Most commonly used axis for central incisors in lateral cephalometric radiographs is the line connecting root apex and incisor edge. However, crown axis and root axis do not always coincide in cases of malocclusion patients. The angle created by these axis are called the collum angle, which should be considered in orthodontic diagnosis and treatment. In this study, 31 Class I malocclusion, 30 Class II division 1 malocclusion, 31 Class II division 2 malocclusion, and 31 Class m malocclusion patients were selected and their collum angles were measured. Correlation between these angles and malocclusions was investigated, and the correlation analysis with other parameters in cephalometrics was done. The results were as follows ; 1. The mean collum angles according to the types of malocclusions are ; $3.11^{\circ}{\pm}3.54^{\circ}$ for Class I, $1.23^{\circ}{\pm}2.41^{\circ}$ for Class II division 1, $3.77^{\circ}{\pm}4.39^{\circ}$ for Class II division 2, and $3.90^{\circ}{\pm}4.08^{\circ}$ for Class III malocclusion. 2. Statistically significant differences in collum angles were noted between Class II division 1 group and Class II division 2 and Class III group. 3. Significant correlations were found between collum angles and other parameters used in cephalometrics, namely IMPA for Class I, Wits for Class II division 1, Overbite for Class II division 2 and for ClassIII.
Journal of the korean academy of Pediatric Dentistry
/
v.27
no.2
/
pp.256-261
/
2000
Trauma to the tooth is the most common accidents in pediatric dentistry and tooth fracture occurs frequently. Fracture is classified into crown fracture, root fracture, and crown-root fracture which involves both. Also, it is classified into simple or complicated fracture depending on whether the pulp is exposed or not. When the fracture is extended down to the subgingival level following the long axis of the root, or when more than 1/3 of the root is involved, extraction is the primary treatment. But alternative treatment such as extruding the root fragment with orthodontic force and restoring it, or intentionally extracting the tooth and replanting it to a position which it can be restored. This is a case report on intentional replantation of a traumatized maxillary central incisor with crown-root fracture of a patient with mixed dentition. The teeth was extracted and immediate endodontic treatment, retrograde filling and resin restoration were carried out.
Journal of the korean academy of Pediatric Dentistry
/
v.31
no.2
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pp.267-272
/
2004
This case report describes an uncommon treatment method for crown-root fractured incisor with immature root. A 7-year-old girl was referred for treatment of crown-root fractured maxillary central incisor. The fracture line extended to 1/2 of the total tooth length with incomplete root formation. The prognosis of crown-root fracture is usually poor and extraction is usually undertaken. But, in the mixed dentition, extraction of maxillary permanent incisor results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation and mastication. Conservative therapy in the permanent dentition comprises of few treatment modalities; supragingival restoration, gingivectomy, orthodontic extraction of apical fragment, surgical extrusion of apical fragment with or without rotational replantation. However, in this case, these indications are not applicable, so intentional replantation with adhesive resin system is the treatment of choice. The tooth was followed-up for 12 months. Currently, there are no symptoms. Since this modality adopts the respective advantages of both intentional replantation and adhesive treatment, it might be the treatment of choice in cases of vertical crown-root fracture.
Statement of the problem: Under anatomical limitations on maxillary posterior region, a poor crown-to root ratio acting on dental implants can result in undesirable stress in surrounding bone, which in turn can cause bone defects and eventual failure of implants. Purpose: The purpose is to compare stress distribution due to different crown-root ratio and effect of splinting between natural teeth and implants in maxillary molar area under different loads. Material and methods: Analysis of stress arising supporting bone of the natural teeth and the implant was made with 3-dimensional finite element method. The model simulated naturel teeth was made with 2nd premolar and 1st molar in the maxillary molar region (Model T). The model simulated implants placed on same positions with two parallel implants of Straumann Dental Implant cemented abutment (Model I). Each model was designed in different crown-root ratio (0.7:1, 1:1, 1.25:1) and set cement type gold crown to make it non-splinted or splinted. After that, 300 N force was loaded to each model in five ways (Load 1: middle of occlusal table, Load 2: middle of buccal cusp, Load 3: middle of lingual cusp, Load 4: horizontal load to buccal cusp of anterior abutment only, Load 5: horizontal load to middle of buccal cusp of each abutment), and stress distribution was analyzed. Results and conclusion: On all occasions, stress was concentrated at the cervical region of the implant. Under load 1, 2 and 3, stress was not increased even when crown-root ratio increases, but under load 4 and 5, when crown-root ratio increases, stress also increased. There was difference in stress values between natural teeth and implants when crown-root ratio gradually increases; In case of natural teeth, splinting decreased stress under vertical and horizontal loads. In case of implants, splinting decreased stress under vertical loads 1,2 and 3, but increased maximal stress under loads 2 and 3. Under horizontal loads, splinting decreased stress, however the effect of splinting decreased under load 5 than load 4. Furthermore, the stress was increased, when crown-root ratio is 1.25:1. Clinical implications: This limited finite element study suggests that the stress on supporting bone may be increased under non-axial loads and poor crown-root ratio. Under poor crown-root ratio, excessive stress was generated at the cervical region of the implant, and decreased splinting effect for stress distribution, which can be related to clinical failure.
