Statement of problem: Over the past decade, increased demand for esthetically pleasing restorations has led to the development of all-ceramic systems. Recent reports suggest that the all-ceramic crowns have excellent physical properties, wear resistance, and color stability. In addition, numerous ceramics have excellent biocompatibility, a natural appearance, and improved physical bonding with resin composite luting agents. However, the brittle nature of ceramics has been a major factor in their restriction for universal usage. Functional occlusal loading can generate stress in the luting agent, and the stress distribution may be affected by the marginal geometry at the finish line. Tooth preparation for fixed prosthodontics requires a decision regarding the marginal configuration. The design dictates the shape and bulk of the all ceramic crowns and influences the fit at the margin. Purpose: The purpose of this study was to evaluate the stress distribution within marginal configurations of all- ceramic crowns (90-degree shoulder, 110-degree shoulder, 135-degree shoulder). Material and methods: The force is applied from a direction of 45 degrees to the vertical tooth axis. Three-dimensional finite element analysis was selected to determine stress levels and distributions. Results and conclusion: The result of stress level for the shoulder marginal configuration was more effective on stress distribution at 135-degree shoulder margin. But the stresses concentrated around at 135-degree shoulder margin. The stress decreased apically at the surface between cements and alumina core, and increased apically at the surface between alumina core and veneering porcelain.
The purpose of this study was to help improve oral health care planning for the elderly in an effort to promote the oral health of elderly people in preparation for aging society. The subjects in this study were 200 elderly people who were selected by random sampling from senior centers in Seoul. An interview was conducted to gather data from June to September 2008, and the data collected were analyzed.: 1. The mean number of residual tooth was 13.71. 2. Concerning connections between gender and subjective oral symptoms, gender had a statistically significant relationship to temporomandibular joint dysfunction(p=0.000), dry mouth(p=0.001) and halitosis(p=0.006). The men underwent more oral symptoms than the women. 3. As for the relationship of mastication(p=0.000), oral pain(p=0.010), temporomandibular joint dysfunction(p=0.010) and dry mouth(p=0.001) to subjective oral health state, the elderly people who were not in a good oral health suffered more oral symptoms, and the gap between them and the others was statistically significant. 4. A larger number of tooth led to less mastication difficulties, less dry mouth and more gingival diseases, and the relationship between the factors was statistically significant. A better oral health state led to less mastication difficulties, less oral pain, less dry mouth and less bad breath, and the relationship between the factors was statistically significant. Through this study the oral health the elderly people perceive wss concerned with oral symptom, and the number of residual teeth also had links to subjective oral symptoms. Therefore, to maintain original teeth of the elderly people, the management system of oral health and the education program for oral health in order to prevent disease relateded with oral and enhance the perception standard of oral state are indispensably necessary to the elderly people.
Rapid canine retraction, first introduced by Liou, is a distraction osteogenesis applied to the periodontal ligament tissue. Rapid tooth movement was facilitated by establishing minimal bony resistance on the distal surface of the canine by socket preparation and by osteogenesis on the mesial side in response to the periodontal distraction. Since undesired buccal tipping or extrusion of the canine during retraction tends to occur, it is crucial to maintain the firm path of movement and the axis of the canine during retraction. In order to improve the predictability of the canine movement, lingually extended distraction screws with heavy labial guiding wires were designed. Prefabricated plastic canine models for the estimation of socket depth and miniscrew implants for anchorage reinforcement were also devised. Applying these devices to a female patient with Class II anterior protrusion, the whole treatment was effectively finished in 13 months. Loss of vitality or periodontal problems did not occur throughout treatment, and stable occlusion was maintained during 10 months of retention. This case report demonstrates that a predictable rapid canine retraction can be achieved through the use of this modified technique.
