• The Journal of Korean Academy of Prosthodontics
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• v.59 no.3
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• pp.291-298
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• 2021

Purpose. The purpose of this study is to compare five interdental cleansing products' effectiveness on removing artificial dental plaque on the interdental space of zirconia crowns. Materials and methods. A model with abutments on the right mandibular second premolar and first molar were prepared. 10 zirconia crowns for each abutment were fabricated. After applying artificial dental plaque between the zirconia crowns, a single clinician attempted to remove the plaque with five products: interdental toothbrush, end-tuft toothbrush, dental floss, Easypick, Water pik. They were conducted 10 times per group. The aspect and area of removed surfaces were analyzed using images taken with a digital camera. One factor analysis of variance was performed as a statistical analysis, and a post-hoc test was performed using the Scheffé method (P < .05). Results. There were differences in the area and the pattern according to the characteristics of the products. The largest area, including the marginal portion, was removed in the dental floss group. Interdental toothbrush group was the most effective in removing the dental plaque at the marginal portion. Easypick was less effective than the interdental toothbrush. The end-tuft toothbrush showed better results than other products in cleansing mesiobuccal and distobuccal area, but could not cleanse the area directly below the contact point. In Water pik group, artificial dental plaque was scarcely removed. The removal rate of artificial dental plaque was in the order of floss (69.47%), end-tuft toothbrush (49.36%), interdental toothbrush (44.20%), Easy pick (13.04%), and Water pik (0.59%). Conclusion. Dental floss showed the highest removal rate in the interdental space restored with zirconia crowns, while interdental toothbrush was the most effective in removing the dental plaque at the marginal portion.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.2
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• pp.72-80
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• 2019

Purpose: The purpose of this study is to compare and analyze the shear bond strength and fracture pattern in different enamel tooth surface treatments for resin splinting materials. Materials and Methods: G-FIX and LightFix were used as tooth splinting materials. Twenty bovine mandibular incisors were used for the preparation of the specimens. The exposed enamel surface was separated into four parts. Each tooth was treated with 37% phosphoric acid, 37% phosphoric acid + adhesive resin, 37% phosphoric acid + G-premio bond, and G-premio bond for each fraction. Shear bond strength was measured using a universal testing machine. After measuring the shear bond strength, the fractured surface of the specimen was magnified with a microscope to observe the fracture pattern. Two-way ANOVA was used to verify the interaction between the material and the surface treatment method. One-way ANOVA was used for comparison between the surface treatment methods of each material and post-hoc test was conducted with Scheffe's test. An independent t-test was conducted to compare shear bond strengths between materials in each surface treatment method. All statistics were conducted at 95% significance level. Results: G-FIX, a tooth splinting resin, showed similar shear bonding strength when additional adhesive resins were used when material was applied after only acid etching, and LightFix showed the highest shear bonding strength when additional adhesive resins were used after the acid etching. In addition, both G-FIX and LightFix showed the lowest shear bond strength when only self-etching adhesive was applied without additional acid etching. Verification of interactions observed interconnection between resins and surface treatment methods. Most of the mixed failure was observed in all counties. Conclusion: When using G-FIX and LightFix, which are tooth-splinting materials, it is considered that sufficient adhesion will be achieved even after applying only acid etching as instructed by the manufacturer.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.2
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• pp.43-49
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• 2018

Maple syrup urine disease (MSUD, OMIM#248600) is a rare and autosomal recessively-inherited metabolic disorder that is caused by mutations in the branched-chain ${\alpha}$-ketoacid dehydrogenase (BCKDH) genes. It prevents the normal breakdown of branched-chain amino acids (BCAAs), such as leucine, isoleucine, and valine, and leads to poor feeding, lethargy, abnormal movements, seizure, and death if untreated. Here, we report the case of a Korean newborn of biochemically- and genetically-confirmed MSUD manifesting lethargy and central apnea, the acute state of which was successfully treated. The molecular genetic investigation revealed two novel heterozygous mutations (p.Ala32Phefs*48 and p.Val 130Phe) in BCKDHB, and both parents were confirmed as carriers. We emphasize the importance of early diagnosis and prompt introduction of specific treatment for MSUD in life saving and prognosis.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.4
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• pp.297-305
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• 2018

Purpose: This study aimed to analyze stress distribution and maximum von Mises stress generated in intracoronal restorations and in tooth structures of mandibular molars with various types of cavity designs and materials. Materials and Methods: Three-dimensional solid models of mandible molar such as O inlay cavity with composite and gold (OR-C, OG-C), MO inlay cavity with composite and gold (MR-C, MG-C), and minimal invasive cavity on occlusal and proximal surfaces (OR-M, MR-M) were designed. To simulate masticatory force, static axial load with total force of 200 N was applied on the tooth at 10 occlusal contact points. A finite element analysis was performed to predict stress distribution generated by occlusal loading. Results: Restorations with minimal cavity design generated significantly lower values of von Mises stress (OR-M model: 26.8 MPa; MR-M model: 72.7 MPa) compared to those with conventional cavity design (341.9 MPa to 397.2 MPa). In tooth structure, magnitudes of maximum von Mises stresses were similar among models with conventional design (372.8 - 412.9 MPa) and models with minimal cavity design (361.1 - 384.4 MPa). Conclusion: Minimal invasive models generated smaller maximum von Mises stresses within restorations. Within the enamel, similar maximum von Mises stresses were observed for models with minimal cavity design and those with conventional design.

