• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.479-489
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• 2008

Statement of the problem: Under anatomical limitations on maxillary posterior region, a poor crown-to root ratio acting on dental implants can result in undesirable stress in surrounding bone, which in turn can cause bone defects and eventual failure of implants. Purpose: The purpose is to compare stress distribution due to different crown-root ratio and effect of splinting between natural teeth and implants in maxillary molar area under different loads. Material and methods: Analysis of stress arising supporting bone of the natural teeth and the implant was made with 3-dimensional finite element method. The model simulated naturel teeth was made with 2nd premolar and 1st molar in the maxillary molar region (Model T). The model simulated implants placed on same positions with two parallel implants of Straumann Dental Implant cemented abutment (Model I). Each model was designed in different crown-root ratio (0.7:1, 1:1, 1.25:1) and set cement type gold crown to make it non-splinted or splinted. After that, 300 N force was loaded to each model in five ways (Load 1: middle of occlusal table, Load 2: middle of buccal cusp, Load 3: middle of lingual cusp, Load 4: horizontal load to buccal cusp of anterior abutment only, Load 5: horizontal load to middle of buccal cusp of each abutment), and stress distribution was analyzed. Results and conclusion: On all occasions, stress was concentrated at the cervical region of the implant. Under load 1, 2 and 3, stress was not increased even when crown-root ratio increases, but under load 4 and 5, when crown-root ratio increases, stress also increased. There was difference in stress values between natural teeth and implants when crown-root ratio gradually increases; In case of natural teeth, splinting decreased stress under vertical and horizontal loads. In case of implants, splinting decreased stress under vertical loads 1,2 and 3, but increased maximal stress under loads 2 and 3. Under horizontal loads, splinting decreased stress, however the effect of splinting decreased under load 5 than load 4. Furthermore, the stress was increased, when crown-root ratio is 1.25:1. Clinical implications: This limited finite element study suggests that the stress on supporting bone may be increased under non-axial loads and poor crown-root ratio. Under poor crown-root ratio, excessive stress was generated at the cervical region of the implant, and decreased splinting effect for stress distribution, which can be related to clinical failure.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.510-521
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• 2006

This investigation was undertaken to examine the extent to which tooth size and arch dimension each contribute to dental crowding. The sample included 50 subjects with well aligned dentition (25 males, 25 females) and those of 40 subjects with gross dental crowding(20 males, 20 females). Plaster model and digital model made from alginate impression taken at the one visit. Tooth size, arch length, arch perimeter, intercanine width and intermolar width was measured on the plaster and digital models. The findings in this study lead to the following conclusions. 1. In maxilla, the mesiodistal diameters of lateral incisor and premolars of the crowded group were significantly larger than those of the normal occlusion group (P<0.05). 2. In mandible, the mesiodistal diameters of central incisor, canine and premolars of crowded group were significantly larger than those of the normal occlusion group (P<0.05). 3. In maxilla, arch perimeter and intermolar width of crowded group were significantly smaller than normal occlusion group but intercanine width of crowded group were larger than normal occlusion group (P<0.05). There was no significantly difference in arch length (P>0.05). 4. In mandible, arch perimeter of crowded group was smaller than normal occlusion group(P<0.05). There were no difference in arch length intermolar width and intercanine width (P>0.05) 5. In the analysis of correlation coefficients of arch length discrepancy with variables, arch perimeter, intermolar width and mesiodistal width of 2nd premolar showed positive correlations in maxilla. 6. There was a significant difference between tooth width measurements made by the 2 methods, with all the digital model measurement larger than plaster model measurements (P<0.05) : the magnitude of the differences does not appear to be clinically relevant. 7. In the analysis for reproducibility, the plaster model measurement was showed lower degree of correlation between 1st and 2nd measurement than digital model.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.375-390
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• 2009

