Comparison of Amyloid Positivity Rate and Accumulation Pattern between Amnestic and Non-Amnestic Type Mild Cognitive Impairment

Objective@#We aimed to compare cerebral beta-amyloid protein (Aβ) positivity rate and amyloid accumulation pattern on amyloid positron emission tomography (PET) between mild cognitive impairment (MCI) subtypes, i.e. amnestic mild cognitive impairment (aMCI) and non-amnestic mild cognitive impairment (naMCI). @*Methods@#The study participants were 34 naMCI patients and age-, sex- and education-matched 68 aMCI patients (1:2 ratio) who visited the Dementia and Age-Associated Cognitive Decline Clinic of the Seoul National University Hospital. All participants received comprehensive clinical and neuropsychological assessments and [18F] florbetaben PET. @*Results@#Aβ positivity rate of naMCI group (26.5%) was significantly lower than that of aMCI group (64.7%). Among Aβ positive individuals, there was no difference in Aβ accumulation pattern between naMCI and aMCI. @*Conclusion@#The findings suggest that MCI subtypes based on impaired cognitive domains have a differential association with brain Aβ deposition, a core pathology of AD. Amnestic subtype of MCI are more closely associated with cerebral Aβ deposition compared to nonamnestic subtype. In contrast, the pattern of amyloid deposition does not appear to have any difference between the subtypes.

Serial Changes in Image Findings of Herniation Pits from the First Appearance

Background@#Herniation pits (HPs) have been considered to be an incidental finding, but recently femoroacetabular impingement (FAI) has been proposed as a possible cause of their formation. The findings on bone scans of HPs are variable in the literature: some showed increased uptake; the majority did not. We hypothesized that serial changes in image findings of HPs would explain the reason for the variable bone scan findings. @*Methods@#Four patients (5 hips) were followed up for more than 7 years. All patients were women and regularly underwent bone scintigraphy after the diagnosis of breast cancer. Small lesions with increased uptake were first detected on bone scintigraphy at the age of 44 to 64 years. In all cases, the lesions were confirmed by magnetic resonance imaging and follow-up bone scintigrams were taken regularly. Four lesions were also evaluated by computed tomography. Changes in the size of the pits and the intensity of the increased uptake on bone scintigraphy were evaluated. @*Results@#On the bone scintigrams, the lesions with increased uptake were detected in the femoral neck at 5–20 months after previous negative bone scintigraphy. There had been no events or symptoms associated with the newly detected increased uptake. On follow-up scans, the intensity of the uptake decreased gradually and the areas of increased uptake disappeared completely at 14–50 months after their first appearance. In 3 cases (2 patients), the pit size increased during follow-up. @*Conclusions@#The areas of increased uptake on bone scintigraphy gradually disappeared in all cases and the increase in pit size was frequent. There was no case in which signs or symptoms suggestive of FAI were noticed.

Perioperative Complications of Orthopedic Surgery for Lower Extremity in Patients with Cerebral Palsy

Because complications are more common in patients with cerebral palsy (CP), surgeons and anesthesiologists must be aware of perioperative morbidity and be prepared to recognize and treat perioperative complications. This study aimed to determine the incidence of and risk factors for perioperative complications of orthopedic surgery on the lower extremities in patients with CP. We reviewed the medical records of consecutive CP patients undergoing orthopedic surgery. Medical history, anesthesia emergence time, intraoperative body temperature, heart rate, blood pressure, immediate postoperative complications, Gross Motor Function Classification System (GMFCS) level, Cormack-Lehane classification, and American Society of Anesthesiologists physical status classification were analyzed. A total of 868 patients was included. Mean age at first surgery was 11.8 (7.6) yr. The incidences of intraoperative hypothermia, absolute hypotension, and absolute bradycardia were 26.2%, 4.4%, and 20.0%, respectively. Twenty (2.3%) patients had major complications, and 35 (4.0%) patients had minor complications postoperatively. The incidences of intraoperative hypothermia, absolute hypotension, and major postoperative complications were significantly higher in patients at GMFCS levels IV and V compared with patients at GMFCS levels I to III (P<0.001). History of pneumonia was associated with intraoperative absolute hypotension and major postoperative complications (P<0.001). These results revealed that GMFCS level, patient age, hip reconstructive surgery, and history of pneumonia are associated with adverse effects on intraoperative body temperature, the cardiovascular system, and immediate postoperative complications.

