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Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
Ready made primary anterior crowns(zirkiz® crowns)-120509
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Ready made primary anterior crowns(zirkiz® crowns)-120509

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Introduction for the ready-made primary zirconia crowns(ZIRKIZ crowns)

Introduction for the ready-made primary zirconia crowns(ZIRKIZ crowns)

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  • 1. Ready-made primary anterior crowns(ZIRKIZ® crowns) Dr. Sung-Ki Kim (Developer of ZIRKIZ ® crowns, South Korea)
  • 2. Requirements• Durable• Retentive• Esthetic
  • 3. Ready-made zirconia crowns• Esthetic• Strength• No need for impression
  • 4. Zirconia?• Physical property : close to metal• Color : tooth-like• “ceramic steel”
  • 5. • Thermostable• Low heat conductivity• Stable chemical resistance• Low thermal expansion• High strength, hardness, abrasion resistance
  • 6. C.S(㎫) T.S(㎫)Composite resin 70~80 30~50Amalgam 300~500 45~60GI 93~226 -Porcelain 150~600 30~60ZPC 100~160 3~8ZOE 2~14 -Ni-Cr - 400~1000Enamel 270~400 -Dentin 230~300 40~50ZIRCONIA 2000 900~1200
  • 7. Physical and chemical properties Requirement for Property Unit ZIRKIZ Value ISO 13356Bulk density g/cm3 6.068~6.090 ≥ 6.00Chemical Composition ZrO2 + HfO2 + Y2O3 99.60 > 99.0 Y2O3 percent mass 5.35 4.5 to 5.4 HfO2 fraction 3.00 ≤5 Al2O3 0.21 < 0.5 Other oxides* 0.19 < 0.5Microstructure : - Mean linear intercept distance ㎛ 0.25 ± 0.05 ≤ 0.4Maximum amount of monoclinic phase : - before accelerated aging % 8.12 ≤ 20 - after accelerated aging 15.82 ≤ 25Biaxial flexure Strength : - before accelerated aging MPa 1200 ≥ 500 - after accelerated aging 1140 ≥ 500(Decrease not more than 20%)Radioactivity Bq/kg 2.2 ≤ 200
  • 8. Biocompatibility Property Standard ZIRKIZ ValueCytotoxicity ISO 10993-5 NoncytotoxicAcute Systemic Toxicity ISO 10993-11 Do not show any systemic toxicity potential.Oral Mucosa Irritation Do not possess any oral mucosa irritation potential. ISO 10993-10Delayed Type Hypersensitivity Do not possess any delayed hypersensitivity. ISO 10993-10
  • 9. Soft tissue adaptation by Zirconia• A Material That Favors Gingival Integration1. Coronary repositioning2. Papillary reconstruction3. Scalloped gum=> Reduced Bacterial Adhesion
  • 10. Historical Input• Characteristics of Epithelial tissue• Characteristics of Connective tissue• Welander et al.(2008)
  • 11. Characteristics of Epithelial tissue• Epithelial cells : proliferation• Connect to Zirconia via a basal lamina and hemidesmosomes connections• Begin 2nd day after operation• Continue to the apical pole(of the basal lamina) until they cover zirconia to 2mm
  • 12. • The newly formed epithelium has all of the historical characteristics of a normal tooth
  • 13. Characteristics of Connective tissue• Proportion : collagen fiber > fibroblast• Collagen fiber – major component of the extracellular matrix – forms essential framework – influences the direction of fibroblasts’ growth
  • 14. 5.47 52 51 61 62
  • 15. • Size : #1, #2, #3, #4• Shade : original shade(A1), PW(Pedo- White)
  • 16. Starter kit
  • 17. Refill kit
  • 18. Laser markig(indeliable)
  • 19. Should be handled by pincette
  • 20. Advantages• Esthetics in addition to strength• Without metal• Luting available• Contouring available• Without facing• Thin labial structure resembles natural primary anterior tooth(gingival tissue adaptation)
  • 21. • Chair-time decreased• Bleeding decreased• Repair available• 1-visit (sedation) : no impression• No metal appearance at gingival margin• Occlusal adjustment available
  • 22. Indications• Every cases which needs full coverage in primary anterior teeth• Proximal caries in primary anterior teeth• In case of crowns for primary central incisor only• Correction of dental crossbite
  • 23. Every cases which needs full coverage in primary anterior teeth
  • 24. Proximal caries
  • 25. Primary central incisor only
  • 26. Correction of dental crossbite
  • 27. Preparation• Incisal edge – 2mm reduction• Proximal surface – Fit to selected size
  • 28. • Labiopalatal surface – The best important part for retention – “Passive fit” – Amount of reduction : approximately 15~20% – At least 2mm subgingivally for the adaptation with gingiva – Avoid too much reduction not to be less retentive
  • 29. • Reduction of incisal tip
  • 30. • Reduction of proximal surface
  • 31. • Reduction of labial surface
  • 32. • Reduction of palatal surface
  • 33. • Reduction completed
  • 34. CementationFull-coverage zirconia-based restorations with adequateretention do not require resin bonding for definitive cementation
  • 35. Resin bonding, however, may be advantageous in certain clinical situations and is a necessity for bonded restorations
  • 36. • Cementation for primary anterior zirconia crowns – No need of strong adhesive strength like permanent tooth – bleeding – passive fit : hard to hold crowns at proper position Recommendation : Light- curing resin cement(or GIC)
  • 37. Shape adjustment• Shape adjustment with high-speed diamond bur• Adjustable after setting of crowns as well as outside of oral cavity• Using finishing & polishing kit for porcelain in order• Should be used with water-cooling when using high or low-speed bur
  • 38. -If you grind ZIRKIZ crowns under the red line too much, it can be fractured because the cervical margin is really thin.
  • 39. Recommended grinding area and the amount - area : incisal to the red line - amount #A ½ proximal : max. 0.2mm incisal : max. 0.4mm - area : incisal to the red line - amount #B proximal : max. 0.2mm ½ incisal : max. 0.4mmThickness at the red line( ): 0.5~0.6mm
  • 40. Case Presentation
  • 41. 2010.6.10
  • 42. After treatment
  • 43. 2010.9.6
  • 44. 2010.11.11
  • 45. 2011.4.16
  • 46. 2011.2.11 Park KB Pre-treatment
  • 47. After treatment, crossbite corrected
  • 48. 3 months later
  • 49. 6 months later
  • 50. 7 months later
  • 51. 2010.11.22 Kim JY Pre-treatment
  • 52. After treatment
  • 53. 1 month later

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