• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.321-327
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• 2017

PURPOSE. The aim of this study was to investigate dental arch dimensions and to classify arch shape in Korean young adults. MATERIALS AND METHODS. The sample included 50 Koreans with age ranging from 24 to 32 years. Maxillary and mandibular casts were fabricated using irreversible hydrocolloid and type III dental stones. Incisor-canine distance, $incisor-1^{st}$ molar distance, $incisor-2^{nd}$ molar distance, intercanine distance, $inter-1^{st}$ molar distance, and $inter-2^{nd}$ molar distance in both the maxillary and mandibular arch were measured using a three-dimensional measuring device. The dental arch was classified into three groups using five ratios from the measured values by the K-means clustering method. The data were analyzed with one-way analysis of variance. RESULTS. Arch lengths (IM2D, $incisal-2^{nd}$ molar distance) were 44.13 mm in the maxilla and 40.40 mm in the mandible. Arch widths (M2W, inter $2^{nd}$ molar width) were 64.12 mm in the maxilla and 56.37 mm in the mandible. Distribution of the dental arch form was mostly ovoid shape (maxilla 52% and mandible 56%), followed by the V-shape and the U-shape. The arch width for the U-shape was broader than for the other forms. CONCLUSION. This study establishes new reference data for dental arch dimensions for young Korean adults. The most common arch form is the ovoid type in the maxilla and mandible of Koreans. Clinicians should be aware of these references and classify arch type before and during their dental treatment for effective and harmonized results in Koreans.

• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.371-380
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• 2017

PURPOSE. The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS. Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS. Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION. The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.341-349
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• 2017

PURPOSE. This study evaluated the accuracies of different bite registration techniques for implant-fixed prostheses using three dimensional file analysis. MATERIALS AND METHODS. Implant fixtures were placed on the mandibular right second premolar, and the first and second molar in a polyurethane model. Aluwax (A), Pattern Resin (P), and Blu-Mousse (B) were used as the bite registration materials on the healing abutments (H) or temporary abutments (T). The groups were classified into HA, HP, HB, TA, TP, and TB according to each combination. The group using the bite impression coping was the BC group; impression taking and bite registration were performed simultaneously. After impression and bite taking, the scan bodies were connected to the lab analogs of the casts. These casts were scanned using a model scanner. The distances between two reference points in three-dimensional files were measured in each group. One-way ANOVA and Duncan's test were used at the 5% significance level. RESULTS. The smallest distance discrepancy was observed in the TB group using the temporary abutments. The Blu-Mousse and HP groups showed the largest distance discrepancy. The TB and BC groups showed a lower distance discrepancy than the HP group (P=.001), and there was no significant difference between the groups using the temporary abutments and healing abutments (P>.05). CONCLUSION. Although this study has limitations as an in-vitro investigation, the groups using the temporary abutments to hold the Blu-Mousse record and bite impression coping showed greater accuracy than the group using the healing abutments to hold the pattern resin record.

• Journal of Technologic Dentistry
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• v.30 no.1
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• pp.109-119
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• 2008