Development of the Korean Version of the Structured Interview for DSM-IV Personality(K-SIDP-IV) : Interrater Reliability / 신경정신의학

OBJECTIVES: The diagnosis and assessment of personality disorders are crucial for research, as well as for clinical practice. The Structured Interview for the DSM-IV Personality (SIDP-IV) is a structured diagnostic interview for DSM-IV personality disorders (PD). This study aimed to develop the Korean version of the SIDP-IV and to test its inter-rater reliability. METHODS: A panel consisting of 7 psychiatrists translated the SIDP-IV into Korean. Six psychiatrists and 1 psychiatric nurse, all trained to apply the SIPD-IV, interviewed 70 inpatients (male, 30;female, 40) using this translation, two joint-examiners per patient interview. We used kappa coefficients to test diagnosis agreement, the Pearson correlation coefficient to test K-SIDP-IV total score agreement, and percent agreement to test the agreement on the number of DSM-IV criteria met. RESULTS: The kappa coefficients for most of the PDs, such as paranoid, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive-compulsive, were excellent (> or =0.80). Moreover, the kappa coefficients for schizoid and antisocial PD were acceptable (k=0.66). The Pearson correlation coefficient for the K-SIDP-IV total scores were high for all personality disorders (r=0.91-0.97). Percent agreement regarding the number of DSM-IV criteria met varied from 92.9% to 100%. CONCLUSION: The Korean version of the SIDP-IV is a reliable instrument for the assessment and diagnosis of personality disorders.

Community Psychiatry Training for Psychiatry Residents: A National Survey / 신경정신의학

OBJECTIVES: There is a increasing need to recruit and retain more psychiatrists who can plan and implement organized programs to work with chronic mentally ill patients in community settings. The aim of study is to discover what training is currently in place to prepare psychiatrist for work in "community" or "public" settings. METHODS: Survey questionnaires were mailed to 85 residency training directors and 10 leaders of community mental health in 2005. Response rate was 75%. RESULTS: Academic seminar about community mental health were not administered to residents in 63% of training hospitals. Forty one out of 64 training hospitals had community mental health rotation programs. Community mental health center (50%) and day hospital (36%) were the most common type of programs. Few general hospital had affiliation with community mental health programs. The amount of time for clinical rotation varied from less than three months part time to 6 months fulltime, with most frequent form of one day per week for three month in second or third year of psychiatry residents. CONCLUSION: Further steps are needed to improve residency training curricula and to encourage well qualified psychiatrist to choose careers in community psychiatry.

The effect of surface finishes on flexural strength, fracture toughness of feldspathic dental porcelain / 대한치과보철학회지

STATEMENT OF PROBLEMS: Conventional feldspathic porcelain is used extensively as a restorative material and it is subjected to grinding and polishing during fabrication and delivery procedures. There is still considerable controversy concerning the best methods to achieve the strongest porcelain restorations after such adjustments. PURPOSE: The objective of this study was to investigate the effects of (1) overglazing, (2) selfglazing, and (3) fine polishing on the flexural strength and fracture toughness of feldspathic dental porcelain. MATERIAL AND METHOD: Ninety porcelain disks were prepared for flexural strength test and sixty porcelain disks were fabricated for fracture toughness test. Specimens were divided into three groups for each test as follows: 1) overglazed 2) self-glazed 3) polished. The flexural strength of feldspathic porcelains was determined by ring-on-ring biaxial flexural strength test. The fracture toughness values of three experimental groups were obtained by indentation fracture toughness test. RESULTS: The flexural strength of overglazed group was significantly higher than that of selfglazed and polished group (P0.05). The fracture toughness values of overglazed and polished group were significantly higher than that of self-glazed group (P0.05). CONCLUSIONS: This results supported the use of polishing as an alternative to glazing metal ceramic restorations, as it was not detrimental in flexural strength and fracture toughness. But, under the conditions of this study, overglazing was the ideal surface finishing method of feldspathic dental porcelain.

