• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.285-294
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• 2014

PURPOSE. The purpose of this study was to evaluate the properties of a porous zirconia scaffold coated with bioactive materials and compare the in vitro cellular behavior of MC3T3-E1 preosteoblastic cells to titanium and zirconia disks and porous zirconia scaffolds. MATERIALS AND METHODS. Titanium and zirconia disks were prepared. A porous zirconia scaffold was fabricated with an open cell polyurethane disk foam template. The porous zirconia scaffolds were coated with ${\beta}$-TCP, HA and a compound of ${\beta}$-TCP and HA (BCP). The characteristics of the specimens were evaluated using scanning electron microscopy (SEM), energy dispersive x-ray spectrometer (EDX), and x-ray diffractometry (XRD). The dissolution tests were analyzed by an inductively coupled plasma spectrometer (ICP). The osteogenic effect of MC3T3-E1 cells was assessed via cell counting and reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS. The EDX profiles showed the substrate of zirconia, which was surrounded by the Ca-P layer. In the dissolution test, dissolved $Ca^{2+}$ ions were observed in the following decreasing order; ${\beta}$-TCP > BCP > HA (P<.05). In the cellular experiments, the cell proliferation on titanium disks appeared significantly lower in comparison to the other groups after 5 days (P<.05). The zirconia scaffolds had greater values than the zirconia disks (P<.05). The mRNA level of osteocalcin was highest on the non-coated zirconia scaffolds after 7 days. CONCLUSION. Zirconia had greater osteoblast cell activity than titanium. The interconnecting pores of the zirconia scaffolds showed enhanced proliferation and cell differentiation. The activity of osteoblast was more affected by microstructure than by coating materials.

• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.253-258
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• 2014

PURPOSE. To compare marginal and internal gaps of zirconia substructure of single crowns with those of three-unit fixed dental prostheses. MATERIALS AND METHODS. Standardized Co-Cr alloy simulated second premolar and second molar abutments were fabricated and subsequently duplicated into type-III dental stone for working casts. After that, all zirconia substructures were made using $Lava^{TM}$ system. Marginal and internal gaps were measured in 2 planes (mesial-distal plane and buccal-palatal plane) at 5 locations: marginal opening (MO), chamfer area (CA), axial wall (AW), cusp tip (CT) and mid-occlusal (OA) using Replica technique. RESULTS. There were significant differences between gaps at all locations. The $mean{\pm}SD$ of marginal gap in premolar was $43.6{\pm}0.4{\mu}m$ and $46.5{\pm}0.5{\mu}m$ for single crown and 3-unit bridge substructure respectively. For molar substructure the $mean{\pm}SD$ of marginal gap was $48.5{\pm}0.4{\mu}m$ and $52.6{\pm}0.4{\mu}m$ for single crown and 3-unit bridge respectively. The largest gaps were found at the occlusal area, which was $150.5{\pm}0.5{\mu}m$ and $154.5{\pm}0.4{\mu}m$ for single and 3-unit bridge premolar substructures respectively and $146.5{\pm}0.4{\mu}m$ and $211.5{\pm}0.4{\mu}m$ for single and 3-unit bridge molar substructure respectively. CONCLUSION. Independent-samples t-test showed significant differences of gap in zirconia substructure between single crowns and three-unit bridge (P<.001). Therefore, the span length has the effect on the fit of zirconia substructure that is fabricated using CAD/CAM technique especially at the occlusal area.

• The Journal of Advanced Prosthodontics
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• v.10 no.5
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• pp.340-346
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• 2018

PURPOSE. In this study, the shear bond strengths (SBS) of luting cements to fixed superstructure metal surfaces under various seating forces were investigated. MATERIALS AND METHODS. Seven different cements [Polycarboxylate (PCC), Glass-Ionomer (GIC), Zinc phospahate (ZPC), Self-adhesive resin (RXU), Resin (C&B), and Temporary cements ((RXT) and (TCS))] were bonded to a total number of 224 square blocks ($5{\times}5{\times}3mm$) made of one pure metal [Titanium (CP Ti) and two metal alloys [Gold-Platinum (Au-Pt) and Cobalt-Chrome (Co-Cr)] under 10 N and 50 N seating forces. SBS values were determined and data were analyzed with 3-way ANOVA. Pairwise comparisons and interactions among groups were analyzed with Tukey's simultaneous confidence intervals. RESULTS. Overall mean scores indicated that Co-Cr showed the highest SBS values ($1.96{\pm}0.4$) (P<.00), while Au-Pt showed the lowest among all metals tested ($1.57{\pm}0.4$) (P<.00). Except for PCC/CP Ti, RXU/CP Ti, and GIC/Au-Pt factor level combinations (P<.00), the cements tested under 10 N seating force showed no significantly higher SBS values when compared to the values of those tested under 50 N seating force (P>.05). The PCC cement showed the highest mean SBS score ($3.59{\pm}0.07$) among all cements tested (P<.00), while the resin-based temporary luting cement RXT showed the lowest ($0.39{\pm}0.07$) (P<.00). CONCLUSION. Polycarboxylate cement provides reliable bonding performance to metal surfaces. Resin-based temporary luting cements can be used when retrievability is needed. GIC is not suitable for permanent cementation of fixed dental prostheses consisting of CP Ti or Au-Pt substructures.

