Kim, Sung-Jin;Pae, Ah-Ran;Woo, Yi-Hyung;Kim, Hyeong-Seob
Journal of Dental Rehabilitation and Applied Science
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v.26
no.1
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pp.21-32
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2010
The convergence angle of a prepared tooth is a very important factor in the retention and resistance of a crown restoration. But various intraoral environments and clinician's techniques make it difficult to obtain the ideal inclination. Therefore, in this study, clinical convergence angle of a prepared tooth was investigated. The data was collected from the patient models of prosthodontic residents and the patient models of general practitioners. The images of mesiodistal and buccolingual surfaces were taken with a digital camera to evaluate the convergence angle on 'ImageJ' program. The images were classified according to the criteria (1. Clinician group, 2. Position in the dental arch, 3. The purpose of abutment preparation)and then analyzed. The mean convergence angle of a prepared tooth for Korean clinicians was $15.02^{\circ}$ (${\pm}10.13^{\circ}$). 1. It was significant in the convergence angle between the general practitioner group and the prosthodontic resident group(p<0.05). 2. It was significant between the mesiodistal and buccolingual surface in the the prosthodontic resident group(p<0.05). 3. For the general practitioner group, it was significant when anteriors and premolars were compared with molars(p<0.05). For the prosthodontic resident group, it was significant when anteriors and premolars were compared with molars (p<0.05). 4. When divided into upper and lower arches, for the general practitioner group, it showed significant difference in the buccolingual aspect(p<0.05). Also in the prosthodontic resident group, it showed significant difference in the buccolingual aspect(p<0.05). 5. Dividing left and right sides of the arches, there was no significant difference in the general practitioner group and the prosthodontic resident group(p>0.05). 6. In the general practitioner group, it was significant in the mesiodistal axial convergence angle of single crown abutment and 3 unit bridge abutment(p<0.05). In the prosthodontic resident group, it was significant in the mesiodistal and overall axial convergence angle of single crown abutment and 3 unit bridge abutment(p<0.05). Clinical convergence angle of prepared tooth in Korea was included in agreement with other studies investigating convergence angle that ranged from 10 to 22 degrees, achieved in clinical practice.
In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.
This study was done to evaluate whether there were any differences in microleakage of class V composite restorations according to restoration site and cavity size. Total sixty-four restorations were made in molar teeth using Esthet-X. Small ($2\;{\times}\;2\;{\times}\;1.5\;mm$) and large ($4{\times}2{\times}1.5\;mm$) restorations were made at the buccal/lingual surface and the proximal surface each. After 1,000 times of thermocycling ($5^{\circ}\;-\;55^{\circ}C$), resin replica was made and the percentage of marginal gap to the whole periphery of the restoration was estimated from SEM evaluation. Thermocycled tooth was dye penetrated with $50\%$ silver nitrate solution. After imbedding in an auto-curing resin, it was serially ground with a thickness of 0.25 mm. Volumetric microleakage was estimated after reconstructing three dimensionally. Two-way ANOVA and independent T-test for dye volume, Mann-Whitney U test for the percentage of marginal gap, Spearman's rho test for the relationship between two techniques were used, The results were as follows : 1. The site and size of the restoration affected on the microleakage of restoration. Namely, much more leakage was seen in the proximal and the large restorations rather than the buccal/lingual and the small restorations. 2. Close relationship was found between two techniques (Correlation coefficient = 0.614/ P = 0.000). Within the limits of this study, it was noted that proximal and the large restorations leaked more than buccal/lingual and the small restorations. Therefore, it should be strictly recommended large exposure of margins should be avoided by reducing unnecessary tooth reduction.
Bond strength depends on characteristics of bonding surface and restorative technique. The majority of studies dealing with dentin bond strength were carried out on flat bonding surface, therefore, difference of bond strength between axial wall and pulpal wall is not clear yet. This study evaluated bonding difference between cavity walls in class I composite resin restoration with different filling techniques. Twenty extracted caries-free human third molars were used. Cavities were prepared in 6 ${\times}$4 ${\times}$3 mm box-type and divided into four groups according to filling technique and bonding surface: Group I; bulk filling - pulpal wall, Group II; bulk filling - axial wall, Group III; incremental filling - pulpal wall, Group IV; incremental filling - axial wall. Cavities were filled with Filtek $Z250^{(R)}$(3M/ESPE., USA) and Clearfill SE $bond^{(R)}$(Kuraray, Japan). After 24 hour-storage in $37^{\circ}C$water, the resin bonded teeth were sectioned bucco-lingualy at the center of cavity. Specimens were vertically sectioned into 1.0 ${\times}$1.0 mm thick serial sticks perpendicular to the bond surface using a low-speed diamond saw (Accutom 50, Struers, Copenhagen, Denmark) under water cooling. The trimmed specimens were then attached to the testing device and in turn, was placed in a universal testing machine (EZ test, Shimadzu Co., Kyoto, Japan) for micro-tensile testing at a cross-head speed of 1 mm/min. The results obtained were statistically analyzed using 2-way ANOVA and t-test at a significance level of 95%. The results were as follows: 1. There was no significant difference between bulk filling and incremental filling. 2. There was no significant difference between pulpal wall and axial wall, either. Within the limit of this study, it was concluded that microtensile bond strength was not affected by the filling technique and the site of cavity walls.
