Purpose: Fracture strength of all-ceramic 3-unit fixed partial dentures manufactured by CAD/CAM and copy-milling systems were evaluated. Methods: Zirconia cores were made by milling the pre-sintered zirconia block by CAD/CAM or copy milling method followed by subsequent sintering. By building-up the corresponding porcelains on the core, all-ceramic bridges were fabricated, and those were evaluated in comparison with PFM fixed partial denture. Results: During the flexural test of the 3-unit PFM bridge, the porcelain started to chip or break at 507.28(${\pm}62.82$)kgf and the metal framework did not break until the maximum load level of 800kgf which was set in the testing instrument of this study. However, among all-ceramic restoration test groups, Everest(EV) group showed a peeling off or breakage of the porcelain from 365.64(${\pm}64.96$)kgf and the core was broken at 491.77(${\pm}55.62$)kgf. Those values of Zirkonzahn(ZR) were 431.03(${\pm}58.47$)kgf and 602.74(${\pm}48.44$)kgf, respectively. The break strength of the porcelain of PFM(PM) group was significantly higher than that of EV (p<0.05) group and there was no significant difference when comparing to that of ZR (p>0.05). ZR group showed higher break strength than that of EV group however there was no significant difference (p>0.05). The break strength of cores were in the increasing order of EV < ZR < PM (p<0.05). Conclusion: We could find that even though the PM group fractured at much higher value than all-ceramic cores, the breakage values of the porcelain of PM group with crack formation or delamination, which will be regarded as clinical failure, was significantly higher than that of EV group and not significantly higher than that of ZR group at p-values of 0.05. The break strength of ZR group was higher than that of EV group at an insignificant level(p>0.05).
STATEMENT OF PROBLEM. Over the years, resin-bonded fixed partial dentures (RBFPDs) have gone through substantial development and refinement. Several studies examined the biomechanics of tooth preparation and framework design in relation to the success rate of RBFPDs and considered retention and resistance form essential for increase of clinical retention. However, these criteria required preparations to be more invasive, which violates not only the original intentions of the RBFPD, but may also have an adverse effect on retention due to loss of enamel, an important factor in bonding. PURPOSE. The object of this in vitro study was to compare the dislodgement resistance of the new types of RBFPDs, the conventional three-unit fixed partial denture, and conventional design of RBFPD (Maryland bridge). MATERIAL AND METHODS. Fifty resin mandibular left second premolars and second molars were prepared on dentiforms, according to the RBFPD design. After model fabrication (five group, n = 10), prostheses were fabricated and cemented with zinc phosphate cement. After cementation, the specimens were subjected to tensile loading at a cross head speed of 4 mm/min in a universal testing machine. The separation load was recorded and analyzed statistically using one-way analysis of variance followed by Duncan's multiple range test. RESULTS. Group V, the pin-retained RBFPDs, had the highest mean dislodgement resistance, whereas specimens of group II, the conventional RBFPDs, exhibited a significantly lower mean dislodgement resistance compared to the other 4 groups (P <.05). There were no significant differences between group I, III, and IV in terms of dislodgement resistance (P>.05). Group V had the highest mean MPa (N/$mm^2$) (P <.05). There was no significant difference between groups I, II, III and IV (P > .05). CONCLUSION. Within the limits of the design of this in vitro study, it was concluded that: 1. The modified RBFPDs which utilizes the original tooth undercuts and requires no tooth preparation, compared with the conventional design of RBFPDs, has significantly high dislodgement resistance (P < .05). 2. The modified RBFPDs which utilizes the original tooth undercuts and requires minimal tooth preparation, compared with the conventional FPDs, has significantly no difference in retention and dislodgement resistance)(P>.05). 3. The pin-retained FPDs showed a high dislodgement resistance compared to the conventional three-unit FPDs (P<.05).
