• The Journal of Korean Academy of Prosthodontics
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• v.46 no.4
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• pp.409-419
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• 2008

Statement of problem: At all times people have tried to fabricate tooth restorations using tooth colored materials. Recently, demands for esthetics, even in restorations requiring strength, has brought a revolution to dentistry and increased use of zirconia. The basic color of zirconia is white to ivory. The color can be partially adapted by veneering it with ceramic materials. However, it would be better if the substructure could already be adapted to the basic color shade of neighboring teeth. By adaptation to the basic shade, it can help to reduce the necessary layer thickness of the veneer ceramic to achieve the desired color. Purpose: The purpose of this study was to spectrophotometrically evaluate the influence of shading of zirconia core on the final shade of all-ceramic restorations using the CIE $L^{*}a^{*}b^{*}$ system. Material and methods: Core specimens (n = 20 per group) of Lava Frame Zirconia, KaVo Everest Zirconia, Digident CAD/CAM Zirconia were fabricated at 20 mm in diameter and 0.5 mm in thickness. Halves of each groups were shaded in A3 color. These core specimens were veneered with A3 porcelain of the recommended manufacturer at thickness of 0.5 mm. CIE $L^{*}a^{*}b^{*}$ coordinates were recorded for each specimen with a spectrophotometer (Model CM-2600d, Minolta, Japan) at 0.5 mm, 0.4 mm, 0.3 mm in thickness. Color differences were calculated using the equation ${\Delta}E^{*}=[({\Delta}L^{*})2+({\Delta}a^{*})2+({\Delta}b^{*})2]1/2$. Results: 1. In the case where porcelain layer has a thickness of 0.5 mm, Lava Frame Zirconia and KaVo Everest group did not show clinically perceived color difference, however Digident CAD/CAM Zirconia group showed clinically perceived color difference according to shade allowed on core. 2. When the thickness of porcelain layer decreased from 0.5 mm to 0.4 mm, Lava Frame Zirconia and KaVo Everest group did not show clinically perceived color difference, on the other hand Digident CAD/CAM Zirconia group showed clinically perceived color difference according to shade allowed on core. 3. When the thickness of porcelain layer decreased from 0.5 mm to 0.3 mm, clinically perceived color differences were observed from all three groups. Conclusions: Ziroconia system, which is possible to allow shade on core, are thought to be much more favorable to reproduce natural shade compared to systems that is impossible to give shade. Therefore, clinicians ought to choose adequate system for certain clinical situation by considering above specific character.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.4
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• pp.396-408
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• 2008

Statement of problem: Within the elastic limit of the screw, the greater the preload, the tighter and more secure the screw joint. However, additional tensile forces can incur plastic deformation of the abutment screw when functional loads are superimposed on preload stresses, and they can elicit the loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum preload that will maximize fatigue life and simultaneously offer a reasonable degree of protection against loosening. Another critical factor in addition to the applied torque which can affect the amount of preload is the joint connection type between implant and abutment. Purpose: The purpose of this study was to evaluate the influence of tightening torque on the implant-abutment screw joint stability. Material and methods: Respectively, three different amount of tightening torque (20, 30, and 40 Ncm) were applied to implant systems with three different joint connections, one external butt joint and two internal cones. The initial removal torque value and the postload (cyclic loading up to 100,000 cycles) removal torque value of the abutment screw were measured with digital torque gauge. Then rate of the initial and the postload removal torque loss were calculated for the comparison of the effect of tightening torques and joint connection types between implant and abutment on the joint stability. Results and conclusion: 1. Increase in tightening torque value resulted in significant increase in initial and postload removal torque value in all implant systems (P < .05). 2. Initial removal torque loss rates in SS II system were not significantly different when three different tightening torque values were applied (P > .05), however GS II and US II systems exhibited significantly lower loss rates with 40 Ncm torque value than with 20 Ncm (P < .05). 3. In all implant systems, postload removal torque loss rates were lowest when the torque value of 30 Ncm was applied (P < .05). 4. Postload removal torque loss rates tended to increase in order of SS II, GS II and US II system. 5. There was no correlation between initial removal torque value and postload removal torque loss rate (P > .05).

