• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.245-256
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• 2023

When restoring with a dental digital system for implant-supported prosthesis, a double digital scanning technique is required: an intraoral scan of the three-dimensional implant location and intraoral scan after placement of temporary denture or provisional prosthesis. During the intraoral scan, the use of scan body as a stable landmark can improve the accuracy of digital impression and simplify laboratory process. In this case, a full-digital system was used to plan and fabricate a custom abutment, provisional prosthesis, and definitive prosthesis. After implant placement, the scan area of the intraoral scan body connected with implant and the intraoral scan body marked on the inside of temporary denture were superimposed. Out of the superimposed files, a custom abutment and provisional prosthesis were fabricated which match the vertical dimension of temporary denture, and definitive prosthesis was fabricated based on provisional prosthesis. We report this case because result has been functionally and esthetically satisfactory by using vertical dimension and central relation set during the fabrication of temporary denture to the definitive prosthesis.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.67-73
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• 2012

Fixed dental prostheses such as inlay, onlay, crown, and bridge fabricated by CAD/CAM technique combined with digital impressions is getting popular due to the recent rapid progress of digital impression taking system. For the scope of implant prosthesis, however, digital intra-oral scan hasn't been actively utilized for the fabrication of superstructures. In this case report, 6 cases of titanium-milled custom abutment based on the iTero intra-oral scan data were introduced, five of them were restored with screw-type prosthesis after cementation (SCRP) and the clinical results were satisfactory on restoring the function and esthetics.

• 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.58 no.3
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• pp.228-238
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• 2020

In order to deliver fixed partial denture to a patient successfully, dentist must take into many considerations beforehand. Patient's occlusal pattern should be fully understood before delivering any type of prosthesis, whether it's canine guidance or group function occlusion. In order to do so, movement of mandible should be recorded precisely. Introduced by Meyers in 1933, functionally generated path technique (FGP) has been successfully used to record mandibular movement with various materials, such as wax, and utilize it in fabricating precise prosthesis. In the following cases, patients showed secondary caries or endodontic-periodontic lesion on maxillary molars. Root canal treatment and subgingival curettage were done for each patient. Since the long term prognosis of each tooth was questionable, lateral force should be minimized. In order to do so, FGP technique was used to record mandibular movements precisely. Instead of using conventional plaster impression, intra-oral scanning of wax tracing was done to fabricate prosthesis efficiently. After delivery of fixed partial denture, favorable outcome was obtained.

• The Journal of Advanced Prosthodontics
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• v.6 no.1
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• pp.1-7
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• 2014

PURPOSE. The accuracy of a gypsum model (GM), which was taken using a conventional silicone impression technique, was compared with that of a polyurethane model (PM), which was taken using an iTero$^{TM}$ digital impression system. MATERIALS AND METHODS. The maxillary first molar artificial tooth was selected as the reference tooth. The GMs were fabricated through a silicone impression of a reference tooth, and PMs were fabricated by a digital impression (n=9, in each group). The reference tooth and experimental models were scanned using a 3 shape convince$^{TM}$ scan system. Each GM and PM image was superimposed on the registered reference model (RM) and 2D images were obtained. The discrepancies of the points registered on the superimposed images were measured and defined as GM-RM group and PM-RM group. Statistical analysis was performed using a Student's T-test (${\alpha}=0.05$). RESULTS. A comparison of the absolute value of the discrepancy revealed a significant difference between the two groups only at the occlusal surface. The GM group showed a smaller mean discrepancy than the PM group. Significant differences in the GM-RM group and PM-RM group were observed in the margins (point a and f), mesial mid-axial wall (point b) and occlusal surfaces (point c and d). CONCLUSION. Under the conditions examined, the digitally fabricated polyurethane model showed a tendency for a reduced size in the margin than the reference tooth. The conventional gypsum model showed a smaller discrepancy on the occlusal surface than the polyurethane model.

• Journal of Periodontal and Implant Science
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• v.53 no.5
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• pp.388-401
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• 2023

Purpose: This study investigated the accuracy of free-hand implant surgery performed by an experienced operator compared to static guided implant surgery performed by an inexperienced operator on an anterior maxillary dental model arch. Methods: A maxillary dental model with missing teeth (No. 11, 22, and 23) was used for this in vitro study. An intraoral scan was performed on the model, with the resulting digital impression exported as a stereolithography file. Next, a cone-beam computed tomography (CBCT) scan was performed, with the resulting image exported as a Digital Imaging and Communications in Medicine file. Both files were imported into the RealGUIDE 5.0 dental implant planning software. Active Bio implants were selected to place into the model. A single stereolithographic 3-dimensional surgical guide was printed for all cases. Ten clinicians, divided into 2 groups, placed a total of 60 implants in 20 acrylic resin maxillary models. Due to the small sample size, the Mann-Whitney test was used to analyze mean values in the 2 groups. Statistical analyses were performed using SAS version 9.4. Results: The accuracy of implant placement using a surgical guide was significantly higher than that of free-hand implantation. The mean difference between the planned and actual implant positions at the apex was 0.68 mm for the experienced group using the free-hand technique and 0.14 mm for the non-experienced group using the surgical guide technique (P=0.019). At the top of the implant, the mean difference was 1.04 mm for the experienced group using the free-hand technique and 0.52 mm for the non-experienced group using the surgical guide technique (P=0.044). Conclusions: The data from this study will provide valuable insights for future studies, since in vitro studies should be conducted extensively in advance of retrospective or prospective studies to avoid burdening patients unnecessarily.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.61-70
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• 2017

