• Title/Summary/Keyword: Dental crowns

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Histological analysis on tissues around orthodontically intruded maxillary molars using temporary anchorage devices: A case report

  • Hui-Chen Tsai;Julia Yu-Fong Chang;Chia-Chun Tu;Chung-Chen Jane Yao
    • 대한치과교정학회지
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    • 제53권2호
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    • pp.125-136
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    • 2023
  • Before progress was recently made in the application of temporary anchorage devices (TADs) in bio-mechanical design, orthodontists were rarely able to intrude molars to reduce upper posterior dental height (UPDH). However, TADs are now widely used to intrude molars to flatten the occlusal plane or induce counterclockwise rotation of the mandible. Previous studies involving clinical or animal histological evaluation on changes in periodontal conditions after molar intrusion have been reported, however, studies involving human histology are scarce. This case was a Class I malocclusion with a high mandibular plane angle. Upper molar intrusion with TADs was performed to reduce UPDH, which led to counterclockwise rotation of the mandible. After 5 months of upper molar intrusion, shortened clinical crowns were noticed, which caused difficulties in oral hygiene and hindered orthodontic tooth movement. The mid-treatment cone-beam computed tomography revealed redundant bone physically interfering with buccal attachment and osseous resective surgeries were followed. During the surgeries, bilateral mini screws were removed and bulging alveolar bone and gingiva were harvested for biopsy. Histological examination revealed bacterial colonies at the bottom of the sulcus. Infiltration of chronic inflammatory cells underneath the non-keratinized sulcular epithelium was noted, with abundant capillaries being filled with red blood cells. Proximal alveolar bone facing the bottom of the gingival sulcus exhibited active bone remodeling and woven bone formation with plump osteocytes in the lacunae. On the other hand, buccal alveolar bone exhibited lamination, indicating slow bone turnover in the lateral region.

Effect of hydrogel-based antibiotic intracanal medicaments on crown discoloration

  • Rayan B. Yaghmoor;Jeffrey A. Platt;Kenneth J. Spolnik;Tien Min Gabriel Chu;Ghaeth H. Yassen
    • Restorative Dentistry and Endodontics
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    • 제46권4호
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    • pp.52.1-52.11
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    • 2021
  • Objectives: This study evaluated the effects of low and moderate concentrations of triple antibiotic paste (TAP) and double antibiotic paste (DAP) loaded into a hydrogel system on crown discoloration and explored whether application of an adhesive bonding agent prevented crown discoloration. Materials and Methods: Intact human molars (n = 160) were horizontally sectioned 1 mm apical to the cementoenamel junction. The crowns were randomized into 8 experimental groups (calcium hydroxide, Ca[OH]2; 1, 10, and 1,000 mg/mL TAP and DAP; and no medicament. The pulp chambers in half of the samples were coated with an adhesive bonding agent before receiving the intracanal medicament. Color changes (ΔE) were detected by spectrophotometry after 1 day, 1 week, and 4 weeks, and after 5,000 thermal cycles, with ΔE = 3.7 as a perceptible threshold. The 1-sample t-test was used to determine the significance of color changes relative to 3.7. Analysis of variance was used to evaluate the effects of treatment, adhesive, and time on color change, and the level of significance was p < 0.05. Results: Ca(OH)2 and 1 and 10 mg/mL DAP did not cause clinically perceivable tooth discoloration. Adhesive agent use significantly decreased tooth discoloration in the 1,000 mg/mL TAP group up to 4 weeks. However, adhesive use did not significantly improve coronal discoloration after thermocycling when 1,000 mg/mL TAP was used. Conclusions: Ca(OH)2 and 1 and 10 mg/mL DAP showed no clinical discoloration. Using an adhesive significantly improved coronal discoloration up to 4 weeks with 1,000 mg/mL TAP.