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.
Axial displacement of an implant-supported prosthesis is frequently reported in clinical and laboratory studies. However, limited information is available about the behavior of the axial displacement of implant-supported prostheses functioning in intraoral situations. The present case report evaluated the three-dimensional displacement of posterior single implant-supported prostheses in 2 different patients. Internal connection type implants were placed, and screw and cement-retained prosthesis (SCRP) type prosthesis were delivered after an appropriate healing period. Intraoral digital scans were performed using an intraoral scanner (Cerec Omnicam, Dentsply Sirona, USA) on the day of crown delivery and one week, one month, and one year after delivery. The amount of 3-dimensional displacement of the prosthesis was evaluated by using a digital inspection software (Geomagic Control X, 3D systems, USA). The axial displacement of implant-supported prosthesis occurred in both patients. Furthermore, the amount of displacement increased over time.
Jaehyeok Ro;Haemin Bang;Sangwon Park;Hyun-Pil Lim;Kwi-Dug Yun;Chan Park
The Journal of Korean Academy of Prosthodontics
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v.61
no.4
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pp.268-274
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2023
In this case, a CAD-CAM complete denture that can be easily remanufactured and reduced the number of visits was decided in consideration of the fact that it was difficult to visit the dental hospital and many existing dentures were lost because the patient was inpatient in a nursing hospital. In order to reflect the shape, vertical dimension, and maxillomandibular relationship of the existing provisional dentures adapted by the patient to the fabrication of the final denture, the existing provisional dentures were scanned and closed mouth impression was taken with the printed individual tray. After digital facebow transfer using UTS CAD and arranging artificial teeth in CAD software, the maxillary and mandibular complete dentures were fabricated by milling the denture base and artificial teeth at once with the monolithic disc.
Traditional options for posterior edentulous treatment include removable partial dentures and implant fixed prostheses. Recently, the concept of implant assisted removable partial denture, in which two treatments are fused, has been introduced in consideration of systemic health and patient's needs, costs, residual alveolar bone status and so on. Implant assisted removable partial denture has the advantage of increasing the retention and stability of the denture and improving its esthetics in cases of large bone defects or biomechanical disadvantages. In addition, it is possible to strategically place the implants in a site where the alveolar bone is relatively sufficient, thereby overcome the limit of the conventional removable partial denture design as well as reducing the burden on a wide range of implant surgery. Cost reduction is also expected. In this case, the patient was treated by placing the implant in both premolar sites of the mandible and fabricating the distal extension removable partial denture with the implant fixed prosthesis as an abutment. After delivering the definitive prosthesis, the patient showed satisfaction with the masticatory function and esthetics. and has been regularly followed-up for more than one year. The following 20-months follow-up case report describes the design of an implant-assisted-removable partial denture (IARPD) in which two cementretained implant crowns used to provide support and stability.
Excessive tooth wear results in unacceptable damage to the occlusal surface and can cause pulpitis, occlusal disharmony, dysfunction, and unesthetic result. Patients with severe attrition have to be classified as several types relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. The patient in this case was a 80 - year - old woman who lost support of posterior occlusion and collapsed of the occlusal plane due to confrontation of the opposing teeth, accompanied by an increase in the number of remaining bristles, resulting in a loss of intermaxillary space for prosthesis. In this case, treatment with increased vertical dimension may have stability if the increase in vertical occlusal height is minimized within the required range, and a stable occlusal contact is provided after an increased vertical occlusal height stabilization period. After the new VDO had been confirmed under interim fixed restorations, definitive fixed restorations were produced. Through these treatment processes, we obtain satisfactory results that are functional and aesthetically pleasing.
Purpose. This retrospective study was to investigate the survival and complication rates of posterior single implant according to the implant diameters, lengths and position. Materials and methods. Patients who had been restored single implant prosthesis in the posterior area by the three prosthodontists in the department of prosthodontics, Daejeon dental hospital of Wonkwang university, in the period from February 2014 to May 2018 were selected for the study. A total of 505 patients with 697 implants were observed. The survival and complications of implants were investigated using electronic medical records and radiographs. Fixture diameters, lengths, position, patient's sex and age were assessed as possible factor affecting the survival and complications of implants. Results. 3-year cumulative survival rates of posterior single implants were 98.5% and 5-year cumulative survival rates were 94.4%. 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm (97.0%) than implants with diameter ≤ 4.0 mm (89.5%), and in females (98.8%) than males (92.4%). There were statistically significant differences (P < .05). The mechanical complication rate was 20.1% and the biological complication rate was 4.7%. Complications occurred in order of abutment screw loosening (7.5%), decementation (6.3%), proximal contact loss (3.7%) and so on. Abutment screw loosening occurred more frequently in the lower molar region (10.5%), in males (9.5%) than females (5.1%), and in patients aged < 65 years (9.4%) than patients aged ≥ 65 years (5.1%). There were statistically significant differences (P < .05). Conclusion. The 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm than implants with diameter ≤ 4.0 mm and in females than males. Abutment screw loosening which was the most commonly occurring complication occurred more frequently in the lower molar region, in males than females, and in patients aged < 65 years than patients aged ≥ 65 years. There were statistically significant differences.
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