The Status of oral health and dental prosthetic treatment in Daegu and Gyoung Buk area was examined. To investigate the correlation between factors such as demographic and socioeconomic characteristics and status of oral health and knowledge about oral preventive measures, a survey was performed. After analyzing the effects of knowledge levels about dental prosthetic treatment on the oral health status and preventive measures, following results were obtained. A Total of 625 people participated in the survey for three months from October 2007 to January 2008. The responses from the survey were then analyzed to assess whether those with less knowledge of preventive measures tended to have more dental prosthetic work. Of those that took part in the survey: ${\cdot}$ 30.2% were in their twenties ${\cdot}$ 56.2% were married ${\cdot}$ 51.4% of respondents had at least a college degree ${\cdot}$ 42.4% had monthly incomes below one million Won ${\cdot}$ 24.3% were students ${\cdot}$ 55.8% were from urban areas After studying the relationship between oral health and various demographics, researchers concluded that respondents' sex, income, job and place of residence had no effect on the overall status of their oral health. However, those that were divorcees or widows (1.95${_+}/{_-}$ 0.32), over the age of 70 (1.67${_+}/{_-}$0.31), or had little education (0.82${_+}/{_-}$0.28), all demonstrated a statistically significant effect on their oral health with a significance level of 0.05.Cross analysis revealed a p-value of 0.000. The correlation between knowledge of oral preventive measures and other factors was examined. No difference was found between men and women but people who were divorced or lost their spouse, people over the age of 60, and people with no education, the results of knowledge of oral preventive measure was poor as 1.74$\pm$0.44, 1.85$\pm$0.40, 1.85$\pm$0.44,and 1.60$\pm$0.47 separately. Cross analysis showed that p-value was 0.000 and correlation between knowledge of oral preventive measures and those factors were statistically significant at significance level of 0.05. The status of dental prosthetic treatment was investigated. Women, people with higher income, and married people had more dental prosthetic treatment and it was related to education, income, residential area, and the status of dental prosthetic treatment. The returns of those factors was 32.7%. Respondents$^{\circ}{\emptyset}$ oral hygiene status and knowledge of oral preventive measures was related to demographic or socioeconomic factors. Therefore, a preventive program for oral health care needs to be developed in advanced countries. Knowledge of oral health is below the international average and more research and effort needs to be put in to develop public knowledge of dental prosthetic treatment. Government intervention such as enacting an oral health initiative or dental insurance that covers prosthetic treatments is urgently needed.

• The Journal of Advanced Prosthodontics
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• v.1 no.3
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• pp.129-135
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• 2009

STATEMENT OF PROBLEM. Zirconia-based restorations have the common technical complication of delamination, or porcelain chipping, from the zirconia core. Thus the shear bond strength between the zirconia core and the veneering porcelain requires investigation in order to facilitate the material's clinical use. PURPOSE. The purpose of this study was to evaluate the bonding strength of the porcelain veneer to the zirconia core and to other various metal alloys (high noble metal alloy and base metal alloy). MATERIAL AND METHODS. 15 rectangular ($4\times4\times9mm$) specimens each of zirconia (Cercon), base metal alloy (Tillite), high noble metal alloy (Degudent H) were fabricated for the shear bond strength test. The veneering porcelain recommended by the manufacturer for each type of material was fired to the core in thickness of 3mm. After firing, the specimens were embedded in the PTFE mold, placed on a mounting jig, and subjected to shear force in a universal testing machine. Load was applied at a crosshead speed of 0.5mm/min until fracture. The average shear strength (MPa) was analyzed with the oneway ANOVA and the Tukey's test ($\alpha$= .05). The fractured specimens were examined using SEM and EDX to determine the failure pattern. RESULTS. The mean shear strength ($\pm\;SD$) in MPa was 25.43 ($\pm\;3.12$) in the zirconia group, 35.87 ($\pm\;4.23$) in the base metal group, 38.00 ($\pm\;5.23$) in the high noble metal group. The ANOVA showed a significant difference among groups, and the Tukey' s test presented a significant difference between the zirconia group and the metal group. Microscopic examination showed that the failure primarily occurred near the interface with the residual veneering porcelain remaining on the core. CONCLUSION. There was a significant difference between the metal ceramic and zirconia ceramic group in shear bond strength. There was no significant difference between the base metal alloy and the high noble metal alloy.

• The Journal of Advanced Prosthodontics
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• v.1 no.3
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• pp.124-128
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• 2009