Statement of problem: Implant supported overdenture is accepted widely as a way to restore edentulous ridge providing better retention and support of dentures. Various types of attachment for overdenture have been developed. Purpose: The purpose of this study was to investigate the influence of attachment type in implant overdentures on the biomechanical stress distribution in the surrounding bone, prosthesis and interface between implant and bone. Material and methods: Finite element analysis method was used. Average CT image of mandibular body(Digital $Korea^{(R)}$, KISTI, Korea) was used to produce a mandibular model. Overdentures were placed instead of mandibular teeth and 2mm of mucosa was inserted between the overdenture and mandible. Two implants($USII^{(R)}$, Osstem, Korea) were placed at both cuspid area and 4 types of overdenture were fabricated ; ball and socket, Locator, magnet and bar type. Load was applied on the from second premolar to second molar tooth area. 6 times of finite element analyses were performed according to the direction of the force $90^{\circ}$, $45^{\circ}$, $0^{\circ}$ and unilateral or bilateral force applied. The stress at interface between implants and bone, and prosthesis and the bone around implants ware compared using von Mises stress. The results were explained with color coded graphs based on the equivalent stress to distinguish the force distribution pattern and the site of maximum stress concentration. Results: Unilateral loading showed that connection area between implant fixture and bar generated maximum stress in bar type overdentures. Bar type produced 100 Mpa which means the most among 4 types of attachments. Bilateral loading, however, showed that bar type was more stable than other implants(magnet, ball and socket). 26 Mpa of bar type was about a half of other types on overdenture under $90^{\circ}$ bilateral loading. Conclusions: In any directions of stress, bar type was proved to be the most vulnerable type in both implants and overdentures. Interface stress did not show any significant difference in stress distribution pattern.

• The Journal of the Korea Contents Association
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• v.12 no.1
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• pp.353-360
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• 2012

The purpose of this study was to evaluate tooth color and microhardness after 15% carbamide peroxide(CP) bleaching treatments with/without potassium nitrate and fluoride(PF), which were used home bleaching. Thirty tooth specimens were obtained from thirty premolar and were randomly divided into three groups: 1, untreated controls(Distilled water): 2, treatment with 15% CP bleaching agent; 3, treatment with 15% CP bleaching agent (contained 3% potassium nitrate and 0.11% fluoride). All groups were treated 6h per day for 14 days then immersed in distilled water. Changes in enamel color were evaluated on Baseline and Day 14. Microhardness were evaluated on Baseline, Days 7 and 14. All the bleached enamel specimens revealed increased whiteness without control group. Groups 2 and 3 showed significantly decreased enamel microhardness compared to control group. On Day 7, Groups 2-3 showed significantly decreased enamel microhardness compared to control group and respective baseline data. The percentage microhardness loss(PML) look at Day 7 and 14 for Group 1, respectively, there was little difference between 1.7 and 0.8. However, Group 2 was 21.9 and 3.5, Group 3 was 16.7 and 1.4 as a baseline and Day 7 were significantly different (p<0.05). The PML of group 2 was significantly highest than that of group 3 on Day 7. As a result, the data indicate that the addition of PF did not influence the whitening efficacy of the bleaching agent negatively. PF-containing bleaching agent reduce the percentage microhardness loss. PF-containing tooth bleaching your teeth with a whitening effect can be reduced by decreasing the hardness of enamel.

• Restorative Dentistry and Endodontics
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• v.14 no.2
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• pp.20-29
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• 1989

The purpose of the study is to evaluate the degree of the marginal leakage of class V cavities with 4 brands of esthetic filling materials by means of the dye penetration at the enamel & dentinal margins. 160 cavities of class V were prepared on the buccal & lingual surfaces of 80 extracted premolar teeth, which divided into 4 groups. The four groups of cavities were filled with Durafill$^{(R)}$-Durafill bond$^{(R)}$(KuIzer & Co GmbH), Bisfil M$^{(R)}$-Resin bond$^{(R)}$(BISCO Inc.), Silux$^{(R)}$-Scotchbond$^{(R)}$(3M Co.) and Fuji ionomer$^{(R)}$(type II, G-C Co.) each. All specimens were immersed in 2% methylene blue dye solution for 24 hours at $37^{\circ}C$ after a 30-second thermocycling at $4^{\circ}C$ and $60^{\circ}C$ and longitudinally sectioned with diamond disk into two parts. The results were as follows : 1. At enamel margins, the group filled with Durafill$^{(R)}$-Durafill bond$^{(R)}$, Bisfil M$^{(R)}$-Resin bond$^{(R)}$ and Silux$^{(R)}$-Scotchbond$^{(R)}$ show no significant difference each other(p>0.05), and the above groups show less marginal leakage comparing with the group filled with Fuji ionomer$^{(R)}$(p<0.01). 2. At dentinal margins, the group filled with Silux$^{(R)}$-Scotchbond$^{(R)}$ or Fuji ionomer$^{(R)}$ show less marginal leakage than that with Durafill$^{(R)}$-Durafill bond$^{(R)}$ or Bisfil M$^{(R)}$-Resin bond$^{(R)}$(p<0.01). 3. The enamel margins show less marginal leakage than dentinal margins in all the class V cavities(p<0.01).

