PURPOSE. Maxillofacial silicone elastomer is usually colored intrinsically with color pigments to match skin colors. The purpose of this study was to investigate the color stability of a maxillofacial silicone elastomer, colored with a thermochromic, color changing pigment. MATERIALS AND METHODS. Disc-shaped maxillofacial silicone specimens were prepared and divided into 3 groups: a conventionally colored control group, one group additionally colored with 0.2 wt% thermochromic pigment, and one group with 0.6 wt% thermochromic pigment. Half of the surface of each specimen was covered with an aluminium foil. All of the specimens were exposed to UV radiation in 6 hour cycles over 46 days. In between the UV exposures, half of the specimens were stored in darkness, at room temperature, and the other half was stored in an incubator, at a humidity of 97% and a temperature of $+37^{\circ}C$. Color measurements were made with a spectrophotometer and registered according to the CIELAB $L^*a^*b^*$ color model system. The changes in $L^*$, $a^*$ and $b^*$ values during artificial aging were statistically analyzed by using paired samples t-test and repeated measures ANOVA. P-values <.05 were considered as statistically significant. RESULTS. The UV exposure resulted in visually noticeable and statistically significant color changes in the $L^*$, $a^*$ and $b^*$ values in both of the test groups containing thermochromic pigment. Storage in the incubator lead to statistically significant color changes in the $a^*$ and $b^*$ values of the specimens containing thermochromic pigment, compared to those stored at room temperature. CONCLUSION. The specimens containing thermochromic pigment were very sensitive to UV radiation, and the thermochromic pigment is not suitable, as such, to be used in maxillofacial prostheses.

PURPOSE. The aim of this study was to evaluate the stability of arginine-glycine-aspartic acid (RGD) peptide coatings on implants by measuring the amount of peptide remaining after installation. MATERIALS AND METHODS. Fluorescent isothiocyanate (FITC)-fixed RGD peptide was coated onto anodized titanium implants (width 4 mm, length 10 mm) using a physical adsorption method (P) or a chemical grafting method (C). Solid Rigid Polyurethane Foam (SRPF) was classified as either hard bone (H) or soft bone (S) according to its density. Two pieces of artificial bone were fixed in a customized jig, and coated implants were installed at the center of the boundary between two pieces of artificial bone. The test groups were classified as: P-H, P-S, C-H, or C-S. After each installation, implants were removed from the SRPF, and the residual amounts and rates of RGD peptide in implants were measured by fluorescence spectrometry. The Kruskal-Wallis test was used for the statistical analysis (${\alpha}$=0.05). RESULTS. Peptide-coating was identified by fluorescence microscopy and XPS. Total coating amount was higher for physical adsorption than chemical grafting. The residual rate of peptide was significantly larger in the P-S group than in the other three groups (P<.05). CONCLUSION. The result of this study suggests that coating doses depend on coating method. Residual amounts of RGD peptide were greater for the physical adsorption method than the chemical grafting method.

PURPOSE. All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. MATERIALS AND METHODS. Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. RESULTS. The mean fracture strengths were as follows: $54.9{\pm}15.6$ N for the Lava CAD/CAM zirconia crowns and $87.0{\pm}16.0$ N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. CONCLUSION. The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain.

PURPOSE. To evaluate the effects of hydrofluoric acid etching and Er,Cr:YSGG laser irradiation on the shear bond strength of resin cement to lithium disilicate ceramic. MATERIALS AND METHODS. Fifty-five ceramic blocks ($5mm{\times}5mm{\times}2mm$) were fabricated and embedded in acrylic resin. Their surfaces were finished with 1000-grit silicon carbide paper. The blocks were assigned to five groups: 1) 9.5% hydrofluoric-acid etching for 60 s; 2-4), 1.5-, 2.5-, and 6-W Er,Cr:YSGG laser applications for 60 seconds, respectively; and 5) no treatment (control). One specimen from each group was examined using scanning electron microscopy. Ceramic primer (Rely X ceramic primer) and adhesive (Adper Single Bond) were applied to the ceramic surfaces, followed by resin cement to bond the composite cylinders, and light curing. Bonded specimens were stored in distilled water at $37^{\circ}C$ for 24 hours. Shear bond strengths were determined by a universal testing machine at 1 mm/min crosshead speed. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests (${\alpha}$=0.05). RESULTS. Adhesion was significantly stronger in Group 2 ($3.88{\pm}1.94$ MPa) and Group 3 ($3.65{\pm}1.87$ MPa) than in Control group ($1.95{\pm}1.06$ MPa), in which bonding values were lowest (P<.01). No significant difference was observed between Group 4 ($3.59{\pm}1.19$ MPa) and Control group. Shear bond strength was highest in Group 1 ($8.42{\pm}1.86$ MPa; P<.01). CONCLUSION. Er,Cr:YSGG laser irradiation at 1.5 and 2.5 W increased shear bond strengths between ceramic and resin cement compared with untreated ceramic surfaces. Irradiation at 6 W may not be an efficient ceramic surface treatment technique.

