Under the fee for service schedule of Korean health insurance system, rational fee for dental laboratory products based on the cost is required to be formulated. The purpose of this study was to find actual cost of dental laboratory products in case of a University Hospital. Materials of this study were used as follows : 1. Balance sheet at Dec. 31, 1992 and profit and loss report of the year 1992 of the sample hospital 2. Performance report of dental laboratory department. 3. Purchasing and other accounting bills of dental laboratory materials. The following methods were used. 1. Actual cost finding of dental laboratory department was performed. 2. Work sampling methods were used for measuring standard working time by the process of working. 3. To porcelain fused to metal crown(non-precious), Relative value of the cost of dental laboratory products was calculated as 1.00. 4. Fee and cost of those products were compared on the basis of Relative values. The results of the study can be summarized as follow : 1. Overall, it took longs time than other items. to product denture-related items. 2. When several teeth are made in a time, average production time is much sorter than when one tooth is made in a time. 3. The relative price cost of Dicor cast crown and denture related items are higher than the criterion items. 4. The material cost occupies average 11% out of the total price cost, proportion of personnel expenses is average as 60.0%. 5. Some of the components consisting of the price cost are not reflected adequately in setting the level of the reimbursement price. 6. Relative values of dental laboratory products price cost are varied in the range from 0.05 to 2.83, overall, the reimbursement price of dental products appears not to reflect adequately the price cost. On the basis of this study results, the following ideas would be suggested : 1. Fee Schedule of dental laboratory products should be renovated in order to reflect their costs. 2. Dental laboratory product manufacturers should be enlarged for the economy of scale which may be useful for cost- containment. 3. Dental laboratory producters themselves are required to be standardiqed according to the categories of skill.
Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.
This study was to analyze the stress distribution of implant and supporting tissue in $Br{\aa}nemark$ osseointegration implant. The analysis has been conducted by using the axisymmetric finite element method and type of model according to crown material. Tests have been performed at 1 kg load on central fossa of crown portion. Each type of model was designed differently according to crown material. 1) Porcelain fused to metal crown(Model A) 2) Composite resin veneered crown(Model B) 3) Acrylic resin veneered crown(Model C) 4) Type III gold crown(Model D) The displacements and stresses of implant and supporting structures were analyzed to investigate the influence of the type of crown material. The results were obtained as follows : 1. Displacement of implant was shown uniformly downward displacement in all models and abutments were observed distally downward displacement. 2. In supporting tissues, stress was concentrated on the crest of compact bone and the spongy bone below implant. 3. The PFM and the type III gold crown showed the largest concentration of stress at the crest of compact bone and the spongy bone below implant, respectively. Acrylic resin artificial teeth and composite resin veneered crown indicated almost the same distribution of stress. 4. The gold screw, the abutment screw and the top of abutment showed the concentration of stress in implants of every model.
The author studied the actual conditions on the production of dental prosthesis made in laboratories, and also studied interrelationships between dentists and laboratory technicians in both personal and technical aspects. Two hundred-eighty four technicians, work in dental laboratories presently, were surveyed via mail and direct contact during the period from June 1 to June 30 and August 27 to August 28 in 1994 respectively. The obtained results were as follows : 1. Among the respondents, 90.5% we re working in commercial dental laboratories and their laboratories were mainly located in the Seoul area(40.9%, P<0.05). The numbers of employees in these laboratories were less than 10 persons(70.0%, P<0.01), and 75.9% of these laboratories have been in operation less than 15 years. 2. Most laboratory procedures were accomplished according to established disciplines. However, procedures such as die trimming in fixed restorations and the qualifications of the people designing removable partial dentures were not. Other problem areas were boxing of the working cast, the person determining the posterior palatal seal area, selection and arrangement of artificial teeth, occlusion rim correction and laboratory remounting of the processed denture in complete denture restorations. 3. Only half of the requesting dentists could send work authorizations to the laboratories with their work and even so, its contents were quite lacking. Consequently, there must be some standards in writing work authorization. 4. Technicians most desired clean and accurate impressions in fixed and removable dentures, and enough tooth reduction in porcelain fused to metal restorations. 5. For the establishment of better relationships between dentist and dental technician, the respondents desired the establishment of equal footing first(33.5%), and frequent conversations and muture understanding second(25.9%).