Kim, Bok-Joo;Kim, Min-Gu;Kim, Jung-Han;Kim, Chul-Hoon
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.36
no.5
/
pp.375-379
/
2010
Introduction: In the management of dentofacial deformities, variable movement of the maxilla can be made possible by a Le Fort I osteotomy. Posterior impaction of the maxilla necessary for rotation of the maxillomandibular complex enhances the functions and esthetic results. In cases of posterior impaction of the maxilla, an increase in the figure of the occlusal plane angle and incisor inclination can occur. This study reports the relationship between the amount of posterior impaction and the change in the occlusal plane angle and incisor inclination in a Le Fort I osteotomy by preoperative and postoperative lateral cephalograms. Materials and Methods: Twenty patients who had undergone orthognathic surgery in Dong-A University Medical Center participated in this study. Lateral cephalometrics, within 3 weeks prior to surgery and 3 days after surgery, were used for analysis. Pre and postoperative measurements of the occlusal plane angle and incisal inclination based on the Frankfort horizontal (FH) plane were performed. X and Y were defined as the amount of vertical change in the upper incisor tip and the amount of vertical change in the upper first molar mesial cup tip through the operation. The amount of final posterior maxillary impaction was determined by subtracting Y from X, which is the difference in vertical height. According to the amount of posterior maxillary impaction, the change in the occlusal plane angle and incisal inclination was measured. Results: The average posterior maxillary impaction was 2.91 mm and the average change in the occlusal plane angle and incisal inclination was $6.54^{\circ}$after surgery. As a result, each mm of posterior maxillary impaction changed the occlusal plane angle and incisal inclination by $2.25^{\circ}$. Statistically, there was high significance. Two cases were observed: one with the same amount of posterior maxillary impaction performed on both the right and left showing $2.20^{\circ}$, and the other with a different amount of posterior maxillary impaction performed showing $2.35^{\circ}$. In this case, there was no significance difference between the two cases. Conclusion: Each mm of posterior maxillary impaction changes the occlusal plane angle and incisal inclination by an average of $2.25^{\circ}$. In posterior maxillary impaction, there was no significant difference in the amount of change in the occlusal plane angle and incisal inclination regardless of whether there was an equal amount of posterior maxillary impaction on both sides. This study is expected to help in the presurgical orthodontic preparation and presurgical treatment planning.
Purpose: This research was conducted to compare the marginal and internal fit of zirconia prostheses fabricated with the model scan method and the intraoral scan method. Materials and methods: In this study, 20 extracted human mandibular first molar was used in the preparation of abutment tooth for the fabrication of zirconia prostheses. In the first group, the model scan method was applied on 10 prepared teeth. In the other group, the intraoral scan method was used on other 10 prepared teeth. Datum of both groups were transmitted to the software system. Afterwards, 20 zirconia prostheses were fabricated using the Ceramill system. Weight technique was used to evaluate the internal gap of the zirconia prostheses. In the Replica technique, marginal gap of the zirconia prostheses were analyzed by optical microscopy. Statistical analysis was based on one-way ANOVA. Results: Model scan group showed lower average weight than intraoral scan group when weight technique was applied, which has significance (P < .05). Also, model scan group showed significantly lower figures in all 5 measurements of replica technique than intraoral scan group (P < .05). Conclusion: Zirconia prostheses of both groups demonstrated clinically acceptable margin and internal fit. However, model scanned zirconia prostheses showed higher marginal and internal fit than intraoral scanned crowns.
Journal of the korean academy of Pediatric Dentistry
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v.37
no.4
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pp.519-525
/
2010
Ectopic eruption means the eruption of the tooth in an abnormal position due to multiple factors, which found most frequently in maxillary fist permanent molars, mandibular lateral incisors and maxillary permanent canines. Ectopic eruption of the maxillary first permanent molar occurs when the molar erupts with a more mesial angulation than normal, and locks itself in an atypical resorption on the distobuccal root of the second primary molar. The maxillary first permanent molar plays important roles for mastication and occlusion, so ectopically erupted maxillary first permanent molars should be relocated into proper position. Treatment options are separation by insertion of the brass wire or elastic rings, preparation of distal aspect of the maxillary second primary molar, using fixed or removable appliance with finger spring, and placement of space maintainer or space regainer after extraction of the maxillary second primary molar. We report three cases treated of ectopically erupted maxillary first permanent molar by re-setting of stainless steel crowns, placement of brass wire and using active plate. We could find out distal movement of maxillary first permanent molars into proper position and normal occlusion.
