• The Journal of Advanced Prosthodontics
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• 제15권1호
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• pp.44-54
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• 2023

PURPOSE. To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. MATERIALS AND METHODS. Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients' preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. RESULTS. Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. CONCLUSION. The high survival and success rates, low number of complications, and the high level of patients' acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the "gold standard" MC crowns.

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.41.1-41.7
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• 2020

Objectives: This study aimed to evaluate the ability of lithium disilicate ceramics to reproduce the A2 shade and to mask A4 substrates. Materials and Methods: Twenty-four discs (8 mm in diameter, shade A2) of high translucency (groups 1-3) and low translucency (groups 4-6) of IPS e.max ceramic with different thicknesses (0.5, 0.75, and 1 mm) were fabricated as monolithic structures. In addition, discs of medium opacity (group 7-8) with different core/veneer combinations (0.3 mm/0.7 mm and 0.5 mm/0.5 mm) were fabricated as bilayer structures. Specimens were superimposed on an A4 substrate (complex). The color changes of the complex were measured using a spectrophotometer on a black background, and the ΔE values of the complex were compared with either the A4 substrate or the A2 shade tab. One-way analysis of variance, the Tukey honest significant difference test, and the Fisher test were used to analyze the data (p < 0.05). Results: Significant between-group differences were found for comparisons to both the A4 substrate and the A2 shade (p < 0.05). When compared with the A4 substrate, the ΔE values in all groups were in the non-acceptable range. When compared with the A2 shade, the ΔE values in all groups, except groups 2 and 3, were in the clinically acceptable range. Conclusions: All translucencies and thicknesses masked the underlying dark substrate. However, the low-translucency IPS e.max Press better reproduced the A2 shade.

• The Journal of Advanced Prosthodontics
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• 제6권3호
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• pp.151-156
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• 2014

PURPOSE. To investigate the microtensile bond strength between two all-ceramic systems; lithium disilicate glass ceramic and zirconia core ceramics bonded with their corresponding glass veneers. MATERIALS AND METHODS. Blocks of core ceramics (IPS e.max$^{(R)}$ Press and Lava$^{TM}$ Frame) were fabricated and veneered with their corresponding glass veneers. The bilayered blocks were cut into microbars; 8 mm in length and $1mm^2$ in cross-sectional area (n = 30/group). Additionally, monolithic microbars of these two veneers (IPS e.max$^{(R)}$ Ceram and LavaTM Ceram; n = 30/group) were also prepared. The obtained microbars were tested in tension until fracture, and the fracture surfaces of the microbars were examined with fluorescent black light and scanning electron microscope (SEM) to identify the mode of failure. One-way ANOVA and the Dunnett's T3 test were performed to determine significant differences of the mean microtensile bond strength at a significance level of 0.05. RESULTS. The mean microtensile bond strength of IPS e.max$^{(R)}$ Press/IPS e.max$^{(R)}$ Ceram ($43.40{\pm}5.51$ MPa) was significantly greater than that of Lava$^{TM}$ Frame/Lava$^{TM}$ Ceram ($31.71{\pm}7.03$ MPa)(P<.001). Fluorescent black light and SEM analysis showed that most of the tested microbars failed cohesively in the veneer layer. Furthermore, the bond strength of Lava$^{TM}$ Frame/Lava$^{TM}$ Ceram was comparable to the tensile strength of monolithic glass veneer of Lava$^{TM}$ Ceram, while the bond strength of bilayered IPS e.max$^{(R)}$ Press/IPS e.max$^{(R)}$ Ceram was significantly greater than tensile strength of monolithic IPS e.max$^{(R)}$ Ceram. CONCLUSION. Because fracture site occurred mostly in the glass veneer and most failures were away from the interfacial zone, microtensile bond test may not be a suitable test for bonding integrity. Fracture mechanics approach such as fracture toughness of the interface may be more appropriate to represent the bonding quality between two materials.

• 대한치과의사협회지
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• 제58권7호
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• pp.413-434
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• 2020

Recently, there are much improvement in optical and mechanical properties of dental ceramic materials coupled with improved fabrication techniques, which have caused a considerable shift in the preference of the dentists to ceramic restorations. Because the chemical composition and microstructure of all-ceramic materials are different by the type, correct choice of cement type and surface treatment procedure, and cementation strategy is essential for the success of ceramic restorations with adequate retention and decreased incidence of complications. This manuscript reviews on the most often prescribed and some newly developed ceramic materials, and the selection criteria and usage guidelines of cement materials that are used in conjunction with various ceramic materials. This manuscript emphasizes that continuous updating the information of newly developed ceramic and cement materials and application techniques by the dentists and dental staffs are demanding in response to the constantly improving ceramic and cement materials and corresponding application protocol changes.

