PURPOSE. The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS. Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posterior-superior and lateral-superior direction. RESULTS. The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately $50^{\circ}$ posterior-superior and $41^{\circ}$ lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION. These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.
Kim, Chang-Soon;Duong, Hieu Pham;Park, Jung-Chul;Shin, Hyun-Seung
Journal of Periodontal and Implant Science
/
v.46
no.5
/
pp.329-336
/
2016
Purpose: The aim of this study was to clinically assess the impact of a prefabricated implant-retained stent clipped over healing abutments on the preservation of keratinized mucosa around implants after implant surgery, and to compare it with horizontal external mattress sutures. Methods: A total of 50 patients were enrolled in this study. In the test group, a prefabricated implant-retained stent was clipped on the healing abutment after implant surgery to replace the keratinized tissue bucco-apically. In the control group, horizontal external mattress sutures were applied instead of using a stent. After the surgical procedure, the width of the buccal keratinized mucosa was measured at the mesial, middle, and distal aspects of the healing abutment. The change in the width of the buccal keratinized mucosa was assessed at 1 and 3 months. Results: Healing was uneventful in both groups. The difference of width between baseline and 1 month was $-0.26{\pm}0.85mm$ in the test group, without any statistical significance (P=0.137). Meanwhile, the corresponding difference in the control group was $-0.74{\pm}0.73mm$ and it showed statistical significance (P<0.001). The difference of width between baseline and 3 months was $-0.57{\pm}0.97mm$ in the test group and $-0.86{\pm}0.71mm$ in the control group. These reductions were statistically significant (P<0.05); however, there was no difference between the 2 groups. Conclusions: Using a prefabricated implant-retained stent was shown to be effective in the preservation of the keratinized mucosa around implants and it was simple and straightforward in comparison to the horizontal external mattress suture technique.
Purpose: A study analysed the stress distribution of abutment screw and supporting bone of fixture by the tightening torque force of the abutment screw within clinical treatment situation for the stability of the dental implant prosthesis. Methods: The finite element analysis was targeted to the mandibular molar crown model, and the implant was internal type 4.0 mm diameter, 10.0 mm length fixture and abutment screw and supporting bone. The occlusal surface was modeled in 4 cusps and loaded 100 N to the buccal cusps. The connection between the abutment and the fixture was achieved by combining three abutment tightening torque forces of 20, 25, and 30 Ncm. Results: The results showed that the maximum stress value of the supporting bone was found in the buccal cortical bone region of the fixture in all models. The von Mises stress value of each model showed 184.5 MPa at the 20 Ncm model, 195.3 MPa in the 25 Ncm model, and 216.5 MPa in the 30 Ncm model. The contact stress between the abutment and the abutment screw showed the stress value in the 20 Ncm model was 201.2 MPa, and the 245.5 MPa in the 25 Ncm model and 314.0 MPa in the 30 Ncm model. Conclusion: The increase of tightening force within the clinical range of the abutment screw of the implant dental prosthesis was found to have no problem with the stability of the supporting bone and the abutment screw.
The purpose of this study was to clarify the effect of clasp design on abutment tooth adjacent to a distal extension base under the influence by the location of functional loading. The RPI clasp, the Akers clasp and the combination clasp were selected for evaluation. Tests were performed at 10Kg, 20Kg, 30Kg loads on the buccal, central, lingual, mesial and distal positions of loading platform of each mandibular distal extension partial denture. The laser reflexion method was used for three dimensional measurement of abutment movement, which is possible to measure precisely without contact. The movement in the mesiodistal(X), buccolingual(Y), and occlusoapical(Z) directions and the rotational movement(R) were measured, and in addition, the total movement (SV) as expressed by the three dimensional summation vector independent of direction was calculated. The data were analyzed using Student t-test, p<.05. The following results were obtained from this study; 1. Clasp design did not generally affect the direction of abutment tooth movement except the movement in an undesirable occlusal direction in case of the Akers clasp and the combination clasp. 2. The greater the load on the prosthesis, the greater was the abutment tooth movement, and the direction of abutment tooth movement was affected by positional loading. 3. Each prosthesis was dislodged from the test base under the small amount of load in the distal load position, and the buccal loading showed the greatest abutment tooth movement under the maximum load. 4. RPI clasp was evaluated as the most favorable design.
