Many studies reported that the presence of cervical enamel projection (CEP) in cemento-enamel junction(CEJ) is greatly related to periodontal disease. The aim of this study was to investigate the prevalence of enamel projections in buccal, mesial, distal and lingual(palatal) surface of maxillary and mandibular first and second molars on extracted teeth. Among 660 teeth extracted due to the periodontal disease and dental caries in Seoul National University Dental Hospital was examined, 530 teeth which has distinct CEJ were examined with 8 times x electronic magnifier by one examiner. The prevalence of CEP for maxillary teeth (45.49%) was higher than that of mandible (39.62%). The first molar (45.22%) had more CEP than second (39.89%). Furthermore, buccal surface had highest incidence of CEP than other surfaces. The results of this study imply that the clinicians should take good care of the prevalence of CEP when scaling or root planning, plaque control instruction and periodontal surgery.
Objective: This study was performed to investigate the alveolar bone of lower incisors in skeletal Class III adults of different vertical facial patterns and to compare it with that of Class I adults using cone-beam computed tomography (CBCT) images. Methods: CBCT images of 90 skeletal Class III and 29 Class I patients were evaluated. Class III subjects were divided by mandibular plane angle: high (SN-MP > $38.0^{\circ}$), normal ($30.0^{\circ}$ < SN-MP < $37.0^{\circ}$), and low (SN-MP < $28.0^{\circ}$) groups. Buccolingual alveolar bone thickness was measured using CBCT images of mandibular incisors at alveolar crest and 3, 6, and 9 mm apical levels. Linear mixed model, Bonferroni post-hoc test, and Pearson correlation analysis were used for statistical significance. Results: Buccolingual alveolar bone in Class III high, normal and low angle subjects was not significantly different at alveolar crest and 3 mm apical level while lingual bone was thicker at 6 and 9 mm apical levels than on buccal side. Class III high angle group had thinner alveolar bone at all levels except at buccal alveolar crest and 9 mm apical level on lingual side compared to the Class I group. Class III high angle group showed thinner alveolar bone than the Class III normal or low angle groups in most regions. Mandibular plane angle showed negative correlations with mandibular anterior alveolar bone thickness. Conclusions: Skeletal Class III subjects with high mandibular plane angles showed thinner mandibular alveolar bone in most areas compared to normal or low angle subjects. Mandibular plane angle was negatively correlated with buccolingual alveolar bone thickness.
Objective: This study was performed to investigate the changes in alveolar bone after maxillary incisor intrusion and to determine the related factors in deep-bite patients. Methods: Fifty maxillary central incisors of 25 patients were evaluated retrospectively. The maxillary incisors in Group I (12 patients; mean age, $16.51{\pm}1.32years$) were intruded with a base-arch, while those in Group II (13 patients; mean age, $17.47{\pm}2.71years$) were intruded with miniscrews. Changes in the alveolar envelope were assessed using pre-intrusion and post-intrusion cone-beam computed tomography images. Labial, palatal, and total bone thicknesses were evaluated at the crestal (3 mm), midroot (6 mm), and apical (9 mm) levels. Buccal and palatal alveolar crestal height, buccal bone height, and the prevalence of dehiscence were evaluated. Two-way repeated measure ANOVA was used to determine the significance of the changes. Pearson's correlation coefficient analysis was performed to assess the relationship between dental and alveolar bone measurement changes. Results: Upper incisor inclination and intrusion changes were significantly greater in Group II than in Group I. With treatment, the alveolar bone thickness at the labial bone thickness (LBT, 3 and 6 mm) decreased significantly in Group II (p < 0.001) as compared to Group I. The LBT change at 3 mm was strongly and positively correlated with the amount of upper incisor intrusion (r = 0.539; p = 0.005). Conclusions: Change in the labial inclination and the amount of intrusion should be considered during upper incisor intrusion, as these factors increase the risk of alveolar bone loss.
Schnutenhaus, Sigmar;Doering, Isabel;Dreyhaupt, Jens;Rudolph, Heike;Luthardt, Ralph G.
