• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.149-159
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• 2011

Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complication of fixed prostheses was found in the mouth of patient. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. The purpose of this study was to evaluate the clinical status of fixed prostheses to improve the quality of dental care. In order to assess the clinical status of fixed prostheses, a total of 154 individuals (aged 22-82, 88 women and 66 men loaded with 578 unit of fixed prostheses, and 423 abutments) who visited the Department of Prosthodontics, Pusan National University Hospital, between January 2009 to December 2009 and removed old fixed prostheses were examined. The results of this study were as follows: 1. Length of service of fixed prostheses was $10.3{\pm}05.5$ years (mean), 10.0 years (median). 2. Location of fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was high in anterior-posterior combination region (mean:13.1, median:13.5) than anterior and posterior region. 3. Longevity of fixed prostheses made of metal was longest (mean:13.3, median:12.3). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 5. Condition of opposing dentition was found to have statistically significant influence on longevity of fixed prostheses (P>.05). The fixed prostheses lasted longest when opposed by complete denture (mean:17.1, median:19.7), removable partial denture, fixed prosthesis and natural dentition trailing behind (P<.05) 6. Periodontal disease (37.5%), dental caries (19.0%), defective margin (18.4%) were frequent complications. In 33.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.470-478
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• 2008

Statement of problem: Use of all-ceramic prostheses fabricated with CAD/CAM systems is increasing in the dentistry. Marginal fidelity in production of all-ceramic restoration has important clinical implications and is a key consideration issue in CAD/CAM production as well. Purpose: The objective of this study was to analyse marginal fidelities of $Procera^{(R)}$ Allceram Crown. Material and methods: On 56 patients treated with $Procera^{(R)}$ system Allceram Crown at Dankook Dental Hospital, marginal discrepancies of 101 abutments were measured by stereomicroscope at coping and final restoration stages. Paired t-test and one-way analysis of variance on marginal discrepancy data were conducted to determine the presence of significant differences between measurement and measuring point stages. Results: Marginal discrepancies of final restoration ($45.82{\pm}30.84\;{\mu}m$) were lower than alumina coping ($53.84{\pm}38.83\;{\mu}m$). Furthermore, the differences were found to be statistically significant at 95% confidence level. Anterior marginal discrepancies were lower than posterior marginal discrepancies, but they were not statistically significant. Lingual marginal discrepancies were higher than other measurement sites, and the differences were found to be statistically significant at 95% confidence level. Conclusion: Within the conditions of this study, marginal fidelities of $Procera^{(R)}$ Allceram Crown were acceptable, and after porcelain build-up, marginal fitness improved over alumina coping. More careful scanning is needed for better results.

• Proceedings of the KACD Conference
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• 2008.05a
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• pp.246-257
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• 2008

The purpose of this study was to investigate the influence of various occlusal loading sites and directions on the stress distribution of the cervical composite resin restorations of maxillary second premolar, using 3 dimensional (3D) finite element (FE) analysis. Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). HyperMesh (Altair Engineering. Inc., Troy, USA) and ANSYS (Swanson Analysis Systems. Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid (Z100, 3M Dental Products, St. Paul, MN, USA) or flowable resin (Tetric Flow, Viva dent Ets., FL-9494-Schaan, Liechtenstein) and each restoration was simulated with adhesive layer thickness ($40{\mu}m$). A static load of 200 N was applied on the three points of the buccal incline of the palatal cusp and oriented in $20^{\circ}$ increments, from vertical (long axis of the tooth) to oblique $40^{\circ}$ direction towards the buccal. The maximum principal stresses in the occlusal and cervical cavosurface margin and vertical section of buccal surfaces of notch-shaped class V cavity were analyzed using ANSYS. As the angle of loading direction increased, tensile stress increased. Loading site had little effect on it. Under same loading condition. Tetric Flow showed relatively lower stress than Z100 overall, except both point angles. Loading direction and the elastic modulus of restorative material seem to be important factor on the cervical restoration.

