• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.157-168
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• 2008

Statement of problem: Over the past two decades, implant supported fixed prosthesis have been widely used. However, there are few studies conducted systematically and intensively on the splinting effect of implant systems in mandible. Purpose: The purpose of this study was to investigate the changes in stress distributions in the mandibular implants with splinting or non-splinting crowns by performing finite element analysis. Materials and methods: Cortical and cancellous bone were modeled as homogeneous, transversely isotropic, linearly elastic. Perfect bonding was assumed at all interfaces. Implant models were classified as follows. Group 1: $Br{{\aa}}nemark$ length 8.5mm 13mm splinting type Group 2: $Br{{\aa}}nemark$ length 8.5mm 13mm Non-splinting type Group 3: ITI length 8.5mm 13mm splinting type Group 4: ITI length 8.5mm 13mm Non-splinting type An load of 100N was applied vertically and horizontally. Stress levels were calculated using von Mises stresses values. Results: 1. The stress distribution and maximum von Mises stress of two-length implants (8.5mm, 13mm) was similar. 2. The stress of vertical load concentrated on mesial side of implant while the stress of horizontal load was distributed on both side of implant. 3. Stress of internal connection type was spreading through abutment screw but the stress of external connection type was concentrated on cortical bone level. 4. Degree of stress reduction was higher in the external connection type than in the internal connection type.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.4
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• pp.343-350
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• 2008

Purpose: The purpose of this study was to spectrophotometrically evaluate the shade difference between of maxillary and mandibular anterior teeth in the Korean by the standard of vita classical shade guide using $SpectroShade^{TM}$. Material and methods: In this study, the shades of healthy anterior teeth were examined and analyzed using the digital shade analysis of $SpectroShade^{TM}$. This study examined 80 individuals in their twenties, thirties, fourties, fifities ages and 40 males and 40 females, presenting 12 healthy, unrestored maxillary and mandibular anterior teeth. Tooth brushing and oral prophylaxis were performed prior to evaluation. The $SpectroShade^{TM}$ was used to acquire images of the 12 maxillary and mandibular anterior teeth. These images were analyzed using $SpectroShade^{TM}$ Software, and shade maps of each tooth were acquired. The shade difference of upper and lower, and gender differences and ages difference were investigated and analyzed with CIE $L^{*}a^{*}b^{*}$ color order system. One-Way ANOVA test was used to find out if there were significant differences between groups tested and Sheffe multiple comparison was used to identify where the differences were. Results: 1. Shade differences were significant (P < .05) between maxillary and mandibular central incisor, lateral incisor, canine. 2. No significant differences in shade distribution were seen between lateral incisors and central incisors. 3. Canine's shade difference were more significant than central incisor's and lateral incisors's. 4. No significant differences in shade distribution were seen between genders in maxillary and mandibulr central incisor, lateral incisor, canine. 5. No significant differences in shade distribution were seen in order of years in maxillary and mandibulr central incisor, lateral incisor, canine. Conclusions: The results of this study show that 1. Shade difference was founded in maxillary and mandibular anterior teeth and ${\Delta}E^{*}$ value was more than 2.0. 2. Canine's shade difference were more significant than central incisor's and lateral incisors's and between central incisors and lateral incisors shade differences were no significant. 3. No significant differences in shade distribution were seen between genders in maxillary and mandibular anterior teeth. 4. No significant differences in shade distribution were seen in order of years grade in maxillary and mandibular anterior teeth.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.226-233
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• 2016

Purpose: The purpose of this study was to evaluate the adaptation of lithium disilicate crowns fabricated by CAD-CAM (computer aided design-computer aided manufacturing) and heat-press technique to compare two different measurement methods in assessing fit of the ceramic crowns: micro CT and cross-section technique. Materials and methods: A prepared typodont mandibular molar for ceramic crown was duplicated and ten dies were produced by milling the PMMA (polymethylmethacrylate) resin. Ten vinyl polysiloxane impressions were made and stone casts were produced. Five dies were used for IPS e.max Press crowns with heat-press technique. The other five dies were used for IPS e.max CAD crowns with CAD-CAM technique. Ten lithium disilicate crowns were cemented on the resin dies using zinc phosphate cement with finger pressure. The marginal and internal fits in central buccolingual plane were evaluated using a micro CT. Then the specimens were embedded and cross-sectioned and the marginal and internal fits were measured using scanning electronic microscope. The two measurement methods and two manufacturing methods were compared using Mann-Whitney U test (SPSS 22.0). Results: The marginal and internal fit values using micro CT and cross-section technique were similar, showing no significant differences. There were no significant differences in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique. Conclusion: Both micro CT and cross-section technique were acceptable methods in the evaluation of marginal and internal fit of lithium disilicate crown. There was no difference in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique except occlusal fit.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.234-238
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• 2016

