• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.3
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• pp.318-327
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• 2019

The purpose of this study was to identify which combination of zirconia crowns and cements is most similar in color to the maxillary primary incisors by varying the color of zirconia crowns, crown thickness, and shade of cements. Prefabricated zirconia crowns in 3 shades and crowns fabricated using 6 types of zirconia blocks were used in this study. These were filled with A2-shade or translucent-shade resin cement and the $L^*$, $a^*$, and $b^*$ values were calculated using a spectrophotometer. The color differences between the natural teeth and the zirconia crowns were assessed. The shade of the final restoration was more similar to that of the natural teeth using A2-shade than translucent-shade resin cement. Application of A2-shade cement to a 0.5-mm-thick crown fabricated from a smile series 2 zirconia block resulted in the color most similar to that of the natural teeth. A2-shade resin cement is recommended for zirconia crown restoration in anterior primary teeth compared to TR-shade resin cement for more esthetic restoration. Since restorations with Nu-smile zirconia crowns were not esthetically favorable in terms of shade, improvement of the shade characteristics of the product or development of a new kind of zirconia crown is required.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.2
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• pp.222-230
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• 2022

Digital technology is gradually expanding its field and has a great influence on various fields of dentistry. Recently in digital dentistry, the importance of superimposing various 3-dimensional (3D) image data is emerging, in order to utilize gathered data effectively for diagnosis and prosthesis fabrication. Integrating data from facial scans, intraoral scans, and mandibular movement recordings can create a virtual patient. A virtual patient is formed by integrating digital 3D diagnostic data such as intraoral and extraoral soft tissues, residual dentition, and dynamic occlusion, and the results of prosthetic treatment can be evaluated virtually. The patients in this case report were a 37-year-old female whose chief complaint is that the appearance of the existing prosthesis was distorted and a 55-year-old female patient whose anterior prosthesis needed to be refabricated after the endodontic treatment. 3D facial scans were obtained from each patient, and the patient's mandibular movements were recorded using ARCUS Digma 2 (KaVo Dental GmbH, Biberach an der Riss, Germany). The collected data were integrated on computer-aided design (CAD) software (Exocad dental CAD; exocad GmbH, Darmstadt, Germany) and transferred to a virtual articulator to create a digital virtual patient. The temporary fixed prostheses were designed, restored, and evaluated, and it was reflected into the final restorations. With the aid of the virtual dental patient, accuracy and predictability could be increased throughout treatment, simplifying the occlusal adjustment and clinical evaluation with improved esthetic outcomes.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.27-35
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• 2016

The present study aimed to assess the perception of a child's primary caregiver on the oral health-related quality of life (OHRQoL) of dental treatment under general anesthesia (GA) or intravenous sedation (IV-SED) in pediatric dental patients. Self-administered questionnaires were completed before dental treatment under GA or IV-SED by 52 primary caregivers of healthy pediatric patients (10 years old or younger), and 43 (84%) of these caregivers completed the same questionnaires within 6 months after treatment. The Korean version of Child Oral Health Impact Profile (COHIP) and the Family Impact Scale (FIS) were used to assess OHRQoL in the questionnaires. The scores of COHIP and FIS improved after dental treatment. Demographic variables such as gender did not affect the improvement of COHIP and FIS, and age did not affect that of COHIP. However, baseline FIS score of younger patients was better than that of older patients before dental treatment. Regardless of the treatment variables, all COHIP and FIS scores were improved after dental treatment. COHIP score improved more in cases with pulp treatments compared to those without the treatments. On the other hand, FIS score improved less in cases with posterior stainless steel crown restorations compared to those without them. Anterior esthetic restorations and anterior teeth extractions did not affect the degree of improvement. Based on the primary caregiver's perceptions, the OHRQoL of healthy pediatric patients was improved by dental treatment under GA or IV-SED.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.2
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• pp.191-202
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• 2007

