• The Journal of Advanced Prosthodontics
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• v.13 no.5
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• pp.269-280
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• 2021

PURPOSE. The objective of this study was to evaluate the effect of thickness reduction and fatigue on the failure load of monolithic zirconia crowns. MATERIALS AND METHODS. 140 CAD-CAM fabricated crowns (3Y-TZP, inCorisTZI, Dentsply-Sirona) with different ceramic thicknesses (2.0, 1.5, 1.0, 0.8, 0.5 mm, respectively, named G2, G1.5, G1, G0.8, and G0.5) were investigated. Dies of a mandibular first molar were made of composite resin. The zirconia crowns were luted with a resin composite cement (RelyX Unicem 2 Automix, 3M ESPE). Half of the specimens (n = 14 per group) were mouth-motion-fatigued (1.2 million cycles, 1.6 Hz, 200 N/ 5 - 55℃, groups named G2-F, G1.5-F, G1-F, G0.8-F, and G0.5-F). Single-load to failure was performed using a universal testing-machine. Fracture modes were analyzed. Data were statistically analyzed using a Weibull 2-parameter distribution (90% CI) to determine the characteristic strength and Weibull modulus differences among the groups. RESULTS. Three crowns (21%) of G0.8 and five crowns (36%) of G0.5 showed cracks after fatigue. Characteristic strength was the highest for G2, followed by G1.5. Intermediate values were observed for G1 and G1-F, followed by significantly lower values for G0.8, G0.8-F, and G0.5, and the lowest for G0.5-F. Weibull modulus was the lowest for G0.8, intermediate for G0.8-F and G0.5, and significantly higher for the remaining groups. Fatigue only affected G0.5-F. CONCLUSION. Reduced crown thickness lead to reduced characteristic strength, even under failure loads that exceed physiological chewing forces. Fatigue significantly reduced the failure load of 0.5 mm monolithic 3Y-TZP crowns.

• The Journal of Advanced Prosthodontics
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• v.13 no.2
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• pp.89-99
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• 2021

PURPOSE. This study aimed to compare the accuracy (trueness and precision) of interim crowns fabricated using DLP (digital light processing) according to post-curing time. MATERIALS AND METHODS. A virtual stone study die of the upper right first molar was created using a dental laboratory scanner. After designing interim crowns on the virtual study die and saving them as Standard Triangulated Language files, 30 interim crowns were fabricated using a DLP-type 3D printer. Additively manufactured interim crowns were post-cured using three different time conditions-10-minute post-curing interim crown (10-MPCI), 20-minute post-curing interim crown (20-MPCI), and 30-minute post-curing interim crown (30-MPCI) (n = 10 per group). The scan data of the external and intaglio surfaces were overlapped with reference crown data, and trueness was measured using the best-fit alignment method. In the external and intaglio surface groups (n = 45 per group), precision was measured using a combination formula exclusive to scan data (10C2). Significant differences in accuracy (trueness and precision) data were analyzed using the Kruskal-Wallis H test, and post hoc analysis was performed using the Mann-Whitney U test with Bonferroni correction (α=.05). RESULTS. In the 10-MPCI, 20-MPCI, and 30-MPCI groups, there was a statistically significant difference in the accuracy of the external and intaglio surfaces (P<.05). On the external and intaglio surfaces, the root mean square (RMS) values of trueness and precision were the lowest in the 10-MPCI group. CONCLUSION. Interim crowns with 10-minute post-curing showed high accuracy.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.27.1-27.12
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• 2019

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.36.1-36.12
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• 2018

