A two-short-implant-supported molar restoration in atrophic posterior maxilla: A finite element analysis

PURPOSE: The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site. MATERIALS AND METHODS: Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex. RESULTS: The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration. CONCLUSION: 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla.

Fiber Reinforced Inlay Adhesion Bridge / 대한치과보철학회지

FRC/ceromer system provides the clinician with a durable, flexible, and esthetic alternative to conventional porcelain fused to metal crowns. FRC is the matrix which is silica-coated and embedded in a resin matrix. The ceromer material which is a second generation indirect composite resin contains silanized, microhybrid inorganic fillers embedded in a light-curing organic matrix. FRC/ceromer restoration has a several advantages: better shock absorption, less wear of occluding teeth, translucency, color stability, bonding ability to dental hard tissues, and resiliency. It has versatility of use including inlay, onlay, single crown, and esthetic veneers. With adhesive technique, it can be used for single tooth replacement in forms of inlay adhesion bridge. In single tooth missing case, conventional PFM bridge has been used for esthetic restoration. However, this restoration has several disadvantages such as high cost, potential framework distortion during fabrication, and difficulty in repairing fractures. Inlay adhesion bridge with FRC/ceromer would be a good alternative treatment plan. This article describes a cases restored with Targis/Vectris inlay adhesion bridge. Tooth preparation guide, fabrication procedure, and cementation procedure of this system will be dealt. The strength/weakness of this restoration will be mentioned, also. If it has been used appropriately in carefully selected case, it can satisfy not only dentist's demand of sparing dental hard tissue but also patient's desire of seeking a esthetic restorations with a natural appearance.

Marginal accuracy and fracture strength of Targis/Vectris Crowns prepared with different preparation designs / 대한치과보철학회지

STATEMENT OF PROBLEM: Targis/Vectris restorations provide excellent esthetics. Marginal accuracy is significantly influenced by the preparation design. There were no studies to examine the effect of preparation design on the marginal discrepancy and fracture strength of Targis/Vectris crowns. PURPOSE: This study evaluated the marginal accuracy before and after cementation, and the fracture strength of FRC/Ceromer(Targis/Vectris) crowns according to different preparation design. MATERIAL AND METHOD: Three metal dies with different convergence angles(6degrees, 10degrees, 15degrees) were prepared. Total 30 (10 for each angle) Targis/Vectris crowns were made. The restorations were evaluated for adaptation of the margin before and after cementation, then were compressively loaded to failure. Fracture surfaces of the crowns were examined using a SEM. Results. The mean marginal gap was 49micrometer for 6degrees, 55micrometer for 10degreesand 70micrometer for 15degreesand in clinically acceptable level. The mean marginal gap increased significantly after cementation. The increasing amount during cementation was the largest in the 6degrees group. The crowns on 6o convergence angle had a significantly higher fracture strength than the crowns on 15degrees angle. Mean fracture strength of total crowns regardless of convergence angle was 1390 N, which was higher than all-ceramic crowns. SEM observation showed two-mode fracture pattern. CONCLUSION: From the results of this study, all of the FRC/Ceromer crowns had clinically acceptable marginal accuracy and could withstand the bite force. Moreover, less convergent angle than all-ceramic crown might be recommended for preparation procedure.

CT demonstration of extrapleural pedunculated thymoma

A case of extrapleural pedunculated thymoma is presented and its CT features are described. A large ovoid extrapleural pedunculated thymoma in the right lower lung field clearly demonstrated a focal tapered pedicle at the level of inferior border of right main bronchus on CT scan, thus establishing the mediastinal origin of the mass in a 61-year-old man.