• Restorative Dentistry and Endodontics
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• v.33 no.3
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• pp.246-257
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• 2008

The purpose of this study was to investigate the influence of various occlusal loading sites and directions on the stress distribution of the cervical composite resin restorations of maxillary second premolar, using 3 dimensional (3D) finite element (FE) analysis. Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). HyperMesh (Altair Engineering, Inc., Troy, USA) and ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid (Z100, 3M Dental Products, St. Paul, MN, USA) or flowable resin (Tetric Flow, Vivadent Ets., FL-9494-Schaan, Liechtenstein) and each restoration was simulated with adhesive layer thickness ($40{\mu}m$). A static load of 200 N was applied on the three points of the buccal incline of the palatal cusp and oriented in $20^{\circ}$ increments, from vertical (long axis of the tooth) to oblique $40^{\circ}$ direction towards the buccal. The maximum principal stresses in the occlusal and cervical cavosurface margin and vertical section of buccal surfaces of notch-shaped class V cavity were analyzed using ANSYS. As the angle of loading direction increased, tensile stress increased. Loading site had little effect on it. Under same loading condition, Tetric Flow showed relatively lower stress than Z100 overall, except both point angles. Loading direction and the elastic modulus of restorative material seem to be important factor on the cervical restoration.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.299-309
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• 1999

The composite resin, due to its esthetic qualities, is considered the material of choice for restoration of anterior teeth. With respect to shade control, the direct-placement resin composites offer some distinct advantages over indirect restorative procedures. Visible-light-cured (VLC) composites allow dentists to match existing tooth shades or to create new shades and to evaluate them immediately at the time of restoration placement. Optimal intraoral color control can be achieved if optical changes occurring during application are minimized. An ideal VLC composite, then, would be one which is optically stable throughout the polymerization process. The shade guides of the resin composites are generally made of plastic, rather than the actual composite material, and do not accurately depict the true shade, translucency, or opacity of the resin composite after polymerization. So the numerous problems associated with these shade guides lead to varied and sometimes unpredictable results. The aim of this study was to assess the color changes of current resin composite restorative materials which occur as a result of the polymerization process and to compare the color differences between the shade guides provided with the products and the actual resin composites before- and after-polymerization. The results obtained from this investigation should provide the clinician with information which may aid in improved color match of esthetic restoration. Five light activated, resin-based materials (${\AE}$litefil, Amelogen Universal, Spectrum TPH VeridonFil-Photo, and Z100) and shade guides were used in this study. Three specimens of each material and shade combination were made. Each material was condensed inside a 1.5mm thick metal mold with 10mm diameter and pressed between glass plates. Each material was measured immediately before polymerization, and polymerized with Curing Light XL 3000 (3M Dental products, USA) visible light-activation unit for 60 seconds at each side. The specimens were then polished sequentially on wet sandpaper. Shade guides were ground with polishing stones and rubber points (Shofu) to a thickness of approximately 1.5mm. Color characteristics were performed with a spectrophotometer (CM-3500d, Minolta Co., LTD). A computer-controlled spectrophotometer was used to determine CIELAB coordinates ($L^*$, $a^*$ and $b^*$) of each specimen and shade guide. The CIELAB measurements made it possible to evaluate the amount of the color difference values (${\Delta}E{^*}ab$) of resin composites before the polymerization process and shade guides using the post-polishing color of the composite as a control, CIE standard D65 was used as the light source. The results were as follows. 1. Each of the resin composites evaluated showed significant color changes during light-curing process. All the resin composites evaluated except all the tested shades of 2100 showed unacceptable level of color changes (${\Delta}E{^*}ab$ greater than 3.3) between pre-polymerization and post-polishing state. 2. Color differences between most of the resin composites tested and their corresponding shade guides were acceptable but those between C2 shade of ${\AE}$litefil and IE shade of Amelogen Universal and their respective shade guides exceeded what is acceptable. 3. Comparison of the mean ${\Delta}E{^*}ab$ values of materials revealed that Z100 showed the least overall color change between pre-polymerization and post-polishing state followed by ${\AE}$litefil, VeridonFil-Photo, Spectrum TPH, and Amelogen Universal in the order of increasing change and Amelogen Universal. Spectrum TPH, 2100, VeridonFil-Photo and ${\AE}$litefil for the color differences between actual resin and shade guide. 4. In the clinical environment, the shade guide is the better choice than the shade of the actual resin before polymerization when matching colors. But, it is recommended that custom shade guides be made from resin material itself for better color matching.