The aim of the present investigation was to see the effect of combined use of PDGF BB and IGF -1 on the guided tissue regeneration(GTR) using barrier membrane in the treatment of human furcation involvement. Twelve patients with initially diagnosed as having moderate to advanced adult periodontitis with mandibular class II buccal furcation defects have been wer selected. Initial scaling and root planing has been performed and baseline data consisting of probing depths and attachment levels have been recorded prior to surgical procedures. The GTR procedures using either barrier membrane(control : ePTFE) alone or together with the application of PDGF - BB and IGF -l(experimental : ePTFE+PDGF/IGF) have been done under the routine guidelines. During the surgery, the distance from CEJ either to the bottom of the bone defects(CEJ - BD) or to the bone crest(CEJ-BC) were measured. Horizontal distance to the deepest area in the furcal defects were measured from the reference line connection the most prominent bony walls of the two buccal roots. 6 months following the GTR therapy, all the measurements were made repeatedly. The probing attachment gain of the experimental and the control grous were 2.14mm and l.07mm, respectively with no statically significnant difference. Amont of vertical bone fill in the experimental and the control groups were 2.43mm and 2.29mm, rexpectively. Amonut of horizontal bone fill were 2.86mm in the experimental group and 2.17mm in the control group, respectively. However, there were no significant differences in the amount of bone fill(both vertical and horizontal)between the two groups.
PURPOSE. This in vitro study aimed to analyze and compare the reproducibility of zirconia and lithium disilicate crowns manufactured by digital workflow. MATERIALS AND METHODS. A typodont model with a prepped upper first molar was set in a phantom head, and a digital impression was obtained with a video intraoral scanner (CEREC Omnicam; Sirona GmbH), from which a single crown was designed and manufactured with CAD/CAM into a zirconia crown and lithium disilicate crown (n=12). Reproducibility of each crown was quantitatively retrieved by superimposing the digitized data of the crown in 3D inspection software, and differences were graphically mapped in color. Areas with large differences were analyzed with digital microscopy. Mean quadratic deviations (RMS) quantitatively obtained from each ceramic group were statistically analyzed with Student's t-test (${\alpha}=.05$). RESULTS. The RMS value of lithium disilicate crown was $29.2\;(4.1){\mu}m$ and $17.6\;(5.5){\mu}m$ on the outer and inner surfaces, respectively, whereas these values were $18.6\;(2.0){\mu}m$ and $20.6\;(5.1){\mu}m$ for the zirconia crown. Reproducibility of zirconia and lithium disilicate crowns had a statistically significant difference only on the outer surface (P<.001). The outer surface of lithium disilicate crown showed over-contouring on the buccal surface and under-contouring on the inner occlusal surface. The outer surface of zirconia crown showed both over- and under-contouring on the buccal surface, and the inner surface showed under-contouring in the marginal areas. CONCLUSION. Restoration manufacturing by digital workflow will enhance the reproducibility of zirconia single crowns more than that of lithium disilicate single crowns.
Purpose: The present study investigated the impact of 2 different suture techniques, the conventional crossed mattress suture (X suture) and the novel hidden X suture, for alveolar ridge preservation (ARP) with an open healing approach. Methods: This study was a prospective randomized controlled clinical trial. Fourteen patients requiring extraction of the maxillary or mandibular posterior teeth were enrolled and allocated into 2 groups. After extraction, demineralized bovine bone matrix mixed with 10% collagen (DBBM-C) was grafted and the socket was covered by porcine collagen membrane in a double-layer fashion. No attempt to obtain primary closure was made. The hidden X suture and conventional X suture techniques were performed in the test and control groups, respectively. Cone-beam computed tomographic (CBCT) images were taken immediately after the graft procedure and before implant surgery 4 months later. Additionally, the change in the mucogingival junction (MGJ) position was measured and was compared after extraction, after suturing, and 4 months after the operation. Results: All sites healed without any complications. Clinical evaluations showed that the MGJ line shifted to the lingual side immediately after the application of the X suture by $1.56{\pm}0.90mm$ in the control group, while the application of the hidden X suture rather pushed the MGJ line slightly to the buccal side by $0.25{\pm}0.66mm$. It was demonstrated that the amount of keratinized tissue (KT) preserved on the buccal side was significantly greater in the hidden X suture group 4 months after the procedure (P<0.05). Radiographic analysis showed that the hidden X suture had a significant effect in preserving horizontal width and minimizing vertical reduction in comparison to X suture (P<0.05). Conclusions: Our study provided clinical and radiographic verification of the efficacy of the hidden X suture in preserving the width of KT and the dimensions of the alveolar ridge after ARP.
