수종의 CAD/CAM 시스템으로 제작한 지르코니아 기반 완전도재관의 적합도 비교
A comparison of the fidelity of various zirconia-based all-ceramic crowns fabricated with CAD/CAM systems
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초록
연구목적: 최근에는 금속도재관의 심미적 문제로 심미성과 강도가 개선된 코아용 도재 및 지르코니아를 이용한 전부도재관 시스템에 관심이 증가되고 있다. 특히 금속과 유사한 강도를 가지면서 금속의 비심미성을 극복할 수 있는 지르코니아를 이용한 보철물의 제작이 국내외에서 많이 이뤄지고 있다. 하지만CAD/CAM 시스템으로 제작되는 여러 종류의 지르코니아를 이용한 전부도재관의 적합도에 대한 임상 연구는 부족한 실정이다. 다양한 CAD/CAM 시스템중 Procera, Cerec inLab, Lava에 의해 제작된 지르코니아를 이용한 전부도재관의 변연 적합도와 내면 적합도를 측정하여 이를 전통적인 방식으로 주조된 금속도재관의 적합도와 비교 평가해 봄으로써 임상 적용에 참고 자료로 활용하고자 한다. 연구 재료 및 방법: 본 연구를 위해 하악 우측 제2소구치에 해당하는 레진치를 삭제하여 인상채득 후, 금속 주모형을 제작하였다. 금속 주모형의 40개의 인상을 채득 후 각 시스템마다 10개씩 총 40개의 crown을 제작하였다. 금속도재관은 전통적인 방식으로 제작하였고 Procera, Lava, Cerec inLab crown은 zirconia core를 이용하여CAD/CAM 시스템으로 제작하였다. 수직 변연 오차와 내면 간격을 각 그룹마다 금속 주모형에 시멘트 접착 없이 측정하였다. 그 결과는 oneway ANOVA와 Tukey’s HSD test로 통계 내었다. 결과: 수직 변연 오차는 금속도재관이 50.6 ± 13.9 μm, Procera crown이 62.3 ± 15.7 μm, Lava crown이 45.3 ± 7.9 μm, Cerec inLab crown은 71.2 ± 2.0 μm로 측정되었다. 내면 간격은 금속도재관이 52.6 ±10.1 μm, Procera crown이161.7 ±18.5 μm, Lava crown이63.0 ±10.2 μm, Cerec inLab crown이73.7 ±10.7 μm로 측정되었다. 변연 적합도 측면에서 볼 때 Procera crown, Lava crown, Cerec inLab 그리고 전통적인 금속도재관은 임상적으로 받아들일 수 있는 적합도 범위(120 ㎛) 내에 있었다. 내면 적합도 측면에서 볼 때 Procera crown을 제외한 Lava crown, Cerec inLab, 금속도재관은 임상적으로 받아들일 수 있는 적합도 범위(140 ㎛) 내에 있었다.
Abstract
Statement of problem: The interest in all-ceramic restorations has increased as more techniques have become available. With the introduction of machinable dental ceramics and CAD/CAM systems there is a need to evaluate the quality levels of these new fabrication techniques. Purpose: This study is to evaluate the crown fidelity (absolute marginal discrepancy and internal gap) of various zirconia-based all-ceramic crowns fabricated with different CAD/CAM (computer-assisted design/computer-assisted manufacturing) systems and conventional cast metal-ceramic crowns. Material and methods: A resin tooth of lower right second premolar was prepared. After an impression was taken, one metal master die was made. Then 40 impressions of metal master dies were taken for working dies. 10 crowns per each system were fabricated using 40 working dies. Metalceramic crowns were cast by using the conventional method, and Procera, Lava, and Cerec inLab crowns were fabricated with their own CAD/CAM manufactruing procedures. The vertical marginal discrepancies and internal gaps of each crown groups were measured on a metal master die without a luting agent. The results were statistically analyzed using the one-way ANOVA and Tukey’s HSD test. Results: 1. Vertical marginal discrepancies were 50.6 ± 13.9 ㎛ for metal-ceramic crowns, 62.3 ± 15.7 ㎛ for Procera crowns, 45.3 ± 7.9 ㎛ for Lava crowns, and 71.2 ± 2.0 ㎛ for Cerec inLab crowns. 2. The Internal gaps were 52.6 ± 10.1 ㎛ for metal-ceramic crowns, 161.7 ± 18.5 ㎛ for Procera crowns, 63.0 ± 10.2 ㎛ for Lava crowns, and 73.7 ± 10.7 ㎛ for Cerec inLab crowns. Conclusion: 1. The vertical marginal discrepancies of, 4 crown groups were all within the clinically acceptable range (120 ㎛). 2. The internal gaps of LAVA, Cerec inlab, and metal-ceramic crowns were within clinically acceptable range except Procera crown (140 ㎛).
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