The restorations of the severely damaged teeth by post core have been increased with the developement of endodontic procedures. But high failure rates of these procedures being reported, various restorative modifications were induced for successful treatments. Cast post-core and prefabricated post with core buildups are choice of treatment. The main causes of failure of the restorations are the fracture of post and core, root fracture, and recurrent caries due to microleakage. Recently, the acid etching technique and the use of dentin bonding agent at tooth surface to reduce the possible microleakage at the tooth-restoration interfaces were introduced. The object of this study was to measure and compare the microleakage by the types and cementation methods of post-core. For this study, forty extracted human anterior teeth were selected for specimen. After cleansing and routine endodontic procedures, anatomic crowns of each specimen were removed at the level of 2mm above the cementoenamel junction. Canals were preparated for post insertion and specimens were divided into four groups randomly. Post-cores were fabricated according to method for each group. Microleakage was measured by length of dye penetration at the tooth-restoration interfaces with measuring microscope at 50 magnification. Oneway ANOVA and t-test were performed for statistical analysis of resulting data. The following results were obtained from this study. 1. There wert significant statistical differences in degree of microleakage between each group (p<0.01). 2. Cast post-core cemented with ZPC (Group I) showed the most severe microleakage pattern$(1.5547{\pm}0.0872mm)$, and cast post-core cemented with adhesive resin cement after tooth surface treatment with dentin bonding agent (Group II) showed the least microleakage $(0.1497{\pm}0.0872mm)$. 3. Group IV revealed less dye penetrations than group III, but no statistical significance was seen between two groups.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제42권5호
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pp.259-264
/
2016
Objectives: We evaluated and recorded post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve (IAN) in mandibular fracture in order to identify associated risk factors. Materials and Methods: This was a prospective cohort study composed of 60 patients treated for mandibular fracture. The primary study variable was the change between the post-traumatic IAN neurosensory examination score and the score after fracture reduction. Risk factors were categorized as demographic, anatomic, fracture displacement, and treatment. Appropriate descriptive and bivariate statistics were computed. Results: Sixty patients with unilateral mandibular fracture reported within 24 hours of injury were evaluated over a one-year period. A post-traumatic neurosensory deficit was observed in 52 patients (86.7%), the percentage of which was reduced to 23.3% over the follow-up period. Abnormal postoperative neurosensory scores were significantly higher in angle fracture cases (33.3%) compared to body fracture cases (11.1%). When recovered and non-recovered neurosensory scores were compared by fracture location, 88.9% of body fracture cases showed significant recovery compared to 66.7% of mandibular angle fracture cases. Cases with less than 5 mm fracture displacement showed statistically significantly higher neurosensory recovery scores (90.6%) compared to those with more than 5 mm fracture displacement (60.7%). Conclusion: Use of a miniplate with mono-cortical screws does not play a role in increasing IAN post-traumatic neurosensory deficit. Early management can reduce the chances of permanent neurosensory deficit. Mandibular fracture displacement of 5 mm or more and fracture location were found to be associated with an increased risk of post-traumatic IAN neurosensory score worsening.
Background Partially resecting ribs of the recipient site to facilitate easy anastomosis of the internal mammary vessels to free flaps during breast reconstruction can cause chest wall pain or deformities. To avoid this, the intercostal perforating branches of the internal mammary vessels can be used for anastomosis. The purpose of this study was to investigate the location and size of the internal mammary perforator vessels based on clinical intraoperative findings and to determine their reliability as recipient vessels for breast reconstruction with microsurgical free tissue transfer. Methods Twelve patients were preoperatively screened for the presence of internal mammary perforators using Doppler tracing. After modified radical mastectomy was performed by a general surgeon, the location and size of the internal mammary perforator vessels were microscopically investigated. The external diameter was examined using a vessel-measuring gauge from a mechanical coupling device, and the distance from the mid-sternal line to the perforator was also measured. Results The largest arterial perforator averaged 1.5 mm, and the largest venous perforator averaged 2.2 mm. Perforators emerging from the second intercostal space had the largest average external diameter; the second intercostal space also had the largest number of perforators arising from it. The average distance from the mid-sternal line to the perforator was 20.2 mm. Conclusions Internal mammary perforators presented consistent and reliable anatomy in this study. Based on these results, the internal mammary perforators appear to have a suitable diameter for microvascular anastomosis and should be considered as an alternative recipient vessel to the internal mammary vessel.
