• Journal of the Korean Academy of Esthetic Dentistry
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• v.21 no.1
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• pp.4-22
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• 2012

치경부에 발생된 병소 부위(cervical lesion)는 "우식성 병소(caries lesion)"와 "비우식성 병소(non-caries lesion)"로 분류할 수 있다. 우식성 병소는 구강 내 세균들의 활동에 기인하여 발생된 병소로서 경조직 손상 부위의 수복과 함께 우식이 재발하지 않도록 체계적으로 대응하는 것이 필요하다. 비우식성 병소는 산성 물질, 저작력 및 이물질에 의한 마모 작용과 같은 다양한 원인에 의해 발생될 수 있으며, 수복 치료에 앞서 병소에 발생 원인을 규명하는 것이 중요하다. 먼저 병소 유발 원인에 대한 분석과 이에 대한 적절한 조치를 취한 후에 수복 치료를 시행하는 것이 바람직하다. 심미적인 요구가 높은 치경부 병소의 수복을 위하여 사용될 수 있는 재료는 "불소를 방출하는 재료"와 "불소를 방출하지 않는 재료"로 나뉘어지는데, 세균의 활동에 의해 형성된 우식성 병소의 수복에는 불소를 방출하는 재료를 사용하는 것이 추천된다. 우수한 심미성과 보다 강력한 유지력이 요구되는 경우에는 복합 레진계 수복 재료들을 사용하여 수복하게 되는데, 이 경우에는 "접착 술식(bonding procedure)"이 중요한 역할을 수행하게 된다. "접착 술식"은 수복물의 일차적인 유지 뿐 아니라 지각과민을 해소하고 2차 우식을 방지하며, 궁극적으로 수복물의 수명을 좌우하는 결정적인 역할을 수행한다. 자연 치아를 최대한 보존하고자 하는 "최소침습(minimum intervention)" 개념에 바탕을 두고 세심하게 형성된 와동에 각각의 증례에 최적화된 수복 재료를 선택하여 수복치료를 시행한다면 보다 심미적이고 환자가 편안한 치경부 수복물을 완성할 수 있을 것이다.

• Restorative Dentistry and Endodontics
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• v.31 no.5
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• pp.359-370
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• 2006

The objective of this study was to investigate the effect of excessive occlusal loading on stress distribution on four type of cervical lesion, using a three dimensional finite element analysis (3D FEA). The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. Four different lesion configurations representative of the various types observed clinically for teeth were studied. A static point load of 500N was applied to the buccal and lingual cusp (Load A and B). The principal stresses in lesion apex, and vertical sectioned margin of cervical wall were analyzed. The results were as follows 1. The patterns of stress distribution were similar but the magnitude was different in four types of lesion 2. The peak stress was observed at mesial corner and also stresses concentrated at lesion apex. 3. The compressive stress under load A and the tensile stress under load B were dominant stress. 4. Under the load, lesion can be increased and harmful to tooth structure unless restored.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.05a
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• pp.521-522
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• 2006

Occlusal loading is considered as the main factor of noncarious cervical lesions. The goal of this study is to identify stress distribution using three dimensional finite element analysis, when occlusal loading is applied on the cervical lesion of human tooth. A finite element model was constructed from micro-CT image and three kinds of static force(500 N) were assumed. In all cases stress concentrates on the same area in the cement-enamel junction. This finding is consistent with published experimental results.

• Proceedings of the KACD Conference
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• 2008.05a
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• pp.184-197
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• 2008

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis. The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress. Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.

• Restorative Dentistry and Endodontics
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• v.33 no.3
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• pp.184-197
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• 2008

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis. The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress. Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.

• Restorative Dentistry and Endodontics
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• v.33 no.1
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• pp.28-38
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• 2008

This study was to investigate the influence of composite resins with different elastic modulus, cavity modification and occlusal loading condition on the stress distribution of restored notch-shaped noncarious cervical lesion using 3-dimensional (3D) finite element (FE) analysis. The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity and a modified cavity with a rounded apex were modeled. Unmodified and modified cavities were filled with hybrid or flowable resin. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress. The results were as follows: 1. In the unrestored cavity, the stresses were highly concentrated at mesial CEJ and lesion apex and the peak stress was observed at the mesial point angle under both loading conditions. 2. After restoration of the cavity, stresses were significantly reduced at the lesion apex, however cervical cavosurface margin, stresses were more increased than before restoration under both loading conditions. 3. When restoring the notch-shaped lesion, material with high elastic modulus worked well at the lesion apex and material with low elastic modulus worked well at the cervical cavosurface margin. 4. Cavity modification the rounding apex did not reduce compressive stress, but tensile stress was reduced.