Purpose: Increasing use of computer aided design-computer aided manufacturing (CAD-CAM) system and number of design software made design of restoration easy and quick. Outcome of restoration has been dependent on dental technician's wax up proficiency, dentists can design restoration for themselves now. This study aims to investigate the outcome of restoration designs, according to handling skill of CAD-CAM design tool. Materials and methods: A patient's mandibular right 1st molar was prepared. After taking impression, stone model was made, scanned the stone model with 3 shape intra-oral scanner, stereolithography (STL) file was extracted. With 3shape dental designer, one dental technician with more than 5 years work experience (designer 0) and three dental technicians with less than 2years work experience (designer 1, 2, 3-group DT) and 4 1st year residents (designer 4, 5, 6, 7-group RT) designed gold crown on the same STL file. Designed crown's MD (mesio-distal) and BL (bucco-lingual) diameter, height of crown, inter-cuspal distance, number of occlusal contact points were compared. Statistical analysis was carried out, test of normality within each group, using independent t-test. Number of contact points were compared, using Wilcoxon signed-rank test. Results: There was no significant difference between group DT and group RT. Number of contact points also resulted in no significant difference. Conclusion: The outcome of each designed crowns showed no statistical differences, in values which can be expressed as numbers. Subjective factors were different. With increasing proficiency in handling designing software, fabrication of restorations according to each designer's occlusal concept can be made easy.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.61-66
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• 2012

Purpose: This study was to compare the cumulative survival rate (CSR) of Br${\aa}$nemark machined surface implants and TiUnite$^{TM}$ imlants and to analyze association between risk factors and the CSR of the implants. Materials and methods: A retrospective study design was used to collect long-term follow-up clinical data from dental records of 156 patients treated with 541 Br${\aa}$nemark machined and TiUnite$^{TM}$ implants at Korea University Guro hospital in South Korea from 1993 through 2008. Machined implant and TiUnite$^{TM}$ implant were compared by CSR. Exposure variables such as gender, systemic disease, location, implant length, diameter, prosthesis type, opposing occlusion type, date of implant placement, type of edentulous space, abutment type, existence of splinting with natural teeth, and existence of cantilever were collected. 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 (${\alpha}$=.05). Results: Patient ages ranged from 16 to 75 years old (mean age, 51 years old). Implants were more frequently placed in men than women (94 men versus 63 women). Since 1993, 264 Br${\aa}$nemark machined implants were inserted in 79 patients and since 2001, 277 TiUnite$^{TM}$ implants were inserted in 77 patients. A total survival rate of 86.07% was observed in Br${\aa}$nemark and Nobel Biocare TiUnite$^{TM}$ during 15 years. A survival rate of machined implant during 15 years was 82.89% and that of TiUnite$^{TM}$ implant during 5 years was 98.74%. The implant CSR revealed lower rates association with several risk factors such as, systemic disease, other accompanied surgery, implant location, and Kennedy classification. Conclusion: Clinical performance of Br${\aa}$nemark machined and TiUnite$^{TM}$ implant demonstrated a high level of predictability. In this study, TiUnite$^{TM}$ implant was more successful than machined implant. The implant CSR was associated with several risk factors.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.36-43
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• 2012

Purpose: To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. Materials and methods: Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type ${\phi}4.0mm{\times}11.5mm$ Osstem$^{(R)}$ USII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture's external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group's implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. Results: The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2mm, there was no significant influence on the stress distribution. Conclusion: For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.2
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• pp.70-79
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• 2020

Purpose: The purpose of this study was to evaluate the effect of attachments and palatal coverage on stress distribution in maxillary implant overdenture using finite element analysis. Materials and Methods: Four maxillary overdenture 3-D models with four implants placed in the anterior region were fabricated with computer-aided design. 1) Ball-F: Non-splinted ball attachment and full palatal coverage, 2) Ball-P: Non-splinted ball attachment and U-shaped partial palatal coverage, 3) Bar-F: Splinted milled bar attachment and full palatal coverage, 4) Bar-P: Splinted milled bar attachment and U-shaped partial palatal coverage. Stress distribution analysis was performed with ANSYS workbench 14. 100 N vertical load was applied at the right first molar unilaterally and maximum stress was calculated at the implant, peri-implant bone and mucosa. Results: The use of the ball attachment showed lower maximum stress on implant and peri-implant bone than the use of the milled bar attachment. But it showed contrary tendency in the mucosa. Regardless of attachment, full palatal coverage showed lower maximum stress on implant, peri-implant bone and mucosa. Conclusion: Within the limitation of this study, ball attachment improved stress distribution on implant and peri-implant bone rather than milled bar attachment in maxillary implant overdenture. Also, full palatal coverage is more favorable in stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.4
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• pp.301-307
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• 2010