Successful cases of the implant-assisted removable partial denture and implant overdentures are reported in which a few implants are additionally placed to secure the maintenance, support, and stability of the denture when there are a few residual teeth. When the lateral force applied to the tooth abutment and implant surveyed crown is minimized, the horizontal and rotational movement of the denture is significantly reduced which is an effective method that can improve the address in patients who complain of reduced retention and stability of their dentures. In this case, a small number of implants were placed to fabricate an implant-assisted removable partial denture with implant surveyed crown in the maxilla and implant overdenture with Locator® attachment in the mandible to improve the retention, stability, and support of the dentures. The patient was satisfied with both functional and aesthetic aspects after the final dentures were delivered.
Currently CAD/CAM technology has been used widely in dentistry. But it has mainly been focused on fabrication of fixed partial dentures and implant-supported prosthesis. DENTCA company uses new cutting edge of CAD/CAM technology to revolutionize denture production. With developing a CAD/CAM technology of DENTCA company, it is possible to make complete dentures with minimum visits to the clinic. The aim of this article is to introduce a new denture-making method by CAD/CAM.
Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.
The purpose of this investigation was to evaluate the mouth preparation and design of removable partial dentures. A total of 187cases for the prefabricated partial denture frameworks in both maxillary and mandibular semi-dentulous situations (66 cases and 203 cases) was selected from this study. The evaluations of mouth preparation and design observed here involved the classification of edentulous spaces, status of abutment splinting with location, design of direct retainer and structure of maxillary major connector according to the incidence of both dental arches, ages, sexes and segment of semidentulousness. The analyzed results were as follows: 1) The order of frequency rate in removable partial denture construction was Class II (50.27%), Class I (36. 90%), Class III (10.69%), and Class IV (2.14 %). 2) The distribution on design of maxillary removable partial denture prosthesis was 33.22% and 64.11% in mandibular removable partial denture prosthesis. 3) The age distribution of removable partial denture prosthesis was prominent after40 years (41.71%). 4) The design pattern of maxillary major connectors was in order of anteroposterior bar, single palatal bar, palatal strap, U-shape connector. 5) The design pattern of direct retainer was in order of Aker's clasp, I-bar clasp, backaction clasp, cuspid universal clasp. 6) The abutment for partial denture clasp splinted between premolar and premolar and its frequency rate revealed 53.44%. 7) It seemed that the location and design of the indirect retainer showed accepatble limit.
PURPOSE. Zirconia has been used in clinical dentistry for approximately a decade, and there have been several reports regarding the clinical performance and survival rates of zirconia-based restorations. The aim of this article was to review the literatures published from 2000 to 2010 regarding the clinical performance and the causes of failure of zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS. An electronic search of English peer-reviewed dental literatures was performed through PubMed to obtain all the clinical studies focused on the performance of the zirconia FPDs. The electronic search was supplemented by manual searching through the references of the selected articles for possible inclusion of some articles. Randomized controlled clinical trials, longitudinal prospective and retrospective cohort studies were the focuses of this review. Articles that did not focus on the restoration of teeth using zirconia-based restorations were excluded from this review. RESULTS. There have been three studies for the study of zirconia single crowns. The clinical outcome was satisfactory (acceptable) according to the CDA evaluation. There have been 14 studies for the study of zirconia FPDs. The survival rates of zirconia anterior and posterior FPDs ranged between 73.9% - 100% after 2 - 5 years. The causes of failure were veneer fracture, ceramic core fracture, abutment tooth fracture, secondary caries, and restoration dislodgment. CONCLUSION. The overall performance of zirconia FPDs was satisfactory according to either USPHS criteria or CDA evaluations. Fracture resistance of core and veneering ceramics, bonding between core and veneering materials, and marginal discrepancy of zirconia-based restorations were discussed as the causes of failure. Because of its repeated occurrence in many studies, future researches are essentially required to clarify this problem and to reduce the fracture incident.
