• Journal of Technologic Dentistry
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• v.34 no.2
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• pp.95-103
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• 2012

Purpose: Fracture strength of all-ceramic 3-unit fixed partial dentures manufactured by CAD/CAM and copy-milling systems were evaluated. Methods: Zirconia cores were made by milling the pre-sintered zirconia block by CAD/CAM or copy milling method followed by subsequent sintering. By building-up the corresponding porcelains on the core, all-ceramic bridges were fabricated, and those were evaluated in comparison with PFM fixed partial denture. Results: During the flexural test of the 3-unit PFM bridge, the porcelain started to chip or break at 507.28(${\pm}62.82$)kgf and the metal framework did not break until the maximum load level of 800kgf which was set in the testing instrument of this study. However, among all-ceramic restoration test groups, Everest(EV) group showed a peeling off or breakage of the porcelain from 365.64(${\pm}64.96$)kgf and the core was broken at 491.77(${\pm}55.62$)kgf. Those values of Zirkonzahn(ZR) were 431.03(${\pm}58.47$)kgf and 602.74(${\pm}48.44$)kgf, respectively. The break strength of the porcelain of PFM(PM) group was significantly higher than that of EV (p<0.05) group and there was no significant difference when comparing to that of ZR (p>0.05). ZR group showed higher break strength than that of EV group however there was no significant difference (p>0.05). The break strength of cores were in the increasing order of EV < ZR < PM (p<0.05). Conclusion: We could find that even though the PM group fractured at much higher value than all-ceramic cores, the breakage values of the porcelain of PM group with crack formation or delamination, which will be regarded as clinical failure, was significantly higher than that of EV group and not significantly higher than that of ZR group at p-values of 0.05. The break strength of ZR group was higher than that of EV group at an insignificant level(p>0.05).

• Journal of Technologic Dentistry
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• v.33 no.3
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• pp.203-210
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• 2011

Purpose: The purpose of this study was to compare color correspondence of different sizes of Vita Mark II$^{(R)}$ and TriLuxe$^{(R)}$ Feldspar blocks. Methods: The three commercially available shades(1M2, 2M2, 3M2) of Mark II & TriLuxe blocks for the CEREC$^{(R)}$ CAD/CAM system were examined. For each of three colors, three different sizes were tested, 5 blocks each. The measurements were made using a spectrophotometer equipped with an integrating sphere using the CIE $L^*$, $a^*$, $b^*$ colorimetric system. Results: The $L^*$, $a^*$, $b^*$ value of Vita Mark II$^{(R)}$ ceramic block showed significantly higher than TriLuxe$^{(R)}$ ceramic block(p<0.05). In comparing the Vita Mark II$^{(R)}$ specimen of the three different shade, color differences between materials(${\Delta}E^*$) showed the lowest value of 2.09, and the highest was 2.24. ${\Delta}E^*$ values of the materials of Vita Mark II$^{(R)}$ were higher than 2. As the size of ceramic block differed, the color correspondence of Vita Mark II$^{(R)}$ showed statistically significant difference but, this result is clinically acceptable. Conclusion: All the different sizes of the different shades of Vita TriLuxe$^{(R)}$ blocks for the CEREC$^{(R)}$ system showed the high degree of color correspondence necessary in industrially prefabricated CAD/CAM blocks. The results of the present study suggested that it would be necessary to establish the reproducible and constant color specification system for an esthetic restoration.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.4
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• pp.454-464
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• 1999

The metal ceramic crown is currently the most popular complete veneer restoration in dentistry, but in many cases, the metal cervical collar at the facial margin is unesthetic and unacceptable. Facial porcelain margin has been used in place of it. But this dose not solve the problems, such as dark gingival discoloration and cervical opaque reflection of porcelain veneer. Recently, metal copings which were designed to terminate its labio-cervical end on the axial walls coronal to the shoulder have been clinically used to solve the esthetic problem of metal ceramic crown. But in this design, porcelain veneer of labio-cervical area which is not supported by metal may not be able to resist the stress during cementation and mastication. The purpose of this study was to evaluate fracture strength and fractured appearance of crowns according to different coping designs. A resin maxillary left central incisor analogue was prepared for a metal ceramic crown, and metal dies were made with duplication mold. Metal copings were made and assigned to one of four groups based on facial framework designs: group 1, coping with 0.5mm metal collar; group 2, metal extended to the shoulder; group 3, metal extended to 1mm coronal tn the shoulder: group 4, metal extended to 2mm coronal to the shoulder. Copings and crowns were adjusted to be same size and thickness, and cemented to metal dies with zinc phosphate cement by finger pressure. Fracture strength was measured with Instron Universal Testing Machine. Metal dies were anchored in Three-way-vice at 3mm below finish line and at $130^{\circ}$ inclined to the long axis of the crown. Load was directed lingually at 2mm below midincisal edge. Load value at initial crack and at catastrophic fracture was recorded. The results obtained were as follows : 1. Fracture strength values at initial crack were higher in groups 1, 2 than in groups 3, 4 but this difference was not statistically significant(P<0.05). 2. Conventional metal collared crown had greater catastrophic fracture strength than any other collarless crowns. 3. The greater the labial metal coping reduction, the lower the catastrophic fracture strength of crowns but when more than 1mm of labial metal reduction was done, the difference in strengths was not statistically significant(p<0.05). 4. The strongest collarless coping design was group 2.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.416-422
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• 2017

