Evaluation of occlusal strength using T-Scan Novus and Dental prescale II in dental prosthodontic treatments: A case report / 대한치과보철학회지

Diagnosis and analysis of occlusal relationships are important factors in prosthetic treatment. A thorough occlusion analysis and evaluation should be performed before treatment to restore a stable interocclusal relationship. Analysis and evaluation are essential during the treatment process and at regular follow-ups. Recently, with the development of dental equipment and digital processing methods, new quantitative analysis methods that can record the patient’s occlusal relationship have been introduced. Among them, the T-Scan Novus (Tekscan Inc., S. Boston, MA, USA) displays the strength of the initial contact point and the occlusal contact point of the teeth using a pressure sensor. With this, occlusal contact time of the teeth, anteroposterior and left-right balance of occlusal force can be compared. The Dental prescale II (GC Co., Tokyo, Japan) scans the occlusal contact point using a pressure-sensing film and analyzes the density of the contact point.It can measure the distribution and strength of the occlusal force of the teeth in the most natural occlusion state. Based on this, appropriate prosthetic treatment (four-unit fixed partial denture, removable partial denture, complete denture, and complete oral restoration cases) was performed according to the area and extent of the patient’s tooth loss. The patient’s occlusion at the first visit, treatment stage, right after treatment, and regular follow-up were compared and evaluated using a quantitative method for appropriate occlusion analysis using T-Scan Novus and Dental prescale II. This report enhances the understanding of occlusion analysis during prosthetic restoration. The results satisfied both the clinician and patients in terms of function and aesthetics.

Using dental virtual patients with dynamic occlusion in esthetic restoration of anterior teeth: case reports / 대한치과보철학회지

Recently, a method of fabricating an esthetic anterior fixed prosthesis by integrating data such as three-dimensional facial scan and jaw motion to form a virtual patient with dynamic occlusion has been introduced. This enables smooth communication with patients during the diagnosis process, improves the predictability of esthetic prosthetic treatment, and lowers the possibility of occlusal adjustment. In this case report, a virtual patient with dynamic occlusion was created in which the results of the treatment were simulated, and esthetic maxillary anterior fixed prosthesis was fabricated. With the aid of the virtual patient, the final restorations were satisfactory both in terms of esthetic and function.

Comparison of internal and marginal fit of crown according to milling order in a single machinable wax disc / 대한치과보철학회지

Purpose@#The purpose of present study was to evaluate the effect of changing structural stability of wax disc on the fit of prosthesis when the milling proceeded in order. @*Materials and methods@#Prepared maxillary left first molar was used to fabricate a Ni-Cr alloy reference model. This was scanned to design crown and then wax pattern was milled, invested and cast to fabricate prosthesis. The wax patterns located in a row centrally within a single wax disc were set into a total of five groups ranging from WM1 group that was first milled to WM5 group that was last milled and the number of each group was set as 10. Silicone replica technique was used to measure the marginal gap, axial internal gap, line angle internal gap, occlusal internal gap. Data was evaluated with one-way ANOVA with significance level set at α = .05 and then Tukey HSD test was conducted for post analysis. @*Results@#Marginal gap measured in each group, it was 40.41 ± 2.15 µm in WM1group, 40.44 ± 2.23 µm in WM2 group, 39.96 ± 2.25 µm in WM3 group, 39.96 ± 2.48 µm in WM4 group, and 40.57 ± 2.53 µm in WM5 group. No significant difference was found between groups. The significant difference between the groups was also not found in the axial internal gap, line angle internal gap, and occlusal internal gap. @*Conclusion@#Internal and marginal fit of single crown to the sequential order of milling processing in the single machinable wax disc did not seem to be affected by the sequence.

Full mouth rehabilitation using transfer coping pick up impression in a patient with severe bleeding: A case report / 대한치과보철학회지

In the case of excessively worn dentition, there is often insufficient space for the prosthesis, and if physiologically acceptable, the prosthesis can be fabricated by increasing the vertical dimension of occlusion. Various methods have been introduced to determine the vertical dimension of occlusion. Clinicians have to choose a method that can comfort the patient among several methods. A removable appliance can be used as a reversible method to ensure that the determined vertical dimension of occlusion does not cause physiological problems. When making impressions of many teeth, it is often difficult to make accurate impressions at once. In this case, after making an accurate impression of the individual teeth, a transfer coping was made and a pickup impression was taken in the oral cavity to create a master cast. In this case, a fixed partial denture was fabricated and full mouth rehabilitation was performed by increasing the vertical dimension of occlusion in a patient with excessively worn dentition and lack of space for restoration. As a result of follow-up of the patient for 7 years, satisfactory results were obtained both esthetically and functionally.

