• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.3
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• pp.145-155
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• 2002

The results of the present feasibility study are summarized as follows, 1. The three unit bridge of knitted material and UD fibre reinforcement has both the rigidity and the strength against a vertical occlusal load of 75N. 2. Stress concentration at the junctional area between the bridge and the abutments, i.e. between the pontic and the knitted caps was observed. In the case of the bridge with reinforcement straps, it was partly shown that the concentration problem could be improved by simply increasing the fillet size at the area. Further refining in the surface of the junctional area will be needed to ensure a further improvement in the stress distribution. This will require some trade off in the level of the stress and the available space. A parametric study will help to decide the appropriate size of the fillet. 3. Design refinement is a must to improve the stress distribution and realize the most favourable shape in terms of fabrication. The current straight bar with a constant cross section area can be redesigned to a tapered shape. The curve from the dental arch should also be placed on the pontic design. In accordance with design refinement, the resistance of the bridge frame to other load cases should be evaluated. 4. Although not included in the present feasibility study, it is estimated that bridges of the anterior teeth can be made strong enough with the knitted material without further reinforcement using unidirectional materials. In this regard, a feasibility study on design concepts and stress analysis for 3, 4, 5 unit bridge is suggested. 5. Two types of bridge were analysed in terms of fatigue. The safe life design concept, i.e. fatigue design concept, looks reasonable for the bridge where if cracks should form and propagate there is virtually nothing a dentist to do. The bridge must be designed so that no crack will be initiated during the life span. In the case of crowns, however, if constructed with composite resin with knitted materials, it might be possible to repair them, which in general is impossible for crowns of PFM or of metal. Therefore for composite resin crowns, a damage tolerance design concept can be applied and reasonably higher operational stresses can be allowed. In this case, of course, a periodic inspection program should be established in parallel. 6. Parts of future works in terms of structural viewpoint which need to be addressed are summarized as the following: 1) To develop processing technology to accommodate design concepts; 2) More realistic modelling of the bridge and analysis-geometry and loading condition. Thickness variation in the knitted material, taper in the pontic, design for anterior tooth bridge, the effect of combined loads, etc, will need to be included; 3) To develop appropriate design concepts and design goals for the fibre composite FPD aiming at taking the best advantage of knitted materials, including the damage tolerance design concept; 4) To develop testing method and perform test such as static ultimate load test, fatigue test, repair test, etc, as necessary.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.359-371
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• 2010

Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.416-423
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• 2009

Statement of problem: The degree of light attenuation at the time of cementation of the PLV restoration depends on characteristics such as thickness, opacity and shade of the restorations, which interfere with light transmittance and, as a result, may decrease the total energy reaching the luting cement. Purpose: The purpose of this study was to compare the degree of conversion of light-cured resin cements measuring by FT-IR in regard to different thickness, light devices and curing time. Material and methods: In the control group, a clear slide glass (1.0 mm) was positioned between the light cured resin cement and light source. The specimens of ceramics were made with IPS Empress Esthetic. The ceramics were fabricated with varying thicknesses-0.5, 1.0, 1.5 mm with shade ETC1. Rely $X^{TM}$ Veneer with shade A3, light-cured resin cement, was used. Light-activation was conducted through the ceramic using a quartz tungsten halogen curing unit, a light emitting diode curing unit and a plasma arc curing unit. The degree of conversion of the light-cured resin cement was evaluated using FT-IR and OMNIC. One-way ANOVA and Tukey HSD test were used for statistical analysis ($\alpha$< .05). Results: The degree of conversion (DC) of photopolymerization using QTH and LED was higher than results of using PAC in the control group. After polymerization using QTH and LED, the DC results from the different ceramic thickness- 0.5 mm, 1.0 mm, 1.5 mm- did not show a significant difference when compared with those of control group. However, the DC for polymerization using PAC in the 1.5mm ceramic group showed significantly lower DC than those of the control group and 0.5 mm ceramic group (P<.05). At 80s and 160s, the DC of light-cured resin cement beneath 1.0 mm ceramic using LED was significantly higher than at 20s (P<.05). Conclusion: Within the limitation of this study, when adhering PLV to porcelain with a thickness between 0.5-1.5 mm, the use of PAC curing units were not considered however, light cured resin cements were effective when cured for over 40 seconds with QTH or LED curing units. Also, when curing the light cured resin cements with LED, the degree of polymerization was not proportional with the curing time. Curing exceeding a certain curing time, did not significantly affect the degree of polymerization.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.191-198
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• 2009

