• Implantology
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• v.22 no.4
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• pp.242-254
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• 2018

The aim of the current study was to evaluate the results of horizontal guided bone regeneration (GBR) with xenograf t (deproteinized bovine bone mineral, DBBM), allograf t (irradiated allogenic cancellous bone and marrow), titanium membrane, resorbable collagen membrane, and advanced platelet-rich fibrin (A-PRF) in the anterior maxilla. The titanium membrane was used in this study has a three-dimensional (3D) shape that can cover ridge defects. Case 1. A 32-year-old female patient presented with discomfort due to mobility and pus discharge on tooth #11. Three months after extracting tooth #11, diagnostic software (R2 GATE diagnostic software, Megagen, Daegu, Korea) was used to establish the treatment plan for implant placement. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$, Rocky Mountain Tissue Bank, Denver, USA), 3D-titanium membrane ($i-Gen^{(R)}$, Megagen, Daegu, Korea), resorbable collagen membrane (Collagen $membrane^{(R)}$, Genoss, Suwon, Korea), and A-PRF because there was approximately 4 mm labial dehiscence after implant placement. Five months after placing the implant, the second stage of implant surgery was performed, and healing abutment was connected after removal of the 3D-titanium membrane. Five months after the second stage of implant surgery was done, the final prosthesis was then delivered. Case 2. A 35-year-old female patient presented with discomfort due to pain and mobility of implant #21. Removal of implant #21 fixture was planned simultaneously with placement of the new implant fixture. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$), 3D-titanium membrane ($i-Gen^{(R)}$), resorbable collagen membrane (Ossix $plus^{(R)}$, Datum, Telrad, Israel), and A-PRF because there was approximately 7 mm labial dehiscence after implant placement. At the second stage of implant surgery six months after implant placement, healing abutment was connected after removing the 3D-titanium membrane. Nine months after the second stage of implant surgery was done, the final prosthesis was then delivered. In these two clinical cases, wound healing of the operation sites was uneventful. All implants were clinically stable without inflammation or additional bone loss, and there was no discomfort to the patient. With the non-resorbable titanium membrane, the ability of bone formation in the space was stably maintained in three dimensions, and A-PRF might influence soft tissue healing. This limited study suggests that aesthetic results can be achieved with GBR using 3D-titanium membrane and A-PRF in the anterior maxilla. However, long-term follow-up evaluation should be performed.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.3
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• pp.211-218
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• 2019

Purpose: The purpose of the present study was to compare the accuracy of four different metal copings fabricated by CAD/CAM technology and to evaluate clinical effectiveness. Materials and methods: Composite resin tooth of the maxillary central incisor was prepared for a metal ceramic crown and duplicated metal die was fabricated. Then scan the metal die for 12 times to obtain STL files using a confocal microscopy type oral scanner. Metal copings with a thickness of 0.5 mm and a cement space of $50{\mu}m$ were designed on a CAD program. The Co-Cr metal copings were fabricated by the following four methods: Wax pattern milling & Casting (WM), Resin pattern 3D Printing & casting (RP), Milling & Sintering (MS), Selective laser melting (SLM). Silicone replica technique was used to measure marginal and internal discrepancies. The data was statistically analyzed with One-way analysis of variance and appropriate post hoc test (Scheffe test) (${\alpha}=.05$). Results: Mean marginal discrepancy was significantly smaller in the Group WM ($27.66{\pm}9.85{\mu}m$) and Group MS ($28.88{\pm}10.13{\mu}m$) than in the Group RP ($38.09{\pm}11.14{\mu}m$). Mean cervical discrepancy was significantly smaller in the Group MS than in the Group RP. Mean axial discrepancy was significantly smaller in the Group WM and Group MS then in the Group RP and Group SLM. Mean incisal discrepancies was significantly smaller in the Group RP than in all other groups. Conclusion: The marginal and axial discrepancies of the Co-Cr coping fabricated by the Wax pattern milling and Milling/Sintering method were better than those of the other groups. The marginal, cervical and axial fit of Co-Cr copings in all groups are within a clinically acceptable range.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.18-26
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• 2021