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.4
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• pp.372-380
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• 2008

Purpose: The purpose of this study was to evaluate the effect of various methods of dentin bonding agent application on microtensile bond strength between dentin and resin, using a 2-step etch-and-rinse dentin bonding agent. Material and methods: Twenty freshly extracted human molars were obtained and divided into 4 groups of 5 teeth. 2-step etch-and-rinse dentin bonding agent was used for all groups. The control specimens were prepared using a direct immediate bonding technique. The delayed dentin sealing (A, C) specimens were prepared using an indirect approach with delayed dentin sealing. For group A, resin was built-up on uncured dentin bonding agent, and for group C, resin was built-up on pre-cured dentin bonding agent. Preparation of the immediate dentin sealing (B) specimens also used an indirect approach with immediate dentin sealing immediately following preparation. All teeth were prepared for a microtensile bond strength test. Specimens were stored in water for 24 hours. Ten beams (1.0 ${\times}$ 1.0 ${\times}$ 11 mm) from each tooth were selected for testing. Bond strength data (MPa) were analyzed with a one-way ANOVA test, and post hoc comparison was done using the Scheffe's test. Results: The mean microtensile bond strengths of control group, B and C (DDS with pre-cure) were not statisticaaly different from each other at 32.7, 33.3, 34.2 MPa. the bond strength for group A (DDS without pre-cure), 19.5 MPa, was statistically different (P < .01) from the other 3 groups. Conclusion: When preparing teeth for indirect bonded restorations, DDS with pre-curing dentin bonding agent and IDS results in the same bond strength between dentin and resin. On the contrast, the bond strength was decreased when DDS without pre-curing dentin bonding agent was used.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.4
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• pp.359-371
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• 2008

Purpose: The purpose of this study was to investigate the stress distribution in mandibular implant overdentures with telescopic crowns compared to bar attachment. Material and methods: Three-dimensional finite element models consisting of the mandibular bone, 4 implants, and primary bar-splinted superstructure or secondary splinted superstructure with telescopic crowns were created. Vertical and oblique loads were directed onto the occlusal areas of the superstructures to simulate the maximal intercuspal contacts and working contacts such as group function occlusion. Maximum stress and stress distribution were analysed in mandibular bone, implant abutments, and superstructures. Results: 1. In comparison of von Mises stress on mandibular bone, telescopic overdenture had a little lower stress values in vertical load and working side load except oblique load. In the mandible, the telescopic overdenture distributed more uniform stress than the bar overdenture. 2. In comparison of von Mises stress on implant abutments, telescopic overdenture had much lower stress values in all load conditions. In implant abutments, the telescopic overdenture distributed stress similar to the bar overdenture. Stress was concentrated on the distal surfaces of the posterior implant abutments in both mandibular overdentures. 3. In comparison of von Mises stress on superstructures, the telescopic overdenture had much more stress values in all load conditions. However, the telescopic overdenture distributed more uniform stress on superstructure than the bar overdenture. In the bar overdenture, stress was concentrated on each cental area of bar structures and connected area between implant abutments and bar structures. Conclusion: In the results of this study, the telescopic overdenture had lower stress values than the bar overdenture in mandibular bone and implant abutments, but more stress values in superstructures. However, if optimal material was selected in making superstructures, the telescopic overdenture was compared to the bar overdenture in stress distribution.

