• Proceedings of the KACD Conference
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• 2008.05a
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• pp.246-257
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• 2008

The purpose of this study was to investigate the influence of various occlusal loading sites and directions on the stress distribution of the cervical composite resin restorations of maxillary second premolar, using 3 dimensional (3D) finite element (FE) analysis. Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). HyperMesh (Altair Engineering. Inc., Troy, USA) and ANSYS (Swanson Analysis Systems. Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid (Z100, 3M Dental Products, St. Paul, MN, USA) or flowable resin (Tetric Flow, Viva dent Ets., FL-9494-Schaan, Liechtenstein) and each restoration was simulated with adhesive layer thickness ($40{\mu}m$). A static load of 200 N was applied on the three points of the buccal incline of the palatal cusp and oriented in $20^{\circ}$ increments, from vertical (long axis of the tooth) to oblique $40^{\circ}$ direction towards the buccal. The maximum principal stresses in the occlusal and cervical cavosurface margin and vertical section of buccal surfaces of notch-shaped class V cavity were analyzed using ANSYS. As the angle of loading direction increased, tensile stress increased. Loading site had little effect on it. Under same loading condition. Tetric Flow showed relatively lower stress than Z100 overall, except both point angles. Loading direction and the elastic modulus of restorative material seem to be important factor on the cervical restoration.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.301-311
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• 2009

Statement of problem: Flapless implant surgery using a soft tissue punch device requires a circumferential excision of the mucosa at the implant site. To date, Although there have been several reports on clinical outcomes of flapless implant surgeries, there are no published reports that address the appropriate size of the soft tissue punch for peri-implant tissue healing. Purpose: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effect of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model. Material and methods: Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a three month healing period, three fixtures (diameter, 4.0 mm) were placed on each side of the mandible using 3 mm, 4 mm, or 5 mm soft tissue punches. During subsequent healing periods, the peri-implant mucosa was evaluated using clinical, radiological, and histometric parameters, which included Gingival Index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues. Results: The results showed significant differences (P <0.05) between the 3 mm, 4 mm and 5 mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss during healing periods after implant placement. When the mucosa was punched with a 3 mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter $\geq$ 4 mm. Conclusion: Within the limit of this study, the size of the soft tissue punch plays an important role in achieving optimal healing. Our findings support the use of tissue punch that 1 mm smaller than implant itself to obtain better peri-implant tissue healing around flapless implants.

• Restorative Dentistry and Endodontics
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• v.33 no.3
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• pp.246-257
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• 2008

The purpose of this study was to investigate the influence of various occlusal loading sites and directions on the stress distribution of the cervical composite resin restorations of maxillary second premolar, using 3 dimensional (3D) finite element (FE) analysis. Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). HyperMesh (Altair Engineering, Inc., Troy, USA) and ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid (Z100, 3M Dental Products, St. Paul, MN, USA) or flowable resin (Tetric Flow, Vivadent Ets., FL-9494-Schaan, Liechtenstein) and each restoration was simulated with adhesive layer thickness ($40{\mu}m$). A static load of 200 N was applied on the three points of the buccal incline of the palatal cusp and oriented in $20^{\circ}$ increments, from vertical (long axis of the tooth) to oblique $40^{\circ}$ direction towards the buccal. The maximum principal stresses in the occlusal and cervical cavosurface margin and vertical section of buccal surfaces of notch-shaped class V cavity were analyzed using ANSYS. As the angle of loading direction increased, tensile stress increased. Loading site had little effect on it. Under same loading condition, Tetric Flow showed relatively lower stress than Z100 overall, except both point angles. Loading direction and the elastic modulus of restorative material seem to be important factor on the cervical restoration.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.2
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• pp.232-247
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• 2005