The staining tendency of esthetic restorative material was very important factor for the people who are great concern about the esthetics. Most external stains were superficial and adjustable by routine prophylactic procedure. But some of these stains were remained under superficial stain. Some of these stains were accumulative on external tooth surface and it's removal alter the anatomic contour of restoration. The purpose of this study was to evaluate and compare the staining tendency of esthetic restorative materials to staining solution. In this study two glass-ionomer cements (Fuji II Glass-Ionomer Cement and Fuji II LC Glass-Ionomer Cement) and three composite resins (Sil$\ddot{u}$x Plus, APH and P-50) were evaluated and compared. Total 8 disc-shaped specimens of each material (17mm diameter, Imm thick) were immersed in coffee staining solution. These specimens were divided into one control and 3 experimental groups according to the immersion period as follows : Control: immersed in distilled water during each testing period Group 1 : immersed in staining solution for 6 hours Group 2 : immersed in staining solution for 24 hours Group 3 : immersed in staining solution for 72 hours Staining tendency was evaluated by total color difference(${\Delta}E^*$) of specimen before and after staining by spectorcolorimeteric readings (ColorQUEST Spectrophotometer, U.SA.). The results were as follows : 1. The total color differences of each testing materials were increased with time. 2. Among the experimental groups, the Fuji II Glass Ionomer Cement showed the highest total color difference(6.803) and the Silux Plus showed the lowest total color difference(1.637). 3. In comparison of glass ionomer cements, the total color difference of chemical cured glass ionomer cements(6.803) were higher than light cured glass ionomer cements(3.891) (P<0.01). 4. In comparison of composite resins, the P-50 showed the highest total color difference and the Silux Plus showed the lowest total color difference, but there was not significant difference among composite resins(P>0.05).
Intervertebral disc(IVD) mainly consists of Annulus fibrosus(AF) and Nucleus pulposus(NP), playing a role of distributing a mechanical load on vertebral body. IVD tissue engineering has been developed the methods to achieve anatomic morphology and restoration of biological function. The goal of present study is to identify the possibilities for creating a substitute of IVD the morphology and biological functions are the same as undamaged complete IVD. To fabricate the AF and NP combine biphasic IVD tissue, AF tissue scaffolds have been printed by 3D bio-printing system with natural biomaterials and NP tissues have been prepared by scaffold-free culture system. We evaluated whether the combined structure of 3D printed AF scaffold and scaffold-free NP tissue construct could support the architecture and cell functions as IVD tissue. 3D printed AF scaffolds were printed with 60 degree angle stripe patterned lamella structure(the inner-diameter is 5mm, outer-diameter is 10 mm and height is 3 mm). In the cytotoxicity test, the 3D printed AF scaffold showed good cell compatibility. The results of histological and immunohistochemical staining also showed the newly synthesized collagens and glycosaminoglycans, which are specific makers of AF tissue. And scaffold-free NP tissue actively synthesized glycosaminoglycans and type 2 collagen, which are the major components of NP tissue. When we combined two engineered tissues to realize the IVD, combined biphasic tissues showed a good integration between the two tissues. In conclusion, this study describes the fabrication of Engineered biphasic IVD tissue by using enable techniques of tissue engineering. This fabricated biphasic tissue would be used as a model system for the study of the native IVD tissue. In the future, it may have the potential to replace the damaged IVD in the future.
Currently electronic apex locators have been widely used to determine working length in endodontic treatment. According to Manufacture's recommendation, it is beneficial to find the working length before instrumenting the canal. However, in crown-down pressureless technique, working length of tooth is established following coronal instrumentation 3mm short of radiographic apex. In narrow canals, mechanically formed constriction might be established by coronal instrumentation in some distance from anatomical constriction. The purpose of this study was to evaluate the accuracy of Root-ZX in the canal with mechanical constriction following considerable coronal enlargement with ProFile .06 series. The 40 root canals in 30 extracted mandibular molars were accessed, and their actual length (AL) established by passing a size 10 file just through the minor apical foramen. The teeth were then embedded in an acrylic container with normal saline. The initial canal length(IL) was measured with Root-ZX by negotiating a size 10 file to the apical constriction. The canal was sequentially enlarged to size 40 with ProFile .06 file 3mm short of actual length. The enlarged final canal lengths (FL) were obtained with a size 15 file. The average values of IL, FL were calculated and compared using Repeated measures Analysis of Variance followed Turkey's Studentized Range test. The results were obtained as follows: 1. The initial canal length was 0.12mm shorter than actual canal length(P>0.05). 2. The differences between initial canal length and final canal length were not significant(P>0.05). 3. As a result of this study, regardless of mechanically formed constriction. Root-ZX differentiated between mechanical and anatomic constriction.
