• Restorative Dentistry and Endodontics
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• v.42 no.3
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• pp.240-252
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• 2017

The restoration of endodontic tooth is always a challenge for the clinician, not only due to excessive loss of tooth structure but also invasion of the biological width due to large decayed lesions. In this paper, the 7 most common clinical scenarios in molars with class II lesions ever deeper were examined. This includes both the type of restoration (direct or indirect) and the management of the cavity margin, such as the need for deep margin elevation (DME) or crown lengthening. It is necessary to have the DME when the healthy tooth remnant is in the sulcus or at the epithelium level. For caries that reaches the connective tissue or the bone crest, crown lengthening is required. Endocrowns are a good treatment option in the endodontically treated tooth when the loss of structure is advanced.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.38.1-38.9
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• 2018

The restoration of endodontically treated teeth (ETT) with more than one cusp missing and thin remaining walls is challenging for the general practitioner. The use of posts combined with full coverage restorations is a well-established approach, yet not following the minimal invasive principles of adhesive dentistry. Endocrowns are indirect monoblock restorations that use the pulp chamber of the ETT for retention. In this study the fabrication of 4 endocrowns and their clinical performance will be discussed. Two clinical cases include computer-aided design/computer-aided manufacturing manufactured molar endocrowns (one feldspathic ceramic and one hybrid composite-ceramic restoration) and the other two are dental laboratory manufactured resin composite premolar endocrown restorations. The modified United States Public Health Service criteria were used to assess the clinical behavior of the restorations at different follow up periods. Endocrown restorations present a satisfactory clinical alternative, either by the use of resin composite or glass ceramic and hybrid materials. Specific guidelines with minimal alterations should be followed for an endocrown restoration to be successful. Due to limited evidence regarding the long term evaluation of this restorative technique, a careful selection of cases should be applied.

• The Journal of Advanced Prosthodontics
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• v.11 no.2
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• pp.112-119
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• 2019

PURPOSE. Zirconia materials have been used for implant-retained restorations, but the stress distribution of zirconia is not entirely clear. The aim of this study is to evaluate the stress distribution and risky areas caused by the different design of zirconia restorations on the atrophic bone of the posterior maxilla. MATERIALS AND METHODS. An edentulous D4-type bone model was prepared from radiography of an atrophic posterior maxilla. Monolithic zirconia and zirconia-fused porcelain implant-retained restorations were designed as splinted or non-splinted. 300-N occlusal forces were applied obliquely. Stress analyses were performed using a 3D FEA program. RESULTS. According to stress analysis, the bone between the 1) molar implant and the 2) premolar in the non-splinted monolithic zirconia restoration model was stated as the riskiest area. Similarly, the maximum von Mises stress value was detected on the bone of the non-splinted monolithic zirconia models. CONCLUSION. Splinting of implant-retained restorations can be more critical for monolithic zirconia than zirconia fused to porcelain for the longevity of the bone.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.4
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• pp.245-256
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• 2001

The purpose of this study is to analyze the mechanical stress and displacement on the jaws during the simulated bilateral clenching task on the three-dimensional finite element model of the dentated skull with unilateral molar loss. For this study, the computed tomography(G.E.8800 Quick, USA) was used to scan the total length of human skull in the frontal plane at 2.0mm intervals. The fully assembled finite element model consists of the articular disc, maxilla, mandible, teeth, periodontal ligament and cranium. The FE model was used to simulate the bilateral clenching in intercuspal position. The loading condition was the force of the masseter muscle exerted on the mandible as reported by Korioth et al. degrees of freedom of the zygomatic region where the masseter muscle is attached were fixed as restraints. In order to reflect the actual action of the muscles force, the displacement of the region was attached where the muscle is connected to the temporal bone and restraint conditions were given values identical to values at the attachment region of the masticatory muscle but with the opposite direction of the reaction from when the muscle force is acted on the mandible. Although the mandible generally has higher displacement and von Mises stress than the maxilla, its mandibular corpus on the molar-loss side has a higher stress and displacement than the molar-presence side. Because the displacement and von Mises Stress was the highest on the lateral surface of mandibular corpus with molar loss, the stress level of the condyle on the molar-loss side is greater than that of the molar-presence side, which in turn caused the symphysis of the mandible to bend. In conclusion, the unilateral posterior bite collapse with molar loss under para-functional activities such as bruxism and clenching can affect the stress concentration on the condyle and mandibular corpus. It is therefore necessary to consider the biomechanical function of dento-skeleton under masticatory force while designing the occlusal scheme of restoration on alveolar bone with the posterior collapse.

• The Journal of Advanced Prosthodontics
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• v.1 no.3
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• pp.140-144
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• 2009

STATEMENT OF PROBLEM. Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE. This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS. Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS. The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION. To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.