• Restorative Dentistry and Endodontics
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• v.32 no.1
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• pp.69-79
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• 2007

The purpose of this study was to investigate the effects of composite resin restorations on the stress distribution of notch shaped noncarious cervical lesion using three-dimensional (3D) finite element analysis (FEA). Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072 ; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid or flowable resin and each restoration was simulated with adhesive layer thickness ($40{\mu}m$) A static load of 500 N was applied on a point load condition at buccal cusp (loading A) and palatal cusp (loading B). The principal stresses in the lesion apex (internal line angle of cavity) and middle vertical wall were analyzed using ANSYS. The results were as follows 1. Under loading A, compressive stress is created in the unrestored and restored cavity. Under loading B, tensile stress is created. And the peak stress concentration is seen at near mesial corner of the cavity under each load condition. 2. Compared to the unrestored cavity, the principal stresses at the cemeto-enamel junction (CEJ) and internal line angle of the cavity were more reduced in the restored cavity on both load con ditions. 3. In teeth restored with hybrid composite, the principal stresses at the CEJ and internal line angle of the cavity were more reduced than flowable resin.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.17-26
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• 2009

Purpose: The non-carious cervical lesion(NCCL) is a loss of tooth structure at the neck of affected teeth that is unrelated to tooth caries. The reported prevalence of NCCL varies from 5% to 85%. Prevalence and severity of lesions have been found to increase with age. They are becoming more significant as people live longer and become more aware of the importance of oral health. The purposes of this study were first, to examine the periodontal conditions associated with NCCL, and second, to investigate the clinical effects of class V restorations of NCCL on periodontal tissues. Materials and methods: The sample size was 982 teeth of 50 subjects(25 male, mean age $52{\pm}7$) who were seen at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, clinical periodontal parameters were measured. After the initial examination, 24 patients who were absent from hypersensitivity were selected. The teeth with NCCL were randomly divided into the test and control groups. The teeth in the test group were restored with flowable resin; the control teeth were not restored. Six months later, the clinical examinations were repeated. The data were analyzed using the SPSS program. Results: The results were as follows: 1) NCCL occurred on 45.8% of examined teeth. The percentage of affected teeth was higher in maxillary and premolar teeth. 2) The shallow saucer type was the most common. 3) Teeth with NCCL had more gingival recession, lower attachment level, and higher incidences of bleeding on probing(BOP) and plaque than NCCL-free teeth. 4) Six months later, gingival recession, attachment level, the percentages of BOP and plaque in the test group were lower than in the control group(p<0.05). Conclusion: NCCLs were more found in maxillary teeth, especially in premolar teeth. The results suggest that the restoration of NCCL could affect some periodontal parameters favorably.

• Korean Journal of Dental Materials
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• v.43 no.1
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• pp.17-28
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• 2016

The aim of this study was to evaluate the changes in dentinal permeability after application of dentin desensitizer on exposed dentin immediately after ultrasonic scaling to teeth with non-carious cervical lesions. Thirty caries-free extracted molars were fixed to slide glasses after horizontally being sectioned at 5 mm below the cemento- enamel junction (CEJ). The prepared specimen was connected to a fluid flow measuring device (nano-Flow), and a V-shaped cavity was formed at the CEJ to imitate the non-carious cervical lesion. After no fluid leakage was confirmed in the connected system with specimen, tooth surface was treated ultrasonic cleaning with piezoelectric ultrasonic scalers until dentinal tubules were exposed. And 6 different desensitizers were applied on exposed dentin. Real-time measurements of dentinal fluid flow were performed during ultrasonic scaling and application of dentin desensitizer. To evaluate the occlusion of exposed dentinal tubules, tooth surface was examined by SEM. Following results were observed. After ultrasonic scaling, more dentinal tubules were exposed on the tooth with non-carious cervical lesions compared to tooth without lesions. The rate of fluid flow measured with nano-Flow system had correlation with the degree of dentin occlusion observed with SEM after application of desensitizers on exposed dentin. Desensitizers with glutaraldehyde and HEMA did not decrease the rate of fluid flow and did not show dentin occlusion. Desensitizers with oxalate showed the limited effects on the rate of fluid flow and dentinal tubule occlusion. Desensitizer with resin monomer showed the significant effect on the rate of fluid flow and dentin occlusion.

• Restorative Dentistry and Endodontics
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• v.31 no.6
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• pp.427-436
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• 2006

The objective of this study was to investigate the effects of various occlusal loads on the stress distribution of the buccal cervical region of a normal maxillary second premolar, using a three dimensional fnite element analysis (3D FEA). After 3D FE modeling of maxillary second premolar, a static load of 500N of three load cases was applied. Stress analysis was performed using ANSYS (Swanson Analysis Systems, Inc., Houston, USA). The maximum principal stresses and minimum principal stresses were sampled at thirteen nodal points in the buccal cervical enamel for each four horizontal planes, 1.0 mm above CEJ, 0.5 mm above CEJ, CEJ, 0.5 mm under CEJ. The results were as follows 1. The peak stress was seen at the cervical enamel surface of the mesiobuccal line angle area, asymmetrically. 2. The values of compressive stresses were within the range of the failure stress of enamel. But the values of tensile stresses exceeded the range of the failure stress of enamel. 3. The tensile stresses from the perpendicular load at the buccal incline of palatal cusp may be shown to be the primary etiological factors of the NCCLs.