Marginal fit of the auro galvano crown system made using the electroforming technique / 대한치과보철학회지

STATEMENT OF PROBLEM: There have been few studies about the marginal fit of Auro Galvano Crowns. PURPOSE: The purpose of this study was to compare the marginal fit of the anterior single restorations. MATERIAL AND METHODS: The in vitro marginal discrepancies of metal-ceramic, Auro Galvano Crown and coping were evaluated and compared. The Auro Gavano Crowns were made from one extracted maxillary central incisor prepared by milling machine. 30crowns per each system were fabricated. Measurements of a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Parametric statistical analysis was performed for the results. RESULTS: Mean marginal gap dimensions and standard deviations at the marginal opening for the anterior single crowns were 74+/-21micrometer for the control (metal-ceramic restoration), 45+/-11 micrometer for Auro Galvano Crown coping, and 51+/-9 micrometer for the Auro Galvano Crown. CONCLUSIONS: Auro Galvano Crown showed significantly smaller (P .05)

Influence of implant-abutment interface design, implant diameter and prosthetic table width on strength of implant-abutment interface: three-dimensional finite element analysis / 대한치과보철학회지

STATEMENT OF PROBLEM: Higher incidence of prosthetic complications such as screw loosening, screw fracture has been reported for posterior single tooth implant. So, there is ongoing research regarding stability of implant-abutment interface. One of those research is increasing the implant diameter and prosthetic table width to improve joint stability. In another part of this research, internal conical type implant-abutment interface was developed and reported joint strength is higher than traditional external hex interface. Purpose. The purpose of this study is to compare stress distribution in single molar implant between external hex butt joint implant and internal conical joint implant when increasing the implant diameter and prosthetic table width : 4mm diameter, 5mm diameter, 5mm diameter/6mm prosthetic table width. MATERIAL AND METHOD: Non-linear finite element models were created and the 3-dimensional finite element analysis was performed to see the distribution of stress when 300N static loading was applied to model at 0., 15., 30.off-axis angle. RESULTS: The following results were obtained: 1. Internal conical joint showed lower tensile stress value than that of external hex butt joint. 2. When off-axis loading was applied, internal conical joint showed more effective stress distribution than external hex butt joint. 3. External hex butt joint showed lower tensile stress value when the implant diameter was increased. 4. Internal conical joint showed lower tensile stress value than external hex butt joint when the implant diameter was increased. 5. Both of these joint mechanism showed lower tensile stress value when the prosthetic table width was increased. CONCLUSION: Internal conical joint showed more effective stress distribution than external hex joint. Increasing implant diameter showed more effective stress distribution than increasing prosthetic table width.

A study of screw loosening after dynamic continous fatigue test of several abutment screw / 대한치과보철학회지

STATEMENT OF PROBLEM: Chronic implant screw loosening remains a problem in restorative practices. Some implant manufactureres have introduced abutment screws with treated material, surfaces and macrostructures in an effort to reduce potential loosening. PURPOSE: This study evaluated the materials and loading cycles on detorque value after dynamic continous fatigue test in the sinulated conditions of posterior single restoration. MATERIAL AND METHOD: Fourteen of each of the following abutment screws - titanium alloy, gold alloy, gold-tite, and titanium alloy modified - were used in test. SEM is used to verify macrostructures of each screws. ZrO2/Al2O3 composite abutment was tightened on 4x10.0mm titanium external implant at 30 Ncm. Cyclic loading machine delivered dynamic loading forces between 20 and 320N for 100,000, 200,000, 300,000, 500,000, and 1,000,000 cycles at frequencies 14Hz. Torque and detorque value after loading was measured. RESULTS: All measued screws had different screw length and thread form. Titanium modified screw had greater detorque value than others before and after cyclic loadings(p<0.05). All abutment screws had no significant change in mean percentage of detorque value after loading to initial value after less than 500,000 cyclic loadings, but significant lower value after 1,000,000 cycles(p<0.05). CONCLUSION: Within limintations of this study, all abutment screws may be loosend after about1 year use. Annual check-up is nessasary to prevent screw loosening.