• The Journal of Advanced Prosthodontics
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• v.10 no.5
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• pp.388-394
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• 2018

PURPOSE. To measure axial displacement of different implant-abutment connection types and materials during screw tightening at the recommended torque by using a contact scanner for two-dimensional (2D) and three-dimensional (3D) analyses. MATERIALS AND METHODS. Twenty models of missing mandibular left second premolars were 3D-printed and implant fixtures were placed at the same position by using a surgical guide. External and internal fixtures were used. Three implant-abutment internal connection (INT) types and one implant-abutment external connection (EXT) type were prepared. Two of the INT types used titanium abutment and zirconia abutment; the other INT type was a customized abutment, fabricated by using a computer-controlled milling machine. The EXT type used titanium abutment. Screws were tightened at $10N{\cdot}cm$, simulating hand tightening, and then at the manufacturers' recommended torque ($30N{\cdot}cm$) 10 min later. Abutments and adjacent teeth were subsequently scanned with a contact scanner for 2D and 3D analyses using a 3D inspection software. RESULTS. Significant differences were observed in axial displacement according to the type of implant-abutment connection (P<.001). Vertical displacement of abutments was greater than overall displacement, and significant differences in vertical and overall displacement were observed among the four connection types (P<.05). CONCLUSION. Displacement according to connection type and material should be considered in choosing an implant abutment. When adjusting a prosthesis, tightening the screw at the manufacturers' recommended torque is advisable, rather than the level of hand tightening.

• The Journal of Advanced Prosthodontics
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• v.12 no.5
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• pp.251-258
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• 2020

PURPOSE. The bond strengths between resin denture teeth with various compositions and denture base resins including conventional and CAD/CAM purposed materials were evaluated to find influence of each material. MATERIALS AND METHODS. Cylindrical rods (6.0 mm diameter × 8.0 mm length) prepared from pre-polymerized CAD/CAM denture base resin blocks (PMMA Block-pink; Huge Dental Material, Vipi Block-Pink; Vipi Industria) were bonded to the basal surface of resin teeth from three different companies (VITA MFT^®; VITA Zahnfabrik, Endura Posterio^®; SHOFU Dental, Duracross Physio^®; Nissin Dental Products Inc.) using resin cement (Super-Bond C&B; SUN MEDICAL). As a control group, rods from a conventional heat-polymerizing denture base resin (Vertex™ Rapid Simplified; Vertex-Dental B.V. Co.) were attached to the resin teeth using the conventional flasking and curing method. Furthermore, the effect of air abrasion was studied with the highly cross-linked resin teeth (VITA MFT^®) groups. The shear bond strengths were measured, and then the fractured surfaces were examined to analyze the mode of failure. RESULTS. The shear bond strengths of the conventional heat-polymerizing PMMA denture resin group and the CAD/CAM denture base resin groups were similar. Air abrasion to VITA MFT^® did not improve shear bond strengths. Interfacial failure was the dominant cause of failure for all specimens. CONCLUSION. Shear bond strengths of CAD/CAM denture base materials and resin denture teeth using resin cement are comparable to those of conventional methods.

• The Journal of Advanced Prosthodontics
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• v.12 no.5
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• pp.299-306
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• 2020

PURPOSE. The aim of this study was to evaluate the accuracy of six recently introduced intraoral scanners (IOSs) for single crown preparations isolated from the complete arch, and to determine the effect of scanning sequence on accuracy. MATERIALS AND METHODS. A complete arch with right and left canine preparations for single crowns was used as a study model. The reference dataset was obtained by scanning the complete arch using a highly accurate industrial scanner (ATOS Core 80, GOM GmbH). Six different IOSs (Trios, iTero, Planmeca Emerald, Cerec Omnicam, Primescan, and Virtuo Vivo) were used to scan the model ten times each. The scans performed with each IOS were divided into two groups, based on whether the scanning sequence started from the right or left quadrant (n=5). The accuracy of digital impression was evaluated using three-dimensional analyzing software (Geomagic Studio 12, 3D Systems). The Kruskal Wallis and Mann- Whitney U statistical tests for trueness analysis and the One-way ANOVA test for precision analysis were performed (α=.05). RESULTS. The trueness and precision values were the lowest with the Primescan (25 and 10 ㎛), followed by Trios (40.5 and 11 ㎛), Omnicam (41.5 ㎛ and 18 ㎛), Virtuo Vivo (52 and 37 ㎛), iTero (70 and 12 ㎛) and Emerald (73.5 and 60 ㎛). Regarding trueness, iTero showed more deviation when scanning started from the right (P=.009). CONCLUSION. The accuracy of digital impressions varied depending on the IOS and scanning sequence used. Primescan had the highest accuracy, while Emerald showed the most deviation in accuracy for single crown preparations.

