• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.655-669
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• 1995

Restorative procedures can lead to weakening tooth due to reduction and alteration of tooth structure. It is essential to prevent fractures to conserve tooth. Among the several parameters in cavity designs, cavity isthmus is very important. In this study, amalgam 0 cavity was prepared on maxillary first premolar. Two dimensional finite element models were made by serial photographic method and isthmus(1/4, 1/3, 1/2, 2/3 of intercuspal distance) were varied. Three or four-nodal mesh were used for the two dimensional finite element models. The periodontal ligament and alveolar bone surrounding the tooth were excluded in these models. 1S model was sound tooth with no amalgam cavity. B model was assumed perfect bonding between the restoration and cavity wall. Both compressive and tensile forces were distributed directly to the adjacent regions. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed von Mises stress, 1 and 2 directional normal stress and Y and Z axis translation with FEM software Super SAPII Version 5.2 (Algor Interactive System Co.) and hardware 486 DX2 PC. The results were as :follows : 1. 1S model was slightly different with 1B model in stress distibution. 1S, 2B, 3B, 4B models showed similiar stress distribution. 2. 1S model and four B models showed similiar pattern in Y axis and Z axis translation. 3. 1S model and four B models showed the bending phenomenon in the translation. 4. As increasing of the width of the cavity, experimental group was similiar with the control group in stress distribution. 5. As increasing of the width of the cavity, experimental group was similiar with the control group in Y and Z axis tranlation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.356-360
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• 1999

PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF"in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.67-75
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• 1999

The use of composite restorative materials is established due to continuing improvements in the materials and restorative techniques. Composite resins are widely used for the restoration of cervical lesions because of esthetics, good physical properties and working time. There are several types of cavity design for class V composite resin filling, but inappropriate cavity form may affect bonding failure, microleakage and fracture during mastication. Cavity preparations for composite materials should be as conservative as possible. The extent of the preparation is usually determined by the size, shape, and location of the defect. The design of the cavity preparation to receive a composite restoration may vary depending on several factors. In this study, 5 types of class V cavity were prepared on each maxillary central incisor. The types are; 1) V-shape, 2) round(U) shape, 3) box form, 4) box form with incisal bevel and 5) box form with incisal bevel and grooves for axial line angles. After restoration, in order to observe the concentration of stress at bonding surfaces of teeth and restorations, developing a 2-dimensional finite element model of labiopalatal section in tooth, surrounding bone, periodontal ligament and gingiva, based on the measurements by Wheeler, loading force from direction of 45 degrees from lingual side near the incisal edge was applied. This study analysed Von Mises stress with SuperSap finite element analysis program(Algor Interactive System, Inc.). The results were as follows : 1. Stress concentration was prevalent at tooth-resin bonding surface of cervical side on each model. 2. In model 2 without line angle, stress was distributed evenly. 3. Preparing bevel eliminated stress concentration much or less at line angle. 4. Model with round-shape distributed stress concentration more evenly than box-type model with sharp line angle, therefore decreased possibility of fracture. 5. Adding grooves to line angles had no effect of decreasing stress concentration to the area.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.2
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• pp.119-124
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• 2013

Many of the patients with extensive abrasion need comprehensive restorative treatment. The abrasion is usually caused by attrition, besides of it, there are many reasons for it. The plan of treatment should be started on assessment of the type of attrition and the etiologic analysis. Patient with well-developed masticatory muscle, alveolar process, and high occlusal force and also with little muscle length difference between the stable and the contracted state should be carefully assessed for the vertical dimensional loss and the restoration should be carefully designed. Decrease of tooth length can be compensated by the growth of the alveolar bone height; therefore, consistency of the occlusal vertical dimension is maintained. Accordingly, a careless increase of the vertical dimension can produce muscle fatigue, depressed tooth and pain, and fracture of the restoration. In this case, the patient with multiple tooth abrasion and clenching habit, the edentulous maxillary area is restored with amalgam inserted RPD, and the dentulous area of the maxilla and mandible are treated with fixed restoration accompanying with the increase of vertical dimension. Consequently, we are going to report about the satisfying result in both functional and esthetic aspects.