• The korean journal of orthodontics
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• v.37 no.4
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• pp.293-304
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• 2007

The purpose of this study was to estimate the fracture resistance of commercially available ceramic brackets to torsional force exerted from arch wires and to evaluate the characteristics of bracket fracture. Methods: Lingual root torque was applied to maxillary central incisor brackets with 0.022-inch slots by means of a $022\;{\times}\;028-inch$ stainless steel arch wire. A custom designed apparatus that attached to an Instron was used to test seven types of ceramic brackets (n = 15). The torque value and torque angle at fracture were measured. In order to evaluate the characteristics of failure, fracture sites and the failure patterns of brackets were examined with a Scanning Electron Microscope. Results: Crystal structure and manufacturing process of ceramic brackets had a significant effect on fracture resistance. Monocrystalline alumina (Inspire) brackets showed significantly greater resistance to torsional force than polycrystalline alumina brackets except InVu. There was no significant difference in fracture resistance during arch wire torsional force between ceramic brackets with metal slots and those without metal slots (p > 0.05). All Clarity brackets partially fractured only at the incisal slot base and the others broke at various locations. Conclusion: The fracture resistance of all the ceramic brackets during arch wire torsion appears to be adequate for clinical use.

• Restorative Dentistry and Endodontics
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• v.35 no.4
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• pp.257-266
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• 2010

The purpose of this study was to determine the effect of post types and sizes on fracture resistance in immature tooth model with various restorative techniques. Bovine incisors were sectioned 8 mm above and 12 mm below the cementoenamel junction to simulate immature tooth model. To compare various post-and-core restorations, canals were restored with gutta-percha and resin core, or reinforced dentin wall with dual-cured resin composite, followed by placement of D.T. LIGHT-POST, ParaPost XT, and various sizes of EverStick Post individually. All of specimens were stored in the distilled water for 72 hours and underwent 6,000 thermal cycles. After simulation of periodontal ligament structure with polyether impression material, compressive load was applied at 45 degrees to the long axis of the specimen until fracture was occurred. Experimental groups reinforced with post and composite resin were shown significantly higher fracture strength than gutta-percha group without post placement (p < 0.05). Most specimens fractured limited to cervical third of roots. Post types did not influence on fracture resistance and fracture level significantly when cement space was filled with dual-cured resin composite. In addition, no statistically significant differences were seen between customized and standardized glass fiber posts, which cement spaces were filled with resin cement or composite resin individually. Therefore, root reinforcement procedures as above in immature teeth improved fracture resistance regardless of post types and sizes.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.383-389
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• 2009

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group. the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core-post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n = 12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core-post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.424-429
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• 2009

This study aimed to assess the influence of different cross-sectional area on the cyclic fatigue fracture of Ni-Ti rotary files using a fatigue tester incorporating cyclical axial movement. Six brands of Ni-Ti rotary files (ISO 30 size with. 04 taper) of 10 each were tested: Alpha system (KOMET), HeroShaper (MicroMega), K3 (SybronEndo), Mtwo (VDW), NRT (Mani), and ProFile (Dentsply). A fatigue-tester (Denbotix) was designed to allow cyclic tension and compressive stress on the tip of the instrument. Each file was mounted on a torque controlled motor (Aseptico) using a 1:20 reduction contra-angle and was rotated at 300 rpm with a continuous, 6 mm axial oscillating motion inside an artificial steel canal. The canal had a $60^{\circ}$ angle and a 5 mm radius of curvature. Instrument fracture was visually detected and the time until fracture was recorded by a digital stop watch. The data were analyzed statistically. Fractographic analysis of all fractured surfaces was performed to determine the fracture modes using a scanning electron microscope. Cross-sectional area at 3 mm from the tip of 3 unused Ni-Ti instruments for each group was calculated using Image-Pro Plus (Imagej 1.34n, NIH). Results showed that NRT and ProFile had significantly longer time to fracture compared to the other groups (p < .05). The cross-sectional area was not significantly associated with fatigue resistance. Fractographycally, all fractured surfaces demonstrated a combination of ductile and brittle fracture. In conclusion, there was no significant relationship between fatigue resistance and the cross-sectional area of Ni-Ti instruments under experimental conditions.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.194-201
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• 2010