Purpose. The purposes of this investigation were to discover the possibility of clinical application in the areas of dental implants and bone grafts by investigating the bone formation histologically around specimen which was depending on the intensity of magnetic field of neodymium magnet inside of the specimens. Material and method. 1. Measurement of magnetic intensity - placed the magnet inside of the specimen, and measured the intensity of magnetic field around the 1st thread and 3rd thread of specimen 20 times by using a Gaussmeter(Kanetec Co., Japan). 2. Surgical Procedure - Male rabbit was anesthetised by constant amount of Ketamine (0.25ml/kg) and Rompun (0.25ml/kg). After incising the flat part of tibia, and planted the specimens of titanium implant, control group was stitched without magnet, while experimental groups were placed a magnedisc 500(Aichi Steel Co., Japan) or magnedisc 800(Aichi Steel Co., Japan) into it, fixed by pattern resin and stitched. 3. Management after the surgery - In order to prevent it from the infection of bacteria and for antiinflammation, Gentamycin and Ketopro were injected during 1 week from operation day, and dressed with potadine. 4. Preparation of histomorphometric analysis - At 2, 4 and 8 weeks after the surgery, the animals were sacrificed by excessed Ketamine, and then, specimens were obtained including the operated part and some parts of tibia, and fixed it to 10% of PBS buffer solution. After embedding specimens in Technovit 1200 and B.P solution, made a H-E stain. Samples width was 75$\mu$m . In histological findings through the optical microscope and using Kappa image base program(Olympus Co. Japan), the bone contact ratio and bone area ratio of each parts of specimens were measured and analyzed. 5. Statistical analysis - Statistical analysis was accomplished with Mann Whitney U-test. Results and conclusion. 1. In histomorphometric findings, increased new bone formation was shown in both control & experimental groups through the experiment performed for 2, 4 & 8 weeks. After 4 weeks, more osteoblasts and osteoclasts with significant bone remodeling were shown in experimental groups. 2. In histomorphometric analysis, the bone contact ratios were 38.5% for experimental group 1, 29.5% for experimental group 2 and 11.9% for control group. Experimental groups were higher than control group(p<0.05) (Fig. 6, Table IV). The bone area ratios were 60.9% for experimental group 2, 46.4% for experimental group 1 and 36.0% for control group. There was no significantly statistical difference between experimental groups and control group(p<0.05) (Fig. 8, Table VII) 3. In comparision of the bone contact ratios at each measurement sites according to magnetic intensity, experimental group 2(5.6mT) was higher than control group at the 1st thread (p<0.05) and experimental group 1 (1.8mT) was higher than control group at the 3rd thread(p<0.05) (Fig. 7, Table V, VI). 4. In comparision of the bone area ratios at each measurement sites according to magnetic intensity, experimental group 2(5.6mT) was higher than control group and experimental group 1 (4.0mT) at the 1st thread(p<0.1) and experimental group 2(4.4mT) was higher than experimental group 1 (1.8mT) at the 3rd thread(p<0.1) (Fig. 9, Table IX, X). Experiment group 2 was largest, followed by experiment group l and control group at the 3rd thread of implant. There was a significant difference at the 1st thread of control group & experiment group 2, and at 1st thread & 3rd thread of experiment group 1 & 2, and not at control group experiment group 1.(p<0.1)

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.1019-1037
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• 2005

The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. There have been increasing interest on the chitosan made by chtin. Chitosan is a derivative of chitin made by deacetylation of side chains. Chitosan has been widely studied as bone substitution and membrane material in periodontology. Many experiments using chitosan in various animal models have proven its beneficial effects. Tetracycline has been considered for use in the treatment of chronic periodontal disease and gingivitis. The aim of this study is to evlauate the osteogenesis of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague Dawley rats. An 8mm surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into five groups: Untreated control group versus four experimental group. Four types of membranes were made and comparative study was been done. Two types of non-woven membranes were made by immersing non-woven chitosan into either the tetracycline solution or chitosan-tetracycline solution. Other two types of sponge membranes were fabricated by immersing chitosan sponge into the tetracycline solution, and subsequent freeze-drying. The animals were sacrificed at 2 and 8 weeks after surgical procedure. The specimens were examined by histologic analyses. The results are as follows: 1. Clinically the use of tetracycline blended chitosan membrane showed great healing capacity. 2. The new bone formations of all the experimental group, non-woven and sponge type membranes were greater than those of control group. But, there was no significant difference between the experimental groups. 3. Resorption of chitosan membranes were not shown in any groups at 2 weeks and 8 weeks. These results suggest that the use of tetracycline blended chitosan membrane on the calvarial defects in rats has significant effect on the regeneration of bone tissue in itself. And it implicate that tetracycline blended chitosan membrane might be useful for guided tissue regeneration.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.2
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• pp.182-206
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• 2003