Implant-supported fixed prostheses with high-performance polymer (PEKK) abutments in partial edentulous patients:A case report / 대한치과보철학회지

Implant treatment, which was first attempted in fully edentulous patients, is now widely used in partially edentulous, and a single tooth missing patients. Moreover, implant treatment has become an essential treatment modality in modern dentistry. The material of fabricating implant prostheses has also become more diverse than before, one of which is the use of high-performance polymers. The frequency of using high-performance polymers, which have been used in the medical field, is also increased in the dental field compared to the past. In the first case, a PEKK abutment and a PFG crown (cement-screw-retaining type) were fabricated in the lower left second premolar, and in the second case, a PEKK abutment and a monolithic zirconia crown (cement-screw-retaining type) were fabricated in the missing upper left first molar, and in the third case two PEKK abutments and a splinted PFM crowns (cement-screw-retaining type) were fabricated and connected to the upper right first and second molar implants. Through these procedures the patients obtained esthetically and functionally satisfactory results after 4 years of follow-up.

Clinical performance of esthetic ceramic partial-coverage restorations with supra-gingival margin using minimally invasive tooth preparation method according to the concept of adhesive dentistry / 대한치과보철학회지

With the rapid development of aesthetic ceramic materials and resin adhesives, the transition from metal ceramic crown to all-ceramic restoration is being actively carried out. When making porcelain restorations, the advantages can be maximized only when appropriate forms and techniques are used. Recently, an esthetic partial-coverage restoration method with supra-gingival margins was introduced by applying a minimally invasive tooth removal method that preserves enamel as much as possible and enhances adhesion efficiency. Through this, various advantages such as minimization of tooth structure removal and ease of excess cement removal can be obtained. In addition, since this manufacturing method does not require cord packing, it is possible to save time for impression taking and reduce patient discomfort. Furthermore, the margins can be clearly obtained without the intervention of gingival fluid or blood, making it possible to manufacture more accurate restorations. In the following cases of patients with partial tooth defects, esthetic ceramic partial-coverage restorations with supra-gingival margin was applied using minimally invasive tooth preparation method according to the concept of adhesive dentistry. Therefore, unnecessary tooth abutment preparation was prevented and residual tooth structure could be preserved as much as possible. After delivery of the ceramic partial-coverage restorations, favorable outcome was obtained.

A case report of single crown restoration using an intraoral scanner for occlusal evaluation / 대한치과보철학회지

The evaluation of occlusion using digital methods is easier and simpler in terms of recording, comparison, analysis, and objectivity compared to existing methods such as articulating paper and occlusion foil. The purpose of this case report was utilizing the digital method for evaluating occlusion. The occlusion of patient requiring full veneer crown restoration was evaluated using an intraoral scanner (i500, Medit, Seoul, Korea) at every visit. The occlusion was also assessed using conventional articulating paper and a digital occlusal analysis system (Dental prescale II, GC corp., Tokyo, Japan) for comparison. Throughout the treatment process, the intraoral scanner and the conventional articulating paper method showed similar outcomes. The results suggest that the use of digital evaluation system is highly probable in the near future.

Clinical performance of esthetic ceramic partial-coverage restorations with supra-gingival margin using minimally invasive tooth preparation method according to the concept of adhesive dentistry / 대한치과보철학회지

With the rapid development of aesthetic ceramic materials and resin adhesives, the transition from metal ceramic crown to all-ceramic restoration is being actively carried out. When making porcelain restorations, the advantages can be maximized only when appropriate forms and techniques are used. Recently, an esthetic partial-coverage restoration method with supra-gingival margins was introduced by applying a minimally invasive tooth removal method that preserves enamel as much as possible and enhances adhesion efficiency. Through this, various advantages such as minimization of tooth structure removal and ease of excess cement removal can be obtained. In addition, since this manufacturing method does not require cord packing, it is possible to save time for impression taking and reduce patient discomfort. Furthermore, the margins can be clearly obtained without the intervention of gingival fluid or blood, making it possible to manufacture more accurate restorations. In the following cases of patients with partial tooth defects, esthetic ceramic partial-coverage restorations with supra-gingival margin was applied using minimally invasive tooth preparation method according to the concept of adhesive dentistry. Therefore, unnecessary tooth abutment preparation was prevented and residual tooth structure could be preserved as much as possible. After delivery of the ceramic partial-coverage restorations, favorable outcome was obtained.