Purpose: Generally, patients are noticed to store denture in water when removed from the mouth. However, few studies have reported the advantage of volumetric change in underwater storage over dry storage. To be a reference in defining the proper denture storage method, this study aims to evaluate the volumetric change and dimensional deformation in case of underwater and dry storage. Materials and methods: Definitive casts were scanned by a model scanner, and denture bases were designed with computer-aided design (CAD) software. Twelve denture bases (upper 6, lower 6) were printed with 3D printer. Printed denture bases were invested and flasked with heat-curing method. 6 upper and 6 lower dentures were divided into group A and B, and each group contains 3 upper and 3 lower dentures. Group A was stored dry at room temperature, group B was stored underwater. Group B was scanned at every 24 hours for 28 days and scanned data was saved as stereolithography (SLA) file. These SLA files were analyzed to measure the difference in volumetric change of a month and Kruskal-Wallis test were used for statistical analysis. Best-fit algorithm was used to overlap and 3-dimensional color-coded map was used to observe the changing pattern of impression surface. Results: No significant difference was found in volumetric changes regardless of the storage methods. In dry-stored denture base, significant changes were found in the palate of upper jaw and posterior lingual border of lower jaw in direction away from the underlying tissue, maxillary tuberosity of upper jaw and retromolar pad area of lower jaw in direction towards the underlying tissue. Conclusion: Storing the denture underwater shows less volumetric change of impression surface than storing in the dry air.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.254-261
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• 2020

Purpose: The purpose of this study was to assess the marginal and internal fit of interim crowns fabricated by two different manufacturing method (subtractive manufacturing technology and additive manufacturing technology). Materials and Methods: Forty study models were fabricated with plasters by making an impression of a master model of the maxillary right first molar for ceramic crown. On each study model, interim crowns (n = 40) were fabricated using three types of 3D printers (Meg-printer 2; Megagen, Zenith U; Dentis, and Zenith D; Dentis) and one type milling machine (imes-icore 450i; imes-icore GmbH). The internal of the interim crowns were filled with silicon and fitted to the study model. Internal scan data was obtained using an intraoral scanner. The fit of interim crowns were evaluated in the margin, absolute margin, axial, cusp, and occlusal area by using the superimposition of 3D scan data (Geomagic control X; 3D Systems). The Kruskal-wallis test, Mann-Whitney U test and Bonferroni correction method were used to compare the results among groups (α = 0.05). Results: There was no significant difference in the absolute marginal discrepancy of the temporary crown manufactured by three 3D printers and one milling machine (P = 0.812). There was a significant difference between the milling machine and the 3D printer in the axial and occlusal area (P < 0.001). The temporary crown with the milling machine showed smaller axial gap and higher occlusal gap than 3D printer. Conclusion: Since the marginal fit of the temporary crown produced by three types of 3D printers were all with in clinically acceptable range (< 120 ㎛), it can be sufficiently used for the fabrication of the temporary crown.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.897-904
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• 2022

The purpose of this study is to compare the difference in dose and image quality when applying the diagnostic reference level (DRL) test conditions for head radiography in a digital radiation environment and the test conditions currently applied in clinical practice. I would like to review the conditions of radiographic examination. In this study, the head model phantom was targeted, and the investigation conditions were divided into clinical conditions (Clinic), DRL value (DRL₇₅), and DRL average value (DRL_mean). For dose, Enterance surface dose (ESD) was measured, and for image quality, signal-to-noise ratio and contrast-to-noise ratio were measured and analyzed for comparison. The average values of skull anterior posterior(AP) ESD according to the changes in test conditions were Clinic 1214.03±4.21 µGy, DRL₇₅ 3017.83±8.14 µGy, DRL_mean 2283.50±7.09 µGy, and skull lateral (Lat). The average value of ESD was statistically significant with Clinic 762.79±3.54 µGy, DRL₇₅ 2168.57±10.83 µGy, and DRL_mean 1654.43±6.48 µGy (p<0.01). The average values of SNR and CNR measured in the orbital, maxillary sinus, frontal sinus, and sella turcica were statistically significant (p<0.01). As a result of this study, compared to DRL, the conditions used in clinical practice showed lower dose levels of about 58% for AP and about 70% for Lat., and there was no qualitative difference in terms of image quality. Through this study, it is necessary to consider a new diagnostic reference level suitable for the digital radiation environment, and it is considered that the dose should be reduced accordingly.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.2
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• pp.179-191
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• 2023

