• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.229-235
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• 2011

PURPOSE. The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS. A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS. Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION. The 5-year CSR of Implantium implants was 97.37 %. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.

• The Journal of Advanced Prosthodontics
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• v.5 no.3
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• pp.287-295
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• 2013

PURPOSE. This study investigated the effect of laser parameters and air-abrasion on the peel strength of silicon-based soft denture liner to different denture resins. MATERIALS AND METHODS. Specimens (N=180) were prepared out of three different denture base resins (Rodex, cross-linked denture base acrylic resin; Paladent, heat-cured acrylic resin; Deflex, Polyamide resin) ($75mm{\times}25mm{\times}3mm$). A silicon-based soft denture liner (Molloplast B) was applied to the denture resins after the following conditioning methods: a) Air-abrasion ($50{\mu}m$), b) Er,Cr:YSGG laser (Waterlase MD Turbo, Biolase Technology) at 2 W-20 Hz, c) Er,Cr:YSGG laser at 2 W-30 Hz, d) Er,Cr:YSGG laser at 3 W-20 Hz, e) Er,Cr:YSGG laser at 3 W-30 Hz. Non-conditioned group acted as the control group. Peel test was performed in a universal testing machine. Failure modes were evaluated visually. Data were analyzed using two-way ANOVA and Tukey's test (${\alpha}$=.05). RESULTS. Denture liner tested showed increased peel strength after laser treatment with different parameters ($3.9{\pm}0.4-5.58{\pm}0.6$ MPa) compared to the control ($3.64{\pm}0.5-4.58{\pm}0.5$ MPa) and air-abraded groups ($3.1{\pm}0.6-4.46{\pm}0.3$ MPa), but the results were not statistically significant except for Paladent, with the pretreatment of Er,Cr:YSGG laser at 3 W-20 Hz. Polyamide resin after air-abrasion showed significantly lower peel strength than those of other groups ($3.1{\pm}0.6$ MPa). CONCLUSION. Heat-cured acrylic resin, PMMA, may benefit from Er,Cr:YSGG laser treatment at 3 W-20 Hz irradiation. Air-abrasion of polyamide resins should be avoided not to impair their peel bond strengths to silicon-based soft denture liners.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.485-493
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• 2013

PURPOSE. To evaluate the effects of surface treatments on shear bond strength (SBS) between microwave and conventionally sintered zirconia core/veneers. MATERIALS AND METHODS. 96 disc shaped Noritake Alliance zirconia specimens were fabricated using YenaDent CAM unit and were divided in 2 groups with respect to microwave or conventional methods (n=48/group). Surface roughness (Ra) evaluation was made with a profilometer on randomly selected microwave (n=10) and conventionally sintered (n=10) cores. Specimens were then assessed into 4 subgroups according to surface treatments applied (n=12/group). Groups for microwave (M) and conventionally (C) sintered core specimens were as follows; $M_C$,$C_C$: untreated (control group), $M_1,C_1:Al_2O_3$ sandblasting, $M_2,C_2$:liner, $M_3,C_3:Al_2O_3$ sandblasting followed by liner. Veneer ceramic was fired on zirconia cores and specimens were thermocycled (6000 cycles between $5^{\circ}-55^{\circ}C$). All specimens were subjected to SBS test using a universal testing machine at 0.5 mm/min, failure were evaluated under an optical microscope. Data were statistically analyzed using Shapiro Wilk, Levene, Post-hoc Tukey HSD and Student's t tests, Two-Way-Variance- Analysis and One-Way-Variance-Analysis (${\alpha}$=.05). RESULTS. Conventionally sintered specimens ($1.06{\pm}0.32{\mu}m$) showed rougher surfaces compared to microwave sintered ones ($0.76{\pm}0.32{\mu}m$)(P=.046), however, no correlation was found between SBS and surface roughness (r=-0.109, P=.658). The statistical comparison of the shear bond strengths of $C_3$ and $C_1$ group (P=.015); $C_C$ and $M_C$ group (P=.004) and $C_3$ and $M_3$ group presented statistically higher (P=.005) values. While adhesive failure was not seen in any of the groups, cohesive and combined patterns were seen in all groups. CONCLUSION. Based on the results of this in-vitro study, $Al_2O_{3-}$ sandblasting followed by liner application on conventionally sintered zirconia cores may be preferred to enhance bond strength.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.479-484
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• 2013