CAD-CAM을 이용하여 디자인한 금관의 치과 직업군에 따른 형태 비교 (Comparison of crown designs of different dental occupational groups, using CAD-CAM)

  • 김태현;김종은;이아름;박영범
    • 대한치과보철학회지
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    • 제54권3호
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    • pp.234-238
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    • 2016
  • 목적: 최근 치과 영역에서 CAD-CAM (computer aided design-computer aided manufacturer) 시스템의 이용과 디자인 소프트웨어가 늘어남에 따라 쉽고 빠른 수복물의 디자인이 가능해졌다. 과거에는 치과 기공사의 wax up 기술의 숙련도에 따라 금관의 외형이 결정 되었으나, CAD-CAM 시스템에서는 디자인 소프트웨어에 대한 숙련도가 더 중요한 요인이 되어가고 있다. 이에 치과 기공사와 치과의사간의 결과물의 차이를 알아보고자 한다. 재료 및 방법: 대합치와 인접치가 양호한 환자의 하악 우측 제1대구치를 금관 지대치 형성 한 후 polyether로 인상채득 하였다. 인상재에 초경석고를 이용하여 모형을 제작 하였으며, Trios 구강내 스캐너를 이용하여 STL (stereolithography) 파일을 추출하였다. 3shape dental designer 상에서 5년 이상 경력의 치과 기공사 1명, 2년 이하 경력의 치과 기공사 3명, 4명의 보철과 1년차 전공의가 동일한 STL 파일을 이용하여 금관을 디자인 하였다. CAD-CAM 시스템 경력이 가장 오래된 기공사의 디자인을 기준으로 하여 치과 기공사 그룹 3명(group DT)과 1년차 전공의 그룹 4명(group RT) 의 금관 외형을 비교하였다. 디자인된 금관의 근원심폭, 협설폭, 높이, 교두간 거리, 대합치와의 접촉점의 수를 측정, 비교 하였다. 독립표본 t검정을 시행하여 그룹간의 차이를 비교하였고, 대합치와의 접촉점의 수는 Wilcoxon signed-rank test 를 이용하였다. 결과: 정규성 검정 결과 근원심폭, 협설폭, 높이, 교두간 거리는 정규분포를 보였다. Group DT와 group RT의 금관 디자인상에서 근원심폭, 협설폭, 높이, 교두간 거리에서 통계적으로 유의할만한 차이가 없었다. 대합치와의 접촉점 수는 정규분포를 보이지 않았으며, wilcoxon signed-rank test 결과 통계적으로 유의한 차이를 보이지 않았다. 결론: 금관의 외형의 크기에 있어서는 group DT와 group RT 사이에 통계학적으로 유의할만한 차이가 없었지만 수치화하기 어려운 금관의 해부학적 형태나 주변 치아와의 형태적 유사성 등은 차이가 있었다. 디자인 소프트웨어에 대한 숙련도가 높아진다면 각 술자가 가지고 있는 교합에 대한 개념을 더 구현하기 쉬울 것이다.

디지털 구강스캐너로 모형 없이 제작한 전부지르코니아 수복물의 변연 및 내면 적합도 평가 (Evaluation of marginal and internal gap under model-free monolithic zirconia restoration fabricated by digital intraoral scanner)

  • 이종원;박지만
    • 대한치과보철학회지
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    • 제54권3호
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    • pp.210-217
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    • 2016
  • 목적: 본 연구의 목적은 실제 환자에서 디지털 구강스캐너로 모형 없이 제작한 보철물의 변연 및 내면 적합도를 평가하는 것이다. 대상 및 방법: 전향적 임상시험으로 시행한 본 예비 연구는 총 11개의 수복물을 대상으로 하였다. 구강스캐너(TRIOS, 3shape, Copenhagen, Denmark)로 디지털 구강인상을 채득한 후, 캐드 디자인 및 밀링 가공 과정을 통해 전부지르코니아 수복물을 제작하였다. 완성된 지르코니아관을 환자 구강 내에 시적하였고, 레플리카 술식으로 보철물-지대치 복제물을 얻었다. 이를 근원심, 협설 방향으로 잘라 변연오차, 변연간극과 축벽부, 선각부, 교합면부의 내면간극을 측정하였다. 통계처리는 Kruskal-Wallis 검정과 Mann-Whitney U 검정을 이용하여 통계적 유의성을 분석하였다(${\alpha}=.05$). 결과: 복제물을 통한 적합도 분석 결과, 근원심, 협설 절편 사이에는 통계적으로 유의한 차이가 없었다(P>.05). 변연간극에 불일치가 있었으며, 변연 오차가 변연간극 보다 컸다(P<.01). 결론: 본 연구의 한계 내에서, 구강스캐너로 모형 없이 제작한 전부지르코니아 수복물의 적합도는 임상적으로 허용할만한 결과를 보였다. 그러나 지르코니아관의 변연부위가 과풍융되는 경향이 있었으므로 주의 깊은 임상 적용 및 추적 연구가 요구된다.

