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

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

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

  1. 1. Ready-made primary anterior crowns(ZIRKIZ® crowns) Dr. Sung-Ki Kim (Developer of ZIRKIZ ® crowns, South Korea)
  2. 2. Requirements• Durable• Retentive• Esthetic
  3. 3. Ready-made zirconia crowns• Esthetic• Strength• No need for impression
  4. 4. Zirconia?• Physical property : close to metal• Color : tooth-like• “ceramic steel”
  5. 5. • Thermostable• Low heat conductivity• Stable chemical resistance• Low thermal expansion• High strength, hardness, abrasion resistance
  6. 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. 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. 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. 9. Soft tissue adaptation by Zirconia• A Material That Favors Gingival Integration1. Coronary repositioning2. Papillary reconstruction3. Scalloped gum=> Reduced Bacterial Adhesion
  10. 10. Historical Input• Characteristics of Epithelial tissue• Characteristics of Connective tissue• Welander et al.(2008)
  11. 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. 12. • The newly formed epithelium has all of the historical characteristics of a normal tooth
  13. 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. 14. 5.47 52 51 61 62
  15. 15. • Size : #1, #2, #3, #4• Shade : original shade(A1), PW(Pedo- White)
  16. 16. Starter kit
  17. 17. Refill kit
  18. 18. Laser markig(indeliable)
  19. 19. Should be handled by pincette
  20. 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. 21. • Chair-time decreased• Bleeding decreased• Repair available• 1-visit (sedation) : no impression• No metal appearance at gingival margin• Occlusal adjustment available
  22. 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. 23. Every cases which needs full coverage in primary anterior teeth
  24. 24. Proximal caries
  25. 25. Primary central incisor only
  26. 26. Correction of dental crossbite
  27. 27. Preparation• Incisal edge – 2mm reduction• Proximal surface – Fit to selected size
  28. 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. 29. • Reduction of incisal tip
  30. 30. • Reduction of proximal surface
  31. 31. • Reduction of labial surface
  32. 32. • Reduction of palatal surface
  33. 33. • Reduction completed
  34. 34. CementationFull-coverage zirconia-based restorations with adequateretention do not require resin bonding for definitive cementation
  35. 35. Resin bonding, however, may be advantageous in certain clinical situations and is a necessity for bonded restorations
  36. 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. 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. 38. -If you grind ZIRKIZ crowns under the red line too much, it can be fractured because the cervical margin is really thin.
  39. 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. 40. Case Presentation
  41. 41. 2010.6.10
  42. 42. After treatment
  43. 43. 2010.9.6
  44. 44. 2010.11.11
  45. 45. 2011.4.16
  46. 46. 2011.2.11 Park KB Pre-treatment
  47. 47. After treatment, crossbite corrected
  48. 48. 3 months later
  49. 49. 6 months later
  50. 50. 7 months later
  51. 51. 2010.11.22 Kim JY Pre-treatment
  52. 52. After treatment
  53. 53. 1 month later

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