• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.227-233
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• 2023

Tardive dyskinesia is an involuntary neurological movement disorder caused by long-term use of dopamine receptor-blocking drugs leading to dental implications like uncontrolled gnashing and grinding of teeth which in turn imperil the oral rehabilitation procedures as the excessive load increases the risk of prosthesis fracture. A 40-year male with a medical history of tardive dyskinesia visited the hospital to receive oral rehabilitation for missing maxillary anterior teeth. After the oral examination, tooth preparation was done on teeth 13, 15, and 23. After that silicon impression was made and the gypsum cast was digitalized using a desktop scanner and an interim prosthesis was fabricated by milling a resin block. During the try-in, the occlusal one-third of the interim prosthesis was trimmed, and an auto-polymerizing acrylic resin was applied on the occlusal surfaces and inserted in the patient's mouth. Then, the functionally generated path (FGP) of occluding surfaces of opposing arches was traced on the resin surface. When the resin was hardened, the modified interim prosthesis was removed and digitized using an intraoral scanner. The scan image was used in designing the occlusal morphology of definitive prosthesis by modifying the design of the interim prosthesis using the dual scan method. Lastly, a monolithic zirconia prosthesis was fabricated by milling a zirconia block. The definitive prosthesis was delivered reflecting the patient's occlusal scheme. This case report shows that the FGP technique with the dual scan method can help in fabricating fixed prosthesis with harmonious occlusion in a tardive dyskinesia patient.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.474-482
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• 2012

Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.416-426
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• 2005

Intravenous sedation have many advantages of rapid onset and recovery, ability of control sedation levels and duration through titration. Midazolam is most commonly used intravenous medication for sedation in pediatrics, endoscopy, oncologic procedures and so on. But in dentistry, midazolam intravenous sedation is usually for adult, and there are few reports for children. Todays, children who need sedation become more and older, intravenous sedation technique is going a matter of concern in pediatric dentistry. The purpose of this paper is to evaluate the efficacy of sedation and clinical success for different initial dosage of midazolam in intravenous sedation for pediatric dental patients. 16 healthy children (male 10, female 6), mean age $54.7{\pm}10.7$ months, who needed at least two separate treatment visits requiring local anesthesia were chosen for this study. Every children were taken 0.3mg/kg, maximum 5mg of midazolam by intramuscular route, and then 30~50% $N_2O-O_2$ for 10 minutes was given. On every visits, one of the following 2 different initial dosage was given by intravenous route : (1) Group I : 0.1mg/kg Midazolam (2) Group II : 0.2mg/kg Midazolam. Additional dosage was half of the first dose. Physiologic parameters (oxygen saturation, heart rate, respiratory rate, end-tidal carbon dioxide pressure) was recorded by ten procedure steps. Behavior was videotaped and rated using Ohio State University Behavioral Rating Scale and Automated Counting System by one investigator, blind to administered dosage. After the treatment, operator evaluated the clinical success. Physiologic parameters were stable and within normal range during treatment in both groups. The analyzed sedative effect, in behavioral evaluation, ratio of favorable Quiet was higher in group II, and clinical success rate of group II was better than group I. Induction time was rapid in group II, and recovery time was rapid in group I. And there was no statistically difference between two groups in every results.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.209-222
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• 2011

Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.175-184
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• 2011

With a development of implant restoration technique, there are increasing use of computer-guided system for edentulous patients. It was carried out simulated operation based on CT information about patient's bone quantity, quality and anatomical landmark. However, there are some difference between the programmed implant and post-operative implant about it's position. If the deviation was severe, it could happen a failure of 'passive fit' and not suited for path of implant restoration. The aim of this presentation is to evaluate about a degree of deviations between programmed implant and post-operative implant. Five patients treated by 'NobelGuide' system (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden) in Department of Prosthodontics, Inha University were included in this study. The patients were performed CT radiograph taking and intra-oral impression taking at pre-operation. Based on CT images and study model, surgical stent was produced by NobelBiocareTM. To fabricated a pre-operative study model, after connected lab analog to surgical template, accomplished a pre-operative model using type 4 dental stone. At final impression, a post-operative study model was fabricated in the conventional procedures. Each study model was performed CT radiograph taking. Based on CT images, each implant was simulated in three dimensional position using $Procera^{(R)}$ software (Procera Software Clinical Design Premium, version 1.5; Nobel Biocare AB). In 3D simulated model, length and angulation between each implant of both pre- and post-operative implants were measured and recorded about linear and angular deviation between pre-and post-operative implants. A total of 24 implants were included in this study and 58 inter-implant sites between each implant were measured about linear and angular deviations. In the linear deviation a mean deviation of 0.41 mm (range 0~1.7 mm) was reported. In the angular deviation, a mean deviation was $1.99^{\circ}$ (range $0^{\circ}{\sim}6.7^{\circ}$). It appears that the both linear and angular mean deviation value were well acceptable to application of computer-guided implant system.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.161-174
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• 2011

