• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.1
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• pp.1-14
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• 2005

The purpose of this study was to assess the loading distributing characteristics of implant prosthesis of internal connection system(ITI system) according to position and direction of load, under vertical and inclined loading using finite element analysis (FEA). The finite element model of a synOcta implant and a solid abutment with $8^{\circ}$ internal conical joint used by the ITI implant was constructed. The gold crown for mandibular first molar was made on solid 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 cusp 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. The following results have been made based on this study: 1. Stresses were concentrated mainly at the ridge crest around implant under both vertical and oblique loading but stresses in the cancellous bone were low under 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. So, the relative positions of the resultant line of force from occlusal contact and the center of rotation seems to be more important. 4. In this internal conical joint, vertical and oblique loads were resisted mainly by the implant-abutment joint at the screw level and by the implant collar. Conclusively, It seems to be more important that how long the distance is from center of rotation of the implant itself to the resultant line of force from occlusal contact (leverage). In a morse taper implant, vertical and oblique loads are resisted mainly by the implant-abutment joint at the screw level and by the implant collar. This type of implant-abutment connection can also distribute forces deeper within the implant and shield the retention screw from excessive loading. Lateral forces are transmitted directly to the walls of the implant and the implant abutment mating bevels, providing greater resistance to interface opening.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.359-370
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• 2011

To identify osseointegration of implants, dentists were performed the radiographic analysis. The fractal analysis methods using periapical radiographs before and after loading on implants was to evaluate whether or not significant. 30 patients who were placed implants in dental hospital of Wonkwang university were participated in this study. Total of 42 implants were analyzed. And, 14 males and 16 females aged from 22 to 73 participated in this study. The two morphologic and Fractal analysis of the one trabecular patterns in alveolar bone were done using periapical views. Two periapical views, after implant placement, and after 2 months of functional loading were analysed. The analysis was done by software, Image J(1.40s, National Institute of Health, Bethesda, USA). The data were statistically analyzed using one-way ANOVA(P<.05). Multiple comparison was done by the Tukey HSD test. The results of Fractal analysis and change in bone density around implants showed significantly different values, especially mandibles. However, in case of implants with failure, Fractal values decreased from 1.2865 to 1.1521 and 1.1135 to 1.0478.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.3
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• pp.267-277
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• 2009

Recently implant supported single crown is the popular treatment option to replace a single missing tooth. The purpose of this retrospective study was to analyze and evaluate the survival of implants with the $TiUnite^{TM}$ surface for single tooth replacement. From September 2002 to December 2006, 269 TiUniteTM surfaced implants were used in single tooth replacements at the Institute of Oral Health Science, Samsung Medical Center. Twenty one cases were excluded because of neighbor implants, missing records & short follow up period. Among 248 implants, the 129 implants (52.0%) were inserted in the maxilla and 119 (48.0%) in the mandible. One hundred implants placement (40.3%) were combined with guided bone regeneration, and 36 implants placement (14.5%) were combined with sinus bone augmentation. Mean observation period was $26.0{\pm}11.8$ months after implant placement. Twelve implants were recorded as failures, rendering a single implant survival rate of 95.2% over the observation period. Among failed 12 implants, 10 implants placed in the maxilla. The survival rate in the maxilla was 92.2% and in the mandible was 98.3%. The use of $TiUnite^{TM}$ surfaced single implant placement showed high survival rate for short time period.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.218-224
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• 2018

Macroglossia is an obstacle in regard to general prosthodontic restoration. Not only is it difficult to obtain support and stability from dentures manufactured from normal protocol, obtaining efficacy from basic mastication is also difficult. In such cases, realizing harmony between the occlusion and surrounding muscle structures may be important with regard to manufacture of stable full dentures, and it is necessary to form the appropriate polished surface for this case. The neutral zone is defined as the potential area resulting from the neuromuscular function that results in equilibrium between the outward force exerted by the tongue and the inward force exerted by the lips and cheeks. The artificial teeth of the full denture lies in this area, and if the polished zone follows the anatomic form of the dynamic muscles, the movement of the muscles simply acts as an element of stabilizing the dentures improving the esthetics through facial support.

