This study was performed to evaluate the fracture resistance of three improved die stone materials according to water/powder ratio. There are lots of handling conditions which affect the physical properties of improved dental stone, and it's well known that the water/powder ratio significantly affect the strength of die stone. If water/power ratio was incorrect, following disadvantages were showed : (1) susceptibility to dimensional change due to abrasion, (2) limited reproduction of fine detail, (3) lack of strength. The maxillary master casts were made of additional silicone impressions(Exaflex, GC America. Inc. USA). Three type IV die stones such as Fuji Rock (GC Europe Intreleuvenlaan, Leuven, Belgium), Velmix(Kerr, Manufacturing company, USA), and Crytal Rock( Maruishi Gypsum Co. Ltd, Japan) were tested. A total of 160 casts were prepared, separated, and tested on the Instron Testing Machine(Model 4201, Co. USA). The obtained results of this study were as follows : 1. Fuji Reck and Velmix less 3ml than the water/power ratio of manufacturer's instruction showed the highest resistance to fracture. According to increasing water/powder ratio, fracture resistance was significantly increased(P<0.05). Crystal Rock showed the highest fracture value when it was mixed with the water/power ratio of manufacturer's instruction. 2. Water/powder ratio of the manufacturer's instructions and less 3ml than that showed lower fracture value of hand mix than that of vacuum mix. Water/powder ratio of more 3ml, 6ml than manufacturer's instructions was not significantly different between hand mix and vacuum mix(p>0.05). 3. Velmix had the highest viscoelastic value among three die materials when it was mixed with the manufacturer's instruction. Viscoelasticity was decreased according to increasing water/powder ratio.
Objectives: To determine and compare the fracture resistance of endodontically treated maxillary central incisors restored with different posts and cores. Materials and Methods: Forty-eight upper central incisors were randomly divided into four groups: cast post and core (group 1), fiber-reinforced composite (FRC) post and composite core (group 2), composite post and core (group 3), and controls (group 4). Mesio-distal and bucco-lingual dimensions at 7 and 14 mm from the apex were compared to ensure standardization among the groups. Twelve teeth were prepared for crown restoration (group 4). Teeth in other groups were endodontically treated, decoronated at 14 mm from the apex, and prepared for posts and cores. Resin-based materials were used for cementation in groups 1 and 2. In group 3, composite was used directly to fill the post space and for core build-up. All samples were restored by standard metal crowns using glass ionomer cement, mounted at $135^{\circ}$ vertical angle, subjected to thermo-mechanical aging, and then fractured using a universal testing machine. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. Results: Fracture resistance of the groups was as follows: Control (group 4) > cast post and core (group 1) > fiber post and composite core (group 2) > composite post and core (group 3). All samples in groups 2 and 3 fractured in restorable patterns, whereas most (58%) in group 1 were non-restorable. Conclusions: Within the limitations of this study, FRC posts showed acceptable fracture resistance with favorable fracture patterns for reconstruction of upper central incisors.
Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.
Purpose. To investigate the fracture resistance of monolithic CAD-CAM all-ceramic surveyed crowns with two different occlusal rest seat designs. Materials and Methods. Two maxillary first premolar were prepared for all-ceramic surveyed crowns with wide (2/3rd of buccolingual width of an unprepared tooth) or narrow (1/3rd of buccolingual width of an unprepared tooth) disto-occlusal rest seat (ORS) designs. Eighty monolithic CAD-CAM all-ceramic surveyed crowns were prepared and divided into 4 groups - Group CR, Composite resin material as a control; Group LDS, Lithium disilicate based material; Group ZIPS, zirconia-material (IPS ZirCAD); and Group ZLHT, zirconia- material (CeramillZolidht+). Crowns were cemented on an epoxy resin die with adhesive resin cement. The fracture resistance of crowns was tested with the universal machine. Univariate regression analysis was used. Results. The mean ± standard deviation of maximum failure force values varied from 3476.10 ± 285.97 N for the narrow ORS subgroup of group ZIPS to 687.89 ± 167.63 N for the wide ORS subgroup of group CR. The mean ± standard deviation of maximum force was 1075 ± 77.0 N for group CR, 1309.3 ± 283.9 N for group LDS, 3476.1 ± 285.97 N for group ZIPS, and 2666.7 ± 228.21 N for group ZLHT, with narrow occlusal rest seat design. The results of the intergroup comparison showed significant differences in fracture strength with various material groups and occlusal rest seat designs (P<.001). Conclusion. The zirconia-based all-ceramic surveyed crowns fractured at more than double the load of Lithium disilicate based crowns. The crowns with narrow base occlusal rest seat design had statistically significantly higher fracture resistance than surveyed crowns with wide occlusal rest seat design. The use of narrow occlusal rest seat design in CAD-CAM all ceramic surveyed crowns provides higher fracture resistance, and therefore narrow occlusal rest design can be used for providing esthetics with high strength.