Precise bracket positioning is essential in modem orthodontics. However, there can be alterations in the vertical position of a bracket due to several reasons. The purpose of this study was to evaluate the effect of variations in the vertical bracket position on the crown inclination in Korean patients with normal occlusion. From a larger group of what was considered to be normal occlusions obtained from the Department of Orthodontics, College of Dentistry, Seoul National University, each of the final 10 subjects (6 males and 4 females, with an average age of 22.3 yews) was selected. The dental models of each of the subjects were scanned three-dimensionally by a laser scanner, and measurements drawn from these were made on the scanned dental casts of the subjects were input into the computer program. From this the occlusal plane and the bracket plane were determined. The tooth plane was then constructed to measure the crown inclination on the bracket plane of each tooth. From a practical standpoint, information was obtained on the extent to which the torque of a tooth would be changed as the bracket position was to be moved vertically (in ${\pm}0.5mm,\;{\pm}1.0mm,\;{\pm}1.5mm$) from its ideal position. A one way analysis of the variance (ANOVA) was used to compare each group of the different vertical distances from the bracket plane on a specific tooth. Duncan's multiple comparison test was then performed. There were statistically significant differences in the crown inclination among the groups of different vertical distances for the upper central incisor, upper lateral incisor, upper canine, upper first and second molars, lower first and second premolars, and lower first and second molars (p<0.05). On the upper anterior teeth, upper molars, lower premolars and lower molars, the resultant torque values due to the vertical displacement of the bracket were different depending on the direction of the displacement, occlusal or gingival. This study implies that the torque of these teeth should be handled carefully during the orthodontic treatment. In circumstances in which the bracket must be positioned more gingivally or occlusally due to various reasons, it would be useful to provide the chart of torque alteration of each tooth referred to in this study with its specified bracket prescription.
The purpose of this study was to evaluate the influence of elastic modulus of restorative materials and the number of interfaces of post and core systems on the stress distribution of three differently restored endodontically treated maxillary second premolars using 3D FE analysis. Model 1, 2 was restored with a stainless steel or glass fiber post and direct composite resin. A PFG or a sintered alumina crown was considered. Model 3 was restored by EndoCrown. An oblique 500 N was applied on the buccal (Load A) and palatal (Load B) cusp. The von Mises stresses in the coronal and root structure of each model were analyzed using ANSYS. The elastic modulus of the definitive restorations rather than the type of post and core system was the primary factor that influenced the stress distribution of endodontically treated maxillary premolars. The stress concentration at the coronal structure could be lowered through the use of definitive restoration of high elastic modulus. The stress concentration at the root structure could be lowered through the use of definitive restoration of low elastic modulus.