• Journal of Technologic Dentistry
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• v.10 no.1
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• pp.159-169
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• 1988

Fixed prosthetic appliance is the restorations of damaged teeth with cast metal or porcelain, and of replacing missing teeth with fixed, or cemented prosthesis. Successfully treating a patient by means of fixed prosthodontics requires the thoughtful combination of dentist and dental laboratory technician. In order to know the satisfaction of dentisits about fixed prosthetic appliances-porcelain, precious and non precious metal-, this study was conducted for 69 practicing dentisis in Pusan during Fed. to Mar. 1988 using a questionnaire method and was analyzed by the use of percentage, $X^2$-test The results are obtained as follow: 1. General characteristics of the respondents, The rate of age distribution of practcing dentists responded was as follow : 31$\sim$35 age group is 29.0%, 51$\sim$55age group 18.8%, 41$\sim$45 age group and 46$\sim$50 group each 11.6%, 36$\sim$40 age group and 56$\sim$60 age group 8.7%, over 60 age group 7.3%, below 30 age group 4.3% respectively. The tate of term of practice experience distribution of dentists responded was as follow : 6$\sim$10 year group 26.1%, 25$\sim$25year group 18.8%, 11$\sim$15 years group and 16~20 years group each 13.0%, below 5 years group and over 30 years group each 10.2%, 26$\sim$30 years group 8.7% in order. The rate of respondents’ degree was follow : bachelor group 81.2%, doctor group 13.0%, master group 5.8% in order. The rate of respondents’completed medical specialist course was as follow : non-complete group 75.4%, complete group 24.6%. The rate of having own laboratory in respondents’clinic was as follow : no having own laboratory group 58.0%, having own labiratory group 42.0% The rate of being lab. technician in respondent;s clinic was as follow: non-being lab. technician group 91.3%, being lab. technician group 8.7%. The rate of transactional commercial dental lab. numbers was as follow : I dental lab. group 40.6%, 2 dental lab. group 30.4%, 3 dental lab. group 20.3%, production at own lab. group 8.7% 2. Cognitions about the respondent's job, About cognition of patient numvers, there were neither many nor few group 62.3%, few group 17.4%, many group 15.9%, too many group 4.4% in order.(P<.01) As compared with the ratio of dentists to patient prothetic treatment, there were moderate level group 46.4%, high level group 33.6%, low level group 18.8% in order.(P<.01) By job satisfaction of respondents, the highest percentage group was satisfied group 44.9%, neither astisfied nor disstified group 33.3%, dissatisfied group 14.5%, much satisfied group 7.3%(P<.01). As compared with the level of prosthetics price, the were moderate level group 71.0%, low level group 23.2%, high level group 5.8%(P<.01) 3. Satisfaction and assessment of dissatisfied factor of the fixed prosthetic appliance, As compared with the satisfaction of al prosthetic appliance, there were neither satisfied nor dissatisfied group 59.4%, satisfied group 20.3% dissatisfied group 18.8%, much satisfied group 1.5% in order.(P<.01). About precious and non precious metal crown and bridge, there were neither satisfied nor dissatisfied group 60.9%, satisfied group 24.6%, dissatisfied group 11.6%, much satisfied group 2.9% in order.(P<.01) The reat of respondent;s satisfaction about porcelain crown and bridge was as follow : neither satisfied nor dissatisfied group 43.5%, dissatisfied group 33.3%, satisfied group 21.7%, much satisfied group 1.5%(P<.01). The rate of respondent's dissatisfied factor item of precious and non precious metal crown and bridge was as follow : inadequate margin fit item 39.1% respondent, inadequate occlusion item 24.6%, inadequate adaptation item 23.2%, poor anat omic form item 15.9%, inadequate contact item 31.9%, improper polishing item 4.4%, the rest item 11.6% respectively. The rate of respondent's dissatisfied factor item of porcelain crown and bridge was as follow : inadequate margin fit item 52.2%, inadequate occlusion item 2.9%, inadequate adaptation item 10.1%, poor anatomic form item 11.6%, improper polishing item 1.5%, shade mismatching item 71%, the rest item 7.2% respectively. The rate of cognition of respondents’ about cause of dissatisfied factor on fixed prosthetic appliance by item was as follow : deficiency of sincerity item 55.1%, deficiency of knowledge about work item 47.8%, deficiency of experience item 15.9%, poor quality of using material item 5.8%, the rest item 2.9% respectively.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.25-39
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• 2011