• The Journal of Advanced Prosthodontics
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• v.12 no.5
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• pp.316-321
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• 2020

PURPOSE. The stress distribution and microgap formation on an implant abutment structure was evaluated to determine the relationship between the direction of the load and the stress value. MATERIALS AND METHODS. Two types of three-dimensional models for the mandibular first molar were designed: bone-level implant and tissue-level implant. Each group consisted of an implant, surrounding bone, abutment, screw, and crown. Static finite element analysis was simulated through 200 N of occlusal load and preload at five different load directions: 0, 15, 30, 45, and 60°. The von Mises stress of the abutment and implant was evaluated. Microgap formation on the implant-abutment interface was also analyzed. RESULTS. The stress values in the implant were as follows: 525, 322, 561, 778, and 1150 MPa in a bone level implant, and 254, 182, 259, 364, and 436 MPa in a tissue level implant at a load direction of 0, 15, 30, 45, and 60°, respectively. For microgap formation between the implant and abutment interface, three to seven-micron gaps were observed in the bone level implant under a load at 45 and 60°. In contrast, a three-micron gap was observed in the tissue level implant under a load at only 60°. CONCLUSION. The mean stress of bone-level implant showed 2.2 times higher than that of tissue-level implant. When considering the loading point of occlusal surface and the direction of load, higher stress was noted when the vector was from the center of rotation in the implant prostheses.

• The Journal of Advanced Prosthodontics
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• v.12 no.5
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• pp.322-328
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• 2020

PURPOSE. This study evaluated the shear bond strength between 3D printed provisional resin and conventional provisional resin depending on type of conventional provisional resin and different surface treatments of 3D printed resin. MATERIALS AND METHODS. Ninety-six disc-shaped specimens (Ø14 mm × 20 mm thickness) were printed with resin for 3D printing (Nextdent C&B, Vertex-Dental B. V., Soesterberg, Netherlands). After post-processing, the specimens were randomly divided into 8 groups (n=12) according to two types of conventional repair resin (methylmethacrylate and bis-acryl composite) and four different surface treatments: no additional treatment, air abrasion, soaking in methylmethacrylate (MMA) monomer, and soaking in MMA monomer after air abrasion. After surface treatment, each repair resin was bonded in cylindrical shape using a silicone mold. Specimens were stored in 37℃ distilled water for 24 hours. The shear bond strength was measured using a universal testing machine at a crosshead speed of 0.5 mm/min. Failure modes were analyzed by scanning electron microscope. Statistical analysis was done using one-way ANOVA test and Kruskal-Wallis test (α=.05). RESULTS. The group repaired with bis-acryl composite without additional surface treatment showed the highest mean shear bond strength. It was significantly higher than all four groups repaired with methylmethacrylate (P<.05). Additional surface treatments, neither mechanical nor chemical, increased the shear bond strength within methylmethacrylate groups and bis-acryl composite groups (P>.05). Failure mode analysis showed that cohesive failure was most frequent in both methylmethacrylate and bis-acryl composite groups. CONCLUSION. Our results suggest that when repairing 3D printed provisional restoration with conventional provisional resin, repair with bis-acryl composite without additional surface treatment is recommended.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.3
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• pp.152-159
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• 2012

Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005-2010) at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of $35{\pm}19$ months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.

• The Journal of Advanced Prosthodontics
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• v.8 no.4
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• pp.290-295
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• 2016

PURPOSE. The aim of this study was to evaluate the effect of paracetic acid (PAA) and ozone disinfection on the tensile bond strength (TBS) of silicone-based resilient liners to acrylic resins. MATERIALS AND METHODS. One hundred and twenty dumbbell shaped heat-polymerized acrylic resins were prepared. From the mid segment of the specimens, 3 mm of acrylic were grinded off and separated parts were reattached by resilient liners. The specimens were divided into 2 control (control1, control7) and 4 test groups of PAA and ozone disinfection (PAA1, PAA7, ozone1 and ozone7; n=10). While control groups were immersed in distilled water for 10 min (control1) and 7 days (control7), test groups were subjected to PAA (16 g/L) or ozone rich water (4 mg/L) for 1 cycle (10 min for PAA and 60 min for ozone) per day for 7 days prior to tensile tests. Measurements of the TBS were analyzed using 3-way ANOVA and Tukey's HSD test. RESULTS. Adhesive strength of Mollosil decreased significantly by application of ozone disinfection. PAA disinfection had no negative effect on the TBS values of Mollosil and Molloplast B to acrylic resin. Single application of ozone disinfection did not have any negative effect on TBS values of Molloplast B, but prolonged exposure to ozone decreased its adhesive strength. CONCLUSION. The adhesion of resilient liners to acrylic was not adversely affected by PAA disinfection. Immersion in ozonated water significantly decreased TBS of Mollosil. Prolonged exposure to ozone negatively affects adhesion of Molloplast B to denture base materials.