Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.
It has been pointed out that the collapses of unsaturated road embankments caused by earthquake are attributed to high water content caused by the seepage of the underground water and/or the rainfall infiltration. Hence, it is important to study influences of water content on the dynamic stability and deformation mode of unsaturated road embankments for development of a proper design scheme including an effective reinforcement to prevent severe damage. This study demonstrates dynamic centrifugal model tests with different water contents to investigate the effect of water content on deformation and failure behaviors of unsaturated road embankments. Based on the measurement of displacement, the pore water pressure and the acceleration during dynamic loading, dynamic behavior of the unsaturated road embankments with about optimum water content and the higher water content than the optimum one have been examined. In addition, an image analysis has revealed the displacement field and the distributions of strains in the road embankment, by which deformation mode of the road embankment with higher water content has been clarified. It has been confirmed that in the case of higher water content the settlement of the crown is large mainly owing to the volume compression underneath the crown, while the small confining pressure at the toe and near the slope surface induces large shear deformation with volume expansion.
Root canal preparation process is of utmost importance in successful treatment of root canal. Also, one of the most important purpose of the root canal preparation is to enlarge the root canal three dimensionally without changing the curvature of the root canal However as the curvature of the root canal increases, there are many difficulties involved in formation of optimum root canal. Therefore in order to solve the above mentioned problems, new developments in methods of root canal preparation and equipments for such purposes were made. Recently, vigorous studies about newly introduced engine-driven nickel-ti-tanium rotary file are conducted. As shown in research results to dates, it is well established that the use of nickel-titanium file is better suited for curved root canal than stainless steel file in maintaining the curvature or root canal and reducing the deformation of root canal. However it is also acknowledged that there are a few discrepancies in research results according to protocol, due to failure to remove variables in experiments. In addition, although it is recommended by the manufacturer that the GT rotary file should maintain a low rotational speed of 150~350rpm and 'light pressure' as light as not to break the lead of a pencil, academic studies about the vertical force which is not yet standardized are not sufficiently explored. Therefore, this research devised and utilized a special research equipment to standardize the appropriate range of vertical force for GT rotary file through experiments by breaking of the lead of a pencil as expressed by the manufacturer and to accurately measure factors involved through repeating and recreating the environment of root canal preparation. Forming nine experimental groups by varying the vertical forces (150g. 220g, 300g) and rpm (150rpm, 250rpm, 350rpm), the effects of changing vertical forces and rpm on working efficiency were measured in terms of time expended in root canal preparation by crown-down method using a transparent resin block with 35 degree curvature and GT rotary file (z-test). The following research using this special research equipment that involved nine experimental groups and varying the vertical force for root canal preparation from 300g which is within the normal vertical force range to 700g and 1000g which fall outside the normal rpm range. The results were as follows : 1. Analysis of the experiment results revealed that the time spent in root canal preparation decreased as the vertical forces and rpm increased (p<0.05). Also, the effects of rpm were greater than those of the vertical forces within the normal vertical force range ($\beta$-weight test). 2. Observation of the deformation of GT rotary file revealed that deformation increases in a direct correlation with the vertical force increase and in a reverse correlation with the rpm decrease. In the case of the vertical forces close to the normal range, the probability of GT rotary file deformation were quite different depending on the rpm changes. In the case of greater vertical forces, the occurrences of deformation of the file were more frequent regardless of the rpm changes. 3. Deformation and breakage of file were also commonly observed in the expended time measurement experiments and GT rotary file deformation experiments in which low speed rpm (150rpm) was used and at the curved portion of the resin block.
Journal of the korean academy of Pediatric Dentistry
/
v.48
no.1
/
pp.42-49
/
2021
This study aimed to evaluate the long-term outcomes of teeth treated with reattachment technique in children and adolescents. Twenty seven permanent anterior teeth from 21 patients treated with fragment reattachment were evaluated. Clinical photos and medical records were used to assess treatment outcomes. Effect of pulp treatment and the ratio of fragment on success rate were statistically analyzed. Detachment of fragment was observed in 17 teeth, and their duration of retention was 21.41 ± 23.39 months. Repeated trauma was found to be the most frequent causes of failure. Pulp treatment before reattachment did not affect the success rate (p > 0.05). The mean ratio of fragment was 0.482 ± 0.147, and the success rate was affected by the ratio of fragment (p = 0.018). The median retention time of the teeth was 72 months if the ratio was under 0.5, and 8 months for that of the others. A significant correlation was found between the ratio of fragment and retention time (p = 0.003). Reattachment can be a predictable treatment option for crown fracture in anterior teeth in children and adolescents when a fracture involves less than 50% of the clinical crown.