Journal of Periodontal and Implant Science
/
v.48
no.4
/
pp.236-250
/
2018
Purpose: Resorption of the alveolar bone is an unavoidable consequence of tooth extraction when appropriate alveolar ridge preservation (ARP) measures are not taken. The objective of this trial was to test the hypothesis that dimensional changes in the alveolar bone after tooth extraction would be reduced by inserting an equine collagen membrane and a collagen cone to fill and seal the alveolus (as ARP), in comparison to extraction with untreated alveoli. Methods: In this randomized clinical trial, 31 patients were directly treated with the collagen material after extraction of a tooth from the maxilla (the ARP group). Twenty-nine patients served as the control group. After extraction, no further treatment (i.e., no socket preservation measures) was performed in the control group. Changes in the alveolar process immediately after extraction and after an 8 (${\pm}1$)-week healing period were evaluated 3-dimensionally. Blinded analyses were performed after superimposing the data from the digitalized impressions and surfaces generated by cone-beam computed tomography. Results: Both the ARP and control groups showed a reduction of bone in the alveolar area after tooth extraction. However, significantly less bone resorption was detected in the clinically relevant buccal region in the ARP group. The median bone reduction was 1.18 mm in the ARP group and 5.06 mm in the control group (P=0.03). Conclusions: The proposed hypothesis that inserting a combination material comprising a collagen cone and membrane would lead to a difference in alveolar bone preservation can be accepted for the clinically relevant buccal distance. In this area, implantation of the collagen material led to significantly less alveolar bone resorption. German Clinical Trials Register at www.drks.de, DRKS00004769.
For the purpose of evaluating the effect of both direct retainer design and bony absorption degree around abutment of indirect retainer on the supporting tissue of abutment of indirect retainer, dislodging force was transmitted to unilateral distal extension RPD bases. Analysis of stress distributed within the supporting tissue around abutment of indirect retainer was carried out. Using three-dimensional photoelastic stress analysis method and the conclusion is a follows. 1. According to the extent of force which the direct retainer of the most distal abutment tooth, the amount of force transmitted to the abutment tooth of indirect retainer was small. 2. Of all the cases, Mandibular first premolar which was used abutment tooth of indirect retainer, buccal, mesial and distal sides represented compression stress and lingual side represented tensile stress. 3. The more bone resorption of abutment tooth of indirect retainer, the more distortion of buccal and distal side of abutment tooth was existed and the extent of compression stress which was existed and distal side to abutment tooth was large. 4. When the alveolar bone around the abutment with indircet retainer is normal. The amount of force transmitted on abutment with indirect retainer was small in the order of Akers clasp, RPA clasp, RPI clasp. 5. When the alveolar bone around the abutment with indirect retainer has been absorbed 20% and 30%, the amount of force transmitted on abutment with indirect retainer was small in the order of RPA calsp, RPI clasp, Akers clasp. 6. When denture is displaced, shape of the direct retainer reciprocating abutment affect much the function of indirect retainer.
Purpose: To compare the measurements of the mandible and the detectability of the mandibular canal on reformatted images using a newly developed 3-dimensional implant simulation program with traditionally used CT multiplanar reconstruction program and true measurements. Materials and Methods: Ten dry dog mandibles were used in this study. Occlusal templates for CT examination were fabricated and marked with gutta perch a at ten sites. Axial CT scans were taken and reconstructed using DentaScan (D group) and Vimplant program (V group), and each mandible was sectioned at the previously marked sites (R group). Maximum vertical height (H) and maximum width (W) of the mandible, the distances from buccal border of the mandibular canal to the most buccal aspect of the mandible (X), and the distance from the superior border of the mandibular canal to the alveolar crest (Y) were measured, and the mandibular measurements in each group were compared. Detectability of mandibular canal was evaluated using a 3-point scale in both V and D groups by three oral radiologists and compared. Results: H in the V group was slightly greater than that in the D group, and Wand X in the V group was slightly less than those in the D group. H in the V group was less than that in the R group, and Wand X in the V group was larger than those in the R group. The detectability of the mandibular canal did not show statistically significant differences between V and D groups. Conclusion: The results of the experiment show that the newly developed, inexpensive Vimplant/TM/ simulation program can be used as an alternative to the traditionally used, and more expensive CT multiplanar reconstruction program.
The purpose of this study was to analyze the stress distribution in the dentin and post structures by the various post core materials and the amount of remaining coronal tooth structures. The 2-dimensional finite element models of mandibular 2nd premolars was divided into seven types according to the various amount of remaining coronal tooth structures. All types were modeled using equal length, diameter and shape of the post. 2 types of post and core materials were used : 1) cast gold post and core 2) stainless steel post and compsite resin core 10 Newton force was applied as follows 1) vertical force on occlusal fossa 2) $45^{\circ}$ oblique force on buccal surface of buccal cusp tip The results were as follows : 1. There was no apparent difference in the pattern of stress distribution according to the amount of remaining coronal tooth structure. 2. There was no apparent difference in the pattern of stress distribution within the dentin according to the post and core materials. A cast gold post and core generated lower dentin stress than a stainless steel post and resin core. 3. Max. dentinal stress resulting from vertical force was observed in the lingual side of dentin around the crown margin.This stress resulting from oblique force was observed in the lingual root surface of alveolar bone crest level.