Statement of problem: Ceramics have been important materials for the restoration of teeth. The demands of patients for tooth-colored restorations and the availability of various dental ceramics has driven the increased use of new types of dental ceramic materials. Improved physical properties of theses materials have expanded its use even in posterior crowns and fixed partial dentures. However, ceramic still has limitation such as low loading capability. This is critical for long-span bridge, because bridge is more subject to tensile force. Purpose: The wire reinforced ceramic was designed to increase the fracture resistance of ceramic restoration. The purpose of this study was to evaluate the fracture resistance of wire reinforced ceramic. Material and methods: Heat pressed ceramic(ingot No.200 : IPS Empress 2, Ivoclar Vivadent, Liechtenstein) and Ni-Cr wire(Alfa Aesar, Johnson Matthey Company, USA) of 0.41 mm diameter were used in this study. Five groups of twelve uniform sized ceramic specimens(width 4 mm, thickness 2 mm, length 15 mm) were fabricated. Each group had different wire arrangement. Wireless ceramic was used as control group. The experimental groups were divided according to wire number and position. One, two and three strands of wires were positioned on the longitudinal axis of specimen. In another experimental group, three strands of wires positioned on the longitudinal axis and five strands of wires positioned on the transverse axis. Three-point bending test was done with universal testing machine(Z020, Zwick, Germany) to compare the flexural modulus, flexural strength, strain at fracture and fracture toughness of each group. Fractured ceramic specimens were cross-sectioned with caborundum disc and grinded with sandpaper to observe interface between ceramic and Ni-Cr wire. The interface between ceramic and Ni-Cr wire was analyzed with scanning electron microscope(JSM-6360, JEOL, Japan) under platinum coating. Results: The results obtained were as follows: 1. The average and standard deviation in flexural modulus, flexural strength and fracture toughness showed no statistical differences between control and experimental groups. However, strain was significantly increased in wire inserted ceramics(P<.001). 2. Control group showed wedge fracture aspects across specimen, while experimental groups showed cracks across specimen. 3. Scanning electron microscopic image of cross-sectioned and longitudinally-sectioned specimens showed no gap at the interface between ceramic and Ni-Cr wire. Conclusion: The results of this study showed that wire inserted ceramics have a high strain characteristic. However, wire inserted ceramics was not enough to use at posterior area of mouth in relation to flexural modulus and flexural strength. Therefore, we need further studies.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.183-189
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• 2013

Purpose: The aim of this study was to evaluate clinical outcomes of implant supported fixed-hybrid prostheses (FHP) in the fully edentulous arches. Materials and methods: Patients in this retrospective study were restored with fixed-hybrid prostheses supported by 4 to 6 implants and functioned more than 1 year of loading. Outcome measures were marginal bone change of implant related with sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients, tilting of posterior implant by Mann- Whitney U test and cantilever length of superstructure by regression analysis, and complication rates. Significance level was set P<.05. Results: A total number of 84 implants (16 restorations) placed in 16 patients were observed for 28 months and mean marginal bone loss was $0.53{\pm}0.39mm$. There were no differences of marginal bone loss according to sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients (P>.05), and cantilever length was not significantly related with a marginal bone loss of implant next to cantilever (P>.05). Complication was shown in 11 patients and veneer fracture and dislodging of artificial teeth were most prevalent. Conclusion: Within the limitations of this study, although marginal bone loss of FHP was very little, complication rates were high. Irrespective of tilting of most posterior implants, marginal bone loss of most posterior implants next to cantilever was less than those of the other implants positioned anteriorly. Cantilever length (<17 mm) did not affect a marginal bone loss of most posterior implants.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.20-26
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• 2013

Purpose: The purpose of this study was to evaluate the bond strengths between the latest CAD/CAM ceramic inlay and various resin cements which are used primarily for esthetic restoration. Materials and methods: Cylindrical ceramic blocks(Height: 5 mm, diameter: 3 mm) were fabricated by using Cerec3 and bonded on the dentin of the ninety extracted caries-free molars using three different kinds of resin cement(Unicem$^{(R)}$, Biscem$^{(R)}$, and Variolink II$^{(R)}$) according to the manufacturer's instructions. Ninety specimens were divided into 3 groups according to three different kinds of resin cement. Half of each group were conducted thermocycling under the conditions of the $5-55^{\circ}C$, 5,000 cycle but the other half of them weren't. All specimens were kept in normal saline $37^{\circ}C$, for 24 hours before measuring the bond strength. The shear bond strength was measured by Universal testing machine with a cross head speed of 0.5 mm/min. The results were analyzed statistically by t-test and one-way ANOVA. Results: Unicem$^{(R)}$ group showed the highest shear bond strength despite a slight decline by thermocycling. The shear bond strength of Unicem$^{(R)}$ group and ValiolinkII$^{(R)}$ group were significantly influenced by thermocycling, whereas Biscem$^{(R)}$ group was not influenced (P<.05). There were no significant differences in the bond strength between the three groups without thermocycling, but there was significant differences between Unicem$^{(R)}$ group and Valiolink II$^{(R)}$ group with thermocycling(P<.05). Conclusion: It has been shown to be clinically effective when the self-adhesive resin cements Unicem$^{(R)}$ and Biscem$^{(R)}$ were used instead of the etch-and-rinse resin cement Valiolink II$^{(R)}$ during the bonding of CAD/CAM ceramic inlay restorations with teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.746-763
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• 1996

