• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.226-233
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• 2016

Purpose: The purpose of this study was to evaluate the adaptation of lithium disilicate crowns fabricated by CAD-CAM (computer aided design-computer aided manufacturing) and heat-press technique to compare two different measurement methods in assessing fit of the ceramic crowns: micro CT and cross-section technique. Materials and methods: A prepared typodont mandibular molar for ceramic crown was duplicated and ten dies were produced by milling the PMMA (polymethylmethacrylate) resin. Ten vinyl polysiloxane impressions were made and stone casts were produced. Five dies were used for IPS e.max Press crowns with heat-press technique. The other five dies were used for IPS e.max CAD crowns with CAD-CAM technique. Ten lithium disilicate crowns were cemented on the resin dies using zinc phosphate cement with finger pressure. The marginal and internal fits in central buccolingual plane were evaluated using a micro CT. Then the specimens were embedded and cross-sectioned and the marginal and internal fits were measured using scanning electronic microscope. The two measurement methods and two manufacturing methods were compared using Mann-Whitney U test (SPSS 22.0). Results: The marginal and internal fit values using micro CT and cross-section technique were similar, showing no significant differences. There were no significant differences in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique. Conclusion: Both micro CT and cross-section technique were acceptable methods in the evaluation of marginal and internal fit of lithium disilicate crown. There was no difference in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique except occlusal fit.

• The Journal of Advanced Prosthodontics
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• v.11 no.2
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• pp.105-111
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• 2019

PURPOSE. Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS. A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with $0.7{\mu}L$ of polymicrobial culture (P. gingivalis, T. forsythia, T. denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (${\alpha}=.05$). RESULTS. Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in ${\mu}m$) of the groups were in the range of 2.7-4.0 (IC-Zr), 1.8-5.3 (IC-Ti), 6.5-17.1 (IT-Zr), 5.4-12.0 (IT-Ti), 16.8-22.7 (EH-Zr), and 10.3-15.4 (EH-Ti). CONCLUSION. The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design.

• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.253-258
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• 2014

PURPOSE. To compare marginal and internal gaps of zirconia substructure of single crowns with those of three-unit fixed dental prostheses. MATERIALS AND METHODS. Standardized Co-Cr alloy simulated second premolar and second molar abutments were fabricated and subsequently duplicated into type-III dental stone for working casts. After that, all zirconia substructures were made using $Lava^{TM}$ system. Marginal and internal gaps were measured in 2 planes (mesial-distal plane and buccal-palatal plane) at 5 locations: marginal opening (MO), chamfer area (CA), axial wall (AW), cusp tip (CT) and mid-occlusal (OA) using Replica technique. RESULTS. There were significant differences between gaps at all locations. The $mean{\pm}SD$ of marginal gap in premolar was $43.6{\pm}0.4{\mu}m$ and $46.5{\pm}0.5{\mu}m$ for single crown and 3-unit bridge substructure respectively. For molar substructure the $mean{\pm}SD$ of marginal gap was $48.5{\pm}0.4{\mu}m$ and $52.6{\pm}0.4{\mu}m$ for single crown and 3-unit bridge respectively. The largest gaps were found at the occlusal area, which was $150.5{\pm}0.5{\mu}m$ and $154.5{\pm}0.4{\mu}m$ for single and 3-unit bridge premolar substructures respectively and $146.5{\pm}0.4{\mu}m$ and $211.5{\pm}0.4{\mu}m$ for single and 3-unit bridge molar substructure respectively. CONCLUSION. Independent-samples t-test showed significant differences of gap in zirconia substructure between single crowns and three-unit bridge (P<.001). Therefore, the span length has the effect on the fit of zirconia substructure that is fabricated using CAD/CAM technique especially at the occlusal area.

• The Journal of Advanced Prosthodontics
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• v.15 no.3
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• pp.155-170
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• 2023

PURPOSE. This study aims to clinically compare the fitness and trueness of zirconia crowns fabricated by different combinations of open CAD-CAM systems. MATERIALS AND METHODS. Total of 40 patients were enrolled in this study, and 9 different zirconia crowns were prepared per patient. Each crown was made through the cross-application of 3 different design software (EZIS VR, 3Shape Dental System, Exocad) with 3 different processing devices (Aegis HM, Trione Z, Motion 2). The marginal gap, absolute marginal discrepancy, internal gap(axial, line angle, occlusal) by a silicone replica technique were measured to compare the fit of the crown. The scanned inner and outer surfaces of the crowns were compared to CAD data using 3D metrology software to evaluate trueness. RESULTS. There were significant differences in the marginal gap, absolute marginal discrepancy, axial and line angle internal gap among the groups (P < .05) in the comparison of fit. There was no statistically significant difference among the groups in terms of occlusal internal gap. The trueness ranged from 36.19 to 43.78 ㎛ but there was no statistically significant difference within the groups (P > .05). CONCLUSION. All 9 groups showed clinically acceptable level of marginal gaps ranging from 74.26 to 112.20 ㎛ in terms of fit comparison. In the comparison of trueness, no significant difference within each group was spotted. Within the limitation of this study, open CAD-CAM systems used in this study can be assembled properly to fabricate zirconia crown.