Journal of the korean academy of Pediatric Dentistry
/
v.35
no.2
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pp.195-204
/
2008
Orthodontic brackets often need to be bonded to porcelain such as porcelain fused to metal crowns and porcelain jacket crowns. The purpose of this study was to evaluate the clinical usability of direct bonding system on porcelain teeth by measuring shear bond strength according to various conditions and observing adhesive failure patterns. The specimens, 20 maxillary premolars and 80 porcelain teeth that were produced by duplication of the labial surface of a maxillary first premolar were used and randomly divided into four groups of twenty teeth each. The 5 different preparation procedures tested: (1) application of 37% phosphoric acid on natural teeth, (2) sandblasting on porcelain surfaces, (3) sandblasting and application of 9.6% hydrofluoric acid on porcelain surfaces, (4) sandblasting and application of silane on porcelain surface, (5) sandblasting and application of 9.6% hydrofluoric acid and silane on porcelain surfaces. The metal brackets were bonded with Transbond $XT^{(R)}$ bonding material. The shear bond strength was tested by the micro universal testing machine(Kyung-Sung, Korea) and the amount of residual adhesive on the tooth surface after debonding was examined by stereoscope and assessed with an adhesive remnant index. The results of this study suggest that the direct bonding system on porcelain teeth with sandblasting, HF and porcelain primer is clinically useful.
In 2015, the population of elderly people in Thailand was 16% of the total population and is predicted to be over 20% by 2021 and nearly 28% by 2031. The increase of the elderly population in Thailand has also increased the proportion of dependent elderly people, and caring for them poses many challenges for both families and the government. This descriptive method research aimed to survey the health status of dependent older people in the rural community of Lampang province in northern Thailand. The participants consisted of 62 older people and 62 primary family caregivers from Hong Ha Health Promoting Hospital, Lampang, Thailand (totaling 124 people). The researchers assessed the health status of older people and their activities of daily living (ADL). In addition, researchers assessed the health status and stress of caregivers. All the participants were interviewed about their experiences with caregiving. The results showed that most of the older respondents were female with an average age of 78.15 years. Based on the ADL assessment, 50 of the 62 older persons were homebound while the rest were bedridden. The majority of older people had chronic or long-term conditions that required hospitalization from time to time. Their frequent health problems included oral disorders such as tooth decay or caries/gum disease/no teeth, reduced sight, psychological disorders, knee pain and risk of falling, low BMI, risk of malnutrition, and urinary leakage and incontinence (58.06%, 66.13%, 62.90%, 70.97%, 38.71%, 66.13%, and 37.10%, respectively). Usual care provided by the family members included personal hygiene care, food preparation and feeding, medication management, housekeeping and organizing necessary equipment, supply of needed equipment, prevention of falls, helping with travel for medical checkups and treatment, and providing companionship. Families experienced shortages of medical supplies, daily use equipment, lack of employment, inadequate income, and difficulty accessing health care services due to lack of transportation. Some caregivers experienced caregiving stress related to a lack of social interactions as well as routine caregiving activities. Families need different types of support in order to promote the well-being of older people and caregivers. This highlights the need for a community participation model for the care of older people in order to reflect sustainable long-term outcomes.