Purpose: Exact knowledge of the location and dimension of the pulp chamber help to maintain the pulp healthy during operative procedure and also reduces the risk of perforation of pulp chamber during root canal treatment. This in-vivo study was carried out to measure critical morphology of pulp chamber of mandibular molar using intra-oral periapical radiograph. Materials and Methods: Mandibular molar teeth of 56 patients were evaluated. The mandibular molar teeth whose pulp chamber was not violated by caries, restoration, fracture crown and those having closed apex were included in the study. The intraoral periapical radiographs were taken with paralleling angle technique using radio-opaque grid with 1 mm space. This grid was placed directly on the film. Results: In 94% of the mandibular first molars specimens the pulp chamber ceiling was at the level of the cemento-enamel junction. The measurements showing the lowest percentage variance were buccal cusp to furcation (approximately 11%) and buccal cusp to pulp chamber ceiling (approximately 15%). The distance from the cusp tip to pulp chamber ceiling height was approximately 6.0 mm, the distance from the pulpal floor to the furcation was approximately 3.0 mm, and the average height of a pulp chamber was 1.5 to 2.0 mm. Conclusion: The exact knowledge of distances of pulp chamber from various anatomical landmarks helps in proper assessment of root canals and ultimately avoids the failure of root canal treatment.
Kim, Sung-Beom;Kim, Young-Kyun;Kim, Su-Gwan;Oh, Ji-Su;Kim, Byung-Hoon
Maxillofacial Plastic and Reconstructive Surgery
/
v.36
no.6
/
pp.247-252
/
2014
Purpose: This study compares the prognosis (the survival rate and marginal bone loss) of resorbable blasting media (RBM) surface implants and sandblasting with large-grit and acid-etching (SLA) surface implants in the early loading. Methods: This study targeted 123 patients treated by implants installation from January 2008 to March 2010. The loading was initiated in the maxilla within three to four months and in the mandible within one to two months. The types of restoration were single crown and fixed partial prosthesis. Those functioned over one year. The implants were classified by the surface of implants as Group 1: RBM surface (GS III; OSSTEM, Busan, Korea) and, Group 2: SLA surface (Superline; Dentium, Seoul, Korea). The groups were categorized by maxilla and mandible and compared by survival rate, marginal bone loss through clinical records evaluation, and radiographic measurements. Results: The marginal bone loss in the maxilla was $0.14{\pm}0.34mm$ (Group 1) and $0.30{\pm}0.37mm$ (Group 2), a statistically significant difference (P<0.05). In the mandible those were $0.28{\pm}0.54mm$ (Group 1) and $0.20{\pm}0.33mm$ (Group 2), not significant (P>0.05). There was no significant difference of marginal bone loss between maxilla and mandible by groups. During observation there was no implant failure, a survival rate of 100%. Conclusion: Both surfaces showed an excellent survival rate, and the marginal bone loss was not substantial.
The purpose of this study was to investigate the effects of desensitizer on shear bond strength of adhesive resin cements for all ceramic crown. For this study, Gluma $desensitizer^{(R)}$(Heraeus Kulzer, Germany) and MS $Coat^{(R)}$(Sun medical, Japan) were used as desensitizer, and Bistite $II^{(R)}$ resin cement(Tokuyama, Japan) and Variolink $II^{(R)}$ resin cement (Ivoclar, Liechtenstein) were used. IPS Empress ceramics were bonded to dentin surfaces after application of desensitizer and shear bond strength of specimens were measured using UTM(Zwick 1456 41. Zwick, Germany) at a crosshead speed of 1mm/min. The obtained results were as follows : 1. The shear bond strength of both resin cements were not affected by Gluma $desensitizer^{(R)}$ containing HEMA 2. The shear bond strength of Bistite $II^{(R)}$ resin cement was significantly decreased by MS $Coat^{(R)}$. 3. The failure mode in MS $Coat^{(R)}-Bistite \;II^{(R)}$ group was mainly adhesive type between dentin and resin cement. but that of Gluma $desensitizer^{(R)}$-Variolink $II^{(R)}$ group was mainly mixed type, combined adhesive failures between dentin and resin cement or porcelain and resin cement.
