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Rehabilitation using endocrown for fracture of maxillary anterior teeth due to trauma in adolescence: a case report (청소년기 외상으로 인한 상악 전치부 파절 시 Endocrown을 이용한 수복: 증례 보고)

  • So-Yeon Lee;Sung-Ae Son;Jeong-Kil Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.1
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    • pp.24-30
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    • 2024
  • Complicated crown fractures of maxillary anterior teeth caused by trauma in adolescence can cause functional and aesthetic problems. For crown fractures with pulp exposure, various restorative methods can be considered depending on the amount of remaining tooth structure. Direct resin restorations are the most traditional and effective method, but they are likely to discolor and break over time. Fixed prosthesis have a high possibility of re-restoration due to marginal disharmony due to tooth movement during the growth period, and restorations using post which are mainly performed for extensive crown fractures increase the risk of root perforation and root fracture. However, endocrown is an integrated structure that gains retention force from the pulp space, enabling effective reconstruction from a biomechanical perspective and providing advantages in restoring function and aesthetics. Therefore, endocrown can be considered as a restoration method for complicated crown fractures caused by trauma in adolescence.

Fracture resistance of zirconia and resin nano ceramic implant abutments according to thickness after thermocycling (지르코니아와 레진나노세라믹 임플란트 지대주의 두께에 따른 열순환 후 파절저항)

  • Lee, Jung-Won;Cha, Hyun-Suk;Lee, Joo-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.144-150
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    • 2017
  • Purpose: The aim of this in vitro study is to investigate load bearing capacity of esthetic abutments according to the type of material and wall thickness. Materials and methods: 70 specimens equally divided into seven groups according to their abutment wall thicknesses. The abutments prepared with titanium 0.5 mm wall thickness were used as a control group (Ti-0.5), whereas zirconia abutments and resin nano ceramic abutments with wall thickness 0.5 mm, 0.8 mm and 1.0 mm were prepared as test groups (Zir-0.5, Zir-0.8, Zir-1.0 and RNC-0.5, RNC-0.8, RNC-1.0). All specimens were tested in a universal testing machine to evaluate their resistance to fracture and all of them underwent thermo-cycling before loading test. Mean fracture values of the groups were measured and statistical analyses were made using two-way ANOVA. Results: Zir-1.0 showed the highest mean strength ($2,476.3{\pm}342.0N$) and Zir-0.8 ($1,518{\pm}347.9N$), Ti-0.5 ($1,041.8{\pm}237.2N$), Zir-0.5 ($631.4{\pm}149.0N$) were followed. The strengths of RNC groups were significantly lower compared to other two materials (RNC-1.0 $427.5{\pm}72.1$, RNC-0.8 $297.9{\pm}41.2$) and the strengths of all the test groups decreased as the thickness decreases (P < .01). RNC-0.5 ($127.4{\pm}35.3N$) abutments were weaker than all other groups (P < .05). Conclusion: All tested zirconia abutments have the potential to withstand the physiologic occlusal forces in anterior and posterior regions. In resin nano ceramic abutments, wall thickness more than 0.8 mm showed the possibility of withstanding the occlusal forces in anterior region.

The fracture resistance of heat pressed ceramics with wire reinforcement (금속선 강화에 따른 열 가압 도재의 파절저항)