PURPOSE. Among the surface treatment methods suggested to enhance the adhesion of resin cement to fiberreinforced composite posts, conflicting results have been obtained with silanization. In this study, the effects of silanization, heat activation after silanization, on the bond strength between fiber-reinforced composite post and resin cement were determined. MATERIALS AND METHODS. Six groups (n=7) were established to evaluate two types of fiber post (FRC Postec Plus, D.T. Light Post) and three surface treatments (no treatment; air drying; drying at $38^{\circ}C$). Every specimen were bonded with dual-curing resin cement (Variolink N) and stored in distilled water for 24 hours at $37^{\circ}C$. Shear-bond strength (MPa) between the fiber post and the resin cement were measured using universal testing device. The data were analyzed with 1-way ANOVA and by multiple comparisons according to Tukey's HSD (${\alpha}$=0.05). The effect of surface treatment, fiber post type, and the interactions between these two factors were analyzed using 2-way ANOVA and independent sample T-tests. RESULTS. Silanization of the FRC Postec Plus significantly increased bond strength compared with the respective non-treated control, whereas no effect was determined for the D.T. Light Post. Heat drying the silane coupling agent on to the fiberreinforced post did not significantly improve bond strength compared to air-syringe drying. CONCLUSION. The bond strength between the fiber-reinforced post and the resin cement was significantly increased with silanization in regards to the FRC Postec Plus post. Bond strength was not significantly improved by heat activation of the silane coupling agent.

PURPOSE. Polymethyl methacrylate (PMMA) is the most commonly used denture base material despite typically low in strength. The purpose of this study was to improve the physical properties of the PMMA based denture base resins (QC-20, Dentsply Ltd., Addlestone, UK; Stellon, AD International Ltd, Dentsply, Switzerland; Acron MC; GC Lab Technologies Inc., Alsip, Japan) by copolymerization mechanism. MATERIALS AND METHODS. Control group specimens were prepared according to the manufacturer recommendations. In the copolymer groups; resins were prepared with 5%, 10%, 15% and 20% acrylamide (AAm) (Merck, Hohenbrunn, Germany) content according to the moleculer weight ratio, respectively. Chemical structure was characterized by a Bruker Vertex-70 Fourier transform infrared spectroscopy (FTIR) (Bruker Optics Inc., Ettlingen, Germany). Hardness was determined using an universal hardness tester (Struers Duramin, Struers A/S, Ballerup, Denmark) equipped with a Vickers diamond penetrator. The glass transition temperature ($T_g$) of control and copolymers were evaluated by Perkin Elmer Diamond DSC (Perkin Elmer, Massachusetts,USA). Statistical analyses were carried out using the statistical package SPSS for Windows, version 15.0 (SPSS, Chicago, IL, USA). The results were tested regarding the normality of distribution with the Shapiro Wilk test. Data were analyzed using ANOVA with post-hoc Tukey test (P<.01). RESULTS. The copolymer synthesis was confirmed by FTIR spectroscopy. Glass transition temperature of the copolymer groups were higher than the control groups of the resins. The 10%, 15% and 20% copolymer groups of Stellon presented significantly higher than the control group in terms of hardness. 15% and 20% copolymer groups of Acron MC showed significantly higher hardness values when compared to the control group of the resin. Acrylamide addition did not affect the hardness of the QC-20 resin significantly. CONCLUSION. Within the limitation of this study, it can be concluded that copolymerization of PMMA with AAm increased the hardness value and glass transition temperature of PMMA denture base resins.