The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from a distal extension removable partial dentures with three kinds of mandibular major connectors, that is, lingual bar, linguoplate, and swing-lock attachment. A photoelastic model was made of the epoxy resin(PC-1) and hardener(PCH-1) and coated with plastic cement-1 (PC-1) at the lingual surface of the epoxy model and set with three kinds of chrome-cobalt removable partial dentures. A bilateral vertical load of 15kg to the middle portion of the metal bar crossing both the first molars of the right and the left, and a unilateral vertical load of 12.5kg to the right first molar were applied with the use of specially designed loading device and the reflective circular polariscope was used to analyze the photoelastic model under each condition. The following results were obtained : 1. When the bilateral vertical load was applied, the magnitude and distribution of the stress concentration of the edentulous area and the terminal abutment or adjacent teeth was in the order of lingual bar, linguoplate, swing-lock attachment. 2. When the unilateral vertical load was applied, the magnitude and distribution of the stress concentration of the edentulous area and the terminal abutment or adjacent teeth was in the order of lingual bar, linguoplate, swing-lock attachment. 3. When the unilateral vertical load was applied, the magnitude and distribution of the stress concentration of the termial abutment or adjacent teeth on the non-loaded side showed the least stress distribution in case of swing-lock attachment. 4. When the bilateral vertical load and the unilateral vertical load were applied the swing-lock attachment showed the mildest uniform stress distribution on the edentulous area and the alveolar bone around the abutment teeth.
This study was perfomed to investigate the prosthodontic and periodontal status of the abutment teeth in distally extending bridges(DEBs) (78 cases) and removable partial dentures(RPDs) (43 cases) for 122 patients (55 males and 57 females) visiting department of Periodontology, Seoul National University Hospital. The average wearing periods were 67.8 months for DEBs and 66.4 months for RPDs. 38.4% of the patients in DEBs and 35.9% in RPDs complainted of chewing discomfort and 22.6% and 24.4% were not chewing on the prosthodontically - treated sides, respectively. In DEBs, when the restoration for 2nd molar supported by 1st molar & 2nd premolar was grouped to type 1, 1st molar supported by 1st & 2nd premolars was type 2, and 1st & 2nd molars supported by 1st & 2nd premolars was type 3, there was a significant differences only in the tooth mobility score among clinical parameters (type 2>type 1>type 3). In RPDs, when bilateral free-end case was grouped to type 1, and unilateral case was type 2, there was a significant difference in the Gingival index (type 1>type 2). In DEBs, 62.8% of restoration were overcontoured, 72% had interproximal space closures, 30.5% overextended pontics and 86.6% overhanging margins. In RPDs, 24.4% of the restorations were overcontoured, 45.5% had interproxinal space closures and 58.3% overhanging margins. From these results of this study, periodontal problems caused by prosthodontic defects were considered to be contributing factors in chewing discomfort.
The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from the mandibular distal extension removable partial dentures with the mesial or distal placement of the occlusal rest and the mesial or distal connection in the back-action clasp with the five various designs of the back-action clasp, that is, the mesial connection and the distal rest, the distal connection and mesial rest, the mesial connection and mesial rest, the distal connection and the mesial and distal rest, and the mesial connection, and the mesial and distal rest. A photoelastic model was made of the epoxy resin(PC-1) and the hardner(PLH-1) with the acrylic resin teeth used and was coated with the plastic cement-1 at the lingual surface of the model and then five kinds of the removable partial dentures on the photoelastic model were set. A unilateral vertical load of 12.5 kg was applied on the central fossa of the first molar with the use of specially designed loading device and the pattern and distribution of the stress of the photoelastic model under each condition was analyzed by the reflective circular polariscope. The following results were obtained. 1. In the back-action clasp with the mesial connection and mesial rest of the case 3, the effect of the stress distribution was the most favorable. 2. In the back-action clasp with the mesial and distal rest, of the case 4 and 5, the stress distribution was more greatly showed in the terminal abutment. 3. Generally, the stress distribution was more favarable in the mesial connection than in the distal connection. 4. In the back-action clasp with the mesial connection of the case 1, 3 and 5, the stress distribution was the most favorable in the mesial rest.
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