  • Jo, Deuk-Won;Dong, Jin-Keun;Oh, Sang-Chun;Kim, Yu-Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.191-198
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    • 2009
  • Statement of problem: Ceramics have been important materials for the restoration of teeth. The demands of patients for tooth-colored restorations and the availability of various dental ceramics has driven the increased use of new types of dental ceramic materials. Improved physical properties of theses materials have expanded its use even in posterior crowns and fixed partial dentures. However, ceramic still has limitation such as low loading capability. This is critical for long-span bridge, because bridge is more subject to tensile force. Purpose: The wire reinforced ceramic was designed to increase the fracture resistance of ceramic restoration. The purpose of this study was to evaluate the fracture resistance of wire reinforced ceramic. Material and methods: Heat pressed ceramic(ingot No.200 : IPS Empress 2, Ivoclar Vivadent, Liechtenstein) and Ni-Cr wire(Alfa Aesar, Johnson Matthey Company, USA) of 0.41 mm diameter were used in this study. Five groups of twelve uniform sized ceramic specimens(width 4 mm, thickness 2 mm, length 15 mm) were fabricated. Each group had different wire arrangement. Wireless ceramic was used as control group. The experimental groups were divided according to wire number and position. One, two and three strands of wires were positioned on the longitudinal axis of specimen. In another experimental group, three strands of wires positioned on the longitudinal axis and five strands of wires positioned on the transverse axis. Three-point bending test was done with universal testing machine(Z020, Zwick, Germany) to compare the flexural modulus, flexural strength, strain at fracture and fracture toughness of each group. Fractured ceramic specimens were cross-sectioned with caborundum disc and grinded with sandpaper to observe interface between ceramic and Ni-Cr wire. The interface between ceramic and Ni-Cr wire was analyzed with scanning electron microscope(JSM-6360, JEOL, Japan) under platinum coating. Results: The results obtained were as follows: 1. The average and standard deviation in flexural modulus, flexural strength and fracture toughness showed no statistical differences between control and experimental groups. However, strain was significantly increased in wire inserted ceramics(P<.001). 2. Control group showed wedge fracture aspects across specimen, while experimental groups showed cracks across specimen. 3. Scanning electron microscopic image of cross-sectioned and longitudinally-sectioned specimens showed no gap at the interface between ceramic and Ni-Cr wire. Conclusion: The results of this study showed that wire inserted ceramics have a high strain characteristic. However, wire inserted ceramics was not enough to use at posterior area of mouth in relation to flexural modulus and flexural strength. Therefore, we need further studies.

Porcelain Fracture in Metal Ceramic, All ceramic and Zirconia restoration (금속도재, 전장도재, 지르코니아 수복물에서의 도재 파절)

  • Cheolyeon Kim
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.2
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    • pp.46-53
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    • 2023
  • Porcelain fractures associated with metal ceramic(MC), all ceramic (AC), and zirconia restorations are common complications. Several factors of fracture are suggested; Property of materials, Design of the coping for metal ceramic, fabrication techniques, supporting structure, occlusal force, parafunctional habit are being considered. In this article, these factors are discussed in detail.

COMPARATIVE STUDY ON MORPHOLOGY OF CROSS-SECTION AND CYCLIC FATIGUE TEST WITH DIFFERENT ROTARY NITI FILES AND HANDLING METHODS (수종의 NiTi 전동 파일 단면 형태 비교 및 pecking motion의 사용방법이 피로 파절에 미치는 영향)

  • Kim, Jae-Gwan;Kum, Kee-Yeon;Kim, Eui-Seong
    • Restorative Dentistry and Endodontics
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    • v.31 no.2
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    • pp.96-102
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    • 2006
  • There are various factors affecting the fracture of NiTi rotary files. This study was performed to evaluate the effect of cross sectional area, pecking motion and pecking distance on the cyclic fatigue fracture of different NiTi files. Five different NiTi $files-Profile^{(R)}$ (Maillefer, Ballaigue, Switzerland), $ProTaper^{TM}$(Maillefer, Ballaigue, Switzerland), $K3^{(R)}$ (SybronEndo. Orange, CA) , Hero $642^{(R)}$ (Micro-mega, Besancon, France), Hero $Shaper^{(R)}$ (Micro-mega, Besancon, France)-were used. Each file was embedded in temporary resin, sectioned horizontally and observed with scanning electron microscope. The ratio of cross-sectional area to the circumscribed circle was calculated. Special device was fabricated to simulate the cyclic fatigue fracture of NiTi file in the curved canal,. On this device, NiTi files were rotated (300rpm) with different pecking distances (3 mm or 6 mm) and with different motions (static motion or dynamic pecking motion) . Time until fracture occurs was measured. The results demonstrated that cross-sectional area didn't have any effect on the time of file fracture. Among the files, $Profile^{(R)}$ took the longest time to be fractured. Between the pecking motions, dynamic motion took the longer time to be fractured than static motion. There was no significant difference between the pecking distances with dynamic motion, however with static motion, the longer time was taken at 3mm distance. In this study, we could suggest that dynamic pecking motion would lengthen the time for NiTi file to be fractured from cyclic fatigue.

