• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.3
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• pp.159-168
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• 2024

Through the use of intraoral scanners, it is possible to obtain intraoral scan impressions and produce prostheses. This approach is also being attempted not only in dentate patients but also in edentulous patients. However, obtaining scans of edentulous areas can be more challenging than scanning dental areas, and there may be limitations, especially in capturing the details of the mucosal tissues. On the other hand, when obtaining impressions with intraoral scanners, simultaneous recording of the occlusal relationship of the maxilla and mandible can reduce the number of patient visits and expedite the restoration process. In this case, we aimed to combine the advantages of direct intraoral scanning and indirect digital impressions obtained after traditional impression-taking by merging two types of scan files. Consequently, in patients with partially edentulous arches, we sought to provide effective interim prostheses through direct and indirect digital model impressions and report our findings accordingly.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.3
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• pp.179-188
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• 2024

To enhance the predictability of aesthetic treatment outcomes in aesthetic prosthetic restorations, considerations must include analysis of facial features, the relationship between teeth and lips, proportions of tooth width/length, gingival form, and more. Traditional diagnostic wax-ups have limitations in considering the patient's facial features and are unable to facilitate rapid form modifications. With recent advancements in digital technology, it is now possible to digitize the patient's facial features in three dimensions, enabling the design of restorations that harmonize with facial features. These digital workflows not only improve efficiency but also provide patients with faster visualization of treatment outcomes, thereby enhancing motivation. Therefore, in this case, a treatment plan is devised to utilize digital diagnostic wax-ups considering the patient's facial features for the final prosthetic design.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.739-748
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• 1998

Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.241-251
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• 2010

This study aims at contributing to the restorative dentistry by examining results in the vertical load test of four different low invasive fixed partial dentures. Based on a hypothesis on the right upper first molar is missing, three units of FPDs were made for the second premolar and the second molar abutment. that is, twelve metal dies and FPDs were made for resin bonded FPD and Two Key Bridges and Human Bridge without occlusal rest and Human Bridge with occlusal rest. By using universal test machine, the numerical maximum value were recorded during the vertical load test of each FPDs after the bonding process treated by Maxcem which is resin cement. The failure process and its result of prosthesis were also observed. The maximum load was 7,295 N, 4,729 N, 2,190 N, 3,073 N from groups of resin bonded FPD, Two Key Bridge, Human Bridge without occlusal rest and Human Bridge with occlusal rest respectively. There was a statistical significance among the groups of resin bonded FPD, Two Key Bridge and Human Brides. However, there was no significant difference between Human Bridge without occlusal rest and Human Bridge with occlusal rest. Regarding the failure of prosthesis, the groups of Resin Bonded FPD and Two Key Bridge showed that one of the abutment teeth in the both side of retention part was highly failed earlier than the other one (83.2% and 66.6% respectively). While, Human Bridge without occlusal rest and Human Bridge with occlusal rest showed high percentage of failure in the abutment teeth in the both side of retention part at the same time (91.6% and 58.3% respectively). This study demonstrates that the group of Human Bridges has low resistance to the vertical loads of low invasive FPDs in comparison with the groups of resin bonded FPD and Two Key Bridge. Nevertheless, the maximum occlusal load of the restorative position, resistance to diverse restoration failure, amount of tooth reduction and patients' cooperation should be considered when they are applied in the clinic in order to choose an appropriate restoration for each patient.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.1
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• pp.13-22
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• 2009

The composite resin, due to its esthetic quality, is considered the material of choice for restoration of anterior teeth. To get a satisfactory result in the composite resin restorations, it is necessary to choose right shade. At present, most of the commercial composite resins are based on the Vita Lumin shade guides or shade guides that are provided by their company, but color differences among them might be expected even using the same shade in various materials. This study is to measure color differences between various light-cured composite resins and shade guides and to provide the clinicians with information which may aid in improved color match of esthetic restoration. Four kinds of light-cured composite resins (Gradia Direct (GD), Z250 (Z250), Clearfil AP-X (AP-X), Esthet X (E X)) and shade guides with A2 and A3 shade were used. Three specimens of each material and one specimen of each shade guide were made. Each composite resin was filled into the Teflon mold (1.35 mm depth, 8 mm diameter), followed by compression, polymerization and polishing with wet sandpaper. Shade guides were grinded with polishing stones and rubber points to a thickness of approximately 1.35 mm. Color characteristics were performed with a spectrophotometer(color i5, GretagMacbeth, USA). A computer-controlled spectrophotometer was used to determine CIELAB coordinates ($L^*$, $a^*$, $b^*$) of each specimen and shade guide. The CIELAB measurements made it possible to evaluate the amount of the color difference values (${\Delta}E^*ab$) between composite resins and shade guides. CIE standard D65 was used as the light source. The results were as follows : 1. Among the $L^*$, $a^*$, $b^*$ values of most of 4 kinds of composite resin specimens which are produced by same shade, there were significant differences(p<0.05). 2. Among all 4 kinds of composite resin specimens which are produced by same shade, there were color differences that is perceptible to human eye(${\Delta}E^*>3.3$). 3. Between most of composite resin specimens investigated and their corresponding shade guides, there were color differences that is perceptible to human eye(${\Delta}E^*>3.3$). 4. In the clinical environment, it is recommended that custom shade guides be made from resin material itself for better color matching. Shade guides supplied by manufacturers or Vita Lumin shade guide may not provide clinicians a accurate standard in matching color of composite resins, and there are perceptible color differences in most of products. Therefore, it is recommended that custom shade guides be made from resin material itself and used for better color matching.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.209-222
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• 2011

Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.175-184
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• 2011

With a development of implant restoration technique, there are increasing use of computer-guided system for edentulous patients. It was carried out simulated operation based on CT information about patient's bone quantity, quality and anatomical landmark. However, there are some difference between the programmed implant and post-operative implant about it's position. If the deviation was severe, it could happen a failure of 'passive fit' and not suited for path of implant restoration. The aim of this presentation is to evaluate about a degree of deviations between programmed implant and post-operative implant. Five patients treated by 'NobelGuide' system (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden) in Department of Prosthodontics, Inha University were included in this study. The patients were performed CT radiograph taking and intra-oral impression taking at pre-operation. Based on CT images and study model, surgical stent was produced by NobelBiocareTM. To fabricated a pre-operative study model, after connected lab analog to surgical template, accomplished a pre-operative model using type 4 dental stone. At final impression, a post-operative study model was fabricated in the conventional procedures. Each study model was performed CT radiograph taking. Based on CT images, each implant was simulated in three dimensional position using $Procera^{(R)}$ software (Procera Software Clinical Design Premium, version 1.5; Nobel Biocare AB). In 3D simulated model, length and angulation between each implant of both pre- and post-operative implants were measured and recorded about linear and angular deviation between pre-and post-operative implants. A total of 24 implants were included in this study and 58 inter-implant sites between each implant were measured about linear and angular deviations. In the linear deviation a mean deviation of 0.41 mm (range 0~1.7 mm) was reported. In the angular deviation, a mean deviation was $1.99^{\circ}$ (range $0^{\circ}{\sim}6.7^{\circ}$). It appears that the both linear and angular mean deviation value were well acceptable to application of computer-guided implant system.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.4
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• pp.280-289
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• 2018

Purpose: The purpose of this randomized clinical trial is to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and peri-implant marginal bone loss (MBL). Materials and Methods: 46 patients with single tooth missing in the posterior molar region of the mandible were included in this study. 19 implants (CMI IS-III $active^{(R)}$ long implant) of 5.0 mm diameter and 10 mm length were installed for the control group, while 27 implants (CMI IS-III $active^{(R)}$ short implant) of 5.5 mm diameter and 6.6, 7.3 or 8.5 mm length were placed for the experimental group. Each implant was inserted and immediately loaded using the digitally pre-fabricated surgical template and provisional restoration. The CAD-CAM monolithic zirconia crown was fabricated at 3 months after the surgery as a definitive restoration. The ISQ value and the MBL was measured at 48 weeks after the surgery. The correlation between the C/I ratio, MBL, and secondary implant stability was analyzed. Results: Successful results in terms of ISQ and MBL were achieved with both groups. There was no significant difference between the groups in terms of ISQ values and MBL at 48 weeks after the surgery (P > 0.05). No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the MBL (P > 0.05). Conclusion: The influence of C/I ratio in both groups was not shown on the stability nor the marginal bone loss in implants supporting single crown of the mandible. Short implant could be a preferable alternative option in the reduced bone height mandible under the limited condition despite its higher C/I ratio.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.156-163
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• 2009