PURPOSE. To investigate the effect of reducing tooth preparation and ceramic thickness on fracture resistance of lithium disilicate crowns. MATERIALS AND METHODS. Specimen preparation included a standard complete crown preparation of a typodont mandibular left first molar with an occlusal reduction of 2 mm, proximal/axial wall reduction of 1.5 mm, and 1.0 mm deep chamfer (Group A). Another typodont mandibular first molar was prepared with less tooth reduction: 1 mm occlusal and proximal/axial wall reduction and 0.8 mm chamfer (Group B). Twenty crowns were milled from each preparation corresponding to control group (n=5) and conditioned group of simultaneous thermal and mechanical loading in aqueous environment (n=15). All crowns were then loaded until fracture to determine the fracture load. RESULTS. The mean (SD) fracture load values (in Newton) for Group A were 2340 (83) and 2149 (649), and for Group B, 1752 (134) and 1054 (249) without and with fatigue, respectively. Reducing tooth preparation thickness significantly decreased fracture load of the crowns at baseline and after fatigue application. After fatigue, the mean fracture load statistically significantly decreased (P<.001) in Group B; however, it was not affected (P>.05) in Group A. CONCLUSION. Reducing the amount of tooth preparation by 0.5 mm on the occlusal and proximal/axial wall with a 0.8 mm chamfer significantly reduced fracture load of the restoration. Tooth reduction required for lithium disilicate crowns is a crucial factor for a long-term successful application of this all-ceramic system.

• The Journal of Advanced Prosthodontics
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• v.9 no.4
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• pp.252-256
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• 2017

PURPOSE. This in vitro study aimed to analyze and compare the reproducibility of zirconia and lithium disilicate crowns manufactured by digital workflow. MATERIALS AND METHODS. A typodont model with a prepped upper first molar was set in a phantom head, and a digital impression was obtained with a video intraoral scanner (CEREC Omnicam; Sirona GmbH), from which a single crown was designed and manufactured with CAD/CAM into a zirconia crown and lithium disilicate crown (n=12). Reproducibility of each crown was quantitatively retrieved by superimposing the digitized data of the crown in 3D inspection software, and differences were graphically mapped in color. Areas with large differences were analyzed with digital microscopy. Mean quadratic deviations (RMS) quantitatively obtained from each ceramic group were statistically analyzed with Student's t-test (${\alpha}=.05$). RESULTS. The RMS value of lithium disilicate crown was $29.2\;(4.1){\mu}m$ and $17.6\;(5.5){\mu}m$ on the outer and inner surfaces, respectively, whereas these values were $18.6\;(2.0){\mu}m$ and $20.6\;(5.1){\mu}m$ for the zirconia crown. Reproducibility of zirconia and lithium disilicate crowns had a statistically significant difference only on the outer surface (P<.001). The outer surface of lithium disilicate crown showed over-contouring on the buccal surface and under-contouring on the inner occlusal surface. The outer surface of zirconia crown showed both over- and under-contouring on the buccal surface, and the inner surface showed under-contouring in the marginal areas. CONCLUSION. Restoration manufacturing by digital workflow will enhance the reproducibility of zirconia single crowns more than that of lithium disilicate single crowns.

• The Journal of Advanced Prosthodontics
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• v.4 no.3
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• pp.162-169
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• 2012

PURPOSE. Fracture of the veneering material of zirconia restorations frequently occurs in clinical situations. The purpose of this in vitro study was to compare the fracture strengths of zirconia crowns veneered with various ceramic materials by various techniques. MATERIALS AND METHODS. A 1.2 mm, $360^{\circ}$ chamfer preparation and occlusal reduction of 2 mm were performed on a first mandibular molar, and 45 model dies were fabricated in a titanium alloy by CAD/CAM system. Forty-five zirconia copings were fabricated and divided into three groups. In the first group (LT) zirconia copings were veneered with feldspathic porcelain by the layering technique. In the second group (HT) the glass ceramic was heat-pressed on the zirconia coping, and for the third group (ST) a CAD/CAM-fabricated high-strength anatomically shaped veneering cap was sintered onto the zirconia coping. All crowns were cemented onto their titanium dies with Rely $X^{TM}$ Unicem (3M ESPE) and loaded with a universal testing machine (Instron 5583) until failure. The mean fracture values were compared by an one-way ANOVA and a multiple comparison post-hoc test (${\alpha}$= 0.05). Scanning electron microscope was used to investigate the fractured interface. RESULTS. Mean fracture load and standard deviation was $4263.8{\pm}1110.8$ N for Group LT, $5070.8{\pm}1016.4$ for Group HT and $6242.0{\pm}1759.5$ N for Group ST. The values of Group ST were significantly higher than those of the other groups. CONCLUSION. Zirconia crowns veneered with CAD/CAM generated glass ceramics by the sintering technique are superior to those veneered with feldspathic porcelain by the layering technique or veneered with glass ceramics by the heat-pressing technique in terms of fracture strength.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.192-198
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• 2014