An alternative design to conventional class II cavity preparation for proximal carious lesions is the tunnel preparation. It preserves the marginal ridge intact, thus making it possible to maintain the natural contact relationship with the adjacent tooth and minimize tooth reduction. This in vitro study was purposed to evaluate the effect of the materials' elastic constants and shear-bond strength on the marginal ridge fracture resistance of teeth restored by the tunnel technique, and to find the materials of choice for tunnel restorations. $Resinomer^{(R)}$, $Ketac-silver^{(R)}$, $Miracle-Mix^{(R)}$, and Tytin were used as restorative material. The elastic constants of each restorative material were evaluated by ultrasonic pulse measurement. Young's modulus and bulk modulus of the restorative materials were evaluated in three specimens for each material type. The shear-bond strength of the restorative materials to the dentin surface was measured after thermocycling 400 times between 6 and $60^{\circ}C$, using ten specimens for each material type. For measuring marginal ridge strength, 60 sound extracted molar teeth were distributed into six groups by size. Sound molar teeth were used as a Control group and unfilled prepared teeth were grouped as Unrestored. Another four groups were named Resinomer group, Ketac-Silver group, Miracle Mix group, and Tytin group by type of restorative material. Tunnel cavity preparation was done with ' 1/2, 2, and 4 round burs in sequence. Initial access to proximal surface was made through an occlusal access preparation started at least 2mm from the marginal ridge, and the proximal opening was formed about 2.5mm below the marginal ridge. After restoration and thermocycling, marginal ridge strength was measured using a universal testing machine. The results were as follows: 1. The Young's modulus of $Tytin^{(R)}$ was 63.95 GPa, followed by $Ketac-Silver^{(R)}$ 27.60 GPa, $Miracle-mix^{(R)}$ 18.48 GPa, and $Resinomer^{(R)}$ 10.74 GPa showing significant differences between the groups(P<0.05). The bulk modulus of the materials showed the same order as Young's modulus. The value of $Tytin^{(R)}$ showed 59.57 GPa indicating that it will deform less than other materials under the same stress. It was followed by $Ketac-Silver^{(R)}$ 23.57 GPa, Miracle $Mix^{(R)}$ 12.50 GPa, and $Resinomer^{(R)}$ 11.60 GPa. 2. The Resinomer group had a shear-bond strength of 7.41 MPa which was significantly higher than those of the Ketac-Silver group (1.80 MPa) and the Miracle Mix group (2.84 MPa) (P<0.01). All the specimens of Tytin group detatched from the dentin surface during thermocycling. 3. The mean marginal ridge strength of the Unrestored group(46.14 kgf) was significantly lower than that of the Control group (84.24 kgf) (P<0.01). The marginal ridge strength of teeth restored by the tunnel technique was, in order, Ketac-Silver group 74.06 kgf, Miracle Mix group 73.36 kgf, Resinomer group 63.47 kgf, and Tytin group 58.76 kgf. The Ketac-Silver, Miracle Mix, and Resinomer groups showed no significant difference with the Control group (P>0.05), but the Tytin group showed significantly lower strength compared to the Control group(P<0.05). The results showed that the marginal ridge strength of the teeth restored by the tunnel technique was not significantly lower than that of sound teeth. They also demonstrated that the bonding strength of the restorative material to the tooth surface should be high and the modulus of elasticity should not be lower than that of the tooth in order to restore the marginal ridge strength to its natural condition.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.1
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• pp.13-22
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• 2009

