Comparison of implant component fractures in external and internal type: A 12-year retrospective study

PURPOSE: The aim of this study was to compare the fracture of implant component behavior of external and internal type of implants to suggest directions for successful implant treatment. MATERIALS AND METHODS: Data were collected from the clinical records of all patients who received WARANTEC implants at Seoul National University Dental Hospital from February 2002 to January 2014 for 12 years. Total number of implants was 1,289 and an average of 3.2 implants was installed per patient. Information about abutment connection type, implant locations, platform sizes was collected with presence of implant component fractures and their managements. SPSS statistics software (version 24.0, IBM) was used for the statistical analysis. RESULTS: Overall fracture was significantly more frequent in internal type. The most frequently fractured component was abutment in internal type implants, and screw fracture occurred most frequently in external type. Analyzing by fractured components, screw fracture was the most frequent in the maxillary anterior region and the most abutment fracture occurred in the maxillary posterior region and screw fractures occurred more frequently in NP (narrow platform) and abutment fractures occurred more frequently in RP (regular platform). CONCLUSION: In external type, screw fracture occurred most frequently, especially in the maxillary anterior region, and in internal type, abutment fracture occurred frequently in the posterior region. placement of an external type implant rather than an internal type is recommended for the posterior region where abutment fractures frequently occur.

Time series analysis of patients seeking orthodontic treatment at Seoul National University Dental Hospital over the past decade / 대한치과교정학회지

OBJECTIVE: This paper describes changes in the characteristics of patients seeking orthodontic treatment over the past decade and the treatment they received, to identify any seasonal variations or trends. METHODS: This single-center retrospective cohort study included all patients who presented to Seoul National University Dental Hospital for orthodontic diagnosis and treatment between January 1, 2005 and December 31, 2015. The study analyzed a set of heterogeneous variables grouped into the following categories: demographic (age, gender, and address), clinical (Angle Classification, anomaly, mode of orthodontic treatment, removable appliances for Phase 1 treatment, fixed appliances for Phase 2 treatment, orthognathic surgery, extraction, mini-plate, mini-implant, and patient transfer) and time-related variables (date of first visit and orthodontic treatment time). Time series analysis was applied to each variable. RESULTS: The sample included 14,510 patients with a median age of 19.5 years. The number of patients and their ages demonstrated a clear seasonal variation, which peaked in the summer and winter. Increasing trends were observed for the proportion of male patients, use of non-extraction treatment modality, use of ceramic brackets, patients from provinces outside the Seoul region at large, patients transferred from private practitioners, and patients who underwent orthognathic surgery performed by university surgeons. Decreasing trends included the use of metal brackets and orthodontic treatment time. CONCLUSIONS: Time series analysis revealed a seasonal variation in some characteristics, and several variables showed changing trends over the past decade.

Angled Cool-Tip Electrode for Radiofrequency Ablation of Small Superficial Subcapsular Tumors in the Liver: A Feasibility Study

OBJECTIVE: To evaluate the feasibility of angled cool-tip electrode for radiofrequency ablation of small superficial subcapsular liver tumors abutting abdominal wall, in order to traverse normal liver parenchyma, and thereby, obtain favorable configuration of ablation margin. MATERIALS AND METHODS: In this study, we retrospectively analyzed 15 small superficial subcapsular liver tumors abutting abdominal wall in 15 patients, treated with radiofrequency ablation from March 2013 to June 2015 using a cool-tip electrode manually modified to create 25-35° angle at the junction between exposed and insulated segments. The tumors were hepatocellular carcinoma (n = 13) and metastases (n = 2: cholangiocellular carcinoma and rectosigmoid cancer), with maximum diameter of 10-26 mm (mean, 15.68 ± 5.29 mm). Under ultrasonographic guidance, the electrode tip was advanced to the depth of the tumors' epicenter about 1 cm from the margin. The tip was re-directed to penetrate the tumor for radiofrequency ablation. Minimal ablation margin was measured at immediate post-treatment CT. Radiological images and medical records were evaluated for success rate, length of minimal ablation margin and complications. RESULTS: Technical success rate of obtaining complete necrosis of the tumors was 100%, with no procedure-related complication. Minimal ablation margin ranged from 3-12 mm (mean, 7.07 ± 2.23 mm). CT/MRI follow-up at 21-1022 days (mean, 519.47 ± 304.51 days) revealed no local recurrence, but distant recurrence in 9 patients. CONCLUSION: Using an angled cool-tip electrode for radiofrequency ablation of small superficial subcapsular tumors abutting abdominal wall may be a feasible technique for obtaining adequate ablation margin and lower complication rate.

