Evaluation of sleep quality and stress response in patients requiring dental prosthetic treatment / 대한치과보철학회지

Purpose@#The purpose of this study is to investigate the stress response and sleep state of the new patients who visit the hospital for prosthodontic treatment due to tooth loss to make reference to further treatment direction. @*Materials and methods@#Examinations, consultations, and surveys were conducted on 236 patients (94 males, 142 females, and 24-86 years old), who newly registered at the department of prosthodontics at Pusan national university hospital, for 2 years from 2018. The number of remaining teeth, edentulous arch, possibility of mastication, and future prosthetic treatment directions were recorded. The visual analogue scale (VAS), stress response inventory (SRI) and Insomnia severity index (ISI) were used as tools to measure patient’s subjective discomfort, stress response, and sleep status. @*Results@#Among the entire prosthodontic patient group, the average value of ‘fatigue’ was significantly higher among the 7 items of SRI, and the value of ‘aggression’ was significantly lower (P<.001). There are a significant difference between the edentulous and full dentition in the oral discomfort value measured by VAS (P=.004). In cases where less than 20 teeth remain, mastication is impossible, and patients who are planning treatment with removable prostheses, VAS value and ‘depression’ and ‘fatigue’ values in SRI were higher than those in the reverse case (P<.05).The patients showed severe level in VAS value have high value of ‘tension’, ‘somatization’, ‘depression’, ‘fatigue’and ‘frustration’in SRI than non-serious patients (P<.05). Clinical insomnia occurred in 11.4% of all patients, and women had significantly lower sleep quality than men (P=.044). Patients with insomnia showed significantly higher scores on the VAS value and all 7 SRI items than those of normal sleepers (P<.05). @*Conclusion@#The new prosthetics had high ‘fatigue’ value among the 7 items of SRI. The oral condition, number of residual teeth and mastication function and clinical insomnia affected oral discomfort and the stress response.

The significance of diagnosis and treatment planning in periapical lesion overfilled with calcium hydroxide paste

Calcium hydroxide has been widely used for root canal dressing material in endodontic treatment. This report describes that when the accurate diagnosis and proper nonsurgical endodontic retreatment is applied to periapical lesion with accidentally extruded calcium hydroxide paste, the lesion can be successfully treated. Overfilled calcium hydroxide can affect the healing process, so the overextension of calcium hydroxide agent should be avoided.

Management of complicated crown fracture by tooth fragment reattachment with fiber post: a case report

Dental trauma is very common in children and relatively young people, with the line of treatment depending on the time elapsed, age of the child, and tooth maturity. If the fractured segment is available and there is close approximation of the segment to the remaining tooth, reattachment of the fractured segment is a feasible option. This treatment offers several advantages, including the reestablishment of function, aesthetics, shape, shine and surface texture, in addition to the original contour and alignment of the teeth. The following cases present two different complex crown fracture cases that were treated using tooth fragment reattachment with fiber-reinforced composite post.

Evaluation of sleep quality and stress response in patients requiring dental prosthetic treatment / 대한치과보철학회지

Purpose@#The purpose of this study is to investigate the stress response and sleep state of the new patients who visit the hospital for prosthodontic treatment due to tooth loss to make reference to further treatment direction. @*Materials and methods@#Examinations, consultations, and surveys were conducted on 236 patients (94 males, 142 females, and 24-86 years old), who newly registered at the department of prosthodontics at Pusan national university hospital, for 2 years from 2018. The number of remaining teeth, edentulous arch, possibility of mastication, and future prosthetic treatment directions were recorded. The visual analogue scale (VAS), stress response inventory (SRI) and Insomnia severity index (ISI) were used as tools to measure patient’s subjective discomfort, stress response, and sleep status. @*Results@#Among the entire prosthodontic patient group, the average value of ‘fatigue’ was significantly higher among the 7 items of SRI, and the value of ‘aggression’ was significantly lower (P<.001). There are a significant difference between the edentulous and full dentition in the oral discomfort value measured by VAS (P=.004). In cases where less than 20 teeth remain, mastication is impossible, and patients who are planning treatment with removable prostheses, VAS value and ‘depression’ and ‘fatigue’ values in SRI were higher than those in the reverse case (P<.05).The patients showed severe level in VAS value have high value of ‘tension’, ‘somatization’, ‘depression’, ‘fatigue’and ‘frustration’in SRI than non-serious patients (P<.05). Clinical insomnia occurred in 11.4% of all patients, and women had significantly lower sleep quality than men (P=.044). Patients with insomnia showed significantly higher scores on the VAS value and all 7 SRI items than those of normal sleepers (P<.05). @*Conclusion@#The new prosthetics had high ‘fatigue’ value among the 7 items of SRI. The oral condition, number of residual teeth and mastication function and clinical insomnia affected oral discomfort and the stress response.

