• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.821-838
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• 1999

On the basis of the evidences that electrical stimulation could enhance proliferation and differentiation of bone cells and promote healing and regeneration of bone, this study was performed to investigate the effects of electrical stimulation on human periodontal ligament cells and gingival fibroblasts in vitro, which also have important roles in regeneration of periodontium, and to evaluate the potential of clinical application of electrical stimulation. Human periodontal ligament cells and gingival fibroblasts were primarily cultured from the root surface of extracted premolar and the adjacent gingiva without periodontal diseases. In control group, the cells ($5{\times}10^4$ cells/ml)were incubated only in Dulbecco's Modified Eagle's Medium contained with 10% fetal bovine serum. In test groups, electrical stimulation was given at the current intensity of $0.25{\mu]A$(test group 1), $1.0{\mu}A$(test group 2), and $2.5{\mu}A$(test group 3) for 12 hours to the same culture media with the control group. After 12 hour exposure of electrical stimulation, the cells were incubated for 2 and a half days(60 hours), and then each group of cells was analyzed for cell proliferation, protein level, and activity of alkaline phosphatase. The results were as follows ; 1. The Rate of cell proliferation of every test group increased significantly in both periodontal ligament cells and gingival fibroblasts, and in periodontal ligament cells, test group 3 showed significantly increased proliferation compared to the other test groups(p<0.05). 2. In the protein levels, neither periodontal ligament cell nor gingival fibroblast showed statistically significant differences between control and test groups. 3. The activity of alkaline phosphatase in periodontal ligament cells increased significantly in all test groups(p<0.05), but there were no significant differences between 3 test groups. In gingival fibroblasts, the activity of alkaline phosphatase increased significantly only in test group 3(p<0.05). From the above results, it is concluded that electrical stimulation may have beneficial effects on the regeneration of destructed periodontal tissue in regard of the stimulation of periodontal ligament cells and gingival fibroblasts as well as electrically stimulated bone formation that has been known, and that electrical stimulation may have the potential of clinical application.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.893-914
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• 1999

Tooth mobility may be the decisive factor that determines whether dental treatment of any kind is undertaken. Although tooth mobility in isolation says little in itself, the finding of increased tooth mobility is of both diagnostic and prognostic importance. Only the detection of an increase or decrease in mobility makes an evaluation possible. Thus prior to treatment, we must understand the pathologic process causing the observed the tooth mobility and decide whether the pattern and degree of observed tooth mobility is reversible or irreversible. And then it must be decided whether retention and treatment or extraction and replacement. The purpose of this study was to compare tooth mobility at different time period during root planing and flap operation and to relate changes in mobility to each treatment method. Twenty-one patients (287 teeth) with chronic adult periodontitis were treated with root planing(control group) and flap operation(experimental group), and each group was divided 3 subgroups based upon initial probing pocket depth (1-3mm, 4-6mm, 7mm and more). Tooth mobility was measured with $Periotest^{(R)}$ at the day of operation, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 8 weeks, 12 weeks after each treatment. Tooth mobility, attachment loss, radiographic bone loss, and bleeding on probing were measured at the day of operation, 4 weeks, 8 weeks and 12 weeks after treatment. 1. In group initial probing depth was 1-3mm, tooth mobility had no significant difference after root planing and flap operation. 2 . In group initial probing depth was 4-6mm, 7mm and more, tooth mobility had decreased in 12 weeks after root planing(p<0.01). And the mobility had increased after flap operation(p<0.01) and was at peak in 1 week, and decreased at initial level in 4 weeks, below the initial level in 12 weeks(p<0.01). 3. In 1 week, significant difference in tooth mobility between control and experimental group was found(p<0.01) but, in 12 weeks no difference between two groups was found. 4. Change of immediate tooth mobility after treatment was more larger in deep pocket than in shallow one. In group with the same probing pocket depth, the change of tooth mobility in molar group was greater than that of premolar group. 5. Tooth mobility before treatment was more strongly correlated with radiographic bone loss (r=0.5325) than probing depth, attachment loss and bleeding on probing, in 12 weeks after treatment, was more strongly correlated with attachment loss($r^2$=0.4761) than probing depth and bleeding on probing. Evaluation of the treatment effect and the prognosis after root planing and flap operation were meaningful on tooth initial probing depth 4mm and more. After flap operation, evaluation of the prognosis should be performed at least in 4 weeks and in 12 weeks after treatment, no difference in tooth mobility between two groups was observed. Radiographic bone loss and attachment loss were good clinical indicators to evaluate tooth mobility.