알루미나-유리 복합체용 글래스의 조성에서 $CeO_2$의 함량변화가 강도에 미치는 영향 (EFFECT OF $CEO_2$ ADDITION IN GLASS COMPOSITION ON THE STRENGTH OF ALUMINA-GLASS COMPOSITES)

  • 이화진;송광엽;강정길
    • 대한치과보철학회지
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    • 제38권5호
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    • pp.595-605
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    • 2000
  • Dental ceramics have good aesthetics, biocompatibility, low thermal conductivity, abrasion resistance, and color stability. However poor resistance to fracture and shrinkage during firing process have been limiting factors in their use, particularly in multiunit ceramic restorations. A new method for making all-ceramic crowns that have high strength and low processing shrinkage has been developed and is referred to as the Vita In-Ceram method. This study was performed to investigate the effect of $CeO_2$ addition in borosilicate glasses on the strength of alumina-glass composites. Porous alumina compacts were prepared by slip casting and sintered at $1,100^{\circ}C$ for 2 hours. Dense composites were made by infiltration of molten glass into partially sintered alumina at $1,140^{\circ}C$ for 4 hours. Specimens were polished sequentially from #800 to #2000 diamond disk. and the final surface finishing on the tensile side was received an additional polishing sequence through $1{\mu}m$ diamond paste. Biaxial flexure test was conducted by using ball-on-three-ball method at a crosshead speed of 0.5mm/min. To examine the microstructural aspect of crack propagation in the alumina-glass composites, Vickers-produced indentation crack was made on the tensile surface at a load of 98.0 N and dwell time of 15 sec, and the radial crack patterns were examined by an optical microscope and a scanning electron microscope. The results obtained were summarized as follows; 1. The porosity rates of partially sintered alumina decreased with the rising of firing temperature. 2. The maximum biaxial flexure strength of 423.5MPa in alumina-glass composites was obtained with an addition of 3 mol% $CeO_2$ in glass composition and strength values showed the aspect of decrease with the increase of $CeO_2$ content. 3 The biaxial flexure strength values of alumina-glass composites were decreased with rising the firing temperature. 4. Observation of the fracture surfaces of alumina-glass composites indicated that the enhancement of strength in alumina-glass composites was due to the frictional or geometrical inter-locking of rough fracture surfaces and ligamentary bridging by intact islands of materials left behind the fracture front.

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변형된 임플란트 임시 지대주의 물성에 대한 연구 (The Study on the Physical Property of Provisional Prosthesis using Modified Temporary Abutment)

  • 양병덕;윤태호;최운재;박주미
    • 구강회복응용과학지
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    • 제22권4호
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    • pp.329-340
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    • 2006
  • Statement of problem: Damping of the peak force transmitted to implants has been reported by in vitro studies using impact forces on resin-veneered superstructures. Theoretical assumptions suggest that use of acrylic resin for the occlusal surfaces of a prosthesis would protect the connection between implant and bone. Therefore, the relationship between prosthesis materials and the force transmitted through the implant system also needs to be investigated under conditions that resemble the intraoral mechanical environment. Purpose: The purpose of this study was to analyze the fracture strength and modes of temporary prosthesis when a flange or occlusally extended structure were connected on the top of the abutment. Material and method: Modified abutments of winged and bulk design were made by casting the desired wax pattern which is made on the UCLA type plastic cylinder. Temporary crowns were made using templates on the modified abutments, and its fracture toughness and strain were compared to the traditional temporary prosthesis. To evaluate the effect of aging, 5.000 times of thermocycling were performed, and their result was compared to the 24hours specimen result. Results: The following conclusions were drawn from this study: 1. In the fracture toughness test, temporary crown's fracture line located next to the screw hole while modified designs with metal support showed fracture line on the metal and its propagation along the metal-resin interface. 2. Wing and bulk structure didn't show significant difference in the fracture toughness (p>0.05), but wing structure showed stress concentration on the screw hole area compared to bulk structure which showed even stress distribution. 3. In the fracture toughness test after thermocycling, wing and bulk structure showed increased or similar results in metal supported area while off-metal area and temporary crown showed decreased results. 4. In the strain measurement after thermocycling, its value increased in the temporary and bulk structure. However, wing structure showed decreased value in the loading point while increased value in the screw hole area. Conclusion: Wing type design showed compatible result to the bulk type that its application with composite resin prosthesis to the implant dentistry is considered promising.

