Resin-bonded bridge has been an alternative to conventional bridge, since resin-bonded bridge has many attractive advantages such as minimal tooth preparation, short chair time and low cost over conventional bridge. Unfortunately, however, it was reported that resin-bonded bridge showed high failure rate from debonding of retainer in spite of consecutive advances in preparation and materials. And it was shown that multiple abutments were more likely to fail. The majority of debonding failure was considered due to the mobility of the abutment during function. In this view, recently, modification in resin-bonded bridge design was tried. Single retainer, single pontic. 2-unit cantilevered resin-bonded bridge was applied to clinical performance and was shown as retentive or more retentive than fixed-fixed type resin-bonded bridge. This was consistent with the results of studies in 2-unit cantilevered resin-bonded bridges made with all ceramic, In-ceram. The purpose of this article was to overview principles of design and to analyze clinical results of 2-unit cantilevered resin-bonded bridge in comparison with the reports of fixed-fixed resin-bonded bridge.
I. Objectives Endodontic success depends on thoroughly cleaned and completely obturated root canal system. Effective cleaning and obturation will be achieved by well shaped canal. Numerous methodologies evaluating the efficacy and safety of canal preparation has been developed and the use of micro-computed tomography(MCT) in endodontic research is one of the latest innovations. This scientific tools could overcome the inherent limitations of other methodologies, and possesses the ability to visualize morphological characteristics in a detailed and accurate manner without destruction of the tooth and offers reproducible data in all three dimensions. The purpose of this study was to determine the optimal master apical file size with less transportation and more efficiency in removing the infected dentin. For this purpose we evaluated the transportation of canal center and change of untouched area after preparation sequentially from #25 file through #40 file with 3 different instruments:Stainless steel(SS) K-type hand instruments(MANI, Japan), ProFile.04 instruments (Dentply Tulsa Dental, USA) and Lightspeed instruments(Lightspeed Technology, San Antonio, USA) using micro-computed tomography.(omitted)
We report two rare cases of extensive bilateral subcutaneous emphysema that occurred during ordinary dental procedures. An air-driven high-speed handpiece, routinely used in dental procedures may cause subcutaneous emphysema when high pressure air is introduced into the loose connective tissues below the dermal layer. The first case occurred with surgical extraction of the lower third molar. The air introduced into the fascial spaces near the surgical field spread to the contralateral spaces, as well as the neck and chest areas. The second case also showed extensive bilateral subcutaneous emphysema caused by the introduction of compressed air from the handpiece during crown preparation without any invasive procedure. Cases where the emphysema extends beyond the treatment site to involve the contralateral cervicofacial areas have been rarely reported. Predicting the occurrence of subcutaneous emphysema is difficult, so it is important to exercise caution during routine dental treatment. If significant bilateral cervicofacial swelling is suspected to be due to subcutaneous emphysema, prompt diagnosis with securing the patient's airway will be necessary.
Journal of the Korea Academia-Industrial cooperation Society
/
v.17
no.12
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pp.198-204
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2016
This research studied the relevance of oral symptoms and fear to find solutions for prevention and treatment at the right time. The study was conducted over a three-month period from September to November 2015. College students who lived in the region of Busan were surveyed, and the data from 288 respondents were analyzed. The female students felt a higher level of fear in every item than the males. To be specific, there were statistically significant differences in postponing the appointment (p=0.014), tension during treatment (p=0.001), dread when making the appointment (p=0.001), dread upon arrival (p=0.001), dread in the waiting room (p=0.001), dread of dental smells (p=0.006), dread while undergoing anesthesia (p<0.001), dread when receiving an injection (p<0.001), dread when looking at a tool for tooth preparation (p<0.001), dread of the sound of a tool for tooth preparation (p<0.001), dread of the feelings of tooth preparation (p<0.001), dread during scaling(p<0.001), and apprehension about the entire treatment (p<0.001). Concerning the fear level according to oral symptom awareness, the respondents with dental caries experienced a higher level of fear in terms of treatment avoidance (p=0.001), physiological reactions (p=0.001) and overall Dental Fear Survey (DFS)(p=0.003), and the students whose teeth were broken had a higher level of fear in terms of treatment avoidance (p=0.010), stimulus factors (p=0.031) and overall DFS (P=0.019). The students who had a missing tooth felt a higher level of fear in terms of physiological reactions (p=0.019) and overall DFS (p=0.033), and the respondents with gingival pain felt a higher level of pain in terms of the stimulus factors (p=0.013) and overall DFS (p=0.034). Therefore, college students should be educated to visit a dental clinic when they are aware of any oral symptom, and methods to reduce the stimulus factors as much as possible should be considered carefully to relieve dental fear.
