• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.83-94
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• 2004

The purpose of this study was to compare the distributing pattern of stress according to the types of occlusal load on the finite element models of the splinted implant prostheses. The finite element model was designed with the parallel placement of two fixtures ($4.0mm{\times}11.5mm$) on mandibular first and second molars. The cemented crowns for mandibular first and second molars were made. Three-dimensional finite element model was created with the components of the implant, surrounding bone and cemented crowns. Two types of occlusal load, the point load and the surface load within 0.5 mm radius circle, were applied to the finite element models with 200N magnitude in axial(along the long axis of the implant and oblique(angulation of $30^{\circ}$ to the long axis) directions perpendicular to cuspal incline. Loads were positioned from the center of central fossa and to distance of 2 mm and 4 mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the fixtures and sections. The results were as following : 1. Under axial loading at the central fossa, the stress was distributed along the fixture except for the apical portion, not relative to both point & surface contacts. 2. With offset distance increasing, the highest stresses were concentrated in the neck portion of the fixture. 3. The maximum von Mises stress under the oblique load was greater than that under the axial load. 4. Under the oblique load, the highest stress were concentrated in the buccal side and lingual neck portion of the fixture with offset distance increasing. The results had a tendency to increase the stress on the neck portion of fixture with the offset and oblique loads increasing. The design of occlusal scheme should be allowed to distribute stress axially in maximum intercuspation and to decrease the angulation of cuspal incline.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.55-68
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• 2007

The purpose of this study was to analyze the distribution of stress in the surrounding bone around implant placed in the first and second molar region. Two different three-dimensional finite element model were designed according to vertical bone level around fixture ($4.0mm{\times}11.5mm$) on the second molar region. A mandibular segment containing two implant-abutments and a two-unit bridge system was molded as a cancellous core surrounded by a 2mm cortical layer. The mesial and distal section planes of the model were not covered by cortical bone and were constrained in all directions at the nodes. Two vertical loads and oblique loads of 200 N were applied at the center of occlusal surface (load A) or at a position of 2mm apart buccally from the center (load B). Von-Mises stresses were analyzed in the supporting bone. The results were as follows; 1. With the vertical load at the center of occlusal surface, the stress pattern on the cortical and cancellous bones around the implant on model 1 and 2 was changed, while the stress pattern on the cancellous bone with oblique load was not. 2. With the vertical load at the center of occlusal surface, the maximum von-Mises stress appeared in the outer distal side of the cortical bone on Model 1 and 2, while the maximum von-Mises stress appeared in the distal and lingual distal side of the cortical bone with oblique load. 3. With the vertical load at a position of 2 mm apart buccally from the center, there was the distribution of stress on the upper portion of the implant-bone interface and the cortical bone except for the cancellous bone, while there was a distribution of stress on the cancellous bones at the apical and lingual sides around the fixture and on the cortical bone with oblique load. 4. With the changes of the supporting bone on the second molar area, the stress pattern on the upper part of the cortical bone between two implants was changed, while the stress pattern on the cancellous bone was not. The results of this study suggest that establishing the optimum occlusal contact considering the direction and position of the load from the standpoint of stress distribution of surrounding bone will be clinically useful.

• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.371-380
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• 2017

PURPOSE. The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS. Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS. Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION. The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.33-38
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• 2013

Occlusal plane is a sagittal expression of dental arch form, and it composes the shape of occlusion, which is one of the most important elements of Maxillo-oral system. In this case, vertical, horizontal coordinates of bionic-median-sagittal plane was produced in articulator, and to achieve relation of left and right position of upper, lower teeth and deficits in alveola, Shilla system was used to reconstruct occlusal plane. In this case, a 41 year-old male patient visited for fracture of 10 unit metal-ceramic fixed partial denture of upper anterior teeth and for overall treatment. Clinical, radiographical, model examination was held, full mouth rehabilitation was achieved by placing dental implant. Maxillo-oral relation was recorded using Gothic arch Tracer complex and were mounted. And for the next step, we estimated original occlusal plane using Shilla system. After analysis we produced diagnosis wax pattern. On the basis of this, radiography stent was manufactured and dental implant was placed, and temporary prosthesis was made by using diagnosis wax pattern. Cross mounting and anterior guiding table were performed in order to reproduce temporary restoration morphology and bite pattern, followed by final restoration made of all ceramic crown with zirconia coping. As stated above, appropriately esthetic and functional results can be seen in using Shilla system in diagnosis and treatment procedure of full mouth rehabilitation patient.