A multidisciplinary approach to restore crown-root fractured maxillary central incisors: orthodontic extrusion and surgical extrusion

To restore a tooth with a fracture line extending below the marginal bone level, a surgical crown lengthening procedure accompanied by ostectomy could be considered to expose the fracture line and reestablish the biologic width. However, this procedure could lead to esthetic failure, especially in the anterior teeth. Therefore, orthodontic extrusion, which elevates the fracture line from within the alveolar socket without sacrificing the supporting bone and gingiva, is recommended. This technique allows for the proper placement of the crown on a sound tooth structure, with the reestablishment of the biologic width.Alternatively, surgical extrusion is an one-step procedure that is simpler and less time-consuming than orthodontic extrusion; placing and adjusting the orthodontic appliance does not require multiple visits. This study presents successful restoration in 2 cases with a crown-tooth root fracture of the maxillary central incisor treated using a multidisciplinary approach through orthodontic extrusion or surgical extrusion followed by successful restoration.

A multidisciplinary approach to restore crown-root fractured maxillary central incisors: orthodontic extrusion and surgical extrusion

To restore a tooth with a fracture line extending below the marginal bone level, a surgical crown lengthening procedure accompanied by ostectomy could be considered to expose the fracture line and reestablish the biologic width. However, this procedure could lead to esthetic failure, especially in the anterior teeth. Therefore, orthodontic extrusion, which elevates the fracture line from within the alveolar socket without sacrificing the supporting bone and gingiva, is recommended. This technique allows for the proper placement of the crown on a sound tooth structure, with the reestablishment of the biologic width.Alternatively, surgical extrusion is an one-step procedure that is simpler and less time-consuming than orthodontic extrusion; placing and adjusting the orthodontic appliance does not require multiple visits. This study presents successful restoration in 2 cases with a crown-tooth root fracture of the maxillary central incisor treated using a multidisciplinary approach through orthodontic extrusion or surgical extrusion followed by successful restoration.

Treatment of a tooth with severe periodontal involvement using intentional replantation: case report

Although intentional replantation is frequently used as a treatment modality for endodontic problems, severe periodontal involvement has usually been regarded as a contraindication. However, there are some studies suggesting that intentional replantation could be a successful treatment alternative for periodontally involved teeth. This paper reports the treatment of a tooth with severe periodontal involvement using intentional replantation. The tooth, which had had root canal therapy due to endodontic-periodontal combined lesion but showed extensive bone loss, was gently extracted and replanted after thorough debridement of the root surface. By intentional replantation, a tooth with severe periodontal involvement in this case could be preserved, without extraction, over the course of a 3-year follow-up period.

Conservative and esthetic approach in crown fracture of maxillay anterior tooth: tooth fragment reattachment

Crown fractures are the most frequent traumatic injuries to permanent teeth and mainly involve the maxillary incisors due to their exposed position in the dental arch. One option for managing crown fractures, when the tooth fragment is present and in good condition, is reattachment of the fragment to its original position. This paper reports on three crown fracture cases in which successful esthetic and functional results were achieved by reattachment of the tooth fragment.

Maxillary complete denture and mandibular All-on-4 implant restoration considering maintenance: a case report

In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.

