이 연구의 목적은 지르코니아 크라운의 종류 및 두께와 시멘트 종류에 따른 색조를 평가하여 상악 유중절치와 가장 유사한 조합을 확인하는 것이었다. 시중에 유통되는 3가지 색조의 기성 지르코니아 크라운과 6종류의 지르코니아 블럭을 이용해 제작한 크라운이 연구에 사용되었고, A2 shade 또는 translucent shade의 레진 시멘트로 크라운 내면을 충전하였다. 분광 광도계를 이용하여 각 시편의 $L^*$, $a^*$, $b^*$ 값을 평가하여, 자연치와 지르코니아 크라운의 색 차이(ΔEn)를 평가하였다. 시편의 색조는 translucent-shade 레진시멘트를 사용했을 때 보다 A2-shade 레진시멘트를 사용하였을 때 더욱 자연치와 유사하였고, smile series 2 (SmS2) 지르코니아 블록으로 0.5 mm 두께의 크라운을 제작하여 A2-shade 레진시멘트로 채웠을 때 가장 자연치와 색 차이가 가장 작았다. 한국 어린이들의 상악 유전치부를 지르코니아 크라운으로 수복할 때, translucent-shade의 레진시멘트 보다는 A2-shade의 레진시멘트를 사용하는 것이 권장되고, 기성 지르코니아 크라운은 색조면에서 심미성이 충분하지 못하기 때문에 기성 지르코니아 크라운의 색조 개선이나 새로운 종류의 지르코니아 크라운의 개발이 필요하다.
이 연구의 목적은 지르코니아 크라운의 종류 및 두께와 시멘트 종류에 따른 색조를 평가하여 상악 유중절치와 가장 유사한 조합을 확인하는 것이었다. 시중에 유통되는 3가지 색조의 기성 지르코니아 크라운과 6종류의 지르코니아 블럭을 이용해 제작한 크라운이 연구에 사용되었고, A2 shade 또는 translucent shade의 레진 시멘트로 크라운 내면을 충전하였다. 분광 광도계를 이용하여 각 시편의 $L^*$, $a^*$, $b^*$ 값을 평가하여, 자연치와 지르코니아 크라운의 색 차이(ΔEn)를 평가하였다. 시편의 색조는 translucent-shade 레진시멘트를 사용했을 때 보다 A2-shade 레진시멘트를 사용하였을 때 더욱 자연치와 유사하였고, smile series 2 (SmS2) 지르코니아 블록으로 0.5 mm 두께의 크라운을 제작하여 A2-shade 레진시멘트로 채웠을 때 가장 자연치와 색 차이가 가장 작았다. 한국 어린이들의 상악 유전치부를 지르코니아 크라운으로 수복할 때, translucent-shade의 레진시멘트 보다는 A2-shade의 레진시멘트를 사용하는 것이 권장되고, 기성 지르코니아 크라운은 색조면에서 심미성이 충분하지 못하기 때문에 기성 지르코니아 크라운의 색조 개선이나 새로운 종류의 지르코니아 크라운의 개발이 필요하다.
The purpose of this study was to identify which combination of zirconia crowns and cements is most similar in color to the maxillary primary incisors by varying the color of zirconia crowns, crown thickness, and shade of cements. Prefabricated zirconia crowns in 3 shades and crowns fabricated using ...
The purpose of this study was to identify which combination of zirconia crowns and cements is most similar in color to the maxillary primary incisors by varying the color of zirconia crowns, crown thickness, and shade of cements. Prefabricated zirconia crowns in 3 shades and crowns fabricated using 6 types of zirconia blocks were used in this study. These were filled with A2-shade or translucent-shade resin cement and the $L^*$, $a^*$, and $b^*$ values were calculated using a spectrophotometer. The color differences between the natural teeth and the zirconia crowns were assessed. The shade of the final restoration was more similar to that of the natural teeth using A2-shade than translucent-shade resin cement. Application of A2-shade cement to a 0.5-mm-thick crown fabricated from a smile series 2 zirconia block resulted in the color most similar to that of the natural teeth. A2-shade resin cement is recommended for zirconia crown restoration in anterior primary teeth compared to TR-shade resin cement for more esthetic restoration. Since restorations with Nu-smile zirconia crowns were not esthetically favorable in terms of shade, improvement of the shade characteristics of the product or development of a new kind of zirconia crown is required.