The purpose of this study was to evaluate the effect of ethanol addition on efficacy of two-step total-etch adhesive under over-wet condition by measurement of remaining volatile part (RVP), microtensile bond strength (${\mu}TBS$), and degree of conversion (DC). Two-step total-etch adhesive, Optibond Solo Plus (Kerr, Orange, USA), was used. Experimental groups were divided into 8 groups: Group 1 (only 10 ${\mu}l$ adhesive), Group 2 (mixture of 3 ${\mu}l$ distilled water and 10 ${\mu}l$ adhesive), From Group 3 to Group 8 (mixture of 3 ${\mu}l$ distilled water, 10 ${\mu}l$ adhesive, and ethanol added in 1 ${\mu}l$ increment from 1 ${\mu}l$ to 6 ${\mu}l$). The mixtures were placed on slide glass and evaporated for 10 s, 30 s, and 60 s by air-drying. The weight of RVP was measured by precision weight. Same procedures were performed for ${\mu}TBS$ test and measurement of DC. The condition of mixed solution was observed under light microscope. For RVP weight, the weights of experimental groups except for group 1 decreased with the increase of air-drying time (p<0.05). The DC increased with the increase of air-drying time in only group 5 and 6 (p<0.05). The ${\mu}TBS$ increased with the increase of air-drying time in group only 5, 6, and 7 (p<0.05). The phase separation was examined and water blisters were diminished with the increase of air-drying time in group 5, 6, 7, and 8. Within the limits of this study, ethanol additionally applied to adhesive decreased RVP and increased DC and ${\mu}TBS$ under over-wet condition. It was shown that the addition of ethanol to two-step total-etch adhesive under over-wet condition would remove water and increase the efficacy of adhesive.

• Progress in Medical Physics
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• v.26 no.3
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• pp.160-167
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• 2015

Radiation exposure from medical diagnostic imaging procedures to patients is one of the most significant interests in diagnostic x-ray system. A miniature x-ray intraoral tube was developed for the first time in the world which can be inserted into the mouth for imaging. Dose evaluation should be carried out in order to utilize such an imaging device for clinical use. In this study, dose evaluation of the new x-ray unit was performed by 1) using a custom made in vivo Pig phantom, 2) determining exposure condition for the clinical use, and 3) measuring patient dose of the new system. On the basis of DRLs (Diagnostic Reference Level) recommended by KDFA (Korea Food & Drug Administration), the ESD (Entrance Skin Dose) and DAP (Dose Area Product) measurements for the new x-ray imaging device were designed and measured. The maximum voltage and current of the x-ray tubes used in this study were 55 kVp, and 300 mA. The active area of the detector was $72{\times}72mm$ with pixel size of $48{\mu}m$. To obtain the operating condition of the new system, pig jaw phantom images showing major tooth-associated tissues, such as clown, pulp cavity were acquired at 1 frame/sec. Changing the beam currents 20 to $80{\mu}A$, x-ray images of 50 frames were obtained for one beam current with optimum x-ray exposure setting. Pig jaw phantom images were acquired from two commercial x-ray imaging units and compared to the new x-ray device: CS 2100, Carestream Dental LLC and EXARO, HIOSSEN, Inc. Their exposure conditions were 60 kV, 7 mA, and 60 kV, 2 mA, respectively. Comparing the new x-ray device and conventional x-ray imaging units, images of the new x-ray device around teeth and their neighboring tissues turn out to be better in spite of its small x-ray field size. ESD of the new x-ray device was measured 1.369 mGy on the beam condition for the best image quality, 0.051 mAs, which is much less than DRLs recommended by IAEA (International Atomic Energy Agency) and KDFA, both. Its dose distribution in the x-ray field size was observed to be uniform with standard deviation of 5~10 %. DAP of the new x-ray device was $82.4mGy*cm^2$ less than DRL established by KDFA even though its x-ray field size was small. This study shows that the new x-ray imaging device offers better in image quality and lower radiation dose compared to the conventional intraoral units. In additions, methods and know-how for studies in x-ray features could be accumulated from this work.