Objectives: Direct pulp capping is a treatment for mechanically exposed pulp in which a biocompatible capping material is used to preserve pulpal vitality. Biocompatibility tests in animal studies have used a variety of experimental protocols, particularly with regard to the exposure site. In this study, pulp exposure on the occlusal and mesial surfaces of molar teeth was investigated in a rat model. Materials and Methods: A total of 58 maxillary first molars of Wistar rats were used. Forty molars were mechanically exposed and randomly assigned according to 3 factors: 1) the exposure site (occlusal or mesial), 2) the pulp-capping material (ProRoot White MTA or Bio-MA), and 3) 2 follow-up periods (1 day or 7 days) (n = 5 each). The pulp of 6 intact molars served as negative controls. The pulp of 12 molars was exposed without a capping material (n = 3 per exposure site for each period) and served as positive controls. Inflammatory cell infiltration and reparative dentin formation were histologically evaluated at 1 and 7 days using grading scores. Results: At 1 day, localized mild inflammation was detected in most teeth in all experimental groups. At 7 days, continuous/discontinuous calcified bridges were formed at exposure sites with no or few inflammatory cells. No significant differences in pulpal response according to the exposure site or calcium-silicate cement were observed. Conclusions: The location of the exposure site had no effect on rat pulpal healing. However, mesial exposures could be performed easily, with more consistent results. The pulpal responses were not significantly different between the 2 capping materials.

• Journal of the Korean Society of Radiology
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• v.13 no.4
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• pp.623-628
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• 2019

The aim of this study was to design fast non local means (FNLM) noise reduction algorithm and to confirm its application feasibility in light microscopic image. For that aim, we acquired mouse first molar image and compared between previous widely used noise reduction algorithm and our proposed FNLM algorithm in acquired light microscopic image. Contrast to noise ratio, coefficient of variation, and no reference-based evaluation parameter such as natural image quality evaluator (NIQE) and blind/referenceless image spatial quality evaluator (BRISQUE) were used in this study. According to the result, our proposed FNLM noise reduction algorithm can achieve excellent result in all evaluation parameters. In particular, it was confirmed that the NIQE and BRISQUE evaluation parameters for analyzing the overall morphologcal image of the tooth were 1.14 and 1.12 times better than the original image, respectively. In conclusion, we demonstrated the usefulness and feasibility of FNLM noise reduction algorithm in light microscopic image of small animal tooth.

• Journal of Environmental Science International
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• v.28 no.6
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• pp.561-570
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• 2019

A zeolitic material (Z-Y2) was synthesized from Coal Fly Ash (CFA) using a fusion/hydrothermal method under low-alkali condition (NaOH/CFA = 0.6). The adsorption performance of the prepared zeolite was evaluated by monitoring its removal efficiencies for Sr and Cs ions, which are well-known as significant radionuclides in liquid radioactive waste. The XRD (X-ray diffraction) patterns of the synthesized Z-Y2 indicated that a Na-A type zeolite was formed from raw coal fly ash. The SEM (scanning electron microscope) images also showed that a cubic crystal structure of size $1{\sim}3{\mu}m$ was formed on its surface. In the adsorption kinetic analysis, the adsorption of Sr and Cs ions on Z-Y2 fitted the pseudo-second-order kinetic model well, instead of the pseudo-first-order kinetic model. The second-order kinetic rate constant ($k_2$) was determined to be $0.0614g/mmol{\cdot}min$ for Sr and $1.8172g/mmol{\cdot}min$ for Cs. The adsorption equilibria of Sr and Cs ions on Z-Y2 were fitted successfully by Langmuir model. The maximum adsorption capacity ($q_m$) of Sr and Cs was calculated as 1.6846 mmol/g and 1.2055 mmol/g, respectively. The maximum desorption capacity ($q_{dm}$) of the Na ions estimated via the Langmuir desorption model was 2.4196 mmol/g for Sr and 2.1870 mmol/g for Cs. The molar ratio of the desorption/adsorption capacity ($q_{dm}/q_m$) was determined to be 1.44 for Na/Sr and 1.81 for Na/Cs, indicating that the amounts of desorbed Na ions and adsorbed Sr and Cs ions did not yield an equimolar ratio when using Z-Y2.