Purpose: Standards of alloy for porcelain fused to metal crown be classified by metallic factor and biological factor. Metallic factors consist of stability of alloy composition and mechanical strength and surface characteristics for chemical bond. Biological factors be considered properties of metallic elements and problems originated by toxicity and hypersensitive reaction. Alloys considered such controversial points are the most suitable alloy for dental instrument. Method: Alloys added Be and Nb using Ni-Cr alloy which has been widely used for dental instrument be selected and classified experimental group. Non-addition Be and Nb to Ni-Cr alloy classify control group and addition Be alloy is Be-experimental group, addition Nb alloy is Nb-experimental group. Specimens for cytotoxicity analysis gave effect to washing and sterilization. and then made an experiment on elution with cell medium after disinfection. It conducted specimens within cell medium with 24hours, 48hours, 72hours, respectively. It cultured human dermal fibroblast(HDF) using cell medium for cytotoxicity test and then investigated elution rate through spectroscopic analysis by MTT-assay. Result: As results of cytotoxicity test by MTT-assay, cultured cell rate of VII measured more low numerical value within elution medium for 24hours focused on control group. Also, cultured cell rate of K3 alloys observed low value for 48hours, 72hours than value of control group. Conclusion: According to final result that synthesize above results, Ni-Cr alloy added Be and Ni has little difference in Cytotoxicity by MTT-assay.
All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at $55^{\circ}$ at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at ${\times}50$ power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram($112{\mu}m$) exhibited significantly greater marginal discrepancy than In Ceram ($97{\mu}m$), and IPS Empress 2 ($94{\mu}m$) at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and accept able marginal fit values to allow clinical application.
An investigation was made Into 1,357 fixed bridges which had been performed at the Department of Prosthetic Dentistry, Seoul National University Hospital from 1973 to 1979. The purpose of this investigation was to establish a basic reference of the treatment with fixed bridges by obtaining statistical conclusions from the data concerning the patients who had been treated with fixed bridges. The following conclusions were obtained; 1. The ratio of the fixed bridges made on the maxillae to those made on the mandible was 1:1. 2. The cases of fixed bridges with one pontic were the most frequent, i.e., 946 cases out of total 1,357 cases, which were 69.7% of the total. 3. As the number of missing teeth increased, the number of the relevant cases of fixed bridges decreased. 4. The most frequent age group of the patients who had been treated with fixed bridges was the twenties, which was 40.8% of the total. As the age of the patients increased, the number of corresponding cases of fixed bridges decreased. 5. Most of the fixed bridges with more than three pontics were made at the anterior portion samely on the maxilla and on the mandible. 6. As for the retainers, the porcelain fused to metal crown and the partial veneer crown were frequently used at the anterior portion, while the full veneer crown was frequently used and the inlay and the attachment were used in some cases at the posterior portion. The locations of fixed bridges in the order of their frequency were: canine, lateral incisor, second bicuspid, central incisor, second molar, first bicuspid, first molar, and third molar on the maxilla; second bicuspid, second molar, first bicuspid, first molar, canine, third molar, lateral incisor, and central incisor on the mandible.
