• Title/Summary/Keyword: Mandibular first molar

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A SURVEY ON THE PREOPERATIVE CONDITIONS OF ENDODONTICALLY TREATED FIRST MOLARS IN CHILDREN AND ADOLESCENTS (소아청소년기에 치수치료를 받은 제1대구치의 술전 상태 조사)

  • Lee, Soon-Young;Lee, Kyung-Ho;Noh, Hong-Seok;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.376-382
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    • 2011
  • In clinical dentistry, it is not difficult to meet the permanent first molars with severe coronal caries lesions in children or adolescents. The circumstances surrounding the first molars of children and adolescents are so immature and imperfect compared with those of adults. So we thought it significant to understand the status of these teeth at the moment of endodontic treatment and immediate cause of it. 106 patients with 135 permanent molars necessitating endodontic treatment in childhood and adolescence were included in this study, and the dental records and radiographs were examined. 1. The mean age was 11.9 year (male 11.5, female 12.5) and the result shows significant difference between gender(p<0.05). The mandibular teeth took more than half percentage than maxillary teeth. 2. Of 135 teeth, 45.2 percent of teeth had history of dental treatment previously and 16.3 percent of teeth showed necessity of re-endodontic treatment. 3. Of 73 teeth, 22 teeth had mesial-wall cavity causing endodontic treatment, 39 had occlusal cavity, and 12 had distal cavity.

Full mouth Rehabilitation with Orthognathic Surgery in Facial Asymmetry Patient : Case Report (안면 비대칭환자의 악교정 수술을 동반한 완전구강회복)

  • Im, So-Min;Shin, Hyoung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.359-371
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    • 2010
  • Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

A MORPHOMETRIC STUDY ON THE PREFORMED STAINLESS STEEL CRORWNS OF SOME BRANDS (유치용 수종 기성금속관의 형태에 대한 계측학적 연구)

  • Han, Eun-Ok;Lee, Ji-Hyun;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.145-152
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    • 2012
  • Whenever pediatric dentists choose the preformed stainless steel crowns for restoration of primary molars, we usually prefer the crown forms that most fit to the abutment teeth. Despite some previous reports on significant ethnic difference in the size and shape of tooth crowns in primary dentition, only the imported products have been available to date, which might show some discrepancy with tooth anatomy of Korean. However, a domestic product of preformed stainless steel crown has been marketed recently that is expected to show more accurate fit to the primary tooth of Korean. To investigate the morphological characteristics of primary molars of Korean children, their mesiodistal and buccolingual diameters from the dental casts of 263 children in Pusan and Kyungsangnamdo province were measured by digital calipers. The measured data were compared with those of the three types of preformed stainless steel crowns(3M ESPE Stainless Steel Primary Molar Crown, Kids Crown, Sankin Anatom Primary Crown) by statistical processes with regression analysis. The results were as follows: 1. In every primary molar crown of three brands, the bucco-lingual width to mesio-distal width ratio (MD-BL ratio) showed higher values compared with those of natural teeth. 2. While the products of 3M ESPE and Shinhung showed similar features, those of Sankin showed some difference from both, and these difference was more marked in mandibular primary molars. 3. The nearer is the mesio-distal width of the crown to the average, the better was the adaptation of the preformed crown, and the reverse was true. 4. The teeth which revealed more discrepancy between preformed crown and natural tooth were upper and lower first primary molars.

Photoelastic stress analysis of the mandibular unilateral free-end removable partial dentures according to the design (하악 편측 유리단 가철성 국소의치의 설계에 따른 광탄성 응력 분석)

