness. Conclusion : In-Ceram is the strongest ceramic material in 3 materials. All the materials can be used according to the required characters.

• The Journal of Advanced Prosthodontics
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• v.6 no.6
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• pp.456-461
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• 2014

PURPOSE. Translucency and colour stability are two most important aspects for an aesthetic dental restoration. Glass ceramic restorations are popular amongst clinicians because of their superior aesthetic properties. In the last decade, zirconia has generated tremendous interest due to its favorable mechanical and biological properties. However, zirconia lacks the translucency that lithium disilicate materials possess and therefore has limitations in its use, especially in esthetically demanding situations. There has been a great thrust in research towards developing translucent zirconia materials for dental restorations. The objective of the study was to evaluate and compare the transmittance of a translucent variant of zirconia to lithium disilicate. MATERIALS AND METHODS. Two commercially available zirconia materials (conventional and high translucency) and 2 lithium disilicate materials (conventional and high translucency) with standardized dimensions were fabricated. Transmittance values were measured for all samples followed by a microstructural analysis using a finite element scanning electron microscope. One way analysis of variance combined with a Tukey-post hoc test was used to analyze the data obtained (P=.05). RESULTS. High translucency lithium disilicate showed highest transmittance of all materials studied, followed by conventional lithium disilicate, high translucency zirconia and conventional zirconia. The difference between all groups of materials was statistically significant. The transmittance of the different materials correlated to their microstructure analysis. CONCLUSION. Despite manufacturers' efforts to make zirconia significantly more translucent, the transmittance values of these materials still do not match conventional lithium disilicate. More research is required on zirconia towards making the material more translucent for its potential use as esthetic monolithic restoration.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.305-310
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• 2012

It is a great challenge for dentists to do prosthetic restorations of a patient with reduced occlusal vertical dimension (OVD). Proper determination of the OVD is significant. An 85-year-old male patient came in with missing right maxillary posterior teeth. After diagnostic wax-up, reversible provisional prostheses were used to evaluate the new OVD in the maxilla and mandible. After that, the patient was evaluated clinically based on the criteria of esthetic, phonetic, and OVD. After 8 weeks, teeth with excessive wear were treated with root canal therapy and fiber post and core and irreversible provisional prostheses were done. After 8 weeks of observation period, final restorations with fixed partial dentures and removable partial dentures were made. Throughout the follow-up period of 6 months, no symptoms related with increased OVD and mechanical complications were observed.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.15.1-15.18
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• 2022

This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.273-279
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• 2016

Severe tooth wear may lead to pathological changes of pulp, imbalance in occlusion as well as functional and esthetic problems. In this case, 34-year-old male came to the hospital because of generally worn dentition due to attrition and erosion. After evaluation, a full mouth restoration with elevation of the vertical dimension of occlusion was planned. After occlusion was stabilized by an occlusal stabilization appliance, centric relation position was recorded and subsequent provisional restorations were fabricated. After evaluation, a CAD-CAM (computer aided design-computer aided manufacturing) prosthetic restoration was carried out using monolithic zirconia. After 12 months of follow up observation, the patient was satisfied with function and esthetic appearance.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.2
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• pp.142-153
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• 2004

Statement of problem: Increasing demand of esthetic restorations made lots of kinds of ceramic materials. Among them, zirconia has been being focused by many dentists. But, mechanical properties of zirconia were still unclear. Purpose : The purposes of this study were to analyze the flexural strength of various zirconia ceramics which had been currently used for clinic i.e., In-Ceram Zirconia(Vita Zahnfabrik, Bad $S\"{a}ckingen$, Germany), Celay Zirconia(Vita Zahnfabrik, Bad $S\"{a}ckingen$, Germany) and CAD/CAM Zirconia (Adens Zi-Ceram. Seoul , Korea). Material and methods: The four point bending test(ASTM Cl161) was used to measure the flexural strength of a specimen before and after circular heat treatment and fatigue loading. Results : 1. The average value of flexural strengths of CAD/CAM Zirconia, Celay Zirconia, In-Ceram Zirconia in dry condition were 806.5 MPa, 669.9 MPa, 605.6 MPa, respectively. There was a statistically significant difference in strength among the types (P<0.05). 2. After thermocycling, the average flexural strengths of CAD/CAM Zirconia, Celay Zirconia, In-Ceram Zirconia were 791.2 MPa, 604.2 MPa, 605.4 MPa, respectively. CAD/CAM Zirconia showed statistically significant higher strength(P<0.05). The others showed no significant difference after thermocycling(P>0.05). 3. After fatigue loading in wet condition. the average flexural strengths of CAD/CAM Zirconia, Celay Zirconia, In-Ceram Zirconia were 806.0 MPa, 674.9 MPa, 601.7 MPa, respectively. There was a significant difference in strength among the types(P<0.05). 4. There was no statistically significant difference in strength of the specimens according to experimental methods except for before and after thermocycling in Celay Zirconia(P>0.05). Conclusion: Besides high esthetic quality, zirconia had sufficiently high mechanical strength.