• Restorative Dentistry and Endodontics
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• v.34 no.2
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• pp.87-94
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• 2009

The purpose of this study was to assess the current materials, methods and difficulties according to the year of licence and educational background of Korean dentists in Class II direct composite resin restorations. Total 17 questions were included in the questionnaire. Questions were broadly divided into two parts: first. operator's information. and second. the materials and methods used in Class II posterior composite restoration. The questionnaire was sent to dentists enrolled in Korean Dental Association via e-mail. Total 12,193 e-mails were distributed to dentists. 2,612 e-mails were opened, and 840 mails (32.2%) were received from respondents. The data was statically analyzed by chi-square test using SPSS(v. 12.0.1, SPSS Inc. Chicago, IL, USA). Male dentists among respondents was 79%. 60.3% of the respondents acquired their licences recently (1998-2007), and 77% practiced in private offices. 83.4% have acquired their knowledge through school lectures, conferences and seminars. For the Class II restorations, gold inlays were preferred by 65.7% of respondents, while direct composite resin restorations were used by 12.1 % amalgam users were only 4.4% of respondents. For the restorative technique, 74.4% of respondents didn't use rubber dam as needed. For the matrix. mylar strip (53.4%), metal matrix (33.8%) and Palodent system (6.5%) were used. 99.6% of respondents restored the Class II cavity by incremental layering. Obtaining of the tight interproximal contact was considered as the most difficult procedure (57.2%) followed by field isolation (21 %). Among various bonding systems, 22.6% of respondents preferred SE Bond and 20.2% used Single Bond. Z-250 was used most frequently among a variety of composite resins.

• Journal of dental hygiene science
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• v.4 no.1
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• pp.21-25
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• 2004

In modern times, children's trauma is increasing every year because of car accidents and life environment changes. There is a limit to prevent traumatic damage for oral cavity organization. The fundamental data of trauma treatment and prevention will be presented through the survey and analysis of traumatic teeth damage. I examined 113 patients from Oct. 4th, 2000 to Feb. 27th, 2004 at Dept. of Children's Dental Clinic, Kangnung National University. The results are as follows. (1) The trauma frequency of male subjects is higher than that of female at a rate of 2.05:1. The average age is 5.27 for men and 5.27 for women. The highest percentage of trauma patients is among 2 year old children. It is 21.2%. (2) A patient survey was taken at a trauma treatment hospital. On the first day 34.4% of the patients had come to receive treatment of their first set of teeth. However, after a week, 38.8% of the patients had received treatment on their permanent teeth. (3) As a result of falling, 59% of patients needing treatment on their first set of teeth. 55.1% of patients is permanent teeth. As a result of bump against physical solid, 26.6% of patients is the first set of teeth and 26.5% of patients is permanent teeth. (4) Teeth damage happened at home. 42.1% were male. 35.1% were female. According to trauma, 59.4% of teeth damage happened at home. 28.6% of permanent teeth damage happened at school or kindergarten. (5) According to trauma, the number of teeth damaged was in the first set of teeth are as follows: 56.3%, one-31.3%, three or four-6.3% each. For permanent teeth: two-46.9%, one-28.6%, four over-16.3% and three-8.2%. Over four teeth is larger number for permanent teeth. (6) 56% of first set of teeth patients and 43.4% of permanent teeth patients were male. 56.8% of first set of teeth patients and 43.2% of permanent teeth were female. Trauma happened to both male and female frequently in the first set of teeth. (7) Most of the tooth damage which was in the first set of teeth and permanent teeth was done to the upper jaw. 75% of patients are the first set of teeth. 63.8% of patients are permanent teeth. Trauma is very high in the two mid teeth of the upper jaw. (8) According to trauma survey, 30.2% is from impulse. 28.0% is from crown fracture, 14.7% is from depression. 8.9% is from concussion. 7.1% is from full dislocation of a joint. 2.2% of patients are extrusion. 1.8% is from displacement. According to teeth damage trauma, 35.8% is pulse in the first set of teeth. The breaking of the crown of a tooth happened a lot in permanent teeth. (9) According to data, 43.2% of teeth damage in the first set of teeth goes without treatment. In permanent teeth, it is 38.9%. After treatment, 22.0% of first set of teeth treatment requires a dental pulp treatment. In permanent teeth, which is used for temporary acid etching resin restoration.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.45-53
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• 2000