The purpose of this study was to identify which combination of zirconia crowns and cements is most similar in color to the maxillary primary incisors by varying the color of zirconia crowns, crown thickness, and shade of cements. Prefabricated zirconia crowns in 3 shades and crowns fabricated using 6 types of zirconia blocks were used in this study. These were filled with A2-shade or translucent-shade resin cement and the $L^*$, $a^*$, and $b^*$ values were calculated using a spectrophotometer. The color differences between the natural teeth and the zirconia crowns were assessed. The shade of the final restoration was more similar to that of the natural teeth using A2-shade than translucent-shade resin cement. Application of A2-shade cement to a 0.5-mm-thick crown fabricated from a smile series 2 zirconia block resulted in the color most similar to that of the natural teeth. A2-shade resin cement is recommended for zirconia crown restoration in anterior primary teeth compared to TR-shade resin cement for more esthetic restoration. Since restorations with Nu-smile zirconia crowns were not esthetically favorable in terms of shade, improvement of the shade characteristics of the product or development of a new kind of zirconia crown is required.
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문제 정의
This study aimed to identify the composition of zirconia crown restorations that resulted in a color most similar to that of the maxillary primary incisors. Based on the results of this study, A2-shade resin cement is recommended for zirconia crown restoration in anterior primary teeth compared to TR-shade resin cement for more esthetic restoration.
Regarding the preformed zirconia crowns, Lee[11] evaluated the shade of commercially available preformed zirconia crowns depending on the type of cements, but there was no esthetic result that is below the color threshold. Thus, this study aimed to evaluate which combination of zirconia crowns and cements is most similar in color to the maxillary primary incisors by varying the color and type of zirconia crowns, crown thickness, and shade of cements.
가설 설정
B: Cement application with composite resin cement; A2 or translucent shade. C: Shade measurement with spectrophotometer on a dentiform.
제안 방법
3 shades of LUXEN (Dentalmax, Cheonan-si, Chungcheongnam-do, Korea) zirconia series (S1, S2, and S3) and 3 shades of LUXEN smile series (SmS1, SmS2, and SmS3) were used to fabricate specimens in this study. 3 shades of Nu-smile zirconia crowns (Nu-Smile, Houston, Texas, USA), extra‑light shade (EL), light shade (LT), and high-translucency shade (HT) for the maxillary right central incisor were used in this study (Table 1).
Second, the limitation that crowns were filled with resin cement without abutment teeth. As the color of the abutment also affects the shade of final restoration, this study has limitation in that it could not assess the effect of abutment teeth. However, utilizing the resin artificial teeth as the abutment teeth have limitation in that the color and characteristic is different from natural teeth, and it is difficult to obtain uniform natural teeth sample having the same shade and shape for abutment teeth.
In this study, shade measurement of the specimens attempted to simulate the intraoral conditions. However, there were several limitations.
The informed consents were obtained from the children and their parents, and 105 children aged between 4 to 6 years old was enrolled in this study. The measurements were performed from 10:00 to 14:00 with the children lying on a mobile dental chair in front of a window with sufficient natural light.
The zirconia specimens were machined by computer-aided design (CAD)/computer-aided manufacturing (CAM) using eight selected zirconia blocks. To fabricate a crown, Nu-smile zirconia crown for the maxillary right central incisor was scanned using a 3Shape D900 scanner (3Shape, Copenhagen, Denmark, Fig.
The zirconia specimens were machined by computer-aided design (CAD)/computer-aided manufacturing (CAM) using eight selected zirconia blocks. To fabricate a crown, Nu-smile zirconia crown for the maxillary right central incisor was scanned using a 3Shape D900 scanner (3Shape, Copenhagen, Denmark, Fig. 2), and a zirconia crown of the same size and shape was designed using a computer-aided design software (3Shape Dental System, 3Shape, Copenhagen, Denmark). To determine the thickness of the zirconia crown to be fabricated, the thickness of the labial surface of the Nu-smile zirconia crown was measured.