Statement of problem : Successful osseointegration of endosseous threaded implants is dependent on many factors. These may include the surface characteristics and gross geometry of implants, the quality and quantity of bone where implants are placed, and the magnitude and direction of stress in functional occlusion. Therefore clinical quantitative measurement of primary stability at placement and functional state of implant may play a role in prediction of possible clinical symptoms and the renovation of implant geometry, types and surface characteristic according to each patients conditions. Ultimately, it may increase success rate of implants. Purpose : Many available non-invasive techniques used for the clinical measurement of implant stability and osseointegration include percussion, radiography, the $Periotest^{(R)}$, Dental Fine $Tester^{(R)}$ and so on. There is, however, relatively little research undertaken to standardize quantitative measurement of stability of implant and osseointegration due to the various clinical applications performed by each individual operator. Therefore, in order to develop non-invasive experimental method to measure stability of implant quantitatively, the resonance frequency analyzer to measure the natural frequency of specific substance was developed in the procedure of this study. Material & method : To test the stability of the resonance frequency analyzer developed in this study, following methods and materials were used : 1) In-vitro study: the implant was placed in both epoxy resin of which physical properties are similar to the bone stiffness of human and fresh cow rib bone specimen. Then the resonance frequency values of them were measured and analyzed. In an attempt to test the reliability of the data gathered with the resonance frequency analyzer, comparative analysis with the data from the Periotest was conducted. 2) In-vivo study: the implants were inserted into the tibiae of 10 New Zealand rabbits and the resonance frequency value of them with connected abutments at healing time are measured immediately after insertion and gauged every 4 weeks for 16 weeks. Results : Results from these studies were such as follows : The same length implants placed in Hot Melt showed the repetitive resonance frequency values. As the length of abutment increased, the resonance frequency value changed significantly (p<0.01). As the thickness of transducer increased in order of 0.5, 1.0 and 2.0 mm, the resonance frequency value significantly increased (p<0.05). The implants placed in PL-2 and epoxy resin with different exposure degree resulted in the increase of resonance frequency value as the exposure degree of implants and the length of abutment decreased. In comparative experiment based on physical properties, as the thickness of transducer increased, the resonance frequency value increased significantly(p<0.01). As the stiffness of substances where implants were placed increased, and the effective length of implants decreased, the resonance frequencies value increased significantly (p<0.05). In the experiment with cow rib bone specimen, the increase of the length of abutment resulted in significant difference between the results from resonance frequency analyzer and the $Periotest^{(R)}$. There was no difference with significant meaning in the comparison based on the direction of measurement between the resonance frequency value and the $Periotest^{(R)}$ value (p<0.05). In-vivo experiment resulted in repetitive patternes of resonance frequency. As the time elapsed, the resonance frequency value increased significantly with the exception of 4th and 8th week (p<0.05). Conclusion : The development of resonance frequency analyzer is an attempt to standardize the quantitative measurement of stability of implant and osseointegration and compensate for the reliability of data from other non-invasive measuring devices It is considered that further research is needed to improve the efficiency of clinical application of resonance frequency analyzer. In addition, further investigation is warranted on the standardized quantitative analysis of the stability of implant.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.125-135
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• 2009

Statement of problem: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. Purpose: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. Material and methods: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques(10, 20, 30 and 40 Ncm) and the external loading(250 N, $30^{\circ}$) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. Results: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. Conclusion: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.148-155
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• 2009

