• Journal of Oral Medicine and Pain
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• v.30 no.3
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• pp.361-373
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• 2005

Occlusal appliance therapy has been proven to be very useful and effective in reducing signs and symptoms of patients with TMD. However, there are no reports about the masticatory efficiency of the occlusal appliance. The purpose of this study was, first, to investigate the masticatory efficiency of the conventional stabilization appliance experimentally in normal healthy subjects, by comparing it with that of their natural dentition; and, second, to develop a modified stabilization appliance as an attempt to increase masticatory efficiency. Eleven subjects (mean age 25.3 years, range from 23 to 33) participated in this study. Six were men and five were women. They were healthy and had complete or near―complete natural dentition, and did not present with signs or symptoms of TMD. Two kinds of occlusal appliances―the conventional flat maxillary stabilization appliance (i.e., FSA) and a modified maxillary stabilization appliance with additional anatomic structures on its occlusal surface (i.e., ASA)―were made for every subject. Subjects chewed peanuts that were selected as a food to test the three masticatory conditions of the natural dentition, the ASA, and the FSA. The number of chewing strokes was counted during each 1-minute chewing period. Chewed peanut boluses were recovered and their hardness was measured by texture analysis. Statistical tests were performed. The following results were obtained. 1. The masticatory efficiency of the FSA was 38.6 percent that of the natural dentition. The efficiency of the ASA was 78.2 percent that of the natural dentition. 2. The number of chewing strokes in the natural dentition condition was measured to be 1.5 strokes per second. It decreased to 90 percent in the ASA and FSA conditions. These results indicate that the ASA could serve an improved masticatory capacity as well as its therapeutic effects in TMD. A clinical application of the ASA should be considered to extend the management of TMD patients.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.2
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• pp.71-90
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• 2021

The virtual patient dataset is a collection of diagnostic data from various sources acquired from a single patient into a coordinate system of three-dimensional visualization. Virtual patient dataset makes it possible to establish a treatment plan, simulate various treatment procedures, and create a treatment planning delivery device. Clinicians can design and simulate a patient's smile on the virtual patient dataset and select the optimal result from the diagnostic process. The selected treatment plan can be delivered identically to the patient using manufacturing techniques such as 3D printing, milling, and injection molding. The delivery of this treatment plan can be linked to the final prosthesis through mockup confirmation through provisional restoration fabrication and delivery in the patient's mouth. In this way, if the diagnostic data superimposition and processing accuracy during the manufacturing process are guaranteed, 3D digital smile design simulated in 3D visualization can be accurately delivered to the real patient. As a clinical application method of the virtual patient dataset, we suggest a decision-making method that can exclude occlusal adjustment treatment from the treatment plan through the digital occlusal pressure analysis. A comparative analysis of whole-body scans before and after temporomandibular joint treatment was suggested for adolescent idiopathic scoliosis patients with temporomandibular joint disease. Occlusal plane and smile aesthetic analysis based on the virtual patient dataset was presented when treating patients with complete dentures.

• The Journal of Advanced Prosthodontics
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• v.13 no.4
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• pp.216-225
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• 2021

PURPOSE. The aim of this study is to evaluate the effects of canine guidance occlusion and group function occlusion on the degree of stress to the bone, implants, abutments, and crowns using finite element analysis (FEA). MATERIALS AND METHODS. This study included the implant-prosthesis system of a three-unit bridge made of monolithic zirconia and hybrid abutments. Three-dimensional (3D) models of a bone-level implant system and a titanium base abutment were created using the original implant components. Two titanium implants, measuring 4 × 11 mm each, were selected. The loads were applied in two oblique directions of 15° and 30° under two occlusal movement conditions. In the canine guidance condition, loads (100 N) were applied to the canine crown only. In the group function condition, loads were applied to all three teeth. In this loading, a force of 100 N was applied to the canine, and 200-N forces were applied to each premolar. The stress distribution among all the components of the implant-bridge system was assessed using ANSYS SpaceClaim 2020 R2 software and finite element analysis. RESULTS. Maximum stress was found in the group function occlusion. The maximum stress increased with an increase in the angle of occlusal force. CONCLUSION. The canine guidance occlusion with monolithic zirconia crown materials is promising for implant-supported prostheses in the canine and premolar areas.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.245-254
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• 2006

While orofacial pain or various dental factors are generally considered as the primary cause of unilateral chewing tendency, there exist several studies indicating that dental factors did not affect the preferred chewing side. The aim of this study was to examine difference of occlusal scheme between the subjects with and without chewing side preference. The difference between the chewing and non-chewing sides in the unilateral chewing group was investigated as well. Computerized, T-Scan II system was used for occlusal analysis. 20 subjects for the unilateral chewing group (mean age of $25.25{\pm}2.84$ years) and 20 subjects for the bilateral chewing group (mean age of $27.00{\pm}5.07$ years) were selected by a questionnaire on presence or absence of chewing side preference and those with occlusal problem or pain and/or dysfunction of jaw were excluded. T-Scan recordings were obtained during maximum intercuspation and excursion movement. The number of contact points, relative occlusal force ratio between right and left sides, tooth sliding area and elapsed time throughout the maximum intercuspation were calculated. Elapsed time for excursion was also investigated. The results of this study shows that the unilateral chewing group had the smaller average tooth contact areas compared with those of the bilateral group (p<0.005). In the unilateral chewing group, the contact areas of non-chewing side are smaller than those of chewing side (p<0.005). The contact areas on their preferred sides were not significantly different with those of right or left side of the subjects without chewing side preference. There was no significant difference in the elapsed time during maximum intercuspation and lateral excursion, the sliding areas and relative of right-to-left occlusal force ratio between the two groups. From the results of this study, it is likely that individuals prefer chewing on the side with more contact areas for efficient chewing.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.69-78
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• 2007