ESTHETIC RESTORATION OF FRACTURED IMMATURE PERMANENT INCISORS (파절된 미성숙 영구 전치의 수복)

  • Lee, In-Young;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Sun-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.126-132
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    • 2009
  • Injuries of permanent teeth by trauma occur frequently in childhood and adolescence. Crown fractures are as frequent as 25-76% and especially maxillary incisors are prone to fractures. There have been numerous efforts to achieve both aesthetically and functionally satisfying restoration. When a mature tooth is fractured, porcelain crown or laminate veneer could be a choice of prosthodontic treatment. However, in a case of immature permanent incisor fracture, prosthodontic treatment is more complicated due to the immaturity of the tooth. Moreover, if endodontic treatment is accompanied with the prosthodontic treatment, the treatment period is prolonged. In the past, restoration using an orthodontic band, a ready-made crown, or glass ionomer cement did not exhibit esthetically satisfying result. As restorational materials have been improved, now more esthetic restoration is possible by reattaching fractured fragments or light-curing composite resin restoration. We reports cases of patients with fractured maxillary incisors and their successful treatment results through reattachment of fractured fragments and composite resin restoration.

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Comparative study in fracture strength of zirconia cores fabricated with three different CAD/CAM systems (3종의 CAD/CAM 시스템에서 지르코니아 코어의 파절 강도에 관한 비교 연구)

  • Shin, Eon-Sick;Lee, Young-Soo;Park, Won-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.22-30
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    • 2008
  • Purpose: The purpose of this study is to compare three different CAD/CAM systems through the fracture strength of zirconia core and to evaluate the clinical availability of each system. Material and methods: The following three groups of 30 maxillary mesial incisor core for all-ceramics(each group 10) were fabricated as follows: group 1. $Adens^{(R)}$ CAD/CAM system, group 2. $Cerasys^{(R)}$ CAD/CAM system, group 3. 3M $Lava^{(R)}$ CAD/CAM system. All specimens were manufactured consistently thickness 0.5mm and relief $40{\mu}m$. Specimens were subjected to compressive loading on the lingual area by Z250/$SN5S^{(R)}$. Each group's mean and standard deviation were calculated and Kruskal Waillis test, Wilcoxon Rank Sum test were utilized to find out the relationship among the groups. Results: The results were as follows: 1. The mean fracture strength of $Adens^{(R)}$ system was $615.89{\pm}156.1N$, the $Cerasys^{(R)}$ system was $863.98{\pm}151.5N$, and the 3M $Lava^{(R)}$ system was $1143.1{\pm}286.6N$. 2. The fracture strength of the systems showed the significant statistical differences in order of 3M $Lava^{(R)}$ system, $Cerasys^{(R)}$ system, $Adens^{(R)}$ system. Conclusion: In this study, in spite of the differences among the groups, every group showed clinically useful results. It is necessary to study further clinical experiments on a long term basis.

THE STUDY OF FRACTURE STRENGTH OF PORCELAIN LAMINATE VENEER WITH VARIOUS LINGUAL EXTENTION LENGTH WHEN LNCISAL RESTORING (Porcelain Laminate veneer 절연 피복시 설측 연장 길이에 따른 파절강도의 연구)