Microleakage and water stability of resin cements / 대한치과보철학회지

STATEMENT OF PROBLEM: Recently, resin cements have become more widely used and have been accepted as prominent luting cements. Current resin cements exhibit less microleakage than conventional luting cements. However, the constant contact with water and exposure to occlusal forces increase microleakage even in resin cements inevitably. Most bonding resins have been modified to contain a hydrophilic resin such as 2-hydroxyethylmethacrylate (HEMA) to overcome some of the problems associated with the hydrophobic nature of bonding resins. By virtue of these modifications, bonding resins absorb a significant amount of water, and there may also be significant stresses at bonding interfaces, which may adversely affect the longevity of restorations. Therefore the reinforcement of water stability of resin cement is indispensable in future study. PURPOSE: This study was conducted to examine the influence of water retention on microleakage of two resin cements over the period of 6 months. MATERIALS AND METHODS: 32 ex acted human teeth were used to test the microleakage of a single full veneer crown. Two resin cements with different components and adhesive properties - Panavia F (Kuraray Co., Osaka, Japan) and Super-Bond C&B (Sun Medical Co., Kyoto, Japan)- were investigated. The storage medium was the physiological saline solution changed every week for 1 month, 3 months, and 6 months. One group was tested after storage for 1 day. At the end of the each storage period, all specimens were exposed to thermocycling from 5.C to 55.C of 500 cycles and chewing simulation of 50,000 cycles, and then stained with 50% silver nitrate solution. The linear penetration of microleakage was measured using a stereoscopic microscope at x 40 magnification and a digital traveling micrometer with an accuracy of +/-3 um. Values were analyzed using two-way ANOVA test, Duncan's multiple range tests (DMRT). RESULTS: Statistically significant difference of microleakage was shown in the 3-month group compared with the 1-day or 1-month group in bot systems (p<0.05) and there were statistically significant differences in microleakage between the 3-month group and the 6-month group in both systems (p<0.05). The two systems showed different tendency in the course of increased microleakage during 3 months. In Panavia F, microleakage increased slowly throughout the periods. In Super-Bond C&B, there was no significant increase of microleakage for 1 month, but there was statistically significant increase of microleakage for the next 2 months. For the mean microleakage for each period, in the 3-month group, microleakage of Super-Bond C&B was significantly greater than that of Panavia F. On the other hand, in the 6-month group, microleakage of Panavia F was significantly greater than that of Super-Bond C&B (p<0.05). CONCLUSION: Within the limitation of this study, water retention of two different bonding systems influence microleakage of resin cements. Further studies with the longer observation periods in viro are required in order to investigate water stabilty and the bonding durability of the resin cement.

Marginal Fit of Celay/in-Ceram, Conventional In-Ceram And Empress 2 All-Ceramic Single Crowns / 대한치과보철학회지

There have been many studies about marginal discrepancy of single restorations made by various systems and materials.But many of statistical inferences are not definite because of sample size,measurement number,measuring instruments,etc. The purpose of this study was to compare the marginal adaptations of the anterior single restorations made by different systems and to consider more desirable statistical methods in analysing the marginal fit.The in vitro marginal discrepancies of three different all-ceramic crown systems(Celay In-Ceram,Conventional In-Ceram,IPS Empress 2 layering technique)and one control group (PFM)were evaluated and compared.The crowns were made from one extracted maxillary central incisor prepared with a 1mm shoulder margin and 6 taper walls by milling machine.10 crowns per each system were fabricated.Measurements of a crown were recorded at 50 points that were randomly selected for marginal gap evaluation.Non-parametric statistical analysis was performed for the results. Within the limits of this study,the following conclusions were drawn: 1.Mean gap dimensions and standard deviations at the marginal opening for the maxillary incisor crowns were 98.2+/-40.6 mu m for PFM,83.5+/-18.7 mu m for Celay In-Ceram,104.9+/-44.1 mu m for conventional In-Ceram,and 45.5+/-11.5 mu m for IPS Empress 2 layering technique.The IPS Empress 2 system showed the smallest marginal gap (P<0.05).The marginal openings of the other three groups were not significantly different (P<0.05). 2.The marginal discrepancies found in this study were all within clinically acceptable standards(100 150 mu m). 3.When the variable is so controlled that the system may be the only one,mean value is interpreted to be the marginal discrepancy of a restoration which is made by each system and standard deviation is to be technique-sensitivity of each one. 4.From the standard deviations,the copy-milling technique (Celay/In-Ceram)was not considered to be technique-sensitive in comparison with other methods. 5.Parametric analysis is more reliable than non-parametric one in interpretation of the mean and standard deviation.The sample size of each group has to be more than 30 to use parametric statistics. The level of clinically acceptable marginal fit has not been established.Further studies are needed.

