CAD/CAM을 이용한 전치부 수복시 색조 및 표면 특성의 개별화를 시행한 증례 Chairside computer-aided design/computer-aided manufacturing (CAD/CAM)-based restoration of anterior teeth with customized shade and surface characterization: a report of 2 cases원문보기
지난 30년동안, CAD/CAM 시스템을 이용한 수복 시스템은 눈부시게 발전하였다. 구치부 수복에서 널리 쓰이던 것과는 달리, 환자와 임상가의 심미적인 요구를 충족해야 하는 전치부 수복 증례에서는 CAD/CAM 시스템을 이용하는데 다소 한계가 있었다. 단일 색조를 가지는 CAD/CAM 수복물에 다양한 색조를 부여하기 위해, A2 lithium disilicate (LS2) 블록에 staining kit를 이용하여 색조 개별화를 시행하여 다양한 색조를 표현하는 예비실험을 시행하였다. 색조 개별화를 진행한 시편을 spectrophotometer를 이용하여 CIE L*a*b* 값을 측정한 후, 임상에서 널리 사용되고 있는 shade guide와 비교하였다. 예비 실험 결과를 바탕으로 2명의 환자의 전치부 수복시, 치아의 부위별 색조 재현과 표면 특성의 개별화를 진행한 증례를 소개한다. 수복물의 해부학적 형태는 CAD/CAM 시스템에서 '복사 및 붙여넣기 기능'과 '거울상 획득 기능'을 이용하여 디자인하였으며, 이 연구에서 소개하는 모든 임상 및 수복물의 기공과정은 진료실 내에서만 이루어졌다.
지난 30년동안, CAD/CAM 시스템을 이용한 수복 시스템은 눈부시게 발전하였다. 구치부 수복에서 널리 쓰이던 것과는 달리, 환자와 임상가의 심미적인 요구를 충족해야 하는 전치부 수복 증례에서는 CAD/CAM 시스템을 이용하는데 다소 한계가 있었다. 단일 색조를 가지는 CAD/CAM 수복물에 다양한 색조를 부여하기 위해, A2 lithium disilicate (LS2) 블록에 staining kit를 이용하여 색조 개별화를 시행하여 다양한 색조를 표현하는 예비실험을 시행하였다. 색조 개별화를 진행한 시편을 spectrophotometer를 이용하여 CIE L*a*b* 값을 측정한 후, 임상에서 널리 사용되고 있는 shade guide와 비교하였다. 예비 실험 결과를 바탕으로 2명의 환자의 전치부 수복시, 치아의 부위별 색조 재현과 표면 특성의 개별화를 진행한 증례를 소개한다. 수복물의 해부학적 형태는 CAD/CAM 시스템에서 '복사 및 붙여넣기 기능'과 '거울상 획득 기능'을 이용하여 디자인하였으며, 이 연구에서 소개하는 모든 임상 및 수복물의 기공과정은 진료실 내에서만 이루어졌다.
Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinic...
Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L*a*b* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from 'copy and paste technique' and 'mirror image acquisition technique'. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.
Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L*a*b* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from 'copy and paste technique' and 'mirror image acquisition technique'. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.
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제안 방법
5B). Fiber post (DT Light-Post) cementation, resin core (Z100) restoration, and crown preparation were performed on the maxillary left central incisor. Digital impression of the tooth was taken with an intraoral scanner (CEREC AC omnicam) (Fig.
In both the cases presented, CAD/CAM restorations were used to restore anterior teeth with high esthetic expectations. The anatomical shape of the restoration was conveniently and esthetically reproduced with the “copy and paste technique” and “mirror image acquisition technique.
In the case reports described herein, two predictable methods were used to reproduce a natural-looking restoration in the anterior dentition. The “copy and paste technique; using an old restoration design image already acquired before operation,” and the “mirror image acquisition technique; using a scanned image of the contralateral tooth” were used to obtain the required shape and contour.
Non-surgical root canal retreatment was performed on the maxillary right central incisor (Fig. 3A, 3B) and followed with fiber post cementation (DT LightPost; Bisco, Schaumburg, USA) and resin core restoration (Z100; 3M ESPE, St. Paul, USA). After crown preparation, an intraoral scan was performed and a conventional final impression of the maxillary right central incisor, using polyvinyl siloxane (Imprint 4; 3M ESPE), was taken.
A non-surgical root canal retreatment and placement of a new CAD/CAM restoration were planned. Preliminary scan of the old restoration was performed with an intraoral scanner (CEREC AC omnicam; Dentsply Sirona, Charlotte, USA) to copy the old restoration before removal of the old crown (Fig. 1C, 1D).
The anatomical shape of the restoration was conveniently and esthetically reproduced with the “copy and paste technique” and “mirror image acquisition technique.
대상 데이터
A 35-year-old man presented to the dental hospital with intermittent gingival pain in the region of the maxillary right central incisor. The tooth had undergone root canal treatment 8 - 9 years ago, followed by a ceramic crown restoration (Fig.
An 81-year-old woman presented at the dental clinic with a fractured maxillary left central incisor. Clinical and radiological examinations revealed a complicated crown fracture of the maxillary left central incisor (Fig.
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