A case report of single crown restoration using an intraoral scanner for occlusal evaluation / 대한치과보철학회지

The evaluation of occlusion using digital methods is easier and simpler in terms of recording, comparison, analysis, and objectivity compared to existing methods such as articulating paper and occlusion foil. The purpose of this case report was utilizing the digital method for evaluating occlusion. The occlusion of patient requiring full veneer crown restoration was evaluated using an intraoral scanner (i500, Medit, Seoul, Korea) at every visit. The occlusion was also assessed using conventional articulating paper and a digital occlusal analysis system (Dental prescale II, GC corp., Tokyo, Japan) for comparison. Throughout the treatment process, the intraoral scanner and the conventional articulating paper method showed similar outcomes. The results suggest that the use of digital evaluation system is highly probable in the near future.

A pilot study using machine learning methods about factors influencing prognosis of dental implants

PURPOSE: This study tried to find the most significant factors predicting implant prognosis using machine learning methods. MATERIALS AND METHODS: The data used in this study was based on a systematic search of chart files at Seoul National University Bundang Hospital for one year. In this period, oral and maxillofacial surgeons inserted 667 implants in 198 patients after consultation with a prosthodontist. The traditional statistical methods were inappropriate in this study, which analyzed the data of a small sample size to find a factor affecting the prognosis. The machine learning methods were used in this study, since these methods have analyzing power for a small sample size and are able to find a new factor that has been unknown to have an effect on the result. A decision tree model and a support vector machine were used for the analysis. RESULTS: The results identified mesio-distal position of the inserted implant as the most significant factor determining its prognosis. Both of the machine learning methods, the decision tree model and support vector machine, yielded the similar results. CONCLUSION: Dental clinicians should be careful in locating implants in the patient's mouths, especially mesio-distally, to minimize the negative complications against implant survival.

Implant-retained overdentures with pre-fabricated bar attachment system in edentulous patients / 대한치과보철학회지

Edentulous patients with severe alveolar bone resorption have trouble with using traditional complete denture. In order to overcome these problems, implant-retained overdenture was developed. SFI-bar(R) system can save time and cost compared to other existing bar systems which need complicated laboratory procedures because it can be adjusted directly in a patient's mouth. A 55-year-old male, who had experienced a fractured lower old implant-retained overdenture, wanted a durable and painless denture. The fractured Locator(R) attachments were removed and edentulous mandible was restored with SFI-bar(R). A 77-year-old female with a medical history of the Parkinson's disease and severely absorbed alveolar bone of mandible, wanted to wear a retentive mandibular denture without pain. After placing two implants in front of mental foramen, two adaptors were connected to two implants and a tube bar was connected to the adaptors. A female part fitted to the bar was attached to the new denture. These clinical reports describe two-implant-retained overdenture using the SFI-bar(R) system in mandibular edentulous patients. Since the patients were satisfied esthetically and functionally during 2 years' observation, we would like to report cases.

Prosthetic reconstruction with an obturator using swing-lock attachment for a patient underwent maxillectomy: A clinical report

Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth.

Effect of the amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics

PURPOSE: This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics. MATERIALS AND METHODS: One-hundred sixty-five monolithic zirconia specimens (16.3 mm x 16.3 mm x 2.0 mm) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (DeltaE*(ab)) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffe test (alpha=.05). RESULTS: There were significant differences in CIE L* between Subgroup 0 and other subgroups in all groups. CIE a* increased (0.523.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups (R2>0.89, P<.001). CONCLUSION: Increasing thickness reduction reduces lightness and increases a reddish, bluish appearance, and translucency of monolithic zirconia ceramics.