Fracture strength and fracture mode of resin root analogs restored with various post and core materials / 대한치과보철학회지

STATEMETN OF PROBLEM: Endodontically treated teeth frequently required posts and cores to pro-vide retention and resistance form for crowns. In spite of excellent mechanical properties of met-al post and core, its metallic color can be detected through all ceramic restorations occasionally. To solve esthetic problems of metal post and core zirconia post system has been introduced recently. PURPOSE: The purpose of this study was to examine the fracture strength and mode of resin root analogs restored with zirconia, gold and titanium posts with resin, ceramic and metal cores after cementation with metal crowns. Materials and methods. To avoid the morphological variations of natural teeth, 40 root analogs were fabricated with composite resin. Forty resin root analogs were randomly assigned to four groups according to post and core materials: Group A: cast gold post and core and complete cast crowns, as control. Group B: titanium posts (Parapost, Coltent/Whaledent Inc., NJ, USA) and composite resin cores. Group C: zirconia posts (Cosmopost, Ivoclar AG, Schaan/Liechtenstein) and composite resin cores Group D: zirconia posts and heat-pressed ceramic cores (IPS Empress Cosmo Ingots, Ivoclar AG) After thermocycling (5 degrees C. 55 degrees C, 30 sec.), cyclic loading was applied at 3mm below the incisal edge on the palatal surfaces at an angle of 135 degree to the long axis (2Hz, 50N, 50000cycles). Fracture strength was measured by universal testing machine (Instron, High Wycombe, UK) and fracture pattern of restored resin root analogs was also evaluated. Results and CONCLUSION: Within the limitations of this study following results were drawn. 1. Resin root analogs restored with zirconia posts and composite resins demonstrated lowest fracture strength among tested groups. 2. There was no significant difference in the fracture strength between zirconia posts and heat pressed glass ceramic cores and cast gold posts and cores 3. The fracture strength of resin root analogs restored with titanium posts and composite resin cores was lower than that of gold posts and cores. 4. The deep oblique fracture lines were dominantly observed in root analogs restored with cast gold post and core and zirconia post and heat-pressed ceramic core groups.

COMPARATIVE STUDY ON THE FRACTURE STRENGTH OF EMPRESS 2 CERAMIC AND TARGIS-VECTRIS CROWN / 대한치과보철학회지

Due to an increasing interest in esthetics and concerns about toxic and allergic reactions to certain alloys, patients and dentists have been looking for metal-free tooth-colored restorations. Recent improvement in technology of new all-ceramic materials and composite materials has broadened the options for esthetic single crown restorations. The aim of this investigation was to study the fracture strength of the metal-free posterior single crowns fabricated using two recently introduced systems, Empress 2 ceramic and Targis-Vectris. Forty premolar-shaped stainless steel dies with the 1mm-wide circumferential shoulder were prepared. Ten cylindrical crowns having a diameter of 8.0mm and total height of 7.5mm were fabricated for each crown system respectively (PFM, Empress staining technique, Empress 2 layering technique, and Targis-Vectris). The crowns were filled with cement and placed on the stainless steel dies with firm finger pressure. The crowns were then stored in distilled water at room temperature for 24 hours before testing. The crowns were tested for fracture strength in an Instron universal testing machine (Instron 6022). With a crosshead speed of 1mm/min the center of the occlusal surface of the crown was loaded using a 4mm-diameter stainless steel ball until fracture occurred. The fracture surfaces of the crowns were gold coated and examined using scanning electron microscopy (Jeol JSM-840 Joel Ltd., Akishima, Tokyo, Japan). Within the parameters of this study the following conclusions were drawn: 1. The mean fracture strength for PFM crowns was 5829(+/-906)N; for Empress staining technique the fracture strength was 1697(+/-604)N; for Empress 2 Layering technique the fracture strength was 1781N(+/-400)N, and the fracture strength for Targis-Vectris was 3093(+/-475)N. 2. The fracture strength of the PFM crowns was significantly higher than that of the Empress 2 and the Targis-Vectris crowns (P<0.05). 3. The fracture strength of the Targis-Vectris crowns was significantly higher than that of the Empress 2 crowns (P<0.05). 4. No statistical difference was found when Empress staining technique was compared with Empress 2 layering technique. 5. The SEM image of fracture surface of Empress 2 crown showed a very dense microstructure of the lithium disilicate crystals and the SEM image of fracture surface of Targis-Vectris crown showed indentations of Vectris and some fibers torn off from Vectris.