In animal studies, Magnesium (Mg) - incorporated oxidized implants showed significant enhancement of the bone response. This prospective clinical trial was performed to investigate the success rate, implant stability and marginal bone loss of Mg oxidized clinical implant. The experimental protocol was approved by Institutional Review Board of the Gangneung-Wonju National University Dental Hospital. Fifty healthy patients had partial edentulism were included in this study. Mg oxidized clinical implants (Implant M, Shinhung, Korea) were installed and restored with conventional protocol. The patients were recalled at 1, 3, 6 months after functional loading. Implant stability quotient (ISQ) was measured and periapical radiographic images were obtained. Amount of marginal bone loss was calculated with calibrated images from periapical radiographs. Repeated measured analysis of variance and post hoc Tukey test were used to compare the mean ISQ and bone level. A total of 101 implants were analyzed. The mean ISQ values increased continuously with time lapse from 68.4 at fixture installation to 71.5 at 6 months after loading. Implant stability was correlated with gender, fixture diameter, bone quality and implant sites. The mean marginal bone loss during 6 months after loading was 0.26 mm. There was no failed implant and six-month success rate was 100%. Within the limitations of this study, the six-month success rate of Mg oxidized implant was satisfactory. The implant stability and marginal bone level were excellent. However, further longer clinical studies will be needed to confirm the success of Mg oxidized clinical implant.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.2
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• pp.73-81
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• 2013

Purpose: The purpose of this study was to evaluate the effect of surface treatment on the shear bond strength of zirconia ceramic to 3 resin cements. Materials and methods: A total of 143 disk-shaped Zirconia blocks (HASS Co., Gangneung, Korea) were randomly divided into three treatment groups: (1) only 50 ${\mu}m$ $Al_2O_3$ sandblasting, (2) 50 ${\mu}m$ $Al_2O_3$ sandblast and zircona liner, (3) 50 ${\mu}m$ $Al_2O_3$ sandblasting and Rocatec (3M ESPE, Seefeld, Germany). Bistite II (Tokuyama Dental Co., Japan), Panavia F (Kuraray Medical, Japan), and Superbond C&B (Sun Medical, Japan) were used to cement onto the zirconia. After 24h of storage in distilled water, shear bond strength was evaluated. High value group was re-tested after thermocycling at 5,000 cycles(5-$55^{\circ}C$). Shear bond strength data were analyzed with one-way ANOVA, two-way ANOVA test and Post Hoc Test (${\alpha}$=.05). Shear bond strength data before and after thermocycling were analyzed with Independent sample T test (${\alpha}$=.05). Results: Super-bond C&B treated with Rocatec showed the most high shear bond strength. Super-bond C&B groups resulted in significantly higher than other cement groups (P<.05). Rocatec groups resulted in significantly higher than other surface treatment groups (P<.05). Shear bond strength has increased in Panavia F treated with Zirconia liner (P<.05). After thermocycling, shear bond strength was increased in Super-bond C&B treated with Rocatec but decreased in other groups (P<.05). Conclusion: Super-bond C&B cement resulted the highest shear bond strength and Rocatec system enhanced the shear bond strength. After thermocycling, shear bond strength has decreased in most resin cements except Super-bond C&B treated with Rocatec.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.2
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• pp.99-106
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• 2013

Purpose: The aim of this research was to establish the effect and variation in differing convergence angle and length of abutment on the retention of full veneer casted gold crown. Materials and methods: Two different length,5 mm and 10 mm in height with convergence angles of 5, 10, 15 and 25 degrees crowns were fabricated. Cementation was done using cements; zinc phosphate cement (Fleck's zinc phosphate cement), resin-modified glass ionomer cement (Vitremer) and resin cement (Panavia 21). These were tested for tensile force at the point of separation by using Instron Universal Testing Machine. Statistical analysis was done by SAS 6.04 package. Results: In all cements the mean retention decreased with significant difference on increase of convergence angle (P<.05). Increase in every 5 degree-convergence angel the retention rate decreased with resin-modified glass ionomer cement of 15.9% and resin cement of 14.8%. With zinc phosphate cement, there was largest decreasing rate of mean retention of 25.5% between convergence angles from 5 degree to 10 degree. When the crown length increased from 5 mm to 10 mm, the retention increased with the significant difference in the same convergence angle and in all types of cement used (P<.05). Conclusion: The retention was strongly dependent on geometric factors of abutment. Much care is required in choosing cements for an optimal retention in abutments with different convergence angles and crown lengths.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.307-314
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• 2013