Biomechanical three-dimensional finite element analysis of monolithic zirconia crown with different cement type

PURPOSE: The objective of this study was to evaluate the influence of various cement types on the stress distribution in monolithic zirconia crowns under maximum bite force using the finite element analysis. MATERIALS AND METHODS: The models of the prepared #46 crown (deep chamfer margin) were scanned and solid models composed of the monolithic zirconia crown, cement layer, and prepared tooth were produced using the computer-aided design technology and were subsequently translated into 3-dimensional finite element models. Four models were prepared according to different cement types (zinc phosphate, polycarboxylate, glass ionomer, and resin). A load of 700 N was applied vertically on the crowns (8 loading points). Maximum principal stress was determined. RESULTS: Zinc phosphate cement had a greater stress concentration in the cement layer, while polycarboxylate cement had a greater stress concentration on the distal surface of the monolithic zirconia crown and abutment tooth. Resin cement and glass ionomer cement showed similar patterns, but resin cement showed a lower stress distribution on the lingual and mesial surface of the cement layer. CONCLUSION: The test results indicate that the use of different luting agents that have various elastic moduli has an impact on the stress distribution of the monolithic zirconia crowns, cement layers, and abutment tooth. Resin cement is recommended for the luting agent of the monolithic zirconia crowns.

Effect of working time on the film thickness of dental resin cements / 대한치과보철학회지

PURPOSE: The aim of this study was to compare the film thicknesses of several resin cements as a function of time after mixing and to examine the effect of working time on the film thicknesses. MATERIALS AND METHODS: The film thickness (microm) of 4 resin cements (n=10), 1 composite resin (Panavia F 2.0), 3 self-adhesive resin (Clearfil SA luting, Zirconite, RelyX U200) cements was measured at 20-second intervals after mixing of the cements up to 200 seconds under a load of 50 N. Linear regression was fitted to verify the effect of working time on the film thickness of each cement. Data were compared to the working time recommended by manufacturers using Wilcoxon test (alpha=.05). RESULTS: All of the materials showed a positive linear correlation between the film thickness and working time. There was no statistically significant difference between the working time based on our results and the values recommended by the manufacturers even though there was a discrepancy between those two values. CONCLUSION: The film thickness of resin cements could increase with the increase of working time. Working time to meet the ISO standard of 50-microm maximum film thickness could be different from the manufacturer's recommended value.

Effect of water storage on the fracture toughness of dental resin cement used for zirconia restoration / 대한치과보철학회지

PURPOSE: The aim of this study was to compare the fracture toughness of currently available resin cements for zirconia restorations and evaluate the effect of water storage on fracture toughness of those resin cements. MATERIALS AND METHODS: Single-edge notched specimens (3 mm x 6 mm x 25 mm) were prepared from three currently available dual cure resin cements for zirconia restorations (Panavia F 2.0, Clearfil SA luting and Zirconite). Each resin cement was divided into four groups: immersed in distilled water at 37degrees C for 1 (Control group), 30, 90, or 180 days (n=5). Specimens were loaded in three point bending at a cross-head speed of 0.1 mm/s. The maximum load at specimen failure was recorded and the fracture toughness (K(IC)) was calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffe test (alpha=.05). RESULTS: In control group, the mean KIC was 3.41 +/- 0.64 MN.m(-1.5) for Panavia F, 2.0, 3.07 +/- 0.41 MN.m(-1.5) for Zirconite, 2.58 +/- 0.30 MN.m(-1.5) for Clearfil SA luting respectively, but statistical analysis revealed no significant difference between them. Although a gradual decrease of K(IC) in Panavia F 2.0 and gradual increases of KIC in Clearfil SA luting and Zirconite were observed with storage time, there were no significant differences between immersion time for each cement. CONCLUSION: The resin cements for zirconia restorations exhibit much higher K(IC) values than conventional resin cements. The fracture toughness of resin cement for zirconia restoration would not be affected by water storage.

Full-mouth rehabilitation with CAD/CAM monolithic zirconia in dentinogenesis imperfecta: a case report / 대한치과보철학회지

Dentinogenesis Imperfecta, with a high incidence rate of 1 : 6 - 8000, is inherited by autosomal dominant genetic transmission. This dental disorder causes discoloration of the teeth and the enamel and dentin show hypoplastic or hypocalcified defects which lead to frequent fractures and rapid attrition. Therefore, timely treatment is necessary for the preservation of the remaining teeth. In this particular case, a 19-year-old patient suffering from Type 1 dentinogenesis imperfecta showed signs of brownish hued teeth with multiple fractures, a loss of vertical dimension, excessive interdental space in the maxillary anterior teeth, and a lack of 5 posterior teeth. To improve the esthetic appearance of the anterior teeth, the vertical dimension was increased. Resin caps were used to alleviate the difficulty of taking an impression of multiple teeth at once. Monolithic zirconia materials used in this case showed high fracture strength and the ability to mask the discoloration of the teeth and therefore, functionally and esthetically favorable results were achieved.

