• Restorative Dentistry and Endodontics
• /
• v.22 no.1
• /
• pp.428-446
• /
• 1997

Restorative procedures can lead to weakening tooth due to reduction and alteration of tooth structure. It is essential to prevent fractures to conserve tooth. The resistance to fracture of the restored tooth may be influenced by many factors, among these are the cavity dimension and the physical properties of the restorative material. The placement of direct composite resin restorations has generally been found to have a strengthening effect on the prepared teeth. It is the purpose of this investigation to study the relationship between the cavity isthmus and the fracture resistance of a tooth in composite resin restorations. In this study, MO cavity was prepared on maxillary first premolar. Three dimensional finite element models were made by serial photographic method and isthmus(1/4, 1/3, 1/2 of intercuspal distance) were varied. Two types of model(B and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall and R model was left unfilled. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as follows : 1. Displacement of buccal cusp in R model occurred and increased as widening of the cavity, and displacement in B model was little and not influenced by cavity width. 2. There was a significant decrease of stress resulting in increase of fracture resistance in B model when compared with R model. 3. With the increase of the isthmus width, B model showed no change in the stress and strain. In R model, the stress and strain increased both in the area of buccal-pulpal line angle and the buccal side of marginal ridge, therefore the possibility of crack increased. 4. The stress and strain were distributed evenly on the tooth in B model, but in R model, were concentrated on the buccal side of the distal marginal ridge and buccal-pulpal line angle, therefore the possibility of fracture increased.

• The Journal of Advanced Prosthodontics
• /
• v.3 no.4
• /
• pp.229-235
• /
• 2011

PURPOSE. The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS. A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS. Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION. The 5-year CSR of Implantium implants was 97.37 %. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.

• The Journal of Korean Academy of Prosthodontics
• /
• v.42 no.3
• /
• pp.280-293
• /
• 2004

Statement of problem. Glass fiber post is one of recent developments to accommodate esthetic restoration for endodontically treated teeth. This has many advantages over conventional post system in physical properties, esthetic factor, risk of root and restoration fracture, adhesion to core, radiopacity, removal and retrievabilty, biocompatibility and chemical stability. Purpose. This in vitro study was to evaluate the most suitable type of resin core for the glass fiber post through surveying the fracture modes and the maximum load that fractures the tooth. Material and methods. 50 sound maxillary premolars restored with glass fiber posts($ParaPost^{(R)}$ Fiber White) and different types of resin cores(ParaCore, $Z100^{TM}$, $Rebilda^{(R)}$ and $Admira^{(R)}$) were prepared and loaded to faiure in a universal test machine. The maximum fracture load and fracture mode were investigated in the specimens that were restored with resin and those of metal cast and core. With the data, Wilcoxon rank sum test was used to validate the significance between the test groups, and Tukey' s studentized range test was used to check if there is any significant statistical difference between each test group. Every analysis was approved with 95% reliance. Results. On measuring the maximum fracture load of teeth specimens, there was a significant difference between the maximum fracture loads of the tooth specimens. ParaCore showed the highest mean maximum fracture load followed by $Z100^{TM}$. And, the distribution of fracture mode of tooth specimens showed generally Type D, the three parted fracture of the core around the post was mostly seen(62.5%), and specifically, ParaCore showed 90% and $Z100^{TM}$ showed 100% Type D fracture. Conclusion. Referring to the values of maximum fracture load and mean compressive fracture load, ParaCore and $Z100^{TM}$ had high values and are recommended as tooth colored resin core material for glass fiber post. CLINICAL IMPLICATIONS. This study was carried out intending to be of aid in selecting the appropriate resin core for the glass fiber post. The dual cure type composite resin ParaCore and light cure type composite resin $Z100^{TM}$ have good properties and are recommended as tooth colored resin core material for glass fiber post.

• Restorative Dentistry and Endodontics
• /
• v.18 no.2
• /
• pp.291-316
• /
• 1993

Restorative procedures can lead to tooth fracture due to the relatively small amount of the remaining tooth structure. It is essential to prevent fractures by having a clear concept of the designs for cavity preparations. Among the several parameters in cavity designs, profound understanding of isthmus width factor would facilitate selection of the appropriate cavity preparation for a specific clinical situation. In this study, MO amalgam cavity were prepared on maxillary first premolar and filled with amalgam. Three dimensional, model with 1365 8-node brick elements was made by serial photographic method. In this model, isthmus was varied in width at 1/4, 1/3, 1/2 and 2/3 of intercuspal width and material properties were given for three element groups, i.e., enamel, dentin and amalgam. A load of 500 N was applied vertically on amalgam and enamel. In case of enamel loading, 2 model (with and without amalgam) was compared to consider the possibility of play at the interface between tooth material and amalgam. These models were analyzed with three dimensional finite element method. The results were as follows: 1. The stress was concentrated on the facio-pulpal line angle and distal marginal ridge of the cavity. 2. With the increase of the isthmus width, the stress spread around the facio-pulpal line angle and the area of stress concentration moved toward the proximal box. 3. In case of narrow isthmus width, the initiation point of crack would be in the area of isthmus corner of the cavity, and with the increase of the isthmus width, it would move toward the proximal box and at the same time the possibility of crack increase at the distal marginal ridge. 4. The direction of crack progressed outward and downward from the facio-pulpal line angle, and with the increase of the isthmus width, it approximated vertical direction. At the marginal ridge, it occurred in vertical direction. 5. It would be favorable to make the isthmus width narrower than a third of the intercuspal width, and to cover the cusp if isthmus width were wider than half of the intercuspal width. 6. It is necessary to apply the possibility of play to the finite element analysis.

