Ameloblastoma is the most agrressive ofht odontogenic tumors and it arises from the dental lamina or the derivatives of lamina. Ameloblastoma is a benign but locally invasive neoplasm consisting of proliferating odontogenic epithelium lying in a fibrous stroma. Usually the ameloblastomas are diagnosed in the forth and fifth decardes. Over 80% of them occur in the mandible, the remainder in the maxilla. The preferred treatment for ameloblastoma is radical excision, conserving(when possible. the inferior border of the mandible. The functional and esthetic rehabilitation of the partially edentulous patient may prevent the remaining structures from supporting conventional prosthetic treatment. Patients with long edentulous spans, malpositioned teeth, residual ridges defects and high muscle attachments may be offered an osseointegrated fixed prosthesis. Osseointegrated dental implants provide a viable alternative of tooth replacement. This is a case report of 16 year old female with ameloblastoma. We treated patient with radical excision, conserving the inferior border of the mandible and allogenous bone graft. The defected residual ridge area was reconstructed implants(Steri-Oss Implant System). the result was satisfactory.
Kim, Kwang-Hoon;Woo, Sung-Gwan;Son, Kwon;Park, Jeong-Kil
Transactions of the Korean Society of Mechanical Engineers A
/
v.32
no.8
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pp.678-684
/
2008
A general treatment is to restore abfraction lesions with dental filler materials to reduce stress concentration. A material should be selected from various dental products based on long term experiences of dentist or personal preference concerning filler methods. A quantitative criterion is necessary to make an evaluation of the results as dentists decide treatment methods and dental materials relying on their clinical experiences. The purpose of this study is to find an optimal restoration method and material for noncarious cervical lesions using the finite element method. An objective function was defined to minimize the sum of tension or compression stress. Trial-and-error and approximation were used to find an optimal restoration method. An optimal solution was to fill TetricFlow inside the lesion and Z100 in the remaining region. The most desirable thickness ratio of the two filler materials was 0.125 with trial-and-error and it was similar to the results of approximation, 0.121 and 0.132.
In this study, 40 hypersensitive teeth of 19 patients were investigated. The procedures performed were as follows: Before desensitization, EPT at occlusal third of buccal surface was done for the evaluation of pulp vitality and the EPT value was recorded for the reference value. And mechanical and thermal test was executed for the test of hypersensitivity. If the tooth responded to the above tests, we did EPT at the exposed surface, using toothpaste as a electrolite medium and recorded the EPT value at patient's response. After the tests had been done, desensitization procedures with Gluma(R) Desensitizer were performed according to the manufacturer's instructions. After desensitization, the same tests except EPT at occlusal third were repeated. All the 40 teeth responded positive before desensitization and negative after desensitization procedures. The EPT value at occlusal third ranged from 31 to 65 (48.9${\pm}$7.2). Before desensitization 34 teeth responded at EPT value of 2 and the remaining 6 teeth was in the range of 17 to 25. After desensitization all 40 teeth responded from 12 to 27 (19.6${\pm}$3.5). The 6 teeth responded at greater number than 2 before desensitization was in the range of 18 to 23. Within the limitations of this study we can conclude that: When a tooth with dentinal hypersensitivity responds to mechanical and thermal stimulation, the tooth shows very low resistance to electricity at the exposed surface while when a tooth is desensitized and doesn't show respond to mechanical and thermal stimuli, the tooth shows increased level of resistance to electric stimulation at the exposed surface. EPT can be used for the diagnosis of dentinal hypersensitivity. Furthermore EPT will be useful to evaluate the outcome of desensitization procedures. However, EPT is not a valid tool for measuring dentinal hypersensitivity.