• The korean journal of orthodontics
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• v.33 no.1 s.96
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• pp.51-61
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• 2003

The purpose of this study was to evaluate the effects of a self-etching primer on the shear bond strength of orthodontic brackets and on the failure pattern of bracket-adhesive interfaces in dry or wet condition. Brackets were bonded to extracted human teeth according to one of three experimental protocols. In the Group P, teeth were etched with $37\%$ phosphoric acid. After the Transbond XT Primer was applied onto the etched surfaces, the brackets were bonded with Transbond XT(3M, Unitek, Monrovia, Calif) and light cured for 40 seconds. In the Group SD, a self-etching primer(3M, Unitek, Monrovia, Calif) was placed on the enamel for 3 seconds and gently evaporated with air, as suggested by the manufacturer. The brackets were then bonded with Transbond XT as in the Group P In the Group SW, artificial saliva was applied to the enamel surface for 10 seconds to allow complete hydration of the surface before application self-etching primer The brackets were then bonded following the procedures of Group SD. Each group was divided into 2 sub-groups(0.5h, 24h) according to debonding time. Shear bond strengths were measured by Instron universal testing machine. After debonding, the teeth and brackets were examined under scanning electron microscope and assessed with the adhesive remnant index. The result obtained were summarized as follows ; 1. The shear bond strengths were high enough to use clinically in all testing groups, but the shear bond strengths of Group SD and SW were significantly lower than Group P(p<0.05). 2. With respect to comparison of debonding time, 24h debonding samples exhibited heigher shear bond strength than 0.5h debonding samples in Group P, SD and SW(p<0.05). 3. In the self etching primer groups(Group SD and Group SW), there was no significant difference in mean shear bond strength between under dry and wet state(p>0.05). 4. There was a greater frequency of ARI score of 0 and 1 with the Group P. On the other hand, there was a higher frequency of ARI scores of 2 and 3 with Group SD and Group SW(p<0.05).

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.517-523
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• 2001

Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.11-18
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• 2004

The eruption of permanent teeth represents the movement in the alveolar bone before appearance in oral cavity, to the occlusal plane after appearance in oral cavity, and additive movement after reaching th the occlusal plane. Tooth eruption is mostly controlled by genetic signals. The eruption stage is divided to preeruptive alveolar stage, alveolar bone stage, mucosal stage according to the process of growth and development. If the disturbance is occured in any stage of eruption, tooth does not erupt. The cause of eruption disturbance are ectopic position of the tooth germ, obstruction of the eruption path and defects in the follicle or PDL. In the treatment of eruption disturbance, surgical procedures are commonly used. There are three kind of surgical procedure ; surgical exposure, surgical repositioning, surgical exposure and traction Surgical exposure is basic procedure. This involves removal of mucosa, bone, lesion that are surrounding the teeth, dental sac when necessary to maintain a patent channel between the crown and the normal eruptive path into the oral cavity. To ensure this patency, many techniques including cementation of a celluloid crown, packing with gutta-percha or zinc oxide-eugenol, or a surgical pack, are used. When surgical exposure is conducted, operators should not expose any part of cervical root cement and not injure periodontium or root of adjunct tooth. After surgical exposure, tooth should be surrounded by keratinized gingiva. There is direct relationship between the extent of development of pathophysiologic aberrations and the intensity of the manipulative injury inflicted on the tooth by surgical treatment, so operator should consider this thing. In these cases, surgical exposure is conducted on Maxillary 1st milars that have a eruption disturbance and improve the eruption disturbance effectively.