Kim, Seo-Rahng;Koak, Jai-Young;Heo, Seong-Joo;Kim, Seong-Kyun;Kim, Myung-Joo
The Journal of Korean Academy of Prosthodontics
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v.53
no.4
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pp.337-344
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2015
Purpose: The purpose of present study is to examine the correlation between the accuracy of abutment preparation and the marginal adaptation of metal coping. With this view, this study compared the correlations regard to the three different manufacturing methods of selective laser sintering technique, milling and casting. Materials and methods: Two master models were made in a different way. First model with deep chamfer margin was prepared directly by a general clinician and the second model was designed by 3-D designing software program with the same abutment preparation principle and produced by computer aided manufacturing. 12 Co-Cr alloy copings were produced respectively with three different method; SLS system, CAD/CAM milling and conventional lost wax technique from each master model. The total 72 copings fully sit on the master model were stereoscopically evaluated at 40 points along the entire circumferential margin. Results: Significant differences in the absolute marginal discrepancies of Co- Cr copings from SLS system (P=.0231) and casting method (P<.0001) were shown between hand preparation model and computer designed model. However, no significant difference was found between the two model groups from milling method (P=.9962). Conclusion: Within the limitation of this study, the effect of the accuracy of abutment preparation on the marginal adaptation of Co-Cr coping is statistically significant in SLS system and casting group. The copings produced by SLS system exhibited the lowest marginal discrepancies among all groups, and the marginal gap of this method group was influenced by the accuracy of the abutment preparation.
Purpose: Dentists suffer back, neck and shoulder pain during their careers due to bad operating posture. If dentists have a good operating posture ergonomically, there would be less pain and discomfort in the shoulder and back. Therefore, dentists should learn the Home position which enables dentists to approach a stable posture ergonomically. This study was to compare tooth preparation in the Home position and the Random position, and evaluate the clinical efficacy of the Home position. Materials and methods: Tooth preparation for fixed partial denture was performed on the maxillary left 2nd premolar and maxillary left 2nd molar at the two different operating positions were compared. The amount of occlusal reduction, marginal width, subgingival margin depth, and convergence angle were measured. A T-test was performed separately to compare the results of the Random position and the Home position. Results: 1. The amounts of average thickness of occlusal reduction on fossa were deficient to the ordered ones in the Random position and the Home position (P > .05). 2. The average subgingival margin depth of prepared margin on maxillary left 2nd premolar, maxillary left 2nd molar were excessive in the Random position than in the Home position. On the maxillary left 2nd premolar, there was no statistical difference in the Random position and the Home position except Distal midline, DL line angle, Lingual midline, ML line angle (P< .05). On the maxillary left 2nd molar, there was no statistical difference in the Random position and the Home position (P < .05). 3. Average convergence angle in the Random position and the Home position were excessive compared to the ordered angle. There was no statistical difference in the Random position and the Home position (P > .05). 4. Analysis of pearson correlation : In the Random position, the amounts of average thickness of occlusal reduction, the average subgingival margin depth of prepared margin, convergence angle were significantly associated with each other (P < .05). But in the Home position, they were not significantly associated with each other (P < .05). 5. The time needed for preparation in the Home position was faster or equal than that of the Random position as time went on. Conclusion: In conclusion, there were no significant differences between Home position and Random position in measures of occlusal reduction, marginal width, marginal depth, convergence angle. However, preparation time and incidence of damaging adjacent teeth were less in Home position than in Random position. Therefore, if trained properly, Home position which is more ergonomically stable can be adopted for clinical use.
Journal of the korean academy of Pediatric Dentistry
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v.34
no.4
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pp.569-578
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2007
This study was performed to compare the shear bond strength of self etching system and two bottle bonding system with or without laser preparation. Group I was prepared with high speed rotary instrument and $Prompt^{TM}$ L-$Pop^{TM}$, group II with Er:YAG laser and $Prompt^{TM}$ L-$Pop^{TM}$, group III with Er:YAG laser, 37% phosphoric acid and Single bond, group IV with Er:YAG laser and Single bond and group V with high speed, etching and Single bond. And also observation of the prepared and etched dentin surface were performed under scanning electro-microscope. The possibility of clinical application of laser preparation which might have an advantage to reduce pain for children with less unfavorable noise were evaluated. The results obtained are as follows; 1. Group V showed significantly higher bond strength than other groups. And group IV showed significantly lower bond strength than other groups. 2. There was no significant difference between group I and group III. 3. Group II showed significantly lower bond strength than group I, III, V, but showed significantly higher bond strength than group IV. 4. Under scanning electro-microscope, laser-preparated dentin surface showed high irregularity and no smear layer. The surface showed less irregularities and more exposed dentinal tubules with etching. Laser preparation has many advantages over conventional tooth preparation. But this method showed lower resin bonding strength. Laser preparated tooth surface differed from the conventionally preparated tooth surface. More researches are needed on suitable methods for laser preparated dentin surface.
