• The Journal of Advanced Prosthodontics
• /
• v.7 no.1
• /
• pp.51-55
• /
• 2015

PURPOSE. Bone density at implant placement site is a key factor to obtain the primary stability of the fixture, which, in turn, is a prognostic factor for osseointegration and long-term success of an implant supported rehabilitation. Recently, an implant motor with a bone density measurement probe has been introduced. The aim of the present study was to test the objectiveness of the bone densities registered by the implant motor regardless of the operator performing them. MATERIALS AND METHODS. A total of 3704 bone density measurements, performed by means of the implant motor, were registered by 39 operators at different implant sites during routine activity. Bone density measurements were grouped according to their distribution across the jaws. Specifically, four different areas were distinguished: a pre-antral (between teeth from first right maxillary premolar to first left maxillary premolar) and a sub-antral (more distally) zone in the maxilla, and an interforaminal (between and including teeth from first left mandibular premolar to first right mandibular premolar) and a retroforaminal (more distally) zone in the lower one. A statistical comparison was performed to check the inter-operators variability of the collected data. RESULTS. The device produced consistent and operator-independent bone density values at each tooth position, showing a reliable bone-density measurement. CONCLUSION. The implant motor demonstrated to be a helpful tool to properly plan implant placement and loading irrespective of the operator using it.

• The Journal of Advanced Prosthodontics
• /
• v.5 no.3
• /
• pp.262-269
• /
• 2013

PURPOSE. Perceived color of ceramics changes by the spectral power distribution of ambient light. This study aimed to quantify the amount of shifts in color and color coordinates of clinically simulated seven all-ceramics due to the switch of three ambient light sources using a human vision simulating spectroradiometer. MATERIALS AND METHODS. CIE color coordinates, such as $L^*$, $a^*$ and $b^*$, of ceramic specimens were measured under three light sources, which simulate the CIE standard illuminant D65 (daylight), A (incandescent lamp), and F9 (fluorescent lamp). Shifts in color and color coordinate by the switch of lights were determined. Influence of the switched light (D65 to A, or D65 to F9), shade of veneer ceramics (A2 or A3), and brand of ceramics on the shifts was analyzed by a three-way ANOVA. RESULTS. Shifts in color and color coordinates were influenced by three factors (P<.05). Color shifts by the switch to A were in the range of 5.9 to 7.7 ${\Delta}E{^*}_{ab}$ units, and those by the switch to F9 were 7.7 to 10.2; all of which were unacceptable (${\Delta}E{^*}_{ab}$ > 5.5). When switched to A, CIE $a^*$ increased (${\Delta}a^*$: 5.6 to 7.6), however, CIE $b^*$ increased (${\Delta}b^*$: 4.9 to 7.8) when switched to F9. CONCLUSION. Clinically simulated ceramics demonstrated clinically unacceptable color shifts according to the switches in ambient lights based on spectroradiometric readings. Therefore, shade matching and compatibility evaluation should be performed considering ambient lighting conditions and should be done under most relevant lighting condition.

• The Journal of Advanced Prosthodontics
• /
• v.5 no.4
• /
• pp.388-395
• /
• 2013

PURPOSE. The purpose of this study was to estimate the effects of occlusal stability to identify action mechanisms of mouthguards, known to have a modulatory effect on limb muscle function. MATERIALS AND METHODS. This study included 20 male subjects to perform the isokinetic muscle tests and the Wingate anaerobic power test on both knee joints under five closed-mouth conditions: without or with 4 types of mouthguards with thickness of 2 mm based on premolar area: (1) full-coverage, (2) anterior partial-coverage, (3) right posterior partial-coverage, and (4) left posterior partial-coverage. The obtained results were subjected to One-way ANOVA with repeated measures, followed by post hoc test of the contrast method (${\alpha}$=.05). RESULTS. There was no significant difference between the closed position with and without a full-coverage mouthguard in all variables. However, significant differences were observed between with and without a partial-coverage mouthguard in muscular endurance during extension of the left knee, muscular power and endurance during flexion of the right knee. Additionally, significant differences were found between occlusal states with full- and partial-coverage mouthguards in muscular power and endurance during extension of the left knee. CONCLUSION. These findings indicate the elevation of vertical dimension by 2 mm or the inducement of occlusal stability had little effect on isokinetic muscle strength and anaerobic performance, while uneven distribution of occlusal force might have some positive effects.