The purpose of this study was to measure the marginal fidelities and the fracture strength of IPS Empress $2^{(R)}\;and\;In-Ceram^{(R)}$ ceramic crowns. After constructed of 12 experimental dies for each group, ceramic crowns were fabricated on the metal master dies prepared on the maxillary right premolar Marginal gaps were measured on the specimen between the margin of each crown and finish-ing line of the metal master die by using stereo-microscope($SZ-ST^{(R)}$ Olympus, Japan) and all specimens were cemented on the metal master die with Bistite $II^{(R)}$ (Tokuyama soda Co, LTD., Japan) resin cement. Finally marginal gaps were measured again. To measure of the fracture strength, buccal incline on the functional cusp of specimens were loaded until the catastrophic failure occurred by using the AGS-1000 $D^{(R)}$(Shimadzu, Japan). The result of marginal fidelities and fracture strength were statistically analyzed with the SPSS version 8.0 programs. The results of this study were as follows : 1. No significant difference was found in the mean marginal fidelities and fracture strength between the IPS Empress $2^{(R)}\;and\;In-Ceram^{(R)}$. 2. In comparison of marginal fidelities between before and after cementation, there was significant difference(P<0.05). The IPS Empress 2 system was shown in this study that had good marginal fidelities and fracture strength compared to In-Ceram ceramics. Although this system was acceptable to clinical applications, the system still has to be considered long-term researches about marginal fidelities and fracture strength due to the lack of data about the clinical researches.
A heat-pressed technique(IPS-Empress, Ivoclar) has been described to construct single unit crown, inlay/onlay and veneers using a partially pre-cerammed and pre-colored glass-leucite ingot that has the greateast strength by the combination of heat-pressed procedure through the smalldiameter sprue and heat treatment procedure. The purpose of this study was to evaluate the flexure strength of a heat-pressed ceramic material(IPS-Empress) without simulated firing treatments according to pontic designs. Two groups of 9 disks(1.4mm thick, 14mm in diameter) each using two types of sprues with different diameters($({\Phi}2.8\;,{\Phi}1.8)$) and numbers were prepared. The specimens were mounted in the testing jig. The flexural strengths were determined, by means of the bi-axial bending test, by loading the center of disk to failure using a universal testing machine(Zwick 145141, Zwick, Germany) at a cross-head speed of 1.0 mm/min. The means flexural strength value of one group using a sprue with ${\Phi}2.8$ was $140.4{\pm}8.0Mpa$. That of the other group using two sprues with ${\Phi}1.8$ was $151.8{\pm}10.3Mpa$. After analysis, results showed that there was a statistical difference between groups(t=2.33m p<0.05). No clnical implications were drawn from these data because of absence of simulated firing treatment.
I measured the movement range on the hinge articulator and the movement range in an oral. And then I studied to analyze the gap. I got wax records by the movement on the hinge articulator, the movement in an oral and the movement on the hand articulating. I measured the distance of the cusp tips that are close to the mesial direction and the distal direction, the buccal direction and the lingual direction then I compared gaps. As I saw results on data, I knew that the hinge articulator represented the range of mandibular movement restrictively. I could find the decisive contradiction that the sliding movement finished on the hinge articulator although it did not finish in an oral. If the sliding movement does not reappear exactly, it brings a fatal failure to the dental prosthesis. In addition it is impossible that the hinge articulator restores the movement in an oral because the lateral condyle inclination and the horizontal condyle inclination are fixed previously. Therefore dental prosthesisses were made by the hinge articulator, they will interfere with a mastication. I have obtained the following results; 1. The distance of sliding movement on the hinge articulator showed shorter than the distance of sliding movement in oral. This means the increase of cusp inclination of the dental prosthesis that was made on the hinge articulator. Therefore, when the lateral movement occurs in oral, there is a possibility to become the premature as the increase of cusp inclination. 2. The results that were impressed records in oral and impressed records on the hand articulating have many congruities. I think that the simple crown etc. that were made by the hand articulating method except the long span bridge and the free end case that can not measure the vertical dimension exactly can represent similarly the mandibular movement. 3. If we want to represent the mandibular movement similarly, we have to use the articulator that can adjust the horizontal condyle inclination and the lateral condyle inclination at least.
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