• The Journal of Advanced Prosthodontics
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• v.2 no.4
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• pp.148-153
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• 2010

PURPOSE. The aim of this study was to investigate a comparison of implant bone bed preparation with Er,Cr:YSGG laser and conventional drills on the relationship between implant stability quotient (ISQ) values and implant insertion variables. MATERIALS AND METHODS. Forty implants were inserted into two different types of pig rib bone. One group was prepared with conventional drills and a total of 20 implants were inserted into type I and type II bone. The other group was prepared with a Er,Cr:YSGG laser and a total of 20 implants were inserted into type I and type II bone. ISQ, maximum insertion torque, angular momentum, and insertion torque energy values were measured. RESULTS. The mean values for variables were significantly higher in type I bone than in type II bone (P < .01). In type I bone, the ISQ values in the drill group were significantly higher than in the laser group (P < .05). In type II bone, the ISQ values in the laser group were significantly higher than in the drill group (P < .01). In both type I and type II bone, the maximum insertion torque, total energy, and total angular momentum values between the drill and laser groups did not differ significantly (P ${\geq}$ .05). The ISQ values were correlated with maximum insertion torque (P < .01, r = .731), total energy (P < .01, r = .696), and angular momentum (P < .01, r = .696). CONCLUSION. Within the limitations of this study, the effects of bone bed preparation with Er,Cr:YSGG laser on the relationship between implant stability quotient (ISQ) values and implant insertion variables were comparable to those of drilling.

• The Journal of Advanced Prosthodontics
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• v.10 no.2
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• pp.79-84
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• 2018

PURPOSE. All-ceramic restorations required extensive tooth preparation. The purpose of this in vitro study was to investigate a minimally invasive preparation and thickness of monolithic zirconia crowns, which would provide sufficient mechanical endurance and strength. MATERIALS AND METHODS. Crowns with thickness of 0.2 mm (group 0.2, n=32) or of 0.5 mm (group 0.5, n=32) were milled from zirconia and fixed with resin-based adhesives (groups 0.2A, 0.5A) or zinc phosphate cements (groups 0.2C, 0.5C). Half of the samples in each subgroup (n=8) underwent thermal cycling and mechanical loading (TCML)(TC: $5^{\circ}C$ and $55^{\circ}C$, $2{\times}3,000cycles$, 2 min/cycle; ML: 50 N, $1.2{\times}10^6cycles$), while the other samples were stored in water ($37^{\circ}C/24h$). Survival rates were compared (Kaplan-Maier). The specimens surviving TCML were loaded to fracture and the maximal fracture force was determined (ANOVA; Bonferroni; ${\alpha}=.05$). The fracture mode was analyzed. RESULTS. In both 0.5 groups, all crowns survived TCML, and the comparison of fracture strength among crowns with and without TCML showed no significant difference (P=.628). Four crowns in group 0.2A and all of the crowns in group 0.2C failed during TCML. The fracture strength after 24 hours of the cemented 0.2 mm-thick crowns was significantly lower than that of adhesive bonded crowns. All cemented crowns provided fracture in the crown, while about 80% of the adhesively bonded crowns fractured through crown and die. CONCLUSION. 0.5 mm thick monolithic crowns possessed sufficient strength to endure physiologic performance, regardless of the type of cementation. Fracture strength of the 0.2 mm cemented crowns was too low for clinical application.

• The Journal of Advanced Prosthodontics
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• v.10 no.2
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• pp.113-121
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• 2018

PURPOSE. The aim of this preliminary study was to investigate, for the first time, the effects of addition of titania nanotubes ($n-TiO_2$) to poly methyl methacrylate (PMMA) on mechanical properties of PMMA denture base. MATERIALS AND METHODS. $TiO_2$ nanotubes were prepared using alkaline hydrothermal process. Obtained nanotubes were assessed using FESEM-EDX, XRD, and FT-IR. For 3 experiments of this study (fracture toughness, three-point bending flexural strength, and Vickers microhardness), 135 specimens were prepared according to ISO 20795-1:2013 (n of each experiment=45). For each experiment, PMMA was mixed with 0% (control), 2.5 wt%, and 5 wt% nanotubes. From each $TiO_2$:PMMA ratio, 15 specimens were fabricated for each experiment. Effects of $n-TiO_2$ addition on 3 mechanical properties were assessed using Pearson, ANOVA, and Tukey tests. RESULTS. SEM images of $n-TiO_2$ exhibited the presence of elongated tubular structures. The XRD pattern of synthesized $n-TiO_2$ represented the anatase crystal phase of $TiO_2$. Moderate to very strong significant positive correlations were observed between the concentration of $n-TiO_2$ and each of the 3 physicomechanical properties of PMMA (Pearson's P value ${\leq}.001$, correlation coefficient ranging between 0.5 and 0.9). Flexural strength and hardness values of specimens modified with both 2.5 and 5 wt% $n-TiO_2$ were significantly higher than those of control ($P{\leq}.001$). Fracture toughness of samples reinforced with 5 wt% $n-TiO_2$ (but not those of 2.5% $n-TiO_2$) was higher than control (P=.002). CONCLUSION. Titania nanotubes were successfully introduced for the first time as a means of enhancing the hardness, flexural strength, and fracture toughness of denture base PMMA.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.379-386
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• 2014