FRACTURE STRENGTH AND MARGINAL FIT OF IN-CERAM, COPY-MILLED IN-CERAM, AND IPS EMPRESS 2 ALL-CERAMIC BRIDGES / 대한치과보철학회지

All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at 55degree at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at x50 power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram (112micrometer) exhibited significantly greater marginal discrepancy than In-Ceram (97micrometer), and IPS Empress 2 (94micrometer at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and acceptable marginal fit values to allow clinical application.

THE EFFECT OF AUTOLOGOUS PLATELET-RICH PLASMA (PRP) ON BONE FORMATION AROUND DENTAL IMPLANT IN THE RABBIT : A HISTOMORPHOMETRIC AND REMOVAL TORQUE STUDY / 대한치과보철학회지

Platelet-rich plasma (PRP) has been known to increase the rate and degree of bone formation by virtue of growth factors in concentrated platelets. Although its great healing effect on bone defect or pre-implantation site preparation in conjunction with bone substitute has been reported, the effect associated with implant is unknown. The purpose of this study was to investigate the effect of PRP on rapid osseointegration of endosseous dental implants in the rabbit tibiae. Twenty two adult female New Zealand white rabbits, weighing approximately 2.7-3.3kg, were used for this study. Twelve of the 22 animals were used for histomorphometric analysis and ten of the 22 were for removal torque test. Each animal received two implants in each tibia (two treated with PRP and two as control) and was given fluorochrome intramuscularly. For histomorphometric analysis, rabbits were divided into four groups according to the healing period. At 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively, each three animals were sacrificed serially and the amount and rate of bone formation around dental implant were examined on the undecalcified sections under fluorescent microscope, polarized microscope and light microscope connected to a personal computer equipped with image analysis system. For removal torque test, rabbits were divided into two groups and removal torque tests were performed at 4 weeks, 10 weeks after implant placement. In total, 88 screw shaped, commercially pure titanium implants (Neoplant, Neobiotech, Seoul, Korea) were used in this study. Labeling pattern reflected differences of two groups in bone formation rate at each period. Histomorphometrically, PRP group showed significantly higher bone volume within threads compared to control group at 2 weeks (70.30+/-4.96% vs. 50.68+/-6.33%; P.05). These findings imply that PRP could induce rapid, more bone formation around implant during early healing period and get faster secondary stability for reducing healing period, though it has not induced bone maturation enough to resist functional loading.

FRACTURE TOUGHNESS OF VARIOUS CORE MATERIALS / 대한치과보철학회지

This investigation evaluated the fracture toughness (KIC) of eight currently available core materials, and relate the fracture toughness value to fractography analysis and surface characteristics using a atomic force microscope (AFM). Single-edge notched (SEN) test specimens (n=10) and compact tension (CT) test specimens (n=10) were prepared conforming to the ASTM Standard E-399 for a high copper amalgam, three composite core materials (Core-Max II, Core Paste, Bisfil Core), two reinforced composite core materials (Ti-Core, Ti-Core Natural), a resin-modified glass ionomer core material (Vitremer), and a conventional glass ionomer core material (Ketac-Molar). The specimens were tested with an Instron Universal Testing Machine. The maximum loads were measured to calculate the fracture toughness (KIC). Thereafter, fracture surfaces of SEN specimens of each material were investigated for fractography analysis using scanning electron microscope. And, disc-shaped specimens with 1mm thickness were fabricated for each material and were investigated under AFM for surface morphology analysis. The results were as follows : 1. Bisfil Core showed the highest mean fracture toughness regardless of test methods. 2. For the tooth-colored materials, Ti-Core Natural exhibited the highest fracture toughness. 3. Ketac Molar showed a significantly low fracture toughness when compared with the amalgam and the composite resin core materials (p<0.05). 4. The fracture toughness values obtained with the single-edge notched test, except Ketac Molar, were higher than those obtained in the compact tension test. 5. SEM revealed that the fracture surface of high fracture toughness material was rougher than that of low fracture toughness material. 6. AFM revealed that the surface particles of the composite resins were smaller in size, with a lower surface roughness than the glass ionomer core materials.