Investigation of anodized titanium implants coated with triterpenoids extracted from black cohosh: an animal study

PURPOSE: The purpose of this study was to evaluate bone response to anodized titanium implants coated with the extract of black cohosh, Asarum Sieboldii, and pharbitis semen. MATERIALS AND METHODS: Forty anodized titanium implants were prepared as follows: group 1 was for control; group 2 were implants soaked in a solution containing triterpenoids extracted from black cohosh for 24 hours; group 3 were implants soaked in a solution containing extracts of black cohosh and Asarum Sieboldii for 24 hours; group 4 were implants soaked in a solution containing extracts of pharbitis semen for 24 hours. The implants from these groups were randomly and surgically implanted into the tibiae of ten rabbits. After 1, 2, and 4 weeks of healing, the nondecalcified ground sections were subjected to histological observation, and the percentage of bone-to-implant contact (BIC%) was calculated. RESULTS: All groups exhibited good bone healing with the bone tissue in direct contact with the surface of the implant. Group 2 (52.44 +/- 10.98, 25.54 +/- 5.56) showed a significantly greater BIC% compared to that of group 3 (45.34 +/- 5.00, 22.24 +/- 2.20) with respect to the four consecutive threads and total length, respectively. The BIC% of group 1 (25.22 +/- 6.00) was significantly greater than that of group 3 (22.24 +/- 2.20) only for total length. CONCLUSION: This study did not show any remarkable effects of the extract of black coshosh and the other natural products on osseointegration of anodized titanium implants as coating agents. Further studies about the application method of the natural products on to the surface of implants are required.

Use of mini-implants to avoid maxillary surgery for Class III mandibular prognathic patient: a long-term post-retention case / 대한치과교정학회지

Because of the potential morbidity and complications associated with surgical procedures, limiting the extent of orthognathic surgery is a desire for many orthodontic patients. An eighteen-year-old woman had a severe Class III malocclusion and required bi-maxillary surgery. By changing the patient's maxillary occlusal plane using orthodontic mini-implants, she was able to avoid the maxillary surgery; requiring only a mandibular setback surgery. To accurately predict the post-surgery outcome, we applied a new soft tissue prediction method. We were able to follow and report the long-term result of her combined orthodontic and orthognathic treatment. The changes to her occlusal plane continue to appear stable over 6 years later.

Comparison of cephalometric norms between Mongolian and Korean adults with normal occlusions and well-balanced profiles / 대한치과교정학회지

OBJECTIVE: The purposes of this study were to establish cephalometric norms of Mongolian adults, which have not previously been reported in orthodontic journals, and to compare them with cephalometric norms of Korean adults. METHODS: Lateral cephalometric radiographs of 74 Mongolian adults (35 men, 39 women) and 95 Korean adults (52 men, 43 women) with normal occlusions and well-balanced lateral profiles were obtained. The subjects were chosen by orthodontists of the same ethnic background. Forty craniofacial variables were measured, and groups were compared by analysis of covariance. RESULTS: The cephalometric norms for male and female Mongolian and Korean adults with normal occlusions and well-balanced lateral profiles were established. Sexual dimorphism was found in linear skeletal measurements and vertical skeletal relationships. Compared with Korean adults, Mongolian adults had shorter anterior facial height, more prominent chins, and more upright upper incisors. There were few differences in soft tissue measurements. The differences were statistically significant, but their clinical importance may be limited. CONCLUSIONS: Cephalometric differences can be considered, but little difference may exist in the orthodontic diagnosis and treatment planning of Mongolian and Korean adults.