• The Journal of Advanced Prosthodontics
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• v.9 no.4
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• pp.271-277
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• 2017

PURPOSE. This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. MATERIALS AND METHODS. Two regular platform dental implants, one with external connection ($Br{\aa}nemark$, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at ${\alpha}=0.05$ of significance. RESULTS. There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups (P<.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom (P<.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments (P<.001). However, neither connection type (P=.15) nor abutment material (P=.38) affected torque loss. CONCLUSION. Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values.

• Journal of Technologic Dentistry
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• v.41 no.3
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• pp.187-193
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• 2019

Purpose: The purpose of this study was to compare two-dimensional fitness of the monolithic zirconia prosthesis by using different type of scanner. Methods: No. 26 abutment tooth of FDI system was selected for the study. Using the extraoral scanner and intraoral scanner, the abutment tooth was scanned 10 times and the scanned files were saved as STL files. CAD/CAM system was used to produce the monolithic zirconia prosthesis. marginal and internal gap of the monolithic zirconia prosthesis were measured by digital microscope(x160) and applied silicone replica technique was applied. t-test, a statistical software, was used to perform data analysis. Results: Marginal gap $mean{\pm}SD$ of the monolithic zirconia prosthesis was $33{\pm}7.5{\mu}m$ with extra oral scanner and $34.7{\pm}11.1{\mu}m$ with intraoral scanner. axial gap mean was $40.5{\pm}3.5{\mu}m$ with extra oral scanner and $44.6{\pm}11.6{\mu}m$ with intraoral scanner. occlusal gap mean was $110.1{\pm}25.4{\mu}m$ with extra oral scanner and $64{\pm}9.7{\mu}m$ with intraoral scanner. Conclusion: In this study, fabricating zirconia prosthesis with different type of scanner was clinically applicable.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.618-629
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• 1998

CAD/CAM-fabricated ceramic restorations nowadays are used as alternatives of amlagam and posterior composite resin restorations, especially in the cases of inlay restorations. But the reported results on marginal and internal fit of CAD/CAM-fabricated ceramic inlay have showed considerable difference. In this study, to evaluate the marginal and internal fit of CEREC2-fabricated ceramic inlay restoration and to compare with the fit of gold inlay and amalgam restoration, standardized Class II MO cavities were prepared in forty extracted caries-free human premolars. The teeth with prepared cavities were divided into 4 groups of ten teeth each. In group 1, CEREC2-fabricated ceramic inlays were treated with Scotchbond Multi-Purpose Plus(SMP plus) and cemented with Scotchbond Resin Cement. In group 2, casted gold inlays were cemented in the same method as in group 1. In group 3, casted gold inlays were cemented with zinc-phosphate cement. And in group 4, the prepared cavities were restored with amalgam. Restored teeth were thermocycled, stored in 1% methylene blue for 24 hours, and sectioned faciolingually and mesiodistally using EXAKT. Sectioned surfaces were observed with stereomicroscope and the gaps were measured at 9 points of mesiodistally sectioned surface and 7 points of faciolingually sectioned surface. The measured data were treated by Kruskal-Wallis one way ANOVA and Student-Newman-Keuls test. 1. The differences among measured gaps at each points were statistically significant for 4 experimental groups (P<0.05). 2. There were statistically significant differences in the measured gaps at each points between group 1 and group 2, group 1 and group 3, group 1 and group 4, group 2 and group 4, and group 3 and group 4 (P<0.05). 3. There were not statistically significant differences in the measured gaps at each points between group 2 and group 3 (P>0.05). 4. In the cases of inlay restorations(group 1, group 2, group 3), the gaps at internal line angle(distopulpal, axiogingival, faciopulpal, linguopulpal line angle) had a tendency to increase. In the cases of amalgam restorations(group 4), the gaps at occlusal margin, gingival margin and axiogingival line angle were greater than those at the other parts of cavities. 5. In CEREC2-fabricated ceramic inlays which were treated with Scotchbond Multi-Purpose Plus and cemented with Scotchbond Resin Cement, the mean gaps were $111{\mu}m$ at cavity margins, $168{\mu}m$ at vertical walls of cavities, $225{\mu}m$ at internal line angles and $123{\mu}m$ at cavity floors.

