Earticle

Purpose: The purpose of this study is to evaluate the marginal gap of all-ceramic crowns fabricated by CERECⓇ in-office CAD/CAM system. Methods: The mandibular first molar was selected as the abutment for the experiments. Thirty working models were prepared. VITA Mark Ⅱ(VM) and VITA Enamic(VE), LAVA Ultimate(LU) blocks were milled using CEREC MCXL with CEREC 3D system to construct 10 crowns for each groups. To measure marginal gap, milled restorations were examined under digital microscope with scale under 160x magnifications. The results were statistically analyzed using the one-way ANOVA and Tukey’s HSD test(α=0.05). Results: There was no significant difference in the marginal gap regarding to ceramic materials (p>0.05). Conclusion: Single crowns fabricated using CEREC in-office CAD/CAM system provided clinically acceptable marginal gap. This confirmed that the type of ceramic material used does not determine the precision of fit of a prosthesis.

Purpose: The purpose of this in vitro study is to evaluate the clinical acceptability of the marginal discrepancies and internal spacing of multi-layered zirconia prothesis by speed sintering. Methods: The two specimen types come from the same manufacturer but differ in the ingredients in layered zirconia and indication, that is anterior and posterior. The designs of both specimens were full contour crowns, and a total of 20 pieces were repeatedly fabricated, 10 for each group. The specimens were divided into two subgroups (n=10) and sintered with various total times (4 hours, 8 hours) at the maximum temperature (1,530℃). The gap between the two groups of multi-layered zirconia prostheses was measured using a silicone replica technique of 2D analysis method. The independent sample t-test was then used to compare and analyze the data obtained from the two groups (α=0.05). Results: The marginal and internal gap was superior in the 8-hour compared to the 4-hour group, and the results exhibited significant differences (p<0.05). All specimens showed that using the speed sintering schedule does not exceed the clinically permitted value of 120 μm, meaning zirconia prothesis using the speed sintering was adequate. Conclusion: The sintering condition is shown to affect the marginal and internal gaps of multi-layered zirconia restoration.

Purpose: The objectives of this study was to evaluate clinical adaptation of dental prostheses printed by 3 dimensional(3D) printing technology. Methods: Ten study models were prepared. Ten specimens of experimental group were printed by 3D printing(3DP group). As a control group, 10 specimens were fabricated by casting method on the same models. Marginal gaps of all specimens were measured to evaluate clinical adaptation. Marginal adaptations were measured using silicone replica technique and measured at 8 sites per specimen. Wilcoxon’s signed-ranks test was used for statistical analysis(α = 0.05). Results: Means of marginal adaptations were 95.1μm for 3DP group and 75.9μm for CAST group(p < 0.000). Conclusion : However, the mean of the 3DP group was within the clinical tolerance suggested by the previous researchers. Based on this, dental prosthesis fabricated by 3D printing technology is considered to be clinically acceptable.

Purpose: The purpose of this study were to evaluate the quality of dental prostheses printed by 3-dimensional printing system. Methods: Mater model was prepared and ten study models were fabricated. Ten single crowns were printed by 3D-printing system(Resin group) and another ten single crowns using casting method were manufactured(Metal group). The marginal adaptation of single crowns were measured using by silicone replica technique. Silicone replicas were sectioned four times. The marginal adaptations were evaluated using by digital microscope. Statistical analyses were performed with Mann-Whitney test(α=0.05). Results: Mean ± standard deviations of all marginal adaptations were 92.1(20.0)㎛ for Metal group and 69.7(12.3)㎛ for Resin group. Two groups were no statistically significant differences(p>0.05). Conclusion: Marginal adaptation of single crowns printed by 3D-printing system were ranged within the clinical recommendation.

Purpose: The purpose of this study was analysis of quality of fixed prostheses fabricated by dental CAD/CAM system. Methods: The ten same cases of stone models were manufactured by dental scannable model, and stone models were scanned using the dental scanner for changing digital model. Ten digital models were completed. The design of zirconia core for zirconia based all-ceramic crown was conducted by the dental CAD program. The samples were fabricated using the pre-sintered zirconia block by dental milling machine. Marginal gaps were analyzed using by silicone replica technique at the eight parts for quality analysis of samples. One-way ANOVA was used for statistical analysis(a =0.05). Results: The mean for marginal gaps were 93.2~99.1㎛ at the eight parts. One-was ANOVA didn’t show significant differences(p=0.089). Conclusion: The fixed dental prostheses fabricated by dental CAD/CAM were within clinically acceptable range.

Purpose: The aim of this study was to evaluate the marginal and internal gap of wax copings fabricated from extraoral scanning with intraoral scanning. Methods: Fifteen study models(abutment of teeth 16) were made by PMMA. STL files of thirty abutment were prepared by intraoral scanning with extraoral scanning. Wax copings of thirty fabricated using CAD/CAM system. Marginal and internal gap of wax copings of thirty were measured by silicone replica technique and digital microscope( 140). Date were analyzed by using independent samples t-test. Results: Mean (SD) of two group were measured 55.61(27.42) for totally gap of ES group and 60.67 (33.14) for totally gap of IS group. But marginal and internal gap of two group were not differences statistically significant(p>0.05). Conclusion: Evaluation of marginal and internal gap of two group showed that no differences statistically significant and clinically acceptable results.