PURPOSE. The purpose of this study was to evaluate the effect of the span length on the fit of zirconia framework fabricated using CAD/CAM system. MATERIALS AND METHODS. Abutments for single, 4-unit and 6-unit fixed partial prostheses were fabricated. Ten zirconia frameworks were fabricated for each group. The marginal and internal gap were presented by means of replica technique and measured by measuring microscope ($AXIO^{(R)}$, Carl Zeiss, Rochester, NY) and software (I-$solution^{(R)}$, IMT i-solution Inc., Vancouver, BC, Canada). The results were statistically analyzed by multivariate analysis test and Dunnett T3 test for post hoc test (${\alpha}$=.05). RESULTS. There were statistically significant differences at 2, 4, 7, 8 points (mesio-distal section) and b, d, e, f, g (labio-lingual section). In some marginal reference points of 6-unit group (P<.05), the marginal gap were larger than 120 ${\mu}m$. CONCLUSION. Span length of zirconia core may have an influence on marginal and internal fit. Within the limitation of this study, the increase of span length of zirconia framework of 6 or more-unit fixed partial denture may decrease the marginal and internal fit.

PURPOSE. Post surface conditioning is necessary to expose the glass fibers to enable bonding between fiber post and resin cement. The purpose of the present study was to evaluate the effect of different surface conditioning on tensile bond strength (TBS) of a glass fiber reinforced post to resin cement. MATERIALS AND METHODS. In this in vitro study, 40 extracted single canal central incisors were endodontically treated and post spaces were prepared. The teeth were divided into four groups according to the methods of post surface treatment (n=10): 1) Silanization after etching with 20% $H_2O_2$, 2) Silanization after airborne-particle abrasion, 3) Silanization, and 4) No conditioning (Control). Adhesive resin cement (Panavia F 2.0) was used for cementation of the fiber posts to the root canal dentin. Three slices of 3 mm thick were obtained from each root. A universal testing machine was used with a cross-head speed of 1 mm/minute for performing the push-out tests. Two-way ANOVA and Tukey post hoc tests were used for analyzing data (${\alpha}$=0.05). RESULTS. It is revealed that different surface treatments and root dentin regions had significant effects on TBS, but the interaction between surface treatments and root canal regions had no significant effect on TBS. There was significant difference among $H_2O_2$ + Silane Group and other three groups. CONCLUSION. There were significant differences among the mean TBS values of different surface treatments. Application of hydrogen peroxide before silanization increased the bond strength between resin cements and fiber posts. The mean TBS mean values was significantly greater in the coronal region of root canal than the middle and apical thirds.

PURPOSE. This study was to evaluate the effect of the solution temperature on the mechanical properties of dualcure resin cements. MATERIALS AND METHODS. For the study, five dual-cure resin cements were chosen and light cured. To evaluate the effect of temperature on the specimens, the light-cured specimens were immersed in deionized water at three different temperatures (4, 37 and $60^{\circ}C$) for 7 days. The control specimens were aged in a $37^{\circ}C$ dry and dark chamber for 24 hours. The mechanical properties of the light-cured specimens were evaluated using the Vickers hardness test, three-point bending test, and compression test, respectively. Both flexural and compressive properties were evaluated using a universal testing machine. The data were analyzed using a two way ANOVA with Tukey test to perform multiple comparisons (${\alpha}$=0.05). RESULTS. After immersion, the specimens showed significantly different microhardness, flexural, and compressive properties compared to the control case regardless of solution temperatures. Depending on the resin brand, the microhardness difference between the top and bottom surfaces ranged approximately 3.3-12.2%. Among the specimens, BisCem and Calibra showed the highest and lowest decrease of flexural strength, respectively. Also, Calibra and Multilink Automix showed the highest and lowest decrease of compressive strength, respectively compared to the control case. CONCLUSION. The examined dual-cure resin cements had compatible flexural and compressive properties with most methacrylate-based composite resins and the underlying dentin regardless of solution temperature. However, the effect of the solution temperature on the mechanical properties was not consistent and depended more on the resin brand.