Seo, Min-Seock;Shon, Won-Jun;Lee, Woo-Cheol;Yoo, Hyun-Mi;Cho, Byeong-Hoon;Baek, Seung-Ho
Restorative Dentistry and Endodontics
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v.34
no.4
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pp.324-332
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2009
The purpose of this study was to investigate the effect of rigidity of post core systems on stress distribution by the theoretical technique, finite element stress-analysis method. Three-dimensional finite element models simulating an endodontically treated maxillary central incisor restored with a zirconia ceramic crown were prepared and 1.5 mm ferrule height was provided. Each model contained cortical bone, trabecular bone, periodontal ligament, 4 mm apical root canal filling, and post-and-core. Six combinations of three parallel type post (zirconia ceramic, glass fiber, and stainless steel) and two core (Paracore and Tetric ceram) materials were evaluated, respectively. A 50 N static occlusal load was applied to the palatal surface of the crown with a $60^{\circ}$angle to the long axis of the tooth. The differences in stress transfer characteristics of the models were analyzed. von Mises stresses were chosen for presentation of results and maximum displacement and hydrostatic pressure were also calculated. An increase of the elastic modulus of the post material increased the stress, but shifted the maximum stress location from the dentin surface to the post material. Buccal side of cervical region (junction of core and crown) of the glass fiber post restored tooth was subjected to the highest stress concentration. Maximum von Mises stress in the remaining radicular tooth structure for low elastic modulus resin core (29.21 MPa) was slightly higher than that for high elastic modulus resin core (29.14 MPa) in case of glass fiber post. Maximum displacement of glass fiber post restored tooth was higher than that of zirconia ceramic or stainless steel post restored tooth.
Statement of problem : Most posts are metallic, but in response to the need for a post that possesses optical properties compatible with an all-ceramic crown. an esthetic post has been developed. Although there have been many studies about the esthetic post materials, 3-dimensional finite element studies about the stress distribution of them are in rare. Purpose : The purpose of this study is to investigate comparatively the distribution of stresses of the restored, endodontically treated maxillary incisors with the esthetic post materials and the displacement on the cement layer on simulated occlusal loading by using a 3-dimensional finite element analysis model. Material and method : Four 3-dimensional finite element models were constructed in a view of a maxillary central incisor, a post, a core, and the supporting tissues to investigate the stresses in various esthetic posts and cores and the displacement on the cement layer (Model 1 ; Cast gold post and core, Model 2 ; Glass fiber post with composite core, Model 3 ; Zirconia post with composite core. Model 4 ; Zirconia post with ceramic core). Force of 300N was applied to the incisal edge and the cingulum (centric stop point) with the angle of 135-degree to the long axis of the tooth. Results : 1. The stresses and displacement on the incisal edge were higher than on the cingulum 2. The stresses in dentin were the highest in Model 2 (Glass fiber post with composite core), and the second was Model 3, the third Model 1, and the lowest Model 4. 3. The stresses in post and core were the highest in Model 4 (Zirconia post with ceramic core), and the second was Model 1, the third Model 3, and the lowest Model 2. 4. The displacement on the cement layer was the highest in Model 2 (Glass fiber post with composite core), and the second was Model 3, the third Model 1, and the lowest Model 4. Conclusion : When a functional maximum bite force was applied, the distribution of stresses or the esthetic post and core materials and the displacement on the cement layer were a little different. It seems that restoring extensively damaged incisors with esthetic post and core materials would be decided according to the remaining tooth structure.
The purpose of this study was to investigate the effect of phosphoric acid concentration on the movement of 2-hydroxyethylmethacrylate(HEMA) from bonding resin - resin composite combination through dentin in vitro. Freshly extracted human third molar teeth were divided into four groups each of 10 teeth. A closed chamber with 1 ml distilled water was attached to the CEJ of each tooth. An occlusal cavity of 4mm diameter & remaining dentin thickness of 1.0-1.5mm was prepared in each tooth. Dentin was treated with 10% phosphoric acid gel for 15 seconds. 32% phosphoric acid gel for 15 seconds, or with 35% phosphoric acid gel for 15 seconds. A control group not treated with acid gel was also prepared. The cavities were rinsed, dried and then treated with the HEMA-containing All-Bond 2 primer & bonding resin which was light-cured for 10 seconds. The cavities were then restored with Z100 composite resin(shade:A3.5:3M Dent. Prod. USA) & light cured for 30 seconds. Water samples were retrieved from the chambers over a time course (4.32, 14.4, 43.2, 144 & 432 minutes ; 1, 3 & 10 days) and analyzed by high performance liquid chromatography. The results were as follows. 1. HEMA was detected in the pulp chambers of all teeth from 4.32 minutes after resin placement The highest rate of release was in the first sample period (0-4.32 min) & rate of release declined exponentially thereafter. 2. No significant differences were found for mean release rate for HEMA over a time course among the four groups (p>0.05). 3. The diffusion rate was significantly (p<0.05) less for 10% phosphoric acid gel than 32% phosphoric acid gel at the second sample period(4.32-14.4 min). 4. No significant differences were found for cumulative HEMA diffusion among the four groups at 10 days(p>0.05) and mean total(cumulative) release at 10 days for all groups was in the 9 - 16 nmol range. 5. The cumulative release was significantly (p<0.05) less for 10% phosphoric acid gel than 32% phophoric acid gel at the third(14.4-43.2 min) & fourth(43.2-144 min) sample period.