Enamel microabrasion is a means by which superficial enamel discoloration is removed using hydrochloric acid and fine pumice. As enamel microabrasion alone may not be sufficient in cases of deeper discoloration, composite resin restoration is recommended in areas where there is remaining discoloration. The purpose of this study was to investigate the effects of different methods and number of applications of enamel microabrasion on the shear bond strength of composite resin to enamel. Untreated control was designated as group 1. 5-second applications of a mixture of 18% HCl and fine pumice were performed 5 and 10 times on groups 2 and 3, respectively. A commercially available mixture of 10% HCl and abrasives(PREMA) was applied using a 10 : 1 gear reduction handpiece 5 and 10 times on groups 4 and 5, respectively, with each application lasting 20 seconds. After etching with 37% phosphoric acid, composite resin was bonded. Thermocycling was performed and shear bond strength was measured. The following results were obtained : 1. Group 2 showed the highest bond strength$(24.36{\pm}3.34)$, while group 3 showed the lowest$(19.35{\pm}3.43)$, Shear bond strength decreased in the following order: 2>4>5>1>3. 2. Group 2 showed bond strength significantly higher compared to groups 1 and 3(p<0.05). 3. There were no significant differences between groups 2 and 3, which had been microabraded using HCl and pumice, and groups 4 and 5, to which PREMA had been applied, when bond strengths were compared(p>0.05). 4. When modes of fracture were examined, adhesive failure was observed in groups 3 and 4, while cohesive failure was observed in groups 1, 2, 3 and 4. Only mixed failures were found group 5. 5. When viewed using a SEM, groups 2 and 3, which had been microabraded using HCl and pumice, showed surface appearances similar to that of enamel etched with phosphoric acid. Groups 4 and 5, treated with PREMA, exhibited a smooth surface similar to that of group 1. All oops showed similar, typical surface characteristics following phosphoric acid etching.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.36-43
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• 2012

Purpose: To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. Materials and methods: Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type ${\phi}4.0mm{\times}11.5mm$ Osstem$^{(R)}$ USII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture's external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group's implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. Results: The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2mm, there was no significant influence on the stress distribution. Conclusion: For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.252-259
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• 2017

Purpose: The purpose of this study was to compare and analyze the wear of a prosthesis for 6 months after restoration with implant-supported fixed dental prosthesis made of either zirconia or gold. Materials and Methods: This study was conducted on patients requiring implant-supported fixed dental prostheses on first or second molar from January, 2015 to January, 2016. A total of 47 prostheses and antagonists were examined. Occlusal surface was recorded by impression of each prosthesis and antagonist 1 week and 6 months after prosthesis delivery. The digital files were created by impression scan. Occlusal shapes of 1 week and 6 months were compared and wear of prostheses and antagonists was analyzed. The Mann-Whitney test was used to analyzed the result data underwent normality test using SPSS (Version 23.0, IBM Corporation) Results: Mann-Whitney test revealed that there was no statistically significant difference in the median amount of mean vertical wear for 6 months in zirconia ($50.84{\mu}m$) and gold ($42.84{\mu}m$) prostheses (P > 0.05). When the opposing teeth were natural, the median amount of mean vertical wear of zirconia and gold prostheses was $47.72{\mu}m$ and $41.97{\mu}m$, respectively, and the median amount of mean vertical wear of enamel was $47.26{\mu}m$ and $44.59{\mu}m$, respectively. Statistical analysis showed no significant difference (P > 0.05). Conclusion: Despite the short study period and the small number of experimental groups, zirconia and gold showed no significant difference in wear during the first 6 months. Opposing natural enamel also showed no significant difference in the wear.