• Journal of Veterinary Clinics
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• v.22 no.1
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• pp.31-35
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• 2005

This study was performed to investigate of dental plaque, calculus and gingival inflammation in Beagle dogs. Forty adults Beagle dogs (28 male and 12 female) were used in this study. The dogs weighed 9.5 kg and were in good oral and systemic health as determined by physical examination, and all dogs had full and normal dentition. The dogs were given a commercial pellet feed during 2 years period. For all examination procedures, the dogs were premedicated with a subcutaneous injection of atropine sulfate (0.04 mg/kg). Anesthesia was induced and maintained by intravenous administration of ketamine (8 mg/kg) and xylazine (2 mg/kg). Dental plaque, calculus and gingival inflammation were assessed by Logan and Boyce clinical plaque index. Calculi covering the maxillary carnassial and first molar teeth were extensive and were accompanied by severe gingival inflammation and pocket formation. Calculi, accompanied by gingival inflammation, were clearly evident on buccal surfaces of other teeth. Calculi didn't showed on the lingual surfaces, but linguogingival inflammation formed in premolar teeth. Although the general pattern was clear, there was considerable variation among dogs in the rate of deposition of calculus and extend of gingival inflammation. This investigation suggest that feeding of the commercial dry food without dental hygiene increase plaque accumulation and may be a contributing factor in calculi formation and periodontal disease.

• Restorative Dentistry and Endodontics
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• v.18 no.2
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• pp.395-411
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• 1993

The purpose of this study was to examine the clear concept of the designs for cavity preparations. Among the several parameters in cavity designs, profound understanding of isthmus width factor would facilitate selection of the appropriate cavity preparation for a specific clinical situation. In this study, the cavities were prepared on maxillary first premolar and filled with gold inaly. A two - dimensional model was composed of 1037 - node triangle elements. In this model, isthmus was varied in width at 1/4, 1/3 and 1/2 of intercuspal width and material properties were given for four element groups, i.e., enamel, dentin, pulp and gold. The 500N occlusal load varied in direction and it was examined using three types of load : concentrated load, divided load and distributed load. The models were also examined with empty cavities using the devided load and distributed load. These models were analyzed the displacement and strees distribution by the two - dimensional Finite Element Method. The results were as follows : 1. All experimental models which filled with gold inlay after cavity preparation were similar direction of displacement with control model under same load type. But in the models with empty cavities, as isthmus width was wider, the degree of displacement was increased at same load type. 2. Among the experimental models which were filled with gold inaly after cavity preparation, the model II showed the least stress concentration under concentrated load and divided load. But in the models with empty cavities, the model III showed the largest stress concentration and tooth fracture is expected regardless isthmus width. 3. All experimental models showed similar displacement pattern beneath restorative material under a concentrated load. In the models with empty cavities, a divided load resulted in a lingual displacement of the lingual cusp, but a distributed load resulted in a buccal displacement of the lingual cusp. In regard to the above results, the restored models were stronger than empty models in respect to the bending moment and tensile stress. The empty models are expected to fracture regardless isthmus width. The safest isthmus width was 1/3 of intercuspal distance, which showed the least stress concentration in respect to the effect of stress distribution.