In this case, the impression surface of the existing denture was scanned and was inverted three-dimensionally to express the residual ridge form. Implant planning was performed on the superimposed data of the CT with the scanned image of the denture with radiopaque markers attached. At the day of surgery, customized abutments fabricated in accordance with the form of the gingival margin were linked with fixtures and temporary restorations were set. In the process of fabricating the final prosthesis after the osseointegration of implant fixture, the intraoral scan images at abutment level were merged with images of the abutments scanned and stored before implant surgery. By fabricating the final prosthesis with the abutments obtained by merging can increase the marginal fitness of the final prosthesis and simplify the clinical process.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.227-233
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• 2023

Tardive dyskinesia is an involuntary neurological movement disorder caused by long-term use of dopamine receptor-blocking drugs leading to dental implications like uncontrolled gnashing and grinding of teeth which in turn imperil the oral rehabilitation procedures as the excessive load increases the risk of prosthesis fracture. A 40-year male with a medical history of tardive dyskinesia visited the hospital to receive oral rehabilitation for missing maxillary anterior teeth. After the oral examination, tooth preparation was done on teeth 13, 15, and 23. After that silicon impression was made and the gypsum cast was digitalized using a desktop scanner and an interim prosthesis was fabricated by milling a resin block. During the try-in, the occlusal one-third of the interim prosthesis was trimmed, and an auto-polymerizing acrylic resin was applied on the occlusal surfaces and inserted in the patient's mouth. Then, the functionally generated path (FGP) of occluding surfaces of opposing arches was traced on the resin surface. When the resin was hardened, the modified interim prosthesis was removed and digitized using an intraoral scanner. The scan image was used in designing the occlusal morphology of definitive prosthesis by modifying the design of the interim prosthesis using the dual scan method. Lastly, a monolithic zirconia prosthesis was fabricated by milling a zirconia block. The definitive prosthesis was delivered reflecting the patient's occlusal scheme. This case report shows that the FGP technique with the dual scan method can help in fabricating fixed prosthesis with harmonious occlusion in a tardive dyskinesia patient.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.555-565
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• 2006

The purpose of the present study is to evaluate the biological stability of the zirconia/alumina composite abutment by histologic and radiographic examination in clinical cases. 17 partially edentulous patients (5 men and 12 women, mean age 47) were treated with 37 implants. The implants were placed following the standard two-stage protocol. After a healing period of 3 to 6 months, zirconia/alumina composite abutments were connected. All radiographs were taken using paralleling technique with individually fabricated impression bite block, following insertion of the prosthesis and at the 3-, 6-, 12 month re-examinations. After processing the obtained images, the osseous level was calculated using the digital image in the mesial and distal aspect in each implant. An ANOVA and t-test were used to test for difference between the baseline and 3-, 6-, 12 months re-examinations, and for difference between maxilla and mandible. Differences at P <0.05 were considered statistically significant. For histologic examination, sample was obtained from the palatal gingiva which implant functioned for 12 months. Sections were examined under a light microscope under various magnifications. Clinically, no abutment fracture or crack as well as periimplantitis was observed during the period of study. The mean bone level reduction(${\pm}standard$ deviation) was 0.34 rom(${\pm}\;0.26$) at 3-months, 0.4 2mm(${\pm}\;0.30$) at 6-months, 0.62 mm(${\pm}\;0.28$) at 12-months respectively. No statistically significant difference was found between baseline and 3-, 6-, 12-months re-examinations (p > 0.05). The mean bone level reduction in maxilla was 0.33(${\pm}0.25$) at 3-months, 0.36(${\pm}0.33$) at 6-months, 0.56(${\pm}0.26$) at 12-months. And the mean bone level reduction in mandible was 0.35(${\pm}0.27$) at 3-months, 0,49(${\pm}0.27$) at 6-months, 0.68(${\pm}0.30$) at 12-months. No statistical difference in bone level reduction between implants placed in the maxilla and mandible. Histologically, the height of the junctional epithelium was about 2.09 mm. And the width was about 0.51 mm. Scattered fibroblasts and inflammatory cells, and dense collagen network with few vascular structures characterized the portion of connective tissue. The inflammatory cell infiltration was observed just beneath the apical end of junctional epithelium and the area of direct in contact with zirconia/alumina abutment. These results suggest the zirconia/alumina composite abutment can be used in variable intraoral condition, in posterior segment as well as anterior segment without adverse effects.