• Journal of the korean academy of Pediatric Dentistry
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• v.51 no.2
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• pp.132-139
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• 2024

This study aimed to compare the fluoride-releasing ability and degree of microbial attachment of a newly developed glass-hybrid restorative material (GH) with those of a high-viscosity glass ionomer (HvGIC), resin-modified glass ionomer (RMGI), and composite resin (CR). In addition, the correlation between fluoride-releasing ability and microbial attachment between materials was evaluated. Specimens were prepared in a disc shape and divided into 4 groups according to the materials (GH, HvGIC, RMGI, and CR). The fluoride release experiments were performed in each group (n = 15). The amount of fluoride released was measured on days 1, 3, 7, 14, 28, and 42 after storage. For the microbial attachment experiment, 12 specimens were produced per group using Mutans Streptococci (S.mutans ), a cariogenic microorganism. S. mutans was cultured on the specimens for 24 hours, and the number of bacteria was measured. GH had the highest cumulative fluoride release and showed a significant difference when compared with RMGI (p = 0.001) and CR (p < 0.0001). Microbial attachment was the lowest in GH; however, no significant difference was observed between the materials (p = 0.169). There was no significant correlation between fluoride release from materials and microbial attachment (p > 0.05). From this perspective, remineralization of low-mineralized areas could be expected due to the high fluoride release of GH, and the effect of delaying the progression of dental caries could be predicted from the low cariogenic microbial attachment. Therefore, GH might be a useful restorative material for treating immature permanent teeth with hypomineralized enamel. However, further studies are needed about the degree of remineralization of hypomineralized areas after restoration and the capacity to recharge fluoride.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.131-139
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• 2024

In a edentulous patient, various methods can be employed for prosthetic treatment using implants, such as implant-supported fixed prostheses, overdentures, hybrid prostheses, and implant assisted removable partial denture. In this case, in a patient with moderate to severe chronic periodontitis requiring full arch extractions, implants were strategically placed using computer-guided surgery. In the maxilla, due to inadequate bone quality and quantity leading to insufficient initial stability, delayed loading was implemented, and interim prosthesis was used during the osseointegration period. In the mandible, stable initial stability was achieved, allowing for immediate loading to reduce patient discomfort. Primary stability is considered the most crucial factor for obtaining immediate loading, so a thorough clinical and radiological evaluation of the remaining alveolar bone quantity and quality must be conducted before surgery.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.443-454
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• 2008

Statement of problem: A clinically successful color match is one of the important factor to get an esthetic dental restoration. Dental shade guides are commonly used to evaluate tooth color in restorative procedure. But numerous reports have indicated that common shade guides do not provide sufficient spectral coverage of the natural tooth colors. To address issues associated with the shade guide, distinct avenues have been pursued objective spectrophotometric / colorimetric assessment. Purpose: This study compared the accuracy of tooth color selection of spectrophotometer with that of human visual determination. Three main factors were investigated, namely, the effect of light, the individual variation and the experience of the observer. Material and methods: At the first experiment, on ten patients, one operator independently selected the best matching shade to the unrestored maxillary central incisor, using a Vita Classical Shade Guide in the morning, at noon and in the afternoon. The same teeth were measured by means of a reflectance spectrophotometer. At the second experiment, on ten patients, ten operators (5 experts, 5 novices) selected and measured by the same method above at noon. At the third experiment, the results of the second experiment were divided into two groups, expert and novice, and analyzed. Results: 1. There was significant difference between visual and spectrophotometric assessment (mean ${\Delta}E$ values) in experiment 1, 2, 3 (P < .05). 2. There was no significant difference between experts and novices group, when comparing with each visual and spectrophotometric assessment (mean ${\Delta}E$ values). Conclusion: Spectrophotometer could be used to analyze the shade of natural tooth objectively. Thereby, this method offers the potential tominimize considerably the need for corrections or even remakesafter intraoral try-in of restoration. Furthermore, to achieve its advantage, both the shade-matching environment and communication between dentist and technician should be optimized with use of visual and instrumental shade-matching systems.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.191-198
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• 2009