PURPOSE. The aim of this study was to evaluate the effects of additional acid etching and curing mechanism (light-curing or self-curing) of a composite resin on the dentin bond strength and compatibility of one-step self-etching adhesives. MATERIALS AND METHODS. Sixteen human permanent molars were randomly divided into eight groups according to the adhesives used (All-Bond Universal: ABU, Clearfil S3 Bond: CS3), additional acid etching (additional acid etching performed: EO, no additional acid etching performed: EX), and composite resins (Filtek Z-250: Z250, Clearfil FII New Bond: CFNB). Group 1: ABU-EO-Z250, Group 2: ABU-EO-CFNB, Group 3: ABU-EX-Z250, Group 4: ABU-EX-CFNB, Group 5: CS3-EO-Z250, Group 6: CS3-EO-CFNB, Group 7: CS3-EX-Z250, Group 8: CS3-EX-CFNB. After bonding procedures, composite resins were built up on dentin surfaces. After 24-hour water storage, the teeth were sectioned to make 10 specimens for each group. The microtensile bond strength test was performed using a microtensile testing machine. The failure mode of the fractured specimens was examined by means of an optical microscope at ${\times}20$ magnification. The data was analyzed using a one-way ANOVA and Scheffe's post-hoc test (${\alpha}$=.05). RESULTS. Additional etching groups showed significantly higher values than the no additional etching group when using All-Bond Universal. The light-cured composite resin groups showed significantly higher values than the self-cured composite resin groups in the Clearfil S3 Bond. CONCLUSION. The additional acid etching is beneficial for the dentin bond strength when using low acidic one-step self-etch adhesives, and low acidic one-step self-etch adhesives are compatible with self-cured composite resin. The acidity of the one-step self-etch adhesives is an influencing factor in terms of the dentin bonding strength and incompatibility with a self-cured composite resin.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.402-408
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• 2013

PURPOSE. The aim of this study was to evaluate the surface properties and in vitro bioactivity to osteoblasts of magnesium and magnesium-hydroxyapatite coated titanium. MATERIALS AND METHODS. Themagnesium (Mg) and magnesium-hydroxyapatite (Mg-HA) coatings on titanium (Ti) substrates were prepared by radio frequency (RF) and direct current (DC) magnetron sputtering.The samples were divided into non-coated smooth Ti (Ti-S group), Mg coatinggroup (Ti-Mg group), and Mg-HA coating group (Ti-MgHA group).The surface properties were evaluated using scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The surface roughness was evaluated by atomic force microscopy (AFM). Cell adhesion, cell proliferation and alkaline phosphatase (ALP) activity were evaluated using MC3T3-E1 cells. Reverse transcription polymerase chain reaction (RT-PCR) analysis was performed. RESULTS. Cross-sectional SEM images showed that Mg and Mg-HA depositionson titanium substrates were performed successfully. The surface roughness appeared to be similaramong the three groups. Ti-MgHA and Ti-Mg group had improved cellular responses with regard to the proliferation, alkaline phosphatase (ALP) activity, and bone-associated markers, such as bone sialoprotein (BSP) and osteocalcin (OCN) mRNA compared to those of Ti-S group. However, the differences between Ti-Mg group and Ti-MgHA group were not significant, in spite of the tendency of higher proliferation, ALP activity and BSP expression in Ti-MgHA group. CONCLUSION. Mg and Mg-HAcoatings could stimulate the differentiation into osteoblastic MC3T3-E1 cells, potentially contributing to rapid osseointegration.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.471-478
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• 2013

PURPOSE. The aim of the study was to evaluate the effect of annealing on the nanostructure and hardness of Co-Cr metal ceramic samples that were fabricated with a direct metal laser sintering (DMLS) technique. MATERIALS AND METHODS. Five groups of Co-Cr dental alloy samples were manufactured in a rectangular form measuring $4{\times}2{\times}2$ mm. Samples fabricated by a conventional casting technique (Group I) and prefabricated milling blanks (Group II) were examined as conventional technique groups. The DMLS samples were randomly divided into three groups as not annealed (Group III), annealed in argon atmosphere (Group IV), or annealed in oxygen atmosphere (Group V). The nanostructure was examined with the small-angle X-ray scattering method. The Rockwell hardness test was used to measure the hardness changes in each group, and the means and standard deviations were statistically analyzed by one-way ANOVA for comparison of continuous variables and Tukey's HSD test was used for post hoc analysis. P values of <.05 were accepted as statistically significant. RESULTS. The general nanostructures of the samples were composed of small spherical entities stacked atop one another in dendritic form. All groups also displayed different hardness values depending on the manufacturing technique. The annealing procedure and environment directly affected both the nanostructure and hardness of the Co-Cr alloy. Group III exhibited a non-homogeneous structure and increased hardness ($48.16{\pm}3.02$ HRC) because the annealing process was incomplete and the inner stress was not relieved. Annealing in argon atmosphere of Group IV not only relieved the inner stresses but also decreased the hardness ($27.40{\pm}3.98$ HRC). The results of fitting function presented that Group IV was the most homogeneous product as the minimum bilayer thickness was measured (7.11 ${\AA}$). CONCLUSION. After the manufacturing with DMLS technique, annealing in argon atmosphere is an essential process for Co-Cr metal ceramic substructures. The dentists should be familiar with the materials that are used in clinic for prosthodontics treatments.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.452-456
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• 2013