The purpose of this study was to investigate the displacement of and the stress distribution on the prosthesis, abutment, and its supporting tissues under functional load, and the effect of alteration in root length of 2nd abutment. The 3-dimensional finite element method was used and the finite element models were prepared in which the abutments of left mandibular 5 unit axed partial denture were canine, the 1st pre-molar and the 2nd molar, and the root lengths of canines were as follows. Model I : Root length of canine was 2mm longer than the 1st premolar Model II : Root length of canine was 2mm shorter than the 1st premolar Static compressive force of 300N was applied to connector between 2nd premolar & 1st molar, and then von Mises stress, displacement and reaction force were obtained. The results were as follows : 1. In fixed partial denture, prosthesis under load on pontic was rotated around mesio-distal long axis of it from longual side to buccal, and simultaneously bended in buccal and gingival direction with mesial end deformed in gingival direction and distolingual end in occlusal. 2. Clinical crowns of abutments were bended in the same directions with those in which prosthesis deforms. Due to that, roots of anterior abutments were twisted in counterclockwise with concentration of shear stress on distal or distobuccal sides of their cervices, and that of posterior was in clockwise with concentration of shear stress on mesiobuccal side of it in the same level with anterior abutments. 3. In case that root length of the 2nd abutment was longer than that of the 1st abutment, its displacement and reaction force which means the force tooth exerts on the surrounding periodontal tissues were smaller but shear stress on itself was larger than in the case root length of 2nd abutment was shorter.
The thirty six mandibular second molars, which were extracted because of hopeless tooth due to advanced periodontal disease, were measured the length of mesial and distal root and the distance from cementoenamel junction to root separation. The molars were cross-sectioned every 1.5 milimeter from cementoenamel junction to root apex perpendicular to long axis and each section was photographed, projected and measured with a calibrated Digital Curvi-Meter(Com Curvi-8. Japan). The root surface area (RSA), percentage of the RSA and the linear variation of the RSA were calibrated for each 1. 5 mm section. The results were as follows. 1. The mean length of the roots was 12. 98mm for mesial root, 11.84 mm for distal root. The mesial root was longer than distal root.(p<0.01) 2. The mean distance from the cementoenamel junction to the point at which the root separate from the root trunk was 3.82mm for the buccal furcation and 4.75mm for lingual furcation. The buccal root separation was coronal than the lingual root separation.(p<0.01) 3. The total root surface area was $317.78mm^2$. 4. The mean surface area of the root trunk was $150.06mm^2$ and averaged 42.54% of the total root surface area. 5. The mean root surface area was $88.79\;mm^2$ for the mesial root, $78.93mm^2$ for distal root, The mesial root surface area was wider than the distal root surface area.(p<0.05) 6. In comparision, the mean root trunk surface area of the mandibular 2nd molar was wider than that of mandibular 1st molar(p<0.01), but each root of 2nd molar was smaller than that of 1st molar(p<0.01).
There is a little scientific documentation reporting the stress, distribution to the edentulous mandible by different concepts of occlusal scheme. So, this study was to investigate the hypothesis that the magnitude and distribution of the occlusal stresses, transmitted through a mandibular complete denture base to the edentulous mandible, would be influenced by the lingualized occlusion. This investigation was performed to analyze the stresses induced in a three-dimensional photoelastic edentulous mandible, when a load is applied to the denture arranged into lingualized occlusion in centric relation, lateral and protrusive functional position. The mounted denture on a Dentatus Type ARO articulator was loaded in a pure vertical direction with 15kgs on the center of articulator in each case and the stresses were frozen into epoxy edentulous model at $127^{\circ}C$ in the stress freezing furnace. The stress-frozen epoxy models were sliced with diamond disc saw into 4mm thick. The slices were examined with a circular polariscope. The results were as follows: 1. In centric relation, the stresses were low at anteriors, and gradually increase to the premolar, molar area and highest at the first molar and gradually decrease from the second molar and lowest at the retromolar pad region. The lingual side showed higher stresses than labiobuccal side. 2. In lateral functional position, the working side showed higher stresses than the balancing side. In working side, the lingual side showed higher stresses than the buccal side and in balancing side, the buccal side showed higher stresses than the lingual side. 3. In protrusive position, stress distribution was symmetrical on the posteriors and the stresses were concentrated at the labial side of the anteriors.
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