  • Park, Cheol-Woo;Kay, Kee-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.206-214
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    • 2009
  • Statement of problem: There are common clinical cases in which the mandibular first and second molars are missing unilaterally. Purpose: This study was designed to compare and evaluate the magnitude and distribution of stress produced by four kinds of mandibular unilateral free-end removable partial dentures that could be applied clinically in Kennedy class II cases. Material and methods: Four unilateral free-end removable partial dentures using clasp, Konus crown, resilient attachment, and flexible resin were fabricated on the photoelastic models of the Kennedy class II cases. The vertical load of 6㎏ was applied on the central fossa of the first molar of every removable partial denture in the stress freezing furnace and the photoelastic models were frozen according to the stress freezing cycle. After these models were sliced mesio-distally to a thickness of 6mm, the photoelastic isochromatic white and black lines of the sliced specimens were examined with the transparent photoelastic experiment device and photographs were taken with a digital camera. The fringe order numbers at eight measuring points in the photograph were measured with the naked eye. Results: The maximum fringe order number of each sliced specimen and the fringe order number at the residual ridge just below the loading point were in the decreasing order of the unilateral removable partial dentures using flexible resin followed by clasp, resilient attachment, and Konus crown. The fringe order number at the root apex of the second premolar was in the decreasing order of the unilateral removable partial dentures using clasp followed by flexible resin, Konus crown, and resilient attachment. Conclusion: The removable partial denture using Konus crown showed the most equalized stress distribution to the supporting alveolar bone of abutment teeth and residual ridge under the vertical loads. The removable partial denture using flexible resin can be applied to the case that has a better state of residual ridge than abutment teeth.

Comparison of marginal and internal fit of 3-unit monolithic zirconia fixed partial dentures fabricated from solid working casts and working casts from a removable die system (가철성 다이 시스템으로 제작된 작업 모형과 솔리드 작업 모형 상에서 제작된 지르코니아 3본 고정성 치과 보철물의 변연 및 내면 적합도 비교)

  • Wan-Sun Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.2
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    • pp.72-81
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    • 2024
  • Purpose: This study aimed to assess the marginal and internal fit of 3-unit monolithic zirconia fixed partial dentures (FPDs) fabricated via computer-aided design and computer-aided manufacturing (CAD/CAM) from solid working casts and removable die system. Materials and Methods: The tooth preparation protocol for a zirconia crown was executed on the mandibular right first premolar and mandibular right first molar, with the creation of a reference cast featuring an absent mandibular right second premolar. The reference cast was duplicated using polyvinyl siloxane impression, from which 20 working casts were fabricated following typical dental laboratory procedures. For comparative analysis, 10 FPDs were produced from a removable die system (RD group) and the remaining 10 FPDs from the solid working casts (S group). The casts were digitized using a dental desktop scanner to establish virtual casts and design the FPDs using CAD. The definitive 3-unit monolithic zirconia FPDs were fabricated via a CAM milling process. The seated FPDs on the reference cast underwent digital evaluation for marginal and internal fit. The Mann-Whitney U test was applied for statistical comparison between the two groups (α = 0.05). Results: The RD group showed significantly higher discrepancies in fit for both premolars and molars compared to the S group (P < 0.05), particularly in terms of marginal and occlusal gaps. Color mapping also highlighted more significant deviations in the RD group, especially in the marginal and occlusal regions. Conclusion: The study found that the discrepancies in marginal and occlusal fits of 3-unit monolithic zirconia FPDs were primarily associated with those fabricated using the removable die system. This indicates the significant impact of the fabrication method on the accuracy of FPDs.

The width of keratinized gingiva and the frenum in mandible (하악에서 부착치은의 폭경과 소대에 관한 연구)

  • Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.28 no.4
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    • pp.785-797
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    • 1998
  • This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency (22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.

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Assessment of the fit of zirconia-based prostheses fabricated with two different scan methods (서로 다른 두 가지 스캔법을 이용하여 제작된 지르코니아 보철물의 적합도에 대한 비교)

  • Choi, Hyun-Suk;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.135-143
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    • 2017
  • Purpose: This research was conducted to compare the marginal and internal fit of zirconia prostheses fabricated with the model scan method and the intraoral scan method. Materials and methods: In this study, 20 extracted human mandibular first molar was used in the preparation of abutment tooth for the fabrication of zirconia prostheses. In the first group, the model scan method was applied on 10 prepared teeth. In the other group, the intraoral scan method was used on other 10 prepared teeth. Datum of both groups were transmitted to the software system. Afterwards, 20 zirconia prostheses were fabricated using the Ceramill system. Weight technique was used to evaluate the internal gap of the zirconia prostheses. In the Replica technique, marginal gap of the zirconia prostheses were analyzed by optical microscopy. Statistical analysis was based on one-way ANOVA. Results: Model scan group showed lower average weight than intraoral scan group when weight technique was applied, which has significance (P < .05). Also, model scan group showed significantly lower figures in all 5 measurements of replica technique than intraoral scan group (P < .05). Conclusion: Zirconia prostheses of both groups demonstrated clinically acceptable margin and internal fit. However, model scanned zirconia prostheses showed higher marginal and internal fit than intraoral scanned crowns.

