• The Journal of Advanced Prosthodontics
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• v.13 no.5
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• pp.281-291
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• 2021

PURPOSE. To evaluate the wear of computer-aided design/computer-aided manufacturing (CAD-CAM) dental ceramic materials opposed by enamel as a function of increased chewing forces. MATERIALS AND METHODS. The enamel cusps of healthy human third molar teeth (n = 40) opposed by materials from CAD-CAM dental ceramic groups (n = 10), including Vita Enamic^® (ENA), a polymer-infiltrated ceramic network (PICN); GC Cerasmart^® (CERA), a resin nanoceramic; Celtra^® Duo (DUO), a zirconia-reinforced lithium silicate (ZLS) ceramic; and IPS e.max ZirCAD (ZIR), a polycrystalline zirconia, were exposed to chewing simulation (1,200,000 cycles; 120 N load; 1 Hz frequency; 0.7 mm lateral and 2 mm vertical motion). The wear of both enamel cusps and materials was quantified using a 3D laser scanner, and the wear mechanisms were evaluated by scanning electron microscopy (SEM). The results were analysed using Welch ANOVA and Kruskal Wallis test (α = .05). RESULTS. ZIR showed lower volume loss (0.02 ± 0.01 mm³) than ENA, CERA and DUO (P = .001, P = .018 and P = .005, respectively). The wear of cusp/DUO [0.59 mm³ (0.50-1.63 mm³)] was higher than cusp/CERA [0.17 mm³ (0.04-0.41 mm³)] (P = .007). ZIR showed completely different wear mechanism in SEM. CONCLUSION. Composite structured materials such as PICN and ZLS ceramic exhibit more abrasive effect on opposing enamel due to their loss against wear, compared to uniform structured zirconia. The resin nano-ceramic causes the lowest enamel wear thanks to its flexible nano-ceramic microstructure. While zirconia appears to be an enamel-friendly material in wear volume loss, it can cause microstructural defects of enamel.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.464-469
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• 2011

Introduction: As dental implant surgery is becoming increasingly popular, it has become one of the causes for the hypesthesia of the inferior alveolar nerve, along with other surgical procedures, such as a third molar extraction. In addition, it tends to cause legal problems between the operator and patient. Therefore, there must be a proper method that is reliable, objective and economical to assess the nerve impairment. For this reason, an attempt was made to use an Electric Pulp Tester to assess inferior alveolar nerve block anesthesia. Materials and Methods: Thirty patients were tested. Electric pulp testing of the lower jaw skin was performed at the three different times, before anesthesia, at the onset of sensory changes and after 15 minutes waiting from the onset, and on the 10 points of the chin, which produced 10 sections on the skin area. Results: Twenty seven patients (90%) could feel the electric stimulus on the chin at all 10 points before local anesthesia and the scores represent the statistical differences between the right and left points except R4 and L4. After anesthesia, the difference between the right and left points (L3-R3, L4-R4, L5-R5) increased significantly with time but two points (L2, R2) showed no significant difference. The scores on the left chin (L3, L4, L5) increased, whereas the other points (R1-R5, L1, L2) showed no significant differences. Conclusion: This study highlights the potential clinical use of an electric pulp tester for an assessment of inferior alveolar nerve impairment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.511-519
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• 2006

Autogenous bone grafts have been considered the gold standard for maxillofacial bony defects. However, this procedure could entail a complicated surgical procedure as well as potential donor site morbidity. Possibly the best solution for bone-defect regeneration is a tissue engineering approach, i.e. the use of a combination of a suitable scaffold with osteogenic cells. A major source of osteogenic cells is the bone marrow. Bone marrow-derived mesenchymal stem cells are multipotent and have the ability to differentiate into osteoblastic, chondrocytic, and adipocytic lineage cells. However, the isolation of cells from bone marrow has someproblems when used in clinical setting. Bone marrow aspiration is sometimes potentially more invasive and painful procedure and carries of a risk of morbidity and infection. A minimally invasive, easily accessible alternative would be cells derived from periosteum. The periosteum also contains multipotent cells that have the potential to differentiate into osteoblasts and chondrocytes. In the present study, we evaluated the osteogenic activity and mineralization of cultured human periosteal-derived cells. Periosteal explants were harvested from mandibule during surgical extraction of lower impacted third molar. The periosteal cells were cultured in the osteogenic inductive medium consisting of DMEM supplemented with 10% fetal calf serum, 50g/ml L-ascorbic acid 2-phosphate, 10 nmol dexamethasone and 10 mM -glycerophosphate for 42 days. Periosteal-derived cells showed positive alkaline phosphatase (ALP) staining during 42 days of culture period. The formation of ALP stain showed its maximal manifestation at day 14 of culture period, then decreased in intensity during the culture period. ALP mRNA expression increased up to day 14 with a decrease thereafter. Osteocalcin mRNA expression appeared at day 7 in culture, after that its expression continuously increased in a time-dependent manner up to the entire duration of culture. Von Kossa-positive mineralization nodules were first present at day 14 in culture followed by an increased number of positive nodules during the entire duration of the culture period. In conclusion, our study showed that cultured human periosteal-derived cells differentiated into active osteoblastic cells that were involved in synthesis of bone matrix and the subsequent mineralization of the matrix. As the periosteal-derived cells, easily harvested from intraoral procedure such as surgical extraction of impacted third molar, has the excellent potential of osteogenic capacity, tissue-engineered bone using periosteal-derived cells could be the best choice in reconstruction of maxillofacial bony defects.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.261-270
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• 1994