Kim, Hee-Ho;Jo, Hyoung-Hoon;Min, Jeong-Bum;Hwang, Ho-Keel
Restorative Dentistry and Endodontics
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제43권3호
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pp.33.1-33.8
/
2018
Objectives: This study aimed to investigate the prevalence of a separate distolingual root and to measure the thickness of the buccal cortical bone in mandibular first molars in Koreans using cone-beam computed tomography (CBCT) images. Materials and Methods: High-quality CBCT data from 432 patients were analyzed in this study. The prevalence of a separate distolingual root of the mandibular first molar was investigated. The distance from the distobuccal and distolingual root apices to the outer surface of the buccal cortical bone was measured. We also evaluated the thickness of the buccal cortical bone. Results: The prevalence of a separate distolingual root (2 separate distal roots with 1 canal in each root; 2R2C) was 23.26%. In mandibular first molars with 2R2C, the distance from the distobuccal root apex to the outer surface of the buccal cortical bone was 5.51 mm. Furthermore, the distance from the distolingual root apex to the outer surface of the buccal cortical bone was 12.09 mm. In mandibular first molars with 2R2C morphology, the thickness of the buccal cortical bone at the distobuccal root apex of the mandibular first molar was 3.30 mm. The buccal cortical bone at the distobuccal root apex was significantly thicker in the right side (3.38 mm) than the left side (3.09 mm) (p < 0.05). Conclusions: A separate distolingual root is not rare in mandibular first molars in the Korean population. Anatomic and morphologic knowledge of the mandibular first molar can be useful in treatment planning, including surgical endodontic treatment.
Nascimento, Eduarda Helena Leandro do;Pontual, Maria Luiza dos Anjos;Pontual, Andrea dos Anjos;Perez, Danyel Elias da Cruz;Figueiroa, Jose Natal;Frazao, Marco Antonio Gomes;Ramos-Perez, Flavia Maria de Moraes
Imaging Science in Dentistry
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제46권2호
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pp.69-75
/
2016
Purpose: Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results: An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, $1.1{\pm}0.8mm$). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion: In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.
An esthetically pleasing result in denture service is dependent upon several consideration. Esthetic considerations for the edentulous patient include tooth size, shape, arrangement, positioning, gingival contour, age, sex, personality differences, and ethnic type. Especially, the form of anterior artificial teeth is an important factor on the esthetics. The selection of artificaial teeth requires understanding and knowledge on physical and biologic factors and has to meet the indivisul esthetics and functional needs of each patient. However, the selection of artificial teeth is based on the large degree of subjective judgement of the dentist, Therefore, this is one of the most unscientific processes. Many attempts have been made to find a guideline for the selection of artificial teeth. Temperamental theory by White and Hall utillized with the physical characteristics such as body size, body form, color of eyes and hair, and disposition. SPA theory by Frush and Fisher utilized with the basis of sex, personalities, and age of the indivisual. There has not been provided for a guideline and study on the selection of artificial teeth for Koreans yet. This study was aimed to evaluate the William's typal matching theory in Koreans. 1. The facial forms of korean adult were ovoid(46.3%), square(36.7%) and tapered(17.0%) form. 2. The anatomic forms of natural maxillary incisors were ovoid(45.3%), tapered(31.3%), square(23.3%) form. 3. The forms of face and natural maxillary incisors were ovoid(21.9%), squared(11%), tapered(6.3%). 4. The natural maxillary incisors were similar in form to the facial form only in 39%. There was no correlation between the form of the face and the form of natural maxillary central inisors in Koreans. 5. Artificaial teeth which was selected according to the typal matching theory did not represent the form of the natural teeth in 61 per cents of the fatal, but it felt that they harmonized with the form of the patient's face and produced good results.
Purpose: Posttraumatic nasal deformities might not be corrected adequately by conventional osteotomy techniques when the configuration of the nasal bone has been changed due to malunion. To consistently obtain good aesthetic and functional results, the anatomic reduction of malunion sites of the nasal bone is important. The purpose of this study is to present an osteotomy technique, including refracture along malunion sites and anatomical reduction of a malformed nasal bone, for the correction of a posttraumatic deviated nose. Methods: From March of 2003 to May of 2004, 27 patients, who underwent corrective rhinoplasty for the correction of bony pyramid deviation, were included in this study. Postoperative results of the technique were evaluated objectively at 1 year after surgery regarding nasal midline location, nose symmetry, and nasal contour. Results were rated as excellent, good, fair, or poor. All patients were also evaluated subjectively for cosmetic improvement, changes in breathing, and overall satisfaction. Results: Objective analysis of the outcomes revealed an excellent result in 17 patients(63%), good in 9(33%), and fair in 1 patient(4%). No case evaluated had a poor result. Regarding subjective analysis, 19 patients(70%) evaluated the cosmetic outcome as perfect. Among the 21 patients with preoperative airway problems, 19 patients(90%) reported improved breathing post-operatively. Patients' overall satisfaction levels were also very positive. No postoperative complications occurred during the 14 month mean follow-up period. Conclusion: The osteotomy technique presented in this study is simple, effective, and safe for correcting posttraumatic nasal deviation, and also produces consistent results.
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