PURPOSE. To evaluate the fit of a three-unit metal framework of fixed dental prostheses made by subtractive and additive manufacturing. MATERIALS AND METHODS. One master model of metal was fabricated. Twenty silicone impressions were made on the master die, working die of 10 poured with Type 4 stone, and working die of 10 made of scannable stone. Ten three-unit wax frameworks were fabricated by wax-up from Type IV working die. Stereolithography files of 10 three-unit frameworks were obtained using a model scanner and three-dimensional design software on a scannable working die. The three-unit wax framework was fabricated using subtractive manufacturing (SM) by applying the prepared stereolithography file, and the resin framework was fabricated by additive manufacturing (AM); both used metal alloy castings for metal frameworks. Marginal and internal gap were measured using silicone replica technique and digital microscope. Measurement data were analyzed by Kruskal-Wallis H test and Mann-Whitney U-test (${\alpha}=.05$). RESULTS. The lowest and highest gaps between premolar and molar margins were in the SM group and the AM group, respectively. There was a statistically significant difference in the marginal gap among the 3 groups (P<.001). In the marginal area where pontic was present, the largest gap was $149.39{\pm}42.30{\mu}m$ in the AM group, and the lowest gap was $24.40{\pm}11.92{\mu}m$ in the SM group. CONCLUSION. Three-unit metal frameworks made by subtractive manufacturing are clinically applicable. However, additive manufacturing requires more research to be applied clinically.

PURPOSE. One of the most important factors in evaluating the quality of fixed dental prostheses (FDPs) is their gap. The purpose of this study was to compare the marginal and internal gap of two different metal-ceramic crowns, casting and selective laser sintering (SLS), before and after porcelain firing. Furthermore, this study evaluated whether metal-ceramic crowns made using the SLS have the same clinical acceptability as crowns made by the traditional casting. MATERIALS AND METHODS. The 10 study models were produced using stone. The 20 specimens were produced using the casting and the SLS methods; 10 samples were made in each group. After the core gap measurements, 10 metal-ceramic crowns in each group were finished using the conventional technique of firing porcelain. The gap of the metal-ceramic crowns was measured. The marginal and internal gaps were measured by two-dimensional and three-dimensional replica techniques, respectively. The Wilcoxon signed-rank test, the Wilcoxon rank-sum test and nonparametric ANCOVA were used for statistical analysis (${\alpha}$=.05). RESULTS. In both groups, the gap increased after completion of the metal-ceramic crown compared to the core. In all measured areas, the gap of the metal cores and metal-ceramic crowns produced by the SLS was greater than that of the metal cores and metal-ceramic crowns produced using the casting. Statistically significant differences were found between cast and SLS (metal cores and metal-ceramic crown). CONCLUSION. Although the gap of the FDPs produced by the SLS was greater than that of the FDPs produced by the conventional casting in all measured areas, none exceeded the clinically acceptable range.

목적: 본 연구의 목적은 실제 환자에서 디지털 구강스캐너로 모형 없이 제작한 보철물의 변연 및 내면 적합도를 평가하는 것이다. 대상 및 방법: 전향적 임상시험으로 시행한 본 예비 연구는 총 11개의 수복물을 대상으로 하였다. 구강스캐너(TRIOS, 3shape, Copenhagen, Denmark)로 디지털 구강인상을 채득한 후, 캐드 디자인 및 밀링 가공 과정을 통해 전부지르코니아 수복물을 제작하였다. 완성된 지르코니아관을 환자 구강 내에 시적하였고, 레플리카 술식으로 보철물-지대치 복제물을 얻었다. 이를 근원심, 협설 방향으로 잘라 변연오차, 변연간극과 축벽부, 선각부, 교합면부의 내면간극을 측정하였다. 통계처리는 Kruskal-Wallis 검정과 Mann-Whitney U 검정을 이용하여 통계적 유의성을 분석하였다(${\alpha}=.05$). 결과: 복제물을 통한 적합도 분석 결과, 근원심, 협설 절편 사이에는 통계적으로 유의한 차이가 없었다(P>.05). 변연간극에 불일치가 있었으며, 변연 오차가 변연간극 보다 컸다(P<.01). 결론: 본 연구의 한계 내에서, 구강스캐너로 모형 없이 제작한 전부지르코니아 수복물의 적합도는 임상적으로 허용할만한 결과를 보였다. 그러나 지르코니아관의 변연부위가 과풍융되는 경향이 있었으므로 주의 깊은 임상 적용 및 추적 연구가 요구된다.

Purpose: The aim of this study was to evaluate the marginal and internal adaptation of monolithic zirconia restoration made without physical model by digital intraoral scanner. Materials and methods: A prospective clinical trial was performed on 11 restorations as a pilot study. The monolithic zirconia restorations were fabricated after digital intraoral impression taking by intraoral scanner (TRIOS, 3shape, Copenhagen, Denmark), computer-aided designing, and milling manufacturing process. Completed zirconia crowns were tried in the patients' mouth and a replica technique was used to acquire the crown-abutment replica. The absolute marginal discrepancy, marginal gap, and internal gap of axial, line angle, and occlusal part were measured after sectioning the replica in the mesiodistal and buccolingual direction. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U test (${\alpha}=.05$). Results: From the adaptation analysis by replica, the statistically significant difference was not found between mesiodistal and buccolingual sections (P>.05), but there was significant difference among the measurement location (P<.01). The amount of absolute marginal discrepancy was larger than those of marginal gap and internal gap (P<.01). Conclusion: Within the limitations of this study, the adaptation accuracy of model-free monolithic zirconia restoration fabricated by intraoral scanner exhibited clinically acceptable result. However, the margin of zirconia crown showed tendency of overcontour and cautious clinical application and follow up is necessary.