The purpose of this study was to evaluate relationship of probing attachment levels, radiographic measurements and surgical measurements according to gingival inflammatory condition. Patients with incipient to moderate periodontitis were selected. Upper and lower premolar and molar teeth excluding third molars were measured. At first visit, gingival index and bleeding on probing were taken, and subjects were grouped into 4 categories as follows : Experimental group I : gingival index 1 and no bleeding on probing. Experimental group II : gingival index 2 and no bleeding on probing absent. Experimental group III : gingival index 1 and bleeding on probing present. Experimental group IV : gingival index 2 and bleeding on probing present. Probing attachment levels were measured with manual probe on mesial and distal surfaces from cementoenamel junctions to terminal ends of probe. Radiographic measurements were made to assess bone loss by measuring the distance from cementoenamel junction to the alveolar crest. After thorough scating, a flap was raised exposing the alveolar bone and surgical measurements were made from cementoenamel junction to alveolar bone. The results were as follows: 1. Differences between probing attachment level and radiographic measurements showed $1.01{\pm}0.73mm$ for experimental group I, $0.98{\pm}0.48mm$ for experimental group II, $0.59{\pm}0.66mm$ for experimental group III, $0.98{\pm}0.38mm$ for experimental group IV and with no significant difference between groups. 2. Differences between probing attachment level and surgical measurements showed $1.36{\pm}0.80mm$ for experimental group I, $1.47{\pm}0.54mm$ for experimental group II, $1.06{\pm}0.39mm$ for experimental group III, $1.41{\pm}0.40mm$ for experimental group IV and with no significant difference between groups. 3. Differences between surgical and radiographic measurements showed $0.36{\pm}0.48mm$ for experimental group I, $0.51{\pm}0.54mm$ for experimental group II, $0.57{\pm}0.72mm$ for experimental group III, $0.41{\pm}0.49mm$ for experimental group IV and with significant difference between experimental group I and experimental group II, III, IV(P<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.5
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• pp.355-364
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• 2011

Introduction: This study evaluated nerve recovery through retrospective study of patients with lingual nerve damage. Patients and Methods: The patients who visited Seoul National University Dental Hospital for an injury to the lingual nerve from April 1988 to August 2009 were enrolled in this study (n=41). The relevance of various factors including the causes of damage, age, etc. was analyzed by the subjective improvement based upon questionnaires and the clinical records. The evaluation variants were a subjective assessment and neurosensory examination composed of the direction, contact threshold, two-point discrimination, pin prick, thermal discrimination and current perception threshold. Results: The causes of lingual nerve damage were an extraction of the lower third molar (75.6%), local anesthesia (9.7%), incision and drainage (4.88%), trauma (2.44%). The evaluation of subjective prognosis exhibited no difference in sensory improvement depending on the cause, age and gender. Based upon the subjective evaluation, 44.7% of patients showed sensory improvement. The first hospital visit from injury was shorter in the group showing subjective improvement (3.41 months) than those showing no improvement (5.24 months) (P=0.301). Thirty six out of 41 patients were treated with only conservative therapy and 5 patients were treated by surgical intervention. Neurosensory examinations revealed improvement, although not statistically significant, and the degree was higher in the subjectively improved group. The contact threshold discrimination showed the highest correlation with subjective improvement (P=0.069). Most of the sensory recovery was gained within 12 months and the degree of improvement at the tip of the tongue was higher than that of the dorsum (P<0.001). Conclusion: The damaged lingual nerve improved at a rate of 44.7% and mostly within 12 months after the incident. There was no difference between the subjective prognosis and neurosensory examination depending on the cause of damage, age and gender, whereas the contact threshold discrimination was the best variant that reflected the subjective prognosis statistically.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.1
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• pp.103-111
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• 2006