한국인 정상교합자의 3차원 디지털 모형을 이용한 순,협측 치면 곡률 (Labial and buccal surface contours of Korean normal occlusion in a three-dimensional digital model)

  • 채지현;송진욱;차정열;최정수;박영철
    • 대한치과교정학회지
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    • 제38권2호
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    • pp.95-103
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    • 2008
  • 본 연구는 한국인의 치아형태에 적합한 브라켓 베이스를 만들기 위해 임상 치관의 순,협측 곡률을 3차원적으로 계측하여 치관의 곡률 자료를 얻고자 하였다. 정상적인 해부학적 형태를 가지는 구강모형 30쌍을 3차원 디지털 모델로 제작한 후, FA점을 기준으로 수평 기준면과 수직 기준면을 설정하였다. 이 기준면에 대한 치면의 곡선을 형성한 후, 곡률을 이차방정식의 계수로 표현하였다. 수평면과 수직면의 곡률과 FA점을 기준으로 근심과 원심, 치은측과 교합면측의 곡률을 측정한 결과, 상악견치와 상악 제2소구치 외에는 남녀간 치면 곡률의 유의한 차이가 없었다. 하악 측절치, 상악 견치, 상하악 제1, 2소구치와 제1대구치에서 근원심 또는 치은교합면측 치면 곡률의 유의한 차이가 관찰되었다 (p < 0.05). 본 연구에서 얻어진 순,협측 치면의 곡률 자료는 한국인의 치아 형태에 적합한 Straight Wire Appliance 개발의 기초 자료로 활용될 수 있다.

섬유강화 포스트와 금속주조 포스트의 파절강도 밋 파절양상의 비교 (COMPARISON OF FRACTURE STRENGTH AND PATTERN OF ENDODONTICALLY TREATED TEETH RESTORED WITH FIBER POSTS AND METAL CAST POST)

  • 김미경;김석규
    • 대한치과보철학회지
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    • 제42권5호
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    • pp.535-543
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    • 2004
  • Purpose: The purpose of this study is to compare the effect of two fiber post systems and one metal cast post system on the fracture strength and fracture pattern of crowned, endodontically treated teeth with 2 mm-height of the reamining tooth structure. Materials and methods: A total of 36 recently extracted sound human mandibular premolars were selected Each tooth structure of the crown portion except 2mm-height of the one above the cementoenamel junction was removed. After being endodontically treated, they were randomly distributed into 3 groups: group 1, restored with quarts fiber post(D.T. Light-Post), group 2, with glass fiber post(FRC Postec), and group 3, metal cast post and core. All teeth were fully covered with nonprecious metal crowns. Each specimen was embedded in an acrylic resin block and then secured in a universal load-testing machine. A compressive load was applied at a 130 degree angle to the long axis of the tooth until fractured, at a crosshead speed 20mm/min. The highest fracture loads were measured and recorded as the fracture strength of each specimen. Fracture areas were measured on the mid-buccal and mid-lingual point from the crown margins. One-way analysis of variance and Turkey test were used to determine the statistic significance of the different fracture loads and areas among the groups (p<0.05). Results: The mean fracture loads were $1391{\pm}$425N(group 1), $1458{\pm}476N$(group 2) and $1301{\pm}319N$(group 3). The fracture loads among the three groups had no statistically signifiant difference (p>.05). The mean fracture area of the fiber post was closer to the crown margin than that of the metal cast post and core(p<.05). The metal cast post showed unrestorable and catastrophic fracture patterns. Conclusion: Within the limitations of this study, fracture loads with any statistically significant difference were not recorded for endodontically treated teeth restored with two fiber posts and the metal cast post. But teeth restored with the fiber posts typically showed the fracture pattern close to the crown margin, which was almost restorable.