Journal of the korean academy of Pediatric Dentistry
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v.36
no.4
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pp.580-585
/
2009
Pediatric dentists often meet children with abnormal in number of tooth. Presence of supernumerary teeth is frequent cause of malocclusion. Etiology for supernumerary teeth is not yet clearly defined, but it is thought to be caused by excessive proliferation of dental lamina by hereditary and environmental factors. Supernumerary teeth occur in the maxilla nine times more frequently than in the mandible. Most common supernumerary tooth is the mesiodens in the maxilla, and some are observed in the maxillary molar and mandibular premolar. It occurs rarely in the mandibular incisor region with the incidence of 1-2% among all supernumerary teeth. A six-year old boy visited the department of the pediatric dentistry, Yonsei University Dental Hospital, with the chief complaint of crowded supernumerary teeth on the mandibular incisor region. Clinical and radiographic examinations revealed six permanent mandibular incisors similar in size, shape, and length. Further investigation using computed tomography(CT) was proceeded on the mandible to measure and compare morphologic features and positions of the six incisors. Then, we decided to remove two incisors which were already erupted. Periodic check-up was followed to monitor the dental development and spontaneous positional enhancement of the remaining four incisors in the mandible.
Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.
Statement of problem: Many kinds of post and core systems are in the market, but there are no clear selection criteria for them. Purpose: The purpose of this study was to compare the flexural strength and modulus of elasticity of core materials, and measure the bending strength of post systems made of a variety of materials. Material and Methods: The flexural strength and elastic modulus of thirteen kinds core buildup materials were measured on beams of specimens of $2.0{\times}2.0{\times}24{\pm}0.1mm$. Ten specimens per group were fabricated and loaded on an lnstron testing machine at a crosshead speed of 0.25mm/min. A test span of 20 mm was used. The failure loads were recorded and flexural strength calculated with the measured dimensions. The elastic modulus was calculated from the slopes of the linear portions of the stress-stram graphs. Also nine kinds commercially available prefabricated posts made of various materials with similar nominal diameters, approximately 1.25mm, were loaded in a three-point bend test until plastic deformation or failure occurred. Ten posts per group were tested and the obtained data were anaylzed with analysis of variance and compared with the Tukey multiple comparison tests. Results: Clearfil Photo Core and Luxacore had flexural strengths approaching amalgam, but its modulus of elasticity was only about 15% of that of amalgam. The strengths of the glass ionomer and resin modified glass ionomer were very low. The heat pressed glass ceramic core had a high elastic modulus but a relatively low flexural strength approximating that of the lower strength composite resin core materials. The stainless steel, zirconia and carbon fiber post exhibited high bending strengths. The glass fiber posts displayed strengths that were approximately half of the higher strength posts. Conclusion: When moderate amounts of coronal tooth structure are to be replaced by a post and core on an anterior tooth, a prefabricated post and high strength, high elastic modulus core may be suitable. CLINICAL IMPLICATIONS In this study several newly introduced post and core systems demonstrated satisfactory physical properties. However when the higher stress situation exists with only a minimal ferrule extension remaining a cast post and core or zirconia post and pressed core are desirable.
In removable partial dentures, many types of retentive systems have been studied and applied in clinical treatment. One of those systems is the double crown denture system which is widely used in European countries such as Germany and Sweden. Telescopic double crown dentures have several advantages such as convenience in maintaining oral hygiene, enabling to transfer occlusal force along the long axis of the abutment, and secondary splinting effect between the abutments which leads to higher clinical performance compared to conventional removal partial dentures. In this clinical case, the patient was initially restored with a maxillary hybrid telescopic double crown denture with friction pin using remaining natural teeth as abutments. After 7 years, due to lack of recall check-up and poor oral hygiene, the abutment teeth were affected by periodontitis and 4 out of 5 of the abutment teeth had to be extracted. 3 additional implants were placed and the original abutment tooth with the inner crown was maintained. The mandible had fixed prostheses including implants but nevertheless, with strategic implant placement, the patient adapted well and was satisfied with the new maxillary tooth-implant combined double crown denture.
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