• The Journal of Advanced Prosthodontics
• /
• v.5 no.3
• /
• pp.312-318
• /
• 2013

PURPOSE. The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. MATERIALS AND METHODS. A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of ${\alpha}$=.05. RESULTS. The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 ${\mu}m/m$ at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. CONCLUSION. Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.5
• /
• pp.339-344
• /
• 2016

PURPOSE. Pre-surface treatments of coping materials have been recommended to enhance the bonding to the veneering ceramic. Little is known on the effect on shear bond strength, particularly with new coping material. The aim of this study was to investigate the shear bond strength of veneering ceramic to three coping materials: i) metal alloy (MA), ii) zirconia oxide (ZO), and iii) lithium disilicate (LD) after various pre-surface treatments. MATERIALS AND METHODS. Thirty-two (n = 32) discs were prepared for each coping material. Four pre-surface treatments were prepared for each sub-group (n = 8); a) no treatment or control (C), b) sandblast (SB), c) acid etch (AE), and d) sandblast and acid etch (SBAE). Veneering ceramics were applied to all discs. Shear bond strength was measured with a universal testing machine. Data were analyzed with two-way ANOVA and Tukey's multiple comparisons tests. RESULTS. Mean shear bond strengths were obtained for MA ($19.00{\pm}6.39MPa$), ZO ($24.45{\pm}5.14MPa$) and LD ($13.62{\pm}5.12MPa$). There were statistically significant differences in types of coping material and various pre-surface treatments (P<.05). There was a significant correlation between coping materials and pre-surface treatment to the shear bond strength (P<.05). CONCLUSION. Shear bond strength of veneering ceramic to zirconia oxide was higher than metal alloy and lithium disilicate. The highest shear bond strengths were obtained in sandblast and acid etch treatment for zirconia oxide and lithium disilicate groups, and in acid etch treatment for metal alloy group.

• The Journal of Advanced Prosthodontics
• /
• v.10 no.3
• /
• pp.252-258
• /
• 2018

PURPOSE. The purpose of this study was to evaluate the repeatability and matching accuracy between two identical intraoral spectrophotometers. MATERIALS AND METHODS. The maxillary right central incisor, canine, and mandibular left central incisor of each of 30 patients were measured using 2 identical intraoral spectrophotometers with different serial numbers (EasyShade V). The color of each shade tab from 3 shade guides (VITA 3D-Master) was also determined with both devices. All measurements were performed by a single operator. Statistical analyses were performed to verify the repeatability, accuracy, and the differences between the devices with paired t-tests, one-way ANOVA, and intra-class correlation coefficients (ICCs) (${\alpha}=.05$). RESULTS. A high level of measurement repeatability (ICC>0.90) among $L^*$, $a^*$, and $b^*$ color components was observed within and between devices (P<.001). Intra-device matching agreement rates were 80.00% and 81.11%, respectively, while inter-device matching agreement rate was 51.85%. ANOVA revealed no significant different color values within each device, while paired t-test provided significant different color values between both devices. The CIEDE2000 color differences between both devices were $2.28{\pm}1.61$ ${\Delta}E_{00}$ for in-vivo readings. Regarding the clinical matching accuracy of both devices, ${\Delta}E_{00}$ values between teeth and matching shade tabs were $3.05{\pm}1.19$ and $2.86{\pm}1.02$, respectively. CONCLUSION. Although two EasyShade V devices with different serial numbers show high repeatability of CIE $L^*$, $a^*$, and $b^*$ measurements, they could provide different color values and shade for the same tooth.

• The Journal of Advanced Prosthodontics
• /
• v.9 no.5
• /
• pp.350-357
• /
• 2017

PURPOSE. The object of the present study was to evaluate the shear bonding strength of composite to PEKK by applying several methods of surface treatment associated with various bonding materials. MATERIALS AND METHODS. One hundred and fifty PEKK specimens were assigned randomly to fifteen groups (n = 10) with the combination of three different surface treatments (95% sulfuric acid etching, airborne abrasion with $50{\mu}m$ alumina, and airborne abrasion with $110{\mu}m$ silica-coating alumina) and five different bonding materials (Luxatemp Glaze & Bond, Visio.link, All-Bond Universal, Single Bond Universal, and Monobond Plus with Heliobond). After surface treatment, surface roughness and contact angles were examined. Topography modifications after surface treatment were assessed with scanning electron microscopy. Resin composite was mounted on each specimen and then subjected to shear bond strength (SBS) test. SBS data were analyzed statistically using two-way ANOVA, and post-hoc Tukey's test (P<.05). RESULTS. Regardless of bonding materials, mechanical surface treatment groups yielded significantly higher shear bonding strength values than chemical surface treatment groups. Unlike other adhesives, MDP and silane containing self-etching universal adhesive (Single Bond Universal) showed an effective shear bonding strength regardless of surface treatment method. CONCLUSION. Mechanical surface treatment behaves better in terms of PEKK bonding. In addition, self-etching universal adhesive (Single Bond Universal) can be an alternative bonding material to PEKK irrespective of surface treatment method.