• Restorative Dentistry and Endodontics
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• v.18 no.2
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• pp.357-367
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• 1993

The purpose of this study was to evaluate the fracture strength of class II restored premolars with amalgam, posterior composite, amalgam - Ketac silver, resin - Ketac silver restorations at marginal ridge. Fifty extacted maxillary and mandibular premolar teeth that were caries free, fracture free, and restoration free were selected and randomly divided into five groups : Group 1 : 10 intact teeth, Group 2 : 10 teeth with class II cavities and restored with, amalgam, Group 3: 10 teeth with class II cavities and restored with posterior resin, Group 4 : 10 teeth with class II cavities and restored with amalgam - ketac silver, Group 5 : 10 teeth with class II cavities and restored with resin - Ketac silver. All teeth were mounted in base of dental stone within metal rings of 2cm diameter, exposing only the crown portion. Class II mesio - occlusal or disto - occlusal cavities were prepared into specimens of Group 2 through 5 by using a No. 710 fissure bur. The occlusal portion was prepared to a faciolingual width of 1.5mm and a pulpal depth of 1.5mm. The proximal protion was prepared to a faciolingual width of 4mm, a occlusogingival height of 4mm, and a gingival floor of 1.5mm. The teeth in Group 2 and 3 were resotored with silver amalgam apd posterior resin respectively. In Group 4 and 5, proximal portions were first filled with Ketac silver 1.5mm gingivally and remaining cavities were restored with amalgam and posterior resin respectively. All specimens were stored in 100 % relative humidity at $37^{\circ}C$ for 48 hours before testing. All teeth were subjected to a compressive load in a Universal Instron Testing Machine at marginal ridges. The loads required to fracture the restorations were recorded in killograms and the data obtained were subjected to statisticall analysis. The results were all follows : 1. The fracture strength of Group 1 which were unprepared were $100{\pm}10.1\;kg$ and the higher values than Group 2, 3, 4, 5 which were prepared and resotred. 2. In restored groups, Group 2 had the higher fracture strength($81.8{\pm}12.4\;kg$) than other groups and Group 4 had the lowest fracture strength($66.8{\pm}9.2kg$). 3. There were significant differences between fracture strength of between Group 1 and Group 3, 4, 5(P<0.05), but not significant difference between fracture strength of Group 2, 3, 4, 5(P>0.05).

• Restorative Dentistry and Endodontics
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• v.18 no.2
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• pp.291-316
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• 1993

Restorative procedures can lead to tooth fracture due to the relatively small amount of the remaining tooth structure. It is essential to prevent fractures by having a clear concept of the designs for cavity preparations. Among the several parameters in cavity designs, profound understanding of isthmus width factor would facilitate selection of the appropriate cavity preparation for a specific clinical situation. In this study, MO amalgam cavity were prepared on maxillary first premolar and filled with amalgam. Three dimensional, model with 1365 8-node brick elements was made by serial photographic method. In this model, isthmus was varied in width at 1/4, 1/3, 1/2 and 2/3 of intercuspal width and material properties were given for three element groups, i.e., enamel, dentin and amalgam. A load of 500 N was applied vertically on amalgam and enamel. In case of enamel loading, 2 model (with and without amalgam) was compared to consider the possibility of play at the interface between tooth material and amalgam. These models were analyzed with three dimensional finite element method. The results were as follows: 1. The stress was concentrated on the facio-pulpal line angle and distal marginal ridge of the cavity. 2. With the increase of the isthmus width, the stress spread around the facio-pulpal line angle and the area of stress concentration moved toward the proximal box. 3. In case of narrow isthmus width, the initiation point of crack would be in the area of isthmus corner of the cavity, and with the increase of the isthmus width, it would move toward the proximal box and at the same time the possibility of crack increase at the distal marginal ridge. 4. The direction of crack progressed outward and downward from the facio-pulpal line angle, and with the increase of the isthmus width, it approximated vertical direction. At the marginal ridge, it occurred in vertical direction. 5. It would be favorable to make the isthmus width narrower than a third of the intercuspal width, and to cover the cusp if isthmus width were wider than half of the intercuspal width. 6. It is necessary to apply the possibility of play to the finite element analysis.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.428-446
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• 1997