The relationship between initial implant stability quotient values and bone-to-implant contact ratio in the rabbit tibia

PURPOSE: Implant stability quotient (ISQ) values have been supposed to predict implant stability. However, the relationship between ISQ values and bone-to-implant contact ratio (BIC%) which is one of the predictors of implant stability is still unclear. The aim of the present study was to evaluate initial ISQ values in relation to BIC% using rabbit model. MATERIALS AND METHODS: Four New Zealand white rabbits received a total of 16 implants in their tibia. Immediately after implant placement ISQ values were assessed. The measurements were repeated at the time of sacrifice of the rabbits after 4 weeks. Peri-implant bone regeneration was assessed histomorphometrically by measuring BIC% and bone volume to total volume values (bone volume %). The relationships between ISQ values and the histomorphometric output were assessed, and then, the osseointegration prediction model via the initial ISQ values was processed. RESULTS: Initial ISQ values showed significant correlation with the BIC%. The bone volume % did not show any significant association with the ISQ values. CONCLUSION: In the limitation of this study, resonance frequency analysis is a useful clinical method to predict the BIC% values and examine the implant stability.

Usefulness of Multi-Detector Computed Tomography before Bronchoscopy and/or Bronchial Arterial Embolization for Hemoptysis / 결핵및호흡기질환

BACKGROUND: Recently, many institutions have acquired multi-detector computed tomography (MDCT) systems. This made it easier and more convenient to use MDCT as a initial diagnostic modality for hemoptysis. The purpose of this study was to evaluate the usefulness of MDCT before bronchoscopy and/or bronchial arterial embolization (BAE) for hemoptysis. METHODS: We studied a total of 125 patients with hemoptysis who underwent, between 2006 and 2008, MDCT in a routine protocol before bronchoscopy and/or BAE. One hundred two patients underwent bronchoscopy and 29 patients underwent BAE. We compared the usefulness of MDCT and bronchoscopy for detecting the bleeding site and identifying the cause. We also evaluated our ability, using MDCT, to detect instances where the bronchial artery caused hemoptysis. RESULTS: The rate of detection of a bleeding site was 75.5% on MDCT and 50.9% on bronchoscopy. MDCT and bronchoscopy detected the bleeding site in agreement in 62.7% of patients. MDCT alone found the bleeding site in 27.5% of cases. MDCT identified the cause of hemoptysis in 77.5% and bronchoscopy in 11.8%. In 29 patients who underwent BAE, we detected a total of 37 hypertrophied bronchial arteries that were causing hemoptysis. Of 37 bronchial arteries, 23 (62.2%) were depicted on MDCT. CONCLUSION: MDCT is superior to bronchoscopy for detecting the bleeding site and identifying the cause of hemoptysis. MDCT can also predict the side of affected bronchial artery with depiction of hypertrophied bronchial artery and localizing the bleeding site. Doing MDCT before bronchoscopy and BAE can provide a guideline for the next step.

Mixed dentition analysis using a multivariate approach / 대한치과교정학회지

OBJECTIVE: To develop a mixed dentition analysis method in consideration of the normal variation of tooth sizes. METHODS: According to the tooth-size of the maxillary central incisor, maxillary 1st molar, mandibular central incisor, mandibular lateral incisor, and mandibular 1st molar, 307 normal occlusion subjects were clustered into the smaller and larger tooth-size groups. Multiple regression analyses were then performed to predict the sizes of the canine and premolars for the 2 groups and both genders separately. For a cross validation dataset, 504 malocclusion patients were assigned into the 2 groups. Then multiple regression equations were applied. RESULTS: Our results show that the maximum errors of the predicted space for the canine, 1st and 2nd premolars were 0.71 and 0.82 mm residual standard deviation for the normal occlusion and malocclusion groups, respectively. For malocclusion patients, the prediction errors did not imply a statistically significant difference depending on the types of malocclusion nor the types of tooth-size groups. The frequency of prediction error more than 1 mm and 2 mm were 17.3% and 1.8%, respectively. The overall prediction accuracy was dramatically improved in this study compared to that of previous studies. CONCLUSIONS: The computer aided calculation method used in this study appeared to be more efficient.

Quantitative analysis of mutans streptococci adhesion to various orthodontic bracket materials in vivo / 대한치과교정학회지

OBJECTIVE: To estimate the effects of bracket material type on enamel decalcification during orthodontic treatment, this study analyzed the adhesion level of mutans streptococci (MS) to orthodontic bracket materials in vivo. METHODS: Three different types of orthodontic bracket materials were used: stainless steel, monocrystalline sapphire, and polycrystalline alumina. A balanced complete block design was used to exclude the effect of positional variation of bracket materials in the oral cavity. Three types of plastic individual trays were made and one subject placed the tray in the mouth for 12 hours. Then, the attached bacteria were isolated and incubated on a mitis salivarius media containing bacitracin for 48 hours. Finally, the number of colony forming units of MS was counted. The experiments were independently performed 5 times with each of the 3 trays, resulting in a total of 15 times. Mixed model ANOVA was used to compare the adhesion amount of MS. RESULTS: There was no difference in colony forming units among the bracket materials irrespective of jaw and tooth position. CONCLUSIONS: This study suggested that the result of quantitative analysis of MS adhesion to various orthodontic bracket materials in vivo may differ from that of the condition in vitro.