Purpose: The purpose was to compare the marginal fidelity and the fracture resistance of the zirconia crowns according to the various coping designs with different thicknesses and cement types. Materials and methods: Zirconia copings were designed and fabricated with various thicknesses using the CAD/CAM system (Everest, KaVo Dental GmbH, Biberach., Germany). Eighty zirconia copings were divided into 4 groups (Group I: even 0.3 mm thickness, Group II: 0.3 mm thickness on the buccal surface and the buccal half of occlusal surface and the 0.6 mm thickness on the lingual surface and the lingual half of occlusal surface, Group III: even 0.6 mm thickness, Group IV: 0.6 mm thickness on the buccal surface and the buccal half of occlusal surface and the 1.0 mm thickness on the lingual surface and the lingual half of occlusal surface) of 20. By using a putty index, zirconia crowns with the same size and contour were fabricated. Each group was divided into two subgroups by type of cement: Cavitec$^{(R)}$ (Kerr Co, USA) and Panavia-$F^{(R)}$ (Kuraray Medical Inc, Japan). After the cementation of the crowns with a static load compressor, the marginal fidelity of the zirconia crowns were measured at margins on the buccal, lingual, mesial and distal surfaces, using a microscope of microhardness tester (Matsuzawa, MXT-70, Japan, ${\times}100$). The fracture resistance of each crown was measured using a universal testing machine (Z020, Zwick, Germany) at a crosshead speed of 1 mm/min. The results were analyzed statistically by the two-way ANOVA and oneway ANOVA and Duncan's multiple range test at $\alpha$=.05. Results: Group I and III showed the smallest marginal fidelity, while group II demonstrated the largest value in Cavitec$^{(R)}$ subgroup (P<.05). For fracture resistance, group III and IV were significantly higher than group I and II in Cavitec$^{(R)}$ subgroup (P<.05). The fracture resistances of Panavia-$F^{(R)}$ subgroup were not significantly different among the groups (P>.05). Panavia-$F^{(R)}$ subgroup showed significantly higher fracture resistance than Cavitec$^{(R)}$ subgroup in group I and II (P<.05). Conclusion: Within the limitation of this study, considering fracture resistance or marginal fidelity and esthetics, a functional ceramic substructure design of the coping with slim visible surface can be used for esthetic purposes, or a thick invisible surface to support the veneering ceramic can be used depending on the priority.

• Journal of Periodontal and Implant Science
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• v.35 no.2
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• pp.413-426
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• 2005

수직 치근파절은 특이성을 나타내지 않기 때문에 치과의사가 정확한 진단을 하기 어렵다. 따라서 수직 치근파절의 임상적 특징, 진단적 증상을 파악하여 향후 근관치료된 치아나 치료되지 않은 치아에서 수직 치근파절의 유발인자와의 관련성 및 고찰을 통해 수직 치근파절의 예방 및 치료에 응용할 수 있을 것으로 생각된다. 연구대상은 조선대학교 부속치과병원 치주과에 내원한 환자 중 최근 2년간 144명의 환자에서 근관치료를 받았거나 받지 않았던 치아 중 임상적 및 방사선학적으로 수직 치근파절로 진단된 156개의 증례를 대상으로 하였다. 모든 불확실한 증례에서 수직 지근파절의 최종 진단은 외과적 탐지를 통해 이루어졌고, 금이 간 치아와 관련될 수 있는 치근파절의 증례의 경우는 제외되었다. 근관치료된 치아와 치료되지 않은 치아, 환자의 나이와 성별, 치아종류 및 파절된 치근부위, 자각증상의 유무를 기준으로 각각의 수치와 백분율로 분류하였다. 수직 치근파절의 증상과 증후별로 분류하였으며, 진단방법에 의한 분류, 치료방법에 따른 분류, 근관 치료 후 수직 치근파절이 발생한 기간에 따른 분류를 시행하고 통계분석을 하여 다음과 같은 결과를 얻었다. 1. 근관치료를 받지 않았던 치아의 수직 치근파절의 발생율은 58%였다. 2. 성별에 따른 발생률에 있어서 남성의 호발양상을 나타내었다. 3. 근관치료된 치아에 있어서 치료되지 않은 치아에 비해 호발연령이 낮았다. 4. 전치부의 수직 치근파절은 관찰되지 않았으며 특히, 강한 교합력을 필요로 히는 구치부에서의 높은 발생율을 나타냈다. 5. 수직 치근파절의 가장 주된 증상 및 증후는 깊은 치주낭 깊이였다. 6. 근관 치료 후 수직 치근파절이 발생한 기간은 평균 5.7년이었다. 7. 다수 증례에 있어서 3개 이하의 결손치를 가졌고, 자각증상이 나타났다. 이상의 결괴에서 한국인에 있어서 근관치료를 받지 않은 치아의 수직 치근파절은 드문 현상이 아님을 알 수 있었고 남성과 구치부에 있어서의 높은 발생율을 알 수 있었다. 그 이유로는 강한 교합력, 딱딱한 음식의 저작습관, 치조골 흡수에 따른 낮은 저항성, 골 유연성의 저하 등으로 여겨진다. 그러나, 수직 치근파절은 아직까지 정확한 진단을 내리기는 여전히 어려운 상태이며, 이를 위한 다양한 진단방법 및 더 나은 연구가 필수적이라 하겠다. 그리고, 향후 보다 많은 증례에 대한 분석, 치주질환에 이환되지 않은 경우의 분석, 치료 후 생존 기간에 대한 고찰 등도 필요하리라 사료된다.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.2
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• pp.135-142
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• 2022