This case is a porcelain laminate veneer (PLV) and all-ceramic crown treatment case on a female patient in her thirties who visited for esthetic improvement. The patient's chief complaint was protrusive and uneven anterior teeth, and she wanted minimum tooth reduction. The patient was in skeletal class II deep bite. Considering this, check bite method was used for mounting on articulator during diagnostic wax-up. Tooth reduction was done using mock-up base on diagnostic wax-up, and the amount of deletion was checked by index. For the accordance of shade, PLVs were restored in prior to all ceramic crown. After using all-ceramic crown, satisfactory esthetic improvement was obtained.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.231-241
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• 2015

As patients' esthetic expectations increase, there is an increase in demand for cosmetic restorations of anterior and posterior teeth that resemble the natural tooth morphology and color. An example of high-strength all-ceramic systems is zirconia with CAD/CAM application. This case report describes a full-mouth rehabilitation using zirconia all-ceramic crowns supported by upper and lower implants and by a minimal increase in the occlusal vertical dimension in a patient with severe abrasion due to loss of posterior teeth.

• The Journal of Advanced Prosthodontics
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• v.14 no.2
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• pp.96-107
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• 2022

PURPOSE. Microstructural and physico-mechanical characterization of highly translucent zirconia, prepared by milling technology (CAD-CAM) and repeated firing cycles, was the main aim of this in vitro study. MATERIALS AND METHODS. Two groups of samples of two commercial highly-translucent yttria-stabilized dental zirconia, VITA YZ-HT^White (Group A) and Zolid HT + White (Group B), with dimensions according to the ISO 6872 "Dentistry - Ceramic materials", were prepared. The specimens of each group were divided into two subgroups. The specimens of the first subgroups (Group A₁ and Group B₁) were merely the sintered specimens. The specimens of the second subgroups (Group A₂ and Group B₂) were subjected to 4 heat treatment cycles. The microstructural features (microstructure, density, grain size, crystalline phases, and crystallite size) and four mechanical properties (flexural strength, modulus of elasticity, Vickers hardness, and fracture toughness) of the subgroups (i.e. before and after heat treatment) were compared. The statistical significance between the subgroups (A₁/A₂, and B₁/B₂) was evaluated by the t-test. In all tests, P values smaller than 5% were considered statistically significant. RESULTS. A homogenous microstructure, with no residual porosity and grains sized between 500 and 450 nm for group A and B, respectively, was observed. Crystalline yttria-stabilized tetragonal zirconia was exclusively registered in the X-ray diffractograms. The mechanical properties decreased after the heat treatment procedure, but the differences were not statistically significant. CONCLUSION. The produced zirconia ceramic materials can be safely (i.e., according to the ISO 6872) used in extensive fixed prosthetic restorations, such as substructure ceramics for three-unit prostheses involving the molar restoration and substructure ceramics for prostheses involving four or more units. Consequently, milling technology is an effective manufacturing technology for producing zirconia substructures for dental fixed all-ceramic prosthetic restorations.

• Journal of Technologic Dentistry
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• v.45 no.3
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• pp.67-73
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• 2023

Purpose: This in vitro study aimed to evaluate the clinical acceptability of precision of fit of the support thickness of Co-Cr alloy copings fabricated using selective laser melting (SLM). Methods: Thirty dental stone models of maxillary left molar abutments were manufactured, images were taken using a scanner, and a computer-aided design program was used to design the form of a conventional metal ceramic crown coping. Overall, 30 single copings were made from Co-Cr alloy using SLM and divided into three support radius groups (0.1, 0.25, and 0.35 mm) of 10 for each. Digitized data were superimposed with three-dimensional inspection software to quantitatively obtain the machinability of a ceramic crown coping, and visual differences were confirmed using a color map. The root mean square values of the ceramic crown coping group were statistically analyzed using one-way analysis of variance (α=0.05). Results: The precision of fit was superior with 0.25 mm compared with 0.1 mm and 0.35 mm, and the results exhibited significant differences (p<0.05). All specimens showed that various support thicknesses did not exceed the clinically permitted value of 120 ㎛, which mean that more than 0.1 mm and 0.35 mm of support radius for SLM was adequate. Conclusion: The support thickness of Co-Cr alloy restoration fabricated using SLM is shown to affect the adaptation.