PURPOSE. The aim of this study was to investigate the destructive effects of biofilm formation and/or biocorrosive activity of 6 different oral microorganisms. MATERIALS AND METHODS. Three different heat polymerized acrylic resins (Ivocap Plus, Lucitone 550, QC 20) were used to prepare three different types of samples. Type "A" samples with "V" type notch was used to measure the fracture strength, "B" type to evaluate the surfaces with scanning electron microscopy and "C" type for quantitative biofilm assay. Development and calculation of biofilm covered surfaces on denture base materials were accomplished by SEM and quantitative biofilm assay. According to normality assumptions ANOVA or Kruskal-Wallis was selected for statistical analysis (${\alpha}$=0.05). RESULTS. Significant differences were obtained among the adhesion potential of 6 different microorganisms and there were significant differences among their adhesion onto 3 different denture base materials. Compared to the control groups after contamination with the microorganisms, the three point bending test values of denture base materials decreased significantly (P<.05); microorganisms diffused at least 52% of the denture base surface. The highest median quantitative biofilm value within all the denture base materials was obtained with P. aeruginosa on Lucitone 550. The type of denture base material did not alter the diffusion potential of the microorganisms significantly (P>.05). CONCLUSION. All the tested microorganisms had destructive effect over the structure and composition of the denture base materials.

PURPOSE. A survey was performed to identify the level of mouthguard use, awareness, wearability issues and attitude toward mouthguard among elite Korean Taewondo athletes. MATERIALS AND METHODS. Survey questionnaires were given to 152 athletes participating in the Korea National Taekwondo team selection event for the 2010 Guangzhou Asian Games. Questionnaires consisted of three sections, mouthguard awareness, reasons for not wearing mouthguard and the last section to test the level of acceptance on current mouthguard and when the identified problems were resolved. For analyzing difference among response, ${\chi}^2$ test was used and significant level (${\alpha}$) was set up as 0.05. RESULTS. Responses in each of items showed significant difference (P<.001). Majority of response regarding each question: Majority of respondents believed that mouthguard were effective in preventing injuries (36.4%) but the result suggested that the provision of information on mouthguard to athletes was inadequate (44.0%) and the result showed that respondents were not greatly interested or concerned in relation to the mandatory mouthguard rule (31.6%). Although the responses on the level of comfort and wearability of mouthguard were negative (34.8%), athletes were positively willing to wear mouthguard if the problems rectified (51.2%). CONCLUSION. Considering the high level of willingness to wear mouthguard if the problems rectified, it is thought that together with efforts in providing more mouthguard information, the work of sports dentistry to research and improve mouthguard will be invaluable in promoting mouthguard to more athletes.

PURPOSE. This in vitro study intended to investigate the mechanical and thermal characteristics of Valplast, and of polymethyl methacrylate denture base resin in which different esthetic fibers (E-glass, nylon 6 or nylon 6.6) were added. MATERIALS AND METHODS. Five groups were formed: control (PMMA), PMMA-E glass, PMMA-nylon 6, PMMA-nylon 6.6 and Valplast resin. For the transverse strength test the specimens were prepared in accordance with ANSI/ADA specification No.12, and for the impact test ASTM D-256 standard were used. With the intent to evaluate the properties of transverse strength, the three-point bending (n=7) test instrument (Lloyd NK5, Lloyd Instruments Ltd, Fareham Hampshire, UK) was used at 5 mm/min. A Dynatup 9250 HV (Instron, UK) device was employed for the impact strength (n=7). All of the resin samples were tested by using thermo-mechanical analysis (Shimadzu TMA 50, Shimadzu, Japan). The data were analyzed by Kruskal-Wallis and Tukey tests for pairwise comparisons of the groups at the 0.05 level of significance. RESULTS. In all mechanical tests, the highest values were observed in Valplast group (transverse strength: $117.22{\pm}37.80$ MPa, maximum deflection: $27.55{\pm}1.48$ mm, impact strength: $0.76{\pm}0.03$ kN). Upon examining the thermo-mechanical analysis data, it was seen that the E value of the control sample was 8.08 MPa, higher than that of the all other samples. CONCLUSION. Although Valplast denture material has good mechanical strength, its elastic modulus is not high enough to meet the standard of PMMA materials.