The marginal integrity of the crown can be broken during endodontic access cavity preparation due to the vibration of burs. Therefore, the purpose of this study was to evaluate the effect of endodontic access cavity preparation on the marginal leakage of full veneer gold crowns. 24 intact molars were mounted in acrylic resin blocks and prepared for crowns by a restorative dentist and crowns were cast with gold alloy. 20 Crowns were cemented with glass ionomer cement and 2 crowns were not cemented for positive control. 200 thermo-cycles from 5$^{\circ}C$ to 5$0^{\circ}C$ with a travel time of 20s were completed. Then samples were randomly divided into 2 experimental groups of 9 each. Endodontic access preparation and zinc-oxide eugenol temporary fillings were done in Group 1. Teeth in Group 2 were not treated. Samples were coated with 2 layers of nail varnish and were immersed in 1% methylene blue dye for 20 hrs. Endodontic access was prepared in 2 samples, which were coated with nail varnish on all surfaces for negative control. After washing in running water gold crowns were cut with a #330 bur. Four buccolingual sections, 2 mm apart, were cut from the central section of each tooth and were examined and scored under the microscope for dye leakage. Score 1: leakage to the cervical 1/3 of the axial wall, Score 2: leakage to the middle 1/3 of the axial wall, Score 3: leakage to the coronal 1/3 of the axial wall, Score 4: leakage to the occlusal surface. The median value for Group 1 is 4 and for Group 2 is 2. The result of this study showed that samples in Group 1 leaked more than those in Group 2. This finding was significant(P<0.001).
The success of porcelain laminate veneer depends on the bond strength between tooth structure and ceramic restoration and the design of tooth preparation. In particular, incisal coverage and incisal finish line are the two most important factors in long-term fracture resistance. Although the majority of clinicians are practicing incisal coverage and there are various opinions on the geo-metrical ratio between the clinical crown length of the remaining tooth structure and the length of incisal extension in porcelain laminate veneer and the optimal incisal finish lines. scientific evidence still loaves much to be desired. The purpose of this study was to determine the effects of the amounts of incisal coverage and the types of incisal finish line on the stress distribution in maxillary anterior porcelain laminate veneers under two different loading conditions. Three-dimensional finite element models of a maxillary anterior porcelain veneer with differ-ent amounts of incisal coverage ; 0, 1, 2, and 3mm and different incisal finish lines feathered edge, incisal bevel, reverse bevel and lingual chamfer with various amounts of lingual extension were developed. 300N force was applied at the point 0.5mm cervical of the linguoincisal edge in two loading conditions ; A) 125 degrees, B) 132 degrees. Tensile and compressive stress in ceramic and shear stress in the resin cement layer were analyzed using three-dimensional finite element method. The results were as follows : 1. The types of incisal finish line had more influence on the stress distribution in porcelain laminate veneer than the amounts of incisal coverage. 2. In case of no incisal coverage, incisal beveled laminate exhibited more evenly distributed tensile stress than feathered edged laminate. And in case of incisal coverage, reverse beveled laminate and lingual chamfered laminate with 1mm lingual extension exhibited more evenly distributed tensile stress than lingual chamfered laminates with 2mm and 3mm lingual extension. 3. As long as the lingual chamfer goes, less tensile stress was found at the incisal edge, while much more tensile stress was found at the lingual margin area in proportion to the length of lingual extension. 4. Under 125 degree load, tensile stress in porcelain laminate veneer had increased compared with that under 132 degree load and the difference exhibited by the change of the amount of tooth support was larger. 5. The types of incisal finish line and the distance from the incisal finish line to the loading point had more influence on the shear stress distribution in the resin cement layer than the amounts of incisal coverage. In contrast loading condition had little influence.
Adequate access cavity is the key to achieving endodontic success. The aims of the access cavity can be considered as follows: 1) Creation of a smooth unimpeded pathway for instruments to canal orifices 2) Removal of the entire roof of the pulp chamber in order to inspect the pulp floor, 3) Preservation of natural tooth substance consistent with the above. Recently, contracted endodontic cavities based on minimally invasive endodontics has introduced. This has the benefit of preserving the pericervical dentin more than traditional access cavity with achieving long-term success. However, some studies reported controversial results regarding root canal detection, instrumentation efficacy (noninstrumented canal area, hard tissue debris accumulation, canal transportation, and centering ratio) as well as fracture resistance. Therefore, further studies are required for accepting contracted access cavity, and modified form of traditional and contracted access cavity could be considered.
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