Statement of problem: The previous unilateral bite force recorder has several limitations for taking long time for measuring and causing discomfort to subjects. Because of these reasons, it could not use widely for epidemiological researches. However, 'Dental Prescale System' which is new equipment for measuring bite force, is more convenient for measuring bite force than previous unilateral recorder. Purpose: The purpose of this study was to compare a new technique(Dental Prescale System) using pressure sensitive foils for recording of maximal jaw closing force with conventional measurement using unilateral bite force recorder Material and method: This studies included 22 healthy dental students in college of dentistry Yonsei university in Rep of Korea. Mean age was 23.9 years. All subjects had continuous dental arches and no significant malocclusion or signs from the teeth and craniomandibular system. The Dental Prescale System (Fuji Film, Tokyo, Japan) consists of a horseshoe-shaped pressure sensitive sheet (50H, R type) and a computerized scanning system.(FPD705) We also used unilateral bite force recorder(Denbotics Co. Seoul, Rep.Korea) for comparing with Dental Prescale. Results and conclusion: The total bite force recorded with Dental Prescale System (1423 N) was systematically higher than that recorded by unilateral bite force recorder. (256 N) However, the maximum bite force values measured in the two ways were significantly correlated (r=0.46, p<0.05). The Dental Prescale bite force calculated for first molar (208 N) was lower than that recorded by unilateral bite force recorder. (256 N) The two values were also very significantly correlated. (r=0.66. p<0.001) There were significantly different in bite force between two measurement methods. The reasons were first, unilateral bite force recorder measured only the bite force of a part of teeth, and Dental Prescale measured the total teeth force. Second, in measurement, a difference in muscle contraction appeared by an extent of mouth-opening. Third, unilateral bite force recorder has the reducing effect of the bite force by protective tape. Fourth, Dental Prescale has limitations during the computer scanning procedure. Therefore, Dental Prescale System is considered to be a very promising alternative to be conventional bite force recording methods.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.199-206
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• 2010

This study investigated the effects of strontium on osteoblastic phenotypes of cultured human periostealderived cells. Periosteal tissues were harvested from mandible during surgical extraction of lower impacted third molar. Periosteal-derived cells were introduced into cell culture. After passage 3, the periostealderived cells were further cultured for 28 days in an osteogenic induction DMEM medium supplemented with fetal bovine serum, ascorbic acid 2-phosphate, dexamethasone and at a density of $3{\times}10^4$ cells/well in a 6-well plate. In this culture medium, strontium at different concentrations (1, 5, 10, and 100 ${\mu}g$/mL) was added. The medium was changed every 3 days during the incubation period. We examined the cellular proliferation, histochemical detection and biochemical measurements of alkaline phosphatase (ALP), the RT-PCR analysis for ALP and osteocalcin, and von Kossa staining and calcium contents in the periostealderived cells. Cell proliferation was not associated with the addition of strontium in periosteal-derived cells. The ALP activity in the periosteal-derived cells was higher in 5, 10, and 100 ${\mu}g$/ml strontium-treated cells than in untreated cells at day 14 of culture. Among the strontium-treated cells, the ALP activity was appreciably higher in 100 ${\mu}g$/ml strontium-treated cells than in 5 and 10 ${\mu}g$/ml strontium-treated cells. The levels of ALP and osteocalcin mRNA in the periosteal-derived cells was also higher in strontium-treated cells than in untreated cells at day 14 of culture. Their levels were increased in a dose-dependent manner. Von Kossa-positive mineralization nodules were strongly observed in the 1 ${\mu}g$/ml strontium-treated cells at day 21 and 28 of culture. The calcium content in the periosteal-derived cells was also higher in 1 ${\mu}g$/ml strontium-treated cells at day 28 of culture. These results suggest that low concentration of strontium stimulates the osteoblastic phenotypes of more differentiated periosteal-derived cells, whereas high concentration of strontium stimulates the osteoblastic phenotypes of less differentiated periosteal-derived cells. The effects of strontium on osteoblastic phenotypes of periosteal-derived cells appear to be associated with differentiation-extent.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.197-205
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• 2007