• 대한치과보철학회지
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• 제54권3호
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• pp.226-233
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• 2016

목적: 본 연구는 수복물의 적합도를 계측하는 두 가지 측정방법을 평가하기 위해 CAD-CAM (computer aided design-computer aided manufacturing)과 열가압 소성법으로 전부 도재관을 제작하고 micro CT와 cross-section technique으로 전부 도재관의 적합도를 비교하고자 하였다. 재료 및 방법: 하악 제 1대구치 레진 치아를 전부 도재관을 위한 지대치를 형성하고 PMMA (polymethylmethacrylate) 레진 블록을 가공하여 10개의 시편을 복제하였다. 복제한 레진 다이의 인상을 채득하고 모형을 제작하여 5개는 열가압 소성법으로 IPS e.max Press (Ivoclar Vivadent, Schaan, Liechtenstein) 도재관을 제작하였다. 다른 5개의 시편은 CAD-CAM 가공법(Ceramil motion 2, Amann Girrbach, Koblach, Austria)을 이용하여 IPS e.max CAD 도재관을 제작하였다. 각 레진 다이에 전부 도재관을 인산아연 시멘트(Fleck's zinc cement, Keystone industries, Gibbstown, NJ, USA)로 손가락 압력에 의해 합착하였다. 변연 및 내면 적합도를 측정하기 위해서 합착된 시편 10개를 먼저 micro CT로 촬영하여 협-설 시상면의 영상정보를 획득하였다. 그 후 절단 시편을 만들어 주사전자현미경으로 micro CT와 동일한 지점의 간극을 측정하였다. SPSS 22.0 프로그램을 이용하여 각 측정 지점에서 제작 방식별, 측정 방식별로 Mann-Whitney 검정 방법을 통해 유의차 검증을 시행하였다. 결과: Micro CT와 주사전자현미경으로 측정한 변연 및 내면 적합도는 유사하였으며, 통계적으로 유의한 차이를 보이지 않았다. 두 가지 제작법의 도재관은 변연 및 내면 적합도에 유의한 차이가 없었다. 결론: CAD-CAM과 열가압소성으로 제작한 전부 도재관은 적합도에 차이를 보이고 있지 않으며, Micro CT와 주사전자현미경을 이용한 측정 방식 모두 임상적으로 이용 가능할 것으로 사료된다.

• 대한치과의사협회지
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• 제56권3호
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• pp.159-166
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• 2018

지르코니아 강화 리튬 실리케이트 세라믹 재료는, 현재 널리 사용되고 있는 e.max(리튬디실리케이트 세라믹) 재료에 비하여 더 개선된 강도를 지니고 있다. 단일 크라운의 수복에 사용될 수 있으며, 1.5mm 의 두께를 확보하는 것이 예지성 있는 치료를 위해 매우 중요하다. Celtra Duo의 경우 열처리를 수행하는 것이 강도나 마모 저항성 측면에서 도움이 될 것이다. 접착을 위해서는 불산의 처리가 도움이 되며, 너무 짧은 시간의 불산은 접착 강도의 개선에 도움을 주지 못할 수 있으므로 충분한 시간의 불산 처리가 필요하다. 지르코니아 강화 리튬 실리케이트 세라믹 재료는 실험실 연구가 지속적으로 수행되고 출판되고 있지만, 아직 신뢰할만한 임상연구는 매우 부족한 실정이다. 추가적인 임상연구를 통해 과학적인 근거를 마련하는 것이 매우 중요한 부분이 될 것이다.