Statement of problem: Ceramics have been important materials for the restoration of teeth. The demands of patients for tooth-colored restorations and the availability of various dental ceramics has driven the increased use of new types of dental ceramic materials. Improved physical properties of theses materials have expanded its use even in posterior crowns and fixed partial dentures. However, ceramic still has limitation such as low loading capability. This is critical for long-span bridge, because bridge is more subject to tensile force. Purpose: The wire reinforced ceramic was designed to increase the fracture resistance of ceramic restoration. The purpose of this study was to evaluate the fracture resistance of wire reinforced ceramic. Material and methods: Heat pressed ceramic(ingot No.200 : IPS Empress 2, Ivoclar Vivadent, Liechtenstein) and Ni-Cr wire(Alfa Aesar, Johnson Matthey Company, USA) of 0.41 mm diameter were used in this study. Five groups of twelve uniform sized ceramic specimens(width 4 mm, thickness 2 mm, length 15 mm) were fabricated. Each group had different wire arrangement. Wireless ceramic was used as control group. The experimental groups were divided according to wire number and position. One, two and three strands of wires were positioned on the longitudinal axis of specimen. In another experimental group, three strands of wires positioned on the longitudinal axis and five strands of wires positioned on the transverse axis. Three-point bending test was done with universal testing machine(Z020, Zwick, Germany) to compare the flexural modulus, flexural strength, strain at fracture and fracture toughness of each group. Fractured ceramic specimens were cross-sectioned with caborundum disc and grinded with sandpaper to observe interface between ceramic and Ni-Cr wire. The interface between ceramic and Ni-Cr wire was analyzed with scanning electron microscope(JSM-6360, JEOL, Japan) under platinum coating. Results: The results obtained were as follows: 1. The average and standard deviation in flexural modulus, flexural strength and fracture toughness showed no statistical differences between control and experimental groups. However, strain was significantly increased in wire inserted ceramics(P<.001). 2. Control group showed wedge fracture aspects across specimen, while experimental groups showed cracks across specimen. 3. Scanning electron microscopic image of cross-sectioned and longitudinally-sectioned specimens showed no gap at the interface between ceramic and Ni-Cr wire. Conclusion: The results of this study showed that wire inserted ceramics have a high strain characteristic. However, wire inserted ceramics was not enough to use at posterior area of mouth in relation to flexural modulus and flexural strength. Therefore, we need further studies.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.209-222
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• 2011

Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.175-184
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• 2011

With a development of implant restoration technique, there are increasing use of computer-guided system for edentulous patients. It was carried out simulated operation based on CT information about patient's bone quantity, quality and anatomical landmark. However, there are some difference between the programmed implant and post-operative implant about it's position. If the deviation was severe, it could happen a failure of 'passive fit' and not suited for path of implant restoration. The aim of this presentation is to evaluate about a degree of deviations between programmed implant and post-operative implant. Five patients treated by 'NobelGuide' system (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden) in Department of Prosthodontics, Inha University were included in this study. The patients were performed CT radiograph taking and intra-oral impression taking at pre-operation. Based on CT images and study model, surgical stent was produced by NobelBiocareTM. To fabricated a pre-operative study model, after connected lab analog to surgical template, accomplished a pre-operative model using type 4 dental stone. At final impression, a post-operative study model was fabricated in the conventional procedures. Each study model was performed CT radiograph taking. Based on CT images, each implant was simulated in three dimensional position using $Procera^{(R)}$ software (Procera Software Clinical Design Premium, version 1.5; Nobel Biocare AB). In 3D simulated model, length and angulation between each implant of both pre- and post-operative implants were measured and recorded about linear and angular deviation between pre-and post-operative implants. A total of 24 implants were included in this study and 58 inter-implant sites between each implant were measured about linear and angular deviations. In the linear deviation a mean deviation of 0.41 mm (range 0~1.7 mm) was reported. In the angular deviation, a mean deviation was $1.99^{\circ}$ (range $0^{\circ}{\sim}6.7^{\circ}$). It appears that the both linear and angular mean deviation value were well acceptable to application of computer-guided implant system.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.5
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• pp.514-523
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• 2004