• The korean journal of orthodontics
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• v.23 no.1 s.40
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• pp.123-136
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• 1993

The purpose of this report is to present the successful improvement of occlusal relationship and facial esthetics in class II division 1 malocclusion with severe labioversion of upper anterior teeth and severe overjet, and in class II malocclusion with infraversion of bilateral maxillary canines by MEAW mechanics, which enables us to get effective distal on mass movement of maxillary dentition, with upper second molar extraction. After treatment, there were natural contact points at canine and premolar regions, normal occlusal relation-ship and treatment results, satisfied the gnathologic concept, in this 2 cases. Compared with the routine treatment with premolar extraction, the treatment time and patients' discomfort were reduced. And the MEAW mechanics, which enables us to get effective distal on mass movement of maxillary dentition, resulted in reduction of the treatment time and getting the good treatment results. Consequently, the majot concerns in orthodontic treatment are appropriate diagnosis and treatment plan, so, the application of second molar extraction with appropriate case analysis and diagnosis is very helpful to orthodontic treatment.

• The Journal of the Korean dental association
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• v.48 no.2
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• pp.140-145
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• 2010

True vertical root fracture (VRF) in nonendodontically treated teeth confined to the root surface (fatigue root fracture; FRF) is apparently uncommon, the few documented reports being Chinese. The aim of this study is to analyze the cases of a fatigue root fracture and to find out the characteristic features of teeth with a FRF. A total of 21 consecutive cases of fatigue root fracture occurring in 16 patients were reviewed. In terms of the occlusion, the presence of restorations, the location, the age and gender, each tooth and patient were analyzed. The prevalent age was in those over 50 years of age (75%) and FRFs were more frequent in male patients (69%). Fatigue root fractures occurred most frequently in the mandibular molars (61.9%; 42.9% in first molar, 19% in second molar). Fatigue root fractures were observed most frequently in the teeth with no restorations (85.7%) and in the patients with occlusal problems (94%). FRFs seem to occur frequently and may represent an undiagnosed clinical entity deserving of our attention.

• The Journal of Advanced Prosthodontics
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• v.12 no.5
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• pp.283-290
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• 2020

PURPOSE. The present study aimed to evaluate the clinical applicability of monolithic zirconia (MZ) crowns of different thickness via determination of fracture resistance and marginal fit. MATERIALS AND METHODS. MZ crowns with 0.5, 0.8, 1.0, and 1.5 mm thickness and porcelain fused to metal (PFM) crowns were prepared, ten crowns in each group. Marginal gaps of the crowns were measured. All crowns were aged with thermal cycling (5 - 55℃/10000 cycle) and chewing simulator (50 N/1 Hz/lateral movement: 2 mm, mouth opening: 2 mm/240000 cycles). After aging, fracture resistance of crowns was determined. Statistical analysis was performed with one-way ANOVA and Tukey's HDS post hoc test. RESULTS. Fracture loads were higher in the PFM and 1 mm MZ crowns compared to 0.5 mm and 0.8 mm crowns. 1.5 mm MZ crowns were not broken even with the highest force applied (10 kN). All marginal gap values were below 86 ㎛ even in the PFM crowns, and PFM crowns had a higher marginal gap than the MZ crowns. CONCLUSION. The monolithic zirconia exhibited high fracture resistance and good marginal fit even with the 0.5 mm thickness, which might be used with reduced occlusal thickness and be beneficial in challengingly narrow interocclusal space.

• The korean journal of orthodontics
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• v.18 no.1 s.25
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• pp.65-78
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• 1988

The development of good arch form, the orientation of the dentition with relation to the craniofacial skeleton and the establishment of correct relationship of axial inclination of upper and lower teeth are required in normal occlusion, but different teeth present different degrees of axial inclination. The purpose of this study was to investigate the axial inclination of upper and lower teeth by analyzing $45^{\circ}$ oblique and $90^{\circ}$ cephalometric roentgenograms of 35 Korean males and 34 females with normal occlusion. The obtained results were as follows: 1. Mean and standard deviation of mesiodistal axial inclination of upper and lower teeth related to palatal plane and occlusal plane were obtained. 2. Mesiodistal axial inclination of upper first premolar was nearly perpendicular to palatal plane, and the axis of lower first premolar was nearly perpendicular to occlusal plane. 3. There was no difference in the mesiodistal axial inclination of anteriorly positioned teeth between the three groups: third molar eruption into good alignment (Group 1), third molar impaction or partial eruption (Group 2), third molar agenesis (Group 3). 4. There were low correlationships only between the axial inclination of central incisor and the mesiodistal axial inclination of canine and first premolar, but no correlationships between central incisor and posterior teeth behind first premolar.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.228-237
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• 2021

Physiologic tooth attrition is accepted as a natural change. But when pathologic changes, such as loss of occlusal vertical dimension, masticatory pain, loss of masticatory function, and loss of esthetics occur, restorative measures should be taken by dentist. A patient visited the clinic with the chief complaint of 'My lower teeth bite the palate and it hurts'. It was diagnosed as iatrogenic attrition of lower natural dentition caused by inappropriate upper restorations, resulting in traumatic overbite. Through model analysis and diagnostic wax up, increase in vertical dimension was decided. Upper and lower dentitions were restored with new prostheses. After restoration, satisfactory outcomes were achieved both in functional and esthetic aspects.

• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.45-51
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• 2021

Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.