• Imaging Science in Dentistry
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• v.50 no.4
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• pp.309-318
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• 2020

Purpose: This study investigated correlations between findings on panoramic radiographs and cone-beam computed tomography (CBCT) to assess the relationship between the maxillary sinus floor and the roots of maxillary posterior teeth. In addition, radiographic signs indicating actual root protrusion into the maxillary sinus were evaluated on panoramic radiographs. Materials and Methods: Paired panoramic radiographs and CBCT images from 305 subjects were analyzed. This analysis classified 2,440 maxillary premolars and molars according to their relationship with the maxillary sinus floor on panoramic radiographs and CBCT images. In addition, interruption of the sinus floor was examined on panoramic radiographs. Results: Root protrusion into the maxillary sinus occurred most frequently in the mesiobuccal roots of the second molars. The classification according to panoramic radiographs and CBCT images was the same in more than 90% of cases when there was no contact between the root apex and the sinus floor. When the panoramic radiograph showed root protrusion into the sinus, the CBCT images showed the same classification in 67.5% of second molars, 48.8% of first molars, and 53.3% of second premolars. There was a statistically significant relationship between interruption of the sinus floor on panoramic radiographs and root protrusion into the sinus on CBCT images. Conclusion: The presence of root protrusion into the sinus on panoramic radiographs demonstrated a moderate ability to predict root protrusion into the maxillary sinus. Interruption of the maxillary sinus floor could be considered an indicator of actual root protrusion into the maxillary sinus.

• Journal of Technologic Dentistry
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• v.42 no.4
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• pp.334-340
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• 2020

Purpose: This study aimed to compare three-dimensional adaptation with the rinsing time of the temporary crown produced using the digital light processing method. Methods: The maxillary right first molar abutment was scanned with a dental scanner. A temporary crown was designed with the scanned abutment. The designed crown was made of 10 temporary crowns using a digital light processing printer. The crowns were divided into the 5-minute and 10-minute rinsing groups; 5 temporary crown washes were performed for each group. In order to obtain the internal data, each group was scanned for a temporary crown. The three-dimensional fit was measured by superimposing the scanned internal surface data and the abutment data. The average comparison of three-dimensional adaptation was analyzed using the Mann-Whitney U test. Results: The 5-minute rinsing group showed a significantly higher adaptation of 71.42±3.08 ㎛ as compared to the 10-minute rinsing group (67.52±0.92 ㎛) (p<0.05). Conclusion: When making a temporary crown with a digital light processing method, a rinsing time of 10 minutes is appropriate.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.6
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• pp.387-395
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• 2020

Background: The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique. Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. Results: Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. Conclusions: The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

• The Journal of Advanced Prosthodontics
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• v.12 no.6
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• pp.344-350
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• 2020

PURPOSE. Recently introduced hybrid and reinforced glass ceramic computer-aided design/computer-aided manufacturing (CAD/CAM) materials have been used for full-coverage restorations. However; the effect of adjustment and type of materials on internal and marginal adaptation are unknown. This study aimed to evaluate and compare the marginal and internal adaptations of crowns made of three different CAD/CAM materials before and after adjustment. MATERIALS AND METHODS. One acrylic resin maxillary first molar was prepared and served as the master die. Thirty-six restorations were fabricated using CAD/CAM system (CEREC Omnicam, MCXL) with three materials including lithium disilicate (IPS e.max CAD), zirconia-reinforced lithium silicate (Suprinity), and hybrid ceramic (Enamic). Internal and marginal adaptations were evaluated with the reference point matching technique before and after adjustment. The data were analyzed using mixed ANOVA considering α=.05 as the significance level. RESULTS. The effect of adjustment and its interaction with the restoration material were significant for marginal, absolute marginal, and occlusal discrepancies (P<.05). Before adjustment, Suprinity had lower marginal discrepancies than IPS e.max CAD (P=.18) and Enamic (P=.021); though no significant differences existed after adjustment. CONCLUSION. Within the limitations of this study, crowns fabricated from IPS e.max CAD and Suprinity resulted in slightly better adaptation compared with Enamic crowns before adjustment. However, marginal, axial, and occlusal discrepancies were similar among all materials after the adjustment.