STATEMENT OF PROBLEM. How the ISQ values measured by $Osstell^{TM}$ and $Osstell^{TM}$ Mentor are related, and whether the ISQ values acquired from the two machines changes in accordance with changes in implant stability are not yet fully understood. PURPOSE. The aim of this study was to find out correlation between the ISQ values acquired from $Osstell^{TM}$ and $Osstell^{TM}$ Mentor, and to evaluate the clinical effectiveness and accuracy of two devices. MATERIAL AND METHODS. Sixty two implants were inserted into 47 patients, and their ISQ values were measured using $Osstell^{TM}$ and $Osstell^{TM}$ Mentor. In the first stage surgery, the ISQ values of forty four implants inserted into thirty five patients were measured. In the second stage surgery, the values of fifty implants inserted into thirty seven patients were measured. The values were analyzed to determine the difference between the mean ISQ values of $Osstell^{TM}$ and $Osstell^{TM}$ Mentor. In addition, the correlation between implants used in the first and second stage of surgery with regard to their types and areas of insertion were analyzed. The difference between the ISQ values of 32 implants in each patient during the first and second stage was analyzed. The statistical assessment was carried out using SPSS V. 12.0 for Win. (SPSS Inc., Chicago, USA). The Pearson correlation coefficient was used to examine the correlation between $Osstell^{TM}$ and $Osstell^{TM}$ Mentor in the first and second stages of surgery, whereas the difference between their ISQ values was evaluated using a paired t-test. RESULTS. In the first stage, the mean ISQ value for $Osstell^{TM}$ and $Osstell^{TM}$ Mentor was 70.84 and 75.09, respectively, showing a significant difference (P < .01). In the second stage, the mean ISQ value of $Osstell^{TM}$ and $Osstell^{TM}$ Mentor was 71.76 and 75.94, respectively, also showing a significant difference (P < .01). The difference between the ISQ values in patients in the first and the second stages was significant with both instruments. CONCLUSION. The significant difference in the values obtained using the $Osstell^{TM}$ and $Osstell^{TM}$ Mentor between the first and second stages of implant surgery indicates that these values can be a convenient and precise way for evaluating the implant stability in clinical practice.

• The Journal of Advanced Prosthodontics
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• v.1 no.3
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• pp.113-117
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• 2009

STATEMENT OF PROBLEM. Recently Yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) has been introduced due to superior flexural strength and fracture toughness compared to other dental ceramic systems. Although zirconia has outstanding mechanical properties, the phenomenon of decrease in the life-time of zirconia resulted from degradation in flexural strength after low temperature aging has been reported. PURPOSE. The objective of this study was to investigate degradation of flexural strength of Y-TZP ceramics after various low temperature aging treatments and to evaluate the phase stability and micro-structural change after aging by using X-ray diffraction analysis and a scanning electron microscope (SEM). MATERIAL AND METHODS. Y-TZP blocks of Vita In-Ceram YZ (Vita Zahnfabrik, Bad $S\ddot{a}ckingen$, Germany) were prepared in 40 mm (length) $\times$ 4 mm (width) $\times$ 3 mm (height) samples. Specimens were artificially aged in distilled water by heat-treatment at a temperature of 75, 100, 125, 150, 175, 200, and $225^{\circ}C$ for 10 hours, in order to induce the phase transformation at the surface. To measure the mechanical property, the specimens were subjected to a four-point bending test using a universal testing machine (Instron model 3365; Instron, Canton, Mass, USA). In addition, X-ray diffraction analysis (DMAX 2500; Rigaku, Tokyo, Japan) and SEM (Hitachi s4700; Jeol Ltd, Tokyo, Japan) were performed to estimate the phase transformation. The statistical analysis was done using SAS 9.1.3 (SAS institute, USA). The flexural strength data of the experimental groups were analyzed by one-way analysis of variance and to detect statistically significant differences ($\alpha$= .05). RESULTS. The mean flexural strength of sintered Vita In-Ceram YZ without autoclaving was 798 MPa. When applied aging temperature at below $125^{\circ}C$ for 10 hours, the flexural strength of Vita In-Ceram YZ increased up to 1,161 MPa. However, at above $150^{\circ}C$, the flexural strength started to decrease. Although low temperature aging caused the tetragonal-to-monoclinic phase transformation related to temperature, the minimum flexural strength was above 700 MPa. CONCLUSION. The monoclinic phase started to appear after aging treatment above $100^{\circ}C$. With the higher aging temperature, the fraction of monoclinic phase increased. The ratio of monoclinic/tetragonal + monoclinic phase reached a plateau value, circa 75% above $175^{\circ}C$. The point of monoclinic concentration at which the flexural strength begins to decrease was between 12% and 54%.