Purpose. This study aims to evaluate the combined effect of reduced thickness in different regions on the fracture resistance of monolithic zirconia crowns. Materials and methods. Seven nickel-chromium dies were generated from a 3D model of mandibular first molar using the digital scanner with the following geometries: 1.5 mm occlusal reduction, 1.0 mm deep chamfer. Based on the abutment model, Zirconia blocks (Luxen Zirconia) were selected to fabricate Sixty-three zirconia crowns with occlusal thicknesses of 0.3 mm, 0.5 mm, and 1.5 mm, and different axial thicknesses of 0.3 mm, 0.5 mm, and 1.0 mm. All crowns were cemented by resin cement. Next, the crowns were subjected to load-to-fracture test until fracture using an electronic universal testing machine. In addition, fracture patterns were observed with a scanning electron microscope (SEM). Two-way ANOVA and the Tuckey HSD test for post hoc analysis were used for statistical analysis (P < .05). Results. The mean values of fracture resistancerecorded was higher than the average biting force in the posterior region. The two-way ANOVA showed that the occlusal and axial thickness affected the fracture resistance significantly (P < .05). However, the effect of axial thickness on fracture resistance did not show a statistical difference when thicker than 0.5 mm. The observed failure modes were partial or complete fracture depending on the severity of crack propagation. Conclusion. Within the limitations of the present study, the CAD-CAM monolithic zirconia crown with extremely reduced thickness showed adequate fracture resistance to withstand occlusal load in molar regions. In addition, both occlusal and axial thickness affected the fracture resistance of the zirconia crown and showed different results as combined.

• Proceedings of the KACD Conference
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• 2008.05a
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• pp.177-183
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• 2008

It was reported that esthetic composite resin restoration reinforces the strength of remaining tooth structure with preserving the natural tooth structure. However, it is unknown how much the strength would be recovered. The purpose of this study was to compare the fracture resistance of three types of undermined cavity filled with composite resin with that of non-cavitated natural tooth. Forty sound upper molars were allocated randomly into four groups of 10 teeth. After flattening occlusal enamel. undermined cavities were prepared in thirty teeth to make three types of specimens with various thickness of occlusal structure (Group $1{\sim}3$). All the cavity have the 5 mm width mesio-distally and 7 mm depth bucco-lingually. Another natural 10 teeth (Group 4) were used as a control group. Teeth in group 1 have remaining occlusal structure about 1 mm thickness, which was composed of mainly enamel and small amount of dentin. In Group 2, remained thickness was about 1.5 mm, including 0.5 mm thickness dentin. In Group 3, thickness was about 2.0 mm, including 1 mm thickness dentin. Every effort was made to keep the remaining dentin thickness about 0.5 mm from the pulp space in cavitated groups. All the thickness was evaluated with radiographic Length Analyzer program. After acid etching with 37% phosphoric acid, one-bottle adhesive (Single $Bond^{TM}$, 3M/ESPE, USA) was applied following the manufacturer's recommendation and cavities were incrementally filled with hybrid composite resin (Filtek $Z-250^{TM}$, 3M/ESPE, USA). Teeth were stored in distilled water for one day at room temperature, after then, they were finished and polished with Sof-Lex system. All specimens were embedded in acrylic resin and static load was applied to the specimens with a 3 mm diameter stainless steel rod in an Universal testing machine and cross-head speed was 1 mm/min. Maximum load in case of fracture was recorded for each specimen. The data were statistically analyzed using one-way analysis of variance (ANOVA) and a Tukey test at the 95% confidence level. The results were as follows: 1. Fracture resistance of the undermined cavity filled with composite resin was about 75% of the natural tooth. 2. No significant difference on fracture loads of composite resin restoration was found among the three types of cavitated groups. Within the limits of this study, it can be concluded the fracture resistance of the undermined cavity filled with composite resin was lower than that of natural teeth, however remaining tooth structure may be supported and saved by the reinforcement with adhesive restoration, even of that portion consists of mainly enamel and a little dentin structure.

