• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.458-467
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• 2016

Cement-retained implant prosthesis has several advantages in the esthetic and occlusal aspects. However, the difficulty of the retrievability and the possibility of peri-implantitis induced by the cement excess would be a threatening factor to the implant prognosis. Peri-implantitis resulting from the remaining cement could occur later on to the patients with periodontitis history. Retention can be controlled by selecting the right cement type. Retention of the cement was the strongest in the resin cement, followed by resin modified glass ionomer cement, poIycarboxylate cement, zinc phosphate cement and glass ionomer cement. Retention of the provisional cement weakened after thermocycling. Other factors such as the abutment number, abutment alignment, height and taper of the abutment can also affect the total retention. To the success of the cement-retained prosthesis, it's important to select the right cement for the clinical purpose. The prosthesis should be fabricated in accordance with the biomechanical requirements. The prosthesis should be cemented with the techniques to reduce the excess cement as much as possible. In addition, the excess cement should be identified using the radiography and carefully removed.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.3
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• pp.206-211
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• 2018

Purpose: Recently, a method of forming a slot in the prosthesis lingual has been introduced to solve the occlusal and aesthetic disadvantages of screw-retained prosthesis in the manufacture of implant-fixed prosthesis and to ensure retrievability in cement retained prostheses. The purpose of this study is to investigate the effect of the internal gap on the removal of the prosthesis in the preparation of cement-retained implant prostheses with lingual slots. Materials and methods: Titanium abutment and internal gap of the zirconia prosthesis to be attached to the upper part were set to 30, 35, and $50{\mu}m$, respectively. Three for each type total 15 were produced for each type. The zirconia prosthesis formed a retrievable cement-type slot with a space of 1 mm at the location where the titanium abutment meets the shelf area. Autocatalytic resin cement was used for bonding of abutment and zirconia prosthesis, and the maximum removal stress value was measured in units of Ncm by using the customized equipment of the cemented specimen. The Kruskal-Wallis test was used to compare the three groups by statistical analysis (${\alpha}=.05$), modified by post hoc test the Mann-Whitney U-test and the Bonferroni correction method were used to compare the two methods (${\alpha}=.017$). Results: There was no statistically significant difference in removal stress between the $30{\mu}m$ group and the $35{\mu}m$ group in the internal gap (P = .032), and there was a significant difference between the $30{\mu}m$ group and the $50{\mu}m$ group, between the $35{\mu}m$ group and the $50{\mu}m$ group (P < .017). Conclusion: Thus, the internal gap of computer-aided design affected the retention between the zirconia prosthesis and the titanium abutment.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.179-190
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• 2012

The installation of an implant in the distal extension area to assist a partial dentrue (IARPD) was used carefully in clinical situations. The purpose of this review on the IARPD is describing the concept, clinical results and guidelines of IARPD. For the review, a literature search was performed using the PubMed. The data from the literature suggest that the placement of the implants could improve function and patient satisfaction. In addition, IARPD reduced the residual ridge resorption. Longer and wider implant should be placed. Less than $15^{\circ}$ angulation may be not harmful. To prevent the loosening of the abutment, modified abutment or resilient attachment should be used. However, the connection method between the clasp retention and IARPD should be considered for long time success. Moreover, longitudinal clinical studies are required for evaluation of IARPD.

• The Journal of Advanced Prosthodontics
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• v.7 no.2
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• pp.172-177
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• 2015