Statement of problems: Long-term success of esthetic restorations, depends on various factors, especially on color stability of the restorations. The color stability is affected by resin cements beneath the porcelain laminate veneers. Purpose: The purpose of this study was to comprehend the color stability of resin cements by comparing with 4 different kinds of resin cements (Choice, Variolink II, Nexus 2, Rely-X). Material and methods: Porcelain laminate disk samples were luted with resin cements. After thermocycling of each 1000, 2000 and 3000 cycle, specimens were measured by spectrophotometers and the color differences were. Results: 1. After thermocycling of 1000, 2000 and 3000cycle, color difference, $({\Delta}E^*)$ of all specimens were incresed, but were not statiscally significant differences. 2. In the Choice of A1 shade and the Nexus 2 of A3 shade, color difference$({\Delta}E^*)$ after thermocycling of 3000cycle was $incre^*ased$ significantly than after thermocycling of 1000cycle. However, other groups did not show any statistically significant differences (P<0.05). 3. After thermocycling of 3000cycle, color difference$({\Delta}E^*)$ between A1 shade and A3 shade of Nexus 2 showed statistically significant difference. However no statistically significant differences were observed in other groups (P<0.05). 4. The mean of color difference$({\Delta}E^*)$ is 1.0-2.06 after 3000 thermocycling and the data were ranked in the ascending order of Variolink II, Nexus 2, Choice and Rely-X in A1 shade group and Choice, Rely-X, Variolink II and Nexus 2 in A3 shade group. Conclusion: Above results revealed that, after 3000 thermocycing, the color difference $({\Delta}E^*)$ of experimental resin cements was within clinically acceptable ranges. Color stability of 4 different resin cements was comparatively excellent.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.4
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• pp.427-435
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• 2017

The most important factor in the treatment of fully edentulous patients using implants is the shape of the definitive prosthesis. After the shape of the definitive prosthesis is determined, residual bone analysis and selection of the implant type, number and position should be followed. In this case, for restoration of an edentulous patient fully implanted (except the maxillary right lateral incisor) without considering definitive prosthesis, facial esthetics and possibility of fixed type prosthesis were evaluated using complete denture. It was determined that the fixed type prosthesis was possible. Implants that could not be used for the definitive prosthesis were excluded from the treatment plan and fixed type provisional restorations were fabricated. After four months of provisional restorations, the patient showed stable occlusion and esthetic satisfaction. Definitive prosthesis was made of zirconia using CAD/CAM (computer aided design and computer aided manufacturing). The results were satisfactory during the 3 months of follow-up period after termination of treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.6
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• pp.599-610
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• 2001

Due to an increasing interest in esthetics and concerns about toxic and allergic reactions to certain alloys, patients and dentists have been looking for metal-free tooth-colored restorations. Recent improvement in technology of new all-ceramic materials and composite materials has broadened the options for esthetic single crown restorations. The aim of this investigation was to study the fracture strength of the metal-free posterior single crowns fabricated using two recently introduced systems, Empress 2 ceramic and Targis-Vectris. Forty premolar-shaped stainless steel dies with the 1mm-wide circumferential shoulder were prepared. Ten cylindrical crowns having a diameter of 8.0mm and total height of 7.5mm were fabricated for each crown system respectively(PFM, Empress staining technique, Empress 2 layering technique, and Targis- Vectris). The crowns were filled with cement and placed on the stainless steel dies with firm finger pressure. The crowns were then stored in distilled water at room temperature for 24 hours before testing. The crowns were tested for fracture strength in an Instron universal testing machine (Instron 6022). With a crosshead speed of 1mm/min the center of the occlusal surface of the crown was loaded using a 4-mm-diameter stainless steel ball until fracture occurred. The fracture surfaces of the crowns were gold coated and examined using scanning electron microscopy(Jeol JSM-840 Joel Ltd., Akishima, Tokyo, Japan). Within the parameters of this study the following conclusions were drawn: 1. The mean fracture strength for PFM crowns was 5829(${\pm}906$)N; for Empress staining technique the fracture strength was 1697(${\pm}604$)N; for Empress 2 Layering technique the fracture strength was 1781N(${\pm}400$)N, and the fracture strength for Targis- Vectris was 3093(${\pm}475$)N. 2. The fracture strength of the PFM crowns was significantly higher than that of the Empress 2 and the Targis-Vectris crowns (P<0.05). 3. The fracture strength of the Targis-Vectris crowns was significantly higher than that of the Empress 2 crowns (P<0.05). 4. No statistical difference was found when Empress staining technique was compared with Empress 2 layering technique. 5. The SEM image of fracture surface of Empress 2 crown showed a very dense microstructure of the lithium disilicate crystals and the SEM image of fracture surface of Targis-Vectris crown showed indentations of Vectris and some fibers tom off from Vectris.