Statement of problem: All-ceramic restorations have been advocated for superior esthetics. Various post and core systems have been used to improve the strength of damaged teeth, but it is unclear whether they affect the final shade of finished all-ceramic restorations. Purpose: The influence of different types of post and core systems on light transmission through all-ceramic crowns was assessed by spectrophotometric analysis. Also the masking effect of different thickness of ceramic ingot was evaluated. Material and Methods : Forty-five sample disks (15mm in diameter) at several thickness(1.0, 1.5, 2.0mm) and value(shade 100, 200, 300) were made in heat pressed ceramic(IPS-Empress). Background specimens simulating gold-alloy cast posts(Type III casting gold alloy), metal posts(Ni-Cr casting alloy) and ceramic posts(CosmoPost) were fabrica-ted. Resin composite(Z250, A3 shade) was used as a tooth substrate reference. For each combination, the change in color was measured with a spectrophotometer. Readings were performed for 2 conditions (1) ability of ceramic to mask the core in relation to its thickness(1.0, 1.5, or 2.0mm) ; (2) influence of post and core types on the final color of the ceramic. Data were recorded according to the CIE $L^*a^*b^*$ systems and color difference($\Delta$E) was calculated. Results: 100 shade ingot: when ceramic thickness was 1.0mm, $\Delta$E value for ceramic post larger than 1 but $\Delta$E value for metal and gold post was larger than 2. For ceramic thickness of 1.5mm, only $\Delta$E value for metal was larger than 2, and the other samples' $\Delta$E value was smaller than 2. For ceramic thickness of 2.0mm, $\Delta$E values for all specimens was smaller than 2. 200 shade ingot: when ceramic thickness was 1.0mm, $\Delta$E value for ceramic post was smaller than 1 but $\Delta$E value for metal and gold post was larger than 2. For ceramic thickness of 1.5 mm, only the $\Delta$E value for metal was larger than 2, and the other samples' $\Delta$E value was smaller than 2. For ceramic thickness of 2.0mm, $\Delta$E values for all specimens was smaller than 1. 300 shade ingot: when ceramic thickness was 1.0mm, only $\Delta$E value for metal was larger than 2 and the other samples' $\Delta$E value was smaller than 2. For ceramic thickness of 1.5mm, $\Delta$E values for all specimens was smaller than 1. For ceramic thickness of 2.0mm, $\Delta$E values for all specimens was smaller than 1. Conclusion: The final esthetic result of the IPS-Empress glass-ceramic restoration was not affected by the presence of different core materials when the thickness was more than 2.0 mm. When ceramic thickness decreases to 1.5mm, it is advised to take the substrate aspects into consideration. If the ceramic thickness is less than 1.0mm, using the tooth color matched substrate is strongly recommended.

• Journal of Periodontal and Implant Science
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• v.37 no.sup2
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• pp.385-396
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• 2007

This study proposed a new classification system for maxillary anterior alveolar ridge deformities based on CAT-scan implant simulation as a useful concept in order to more precisely predict treatment outcomes and the necessity for ridge augmentation prior to implant placement. The results indicate that a high number of cases in the maxillary anterior area would require augmentation procedures in order to achieve ideal implant placement and restoration.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.498-503
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• 2006

This in vitro study compared the remineralization of incipient interproximal caries in the presence of three glass ionomer cements (highly-filled glass ionomer cement, compomer, resin-modified glass ionomer cement) and a resin composite(control). The long-term changes in remineralization caused by each material were evaluated by microtomography. Proximal restoration was simulated by placing tooth specimens and the various glass ionomer cements in closed containers with artificial saliva at $37^{\circ}C$ and pH 7.0 for 30 days with constant circulation Tomographic images were obtained with a micro CT scanner at 90, 180, and 270 days, and density-measuring software was used to calculate the micro-density of artificial caries lesions in the specimens. The mean density changes were compared between groups in order to evaluate the effects of remineralization. All data were analyzed using one-way ANOVA and the post-HOC Tukey multiple comparison test at p<0.05. While the density of artificial caries lesions increased for all treatments, the increases for the three glass ionomer groups were significantly higher than that for the resin group in each three month period. As time went on, the amount of density increase of the glass ionomer groups decreased, and significant differences were found between the remineralization effects of the glass ionomer groups.

• Restorative Dentistry and Endodontics
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• v.34 no.1
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• pp.51-60
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• 2009

The purpose of this study was to perform quantitative comparisons of water permeable zones in both the adhesive and the hybrid layer before and after thermo cycling in order to assess the integrity of the bonding interface. Twenty eight flat dentin surfaces were bonded with a light-cured composite resin using one of four commercial adhesives [OptiBond FL (OP), AdheSE (AD), Clearfil SE Bond (CL). and Xeno III (XE)]. These were sectioned into halves and subsequently cut to yield 2-mm thick specimens; one specimen for control and the other subjected to thermocycling for 10,000 cycles. After specimens were immersed in ammoniacal silver nitrate for 24 h and exposed to a photo developing solution for 8 h, the bonded interface was analyzed by scanning electron microscopy (SEM) and wavelength dispersive spectrometry (WDS) at five locations per specimen. Immediately after bonding. the adhesive layer of OP showed the lowest silver uptake, followed by CL, AD. and XE in ascending order (p < 0.0001); the hybrid layer of CL had the lowest silver content among the groups (p = 0.0039). After thermocycling, none of the adhesives manifested a significant increase of silver in either the adhesive or the hybrid layer. SEM demonstrated the characteristic silver penetrated patterns within the interface. It was observed that integrity of bonding was well maintained in OP and CL throughout the thermocycling process. Adhesive-tooth interfaces are vulnerable to hydrolytic degradation and its permeability varies in different adhesive systems, which may be clinically related to the restoration longevity.