  • Park, Johng-Han;Jo, Kwang-Hun
    • The Journal of Korean Academy of Prosthodontics
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    • v.34 no.4
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    • pp.746-754
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    • 1996
  • The purpose of this study was to evaluate the fracture strength of porcelain laminate veneer with various lingual extention length when incisal restoring. Sixty recently extracted, intact maxillary incisors were used and stored in a physiologic saline solution from the time of extraction. Seating form was preparation at the labial surface of each tooth with a water-cooled round diamond bur. Standard block was formed with 32 gauge and 24 gauge wax at tooth labial and lingual surface. Lingual extention length differed according to each group. (group I : 0.5mm, group II : 1 mm, group III : 2mm, group IV : 0mm) All tooth specimens were impressioned with examix(GC Inc., Japan). Refractory cast were maked with refractory die material(Ceramco Inc., U.S.A.) Laminate porcelain (Ceramco II Veneer porcelain, Ceramco Inc., U.S.A.) was condensed in refractory die cast and baked according to the manufacturer's recommendations. Each surface was contoured with low speed diamond bur according to guide block. All porcelain specimens were sandblasted and ultrasonically cleaned in distlled water for 3 minutes. Then, all porcelain specimen were etched with 8% hydrofluoric acid for 5 minutes. Sixty specimens were bonded with composite resin cement(Choice Porcelain Veneer System, Bisco Inc., U.S.A.) according to manufacture's directions. The fracture loads of the specimen were measured by Instron universal testing machine. The mean values of fracture loads for the groups were statistically compared by Duncan's multiful range test. The result were as follows : Mean fracture strengths of each group were 86.95Mpa in no lingual extention group, 44.98Mpa in 0.5mm lingual extention group, 27.47Mpa in 1mm lingual extention group, 19.61Mpa in 2mm lingual extention group. There was a statistically significant difference between all group(p<0.01).

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Effect of Intracanal Medicaments on Push-out Bond Strength of Calcium Silicate-based Materials (근관내 약제가 규산칼슘 기반 재료의 압출 강도에 미치는 영향)

  • Jeong, Hyuntae;Yang, Sunmi;Kim, Seonmi;Choi, Namki;Kim, Jaehwan
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.4
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    • pp.455-463
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    • 2018
  • The purpose of this study was to evaluate the effect of the intracanal medicaments on the push-out bond strength of the calcium silicate-based materials. Forty extracted single-root human mandibular premolars were sectioned below cementoenamel junction. Standardized root canal dimension was obtained with a parallel post drill. The specimens were randomly divided into a control group (no medicament), and experimental groups received medicaments with either CH (calcium hydroxide), DAP (double antibiotic paste; a mixture of ciprofloxacin and metronidazole), or TAP (triple antibiotic paste; a mixture of minocycline, ciprofloxacin and metronidazole). Following removal of medicaments with irrigation, roots were cut into sections with 1-mm-thickness. Thereafter, calcium silicate-based materials are applied to the specimens : (i) ProRoot MTA$^{(R)}$ and (ii) Biodentine$^{(R)}$. A push-out bond strength was measured and each specimen was examined to evaluate failure mode. Intracanal medication using CH significantly increased the bond strength to the root dentin. But there are no significant differences on the bond strength of ProRoot MTA$^{(R)}$ or Biodentine$^{(R)}$ among TAP, DAP and control groups. The dislodgement resistance of Biodentine$^{(R)}$ from root dentin was significantly higher than that of ProRoot MTA$^{(R)}$ regardless of the type of intracanal medicaments.

Treatment of crown-root fracture with a modified crown fragment reattachment technique (변형된 치관부 파절편 재부착술식을 이용한 치관치근파절의 치료)

  • Song, Chang-Won;Song, Min-Ju;Shin, Su-Jung;Park, Jeong-Won
    • Restorative Dentistry and Endodontics
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    • v.35 no.5
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    • pp.395-400
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    • 2010
  • The development of adhesive dentistry has allowed that the crown fragment reattachment can be another option in the treatment of crown fracture. However, additional crown lengthening procedure or extrusion of the tooth may be necessary in the treatment of crown root fracture because subgingival fracture line in close proximity to the alveolar bone leads to challenges for restorative procedure and the violation of the biologic width. This case report presents a modified crown fragment reattachment technique of crown root fracture with pulp exposure, which was done without additional crown lengthening procedures. After the endodontic treatment, the patient was treated using a post insertion and the fragment reattachment technique, which made it possible to preserve the space for the biologic width and maintain a dry surgical field for adequate adhesion through the modification of the fractured coronal fragment. Since a coronal fracture was occurred and reattached afterward, it was observed that the coronal fragment was well maintained without the additional loss of periodontal attachment through 2-year follow up.