This study was performed to compare the stress distribution pattern in the crestal cortical bone and cancellous bone using 3-dimensional finite element stress analysis when 2 different Young's modulus(high modulus, model 1; low modulus, model 2) of cancellous bone was assumed. For the analysis, a finite element model was designed to have two square-threaded implants fused together and located at first and second molar area. Stress distribution was observed when vertical load of 200N was applied at several points on the occlusal surfaces of the implants, including central fossa, points 1.5mm, 2mm, 3mm and 3.5mm buccally away from central fossa. The results were as follows; 1. In both model, the maximum Von-Mises stress in the crestal cortical bone was greater when the load was applied at the central point, points 1.5mm and 2mm buccally away from central fossa than other cases. 2. In the cortical bone around first and second molar, model 2 showed greater Von-Mises stress than model 1. It is concluded that when the occlusal contact is afforded, the distribution of stress varies depending on the density of cancellous bone and the location of loading. More favorable stress distribution is expected when the contact load is applied within the diameter of fixtures.

• Journal of Periodontal and Implant Science
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• v.45 no.1
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• pp.8-13
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• 2015

Purpose: The aim of this study was to evaluate the transfer of different occlusal forces in various skeletal malocclusions using finite element analysis (FEA). Methods: Three representative human cone-beam computed tomography (CBCT) images of three skeletal malocclusions were obtained from the Department of Orthodontics, Yonsei University Dental Hospital, Seoul, South Korea. The CBCT scans were read into the visualization software after separating bones and muscles by uploading the CBCT images into Mimics (Materialise). Two separate three-dimensional (3D) files were exported to visualize the solid morphology of skeletal outlines without considering the inner structures. Individual dental impressions were taken and stone models were scanned with a 3D scanner. These images were integrated and occlusal motions were simulated. Displacement and Von Mises stress were measured at the nodes of the FEA models. The displacement and stress distribution were analyzed. FEA was performed to obtain the 3D deformation of the mandibles under loads of 100, 150, 200, and 225 kg. Results: The distortion in all three skeletal malocclusions was comparable. Greater forces resulted in observing more distortion in FEA. Conclusions: Further studies are warranted to fully evaluate the impact of skeletal malocclusion on masticatory performance using information on muscle attachment and 3D temporomandibular joint movements.

• The korean journal of orthodontics
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• v.47 no.6
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• pp.401-413
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• 2017

Objective: The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods: Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results: A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3-30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6-25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions: The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.3
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• pp.175-180
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• 2004

In this study, three treatment options to replace two posterior missing teeth were investigated using three dimensional finite element analysis: two wide(${\phi}5.0mm$) implants(the experimental model I), two standard(${\phi}3.75mm$) implants(the experimental model II), and three standard(${\phi}3.75mm$) implants(the experimental model III). Two kinds of load case were applied ; 1) perpendicular on occlusal surface(axial load), parallel on occlusal surface(lateral load). 2) perpendicular on occlusal surface(3mm lateral to central point). The results obtained from this study were as follows; value of Von-mises stress (equivalent stress) was smallest in the two wide implant among the three experimental models. It was reported that the diameter is the efficient factor than osseointegrated surface area.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.315-323
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• 2014

Excessive teeth abrasion causes pathologic changes of oral environment and masticatory system due to decrease in occlusal vertical dimension. When establishing new occlusal plane and recovering vertical dimension, accurate diagnosis and analysis are essential. In this case, after appropriate centric relation in elevated vertical dimension was taken using Gothic arch tracer, full mouth rehabilitation was performed. A 70-year-old male patient had the chief complaint that he could not eat due to teeth wear. He showed generalized teeth wear and decreased vertical dimension. Elevation of vertical dimension was planned by model analysis. According to increased vertical dimension, centric relation was recorded using Gothic arch tracer and temporary prostheses were applied. Appropriate occlusion was established by temporary prostheses for 4 months. Final prostheses were fabricated using vertical dimension adapted by temporary prostheses. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.3
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• pp.351-384
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• 1993

Complete denture occlusion must be developed to function efficiently and with the least amount of trauma to the supporting tissues. For the preservation of supporting tissues, it is imperative to reduce to a minimum the functional stress induced by dentures. The magnitude of the horizontal component of functional stress contributed by various occlusal teeth forms has not been studied. This study was aimed to investigate the influence of different occlusal teeth forms on the mode of distribution of the stresses in the mandibular tissue, and the displacement of lower dentures during the variant functional movement of mandible for this study three dimensional finite element analysis was used. FEM models were created using commercial software Super Sap for IBM 32 bit computer. The model was composed of 3380 brick elements and 4346 nodes. The results were as follows. 1. The magnitude of stress was similar between two models in centric occlusion, in the case of anatomic model, the stress was concentrated on the buccal side of alveolar ridge beneath the bicuspids. 2. During the protrusive movement, the increasing of stress from the posterior to anterior part of mandible was seen in the case of anatomic model. 3. During the lateral movement, the stress of anatomic model was greater than that of nonanatomic model. 4. The stress of anatomic model was concentrated on the anterior region of residual ridge during the lateral movement. 5. In the case of anatomic model the anterior part of denture was displaced severely at the centric and lateral position, but the denture of nonanatomic model was displaced minutely at the protrusive and lateral position.