Purpose: The objectives of the current study are to assess the accuracy of X-Ray Micro Computed Tomography (microCT) in measuring enamel thickness and to evaluate enamel thickness in maxillary incisors of Koreans. Materials and methods: Five maxillary incisors were embedded in resin block. These teeth were longitudinally sectioned labiolingually through the medial axis. After polishing, the teeth were scanned using a microCT (X-EYE SYSTEM; DRGEM, Seoul, Korea). On a scanning electron microscope (S-4300; Hitachi, Tokyo, Japan) (${\times}20$) and a microCT, nearly identical planes were reconstructed. In each tooth, the thickness of labial enamel was measured 1, 3 and 5 mm above the cementoenamel junction (CEJ). Thus, the accuracy of the microCT was evaluated. In addition, using 26 maxillary central incisors and 11 maxillary lateral incisors, in the medial axis and 2 mm remote areas mesially and distally from the medial axis, the thickness of labial enamel was measured 1, 3 and 5 mm above the CEJ along the long axis of the teeth. Results: Measurements from nearly identical planes in physical and microCT sections differed by 3.81%. An independent t-test was performed and this showed that there were no significant differences in the measurements between the two methods. Mean values of labial enamel thickness in maxillary central incisors 1, 3 and 5 mm above the CEJ were $0.32{\pm}0.01$, $0.50{\pm}0.0.2$ and $0.70{\pm}0.02\;mm$, respectively. Mean values of labial enamel thickness in maxillary lateral incisors 1, 3 and 5 mm above the CEJ were $0.30{\pm}0.01$, $0.55{\pm}0.03$ and $0.80{\pm}0.02\;mm$, respectively. Conclusion: In measuring enamel thickness, microCT is one of useful way of measurement. So according to the results of this research, when restoring a porcelain laminate veneer on maxillary incisors in Koreans, careful consideration is needed in the amount of enamel reduction.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.66-78
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• 2004

The objective of this study was to apply the vibration technique to reduce the viscosity of bonding adhesives and thereby compare the bond strength and resin penetration in enamel and dentin achieved with those gained using the conventional technique and vibration technique. For enamel specimens, thirty teeth were sectioned mesio-distally. Sectioned two parts were assigned to same adhesive system but different treatment(vibration vs. non-vibration). Each specimen was embedded in 1-inch inner diameter PVC pipe with a acrylic resin. The buccal and lingual surfaces were placed so that the tooth and the embedding medium were at the same level. The samples were subsequently polished silicon carbide abrasive papers. Each adhesive system was applied according to its manufacture's instruction. Vibration groups were additionally vibrated for 15 seconds before curing. For dentin specimen, except removing the coronal part and placing occlusal surface at the mold level, the remaining procedures were same as enamel specimen. Resin composite(Z250. 3M. U.S.A.) was condensed on to the prepared surface in two increments using a mold kit(Ultradent Inc., U.S.A.). Each increments was light cured for 40 seconds. After 24 hours in tap water at room temperature, the specimens were thermocycled for 1000cycles. Shear bond strengths were measured with a universal testing machine(Instron 4465, England). To investigate infiltration patterns of adhesive materials, the surface of specimens was examined with scanning electron microscope. The results were as follows: 1. In enamel the mean values of shear bond strengths in vibration groups(group 2, 4, 6) were greater than those of non-vibration group(group 1, 3, 5). The differences were statistically significant except AQ bond group. 2. In dentin, the mean values of shear bond strengths in vibration groups(group 2, 4, 6) were greater than those of non-vibration groups(group 1, 3, 5). But the differences were not statistically significant except One-Up Bond F group. 3. The vibration group showed more mineral loss in enamel and longer resin tag and greater number of lateral branches in dentin under SEM examination.

• The korean journal of orthodontics
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• v.31 no.3 s.86
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• pp.381-391
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• 2001

In orthodontic patients, frequently, amalgam restorations are present on the buccal surface of molars. The ability to successfully bond orthodontic brackets and buccal tubes to amalgam restorations would therefore be of clinical value. But the bond strength to total amalgam surface is probably not critical in most instances. Because there is usually a considerable amount of sound enamel surrounding a buccal amalgam filling. The purpose of this study was to evaluate the bond strengths of orthodontic brackets according to surface treatments and size of amalgam restorations. Eighty tooth specimen were assigned to four groups according to amalgam size-1.5mm, 2.0mm, 2.5mm, 3.0mm diameter-and then divided into two groups : one half was sandblasting group the other half was no sandblasting group. After Bracket bonding, shear bond strength for each specimen was determined and bond failure patterns was evaluated. 1. Shear bond strength of amalgam size 1.5mm group was significantly higher than that of the other groups. (p<0.05) 2. There was no significant difference in the bond strength produced by sandblasting. (p<0.05) 3. Shear bond strength of G and H group of which amalgam restoration ratio to the bracket base sizes were $61\%$ were significantly decreased $50-60\% level of that of control group. (p<0.05) 4. There was positive correlation between sandblasting and mARI. (p<0.05) The results of the present study indicate that it may be feasible to bond orthodontic bracket clinically successfully to amalgam restoration with conventional orthodontic resin when its size is less than $50\%$ of that of bracket base.