The purpose of this study was to investigate the prevalence and patterns of congenitally missing teeth in permanent teeth excluding third molars, in patients aged 8 to 16 years who visited Pusan National University Dental Hospital from January 2010 to February 2021. This retrospective study evaluated tooth agenesis and the pattern of missing teeth represented by the tooth agenesis code by reviewing panoramic radiographs and electronic medical records of 11,759 patients, including 5,548 females and 6,211 males. The prevalence of congenitally missing teeth was 10.74% (females 11.95%, males 9.66%, p < 0.0001). Patients with tooth agenesis had an average of 2.22 missing teeth, and congenitally missing teeth occurred more frequently in the mandible (8.39%) than in the maxilla (4.52%, p < 0.0001). The mandibular second premolar (58.19%) was the most frequently missing tooth. The second premolar was the most frequently missing tooth in all quadrants (30.10%, 31.67%, 43.14%, and 35.59%) when a single tooth was absent, while the first and second premolars were the most commonly absent teeth (11.69%, 11.47%, 5.94%, and 5.24%) when two or more teeth were missing. In the relationship between maxillary-mandibular antagonistic quadrants and full mouth, the 1st to 4th place of the missing patterns were all involved with the 1st and 2nd premolars. This study can be clinically helpful in establishing a treatment plan for patients with missing teeth. In addition, it can be used as basic data for molecular biological research to find out the relationship between tooth agenesis and specific genes.

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.209-223
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• 2001

At intrusion of upper anterior teeth in patient with periodontal defect, the use of three-piece base arch appliance for pure intrusion is required. To investigate the change of the center of resistance and of the distal traction force according to alveolar bone height at intrusion of upper anterior teeth using this appliance, three-dimensional finite element models of upper six anterior teeth, periodontal ligament and alveolar bone were constructed. At intrusion of upper anterior teeth by three-piece base arch appliance, the following conclusions were drawn to the locations of the center of resistance according to the number of teeth, the change of distal traction force for pure intrusion and the correlation to the change of vertical, horizontal location of the center of resistance according to alveolar bone loss. 1. When the axial inclination and alveolar bone height were normal, the anteroposterior locations of center of resistance of upper anterior teeth according to the number of teeth contained were as follows : 1) In 2 anterior teeth group, the center of located in the mesial 1/3 area of lateral incisor bracket. 2) In 4 anterior teeth group. the center of resistance was located in the distal 2/3 of the distance between the bracket of lateral incisor and canine. 3) In 6 anterior teeth group, the center of resistance was located in the central area of first premolar bracket .4) As the number of teeth contained in anterior teeth group increased, the center of resistance shifted to the distal side. 2. When the alveolar bone height was normal, the anteroposterior position of the point of application of the intrusive force was the same position or a bit forward position of the center of resistance at application of distal traction force for pure intrusion. 3. When intrusion force and the point of application of the intrusive force were fixed, the changes of distal traction force for pure intrusion according to alveolar bon loss were as follows :1) Regardless of the alveolar bone loss, the distal traction force of 2, 4 anterior teeth groups were lower than that of 6 anterior teeth group. 2) As the alveolar bone loss increased, the distal traction forces of each teeth group were increased. 4. The correlations of the vertical, horizontal locations of the center of resistance according to maxillary anterior teeth groups and the alveolar bone height were as follows : 1) In 2 anterior teeth group, the horizontal position displacement to the vortical position displacement of the center of resistance according to the alveolar bone loss was the largest. As the number of teeth increased, the horizontal position displacement to the vertical position displacement of the center of resistance according to the alveolar bone loss showed a tendency to decrease. 2) As the alveolar bone loss increased, the horizontal position displacement to the vertical position displacement of the center of resistance regardless of the number of teeth was increased.

• The korean journal of orthodontics
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• v.36 no.5
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• pp.339-348
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• 2006

Objective: With development of the skeletal anchorage system, orthodontic mini-implant (OMI) assisted on masse sliding retraction has become part of general orthodontic treatment. But compared to the emphasis on successful anchorage preparation, the control of anterior teeth axis has not been emphasized enough. Methods: A 3-D finite element Base model of maxillary dental arch and a Lingual tipping model with lingually inclined anterior teeth were constructed. To evaluate factors influencing the axis of anterior teeth when OMI was used as anchorage, models were simulated with 2 mm or 5 mm retraction hooks and/or by the addition of 4 mm of compensating curve (CC) on the main archwire. The stress distribution on the roots and a 25000 times enlarged axis graph were evaluated. Results: Intrusive component of retraction force directed postero-superiorly from the 2 mm height hook did not reduce the lingual tipping of anterior teeth. When hook height was increased to 5 mm, lateral incisor showed crown-labial and root-lingual torque and uncontrolled tipping of the canine was increased.4 mm of CC added to the main archwire also induced crown-labial and root-lingual torque of the lateral incisor but uncontrolled tipping of the canine was decreased. Lingual tipping model showed very similar results compared with the Base model. Conclusion: The results of this study showed that height of the hook and compensating curve on the main archwire can influence the axis of anterior teeth. These data can be used as guidelines for clinical application.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.525-534
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• 2001