• The Journal of Advanced Prosthodontics
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• 제11권1호
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• pp.23-31
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• 2019

PURPOSE. To investigate and compare the surface roughness (SR), weight and height of monolithic zirconia (MZ), ceramometal (CM), lithium disilicate glass ceramic (LD), composite resin (CR), and their antagonistic human teeth enamel. MATERIALS AND METHODS. 32 disc shaped specimens for the four test materials (n=8) and 32 premolars were prepared and randomly divided. SR, weight and height of the materials and the antagonist enamel were recorded before and after subjecting the specimens to 240,000 wear-cycles ($49N/0.8Hz/5^{\circ}C/50^{\circ}C$). SR, height, weight, and digital microscopic qualitative evaluation were measured. RESULTS. CM ($0.23+0.08{\mu}m$) and LD ($0.68+0.16{\mu}m$) exhibited the least and highest mean difference in the SR, respectively. ANOVA revealed significance (P=.001) between the materials for the SR. Paired T-Test showed significance (P<.05) for the pre- and post- SR for all the materials. For the antagonistic enamel, no significance (P=.987) was found between the groups. However, the pre- and post- SR values of all the enamel groups were significant (P<.05). Wear cycles had significant effect on enamel weight loss against all the materials (P<.05). CR and MZ showed the lowest and highest height loss of 0.14 mm and 0.46 mm, respectively. CONCLUSION. MZ and CM are more resistant to SR against the enamel than LD and CR. Enamel worn against test materials showed similar SR. Significant variations in SR values for the tested materials (MZ, LD, CM, and CR) against the enamel were found. Wear simulation significantly affected the enamel weight loss against all the materials, and enamel antagonist against MZ and CM showed more height loss.

• The Korean Journal of Ceramics
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• 제5권4호
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• pp.363-367
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• 1999

New glass ceramics were investigated for the application as substrates to be used in hard disk devices. The glass system to precipitate lithium di-silicate was studied so as to optimize the composition to realize very high surface flatness. The addition of small amount of several metal oxides with high valences had very drastic effects on the microstructure, because they played a role of crystallization agents, and consequently it determined surface flatness even after the polishing process. The possible mechanism changes of crystal growth due to the addition of metal oxides were discussed in relation to the final micro-texture development. The glass ceramics with very high surface flatness(Ra=7.1 $\AA$) was obtained by the addition of the mixture of $P-2O_5 \;and \;MoO_3$ as crystallization agents.

• 한국세라믹학회지
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• 제27권4호
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• pp.521-528
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• 1990

Li2O.2SiO2 glass-ceramics were made from the melt by the nucleation and growth treatment. The optimum nucleation temperature and time were determined from DTA curves of as-quenched and thermally treated glasses, and found to be 44$0^{\circ}C$ and 3hrs. The optical microscopic technique was also used to support this result. The volume fractions of crystals present in the partially crystallized specimens were measured using the optical microscopy and the amorphous X-ray scattering methods. The degree of crystallization increased with increasing the crystallization temperature and time. The crystalline phase identified by X-ray diffraction was lithium disilicate. As the crystallinity increased up to 95%, the transmittance of glass-ceramics was decreased linearly. It was also found that for the same heat treatment condition (575$^{\circ}C$, 30min), a thicker specimen showed higher transmittance, presumably due to less crystallinity.

• The Journal of Advanced Prosthodontics
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• 제9권6호
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• pp.423-431
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• 2017

PURPOSE. The goal of this study was to evaluate the fracture resistances of various monolithic crowns fabricated by computer-aided design and computer-aided manufacturing (CAD/CAM) with different thickness. MATERIALS AND METHODS. Test dies were fabricated as mandibular molar forms with occlusal reductions using CAD/CAM. With different occlusal thickness (1.0 or 1.5 mm), a polymer-infiltrated ceramic network (Enamic, EN), and zirconia-reinforced lithium silicate (Suprinity, SU and Celtra-Duo, CD) were used to fabricate molar crowns. Lithium disilicate (e.max CAD, EM) crowns (occlusal: 1.5 mm) were fabricated as control. Seventy crowns (n=10 per group) were bonded to abutments and stored in water for 24 hours. A universal testing machine was used to apply load to crown until fracture. The fractured specimens were examined with a scanning electron microscopy. RESULTS. The type of ceramics and the occlusal thickness showed a significant interaction. With a recommended thickness (1.5 mm), the SU revealed the mean load similar to the EM, higher compared with those of the EN and CD. The fracture loads in a reduced thickness (1.0 mm) were similar among the SU, CD, and EN. The mean fracture load of the SU and CD enhanced significantly when the occlusal thickness increased, whereas that of the EN did not. CONCLUSION. The fracture loads of monolithic crowns were differently influenced by the changes in occlusal thickness, depending on the type of ceramics. Within the limitations of this study, all the tested crowns withstood the physiological masticatory loads both at the recommended and reduced occlusal thickness.