Implant treatment on anterior cross-bite of a patient who had orthognathic surgery 20 years ago / 대한치과보철학회지

Orthognathic surgery of skeletal Class III malocclusion improves oral function and facial appearance. The greater amount of skeletal discrepancy, the greater amount of teeth movement required for decompensation, and this often causes pathological changes in periodontal tissue especially in lower anterior dentition. We made a Top-Down treatment plan with personalized analysis using Face Hunter, Plane System and ARCUS Digma II, in order to resolve severe mobility and cross-bite of lower anterior teeth for 49-year-old female patient who had undergone orthognathic surgery 20 years ago due to skeletal Class III malocclusion and mandibular prognathism. Lower anterior teeth were extracted and alveoloplasty was done. After healing of the wound, immediate loading was conducted immediately after implant placement. Final restorations were fabricated Zirconia using CAD/CAM, and inserted intraorally screw-retained type. During 6-month follow-up, no abnormal episodes of restorations were observed, and obtained satisfactorily both of functional and esthetic outcomes.

Microscopical and chemical surface characterization of CAD/CAM zircona abutments after different cleaning procedures. A qualitative analysis

PURPOSE: To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS: A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non-quantitatively. RESULTS: All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION: The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented.

Microscopical and chemical surface characterization of CAD/CAM zircona abutments after different cleaning procedures. A qualitative analysis

PURPOSE: To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS: A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non-quantitatively. RESULTS: All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION: The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented.

Influence of porcelain veneering on the marginal fit of Digident and Lava CAD/CAM zirconia ceramic crowns

PURPOSE: Marginal fit is a very important factor considering the restoration's long-term success. However, adding porcelain to copings can cause distortion and lead to an inadequate fit which exposes more luting material to the oral environment and causes secondary caries. The purpose of this study was to compare the marginal fit of 2 different all-ceramic crown systems before and after porcelain veneering. This study was also intended to verify the marginal fit of crowns originated from green machining of partially sintered blocks of zirconia (Lava CAD/CAM system) and that of crowns obtained through machining of fully sintered blocks of zirconia (Digident CAD/CAM system). MATERIAL AND METHODS: 20 crowns were made per each system and the marginal fit was evaluated through a light microscope with image processing (Accura 2000) at 50 points that were randomly selected. Each crown was measured twice: the first measurement was done after obtaining a 0.5 mm coping and the second measurement was done after porcelain veneering. The means and standard deviations were calculated and statistical inferences among the 2 groups were made using independent t-test and within the same group through paired t-test. RESULTS: The means and standard deviations of the marginal fit were 61.52 +/- 2.88 micrometer for the Digident CAD/CAM zirconia ceramic crowns before porcelain veneering and 83.15 +/- 3.51 micrometer after porcelain veneering. Lava CAD/CAM zirconia ceramic crowns showed means and standard deviations of 62.22 +/- 1.78 micrometer before porcelain veneering and 82.03 +/- 1.85 micrometer after porcelain veneering. Both groups showed significant differences when analyzing the marginal gaps before and after porcelain veneering within each group. However, no significant differences were found when comparing the marginal gaps of each group before porcelain veneering and after porcelain veneering as well. CONCLUSION: The 2 all-ceramic crown systems showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.

Comparison of marginal fit before and after porcelain build-up of two kinds of CAD/CAM zirconia all-ceramic restorations / 대한치과보철학회지

PURPOSE: Marginal fit is one of the important components for the successful prosthodontic restoration. Poor fitting margin of the restoration causes hypersensitivity, secondary caries, and plaque accumulation, which later result in prosthodontic failure. CAD/CAM zirconia all-ceramic restorations, such as LAVA(R) (3M ESPE, St.Paul, MN) and EVEREST(R) (KaVo Dental GmbH, Biberach, Germany) systems were recently introduced in Korea. It is clinically meaningful to evaluate the changes of the marginal fit of the CAD/CAM zirconia systems before and after build-up. The purposes of this study are to compare the marginal fit of the two CAD/CAM all-ceramic systems with that of the ceramometal restoration, before and after porcelain build-up. MATERIAL AND METHODS: A maxillary first premolar dentiform tooth was prepared with 2.0 mm occlusal reduction, 1.0 mm axial reduction, chamfer margin, and 6 degree taperness in the axial wall. The prepared dentiform die was duplicated into the metal abutment die. The metal die was placed in the dental study model, and the full arch impressions of the model were made. Twenty four copings of 3 groups which were LAVA(R), EVEREST(R), and ceramometal restorations were fabricated. Each coping was cemented on the metal die with color-mixed Fit-checker II(R) (GC Cor., Tokyo, Japan). The marginal opening of each coping was measured with Microhiscope(R) system (HIROX KH-1000 ING-Plus, Seoul, Korea. *300 magnification). After porcelain build-up, the marginal openings of LAVA(R), EVEREST(R),and ceramometal restorations were also evaluated in the same method. Statistical analysis was done with paired t-test and one-way ANOVA test. RESULTS: In coping states, the mean marginal opening for EVEREST(R) restorations was 52.00 +/- 11.94 micrometer, for LAVA(R) restorations 56.97 +/- 10.00 micrometer, and for ceramometal restorations 97.38 +/- 18.54 micrometer. After porcelain build-up, the mean marginal opening for EVEREST(R) restorations was 61.69 +/- 19.33 micrometer, for LAVA(R) restorations 70.81 +/- 12.99 micrometer, and for ceramometal restorations 115.25 +/- 23.86 micrometer. CONCLUSION: 1. LAVA(R) and EVEREST(R) restorations in comparison with ceramometal restorations showed better marginal fit, which had significant differences (P .05). 3. EVEREST(R), LAVA(R) and ceramometal restorations showed a little increased marginal opening after porcelain build-up, but did not show any statistical significance (P > .05).

Marginal fit of the digident CAD/CAM zirconia ceramic crowns / 대한치과보철학회지

Statement of problem. There have been many studies about marginal discrepancy of single restorations made by various systems and materials. However most of the statistical inferences are not definite because of sample size, measurement number, measuring instruments, etc, and there have been few studies about the marginal fit of the Digident CAD/CAM zirconia ceramic crowns. Purpose. The purpose of this study was to compare the marginal fit of the anterior single restorations made by using the Digident CAD/CAM zirconia ceramic crowns with metal-ceramic restorations and to obtain more accurate information by using a large enough sample size and by making sufficient measurements per specimen. Material and Methods. The crowns were made from one extracted maxillary central incisor prepared with a 1mm shoulder margin and 6.taper walls by milling machine. The in vitro marginal discrepancies of the digident CAD/CAM zirconia ceramic crowns and control groups(metal ceramic crowns) were evaluated and compared. Twenty crowns per each system were fabricated. Measurements of a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Parametric statistical analysis was performed for the results. Conclusion. Within the limitations of this in vitro study, the following conclusions were drawn: 1. Mean gap dimensions and standard deviations at the marginal opening for maxillary incisal crowns were 88+/-10microm for the control (metal-ceramic crowns), 92+/-4microm for Digident CAD/CAM zirconia ceramic crowns. 2. Marginal gap between Digident CAD/CAM zirconia ceramic crowns and metal ceramic crowns did not show significant difference (P>.05). 3. The Digident CAD/CAM zirconia ceramic crowns and metal ceramic crowns showed clinically acceptable marginal discrepancy.