Root canal treatment of dens invaginatus and fused tooth

  • Park, So-Young;Bae, Kwang-Shik;Lim, Sung-Sam;Baek, Seung-Ho
    • 대한치과보존학회:학술대회논문집
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    • 대한치과보존학회 2001년도 춘계학술대회
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    • pp.247-251
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    • 2001
  • ;A dental developmental anomaly is defined as an isolated aberration in tooth form, caused by a disturbance or abnormality which occurred during tooth development. There are numerous types of dental anomalies, and a considerable variation in the extent of the defects occurs with each type. Teeth with these anomalies pose unique challenges. Since the defects are not always apparent clinically, they can confuse diagnosticians investigating the etiology of pulpal pathosis. When endodontic treatment is required, the defects often hinder access cavity preparation and canal instrumentation. Treatment planning also becomes more challenging, since the defects can create complicated periodontal problems, and the malformed teeth can be difficult to restore, particularly those weakened by endodontic therapy. Fusion is defined as the joining of two developing tooth germs resulting in a single large tooth structure. The incidence of fusion is < 1% in the Caucasian population, and it is believed that physical force or pressure produces contact of the developing teeth. Clinically and radiographically, a fused tooth usually appears as one large crown with at least partially separated roots and root canals. There may be a vertical groove in the tooth crown delineating the originally separate crowns. Dens invaginatus is a deep surface invagination of the crown or root that is lined by enamel. Teeth in both maxillary and mandibular arches may be affected, but the permanent maxillary lateral incisor is the tooth most commonly involved. Studies have revealed an incidence ranging from 0.25% to as high as 10%. The invagination ranges from a slight pitting to an anomaly occupying most of the crown and root. The invagination frequently communicates with the oral cavity, allowing the entry of irritants and microorganism either directly into pulpal tissues or into an area that is deparated from pulpal tissues by only a thin layer of enamel and dentin. This continuous ingress of irritants and the subsequent inflammation usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscesses. If the invagination extends from the crown to the periradicular tissue and has no communication with the root canal system, the pulp may remain vital. Recommended treatment of fused tooth and dens invaginatus has been reported in the endodontic literature. This case report describes the endodontic treatment of a maxillary laterl incisors having fused crown and dens invaginatus.natus.

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수종의 레진 시멘트의 용해도와 수분흡착에 관한 연구 (A STUDY ON THE SOLUBILITY AND THE WATER SORPTION OF VARIOUS RESIN CEMENTS)

  • 황유진;조인호;임주환;임헌송
    • 대한치과보철학회지
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    • 제43권1호
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    • pp.1-14
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    • 2005
  • Statement of problem. Among the physical properties of adhesion luting cement, the aspect that requires the most important factor is the degree of solubility and water sorption. Dissolution or an inadequate due to excessive water sorption inside the oral cavity compromises the while concurrently increasing the susceptibility to secondary dental caries. Susceptibility to dissolution and difficulty of removing remnant cement from the gingival sulcus have hindered the use of dental resin cement in the clinical practice, but the improved characteristics of newer generation resin cements have interest in and enabled resin cements to be widely used in adhesion of fixed prosthesis, such as laminate veneers and all-ceramic crowns. Purpose. The purpose of this study is to compare and analyze the degrees of solubility and water sorption of a variety of resin cements widely used for clinical purposes with different curing methods. Material and methods. Self-curing resin cements, $Avanto^{(R)}$, $C&B^{TM}$ CEMENT and Superbond C&B cements comprised group 1, 2 and 3. The dual-curing resin cements $Panavian^{TM}$ F, $Calibra^{(R)}$ and $Variolink^{(R)}$ II were divided into groups 4, 5, and 6, respectively. The investigation was carried out using disc-shaped specimens as specified by ANSI/ADA Specification No. 27. The degree of water sorption, water solubility and lactic acid solubility of each test group was analyzed statistically leading to the following conclusion. Results. The degree of water sorption was shown to increase in the following order : group 6, 5, 4, 2, 1 and 3. There were significant differences between the water sorption of each group. Results of the degree of water solubility were shown to increase in the following order : group 6, 5, 4, 2, 1 and 3. Statistically significant differences were found between each group, with the exception of groups 1 and 3. Finally, the degree of lactic acid solubility was found to increase in the following order : group 6,5,4,2,3 and 1. Significant differences were found between each group. In general dual-curing resin cements displayed substantially lower values than self-curing resin cements with regard to water sorption, water solubility, and lactic acid solubility. Conclusions. From the results of this study, dual-curing resin cements show a significantly lower degree of water sorption and solubility than their self-curing counterparts. Clinically, when selecting resin cements, the product with a lower degree of water sorption and solubility are preferred. The results of this study indicate that the use-of dual-curing resin cements is preferable to self-curing cements.