Even if the same materials were used, spectrophotometric result may vary depending on the background color[31]. Unlike previous study, this study is more significant in that it attempted to simulate the condition of the shade measurement of natural teeth.
After brushing, the child was laid on the chair and the labial surface of the teeth was wiped with sterile gauze. Visual inspection was performed to exclude teeth with labial or proximal caries, teeth discolored due to trauma, restored teeth, and extracted teeth. To avoid excessive drying, the child drank a cup of water.
대상 데이터
3℃/min and maintained for 2 hours, followed by oven-cooling to room temperature. 10 specimens were prepared for each thickness and divided into 2 subgroups for 2 types of cement. Thus, each subgroup comprised 5 specimens.
3 shades of LUXEN (Dentalmax, Cheonan-si, Chungcheongnam-do, Korea) zirconia series (S1, S2, and S3) and 3 shades of LUXEN smile series (SmS1, SmS2, and SmS3) were used to fabricate specimens in this study. 3 shades of Nu-smile zirconia crowns (Nu-Smile, Houston, Texas, USA), extra‑light shade (EL), light shade (LT), and high-translucency shade (HT) for the maxillary right central incisor were used in this study (Table 1).
The shade of intact maxillary right central incisors of children was measured by Shadepilot at three randomly selected child daycare centers. The informed consents were obtained from the children and their parents, and 105 children aged between 4 to 6 years old was enrolled in this study. The measurements were performed from 10:00 to 14:00 with the children lying on a mobile dental chair in front of a window with sufficient natural light.
Thus, each subgroup comprised 5 specimens. The interiors of the crowns produced for this study and the Nu-smile zirconia crowns were filled with 2 shades of RelyX U200 Automix (3M/ESPE, Neuss, Germany): translucent (TR) and A2 shade. In accordance with the manufacturer’s instructions, the crown was filled with cement using an automatic mixing syringe from the incisal tip to a slight overflow, taking care to avoid producing air bubbles.
이론/모형
Shadepilot (DeguDent GmbH, Hanau, Germany, Fig. 1), a spectrophotometer with high levels of accuracy and reproducibility in vivo and in vitro, was used in this study[12]. The shade of intact maxillary right central incisors of children was measured by Shadepilot at three randomly selected child daycare centers.
The Mann-Whitney U test was performed to compare color differences according to the shade of cement in preformed crowns, and the color differences between the Nu-smile zirconia crowns and fabricated zirconia crowns for this study. Statistical analysis was performed using SPSS (version 23.
성능/효과
This study aimed to identify the composition of zirconia crown restorations that resulted in a color most similar to that of the maxillary primary incisors. Based on the results of this study, A2-shade resin cement is recommended for zirconia crown restoration in anterior primary teeth compared to TR-shade resin cement for more esthetic restoration. However, since restorations with Nu-smile zirconia crowns which are widely used on primary anterior teeth were not esthetically favorable in terms of shade, improvement of the shade characteristics of the product or development of a new kind of zirconia crown is required.
In this study, the ΔEn values of crowns using A2- shade cement showed lower than those using TR-shade cement in all types of crowns.
However, utilizing the resin artificial teeth as the abutment teeth have limitation in that the color and characteristic is different from natural teeth, and it is difficult to obtain uniform natural teeth sample having the same shade and shape for abutment teeth. Third, zirconia crowns fabricated in this study had a consistent labial thickness of 0.5 mm or 0.6 mm, while the labial thickness of Nu-smile zirconia crown varies with region of the crown. Since it was impossible to scan the inner surface of the Nu-smile zirconia crowns, the limitation was that the shape of fabricated crowns did not completely coincide with the Nu-smile crowns.
Within the results of this study, it was found that the commercially available preformed zirconia crowns differed in shade from the natural primary teeth, and the crowns fabricated from other zirconia blocks resulted in more esthetic shade. Therefore, improvement of shade of preformed zirconia crown or development of new kinds of zirconia crown will be needed for esthetic restoration of primary teeth.
후속연구
Finally, there was a limit to the variety of zirconia blocks used in this study. Considering these limitations, further study using other zirconia block products and natural teeth abutment is necessary.
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