• Pediatric Infection and Vaccine
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• v.25 no.3
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• pp.148-155
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• 2018

Purpose: The purpose of this study was to investigate the clinical significance of Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) site reaction in terms of diagnosis and outcome prediction in young children with Kawasaki disease (KD). Methods: The incidence of BCG site reaction in the respective age ranges was investigated in 1,058 patients who were admitted at Asan Medical Center between January 2006 and February 2017. The 416 patients under 18 months of age were enrolled as subjects for the analysis of the association between BCG site reaction and other laboratory and clinical findings. The analysis was performed separately in complete and incomplete KD groups. Results: The incidence rate of BCG site reaction was peaked at 6-12 months (83%) and decreased with increasing age after 12 months in 1,058 patients (P<0.001). The incidence rate was above 70% in KD aged less than 18 months and more frequent than those of cervical lymphadenopathy. The logistic regression analyses showed that the principal clinical findings including conjunctivitis (P=0.781), red lips/oral mucosa (P=0.963), rash (P=0.510), cervical lymphadenopathy (P=0.363), changes in extremities (P=0.283) and the coronary artery aneurysm (P=0.776) were not associated with the BCG site reaction. Conclusions: The BCG site reaction could be a useful diagnostic tool independent to principal clinical findings in KD developing in children aged <18 months, who underwent BCG vaccination. Outcome of KD patients was not different between groups with or without the BCG site reaction in both complete KD and incomplete KD.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.4
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• pp.280-289
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• 2018

Purpose: The purpose of this randomized clinical trial is to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and peri-implant marginal bone loss (MBL). Materials and Methods: 46 patients with single tooth missing in the posterior molar region of the mandible were included in this study. 19 implants (CMI IS-III $active^{(R)}$ long implant) of 5.0 mm diameter and 10 mm length were installed for the control group, while 27 implants (CMI IS-III $active^{(R)}$ short implant) of 5.5 mm diameter and 6.6, 7.3 or 8.5 mm length were placed for the experimental group. Each implant was inserted and immediately loaded using the digitally pre-fabricated surgical template and provisional restoration. The CAD-CAM monolithic zirconia crown was fabricated at 3 months after the surgery as a definitive restoration. The ISQ value and the MBL was measured at 48 weeks after the surgery. The correlation between the C/I ratio, MBL, and secondary implant stability was analyzed. Results: Successful results in terms of ISQ and MBL were achieved with both groups. There was no significant difference between the groups in terms of ISQ values and MBL at 48 weeks after the surgery (P > 0.05). No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the MBL (P > 0.05). Conclusion: The influence of C/I ratio in both groups was not shown on the stability nor the marginal bone loss in implants supporting single crown of the mandible. Short implant could be a preferable alternative option in the reduced bone height mandible under the limited condition despite its higher C/I ratio.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.3
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• pp.211-218
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• 2019

Purpose: The purpose of the present study was to compare the accuracy of four different metal copings fabricated by CAD/CAM technology and to evaluate clinical effectiveness. Materials and methods: Composite resin tooth of the maxillary central incisor was prepared for a metal ceramic crown and duplicated metal die was fabricated. Then scan the metal die for 12 times to obtain STL files using a confocal microscopy type oral scanner. Metal copings with a thickness of 0.5 mm and a cement space of $50{\mu}m$ were designed on a CAD program. The Co-Cr metal copings were fabricated by the following four methods: Wax pattern milling & Casting (WM), Resin pattern 3D Printing & casting (RP), Milling & Sintering (MS), Selective laser melting (SLM). Silicone replica technique was used to measure marginal and internal discrepancies. The data was statistically analyzed with One-way analysis of variance and appropriate post hoc test (Scheffe test) (${\alpha}=.05$). Results: Mean marginal discrepancy was significantly smaller in the Group WM ($27.66{\pm}9.85{\mu}m$) and Group MS ($28.88{\pm}10.13{\mu}m$) than in the Group RP ($38.09{\pm}11.14{\mu}m$). Mean cervical discrepancy was significantly smaller in the Group MS than in the Group RP. Mean axial discrepancy was significantly smaller in the Group WM and Group MS then in the Group RP and Group SLM. Mean incisal discrepancies was significantly smaller in the Group RP than in all other groups. Conclusion: The marginal and axial discrepancies of the Co-Cr coping fabricated by the Wax pattern milling and Milling/Sintering method were better than those of the other groups. The marginal, cervical and axial fit of Co-Cr copings in all groups are within a clinically acceptable range.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.1
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• pp.1-10
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• 2019