• The Journal of the Korean dental association
• /
• v.50 no.8
• /
• pp.507-515
• /
• 2012

The purpose of this article is to discuss the effect of aging on the treatment of replantation and transplantation of teeth in old patients. I case of replantation and 2 cases of transplantations in old patients are reported in this article. Patients aged 65 and over are included. They had several problems such as periapical lesion, crack or foot fractures. In those cases, the replantation and transplantation were treatment of choice. White ProRoot MTA was used in apical retrograde filling and perforation repair. After replantation and transplantation of teeth, follow-up visits showed signs of healing in 3 cases. Considerations and indications for replantation and transplantation are not much affected by age. Old patients are aware that replantation and transplantation can be performed comfortably and that age is not a factor in prediction success.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.3
• /
• pp.562-567
• /
• 1997

During the eruption of permanent teeth, Traumatic root fractures in young permanent incisors are rare. They occur most commonly in the maxillary central incisors of male patient and are frequently seen in the coronal third of the root. Permanent incisors are very important in terms of esthetics as well as of function, and so conservative treatment is advisable. It is important to maintain vitality of pulp to achieve better result. Location of the fracture line determines the Prognosis. No clinical change were seen in this three case. A case of central incisor with apparent healing of a root fracture without any tratment is presented in this paper. Long term clinical observation is required periodically.

• The Journal of the Korean dental association
• /
• v.57 no.11
• /
• pp.679-688
• /
• 2019

A 8-year-old patient presented with a crown-root fracture of the maxillary right central incisor with an oblique subgingival fracture line. A multidisciplinary treatment approach including endodontic treatment, surgical extraction and intraalveolar repositioning was used to gain sufficient crown length of the fractured maxillary incisor. The coronally repositioned maxillary right central incisor was stabilized by a resin wire splint. Apexification using MTA was performed. Resin core and direct resin restoration(Cl IV) on fractured teeth was built up. Clinical and radiographic follow-up of the maxillary right central incisor after 36 months showed no signs of root resorption or pathology and acceptable aesthetics and functions were maintained. Surgical extrusion can be considered as a good treatment modality for young patients.

• Journal of Technologic Dentistry
• /
• v.46 no.1
• /
• pp.15-19
• /
• 2024

An ideal post material should have physical properties similar to those of dentin. Post materials with high elastic moduli may cause root fractures. This clinical report describes the treatment of a severely damaged tooth using a recently introduced material. Polyetherketoneketone (PEKK) is a semicrystalline high-performance thermoplastic polymer. PEKK is a promising material for custom post-and-core fabrication because of its elasticity close to that of dentin, good shock absorbance, machinability, and low cost. A laboratory scanner was used to digitize the conventional impression of a severely damaged maxillary right first molar. A custom PEKK post-and-core was designed and milled using computer-aided design and computer-aided manufacturing technology. Using the proposed technique, a custom PEKK post-and-core was fabricated accurately and human error was reduced. Restoration was luted with resin cement. Custom PEKK post-and-core restorations are a viable alternative for treating severely damaged teeth.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.3
• /
• pp.281-289
• /
• 1994

This is a clinical study on 235 inpatients who sustained a total of 350 mandibular fractures and who were treated in our department during the period of Oug., 1989 through Dec., 1993. The results obtained are as follows : 1. The mumber of patients has not been increased year after year. In respect of incidence, there were the highest frequency as 67 patients(28.5%) in 1991 and the least frequency as 16 patients(6.8%) in 1989 and the highest frequency as 28 patients(11.9%) in October and the least frequncy as 12 patients(5.2%) in February. 2. The age frequency was the highest in the second decade(30.6%). The youngest patient was 8 months and the eldest patient was 80 years and mean age was 27.8 years. The ratio of men to Wemen was 4 : 1. 3. The most frequent cause was fall down as 86 patients(36.6%) and the next was fist blow 4 as 75 patients(31.9%), traffic accident as 56 patients(23.9%) in order. 4. The most common location was symphysis as 141 numbers(40.3%) and the next was condyle as 96 numbers(27.4%), angle as 94 numbers(26.8%), body as 14 numbers(4.0%) in order. The sum of fracture sites were 350 and there were 1.49 fracture sites per one patient and multiple fractures occured in 100 patients(40.5%) of the 235 patients. The ratio of Left to Right except for symphysis was 1.71 : 1. 5. Among the 333 associated injuries, facial laceration was 136(57.9%) and tooth injury was 58(24.7%) and extremity was 31(13.2%). 6. Among the 350 mandibular fractures, complications after treatment occured in 51(14.6%) and infection as 20(5.7%) was the most frequent complication. 7. In respect of treatment of mandibular fracture, close reduction was 64 patients(27.2%) and open reduction was 164 patients(69.8%) and other were 7 patients(3.0%) of all and so open reduction was the most common in type of treatment.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.1
• /
• pp.126-132
• /
• 2009

Injuries of permanent teeth by trauma occur frequently in childhood and adolescence. Crown fractures are as frequent as 25-76% and especially maxillary incisors are prone to fractures. There have been numerous efforts to achieve both aesthetically and functionally satisfying restoration. When a mature tooth is fractured, porcelain crown or laminate veneer could be a choice of prosthodontic treatment. However, in a case of immature permanent incisor fracture, prosthodontic treatment is more complicated due to the immaturity of the tooth. Moreover, if endodontic treatment is accompanied with the prosthodontic treatment, the treatment period is prolonged. In the past, restoration using an orthodontic band, a ready-made crown, or glass ionomer cement did not exhibit esthetically satisfying result. As restorational materials have been improved, now more esthetic restoration is possible by reattaching fractured fragments or light-curing composite resin restoration. We reports cases of patients with fractured maxillary incisors and their successful treatment results through reattachment of fractured fragments and composite resin restoration.