PURPOSE. This study aimed to identify the effects of the sintering conditions of dental zirconia on the grain size and translucency. MATERIALS AND METHODS. Ten specimens of each of two commercial brands of zirconia (Lava and KaVo) were made and sintered under five different conditions. Microwave sintering (MS) and conventional sintering (CS) methods were used to fabricate zirconia specimens. The dwelling time was 20 minutes for MS and 20 minutes, 2, 10, and 40 hours for CS. The density and the grain size of the sintered zirconia blocks were measured. Total transmission measurements were taken using a spectrophotometer. Two-way analysis of variance model was used for the analysis and performed at a type-one error rate of 0.05. RESULTS. There was no significant difference in density between brands and sintering conditions. The mean grain size increased according to sintering conditions as follows: MS-20 min, CS-20 min, CS-2 hr, CS-10 hr, and CS-40 hr for both brands. The mean grain size ranged from 347-1,512 nm for Lava and 373-1,481 nm for KaVo. The mean light transmittance values of Lava and KaVo were 28.39-34.48% and 28.09-30.50%, respectively. CONCLUSION. Different sintering conditions resulted in differences in grain size and light transmittance. To obtain more translucent dental zirconia restorations, shorter sintering times should be considered.

PURPOSE. The purpose of this case series was to evaluate the effect of guided bone regeneration using demineralized allogenic bone matrix with calcium sulfate. MATERIALS AND METHODS. Guided bone regeneration using Demineralized Allogenic Bone Matrix with Calcium Sulfate ($AlloMatrix^{TM}$, Wright. USA) was performed at the time of implant placement from February 2010 to April 2010. At the time of the second surgery, clinical evaluation of bone healing and histologic evaluation were performed. The study included 10 patients, and 23 implants were placed. The extent of bony defects around implants was determined by measuring the horizontal and vertical bone defects using a periodontal probe from the mesial, distal, buccal, and lingual sides and calculating the mean and standard deviation of these measurements. Wedge-shaped tissue samples were obtained from 3 patients and histologic examination was performed. RESULTS. In clinical evaluation, it was observed that horizontal bone defects were completely healed with new bones, and in the vertical bone defect area, 15.1% of the original defect area remained. In 3 patients, histological tests were performed, and 16.7-41.7% new bone formation was confirmed. Bone graft materials slowly underwent resorption over time. CONCLUSION. $AlloMatrix^{TM}$ is an allograft material that can be readily manipulated. It does not require the use of barrier membranes, and good bone regeneration can be achieved with time.

PURPOSE. The purpose of this study was to assess the difference in efficacy between calcium metaphosphate (CMP)-coated implant fixtures and conventional resorbable blasted media (RBM) processed implant fixtures. MATERIALS AND METHODS. This study targeted 50 implants from 44 patients who visited Dankook University Dental Hospital. Implantations were done separately for RBM treated and CMP-coated implants, although their design was the same. Calcium metaphosphate has a quicker biodegradation process through hydrolysis compared to other phosphate calcium groups. For the first year of the implantation, the resorption volume of marginal bone analyzed via radiography and perio-test value were measured, under the check plan. Their analyses were composed of a non-inferiority trials test. A 95% level of reliability was used. RESULTS. In the comparative analysis of the resorption volume of marginal bone and the perio-test value, no statistically significant difference was found between the CMP-coated implants and RBM implants. CONCLUSION. One year after the implant placement, CMP-coated implants were found not to be inferior to the conventional RBM implants.

PURPOSE. One of the most important factors in evaluating the quality of fixed dental prostheses (FDPs) is their gap. The purpose of this study was to compare the marginal and internal gap of two different metal-ceramic crowns, casting and selective laser sintering (SLS), before and after porcelain firing. Furthermore, this study evaluated whether metal-ceramic crowns made using the SLS have the same clinical acceptability as crowns made by the traditional casting. MATERIALS AND METHODS. The 10 study models were produced using stone. The 20 specimens were produced using the casting and the SLS methods; 10 samples were made in each group. After the core gap measurements, 10 metal-ceramic crowns in each group were finished using the conventional technique of firing porcelain. The gap of the metal-ceramic crowns was measured. The marginal and internal gaps were measured by two-dimensional and three-dimensional replica techniques, respectively. The Wilcoxon signed-rank test, the Wilcoxon rank-sum test and nonparametric ANCOVA were used for statistical analysis (${\alpha}$=.05). RESULTS. In both groups, the gap increased after completion of the metal-ceramic crown compared to the core. In all measured areas, the gap of the metal cores and metal-ceramic crowns produced by the SLS was greater than that of the metal cores and metal-ceramic crowns produced using the casting. Statistically significant differences were found between cast and SLS (metal cores and metal-ceramic crown). CONCLUSION. Although the gap of the FDPs produced by the SLS was greater than that of the FDPs produced by the conventional casting in all measured areas, none exceeded the clinically acceptable range.