The composite resin, due to its esthetic quality, is considered the material of choice for restoration of anterior teeth. To get a satisfactory result in the composite resin restorations, it is necessary to choose right shade. At present, most of the commercial composite resins are based on the Vita Lumin shade guides or shade guides that are provided by their company, but color differences among them might be expected even using the same shade in various materials. This study is to measure color differences between various light-cured composite resins and shade guides and to provide the clinicians with information which may aid in improved color match of esthetic restoration. Four kinds of light-cured composite resins (Gradia Direct (GD), Z250 (Z250), Clearfil AP-X (AP-X), Esthet X (E X)) and shade guides with A2 and A3 shade were used. Three specimens of each material and one specimen of each shade guide were made. Each composite resin was filled into the Teflon mold (1.35 mm depth, 8 mm diameter), followed by compression, polymerization and polishing with wet sandpaper. Shade guides were grinded with polishing stones and rubber points to a thickness of approximately 1.35 mm. Color characteristics were performed with a spectrophotometer(color i5, GretagMacbeth, USA). A computer-controlled spectrophotometer was used to determine CIELAB coordinates ($L^*$, $a^*$, $b^*$) of each specimen and shade guide. The CIELAB measurements made it possible to evaluate the amount of the color difference values (${\Delta}E^*ab$) between composite resins and shade guides. CIE standard D65 was used as the light source. The results were as follows : 1. Among the $L^*$, $a^*$, $b^*$ values of most of 4 kinds of composite resin specimens which are produced by same shade, there were significant differences(p<0.05). 2. Among all 4 kinds of composite resin specimens which are produced by same shade, there were color differences that is perceptible to human eye(${\Delta}E^*>3.3$). 3. Between most of composite resin specimens investigated and their corresponding shade guides, there were color differences that is perceptible to human eye(${\Delta}E^*>3.3$). 4. In the clinical environment, it is recommended that custom shade guides be made from resin material itself for better color matching. Shade guides supplied by manufacturers or Vita Lumin shade guide may not provide clinicians a accurate standard in matching color of composite resins, and there are perceptible color differences in most of products. Therefore, it is recommended that custom shade guides be made from resin material itself and used for better color matching.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.148-155
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• 2009

Statement of problem: The interest in all-ceramic restorations has increased as more techniques have become available. With the introduction of machinable dental ceramics and CAD/CAM systems there is a need to evaluate the quality levels of these new fabrication techniques. Purpose: This study is to evaluate the crown fidelity(absolute marginal discrepancy and internal gap) of various zirconia-based all-ceramic crowns fabricated with different CAD/CAM(computer-assisted design/computer-assisted manufacturing) systems and conventional cast metal-ceramic crowns. Material and methods: A resin tooth of lower right second premolar was prepared. After an impression was taken, one metal master die was made. Then 40 impressions of metal master dies were taken for working dies. 10 crowns per each system were fabricated using 40 working dies. Metal-ceramic crowns were cast by using the conventional method, and Procera, Lava, and Cerec inLab crowns were fabricated with their own CAD/CAM manufactruing procedures. The vertical marginal discrepancies and internal gaps of each crown groups were measured on a metal master die without a luting agent. The results were statistically analyzed using the one-way ANOVA and Tukey's HSD test. Results: 1. Vertical marginal discrepancies were $50.6{\pm}13.9{\mu}m$ for metal-ceramic crowns, $62.3{\pm}15.7{\mu}m$ for Procera crowns, $45.3{\pm}7.9{\mu}m$ for Lava crowns, and $71.2{\pm}2.0{\mu}m$ for Cerec inLab crowns. 2. The Internal gaps were $52.6{\pm}10.1{\mu}m$ for metal-ceramic crowns, $161.7{\pm}18.5{\mu}m$ for Procera crowns, $63.0{\pm}10.2{\mu}m$ for Lava crowns, and $73.7{\pm}10.7{\mu}m$ for Cerec inLab crowns. Conclusion: 1. The vertical marginal discrepancies of, 4 crown groups were all within the clinically acceptable range($120{\mu}m$). 2. The internal gaps of LAVA, Cerec inlab, and metal-ceramic crowns were within clinically acceptable range except Procera crown($140{\mu}m$).

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.600-612
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• 2001

The purpose of this study is concerned with an investigation of the actual condition of traumatic injuries of teeth and supporting structures in children to set up possible criteria for prevention and treatment of injured teeth. The materials consisted of the clinical records of 431 traumatically injured teeth of 212 children, accumulated during two years from the first of April in 1998 to the end of March in 2000, supplied from the Dept. of Pediatric Dentistry, Chonbuk National University Hospital. The incidence of injuries in boys was extremely high for permanent teeth, twice as high as in girls. Accidents to primary teeth were most common from 1 to 2 years of age and to permanent teeth were most from 8 to 9 years of age. The most common cause of trauma was a fall for both primary and permanent teeth, followed by collision. The anterior teeth in maxilla was most frequently affected by trauma in both the primary and permanent teeth. The most common type of trauma were loosening for the primary teeth, followed by luxation types which included the intrusion, displacement and extrusion and complete avulsion types. For the permanent teeth, the most common type of trauma were tooth fracture. The most common trauma of soft tissue was laceration of upper lip, lower lip and gingiva of maxilla Concerning treatment at the first visit, primary teeth with only loosening and concussion were not usually treated. Permanent teeth were often treated by crown restorations for crown fractures and by endodontic procedures for pulpal exposure. Though we could elucidate actual condition of traumatic injuries of teeth in children, we should make a follow-up survey to ensure the prognosis of injured teeth and establish the most desirable criteria for traumatized teeth in children.