Effects of immediate and delayed light activation on the polymerization shrinkage-strain of dual-cure resin cements / 대한치과보철학회지

PURPOSE: This study was designed to compare the amount of polymerization shrinkage of dual-cure resin cements according to different polymerization modes and to determine the effect of light activation on the degree of polymerization. MATERIALS AND METHODS: Four kinds of dual-cure resin cements were investigated: Smartcem 2, Panavia F 2.0, Clearfil SA Luting and Zirconite. Each material was tested in three different polymerization modes: self-polymerization only, immediate light polymerization and 5 minutes-delayed light polymerization. The time-dependent polymerization shrinkage-strain was evaluated for 30 minutes by Bonded-disk method at 37degrees C. Five recordings of each material with three different modes were taken. Data were analyzed using one-way ANOVA and multiple comparison Scheffe'test (alpha=.05). RESULTS: All materials, except Panavia F 2.0, exhibited the highest polymerization shrinkage-strain through delayed light-activated polymerization. No significant difference between light activation modes was found with Panavia F 2.0. All materials exhibited more than 90% of polymerization rate in the immediate or delayed light activated group within 10 minutes. CONCLUSION: As a clinical implication of this study, the application of delayed light activation mode to dual-cure resin cements is advantageous in terms of degree of polymerization.

Rheological properties of dental resin cements during polymerization / 대한치과보철학회지

PURPOSE: The purpose of this study was to observe the change of viscoelastic properties of dental resin cements during polymerization. MATERIALS AND METHODS: Six commercially available resin cement materials (Clearfil SA luting, Panavia F 2.0, Zirconite, Variolink N, RelyX Unicem clicker, RelyX U200) were investigated in this study. A dynamic oscillation-time sweep test was performed with AR1500 stress controlled rheometer at 32degrees C. The changes in shear storage modulus (G'), shear loss modulus (G"), loss tangent (tan delta) and displacement were measured for twenty minutes and repeated three times for each material. The data were analyzed using one-way ANOVA and Tukey's post hoc test (alpha=0.05). RESULTS: After mixing, all materials demonstrated an increase in G' with time, reaching the plateau in the end. RelyX U200 demonstrated the highest G' value, while RelyX Unicem (clicker type) and Variolink N demonstrated the lowest G' value at the end of experimental time. Tan delta was maintained at some level and reached the zero at the starting point where G' began to increase. The tan delta and displacement of the tested materials showed similar pattern in the graph within change of time. The displacement of all 6 materials approached to zero within 6 minutes. CONCLUSION: Compared to other resin cements used in this study, RelyX U200 maintained plastic property for a longer period of time. When it completed the curing process, RelyX U200 had the highest stiffness. It is convenient for clinicians to cement multiple units of dental prostheses simultaneously.

The influence of various core designs on stress distribution in the veneered zirconia crown: a finite element analysis study

PURPOSE: The purpose of this study was to evaluate various core designs on stress distribution within zirconia crowns. MATERIALS AND METHODS: Three-dimensional finite element models, representing mandibular molars, comprising a prepared tooth, cement layer, zirconia core, and veneer porcelain were designed by computer software. The shoulder (1 mm in width) variations in core were incremental increases of 1 mm, 2 mm and 3 mm in proximal and lingual height, and buccal height respectively. To simulate masticatory force, loads of 280 N were applied from three directions (vertical, at a 45degrees angle, and horizontal). To simulate maximum bite force, a load of 700 N was applied vertically to the crowns. Maximum principal stress (MPS) was determined for each model, loading condition, and position. RESULTS: In the maximum bite force simulation test, the MPSs on all crowns observed around the shoulder region and loading points. The compressive stresses were located in the shoulder region of the veneer-zirconia interface and at the occlusal region. In the test simulating masticatory force, the MPS was concentrated around the loading points, and the compressive stresses were located at the 3 mm height lingual shoulder region, when the load was applied horizontally. MPS increased in the shoulder region as the shoulder height increased. CONCLUSION: This study suggested that reinforced shoulder play an essential role in the success of the zirconia restoration, and veneer fracture due to occlusal loading can be prevented by proper core design, such as shoulder.