Guided tissue regeneration therapy after root canal therapy for long standing periodontal-endodontic combined lesion in the mandibular anterior area: case report

When inflammatory products are found in both periodontal and pulpal tissues simultaneously, a periodontal-endodontic combined lesion is established. The treatment of periodontal-endodontic combined lesions includes root canal therapy and periodontal regenerative procedure for resolution of both the apical and marginal inflammatory lesions. The present study reports the treatment of periodontal-endodontic combined lesions in the mandibular anterior area with root canal therapy, followed by guided tissue regeneration therapy. Teeth with severe bone destruction in each case could be preserved, without extraction, over a 3-year period. Therefore, it appears that treatment of periodontal-endodontic combined lesions in the mandibular anterior area using guided tissue regeneration technique after root canal therapy may provide clinical advantages.

Implant overdenture of mandible with severe unilateral atrophy: Report of two cases / 대한치과보철학회지

There are several unfavorable conditions regarding alveolar bone condition that may compromise the denture patient's satisfaction. Chewing efficiency may not be satisfactory when alveolar bone is deficient, and the denture stability could hardly be achieved when alveolar bone shape is irregular. Implant overdenture can be useful to provide satisfactory denture experience compared to conventional denture. The attachment for implant overdenture can be classified into bar attachment and solitary attachment. When the positions of the implants are in the mandibular anterior region, bar attachment may be favorable to obtain a rigid support of the entire denture. When implants are distributed both on anterior and posterior region, a solitary attachment could be considered for ease of removal and maintenance. This report presents implant overdenture cases with the patients that had unilateral mandibular alveolar bone atrophy conditions. Different abutments were chosen based on the individual patient's mandibular alveolar bone condition and the treatments were successful in terms of patient satisfaction.

Effects of Bioactive Glass on Microhardness of Bleached Enamel Surface / 대한치과재료학회지

The purpose of this study was to examine effects of bioactive glass on Vickers hardness of bleached enamel surface. Enamel specimens were bleached with 15% carbamide peroxide (CP) for 14days. After bleaching, Artificial saliva (AS), 45S5 bioactive glass (BAG) and fluoride varnish (FV) are applied each specimens (n=10). The Vickers hardness of the specimens was measured before and after the bleaching, after the remineralized treatment at 1 day and after 7 and 14 days. The Vickers hardness on enamel surface after bleaching decreased statistically (p < 0.05) compared to before bleached enamel surface. The Vickers hardness increased significantly in the BAG and FV groups compared to the AS group values at 1 day and 7 days after remineralization (P < 0.05). 45S5 bioactive glass rapidly increase Vickers hardness of the bleached enamel surface.

Conservative and esthetic closure of maxillary midline diastema without creating "black triangle" using direct resin composite

Anterior diastemas are common esthetic problems. One of the challenges in clinical esthetic dentistry is closing anterior diastemas without creating “black triangles” between the teeth. The success of a restorative treatment in anterior teeth depends on the esthetic integration between soft tissues and hard tissues. This report describes the successfully accomplished diastema closure case by producing the emergence profile with natural contours at the gingival-tooth interface and then generating of gingival recontouring process.

Spontaneous teeth migration after periodontal treatment in the patients with drug-induced gingival enlargement

Anticonvulsants, calcium channel blockers and immunosuppressants are representative drugs related with gingival enlargement. Clinical signs and symptoms caused by drug-induced gingival enlargment frequently appear within 1 to 3 months after medication. At initial stage, it is limited to attached gingiva but may extend coronally and interfere with esthetics, mastication and speech. Interproximal spaces are common beginning area and pathologic teeth migration could be occurred by the lesion. Withdrawal or substitution of medication would be the most effective treatment of drug-induced gingival enlargement. However, periodontal treatment and further supportive periodontal therapy should be provided where change in medication is impossible. The present study reports the cases which show the resolution of inflammation with spontaneous teeth migration without change in medication. In all cases discussed in this report could be efficiently managed with proper periodontal treatment and further supportive periodontal therapy.