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.90-96
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• 2012

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.147-161
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• 2012

This study is to assess the effect of horizontal misfit of an implant supported 3-unit fixed prosthodontics on the stress development at the marginal cortical bone surrounding implant neck. Two finite element models consisting of a three unit fixed prosthodontics and an implant/bone complex were constructed on a three dimensional basis. The three unit fixed prosthodontics were designed either shorter (d=17.8mm model) or longer (d=18.0mm model) by 0.1mm than the span of two implants placed at the mandibular second premolar and second molar areas 17.9mm apart. Fitting of the fixed prosthodontics onto the implant abutments was simulated by a total of 6 steps, that is to say, 0.1mm displacement per each step, using DEFORM 3D (ver 6.1, SFTC, Columbus, OH, USA) program. Stresses in the fixed prosthodontics and implants were evaluated using von-Mises stress, maximum compressive stress, and radial stress as necessary. The d=17.8mm model assembled successfully on to the implant abutments while d=18.0mm model did not. Regardless if the fixed prosthodontics fitted onto the abutments or not, excessively higher stresses developed during the course of assembly trial and thereafter. On the marginal cortical bone around implants during the assembly, the peak tensile and compressive stresses were as high as 186.9MPa and 114.1MPa, respectively, even after the final sitting of the fixed prosthodontics (for d=17.8mm model). For this case, the area of marginal bone subject to compressive stresses above 55MPa, equivalent of the $4,000{\mu}{\varepsilon}$, i.e. the reported threshold strain to inhibit physiological remodeling of human cortical bone, extended up to 2mm away from implant during the assembly. Horizontal misfit of 0.1mm can produce excessively high stresses on the marginal cortical bone not only during the fixed prosthodontics assembly but also thereafter.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.51-61
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• 2001

Cleft lip and/or palate (CLP) is one of the most common congenital craniofacial anomalies and occurs more frequently in Asian people. Dental abnormalities in number, size, shape, and eruption of teeth are frequently associated with CLP. The purposes of this study were to investigate the effects of CLP on number, size, shape and eruption of teeth and to provide basic clinical data for diagnosis and treatment of the CLP patients. With the orthodontic and cleft charts, diagnostic models, orthopantomograms and intraoral x-ray films from 241 CLP patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital, we evaluated the frequency of congenital missing teeth, supernumerary teeth, Impacted teeth, and microdontia. The results were as fellows ; 1. Frequency of congenital missing was relatively high up to $56.8\%$. Congenital missing occurred frequently in the maxillary lateral incisor and the maxillary second premolar. Among the CLP types, frequencies of congenital missing in cleft lip and Palate group and cleft lip and alveolus group were higher than those of cleft lip group and cleft palate group. And bilateral cleft showed higher frequencies than unilateral ones. 2. Supernumerary tooth was shown in $11.2\%$ of CLP patients. It occurred frequently in the area between the maxillary lateral Incisors and the maxillary canine. Among the CLP types, cleft lip group showed relatively most highest frequency. 3. Impaction was shown in $18.3\%$ of CLP patients. It occurred most frequently In the maxillary lateral incisor and the maxillary canine than other teeth. Among the CLP types, cleft lip group and cleft lip and palate group showed most highest frequencies. 4. Microdontia was shown in $15.8\%$ of CLP patients. It occurred the most frequently In the maxillary lateral incisors and maxillary canines. Among the CLP types, cleft lip and alveolus group and cleft lip and palate group showed relatively higher frequencies. There was no microdontia in cleft palate group.