Purpose: The aim of this study was to evaluate the effect of immobilization of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on anodized titaum implants coated with heparin to enhance the vertical alveolar ridge augmentation in the supraalveolar peri-implant defect region. Materials and methods: 18 pure titanium implants (7.0 mm in length, 3.5 mm in diameter) were manufactured for this study. All implants were anodized and designed insertion reference line marked with laser at the apical 2.5 mm from the fixture platform. Implantation of 6 noncoated anodized implants (Control group), 6 anodized implants physically adsorbed with rhBMP-2 by dip and dry method (BMP group) and 6 anodized implants chemically immobilized 3,4-dihydroxyphenylalanine (DOPA)-heparin/ rhBMP-2 (Hep-BMP group) was performed in the both mandibular of three male adult beagle dogs using split-mouth design. Radiologic examinations were performed immediately after implant placement and 4 and 8 weeks after implant placement. The amount of mesio-distal bone augmentation was evaluated by measuring the vertical distance from the platform to the marginal bone. Statistical analysis was performed using one-way analysis of variance (SPSS version 18.0) and multiple comparison analysis of The Kruskal-Wallis test and the Mann-Whitney U test. Statistical significance was established at the 5% significant level. Results: At the 4 weeks vertical alveolar ridge augmentation of Control group, BMP group and Hep-BMP group is $0.09{\pm}0.22mm$, $1.02{\pm}0.72mm$, and $1.29{\pm}0.51mm$, At the 8 weeks $0.11{\pm}1.26mm$, $1.11{\pm}0.58mm$, $1.59{\pm}0.79mm$ according to radiographic observations. The two experimental groups showed a significantly increasing in vertical bone height compared with the control group (P<.05). However, there is no significant difference between the BMP group and Hep-BMP group (P>.05). Conclusion: The rhBMP-2 coated implants were enhanced the vertical bone growth in the supraalveolar peri-implant defect area. However, there is no significant difference between chemically and physically coating method.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.315-322
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• 2013

Purpose: To evaluate the axial displacement of implant-abutment assembly after cyclic loading in internal tapered connection system. Materials and methods: External butt-joint connection implant and internal tapered connection implant were connected with three types of abutment for cement-retained prostheses, i.e. external type abutment (Ext group), internal tapered 1-piece abutment (Int-1 group), and internal tapered 2-piece abutment (Int-2 group). For each group, 7 implants and abutments were used. The implantabutments assemblies were clamped into the implant holder for vertical loads. A dynamic cyclic loading was applied for $150{\pm}10N$ at a frequency of 4 Hz. The amount of axial displacement of the abutment into the implant was calculated at each cycle of 0, 5, 10, 50, 100, 1,000, 5,000, and 10,000. A repeated measures analysis of variance (ANOVA) for the overall effect of cyclic loading and the pattern analysis by linear mixed model were used for statistical analysis. Differences at P<.05 were considered statistically significant. Results: The mean axial displacement after 10,000 cycles were $0.714{\pm}0.488{\mu}m$ in Ext group, $5.286{\pm}1.604{\mu}m$ in Int-1 group, and $11.429{\pm}1.902{\mu}m$ in Int-2 group. In the pattern analysis, Int-1 and Int-2 group showed continuous axial displacement at 10,000 cycles. There was no declining pattern of axial displacement in the Ext group. Conclusion: The pattern of linear mixed model in Ext group showed no axial displacement. There were continuous axial displacements in abutment-implant assemblies in the Int-1 and Int-2 group at 10,000 cycles. More axial displacement was found in Int-2 group than in Int-1 group.