• Restorative Dentistry and Endodontics
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• v.41 no.4
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• pp.278-282
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• 2016

Objectives: Glass ionomer cements (GICs), which are biocompatible and adhesive to the tooth surface, are widely used nowadays for tooth restoration. They inhibit the demineralization and promote the remineralization of the tooth structure adjacent to the restoration, as well as interfere with bacterial growth. Hence, the present study was conducted to assess and compare the antimicrobial activity of three commercially available GICs against two cariogenic bacteria. Materials and Methods: An agar plate diffusion test was used for evaluating the antimicrobial effect of three different GICs (Fuji IX, Ketac Molar, and d-tech) on Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus). Thirty plates were prepared and divided into two groups. The first group was inoculated with S. mutans, and the second group was inoculated with L. acidophilus. These plates were then incubated at $37^{\circ}C$ for 24 hours. Zones of bacterial growth inhibition that formed around each well were recorded in millimeters (mm). Results: The zones of inhibition for Fuji IX, Ketac Molar, and d-tech on S. mutans were found to be $10.84{\pm}0.22mm$, $10.23{\pm}0.15mm$, and $15.65{\pm}0.31mm$, respectively, whereas those for L. acidophilus were found to be $10.43{\pm}0.12mm$, $10.16{\pm}0.11mm$, and $15.57{\pm}0.13mm$, respectively. Conclusions: D-tech cement performed better in terms of the zone of bacterial inhibition against the two test bacteria, than the other two tested glass ionomers.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.98-102
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• 2000

Ectopic eruption is out of a normal position by local eruption disturbance in the developing permanent molar. The prevalence of ectopic eruption is reported to be the between 2 and 6%, most often associated maxillary first permanent molar whereas, the occurrence for the mandibular is quite rare. The etiologic factors of ectopic eruption are inadequate arch length, lack of growth in the posterior region of the jaw, mesially inclined eruption path of first permanent molars, abnormally large first permanent molars, hereditary factor and a stainless steel crown which has been improperly restored. Ectopic eruption can be treated by the use of brass wire, separating elastics, distal disking and Humphrey appliance and the use of removable appliance and cervical traction headgear after extraction of the second primary molar. This case was that lower right first permanent molar was mesially tilted state by locking on the stainless steel crown of a lower right second primary molar. The stainless steel crown was removed and Humphrey appliance was set. Like this case, ectopic eruption could be happened by the stainless steel crown which improperly restored. In restoration of the stainless steel crown, selection of proper size, trimming and contouring are very important.

• The Journal of Advanced Prosthodontics
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• v.8 no.6
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• pp.494-503
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• 2016

PURPOSE. The aim of this study was to compare the efficacies of two-implant splinting (2-IS) and single-implant restoration (1-IR) in the first and second molar regions over a mean functional loading period (FLP) of 40 months, and to propose the appropriate clinical considerations for the splinting technique. MATERIALS AND METHODS. The following clinical factors were examined in the 1-IR and 2-IS groups based on the total hospital records of the patients: sex, mean age, implant location, FLP, bone grafting, clinical crown-implant ratio, crown height space, and horizontal distance. The mechanical complications [i.e., screw loosening (SL), screw fracture, crown fracture, and repeated SL] and biological complications [i.e., peri-implant mucositis (PM) and peri-implantitis (PI)] were also evaluated for each patient. In analysis of two groups, the chi-square test and Student's t-test were used to identify the relationship between clinical factors and complication rates. The optimal cutoff value for the FLP based on complications was evaluated using receiver operating characteristics analysis. RESULTS. In total, 234 patients with 408 implants that had been placed during 2005 - 2014 were investigated. The incident rates of SL (P<.001), PM (P=.002), and PI (P=.046) differed significantly between the 1-IR and 2-IS groups. The FLP was the only meaningful clinical factor for mechanical and biological complication rates in 2-IS. CONCLUSION. The mechanical complication rates were lower for 2-IS than for 1-IR, while the biological complication rates were higher for 2-IS. FLP of 39.80 and 46.57 months were the reference follow-up periods for preventing biological and mechanical complications, respectively.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.3
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• pp.249-256
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• 2015

Restorative dental materials have advanced rapidly, with improved physical properties that improve survival rates. Accordingly, various materials can be selected. Amalgam, composite resin, glass-ionomer cement, and preformed stainless steel crowns have all been used widely for the restoration of dental caries in primary molars. The various dental materials used to treat proximal caries in the primary molars have distinct advantages and disadvantages. However, few studies have examined their survival rates. This retrospective study examined the 2-year survival rates of more than 700 class II restorations of proximal caries in primary molars clinically and radiologically according to the type of restoration. The study results should help in the selection of class II restorations for molars, one of the biggest concerns of pediatric dentists.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.1
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• pp.111-118
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• 2019

Post-endodontic restorations are both important and challenging for clinical success in endodontically treated posterior teeth. Several options have been proposed to restore endodontically treated molars. In pediatric dentistry, restoration using conventional single crowns, especially for partially erupted molars with insufficient retentive tooth structure, has proven to be difficult. However, the endocrown presents a conservative and esthetic restorative alternative to conventional crowns with post-and-core, as it acquires additional retention within the pulp chamber. The tooth preparation consists of a circular, equigingival, butt-joint margin and a central retention cavity in the pulp chamber that helps to construct both the crown and core as a single unit. This case report describes the esthetic and conservative endocrown restorations of erupting permanent first molars with extensive coronal destruction.