An In-Vitro Wear Study of Ceromer and Human Enamel / 대한치과보철학회지

The ideal restorative material should mimic the properties of the tissues it replaces. Dental composite resins have been used widely as restorative materials due to its advantages such as excellent esthetics and ease of manipulation. But inadequate wear resistance has been a major factor limiting the use of composite restorative materials. Improved manufacturing techniques have allowed the development of hybrid composites, with a greater percentage volume filler loading, which have improved physical an mechanical properties. However they are lacking the study wear resistance. The purpose of this study was to evaluate the wear of human enamel against ceromer by the use of a pin-on-disk type wear testers. Discs of ceromer(Targis : Ivoclar, Vivadent, Amherst. NY) and discs of type III gold alloy as a control were used for test specimens. Intact cusp of premolar and molar were used for enamel specimens. The wear of enamel was determined by weighing the cusp before and after each test, and the weight converted to volumes by average density of enamel. Surface profilometer was used to quantify wear of the ceromer and gold specimens. Vicker's hardness tester was used to evaluate the surface hardness of test specimens. The SEM was used to evaluate the wear surfaces. The results were as follows; 1. Ceromer produced less enamel wear than gold(p<0.05). 2. The wear volume of ceromer was greater than that of gold(p<0.01). 3. The hardess of ceromer was lower than that of gold, but there was no correlation between the hardness and wear of the ceromer and gold. 4. SEM analysis revealed that there were many voids and microcracks in the wear tract of ceromer. in gold group, many minute V-shaped grooves were examined.

Influence of Thickness of Empress 2 Ceramic on Fracture Strength / 대한치과보철학회지

All ceramic restorations have had a more limited life expectancy than metal ceramic crowns because of their lower strength. The relatively lower strength has limited the use of all-ceramic crowns to the areas where occlusal loads are lower. Therefore many researches have been done to increase the strength of all-ceramic crowns. IPS Empress 2 is a new type of lithium disilicate glass-ceramic with enhanced physical characteristics which has been in use clinically since 1998. Previous researches reported that the flexural strength of all-ceramic material was greater than 300MPa, and all-ceramic crowns can be used in staining or layering technique. The objective of this study was to investigate the influence of the thickness of IPS Empress 2 ceramic on fracture strength. Both staining technique and layering technique was investigated. Vita VMK was used as control. For all three groups, five specimens each of 0.8mm, 1.0mm, 1.4mm, 1.8mm, and 2.2mm thickness (a total of 75 specimens) were prepared. Control group: Vita VMK Porcelain specimens were prepared with dentine ceramic and liquid glazing was done. Group I: IPS Empress 2 were prepared with staining technique and stained twice and glazed once. Group II : IPS Empress 2 were prepared with layering technique and glazed after wash firing. The thickness and diameter of the specimen were measured and controlled after specimen preparation. Biaxial Flexure Test (ASTM Standard F394-78) was adopted as this test method produces results least affected by the edge condition of the specimens. Fracture strength was measured with Instron Universal Testing Machine. Conclusions are as follow : 1. The fracture strength was increase in order of control group, test group I, test group II. 2. Fracture strength of the group I(Empress 2 Staining) was 65.54 N in 0.8mm, 155.2 N in 1.0mm, 233.5 N in 1.44mm, 434.5 N in 1.8mm, and 600.1 N in 2.2mm. 3. Fracture strength of the group II (Empress 2 Layering) was 190.0 N in 0.8mm, 283.5 N in 1.0mm, 437.2 N in 1.4mm, 732.0 N in 1.8mm, and 1115.0 N in 2.2mm. 4. No statistical difference was found in flexural strengths according to thickness in a specified group(p>0.05).