Chan, Siew Wui;Kallarakkal, Thomas George;Abraham, Mannil Thomas
Asian Pacific Journal of Cancer Prevention
/
v.15
no.5
/
pp.2145-2152
/
2014
Background: The survival rate for oral squamous cell carcinoma (OSCC) has remained generally unchanged in the past three decades, underlining the need for more biomarkers to be developed to aid prognostication and effective management. The prognostic potential of E-cadherin expression in OSCCs has been variable in previous studies while galectin-9 expression has been correlated with improved prognosis in other cancers. The aim of the present study was to investigate the expression of galectin-9 and E-cadherin in OSCC and their potential as prognostic biomarkers. Materials and Methods: E-cadherin and Galectin-9 expression was examined by immunohistochemistry in 32 cases of OSCC of the buccal mucosa (13 with and 19 without lymph node metastasis), as well as 6 samples of reactive lesions and 5 of normal buccal mucosa. Results: The expression of E-cadherin in OSCC was significantly lower than the control tissues but galectin-9 expression was conversely higher. Median E-cadherin HSCOREs between OSCCs positive and negative for nodal metastasis were not significantly different. Mean HSCOREs for galectin-9 in OSCC without lymph node metastasis ($127.7{\pm}81.8$) was higher than OSCC with lymph node metastasis ($97.9{\pm}62.9$) but this difference was not statistically significant. Conclusions: E-cadherin expression is reduced whilst galectin-9 expression is increased in OSCC. However, the present results suggest that E-cadherin and galectin-9 expression may not be useful as prognostic markers for OSCC.
Recombinant human bone morphogenetic protein-2 (rhBMP-2 ), a member of the TGF-${\beta}$ family, has been used widely in recent years to regenerate defects of the maxillary and mandible bones. Such defects are sometimes caused by resection of oral squamous cell carcinoma (OSCC) yet the biologic effects of rhBMP-2 on these carcinomas are not fully clear. The objective of this study was to determine histologically whether rhBMP-2 produces adverse effects on angiogenesis during induction of OSCC, a biologic process critical for tumor formation in an experimental model in the buccal pouch of golden Syrian hamsters. Buccal cavities were exposed to painting with 0.5% DMBA in liquid paraffin three times a week for 14 weeks, then biopsies were taken. Division was into 2 groups: a study group of 10 hamsters receiving $0.25{\mu}g/ml$ of rhBMP-2 in the $3^{rd}$ and $6^{th}$ weeks; and a control group of 10 hamsters which did not receive any additional treatment. VEGF expression and microvessel density were measured but no differences were noted between the two groups. According to this study, rh-BMP-2 does not stimulate angiogenesis during induction of OCSSs.
The purpose of this study was to analyse the center of resistance of the maxillary first molar using the 3-dimension finite element method. An extracted maxillary first molar of normal shape and average root length was selected and sectioned every 1.5mm parallel to the cementoenamel junction. Each section was traced and digitized to construct 3-D finite element model of the maxillary first molar. After a certain magnitude of counterbalancing moment(M) was applied to the tooth, a varying single force(F) of distomesial direction was applied to a certain point of th tooth until the tooth was translated. The force producing translation(Ft) was substituted to the equation ${\Delta}d=M/Ft$ to calculate the center of resistance of the maxillary first molar. And reducing the alveolar bone level 1.68mm, and 3.36mm below to the cementoenamel junction, the tooth movement was analysed to see the effect of reducing the alveolar bone level to the location of the center of resistance. The results were as follows ; 1. The center of resistance of the maxillary first molar was 3.72mm apical, 1.10mm buccal, and 0.71mm mesial to the geometric center of the horizontally sectioned surface at the cementoenamel junction. This point was 0.36mm apical, 1.20mm buccal, and 0.71mm mesial to the trifurcation point, indicating that it was not on the tooth root. 2. As the alveolar bone level was reduced, the center of resistance of the maxillary first molar was moved to the apical direction.
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