• The Journal of Advanced Prosthodontics
• /
• v.6 no.5
• /
• pp.333-345
• /
• 2014

PURPOSE. Bonding agents (BA) are the crucial weak link of composite restorations. Since the commercial materials' compositions are not disclosed, studies to formulize the optimum ratios of different components are of value. The aim of this study was to find a proper formula of BAs. MATERIALS AND METHODS. This explorative experimental in vitro study was composed of 4 different sets of extensive experiments. A commercial BA and 7 experimental formulas were compared in terms of degree of conversion (5 experimental formulas), shear bond strength, mode of failure, and microleakage (3 experimental formulas). Statistical analyses were performed (${\alpha}$=.05). The DC of selected formula was tested one year later. RESULTS. The two-way ANOVA indicated a significant difference between the shear bond strength (SBS) of two tissues (dentin vs. enamel, P=.0001) in a way that dentinal bonds were weaker. However, there was no difference between the four materials (P=.283). The adhesive mode of failure was predominant in all groups. No differences between the microleakage of the four materials at occlusal (P=.788) or gingival (P=.508) sites were detected (Kruskal-Wallis). The Mann-Whitney U test showed a significant difference between the microleakage of all materials (3 experimental formulas and a commercial material) together at the occlusal site versus the gingival site (P=.041). CONCLUSION. A formula with 62% bisphenol A-glycidyl methacrylate (Bis-GMA), 37% hydroxy ethyl methacrylate (HEMA), 0.3% camphorquinone (CQ), and 0.7% dimethyl-para-toluidine (DMPT) seems a proper formula for mass production. The microleakage and SBS might be respectively higher and lower on dentin compared to enamel.

• The Journal of Advanced Prosthodontics
• /
• v.9 no.1
• /
• pp.67-73
• /
• 2017

PURPOSE. The aims of the study were to evaluate the fracture load of zirconia core material after dipping in coloring liquid at different time intervals and to compare the color of dipped blocks with that of prefabricated shaded blocks. MATERIALS AND METHODS. 3-unit bridge frameworks were designed digitally. Sixty frameworks were fabricated using uncolored zirconia blocks by CAD/CAM and divided into 4 groups randomly (n = 15). Group 2 (G2) was subjected to coloring liquids for 2 minutes, Group 4 (G4) for 4 minutes, and Group 6 (G6) for 6 minutes. CFS group was not subjected to any coloring procedure. After coloring, color differences between the test groups and a prefabricated shaded zirconia group (CPZ, n = 15) were evaluated by using a spectrophotometer. Fracture test was conducted immediately after shade evaluation with a Testometric test device at a cross-head speed of 1 mm/sec. Statistical analysis for evaluating color and fracture load was performed by using one way ANOVA followed by Tukey HSD test ($P{\leq}.05$). Weibull analysis was conducted for distribution of fracture load. RESULTS. There was no difference in terms of fracture load and color between CFS (1176.681 N) and G2 (985.638 N) group and between CPZ (81.340) and G2 (81.140) group, respectively. Fracture load values of G4 (779.340 N) and G6 (935.491 N) groups were statistically significantly lower than that of CFS group ($P{\leq}.005$). The color values of G4 (79.340) and G6 (79.673) groups were statistically different than that of CPZ group ($P{\leq}.005$). CONCLUSION. Prolonged immersion of zirconia in coloring liquid not only negatively affected the fracture load of the zirconia being tested in the current study but also deteriorated the desired shade of the restoration.

• The Journal of Advanced Prosthodontics
• /
• v.9 no.6
• /
• pp.453-462
• /
• 2017

PURPOSE. The purpose of this study was to investigate the in vitro cytotoxicity of thermoplastic denture base resins and to identify the possible adverse effects of these resins on oral keratinocytes in response to hot water/ food intake. MATERIALS AND METHODS. Six dental thermoplastic resin materials were evaluated: three polyamide materials (Smile tone, ST; Valplast, VP; and Luciton FRS, LF), two acrylic materials (Acrytone, AT; and Acryshot, AS), and one polypropylene resin material (Unigum, UG). One heat-polymerized acrylic resin (Vertex RS, RS) was chosen for comparison. After obtaining extracts from specimens of the denture resin materials (${\phi}=10$ mm and d=2 mm) under different extraction conditions ($37^{\circ}C$ for 24 hours, $70^{\circ}C$ for 24 hours, and $121^{\circ}C$ for 1 hour), the extracts (50%) or serial dilutions (25%, 12.5%, and 6.25%) in distilled water were co-cultured for 24 hours with immortalized human oral keratinocytes (IHOKs) or mouse fibroblasts (L929s) for the cytotoxicity assay described in ISO 10993. RESULTS. Greater than 70% viability was detected under all test conditions. Significantly lower IHOK and L929 viability was detected in the 50% extract from the VP ($70^{\circ}C$) and AT ($121^{\circ}C$) samples (P<.05), but only L929 showed reduced viability in the 50% and 25% extract from LF ($37^{\circ}C$) (P<.05). CONCLUSION. Extracts obtained from six materials under different extraction conditions ($37^{\circ}C$, $70^{\circ}C$, and $121^{\circ}C$) did not exhibit severe cytotoxicity (less than 70% viability), although their potential risk to oral mucosa at high temperatures should not be ignored.