• Restorative Dentistry and Endodontics
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• v.25 no.1
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• pp.17-40
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• 2000

Resin cements are used for cementing indirect esthetic restorations such as resin or porcelain inlays. Because of its limitations in curing of purely light cured resin cements due to attenuation of the curing light by intervening materials, dual cured resin cements are recommended for cementing restorations. The physical properties of resin cements are greatly influenced by the extent to which a resin cures and the degree of cure is an important factor in the success of the inlay. The purpose of this study was to evaluate the influence of porcelain thickness and exposure time on the polymerization of resin cements by measuring the microhardness and the degree of conversion, to investigate the nature of the correlation between two methods mentioned above, and to determine the exposure time needed to harden resin cements through various thickness of porcelain. The degree of resin cure was evaluated by the measurements of microhardness [Vickers Hardness Number(VHN)] and degree of conversion(DC), as determined by Fourier Transform Infrared Spectroscopy(FTIR) on one light cured composite resin [Z-100(Z)] and three dual cured resin cements [Duo cement(D), 3M Resin cement(R), and Dual cement(DA)] which were cured under porcelain discs thickness of 0mm, 1mm, 2mm, 3mm with light exposure time of 40sec, 80sec, 120sec, and regression analysis was performed to determine the correlation between VHN and DC. In addition, to determine the exposure time needed to harden resin cements under various thickness of porcelain discs, the changes of the intensity of light attenuated by 1mm, 2mm, and 3mm thickness of porcelain discs were measured using the curing radiometer. The results were obtained as follows ; 1. The values of microhardness and the degree of conversion of resin cements without intervening porcelain discs were 31~109VHN and 51~63%, respectively. In the microhardness Z was the highest, followed by R, D, DA. In the degree of conversion, D and DA was significantly greater than Z and R(p<0.05). 2. The microhardness and the degree of conversion of the resin cements decreased with increasing thickness of porcelain discs, and increased with increasing exposure time, D and R showed great variation with inlay thickness and exposure time, whereas, DA showed a little variation. 3. The intensity of light through 1mm, 2mm, and 3mm porcelain inlays decreased by 0.43, 0.25, and 0.14 times compared to direct illumination, and the respective needed exposure times are 53 sec, 70 sec, and 93 sec. In D and R, 40 sec of light irradiation through 2mm porcelain disc and 80 sec of light irradiation through 3mm porcelain disc were not enough to complete curing. 4. The microhardness and the degree of conversion of the resin cements showed a positive correlationship(R=0.791~0.965) in the order of R, D, Z, DA. As the thickness of porcelain discs increased, the decreasing pattern of microhardness was different from that of the degree of conversion, however.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.3
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• pp.245-253
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• 2019

Orthognathic surgery of skeletal Class III malocclusion improves oral function and facial appearance. The greater amount of skeletal discrepancy, the greater amount of teeth movement required for decompensation, and this often causes pathological changes in periodontal tissue especially in lower anterior dentition. We made a Top-Down treatment plan with personalized analysis using Face Hunter, Plane System and ARCUS Digma II, in order to resolve severe mobility and cross-bite of lower anterior teeth for 49-year-old female patient who had undergone orthognathic surgery 20 years ago due to skeletal Class III malocclusion and mandibular prognathism. Lower anterior teeth were extracted and alveoloplasty was done. After healing of the wound, immediate loading was conducted immediately after implant placement. Final restorations were fabricated Zirconia using CAD/CAM, and inserted intraorally screw-retained type. During 6-month follow-up, no abnormal episodes of restorations were observed, and obtained satisfactorily both of functional and esthetic outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.263-275
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• 2022

The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.22 no.1
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• pp.22-29
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• 2013

In general, to conduct aesthetic restorations, various analyses are carried out using a camera from the initial examination with the final prosthesis in consideration. With the reality that many dentists are using digital cameras, it can be considered that the time of digital impression has already started. Just as the recent general trend is that more and more internationally renowned photographers are switching their film cameras to digital counterparts, it is likely that CAD/CAM will show another direction in the area of the aesthetic dentistry that we may want to pursue. With the word 'digital', the convenience and economics often come to mind in the first place. However, from the dental clinical viewpoint, it is important to improve and develop the CAD/CAM system based on understanding its specialty and superiority while respecting the conventional analog techniques. However, a regretful aspect is that it is often difficult to catch up with the latest advancements for proper referencing and follow-up of digital technologies since the CAD/CAM device and material are developing very rapidly. Accordingly, although it is ideal to have hands-on experiences in various digital material and devices, and adapt to their fast changes, it must be stressed that the clinical application is to be implemented on the basis of the proven traditional way of dental clinics in order to obtain better outcomes. This presentation will explore types of approaches that can be made by combining the traditional techniques and the CAD/CAM from the aesthetic viewpoint. In addition, it is hoped and eagerly awaited that the CAD/CAM restoration may play a significant role in the field of the 'digital art'.