The lastest concepts in bonding are "total etch", in which both enamel and dentin are etched with an acid to remove the smear layers, and "wet dentin" in which the dentin is not blown dry but left moist before application of the bonding primer. Ideally, the application of a bonding agent to tooth structure should be insensitive to minor contamination from oral fluids. Clinically contaminations such as saliva, gingival fluid, blood and handpiece lubricant are often encountered by dentists during preparation of a restoration. The aim of this study was to evaluate the effect of contamination by hem-ostatic agents on shear bond strength of compomer restorations. One hundred and ten extracted human maxillary and mandibular molar teeth were collected. The teeth were cleaned from soft tissue remnant and debris and stored in physiologic solution until they were used. Small flat area on dentin of the buccal surface were wet ground serially with 400, 800 and 1200 abrasive paper on automatic polishing machine. The teeth were randomly divided into 11 groups. Each group was conditioned as follows: Group 1 : Dentin surface was not etched and not contaminated by hemostatic agents. Group2 : Dentin surface was not etched but was contaminated by Astringedent (Ultradent product Inc., Utah, U.S.A.). Group3 : Dentin surface was not etched but was contaminated by Bosmin (Jeil Phann, Korea.). Group4 : Dentin surface was not etched but was contaminated by Epri-dent (Epr Industries, NJ, U.S.A.). Group5: Dentin surface was etched and not contaminated by hemostatic agents. Group 6 : Dentin surface was etched and contaminated by Astringedent. Group7 : Dentin surface was etched and contaminated by Bosmin. Group8 : Dentin surface was etched and contaminated by Epri-dent. Group9 : Dentin surface was contaminated by Astringedent. The contaminated surface was rinsed by water and dried by compressed air. Group10 : Dentin surface was contaminated by Bosmin. The contaminated surface was rinsed by water aud dried by compresfed air. Group 11 : Dentin surface was contaminated by Epri-dent. The contaminated surface was rinsed by water and dried by compresfed air. After surface conditioning, F2000 was applicated on the conditoned dentin surface. The teeth were thermocycled in distilled water at $5^{\circ}C\;and\;55^{\circ}C$ for 1000 cycles. The samples were placed on the binder with the bonded compomer-dentin interface parallel to the lmife-edge shearing rod of the Universal testing machine(Zwick 020, Germany) running at a cross head speed of 1.0mmimin. There were no significant differences in shear bond strength between groups 1 and group 3 and 4, but group 2 showed significant decrease in shear bond strength compared with group 1. There were no significant differences in shear bond strength between group 5 and group 7 and 8, but group 6 showed significant decrease in shear bond strength compared with group 5. There were no significant differences in shear bond strength between group 5 and group 9, 10 and 11.
The purpose of this study was to observe the effect of dentin surface conditioners on the dentin surfaces. Freshly extracted human molars were used in this study. They were stored at $4^{\circ}C$ saline solution before experiment. The crown portions of the teeth were cut in various directions by means of wet diamond point to expose dentin which include transverse, vertical oblique, horizontal and oblique cut to the long axis (Fig. 1). Each tooth was then mounted with self curing acrylic resin in brass ring to expose the flattened dentin surfaces. Final finish was accomplished by grinding the dentin specimens with wet No. 180 and No. 600 grit silicon carbide abrasive paper until a 6.0mm in diameter on a dentin surface was exposed without pulp exposure. The specimens were divided into 9 groups according to the modes of dentin treatment procedure. The following surface treatments were applied on these preparation surfaces; Group 1: unetched (control group) after finish with No. 600 silicon carbide abrasive paper. Group 2: etched with 30% phosphoric acid for 60s Group 3: etched with 10-3 solution for 60s Group 4: Cleaned with 5% NaOCl for 30s Group 5: applied Dentin Adhesit Group 6: cleaned with 5% NaOCl followed by applying the Dentin Adhesit$^{(R)}$ Group 7: applied Photo Bond on the unetched dentin followed by applying the Photo Clearfil Bright Group 8: Etched with 30% phosphoric acid followed by applying Photo Bond and Photo Clearfil Bright Group 9: etched with 10-3 solution followed by applying Photo Bond and Photo Clearfil Bright All the specimens were stored in $37^{\circ}C$ under 50% relative humidity for 24 hours before observations. The specimens in 7, 8, and 9 group, omitting the group 1 to 6, were demineralized in 10% HCl for 10s in order to observe the resin tags. All the specimens in each group were then dried at room temperature. The dried specimens were ion coated with Eiko ion coater (Eiko-engineering Co.), and observed in Hitachi S-430 Scanning electron microscope (Hitachi, Co. Tokyo) at 15KV. The following results were obtained as follows; 1. The smear layers were still remained in group 1,2,4,5, and 6. 2. There is no effect of 5% NaOCl and 30% phosphoric acid on the changes of dentin morphology 3. The dentin treated with 10-3 solution, indicating the tubules opened when the smear layer and the dental plug dissolved. 4. In case of applying the bonding agents the resin tag was not formed at the deep area of dentinal tubules, but in case of applying the Dentin Adhesit$^{(R)}$ that was not.
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