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 $45^{\circ}$ 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.

PURPOSE. The purpose of this study was to investigate the effect of resin cements and primer on the retentive force of zirconia copings bonded to zirconia abutments with insufficient retention. MATERIALS AND METHODS. Zirconia blocks (Lava, 3M ESPE, St. Paul, MN, USA) were obtained and forty sets of zirconia abutments and copings were fabricated using CAD/CAM technology. They were grouped into 4 categories as follows, depending on the types of resin cements used, and whether the primer is applied or not:Panavia F2.0 (P), Panavia F2.0 using Primer (PRIME Plus, Bisco Inc, Schaumburg, IL, USA) (PZ), Superbond C&B (S), and Superbond C&B using Primer (SZ). For each of the groups, the cementation was conducted. The specimens were kept in sterilized water ($37^{\circ}C$) for 24 hours. Retentive forces were tested and measured, and a statistical analysis was carried out. The nature of failure was recorded. RESULTS. The means and standard deviations of retentive force in Newton for each group were $265.15{\pm}35.04$ N (P), $318.21{\pm}22.24$ N (PZ), $445.13{\pm}78.54$ N (S) and $508.21{\pm}79.48$ N (SZ). Superbond C&B groups (S & SZ) showed significantly higher retentive force than Panavia F2.0 groups (P & PZ). In Panavia F2.0 groups, the use of primer was found to contribute to the increase of retentive force. On the other hand, in Superbond C&B groups, the use of primer did not influence the retention forces. Adhesive failure was observed in all groups. CONCLUSION. This study suggests that cementation of the zirconia abutments and zirconia copings with Superbond C&B have a higher retentive force than Panavia F2.0. When using Panavia F2.0, the use of primer increases the retentive force.

PURPOSE. The purpose of this study was to evaluate the effectiveness of a promotion campaign for subject recruitment and selection, and reasons of withdrawal from a prospective clinical trial of mandibular two-implant supported overdenture. MATERIALS AND METHODS. The subjects of this study were participants in a randomized controlled clinical trial for investigating prognosis of implants and overdentures with attachments. Recruited subjects were classified by gender, age, and participation motives. Withdrawal rate of the participants before and after enrollment were evaluated. RESULTS. 177 patients were recruited and 51 patients were enrolled for the trial. Among them, 40 participants eventually took part in the trial. 116 subjects (65.5%) were recruited by advertisement and 61 (34.5%) were referred by patients of the hospital or local clinics. Regarding recruitment effectiveness, newspaper recruited the largest number of participants. With respect to referral patients, the proportion of our hospital patients was higher (37/61). Subjects in their 70s comprised the largest proportion (22/51). The male to female ratio was similar (25:26). Final withdrawal rate of all subjects were 74.0%. Among the reasons for withdrawal from enrollment (n=126) presence of remaining teeth and lack of motivation were the most common reasons. CONCLUSION. To facilitate recruitment of clinical trial subjects and improve enrollment rate, it is important to obtain a sufficient number of researchers, perform promotion activity with diverse strategies, cooperate with local dentists, increase the research funding, and alleviate subjects' fear against clinical trials by thorough consultation.

This clinical report presents the reconstruction of a maxillary arch with a cement retained implant supported fixed prosthesis using a monolithic zirconia generated by CAD/CAM system on eight osseointegrated implants. The prosthesis was copy milled from an interim prosthesis minimizing occlusal adjustments on the definitive prosthesis at the time of delivery. Monolithic zirconia provides high esthetics and reduces the number of metal alloys used in the oral cavity.