PURPOSE. The purpose of this study was to evaluate cell toxicity due to ion release caused by galvanic corrosion as a result of contact between base metal and titanium. MATERIALS AND METHODS. It was hypothesized that Nickel (Ni)-Chromium (Cr) alloys with different compositions possess different corrosion resistances when contacted with titanium abutment, and therefore in this study, specimens ($10{\times}10{\times}1.5mm$) were fabricated using commercial pure titanium and 3 different types of Ni-Cr alloys (T3, Tilite, Bella bond plus) commonly used for metal ceramic restorations. The specimens were divided into 6 groups according to the composition of Ni-Cr alloy and contact with titanium. The experimental groups were in direct contact with titanium and the control groups were not. After the samples were immersed in the culture medium - Dulbecco's modified Eagle's medium[DMEM] for 48 hours, the released metal ions were detected using inductively coupled plasma mass spectrometer (ICP-MS) and analyzed by the Kruskal-Wallis and Mann-Whitney test (P<.05). Mouse L-929 fibroblast cells were used for cell toxicity evaluation. The cell toxicity of specimens was measured by the 3-{4,5-dimethylthiazol-2yl}-2,5-diphenyltetrazolium bromide (MTT) test. Results of MTT assay were statistically analyzed by the two-way ANOVA test (P<.05). Post-hoc multiple comparisons were conducted using Tukey's tests. RESULTS. The amount of metal ions released by galvanic corrosion due to contact between the base metal alloy and titanium was increased in all of the specimens. In the cytotoxicity test, the two-way ANOVA showed a significant effect of the alloy type and galvanic corrosion for cytotoxicity (P<.001). The relative cell growth rate (RGR) was decreased further on the groups in contact with titanium (P<.05). CONCLUSION. The release of metal ions was increased by galvanic corrosion due to contact between base metal and titanium, and it can cause adverse effects on the tissue around the implant by inducing cytotoxicity.

• Journal of Korean Dental Science
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• v.10 no.1
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• pp.29-34
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• 2017

Purpose: The purpose of this study was to evaluate the microleakage of various types of resin-bonded fixed partial dentures (RBFPDs) after artificial aging. Materials and Methods: Forty models with missing first molar were fabricated using artificial resin teeth and were divided into four groups: Group A, conventional RBFPDs design; Group B, modified RBFPDs design; Group C, assembled 3-piece RBFPDs design; and Group D, assembled 3-piece RBFPDs with different occlusal rest positions. Half of the specimens underwent chewing simulation process (240,000 cycles, 50 N load, 1.7 Hz) and thermocycling (temperatures $5^{\circ}C{\sim}55^{\circ}C$, dwelling time 30 seconds) and the remaining 20 specimens didn't receive any treatment. All the specimens were immersed in 2% methylene blue solution for 24 hours to evaluate microleakage, and were sectioned at the middle part of abutment teeth. To evaluate the microleaskage, a dye penetration was calculated. Result: With artificial aging, cyclic loading and thermocycling, a 3-piece RBPFD and a 2-piece RBPFD using original tooth undercuts have significantly lower microleakge (P<0.05) compared to the conventional design of RBPFD and modified RBPFD. Conclusion: Within the limit of this experiment, the assembled RBFPDs exhibited a smaller microleakage than the conventional RBFPDs, implying that the assembled RBFPDs can be more effective for reducing the dislodgement of the RBFPDs.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.160-170
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• 2019

The anterior guidance is one of the important factors in prosthodontic treatment of anterior teeth. The lingual surface shape of anterior restorations is so critical that small errors of treatment procedure can cause discomfort of the patient and disharmony of the dentition. If the anterior restorations are achieved harmonious anterior guidance through the fabrication and adjustment of provisional restorations, it is important to accurately reproduce the lingual surface shape of provisional restorations as the final prosthesis. In this case report, it was used the modified Dahl principle and copy-milled technique of computer-aided design/computer-aided manufacturing (CAD/CAM) system for systematic diagnosis and treatment. Therefore, we tried to reconstruct the restoration shape more precisely by setting the appropriate anterior guidance and superimposing the digital image of the abutment teeth and the provisional restorations. Thus, by promoting functional and esthetic recovery, this case report demonstrates satisfying results to both the patients and dentist.