PURPOSE. The aim of this study was to evaluate the repeatability of the digitizing of silicon rubber impressions of abutment teeth by using a white light scanner and compare differences in repeatability between different abutment teeth types. MATERIALS AND METHODS. Silicon rubber impressions of a canine, premolar, and molar tooth were each digitized 8 times using a white light scanner, and 3D surface models were created using the point clouds. The size of any discrepancy between each model and the corresponding reference tooth were measured, and the distribution of these values was analyzed by an inspection software (PowerInspect 2012, Delcamplc., Birmingham, UK). Absolute values of discrepancies were analyzed by the Kruskal-Wallis test and multiple comparisons (${\alpha}$=.05). RESULTS. The discrepancy between the impressions for the canine, premolar, and molar teeth were $6.3{\mu}m$ (95% confidence interval [CI], 5.4-7.2), $6.4{\mu}m$ (95% CI, 5.3-7.6), and $8.9{\mu}m$ (95% CI, 8.2-9.5), respectively. The discrepancy of the molar tooth impression was significantly higher than that of other tooth types. The largest variation (as mean [SD]) in discrepancies was seen in the premolar tooth impression scans: $26.7{\mu}m$ (95% CI, 19.7-33.8); followed by canine and molar teeth impressions, $16.3{\mu}m$ (95% CI, 15.3- 17.3), and $14.0{\mu}m$ (95% CI, 12.3-15.7), respectively. CONCLUSION. The repeatability of the digitizing abutment teeth's silicon rubber impressions by using a white light scanner was improved compared to that with a laser scanner, showing only a low mean discrepancy between $6.3{\mu}m$ and $8.9{\mu}m$, which was in an clinically acceptable range. Premolar impression with a long and narrow shape showed a significantly larger discrepancy than canine and molar impressions. Further work is needed to increase the digitizing performance of the white light scanner for deep and slender impressions.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.494-501
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• 2013

PURPOSE. The purpose of this study was to provide an actual guideline in determining the shape, diameter, and position of the implant in immediate implantation by the measurement of the thickness of facial and palatal plate, the thickness of cortical bone on the facial and palatal plate, the diameter of the root, and the distance between the roots in the cadavers. MATERIALS AND METHODS. The horizontal sections of 20 maxillae were measured and analyzed to obtain the average values. Resin blocks were produced and cut serially at 1 mm intervals from the cervical line to the root apex. Images of each section were obtained and the following measurements were performed: The thickness of the facial and palatal residual bone at each root surface, the thickness of the facial and palatal cortical bone at the interdental region, the diameter of all roots of each section on the faciopalatal and mesiodistal diameter, and the interroot distance. Three specimens with measurements close to the average values were chosen and 3-dimensional images were reconstructed. RESULTS. The thickness of the facial and palatal cortical bone at the interdental region in the maxilla, the buccal cortical bone was thicker in the posterior region compared to the anterior region. The interroot distance of the alveolar bone thickness between the roots increased from anterior to posterior region and from coronal to apical in the maxilla. CONCLUSION. In this study, the limited results of the morphometric analysis of the alveolar ridge using the sections of maxilla in the cadavers may offer the useful information when planning and selecting optimal implant for immediate implantation in the maxilla.

• The Journal of Advanced Prosthodontics
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• v.8 no.5
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• pp.363-371
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• 2016

PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

• The Journal of Advanced Prosthodontics
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• v.10 no.3
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• pp.218-226
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• 2018

PURPOSE. The aim of this study was to define a color space of non-vital teeth and to compare it with the color space of matched vital teeth, recorded in the same patients. MATERIALS AND METHODS. In a group of 218 patients, with the age range from 17 to 70, the middle third of the buccal surface of 359 devitalized teeth was measured using a clinical spectrophotometer (Vita Easyshade Advance). Lightness ($L^*$), chromatic parameters ($a^*$, $b^*$), chroma ($C^*$), hue angle (h) and the closest Vita shade in Classical and 3D Master codifications were recorded. For each patient, the same data were recorded in a vital reference tooth. The measurements were performed by the same operator with the same spectrophotometer, using a standardized protocol for color evaluation. RESULTS. The color coordinates of non-vital teeth varied as follows: lightness $L^*$: 52.83-92.93, $C^*$: 8.23-58.90, h: 51.20-101.53, $a^*$: -2.53-24.80, $b^*$: 8.10-53.43. For the reference vital teeth, the ranges of color parameters were: $L^*$: 60.90-97.16, $C^*$: 8.43-39.23, h: 75.30-101.13, $a^*$: -2.36-9.60, $b^*$: 8.36-39.23. The color differences between vital and non-vital teeth depended on tooth group, but not on patient age. CONCLUSION. Non-vital teeth had a wider color space than vital ones. Non-vital teeth were darker (decreased lightness), more saturated (increased chroma), and with an increased range of the hue interval. An increased tendency towards positive values on the $a^*$ and $b^*$ axes suggested redder and yellower non-vital teeth compared to vital ones.