PURPOSE. These days, mesenchymal stem cells (MSCs) have received worldwide attention because of their potentiality in tissue engineering for implant dentistry. The purpose of this study was to evaluate various growth inducing factors in media for improvement of acquisition of bone marrow mesenchymal stem cells (BMMSCs) and colony forming unit-fibroblast (CFU-F). MATERIALS AND METHODS. The mouse BMMSCs were freshly obtained from female C3H mouse femur and tibia. The cells seeded at the density of $10^6$/dish in media supplemented with different density of fetal bovine serum (FBS), $1{\alpha}$, 25-dihydroxyvitamin (VD3) and recombinant human epidermal growth factor (rhEGF). After 14 days, CFU-F assay was conducted to analyze the cell attachment and proliferation, and moreover for VD3, the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was additionally conducted. RESULTS. The cell proliferation was increased with the increase of FBS concentration (P<.05). The cell proliferation was highest at the density of 20 ng/mL rhEGF compared with 0 ng/mL and 200 ng/mL rhEGF (P<.05). For VD3, although the colony number was increased with the increase of its concentration, the difference was not statistically significant (P>.05). CONCLUTION. FBS played the main role in cell attachment and growth, and the growth factor like rhEGF played the additional effect. However, VD3 did not have much efficacy compare with the other two factors. Improvement of the conditions could be adopted to acquire more functional MSCs to apply into bony defect around implants easily.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.406-414
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• 2014

PURPOSE. The objective of this study was to investigate the biologic effects of enamel matrix derivative (EMD) with different concentrations on cell viability and the genetic expression of human gingival fibroblasts (HGF) to zirconia surfaces. MATERIALS AND METHODS. Immortalized human gingival fibroblasts (HGF) were cultured (1) without EMD, (2) with EMD $25{\mu}g/mL$, and (3) with EMD $100{\mu}g/mL$ on zirconia discs. MTT assay was performed to evaluate the cell proliferation activity and SEM was carried out to examine the cellular morphology and attachment. The mRNA expression of collagen type I, osteopontin, fibronectin, and TGF-${\beta}1$ was evaluated with the real-time polymerase chain reaction (RT-PCR). RESULTS. From MTT assay, HGF showed more proliferation in EMD $25{\mu}g/mL$ group than control and EMD $100{\mu}g/mL$ group (P<.05). HGFs showed more flattened cellular morphology on the experimental groups than on the control group after 4h culture and more cellular attachments were observed on EMD $25{\mu}g/mL$ group and EMD $100{\mu}g/mL$ group after 24h culture. After 48h of culture, cellular attachment was similar in all groups. The mRNA expression of type I collagen increased in a concentration dependent manner. The genetic expression of osteopontin, fibronectin, and TGF-${\beta}1$ was increased at EMD $100{\mu}g/mL$. However, the mRNA expression of proteins associated with cellular attachment was decreased at EMD $25{\mu}g/mL$. CONCLUSION. Through this short term culture of HGF on zirconium discs, we conclude that EMD affects the proliferation, attachment, and cell morphology of HGF cells. Also, EMD stimulates production of extracellular matrix collagen, osteopontin, and TGF-${\beta}1$ in high concentration levels. CLINICAL RELEVANCE. With the use of EMD, protective barrier between attached gingiva and transmucosal zirconia abutment may be enhanced leading to final esthetic results with implants.

• The Journal of Advanced Prosthodontics
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• v.6 no.2
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• pp.71-78
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• 2014

PURPOSE. The objective of this study was to evaluate the clinical acceptability of all-ceramic crowns fabricated by the digital veneering method vis-$\grave{a}$-vis the traditional method. MATERIALS AND METHODS. Zirconia specimens manufactures by two different manufacturing method, conventional vs digital veneering, with three different thickness (0.3 mm, 0.5 mm, 0.7 mm) were prepared for analysis. Color measurement was performed using a spectrophotometer for the prepared specimens. The differences in shade in relation to the build-up method were calculated by quantifying ${\Delta}E^*$ (mean color difference), with the use of color difference equations representing the distance from the measured values $L^*$, $a^*$, and $b^*$, to the three-dimensional space of two colors. Two-way analysis of variance (ANOVA) combined with a Tukey multiple-range test was used to analyze the data (${\alpha}$=0.05). RESULTS. In comparing means and standard deviations of $L^*$, $a^*$*, and $b^*$ color values there was no significant difference by the manufacturing method and zirconia core thickness according to a two-way ANOVA. The color differences between two manufacturing methods were in a clinically acceptable range less than or equal to 3.7 in all the specimens. CONCLUSION. Based on the results of this study, a carefully consideration is necessary while selecting upper porcelain materials, even if it is performed on a small scale. However, because the color reproducibility of the digital veneering system was within the clinically acceptable range when comparing with conventional layering system, it was possible to estimate the possibility of successful aesthetic prostheses in the latest technology.