Usefulness of FDG-PET/CT as a Diagnostic Tool for Routine Post Therapy Evaluation in Endometrial Cancer / 핵의학분자영상

PURPOSE: The aim of this study was to evaluate the usefulness of FDG-PET/CT as follow up imaging tool in patients with endometrial cancer after therapy. Material and Methods: One hundred one patients with endometrial cancer who underwent FDG PET/CT after the treatment of this disease were included in this study population (25-79 yr old, Mean age 50.6 yr old) and all these patients also performed various laboratory and imaging studies such as serum tumor marker, CT or MRI. The lesions having increased focal FDG uptake were classified into benign, equivocal, and malignant one according to their pattern and activity. Tumor recurrence was confirmed by histopathological results and other clinical and imaging data. RESULTS: Among the 19 patients with 30 malignant or equivocal hot uptakes, 11 of 14 patients supposed to be malignant finding in PET/CT were proved to be tumor recurrence, while one of 5 patients with equivocal lesions were recurred malignancy. Two false negative cases were turned out to be peritoneal carcinomatosis. Estimated sensitivity, specificity and accuracy of PET/CT for diagnosis of recurrence in endometrial carcinoma after treatment were 86 %, 92 % and 91%, respectively. Positive and negative predictive values in the same issue were 63% and 98%, respectively. CONCLUSION: FDG-PET/CT is useful for regular work up of endometrial carcinoma after the treatment because of its high negative predictive value as well as high sensitivity and specificity.

Effects of the Er,Cr:YSGG laser on bone bed preparation with various laser tips / 대한치과보철학회지

STATEMENT OF PROBLEM: Preparation of implant beds with lasers is considered a safe and reliable method, but the accuracy of this technique has not been examined. PURPOSE: The purpose of this study was to evaluate the accuracy and effectiveness of implant bed preparation using an Er,Cr:YSGG laser. MATERIAL AND METHODS: An Er,Cr:YSGG laser was applied to pig rib bone. The laser was employed at a 5.75 W power setting, 30 Hz/sec pulse repetition, and 70 micro sec pulse duration with 50 % water and 60% air spray. According to laser tips the groups were divided as follows; Group 1: paralleled - shaped sapphire tip (0.6 mm phi), Group 2: paralleled - shaped zirconia tip (0.6 mm phi), Group 3: tapered sapphire tip (0.4 mm phi). The Er,Cr:YSGG laser tip was separated by 1 mm from the bone and applied for 15 seconds in a non-contact mode. After the application, the bone was sectioned for specimens. Histologic measurements were determined by computerized morphometry. The length of the prepared bone surface was measured and the width of the entrance was measured. The results were analyzed with one-way ANOVA (P<0.05). RESULTS: The prepared length of group 3 was longer than that of group 2. The prepared bone width was larger than the width of the laser tip in every group. Additional bone removal was observed adjacent to the prepared area and displayed an irregular surface. CONCLUSION & DISCUSSION: Different cutting effects were observed according to the laser tip, emphasizing the importance of proper tip selection in the clinical setting. This preliminary study supported the existence of hydrokinetic effects.

The effect of tongue cleaner-equipped manual toothbrush on tooth and tongue cleanness and malodor index / 대한치주과학회지