Background: The zygomaticomaxillary complex (ZMC) has a protruded, convex shape and plays a vital role in determining the contour by affecting the width of the middle face. This study aimed to evaluate the efficiency of ZMC fracture reduction and explore detailed directions for outcome improvement. Methods: We conducted a retrospective study of patients diagnosed with unilateral ZMC fracture who underwent ZMC reduction surgery at a single hospital between January 2015 and May 2020. The primary outcome variable was facial asymmetry using the difference in the bilateral malar eminence (ME) position measured by computed tomography scan. The 3-dimensional distance (IA, asymmetry index) and the distance in each dimension, Dx (anteroposterior distance), Dy (mediolateral distance), and Dz (superoinferior distance) were compared. Results: A total of 101 patients with ZMC fractures and 54 non-fracture patients were enrolled in the study. The mean age of the study sample was 43.49 years (control sample, 43.35 years), and the male-to-female ratio was 66.3:33.7 (control sample, 64.8:35.2). There were 53 and 48 patients with right and left ZMC fractures, respectively. The IA was not statistically different between the two groups. In terms of position in each dimension, only Dx was significantly different between the two groups. Conclusion: The results show that overall facial asymmetry was recovered after ZMC reduction, but in certain dimension significant difference in ME position has still remained. For further improvement, treatment should be performed to relieve malar depression in the anteroposterior dimension.
Statement of problem. Glass fiber post is one of recent developments to accommodate esthetic restoration for endodontically treated teeth. This has many advantages over conventional post system in physical properties, esthetic factor, risk of root and restoration fracture, adhesion to core, radiopacity, removal and retrievabilty, biocompatibility and chemical stability. Purpose. This in vitro study was to evaluate the most suitable type of resin core for the glass fiber post through surveying the fracture modes and the maximum load that fractures the tooth. Material and methods. 50 sound maxillary premolars restored with glass fiber posts($ParaPost^{(R)}$ Fiber White) and different types of resin cores(ParaCore, $Z100^{TM}$, $Rebilda^{(R)}$ and $Admira^{(R)}$) were prepared and loaded to faiure in a universal test machine. The maximum fracture load and fracture mode were investigated in the specimens that were restored with resin and those of metal cast and core. With the data, Wilcoxon rank sum test was used to validate the significance between the test groups, and Tukey' s studentized range test was used to check if there is any significant statistical difference between each test group. Every analysis was approved with 95% reliance. Results. On measuring the maximum fracture load of teeth specimens, there was a significant difference between the maximum fracture loads of the tooth specimens. ParaCore showed the highest mean maximum fracture load followed by $Z100^{TM}$. And, the distribution of fracture mode of tooth specimens showed generally Type D, the three parted fracture of the core around the post was mostly seen(62.5%), and specifically, ParaCore showed 90% and $Z100^{TM}$ showed 100% Type D fracture. Conclusion. Referring to the values of maximum fracture load and mean compressive fracture load, ParaCore and $Z100^{TM}$ had high values and are recommended as tooth colored resin core material for glass fiber post. CLINICAL IMPLICATIONS. This study was carried out intending to be of aid in selecting the appropriate resin core for the glass fiber post. The dual cure type composite resin ParaCore and light cure type composite resin $Z100^{TM}$ have good properties and are recommended as tooth colored resin core material for glass fiber post.
Lee, Hyung Chul;Kang, Dong Hee;Koo, Sang Hwan;Park, Seung Ha
Archives of Plastic Surgery
/
v.32
no.6
/
pp.739-743
/
2005
Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.
An endodontically treated tooth is likely to be brittle than a vital tooth. Internal structure of the tooth has been weakened due to a significant removal of dentin by coronal access, canal preparation. There are many controversies concerning with various methods of reinforcing an intact anterior tooth that has endodontic treatment. In this experiment, 128 extracted maxillary anterior teeth were endodontically treated, and prepared with 4 methods of restorations; Composite resin filling with zinc phosphate cement, composite resin filling without zinc phosphate cement, composite resin filling with post, and metal crown with post. An Instron testing machine was used to measure the fracture loads of the specimens. The means of the failure loads for the 4 groups were compared by F-test statistically and the failure modes were observed. The results were as follows; 1. There were no statistically significant difference between the failure loads of the four methods of restoration. 2. Teeth without post were fractured in a horizontal or oblique plane through upper or middle third of the root. 3. In the posted teeth, fractures were occurred around the post. 4. In the metal crowned teeth with post, the fracture were occurred around the post or coronal area.
This report constitutes a 7-year study of facial fractures based on a series of 616 patients who were treated for facial fractures as in-patients at Chosun University Dental Hospital between 1998 and April 2005. The following results were obtained : 1. The ratio of men to women was 5 : 1. 2. The major etiological factors were falls (36.2%), traffic accidents (23.4%), punches (18.1%), sports (8.3%), and accidents related to work (2.8%). 3. They were most frequent in the second (28.8%), first (26.6%), and third (12.3) decades, in that order. 4. The sites of frequent mandible fracture are the symphysis (32%), left mandibular angle (25.3%), and right mandibular angle (10.9%). 5. The most frequent maxillary fractures were zygomatic fractures (46.4%), Le Fort I fractures (28.8%), and Le Fort II (12.0%) fractures.
Hwang, Jae Ha;Kim, Woo Hyeong;Choi, Jun Ho;Kim, Kwang Seog;Lee, Sam Yong
Archives of Craniofacial Surgery
/
v.22
no.3
/
pp.168-172
/
2021
Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.
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