• The korean journal of orthodontics
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• v.26 no.2 s.55
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• pp.175-186
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• 1996

The purpose of this study was to examine the effects of mechanical and thermal fatigue on the shear bond strength(SBS) of stainless steel mesh brackets bonded to human premolar teeth with 3 no-mix adhesives. The stainless steel mesh bracket was Ormesh(Ormco, .022 slot) and three types of no-mix adhesives were Ortho-one(Bisco), $Monolok^2$(RMO), $System\;1^+$(Ormco). The $10^6$ loadcycles of $17.4{\times}10^2sin2{\pi}ftlg{\cdot}cm$ and the 1,000 thermocycles of 15 second dwell time in each bath of $5^{\circ}C\;and\;55^{\circ}C$ were acturated as mechanical and thermal fatigue stress, and SBS were measured after each fatigue test. The fracture sites were analyzed by stereoscope and scanning electron microscope. The results obtained were summarized as follows; 1. Before thermocycles, $Monolok^2$ showed the highest Knoop hardness number(KHN, $64.03kg/mm^2$) and $System\;1^+$ showed the lowest value($31.60kg/mm^2$). After thermocycling, $Monolok^2$ also showed the highest KHN($38.03kg/mm^2$) and $system\;1^+$ showed the minimum($20.87kg/mm^2$). The KHN of Ortho-one, $Monolok^2,\;System\;1^+$ significantly decreased after thermocycling (P<0.01). 2. In static shear bond test, three adhesives had no significant differences in the SBS(P>0.01). 3. After thermocycling test, $Monolok^2$ showed the maximum SBS($19.34{\pm}2.75MPa$) and Ortho-one showed the minimum SBS($13.66{\pm}2.23MPa$). The SBS of Ortho-one(P<0.01) and $System\;1^+$(P<0.05) significantly decreased after $10^3$ thermocycles. 4. The SBS of three adhesives after $10^6$ loadcycles were similar and were not significantly decreased compared with static group(P>0.01). 5. The failure sites were usually bracket/resin interface in all groups irrespective of experimental conditions.

• The korean journal of orthodontics
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• v.26 no.2 s.55
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• pp.153-162
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• 1996

Rapid maxillary expansion is widely used for the correction of anteroposterior discrepancies, constriction of the maxillary arch, etc. This experiment was undertaken to examine the serial changes in the osteogenesis as well as the collagen fiber bundles in the intermaxillary suture during the rapid maxillary expansion treatment. Four young female dogs aged 6 to 8 months old and not showing menarche yet were used for the experiment. The maxillary impression of dogs were taken, expansion device cast and Hyrax screw soldered at the midline in the 1st premolar area. RME device was delivered to the dogs and the activation of 0.25 mm per quarter-turn was done 2 times per day for 10 days until 5 mm separation was made. Separation of the maxilla was confirmed by X-ray. The animals were sacrificed on 0, 15, 30, 60 days from the finish of maxillary separation and preparations for light microscopy and surface electron microscopy were made. The sutures were cut into frontal serial sections for examination of the histological reactions. The following results were obtained and the conclusions made. 1. The edges of the two palatal plates bordering the midpalatal suture which at the beginning of the retention period were mainly composed of compact bone, underwent extensive resorption followed by new bone formation and gradually became spongy bone rich in bone marrow which in the 60 day retention animal became the compact bone with short intermaxillary suture space. During this transformation, newly formed trabecular bone tissues were added to the original margin. 2. Throughout the expansion period, the collagen fibers underwent successive changes such as stretching, loss of polarity, and finally fibrillogenesis. Towards the end of the expansion procedure, sharpey's fiber formation in newly formed bones were observed. 3. Bony spicules were found in the initial stage of retention on occlusal topographic X-rays, which later were confirmed to have ossified. 4. Judging from the histological changes occuring during the experimental expansion, excessive expansion will cause an excessive bleeding, and retard the remodeling of intermaxillary suture. According to the above results, the bone remodeling after rapid maxillary expansion was preceded by the migration of migratory cells into the intermaxillary suture area. The bone remodeling phenomena were on-going during the 2 months retention sample.