PURPOSE: The aim of this study was to investigate the effect of tongue cleaner-equipped manual toothbrush on tooth cleanness, tongue cleanness and malodor index. MATERIALS AND METHODS: 504 subjects were included in this study. At 1st visit, basic information such as age, sex, smoking amount and alcohol consumption was recorded. Self assessment by individual subjects was performed regarding satisfaction to old toothbrush and toothbrushing habit. Tooth cleanness, tongue cleanness and malodor index was assessed by professional researcher. Tongue cleaner-equipped manual toothbrush was given to each subject with proper toothbrushing instruction. After 1 month passed, self assessment and researcher assessment regarding the same index were performed and analyzed statistically by chi-square test. RESULTS: At 1st visit subjects seem to ignore tongue cleansing and showed poor tooth cleanness index, tongue cleanness index and malodor index, however the same subjects were motivated to clean their tongue and teeth and presented statistically improved distribution pattern in tooth cleanness index, tongue cleanness index and malodor index after using tongue cleaner-equipped manual toothbrush(p<0.01). Satisfaction to tongue cleaner-equipped manual toothbrush was 98%. CONCLUSION: Tongue cleaner-equipped manual toothbrush would be an effective tool for maintaining good oral hygiene through improving tooth and tongue cleanness and preventing malodor formation.

Evaluation of nasolabial angle in adult patients with skeletal Class III malocclusion / 대한치과교정학회지

OBJECTIVE: The purposes of this study were to evaluate the nasolabial angle changes between closed lip position at centric occlusion and relaxed lip position at which the bite is open so that the lips do not touch and to elucidate the significance of the relaxed lip position for dentofacial diagnosis. METHODS: The subjects consisted of 60 (35 Males, 25 Females) skeletal Class III malocclusion adult patients (mean age 23.3 years) with anterior crossbite. RESULTS: In Class III malocclusion adult patients, there were significant differences in the nasolabial angle changes between closed lip position and relaxed lip position. Using the cluster analysis, the subjects were divided into three groups according to the pattern of nasolabial angle change: Group 1 (N = 27, 45%, -8 ~ 1), Group 2 (N = 30, 50%, 2degrees ~ 17), and Group 3 (N = 3, 5%, over 18). CONCLUSION: The results showed that the pattern of the nasolabial angle change between closed lip position and relaxed lip position varies in skeletal Class III malocclusion patients. Thus, relaxed lip position should be taken into account when diagnostic records are obtained and analyzed to accurately to evaluate the facial soft tissues and predict facial esthetics after surgical-orthodontic treatment.

Construction of a reference stature growth curve using spline function and prediction of final stature in Korean / 대한치과교정학회지

OBJECTIVE: Evaluation of individual growth is important in orthodontics. The aim of this study was to develop a convenient software that can evaluate current growth status and predict further growth. METHODS: Stature data of 2 to 20 year-old Koreans (4893 boys and 4987 girls) were extracted from a nationwide data. Age-sex-specific continuous functions describing percentile growth curves were constructed using natural cubic spline function (NCSF). Then, final stature prediction algorithm was developed and its validity was tested using longitudinal series of stature measurements on randomly selected 200 samples. Various accuracy measurements and analyses of errors between observed and predicted stature using NCSF growth curves were performed. RESULTS: NCSF growth curves were shown to be excellent models in describing reference percentile stature growth curve over age. The prediction accuracy compared favorably with previous prediction models, even more accurate. The current prediction models gave more accurate results in girls than boys. Although the prediction accuracy was high, the error pattern of the validation data showed that in most cases, there were a lot of residuals with the same sign, suggestive of autocorrelation among them. CONCLUSION: More sophisticated growth prediction algorithm is warranted to enhance a more appropriate goodness of model fit for individual growth.

Effect of dual pitch mini-implant design and diameter of an orthodontic mini-implant on the insertion and removal torque / 대한치과교정학회지

OBJECTIVE: Small orthodontic mini-implants are useful as anchorage. However they have some weaknesses such as loosening. This study was carried out to analyze the mechanical effects of the dual pitch and diameter on the insertion and removal torque of mini-implants. METHODS: The threads of mini-implants were mono and dual pitch. The diameters of mini-implants were 1.4 mm and 1.6 mm. Four groups were tested (mono 1.4 mm, mono 1.6 mm, dual 1.4 mm and dual 1.6 mm). All were inserted and removed on polyurethane foam with the torques being measured. RESULTS: The maximum torque of the dual pitch groups was higher than the mono pitch groups during removal but lower during insertion. The maximum torque of the 1.6 mm diameter groups was higher than the 1.4 mm diameter groups during insertion and removal. The dual pitch 1.4 mm group showed the lowest insertion torque but had similar or superior levels of removal torque to that of the mono pitch 1.6 mm group. CONCLUSIONS: The dual pitch especially showed a continuous high removal torque after the peak. Despite the small diameter, the dual pitch might improve the initial mechanical stability.