• Restorative Dentistry and Endodontics
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• v.33 no.3
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• pp.177-183
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• 2008

It was reported that esthetic composite resin restoration reinforces the strength of remaining tooth structure with preserving the natural tooth structure. However, it is unknown how much the strength would be recovered. The purpose of this study was to compare the fracture resistance of three types of undermined cavity filled with composite resin with that of non-cavitated natural tooth. Forty sound upper molars were allocated randomly into four groups of 10 teeth. After flattening occlusal enamel, undermined cavities were prepared in thirty teeth to make three types of specimens with various thickness of occlusal structure (Group $1{\sim}3$). All the cavity have the 5 mm width mesiodistally and 7 mm depth bucco-lingually. Another natural 10 teeth (Group 4) were used as a control group. Teeth in group 1 have remaining occlusal structure about 1 mm thickness, which was composed of mainly enamel and small amount of dentin. In Group 2, remained thickness was about 1.5 mm, including 0.5 mm thickness dentin. In Group 3, thickness was about 2.0 mm, including 1 mm thickness dentin. Every effort was made to keep the remaining dentin thickness about 0.5 mm from the pulp space in cavitated groups. All the thickness was evaluated with radiographic Length Analyzer program. After acid etching with 37% phosphoric acid, one-bottle adhesive (Single $Bond^{TM}$, 3M/ESPE, USA) was applied following the manufacturer's recommendation and cavities were incrementally filled with hybrid composite resin (Filtek $Z-250^{TM}$, 3M/ESPE, USA). Teeth were stored in distilled water for one day at room temperature, after then, they were finished and polished with Sof-Lex system. All specimens were embedded in acrylic resin and static load was applied to the specimens with a 3 mm diameter stainless steel rod in an Universal testing machine and cross-head speed was 1 mm/min. Maximum load in case of fracture was recorded for each specimen. The data were statistically analyzed using one-way analysis of variance (ANOVA) and a Tukey test at the 95% confidence level. The results were as follows: 1. Fracture resistance of the undermined cavity filled with composite resin was about 75% of the natural tooth. 2. No significant difference in fracture loads of composite resin restoration was found among the three types of cavitated groups. Within the limits of this study, it can be concluded the fracture resistance of the undermined cavity filled with composite resin was lower than that of natural teeth, however remaining tooth structure may be supported and saved by the reinforcement with adhesive restoration, even if that portion consists of mainly enamel and a little dentin structure.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.127-133
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• 2019

Purpose: The purpose of present study was to investigate fracture strength and mode of failure of endodontically treated teeth restored with metal cast post-core system, prefabricated fiber post system, and newly introduced polyetherketoneketone (PEKK) post-core system. Materials and methods: A total of 21 mandibular premolar were randomly grouped into 3 groups of 7 each according to the post material. Group A was for metal cast post core; Group B for prefabricated glass fiber post and resin core; and Group C for milled PEKK post cores. All specimens were restored with metal crown. The fracture strength of each specimen was measured by applying a static load of 135-degree to the tooth at 2 mm/min crosshead speed using a universal testing machine. After the fracture strength measurement, the mode of failure was observed. The results were analyzed using Kruscal-Wallis test and post hoc Mann-Whitney U test at confidence interval ${\alpha}=.05$. Results: Fracture resistance of PEKK post core was lower than those of cast metal post and fiber reinforced post with composite resin core. In the aspect of fracture mode most of the root fracture occurred in the metal post core, whereas the post detachment occurred mainly in the fiber reinforced post. In the case of PEKK post core, teeth and post were fractured together. Conclusion: It is necessary to select appropriate materials of post for extensively damaged teeth restoration and clinical application of the PEKK post seems to require more research on improvement of strength.