Restorative procedures can lead to weakening tooth due to reduction and alteration of tooth structure. It is essential to prevent fractures to conserve tooth. The resistance to fracture of the restored tooth may be influenced by many factors, among these are the cavity dimension and the physical properties of the restorative material. The placement of direct composite resin restorations has generally been found to have a strengthening effect on the prepared teeth. It is the purpose of this investigation to study the relationship between the cavity isthmus and the fracture resistance of a tooth in composite resin restorations. In this study, MO cavity was prepared on maxillary first premolar. Three dimensional finite element models were made by serial photographic method and isthmus(1/4, 1/3, 1/2 of intercuspal distance) were varied. Two types of model(B and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall and R model was left unfilled. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as follows : 1. Displacement of buccal cusp in R model occurred and increased as widening of the cavity, and displacement in B model was little and not influenced by cavity width. 2. There was a significant decrease of stress resulting in increase of fracture resistance in B model when compared with R model. 3. With the increase of the isthmus width, B model showed no change in the stress and strain. In R model, the stress and strain increased both in the area of buccal-pulpal line angle and the buccal side of marginal ridge, therefore the possibility of crack increased. 4. The stress and strain were distributed evenly on the tooth in B model, but in R model, were concentrated on the buccal side of the distal marginal ridge and buccal-pulpal line angle, therefore the possibility of fracture increased.

• Restorative Dentistry and Endodontics
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• v.34 no.1
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• pp.69-79
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• 2009

The purpose of this study was to evaluate the influence of elastic modulus of restorative materials and the number of interfaces of post and core systems on the stress distribution of three differently restored endodontically treated maxillary second premolars using 3D FE analysis. Model 1, 2 was restored with a stainless steel or glass fiber post and direct composite resin. A PFG or a sintered alumina crown was considered. Model 3 was restored by EndoCrown. An oblique 500 N was applied on the buccal (Load A) and palatal (Load B) cusp. The von Mises stresses in the coronal and root structure of each model were analyzed using ANSYS. The elastic modulus of the definitive restorations rather than the type of post and core system was the primary factor that influenced the stress distribution of endodontically treated maxillary premolars. The stress concentration at the coronal structure could be lowered through the use of definitive restoration of high elastic modulus. The stress concentration at the root structure could be lowered through the use of definitive restoration of low elastic modulus.

• Proceedings of the KACD Conference
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• 2008.05a
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• pp.184-197
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• 2008

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis. The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress. Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.

• Restorative Dentistry and Endodontics
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• v.30 no.3
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• pp.149-157
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• 2005

Mechanical removals in decayed teeth have been performed using drill and sharp hand instruments. These methods have some disadvantages such as pain, local anesthesia and overextended cavities Therefore chemo-mechanical excavation of dentin carious lesions has been introduced. The purpose of this study was to evaluate the efficacy of traditional mechanical methods using burs and chemo-mechanical methods (Carisolv) of caries dentin. Mechanical caries removal was carried with low speed round bur Chemo-mechanical caries excavation was performed with Carisolv (Medi-team), using the Carisolv hand instruments. The mean time to remove caries with two different methods was evaluated and the data analyzed with SPSS software (ver 11.5) by t-test (p < 0.05). For histomorphometry of caries removal were also carried with mechanical or chemo-mechanical (Carisolv) methods from 20 extracted caries permanent molars. Complete caries removal was verified with a $\#$23 sharp explorers, Caries Detector (Kuraray Co. Japan), and standard apical radiography. 1. Chemo-mechanical method was taken more times than mechanical method (1.5 fold) (p < 0.05) 2. Excavation for caries took more time for molar lesion than premolar lesion, and the least time was taken to remove the caries in incisor lesion (p < 0.05). 3. There were no significant differences to remove the caries between the maxilla and mandible (p > 0.05). 4. The remaining carious dentin was detected after the ckemo-mechanical removal of the carious dentin, and no smear layer were seen after the mechanical and chemo-mechanical removal of the carious dentin.