• Journal of Technologic Dentistry
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• v.40 no.4
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• pp.209-215
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• 2018

Purpose: The purpose of this study was to evaluate the clinical acceptability of the marginal and internal gap of Co-Cr metal copings fabricated with stereolithography (SLA). Methods: Titanium master dies were milled after scanning of the prepared tooth (n=30). For group I, Co-Cr metal copings were made from conventional lost-wax technique(LWT, n=10). For group II, the master dies were scanned and designed with CAD system. Then, metal copings were milled with Co-Cr(SUB, n=10). For group III(ADD, n=10), the scanning and design procedures were same as group II and burn-out resins were fabricated with SLA device. The marginal and internal discrepancies were measured under an optical microscope(100x) on ten reference points and were statistically analyzed with one-way ANOVA(${\alpha}=.05$). Results: The mean total discrepancies were $53.76{\pm}12.42{\mu}m$ in the LWT group and $69.82{\pm}15.48{\mu}m$ in the ADD group. The SUB group showed the largest total mean value $110.33{\pm}13.77{\mu}m$. There was statistically significant difference between the SUB and the other groups(P<0.05). Conclusion : Co-Cr metal copings fabricated with SLA technology showed clinically acceptable value on marginal and internal gap and there was no statistically significant difference between conventional lost-wax technique and SLA.

• The Journal of Advanced Prosthodontics
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• v.10 no.5
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• pp.367-373
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• 2018

PURPOSE. To evaluate the fit of a crown produced based on a 3D printed model and to investigate its clinical applicability. MATERIALS AND METHODS. A master die was fabricated with epoxy. Stone dies were fabricated from conventional impressions (Conventional stone die group: CS, n=10). Digital virtual dies were fabricated by making digital impressions (Digital Virtual die group: VD, n=10). 3D data obtained from the digital impression was used to fabricate 3D printed models (DLP die group: DD, n=10, PolyJet die group: PD, n=10). A total of 40 crowns were fabricated with a milling machine, based on CS, VD, DD and PD. The inner surface of all crowns was superimposed with the master die files by the "Best-fit alignment" method using the analysis software. One-way and 2-way ANOVA were performed to identify significant differences among the groups and areas and their interactive effects (${\alpha}=.05$). Tukey's HSD was used for post-hoc analysis. RESULTS. One-way ANOVA results revealed a significantly higher RMS value in the 3D printed models (DD and PD) than in the CS and DV. The RMS values of PD were the largest among the four groups. Statistically significant differences among groups (P<.001) and between areas (P<.001) were further revealed by 2-way ANOVA. CONCLUSION. Although the fit of crowns fabricated based on the 3D printed models (DD and PD) was inferior to that of crowns prepared with CS and DV, the values of all four groups were within the clinically acceptable range (<$120{\mu}m$).

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.72-81
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• 2024

Purpose: This study aimed to assess the marginal and internal fit of 3-unit monolithic zirconia fixed partial dentures (FPDs) fabricated via computer-aided design and computer-aided manufacturing (CAD/CAM) from solid working casts and removable die system. Materials and Methods: The tooth preparation protocol for a zirconia crown was executed on the mandibular right first premolar and mandibular right first molar, with the creation of a reference cast featuring an absent mandibular right second premolar. The reference cast was duplicated using polyvinyl siloxane impression, from which 20 working casts were fabricated following typical dental laboratory procedures. For comparative analysis, 10 FPDs were produced from a removable die system (RD group) and the remaining 10 FPDs from the solid working casts (S group). The casts were digitized using a dental desktop scanner to establish virtual casts and design the FPDs using CAD. The definitive 3-unit monolithic zirconia FPDs were fabricated via a CAM milling process. The seated FPDs on the reference cast underwent digital evaluation for marginal and internal fit. The Mann-Whitney U test was applied for statistical comparison between the two groups (α = 0.05). Results: The RD group showed significantly higher discrepancies in fit for both premolars and molars compared to the S group (P < 0.05), particularly in terms of marginal and occlusal gaps. Color mapping also highlighted more significant deviations in the RD group, especially in the marginal and occlusal regions. Conclusion: The study found that the discrepancies in marginal and occlusal fits of 3-unit monolithic zirconia FPDs were primarily associated with those fabricated using the removable die system. This indicates the significant impact of the fabrication method on the accuracy of FPDs.