THE EFFECT OF CYCLIC LOADING ON THE RETENTIVE STRENGTH OF FULL VENEER CROWNS / 대한치과보철학회지

Dislodgement of a crown or extension bridge and the loosening of a retainer of a bridge is a serious clinical problem in fixed restoration. Generally these problems are considered to be associated with deformation of the restoration. During biting, the restoration is subjected to complex forces and deforms considerably within the limit of its elasticity. Deformation of the restoration under the occlusal force induces excessive stress in the cement film, which then leads to the cement fracture. Such a fracture may eventually cause loss of the restoration. Because most of the past retention tests for full veneer crown were done without fatigue loading, they were not exactly simulating intraoral environment. And the purpose of this study was to evaluate the effect of cyclic cantilever loading on the retentive strength of full veneer crowns depending on different type of cements and taper of prepared abutment. Steel dies with 8degrees or 16degrees convergence angle were fabricated through milling and crowns with the same method. These dies and crowns were divided into 8 groups. Group 1: 16degrees taper die, cementation with zinc phosphate cement, without loading Group 2: 16'taper die, cementation with zinc phosphate cement, with loading Group 3: 8degrees taper die, cementation with zinc phosphate cement, without loading Group 4: 8degrees taper die, cementation with zinc phosphate cement, with loading Group 5: 16degrees taper die, cementation with Panavia 21, without loading Group 6: 16degrees taper die, cementation with Panavia 21, with loading Group 7: 8degrees taper die, cementation with Panavia 21, without loading Group 8: 8degrees taper die, cementation with Panavia 21, with loading After checking the fit of die and crown, the luting surface of dies and inner surface of crowns were air-abraded for 10 seconds. The crowns were cemented to the dies, with cements mixed ac cording to the manufacturer' s recommendations. A static load of 5 kg was then applied for 10 min utes with static loading device. Twenty-four hours later, group 1,3,5,7 were only thermocycled, group 2,4,6,8 were subjected to cyclic loading after thermocycling. Retentive tests were performed on the Instron machine. From, the finding of this study, the following conclusions were obtained. 1. Panavia 21 showed significantly higher retentive strength than zinc phosphate cement for all groups(p0.05). 3. Cyclic loading significantly decreased the retentive strength for all groups (p<0.05) . 4. For zinc phosphate cement, there was 35% reduction of the retentive strength after loading in the 16degrees taper die, 25% in the 8degrees taper die, and for Panavia 21, 21% in the 16degrees taper die, 18% in the 8degrees taper die.

THE INFLUENCE OF SURFACE TREATMENTS ON THE SHEAR BOND STRENGTH OF RESIN CEMENTS TO IN-CERAM CORE / 대한치과보철학회지

An increasing demand for esthetic restorations has led to the development of new ceramic systems. In-Ceram, a glass-infiltrated alumina ceramic has three to four times greater flexural strength than other ceramic glass material. Because of its high strength, In-Ceram has been suggested as inlay, crown, laminate veneer and core material for resin bonded fixed partial dentures. This clinical application requires a stable resin bond to In-Ceram core. The purpose of this study was to evaluate the shear bond strength between In-Ceram core and resin cements according to various surface treatments and storage conditions. The surface of each In-Ceram core sample was subjected to one of the following treatments and then bonded to Panavia 21 or Variolink II resin cement. ; (1) sandblasting with 110 micrometer aluminum oxide powder, (2) sandblasting and silanization, (3) sandblasting and Siloc treatment, (4) sandblasting and Targis link application. Each of eight bonding groups was tested in shear bond strengths after the following storage times and thermocycling. ; A) 24 hours storage in distilled water at 371C, B) 5 weeks storage in dis tilled water at 37 C, C) 5 weeks storage in distilled water at 371C and thermocycled 2,000 ther mocycling for every 10 days(totally 10,000 thermocycling) in 51C - 551C bath. The bond failure modes were observed with scanning electron microscope (SEM). The results were as follows : 1. The shear bond strengths of sandblasting group were significantly lesser than the other groups after 24 hours water storage. 2. No significant difference of bonding strengths was found between storage time conditions (24 hours and 5 weeks). The shear bond strengths showed a tendency to decrease in Variolink II bonding groups and to increase in Panavia 21 bonding groups. 3. After thermocycling, the shear bond strengths of all groups were significantly decreased (p<0.01) and Targis link group exhibited significantly greater strengths than the other groups(p<0.05). 4. Panavia 21 bonding groups exhibited significantly greater bonding strengths in sandblasting group(p<0.01) and silane group(p<0.05) than Variolink II bonding groups. 5. In observation of bond failure modes, Targis link group showed cohesive failure in resin part and silane group and Siloc group showed complex failure and sandblasting group showed adhesive failure between In-Ceram and resin.