Comparing locus of control in orthodontic patients of a university dental hospital with those of a private dental clinic / 대한치과교정학회지

OBJECTIVE: Many factors are considered when a patient chooses the type of dental institution they wish to receive treatment from. Numerous studies have been conducted regarding this issue. However, more research is needed in analyzing the patient's psychological aspects when he/she decides to choose the dental institution they wish to receive treatment from. METHODS: A locus of control test was utilized to analyze the psychological aspects in orthodontic patients of a university dental hospital and a private dental clinic. The locus of control test is known to be useful in predicting a human being's behavior. Both intrinsic and extrinsic locus of control tests were carried out in 934 orthodontic patients attending Seoul National University Dental Hospital and 1466 orthodontic patients from a private dental clinic. RESULTS: The orthodontic patients at the university dental hospital showed a stronger extrinsic locus of control compared with those from the private dental clinic. CONCLUSION: The orthodontic patients at the university dental hospital value the doctor as the authority figure and the treatment quality more than those at the private dental clinic.

New evaluation chart of stature and weight for Koreans / 대한치과교정학회지

For orthodontic treatment of growing patients and those which involve long treatment times, knowledge of growth and development are essential. Data from the general growth observation chart being used at present does not reflect the growth transition of modern times. This is because these data are out of date. The present study, therefore, aims to introduce the process of producing a growth curve and growth rate curve based on data which represents a more accurate description of the present situation. The data used were from the 5th nationwide survey, SIZE KOREA 2004 study, carried out by the Technology and Standards Policy Division, Department of Technology and Standards Planning, Ministry of Commerce. Processing and rearranging produced data with variations divided into the three quartiles and the 1st, 5th, 95th and 99th percentiles were included to produce a growth observation chart according to sex, height and weight differences. In the same way, a growth rate curve based on the geometric mean value was produced. The resulting growth charts can be used as an index for growth and development, and used for better communication between the orthodontist, patients and parents.

Mechanical analysis of the taper shape and length of orthodontic mini-implant for initial stability / 대한치과교정학회지

Orthodontic mini-implants, despite its usefulness as anchorage, have some limits such as loosening. Therefore, various shapes and lengths have been studied. The aim of this study is to analyze the shape and length of mini-implants mechanically. The shapes of mini-implants (1.6 mm, Dual Top, Jeil Medical Co., Seoul, Korea) were cylindrical and taper. The lengths of mini-implants were 6 mm and 8 mm. The tested groups were 5 groups (cylindrical 6 mm, cylindrical 8 mm, taper 6 mm, taper 8 mm and taper 8 mm modified whose thread is reduced from the middle to upper part). All were inserted and removed on the polyurethane foam with the torque measured. During insertion and removal, the taper shape needed higher torque than the cylindrical shape, and the 8 mm length than the 6 mm length (p < 0.001). The taper 6 mm group showed superior insertion torque (p < 0.001) and similar removal torque to the cylindrical 8 mm group. The taper 8 mm modified group with gradually reduced threads, showed continuous high removal torque after the peak. The initial mechanical stability can be provided by the tapered shape and also, affected by length and thread design.

A clinical evaluation of a bleaching strip containing 2.9% hydrogen peroxide / 대한치과보존학회지

This study evaluated the effectiveness and safety of an experimental bleaching strip (Medison dental whitening strip, Samsung medical Co., Anyang, Korea) containing 2.9% hydrogen peroxide. Twenty-three volunteers used the bleaching strips for one and a half hour daily for 2 weeks. As control group, the same strips in which hydrogen peroxide was not included were used by 24 volunteers with the same protocol. The shade change (DeltaE*, color difference) of twelve anterior teeth was measured using Shade Vision (X-Rite Inc., S.W. Grandville, MI, USA), Chroma Meter (Minolta Co., Ltd. Osaka, Japan) and Vitapan classical shade guide (Vita Zahnfabrik, Germany). The shade change of overall teeth in the experimental group was significantly greater than that in the control group (p < 0.05) and was easily perceivable. The change resulted from the increase of lightness (CIE L* value) and the decrease of redness (CIE a* value) and yellowness (CIE b* value). The shade change of individual tooth was greatest in canine, and smallest in central incisor. The safety of the bleaching strip was also confirmed.