Weigl, Paul;Trimpou, Georgia;Grizas, Eleftherios;Hess, Pablo;Nentwig, Georg-Hubertus;Lauer, Hans-Christoph;Lorenz, Jonas
The Journal of Advanced Prosthodontics
/
v.11
no.1
/
pp.48-54
/
2019
PURPOSE. The aim of the present randomized controlled study was to compare prefabricated all-ceramic, anatomically shaped healing abutments followed by all-ceramic abutments and all-ceramic crowns and prefabricated standard-shaped (round-diameter) titanium healing abutments followed by final titanium abutments restored with porcelain-fused-to-metal (PFM) implant crowns in the premolar and molar regions. MATERIALS AND METHODS. Forty-two patients received single implants restored either by all-ceramic restorations (test group, healing abutment, final abutment, and crown all made of zirconia) or conventional titanium-based restorations. Immediately after prosthetic incorporation and after 12 months of loading, implant survival, technical complications, bone loss, sulcus fluid flow rate (SFFR) as well as plaque index (PI) and implant stability (Periotest) were analyzed clinically and radiologically. RESULTS. After 12 months of loading, an implant and prosthetic survival rate of 100% was observed. Minor prosthetic complications such as chipping of ceramic veneering occurred in both groups. No statistical significant differences were observed between both groups with only a minimum of bone loss, SFFR, and PI. CONCLUSION. All-ceramic implant prostheses including a prefabricated anatomically shaped healing abutment achieved comparable results to titanium-based restorations in the posterior region. However, observational results indicate a benefit as shaping the peri-implant soft-tissue with successive provisional devices and subsequent compression of the soft tissue can be avoided.
Journal of the Korean Academy of Esthetic Dentistry
/
v.22
no.1
/
pp.30-46
/
2013
Porcelain fused to metal crown has been used mostly over the last 50 years for restorations in dentistry. However, the patients' awareness of aesthetic aspect, biocompatibility and the problems such as an allergy to metals led to the growing interest in the 'metal free restoration'. In particular, the price of the precious metals that have been mainly used to date has risen drastically, which made them impossible to play their role as oral restorative materials anymore, and in addition, the PFM restoration has intrinsic problems of chipping and fracture. Therefore, the CAD/CAM has been drawing more attention than ever due to the popular needs for the material that is more aesthetic and stronger for restoration of the molar implant. Considerations in carrying out the full zirconia restoration are as follows: 1) strength, 2) combination work, 3) light penetrability, 4) treatment of cracks, 5) the color reproducibility of the block, 6) the abrasivity of antagonistic tooth, 7) low temperature degradation. In this presentation, the color reproducibility of the block will be discussed. One of the biggest reasons for avoiding the full zirconia restoration is that it is difficult to reproduce the natural color compared to the conventional PFM restoration. Thus, many clinicians show reluctance due to the exposure of the ugly block when the coloring on the surface is removed after occlusal adjustment. From the experience of using blocks by Zirkonzahn for more than 4 years, it is considered that these problems can be addressed to some degrees. Accordingly, how to make restorations that are well in harmony with surrounding prosthesis or natural teeth will be discussed.
The purpose of this study was to determine if repeated casting has a detrimental effect on the corrosion behavior of nickel-chrome casting alloys. The X-ray diffraction analysis, vickers hardness test, SEM, EDX and corrosion test were performed to determine the effects of recasting on chemical composition, microstructure, physical property, castability and corrosion behavior of nickel-chrome casting alloys. The X-ray diffraction analysis results for the cast and recast specimens of the VeraBond and the Rexillium V showed that major crystal phase contained nickel-chrome compounds, Nickel carbide and Chrome carbide. Microstructure analysis results for the cast and recast specimens of the VeraBond and the Rexillium V showed recasting has no effect on microstructure. EDX analysis results indicated the percentage of the main component nickel(Ni) in the specimens of the VeraBond showed a tendency to increase with recasting, but those of other components Carbon(C) showed a tendency to decrease with recasting, Chrome(Cr), Silicon(Si), Aluminium(Al) and molybdenum(Mo) showed no changes in the percentage. The percentage of the main component nickel(Ni) in the specimens of the Rexillium V showed a tendency to increase with recasting, but those of other components silicon(Si), carbon(C) and molybdenum(Mo) showed a tendency to decrease with recasting, chrome(Cr) and aluminium(Al) showed no changes in the percentage. The vickers hardness results for the cast and recast specimens of the VeraBond and the Rexillium V showed a tendency to decrease with recasting, but the differences for the first to fifth cast were not statistically significant. The castability results for the cast and recast specimens of the VeraBond and the Rexillium V showed a tendency to decrease with recasting, but the differences for the first to fifth cast were not statistically significant. The cast and recast specimens of the VeraBond and the Rexillium V showed no differences in the corrosion resistance. The results indicate that the VeraBond and the Rexillium V can be safely recast.
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