An analysis of the dental arch and skeletal characteristics in adult patients exhibiting open bite (Openbite을 나타내는 성인의 치열 특성 및 그에 따른 골격적 특성 분석)

  • Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.34 no.4 s.105
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    • pp.289-301
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    • 2004
  • It is the purpose of this study to characterize oral symptoms and to comprehend the cause and the relapse possibility of patients with open bite. This case study examines the orthodontic treatment of a group of female patients with open bite and Angle's Class I malocclusion. A cephalograph of the patient was taken and tracing of the radiograph was completed. In addition to Bjork and Ricketts analysis, additional measurements of specific areas were taken. The occlusal plane was determined by drawing a line connecting the mesiobuccal cusp tip of the maxillary first molar and the incisal edge of the maxillary central incisors. Patients were divided into two groups depending on the relationship between the marginal ridge of the maxillayy first premolar and the drawn line. Those patients with marginal ridges above the occlusal plane were placed into Group 1, while Group 2 subjects exhibited marginal ridges lower than the occlusal plane. The common characteristics within each group and the characteristic differences between each group both prior to and after orthodontic treatment were examined, and finally, the functional oral volume of each patient was analyzed. The results of the case study were as follows: 1. An examination of the skeletal relationship and anatomical form for both Group 1 and 2 showed that all subjects exhibited hyperdivergent skeletal forms, but Group 2 subjects generally demonstrated underdevelopment of the mandible and a smaller articular angle, resulting in an anterior positioning tendency of the mandible. 2. An analysis of the maxillary arches of Group 1 subjects prior to and after orthodontic treatment showed that the antero-inferior direction had changed to an antero-superior directional tendency, while the maxillary arches of the Group 2 patients showed a trend from an antero-superior direction to an antero-inferior relationship. The mandibular arches in both groups showed a change to an antero-superior direction. 3. Functional space analysis showed that Group 2 patients exhibited a greater tendency of haying palatal planes that drop in a postero-inferior direction, resulting in a more severe open bite than their Group 1 counterparts. The results of this case study show that although patients belonging to either Group 1 or 2 exhibited few external differences in the appearance of open bite, an examination of the dental and skeletal relationships by analyzing patient cephalographs showed that patients presenting with flat maxillary occlusal planes exhibited more severe open bite relationships than patients with curved occlusal planes.

EFFECT OF NUMBER OF IMPLANTS AND CANTILEVER DESIGN ON STRESS DISTRIBUTION IN THREE-UNIT FIXED PARTIAL DENTURES: A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS

  • Park, Ji-Hyun;Kim, Sung-Hun;Han, Jung-Suk;Lee, Jai-Bong;Yang, Jae-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.3
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    • pp.290-297
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    • 2008
  • STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. $4.1{\times}10$ mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 1-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 1-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 2-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 2-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N, it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2- 3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.

Quantitative evaluation of cortical bone and soft tissue thickness in the mandible (하악 피질골과 연조직의 해부학적 두께를 위한 정량적 평가)

  • Lee, Soo-Kyung;Chun, Youn-Sic;Lim, Won-Hee
    • The korean journal of orthodontics
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    • v.37 no.3 s.122
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    • pp.212-219
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    • 2007
  • Objective: The purpose of this study was to provide an anatomical reference for cortical bone and soft tissue thickness, and the attached gingiva width in the mandible. Methods: Fifteen males and fifteen females participated in this study. An acrylic template was fabricated and the radiopaque markers were bonded on the estimated alveolar crest to take measurements of the hard and soft tissue thickness at the same locations. CT images were taken in samples wearing an acrylic template. Cortical bone and soft tissue thickness were measured at 2, 4, 6 and 8 mm from the alveolar crest in interradicular spaces from central incisor to first permanent molar. The attached gingival width was calibrated. Results: Cortical bone thickness was $1.33{\pm}0.38mm$ and soft tissue thickness was $1.49{\pm}0.54mm$. Cortical bone thickness was increased in the posterior area, while it was not the case for the soft tissue thickness. In addition, the total thickness was $2.82{\pm}0.70$. The attached gingival width was wider in the anterior area compared to that in posterior area. Conclusion: These results suggest that the attached gingiva width should be considered upon placement of mini-implants in the mandibular posterior area for orthodontic anchorage.