Implant impression using closed mouth impression technique: a case report

Closed mouth impression technique by using bite tray is preferred for single tooth impression taking. However, for implant impression taking, open mouth impression technique by using single arch tray is generally used whether it is for single implant or multiple implant. Closed mouth impression technique by using bite tray can save time and materials. It also decreases the chance of error occurrence when a model is mounted on an articulator. In this case report, we tried to show a satisfying result of fabricating single implant fixed prosthodontics after bite tray impression taking by using two different copings for closed mouth impression.

Effect of dentin pretreatment and curing mode on the microtensile bond strength of self-adhesive resin cements

PURPOSE: The aim was to evaluate the effect of curing mode and different dentin surface pretreatment on microtensile bond strength (microTBS) of self-adhesive resin cements. MATERIALS AND METHODS: Thirty-six extracted human permanent molars were sectioned horizontally exposing flat dentin surface. The teeth were divided into 12 groups (3 teeth/group) according to the dentin surface pretreatment methods (control, 18% EDTA, 10% Polyacrylic acid) and curing mode (self-curing vs. light-curing) of cement. After pretreatment, composite resin blocks were cemented with the following: (a) G-CEM LinkAce; (b) RelyX U200, followed by either self-curing or light-curing. After storage, the teeth were sectioned and microTBS test was performed using a microtensile testing machine. The data was statistically analyzed using one-way ANOVA, Student T-test and Scheffe's post-hoc test at P<.05 level. RESULTS: For G-CEM LinkAce cement groups, polyacrylic acid pretreatment showed the highest microTBS in the self-cured group. In the light-cured group, no significant improvements were observed according to the dentin surface pretreatment. There were no significant differences between curing modes. Both dentin surface pretreatment methods helped to increase the microTBS of RelyX U200 resin cement significantly and degree of pretreatment effect was similar. No significant differences were found regarding curing modes except control groups. In the comparisons of two self-adhesive resin cements, all groups within the same pretreatment and curing mode were significantly different excluding self-cured control groups. CONCLUSION: Selecting RelyX U200 used in this study and application of dentin surface pretreatment with EDTA and polyacrylic acid might be recommended to enhance the bond strength of cement to dentin.

Effect of immersion into solutions at various pH on the color stability of composite resins with different shades

OBJECTIVES: This study examined the color changes of a resin composite with different shades upon exposure to water with different pH. MATERIALS AND METHODS: Nanohybrid resin composites (Filtek Z350XT, 3M ESPE) with four different shades (A2, A3, B1, and B2) were immersed in water with three different pH (pH 3, 6, and 9) for 14 day. The CIE L*a*b* color coordinates of the specimens were evaluated before and after immersion in the solutions. The color difference (DeltaE*) and the translucency parameter (TP) were calculated using the color coordinates. RESULTS: DeltaE* ranged from 0.33 to 1.58, and the values were affected significantly by the pH. The specimens immersed in a pH 6 solution showed the highest DeltaE* values (0.87 - 1.58). The specimens with a B1 shade showed the lowest DeltaE* change compared to the other shades. TP ranged from 7.01 to 9.46 depending on the pH and resin shade. The TP difference between before and after immersion in the pH solutions was less than 1.0. CONCLUSIONS: The resulting change of color of the tested specimens did not appear to be clinically problematic because the color difference was < 1.6 in the acidic, neutral, and alkaline solutions regardless of the resin shade, i.e., the color change was imperceptible.

Effect of additional etching and ethanol-wet bonding on the dentin bond strength of one-step self-etch adhesives