Statement of problem: Recently, there have been increased esthetic needs for posterior dental restorations. The failure of posterior dental ceramic restoration are possible not only by the characters of the component materials but also by the type of food. Purpose: The research aim was to compare the in vitro fracture resistance of simulated first molar crowns fabricated using 4 dental ceramic systems, full-porcelain-occlusal-surfaced PFG, half-porcelain-occlusal-surfaced PFG, Empress 2, Ice Zirkon and selected Korean foods. Material and methods: Eighty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a Instron 4465, and the maximum load(N) was recorded. Afterwards, selected Korean foods specimens(boiled crab, boiled chicken with bone, boiled beef rib, dried squid, dried anchovy, round candy, walnut shell) were prepared. 15 specimens per each food were placed under the Instron and the maximum fracture loads for them were recorded. The 95% confidence intervals of the characteristic failure load were compared between dental ceramic systems and Korean foods. Afterwards, on the basis of previous results, 14Hz cyclic load was applied on the 4 systems of dental ceramic restorations in MTS. The reults were analyzed by analysis of variance and Post Hoc tests. Results: 95% confidence intervals for mean of fracture load 1. full porcelain occlusal surfaced PFG Crown: 2599.3 to 2809.1 N 2. half porcelain occlusal surfaced PFG Crown: 3689.4 to 3819.8 N 3. Ice Zirkon Crown: 1501.2 to 1867.9 N 4. Empress 2 Crown: 803.2 to 1188.5 N 5. boiled crab: 294.1 to 367.9 N 6. boiled chicken with bone: 357.1 to 408.6 N 7. boiled beef rib: 4077.7 to 4356.0 N 8. dried squid: 147.5 to 190.5 N 9. dried anchovy: 35.6 to 46.5 N 10. round candy: 1900.5 to 2615.8 N 11. walnut shell: 85.7 to 373.1 N under cyclic load(14Hz) in MTS, fracture load and masticatory cycles are: 1. full porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 4796.8-9321.2 cycles under 2224.8 N(round candy)load, no fracture under smaller loads. 2. half porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 881705.1-1143565.7 cycles under 2224.8 N(round candy). no fracture under smaller loads. 3. Ice Zirkon Crown fractured at 95% confidence intervlas of 979993.0-1145773.4 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. 4. Empress 2 Crown fractured at 95% confidence intervals of 564.1-954.7 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. Conclusion: There was a significant difference in fracture resistance between experimental groups. Under single load, Korean foods than can cause fracture to the dental ceramic restorations are boiled beef rib and round candy. Even if there is no fracture under single load, cyclic dynamic load can fracture dental posterior ceramic crowns. Experimental data with 14 Hz dynamic cyclic load are obtained as follows. 1. PFG crown(full porcelain occlusion) was failed after mean 0.03 years under fracture load for round candy(2224.8 N). 2. PFG crown(half porcelain occlusion) was failed after mean 4.1 years under fracture load for round candy(2224.8 N). 3. Ice Zirkon crown was failed after mean 4.3 years under fracture load for boiled chicken with bone(382.9 N). 4. Empress 2 crown was failed after mean 0.003 years under fracture load for boiled chicken with bone(382.9 N).

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.129-146
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• 2008

The aim of this study was to compare and analyze wear resistance of acrylic resin tooth in denture opposing to different types of restoration materials. Also, it aimed to compare and analyze the hardness of three various types of resin artificial teeth when using five different types of denture detergents. In this study three types of artificial teeth were used. As ordinary acrylic resin tooth $Trubyte^{(R)}Biotone^{(R)}$ (Dentsply, U.S.A.) was used, and as high hardness resin tooth Endura $Posterio^{(R)}$ (Shofu, Japan) and Physio $Duracross^{(R)}$ (Nissin, Japan) were used. To compare wear resistance, gold alloy, dental porcelain, and composite resin were used as opposing restorations. In addition, with three types of resin tooth stated above, five types of denture detergents, which are $Yuhanrox^{(R)}$ (Yuhanclorox, Korea), $Polident^{(R)}$ (Yuhan Co., Korea), $Cidex^{(R)}OPA$ (Johnson & Johnson Medical Co., Korea), $Hexamedin^{(R)}$ (Bukwang Pharm Co., Korea) and Daihan sterile $water^{(R)}$ (Daihan Pharm Co., Korea) were used to compare and analyze the effects denture detergents have on the surface hardness. The results of this study were as follow : 1. When composite resin and dental porcelain were used as the opposing restorations, $Trubyte^{(R)}$ $Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ in ascending order showed decrease of cusp height with significant difference (p<0.05). 2. When gold alloy was used as opposing restoration, there was decrease in the cusp height in order of $Trubyte^{(R)}Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ and $Trubyte^{(R)}$ $Biotone^{(R)}$ especially showed significant decrease in high cusp height as compared to two other types of artificial tooth (p<0.05). 3. When composite resin, gold alloy and dental porcelain were used as opposing restorations, $Trubyte^{(R)}$ $Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ in order decreased greatly in weight and these three materials showed significant difference (p<0.05). 4. Comparing the experiment values, decrease in strength had significant difference in all resin artificial teeth before and after the denture detergents were used (p<0.05). 5. When resin artificial teeth were subsided in $Yuhanrox^{(R)}$, $Cidex^{(R)}OPA$, and $Hexamedin^{(R)}$, $Trubyte^{(R)}$ $Biotone^{(R)}$, Endura $Posterio^{(R)}$, Physio $Duracross^{(R)}$ in order showed decrease in hardness, and $Trubyte^{(R)}$ $Biotone^{(R)}$ especially showed significant high decrease hardness as to other two types of artificial teeth (p<0.05). Therefore, Physio $Duracross^{(R)}$ seems to have superior wear resistance, and together with Endura $Posterio^{(R)}$, it presents excellent hardness as compared to $Trubyte^{(R)}$ $Biotone^{(R)}$. However, since this study is fragmentary, it should be given careful consideration and more study need to be done before making a definitive conclusion.