Statement of problem: The interest in all-ceramic restorations has increased as more techniques have become available. With the introduction of machinable dental ceramics and CAD/CAM systems there is a need to evaluate the quality levels of these new fabrication techniques. Purpose: This study is to evaluate the crown fidelity(absolute marginal discrepancy and internal gap) of various zirconia-based all-ceramic crowns fabricated with different CAD/CAM(computer-assisted design/computer-assisted manufacturing) systems and conventional cast metal-ceramic crowns. Material and methods: A resin tooth of lower right second premolar was prepared. After an impression was taken, one metal master die was made. Then 40 impressions of metal master dies were taken for working dies. 10 crowns per each system were fabricated using 40 working dies. Metal-ceramic crowns were cast by using the conventional method, and Procera, Lava, and Cerec inLab crowns were fabricated with their own CAD/CAM manufactruing procedures. The vertical marginal discrepancies and internal gaps of each crown groups were measured on a metal master die without a luting agent. The results were statistically analyzed using the one-way ANOVA and Tukey's HSD test. Results: 1. Vertical marginal discrepancies were $50.6{\pm}13.9{\mu}m$ for metal-ceramic crowns, $62.3{\pm}15.7{\mu}m$ for Procera crowns, $45.3{\pm}7.9{\mu}m$ for Lava crowns, and $71.2{\pm}2.0{\mu}m$ for Cerec inLab crowns. 2. The Internal gaps were $52.6{\pm}10.1{\mu}m$ for metal-ceramic crowns, $161.7{\pm}18.5{\mu}m$ for Procera crowns, $63.0{\pm}10.2{\mu}m$ for Lava crowns, and $73.7{\pm}10.7{\mu}m$ for Cerec inLab crowns. Conclusion: 1. The vertical marginal discrepancies of, 4 crown groups were all within the clinically acceptable range($120{\mu}m$). 2. The internal gaps of LAVA, Cerec inlab, and metal-ceramic crowns were within clinically acceptable range except Procera crown($140{\mu}m$).

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.1
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• pp.8-15
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• 2010

Purpose: The purpose of this study was to evaluate the effect of various methods of dentin bonding agent application and air abrasion pretreatment on microtensile bond strength between dentin and resin, using a self-etching adhesive system. Material and methods: Thirty freshly extracted human molars were obtained and divided into 6 groups of 5 teeth. A 2-step self etching adhesive system (Clearfil SE Bond) was used for all groups. The control specimens were prepared using a direct immediate bonding technique. The delayed dentin sealing specimens were prepared using an indirect approach without dentin prebonding. The immediate dentin sealing specimens were prepared using dentin prebonding immediately following preparation. Immediate dentin sealing teeth and delayed dentin sealing teeth had provisional restorations using Fermit for two weeks. Then all specimens of each group were divided into two groups of three, depending on air abrasion pretreatment. Composite "crowns" were incrementally built on and specimens were stored in water for 24 hours. All teeth were prepared for a microtensile bond strength test. Bond strength data were analyzed with a one-way ANOVA test, and post hoc comparison was done using the Scheffe's test. Results: The mean microtensile bond strengths of all groups were not statistically different from each other. Conclusion: When preparing teeth for indirect restorations, IDS and DDS with Clearfil SE bond, have no difference on the microtensile bond strength between dentin and resin. Air abrasion pretreatment did not affect the microtensile bond strength when using IDS and DDS with Clearfil SE bond.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.222-231
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• 2009

Statements of the problem: Over the past decades, conventional complete dentures were used for various patients although they have incomplete function. Overdentures using dental implants could help the improvement of denture function. Purpose: The purpose of this study was to compare the strains of abutment and bone on implant overdenture between splinted and unsplinted type of prosthesis. Additionally, the strain values of parallel placed implant model and unparallel placed implant model were compared. Material and methods: Two acrylic resin model were prepared and two implants were placed at the canine positions in each model. In the first model, two implant were placed parallel. In the second model, two implants were placed with 10 degree labiolingual divergence. Two types of abutment were connected to the fixtures alternatively. One was splint type of Hader bar, the other was unsplint type of ball abutment. Overdentures were fabricated with corresponding attachment systems and seated on abutments. Strains of abutments and labial bone simulants were measured with electric resistance strain gauges when static load from 100 N to 200 N were applied to overdentures. Results: 1. Splinted type of overdentures using bar and clip showed higher absolute strain values. But the strain was compressive and the load was shared by two implants(P<.05). 2. Unsplinted type overdentures using ball and O-ring showed low absolute strain values(P<.05). 3. Labially inclined implant showed higher tensile strain values in unsplinted type of prosthesis than in splinted type of prosthesis. Lingually inclined implant showed rather low strain values under load(P<.05). 4. Non parallel implant model showed higher absolute strain values than parallel placed implant model comprehensively(P<.05).