OBJECTIVES: This study examined the effects of additional acid etching on the dentin bond strength of one-step self-etch adhesives with different compositions and pH. The effect of ethanol wetting on etched dentin bond strength of self-etch adhesives was also evaluated. MATERIALS AND METHODS: Forty-two human permanent molars were classified into 21 groups according to the adhesive types (Clearfil SE Bond [SE, control]; G-aenial Bond [GB]; Xeno V [XV]; Beauti Bond [BB]; Adper Easy Bond [AE]; Single Bond Universal [SU]; All Bond Universal [AU]), and the dentin conditioning methods. Composite resins were placed on the dentin surfaces, and the teeth were sectioned. The microtensile bond strength was measured, and the failure mode of the fractured specimens was examined. The data were analyzed statistically using two-way ANOVA and Duncan's post hoc test. RESULTS: In GB, XV and SE (pH 0.05). In AU (pH = 3.2), additional etching increased the bond strength significantly (p < 0.05). When adhesives were applied to the acid etched dentin with ethanol-wet bonding, the bond strength was significantly higher than that of the no ethanol-wet bonding groups, and the incidence of cohesive failure was increased. CONCLUSIONS: The effect of additional acid etching on the dentin bond strength was influenced by the pH of one-step self-etch adhesives. Ethanol wetting on etched dentin could create a stronger bonding performance of one-step self-etch adhesives for acid etched dentin.

Effect of resin thickness on the microhardness and optical properties of bulk-fill resin composites

OBJECTIVES: This study evaluated the effects of the resin thickness on the microhardness and optical properties of bulk-fill resin composites. METHODS: Four bulk-fill (Venus Bulk Fill, Heraeus Kulzer; SDR, Dentsply Caulk; Tetric N-Ceram Bulk Fill, Ivoclar vivadent; SonicFill, Kerr) and two regular resin composites (Charisma flow, Heraeus Kulzer; Tetric N-Ceram, Ivoclar vivadent) were used. Sixty acrylic cylindrical molds were prepared for each thickness (2, 3 and 4 mm). The molds were divided into six groups for resin composites. The microhardness was measured on the top and bottom surfaces, and the colors were measured using Commission Internationale d'Eclairage (CIE) L*a*b* system. Color differences according to the thickness and translucency parameters and the correlations between the microhardness and translucency parameter were analyzed. The microhardness and color differences were analyzed by ANOVA and Scheffe's post hoc test, and a student t-test, respectively. The level of significance was set to alpha = 0.05. RESULTS: The microhardness decreased with increasing resin thickness. The bulk-fill resin composites showed a bottom/top hardness ratio of almost 80% or more in 4 mm thick specimens. The highest translucency parameter was observed in Venus Bulk Fill. All resin composites used in this study except for Venus Bulk Fill showed linear correlations between the microhardness and translucency parameter according to the thickness. CONCLUSIONS: Within the limitations of this study, the bulk-fill resin composites used in this study can be placed and cured properly in the 4 mm bulk.

Effect of resin thickness on the microhardness and optical properties of bulk-fill resin composites

OBJECTIVES: This study evaluated the effects of the resin thickness on the microhardness and optical properties of bulk-fill resin composites. METHODS: Four bulk-fill (Venus Bulk Fill, Heraeus Kulzer; SDR, Dentsply Caulk; Tetric N-Ceram Bulk Fill, Ivoclar vivadent; SonicFill, Kerr) and two regular resin composites (Charisma flow, Heraeus Kulzer; Tetric N-Ceram, Ivoclar vivadent) were used. Sixty acrylic cylindrical molds were prepared for each thickness (2, 3 and 4 mm). The molds were divided into six groups for resin composites. The microhardness was measured on the top and bottom surfaces, and the colors were measured using Commission Internationale d'Eclairage (CIE) L*a*b* system. Color differences according to the thickness and translucency parameters and the correlations between the microhardness and translucency parameter were analyzed. The microhardness and color differences were analyzed by ANOVA and Scheffe's post hoc test, and a student t-test, respectively. The level of significance was set to alpha = 0.05. RESULTS: The microhardness decreased with increasing resin thickness. The bulk-fill resin composites showed a bottom/top hardness ratio of almost 80% or more in 4 mm thick specimens. The highest translucency parameter was observed in Venus Bulk Fill. All resin composites used in this study except for Venus Bulk Fill showed linear correlations between the microhardness and translucency parameter according to the thickness. CONCLUSIONS: Within the limitations of this study, the bulk-fill resin composites used in this study can be placed and cured properly in the 4 mm bulk.