• The Journal of Advanced Prosthodontics
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• v.10 no.1
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• pp.18-24
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• 2018

PURPOSE. In literature, many studies compare survival rates of different types of FPDs. Most of them compared restorations, which originated from one university, but from different clinicians. Data about restoration survival rates by only one experienced dentist are very rare. The aim of this study was to evaluate the survival rate of all-ceramic FPDs without the blurring effects of different clinicians. MATERIALS AND METHODS. 153 veneered-zirconia FPDs were observed for follow-up. 22 patients received 131 single crowns and 22 bridges. Because of the different bridge lengths, one unit was defined as a restored or replaced tooth. In total, 201 units were included. Only the restorations performed by the same clinician and produced in the same dental laboratory from 2011 to 2016 were included. Considered factors were defined as "type of unit", "type of abutment", "intraoral region", and "vitality". Modified UHPHS criteria were used for evaluation. Statistical analysis was performed using cox-regression. RESULTS. 189 units (94.0%) showed no kind of failure. 5 chippings (2.4%) could be corrected by intraoral polishing. 4 units (1.9%) exhibited spontaneous decementation. These polishable and recementable restorations are still in clinical use. Chippings or decementations, which lead to total failure, did not occur. One unit was completely fractured (0.5 %). Biological failures (caries, periodontitis or periimplantitis) did not occur. The statistical analysis of the factors did not reveal any significant differences. CONCLUSION. Modern all-ceramic FPDs seem to be an appropriate therapy not only for single restorations but for complex occlusal rehabilitations.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.637-646
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• 2007

Implants placed immediately after tooth extraction have been shown to be a successfully predictable treatment modality. Several clinical papers suggest that placing implants immediately after tooth extraction may provide some advantages: reduction of the number of surgical procedures or patient visits, preservation of the dimensions of alveolar ridge, and shortening of the interval between the removal of the tooth and the insertion of the implant supported restoration. In this case report, three patients received single immediate implant placements to replace a maxillary anterior tooth at the time of extraction. As the three cases were somewhat different, treatment protocols had to be modified as follows: Case 1. Immediate implant placement with healing abutment connection. Case 2. Immediate implant placement with immediate provisionalization. Case 3. Immediate implant placement with Guided Bone Regeneration(GBR). Every implant of these cases was placed in proper position buccolingually, mesiodistally and apicocoronally, The procedures following implantation such as immediate provisionalization and GBR were free of problem. Healing of each case was uneventful. In all cases, treatment outcomes were mostly satisfactory and the results maintained during follow-up periods. However, one case (Case 3) showed some papilla loss due to failure in delicate soft tissue handling during surgery. This papilla loss was compromised by prosthetic means. In conclusion, immediate implant placement in the fresh extraction socket can be a valid and successful option of treatment in aesthetic area. Moreover, this treatment protocol seems to maintain the preexisting architecture of soft and hard tissues in most cases.

• The Journal of Advanced Prosthodontics
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• v.8 no.3
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• pp.207-213
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• 2016

PURPOSE. A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS. For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (${\alpha}=.05$). RESULTS. The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION. The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.2
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• pp.99-106
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• 2013

Purpose: The aim of this research was to establish the effect and variation in differing convergence angle and length of abutment on the retention of full veneer casted gold crown. Materials and methods: Two different length,5 mm and 10 mm in height with convergence angles of 5, 10, 15 and 25 degrees crowns were fabricated. Cementation was done using cements; zinc phosphate cement (Fleck's zinc phosphate cement), resin-modified glass ionomer cement (Vitremer) and resin cement (Panavia 21). These were tested for tensile force at the point of separation by using Instron Universal Testing Machine. Statistical analysis was done by SAS 6.04 package. Results: In all cements the mean retention decreased with significant difference on increase of convergence angle (P<.05). Increase in every 5 degree-convergence angel the retention rate decreased with resin-modified glass ionomer cement of 15.9% and resin cement of 14.8%. With zinc phosphate cement, there was largest decreasing rate of mean retention of 25.5% between convergence angles from 5 degree to 10 degree. When the crown length increased from 5 mm to 10 mm, the retention increased with the significant difference in the same convergence angle and in all types of cement used (P<.05). Conclusion: The retention was strongly dependent on geometric factors of abutment. Much care is required in choosing cements for an optimal retention in abutments with different convergence angles and crown lengths.