Angiogenesis is a essential part for bone formation and bone fracture healing. Vascular endothelial growth factor (VEGF), one of the most important molecules among many angiogenic factors, is a specific mitogen for vascular endothelial cells. VEGF-mediated angiogenesis is required for bone formation and repair. However, the effect of VEGF on osteoblastic cells during osteogenesis is still controversial. In recent days, substantial progress have been made toward developing tissue-engineered alternatives to autologous bone grafting for maxillofacial bony defects. Periosteum has received considerable interest as a better source of adult stem cells. Periosteum has the advantage of easy harvest and contains various cell types and progenitor cells that are able to differentiate into a several mesenchymal lineages, including bone. Several studies have reported the bone formation potential of periosteal cells, however, the correlation between VEGF signaling and cultured human periosteal cell-derived osteogenesis has not been fully investigated yet. The purpose of this study was to examine the correlation between VEGF signaling and cultured human periosteal-derived cells osteogenesis. Periosteal tissues of $5\;{\times}\;20\;mm$ were obtained from mandible during surgical extraction of lower impacted third molar from 3 patients. Periosteal-derived cells were introduced into the cell culture and were subcultured once they reached confluence. After passage 3, the periosteal-derived cells were further cultured for 42 days in an osteogenic inductive culture medium containing dexamethasone, ascorbic acid, and ${\beta}-glycerophosphate$. We evaluated the alkaline phosphatase (ALP) activity, the expression of Runx2 and VEGF, alizarin red S staining, and the quantification of osteocalcin and VEGF secretion in the periosteal-derived cells. The ALP activity increased rapidly up to day 14, followed by decrease in activity to day 35. Runx2 was expressed strongly at day 7, followed by decreased expression at day 14, and its expression was not observed thereafter. Both VEGF 165 and VEGF 121 were expressed strongly at day 35 and 42 of culture, particularly during the later stages of differentiation. Alizarin red S-positive nodules were first observed on day 14 and then increased in number during the entire culture period. Osteocalcin and VEGF were first detected in the culture medium on day 14, and their levels increased thereafter in a time-dependent manner. These results suggest that VEGF secretion from cultured human periosteal-derived cells increases along with mineralization process of the extracellular matrix. The level of VEGF secretion from periosteal-derived cells might depend on the extent of osteoblastic differentiation.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.103-109
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• 2004

The present study prepared 72 test samples - 24 made of amalgam alloy, 24 of Verabond (Ni-Cr alloy) for crown and 24 of Talladium $^{TM}alloy$ for denture - according to the manufacturers' manuals and general method in consideration of the width of the mesial-distal dental crown of the lower $1^{st}$ molar and MOD cavity in clinics, put them in a 200 ml beaker containing 80 ml of artificial saliva, and measured their galvanic corrosion at distances of 0 mm, 7 mm and 40 mm after 7 days. Isolated metals in the electrolyte such as Cu, Ag, Ni, Cr, Sn, Zn and Hg were quantitatively analyzed with Inductively Coupled Plasma - Atomic Emission Spectrometer (ICP-AES, JY-50P, VG Elemental Co. France), and from the results were drawn conclusions as follows. First, Cu, Sn, Ag, Hg and Zn were highly advantageous when amalgam contacted gold alloy compared to Ni-Cr alloy for crown and Talladium alloy for denture. In addition, although gold alloy was finest in terms of oral tissue and biocompatibility, it was most disadvantageous when it was with amalgam. Second, when amalgam contacted gold alloy, heavy metals such as Ni and Cr were not isolated at all because gold alloy did not contain such elements but Sn was isolated as much as $227.1{\pm}18.0035{\mu}g/cm^2$ although it was not included in the composition either. Hg was also isolated. These elements are assumed to have been isolated from amalgam itself. Third, when amalgam alloy was apart from gold alloy 0 mm, 7 mm and 40 mm, Cu and Ag showed significance but Hg did not. This suggests that gold alloy must not be used together with amalgam, and must not be used between dissimilar prostheses regardless of distance. Fourth, when amalgam alloy contacted Ni-Cr alloy for crown, Ag was not isolated from the amalgam, but Zn, Ni, Sn, Hg and Cu were isolated in order of quantity. Significance was observed according to distance - 0 mm, 7 mm and 40 mm. Hg was not isolated but heavy metals Ni and Cr were isolated. If amalgam alloy was in the opposite arch or it was apart from Ni-Cr alloy for crown, the isolation Hg was less than that when amalgam alloy contacted Ni-Cr alloy for crown. Fifth, when amalgam alloy contacted Talladium alloy for denture, significance was observed at distances of 0mm, 7 mm and 40 mm. Hg was not isolated but heavy metals Ni and Cr were isolated. If amalgam alloy was in the opposite arch or it was apart from Talladium alloy for denture, the isolation Hg was less than that when amalgam alloy contacted Talladium alloy for denture. Sixth, according to the result of ICPES test on Cu, Sn, Ag, Hg, Zn, Ni and Cr of amalgam alloy, gold ally, Verabond and Talladium alloy when these alloys contacted artificial saliva, significance was observed in Cu and Hg. Seventh, when amalgam alloy contracted two non-precious metals Ni-Cr alloy for crown and Talladium alloy for denture in artificial saliva, significance was observed in the isolated by-products of Hg, Ni and Cr according to distance.