Purpose: The aim of this study was to evaluate the influence of polishing methods on the color stability of composite resins. Materials and Methods: Two bulk-fill and four conventional resin composites were filled in cylindrical molds (6 mm diameter, 4 mm height) and light-cured. The specimens were stored in $34^{\circ}C$ distilled water for 24 h. Spectrophotometer was used to determine the color value according to the CIE $L^*a^*b^*$ color space. Each group was divided into three groups according to polishing methods (n = 5). Group 1 was control group (Mylar strip group), group 2 was polished with PoGo, and group 3 was polished with Sof-Lex Spiral wheels. Color evaluation was performed weekly for 4 weeks after immersion in $34^{\circ}C$ distilled water. The results were analyzed by generalized least squares method (P < 0.05). Results: Generalized least squares analysis revealed that Sof-Lex Spiral wheels group showed the significantly lower ${\Delta}E$ values compared to PoGo and control group (P < 0.05). The ${\Delta}E$ values of polished group showed the significantly lower than the ${\Delta}E$ values of unpolished group (P < 0.05). Regarding color changes of composite resins, there was no significant difference between the ${\Delta}E$ values of Filtek Z250 and Filtek Z350 XT Universal restorative in all time intervals (P < 0.05). Tetric N-Ceram Bulk Fill showed the significantly lower ${\Delta}E$ values compared to other composite resins in 1, 2, 3 weeks (P < 0.05). Conclusion: Within the limitations of this study, polishing methods influence the color stabilities of composite resins. The group polished with Sof-Lex Spiral Wheels showed more resistance to discoloration than group polished with PoGo.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.1
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• pp.20-26
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• 2019

Purpose: Recently TF-adaptive movement is developed in order to increase the durability of TF files. The purpose of this study was to assess the effects of adaptive movement on durability and performance of twisted files. Materials and Methods: Resin blocks simulating artificial J-shape canals were used for this study. In TFC group, TF-adaptive ML-1 (25/.08 size) files were used to prepare the canals under continuous rotation 500 rpm/4.0 Ncm. In TFA group, TF-adaptive ML-1 (25/.08 size) files were used to prepare the canals under adaptive movement. After preparing each artificial canal, TF files were observed under dental microscope for assessing existence of unwinding, distortion, and fracture. If unwinding of flute was observed, the number of artificial canals until unwinding of flute occurs was recorded. Required time until instruments reach working length and distance of unwinded portion of files from D0 were measured. All test results were conducted by Mann-Whitney U test at a 0.05 level of significance. Results: No Ni-Ti instrument's separation was observed. Number of resin blocks until file unwinding happens and working time was significantly high in TFA group compared to TF group. Distance of distortion from D0 didn't show significant difference between TFA, TF groups. Conclusion: The number of resin blocks prepared until unwinding happens and working time were significantly high in TFA group. The location of unwinding showed no significant difference between 2 groups. Adaptive movement increased the number of canals prepared until unwinding occurs and working time of twisted files.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.110-117
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• 2019

Purpose: This study was to evaluate the wear resistance of 3D printed, milled, and conventionally cured provisional resin materials. Materials and methods: Four types of resin materials made with different methods were examined: Stereolithography apparatus (SLA) 3D printed resin (S3P), digital light processing (DLP) 3D printed resin (D3P), milled resin (MIL), conventionally self-cured resin (CON). In the 3D printed resin specimens, the build orientation and layer thickness were set to $0^{\circ}$ and $100{\mu}m$, respectively. The specimens were tested in a 2-axis chewing simulator with the steatite as the antagonist under thermocycling condition (5 kg, 30,000 cycles, 0.8 Hz, $5^{\circ}C/55^{\circ}C$). Wear losses of the specimens were calculated using CAD software and scanning electron microscope (SEM) was used to investigate wear surface of the specimens. Statistical significance was determined using One-way ANOVA and Dunnett T3 analysis (${\alpha}=.05$). Results: Wear losses of the S3P, D3P, and MIL groups significantly smaller than those of the CON group (P < .05). There was no significant difference among S3P, D3P, and MIL group (P > .05). In the SEM observations, in the S3P and D3P groups, vertical cracks were observed in the sliding direction of the antagonist. In the MIL group, there was an overall uniform wear surface, whereas in the CON group, a distinct wear track and numerous bubbles were observed. Conclusion: Within the limits of this study, provisional resin materials made with 3D printing show adequate wear resistance for applications in dentistry.