Bone remodeling in response to force requires coordinated actions of osteoblasts, osteoclasts, osteocytes, and periodontal ligament cells. Coordination among these cells may be mediated, in part, by cell-to-cell communication via gap junctions. This study was designed to evaluate the expression of gap junction, connection 43 In periodontal tissue during the experimental movement of rat's incisors, by LSAB(labelled streptavidine biotin) immunohistochemical staining for connexin 43. Twenty seven Sprague-Dawley rats were divided into a control group(3 rats), and 6 experimental groups(24 rats) where 75g of force was applied from helical springs across the maxillary incisors. Rats of experimental groups were sacrificed at 12 hours, 1, 4, 7, 14 and 28 days after force application, respectively. And the tissues of a control group and experimental groups were studied immunohistochemically. The results were as follows : 1. In control group, the expression of connexin 43 was rare in gingiva, dentin, cementum, periodontal ligament, and bone cells. 2. In experimental group, the expression of connexin 43 was increased in pulp, periodontal ligament, osteoblasts, and osteoclasts, comparing to that in control. And it was rare in gingiva, dentin, and odontoblasts regardless of the duration of force application, which was not different from that of control group. 3. The expression of connexin 43 in pulp of experimental group began to increase in 4-day after force application and got to the highest degree at 7-day. And it decreased after 14-day to be similar to that of control group at 28-day. 4. The expression of connexin 43 in periodontal ligament was noted in small capillaries adjacent to alveolar bone, showing higher intensity of immunolabelling after 4-day And it was stronger in the pressure side than in tension side of periodontal ligament. After 7-day, decrease in connexin 43 expression was observed. 5. The expression of connexin 43 in alveolar bone began to increase 1-day, reached to the highest degree at 4-day, and decreased at 7-day. And the expression in osteoclasts was more than that in osteoblasts or osteocyte at 7-day.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.253-261
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• 2009

The purpose of this study was to present new data on the timing and sequence of permanent teeth emergence and to compare these findings with the results of earlier studies. The dental examinations had been performed to E-elementary school students, who visited the Yonsei University Dental Hospital between 1998 and 2005; 1,307 boys and 1,312 girls with the age ranging from 6 to 12 years old. The followings were concluded. 1. Eruption time of the maxillary permanent teeth is as follows. It was 6.81 years in male and 6.73 years in female for the central incisor, 7.78 years in male and 7.65 years in female for the lateral incisor, 10.48 years in male and 9.92 years in female for the canine, 9.76 years in male and 9.63 years in female for the first premolar, 10.66 years in male and 10.49 years in female for the second premolar, 6.39 years in male and 6.26 years in female for the first permanent molar, and 12.13 years in male and 12.03 years in female for the second permanent molar. 2. Eruption time of the mandibular permanent teeth is as follows. The central incisor could not be determined in this study, but it is assumed to erupt before the age of 6.08. In the mandible, eruption time was 6.78 years in male and 6.65 years in female for the lateral incisor, 9.76 years in male and 9.05 years in female for the canine, 9.82 years in male and 9.59 years in female for the first premolar, 10.67 years in male and 10.52 years in female for the second premolar, 6.22 years in male and 6.12 years in female for the first permanent molar, and 11.58 years in male and 11.14 years in female for the second permanent molar. 3. The eruption sequence is as follows. In the maxilla, the first permanent molar erupted first, followed by the central incisor, the lateral incisor, the first premolar, the canine, the second premolar, and the second permanent molar. In the mandible, the central incisor erupted first, followed by the first permanent molar, the lateral incisor, the canine, the first premolar, the second premolar, and the second permanent molar. 4. Tooth eruption occurred earlier in female compared to male by average of 0.19 year in the maxilla and 0.29 year in the mandible. 5. In both male and female, the hiatus (interval of rest) occurred between the emergence of lateral incisor and first premolar in the maxilla while it was observed between the lateral incisor and canine in the mandible. Male had a hiatus of 1.98 years in the maxilla and 2.90 years in the mandible, while the female's were 1.98 years and 2.40 years, respectively.