Purpose: The purpose of this study was to compare the stress distribution characteristics of four different abutment connections on SS-$III^{(R)}$ fixture under occlusal loading, using 3-dimensional finite element method. Materials and methods: The fixture of SS-$III^{(R)}$ (Osstem, Korea) with 4 mm diameter and 11.5 mm length and 4 types of abutments were analyzed; Solid, Com-Octa, ComOcta Gold, and Octa abutment. The models were placed in the area of first molar in the mandible. The 4 loading conditions were; (1) the vertical loading of 100 N on the central fossa, (2) the vertical loading of 100 N on the buccal cusp, (3) the $30^{\circ}$ inclined loading of 100 N to lingual side on the central fossa, and (4) the $30^{\circ}$ inclined loading of 100 N to the lingual side on the buccal cusp. The 3G.Author program was used, the von-Mises stress was calculated and the stress contours were plotted on each part of the implant systems and the surrounding bone structures. Results: Regardless of abutment types and loading conditions, higher stress concentration was observed at the cortical bone. In cancellous bone, the highest stress was observed at apical portion and the maximum stress occurred at the implant neck. The higher internal stress was observed in the fixtures than in the bone. The lowest stress was observed at loading condition 1 and the stress concentration was also lower than any other loading conditions. Conclusion: Within the limitation of the result of this study, it seems that the abutment connection type does not affect much on the stress distribution of bone structure.
Purpose: The purpose of this study was to compare the fracture behavior of Zironia, glass infiltrated Alumina and PFM full crown system. Materials and methods: Fifteen crowns for each of 3 experimental groups (Zironia, glass infiltrated Alumina and PFM full crown) were made by the conventional method. The crowns mounted on the testing jig were inclined in 30 degrees to the long axis of the tooth and the universal testing machine was used to measure the fracture strength. Results: 1. The mean fracture strengths were $588.3{\pm}49.6MPa$ for zirconia system, $569.1{\pm}61.8MPa$ for PFM system and $551.0{\pm}76.5MPa$ for glass-infiltrated alumina system (P>.05). 2. The mean shear bond strengths were $25.5{\pm}5.6MPa$ for zirconia system, $38.9{\pm}5.0MPa$ for Ni-Cr alloy system and $39.4{\pm}5.1MPa$ for glass-infiltrated alumina system. 3. The chemical bonding was observed at interfaces between PFM or glass-infiltrated alumina and veneering porcelain, however, no chemical bonding was observed at interface between zirconia and veneering porcelain. Conclusion: With the study, the fracture strengths of PFM crown system had a higher fracture strength than conventional zirconia system crown and glass-infiltrated alumina crowns. and than the shear bond strengths glass-infiltrated alumina system had a higher shear bond strength than conventional PFM system and zirconia system.
Purpose: The purpose of this study was to investigate the effects of the surface morphology of the implant neck on marginal bone stress measured by using finite element analysis in six implant models. Materials and methods: The submerged type rescue implant system (Dentis co., Daegu, Korea) was selected as an experimental model. The implants were divided into six groups whose implant necks were differently designed in terms of height (h, 0.4 and 1.0 mm) and width (platform width, w = 3.34 + 2b [b, 0.2, 0.3 and 0.4 mm]). Finite element models of implant/bone complex were created using an axisymmetric scheme. A load of 100 N was applied to the central node on the top of crown in parallel with the implant axis. The maximum compression stress was calculated and compared. Results: Stress concentration commonly observed around dental implants did not occur in the marginal bone around all six test implant models. Marginal bone stress varied according to the implant neck bevel which had different width and height. The stress was affected more markedly by the difference in height than in width. Conclusion: This result indicates that the implant neck bevel may play an important role in improving stress distribution in the marginal bone area.
Journal of the korean academy of Pediatric Dentistry
/
v.43
no.2
/
pp.176-186
/
2016
This study was performed to compare the shape and dimension of anterior zirconia crowns to other pediatric crowns using a three-dimensional scanner to investigate adequate amount of tooth preparation. Primary central and lateral anterior zirconia crowns, stainless steel crowns and celluloid strip crowns were scanned by a three-dimensional scanner. Outer and inner surfaces of zirconia and stainless steel crowns, and outer surface of celluloid strip crowns were analyzed. In outer scanned images, all sizes of central and lateral size 1 zirconia crown had the largest labiolingual diameter among the three crowns. In inner scanned images, zirconia crown's mesiodistal diameter was 0.7-1.0 mm smaller and crown length was approximately 1 mm shorter than those of stainless steel crowns. Zirconia crown's labiolingual diameter was larger in central crowns whereas it was smaller in lateral crowns than that of stainless steel crowns. Recommended preparation required for zirconia crown is incisal 2.5-3.0 mm, mesiodistal 1.5-2.0 mm, labial 0.5-1.0 mm. Cingulum should be trimmed parallel to the long axis. No more lingual reduction is needed in central incisors whereas additional 0.5 mm reduction is suggested in lateral incisors.
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