• The korean journal of orthodontics
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• v.41 no.4
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• pp.268-279
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• 2011

Objective: The purpose of this study was to compare self-drilling orthodontic mini-implants of different surfaces, namely, machined (untreated), etched (acid-etched), RBM (treated with resorbable blasting media) and hybrid (RBM + machined), with respect to the following criteria: physical appearance of the surface, measurement of surface roughness, and insertion pattern. Methods: Self-drilling orthodontic mini-implants (Osstem implant, Seoul, Korea) with the abovementioned surfaces were obtained. Surface roughness was measured by using a scanning electron microscope and surface-roughness-testing machine, and torque patterns and vertical loadings were measured during continuous insertion of mini-implants into artificial bone (polyurethane foam) by using a torque tester of the driving-motor type (speed, 12 rpm). Results: The mini-implants with the RBM, hybrid, and acid-etched surfaces had slightly increased maximum insertion torque at the final stage ($p$ < 0.05). Implants with the RBM surface had the highest vertical load for insertion ($p$ < 0.05). Testing for surface roughness revealed that the implants with the RBM and hybrid surfaces had higher Ra values than the others ($p$ < 0.05). Scanning electron microscopy showed that the implants with the RBM surface had the roughest surface. Conclusions: Surface-treated, self-drilling orthodontic mini-implants may be clinically acceptable, if controlled appropriately.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.22 no.1
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• pp.30-46
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• 2013

Porcelain fused to metal crown has been used mostly over the last 50 years for restorations in dentistry. However, the patients' awareness of aesthetic aspect, biocompatibility and the problems such as an allergy to metals led to the growing interest in the 'metal free restoration'. In particular, the price of the precious metals that have been mainly used to date has risen drastically, which made them impossible to play their role as oral restorative materials anymore, and in addition, the PFM restoration has intrinsic problems of chipping and fracture. Therefore, the CAD/CAM has been drawing more attention than ever due to the popular needs for the material that is more aesthetic and stronger for restoration of the molar implant. Considerations in carrying out the full zirconia restoration are as follows: 1) strength, 2) combination work, 3) light penetrability, 4) treatment of cracks, 5) the color reproducibility of the block, 6) the abrasivity of antagonistic tooth, 7) low temperature degradation. In this presentation, the color reproducibility of the block will be discussed. One of the biggest reasons for avoiding the full zirconia restoration is that it is difficult to reproduce the natural color compared to the conventional PFM restoration. Thus, many clinicians show reluctance due to the exposure of the ugly block when the coloring on the surface is removed after occlusal adjustment. From the experience of using blocks by Zirkonzahn for more than 4 years, it is considered that these problems can be addressed to some degrees. Accordingly, how to make restorations that are well in harmony with surrounding prosthesis or natural teeth will be discussed.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.4
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• pp.257-268
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• 2003

The purpose of this study was to assess the loading distributing characteristics of implant prosthesis according to position and direction of load, under vertical and inclined loading using FEA analysis. The finite element model was designed according to standard fixture (4.1mm restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction (loading condition A), 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction (loading condition B), 200N at the centric usp in a $15^{\circ}$ inward oblique direction (loading condition C), 200N at the in a $30^{\circ}$ inward oblique direction (loading condition D) or 200N at the centric cusp in a $30^{\circ}$ outward oblique direction (loading condition E) individually. Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study: 1. Stresses were concentrated mainly at the ridge crest around implant in both vertical and oblique loading but stresses in the cancellous bone were low in both vertical and oblique loading. 2. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading than with the vertical loading. 3. An offset of the vertical occlusal force in the buccolingual direction relative to the implant axis gave rise to increased bending of the implant. 4. The relative positions of the resultant line of force from occlusal contact and the center of rotation seems to be more important. 5. The magnitude of the stress in the supporting bone, fixture and abutment screw was greater with the outward oblique loading than with the inward oblique loading and was the greatest under loading at the centric cusp in a $30^{\circ}$ outward oblique direction. Conclusively, this study provides evidence that bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. But it seems to be more important that how long is the distance from center of rotation of the implant itself to the resultant line of force from occlusal contact(leverage). The goal of improving implants should be to avoid bending of the implant.