• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.29.1-29.11
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• 2021

Objectives: This study was conducted to compare the post-fracture survival rate of endodontically treated molar endodontically treated teeth (molar ETT) restored with resin composites or crowns and to identify potential risk factors, using a retrospective cohort design. Materials and Methods: Dental records of molar ETT with crowns or composite restorations (recall period, 2015-2019) were collected based on inclusion and exclusion criteria. The incidence of unrestorable fractures was identified, and molar ETT were classified according to survival. Information on potential risk factors was collected. Survival rates and potential risk factors were analyzed using the Kaplan-Meier log-rank test and Cox regression model. Results: The overall survival rate of molar ETT was 87% (mean recall period, 31.73 ± 17.56 months). The survival rates of molar ETT restored with composites and crowns were 81.6% and 92.7%, reflecting a significant difference (p < 0.05). However, ETT restored with composites showed a 100% survival rate if only 1 surface was lost, which was comparable to the survival rate of ETT with crowns. The survival rates of ETT with composites and crowns were significantly different (97.6% vs. 83.7%) in the short-term (12-24 months), but not in the long-term (> 24 months) (87.8% vs. 79.5%). Conclusions: The survival rate from fracture was higher for molar ETT restored with crowns was higher than for ETT restored with composites, especially in the first 2 years after restoration. Molar ETT with limited tooth structure loss only on the occlusal surface could be successfully restored with composite restorations.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.3
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• pp.168-175
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• 2023

Long-term use of inappropriate prosthesis often results in habitual closure or irregular mandibular movements. In that case, guide to the stable centric position is difficult. Therefore, by using a treatment denture, the muscles and TMJ should be stabilized and the jaw relation should be acquired with the treatment position. Compared to the conventional method, digital technology in fabrication complete denture has the advantage of reproducing a stable tooth arrangement in cases of difficult tooth alignment, minimizing laboratory errors and reducing denture fabrication time. Therefore, in this case, the final denture was fabricated by digitally reproducing the stable treatment position, vertical dimension, and lip support with a treatment denture, and satisfactory results were obtained.

• The Journal of Advanced Prosthodontics
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• v.16 no.2
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• pp.77-90
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• 2024

PURPOSE. The study aims to investigate the influence of the ferrule effect and types of posts on the stress distribution in three morphological types of the maxillary central incisor. MATERIALS AND METHODS. Nine models were created for 3 maxillary central incisor morphology types: "Fat" type - crown 12.5 mm, root 13 mm, and buccolingual cervical diameter 7.5 mm, "Medium" type - crown 11 mm, root 14 mm, and buccolingual cervical diameter 6.5 mm, and "Slim" type - crown 9.5 mm, root 15 mm, and buccolingual cervical diameter 5.5 mm. Each model received an anatomical castable post-and-core or glass-fiber post with resin composite core and three ferrule heights (nonexistent, 1 mm, and 2 mm). Then, a load of 14 N was applied at the cingulum with a 45° slope to the long axis of the tooth. The Maximum Principal Stress and the Minimum Principal Stress were calculated in the root dentin, crown, and core. RESULTS. Higher tensile and compression stress values were observed in root dentin using the metallic post compared to the fiber post, being higher in the slim type maxillary central incisor than in the medium and fat types. Concerning the three anatomical types of maxillary central incisors, the slim type without ferrule height in mm presented the highest tensile stress in the dentin, for both types of metal and fiber posts. CONCLUSION. Post system and tooth morphology were able to modify the biomechanical response of restored endodontically-treated incisors, showing the importance of personalized dental treatment for each case.

• Journal of Korean Dental Science
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• v.17 no.2
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• pp.64-74
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• 2024

This case report presents the long-term radiographic outcomes of a novel approach for simultaneous lateral augmentation and implant surgery. A 60-year-old male patient who required tooth extraction of the maxillary central and lateral incisors due to trauma visited the clinic. After tooth extraction, severe horizontal and vertical deficiencies occurred owing to atrophy of the alveolar ridge, and a simultaneous guided bone regeneration (GBR) procedure was planned along with the installation of two implants. In the present case, a modification of the conventional 'sandwich technique' was used by placing the mixture of autogenous bone chips and xenografts at the outermost layer to maximize the osteogenic potential at the coronal part of augmentation while applying solely xenografts at the inner layer. To enhance volumetric stability, an autogenous block of periosteum harvested from the maxillary tuberosity was incorporated between the two layers. Cone-beam computed tomography was performed at baseline and 3 years after the surgery to compare radiographic outcomes. Dehiscence after fixture installation was successfully observed at the re-entry of the surgery site. Three years after the surgery, average horizontal bone gains of 6.11 mm and 4.12 mm were observed in the maxillary central and lateral incisor areas, respectively. Healthy peri-implant mucosa and well maintained marginal bone levels were observed 8 years after the surgery, meeting the criteria for implant success. The findings of this case suggest that a substantial amount of horizontal bone gain can be obtained with a layered approach using autogenous bone materials and xenografts, highlighting the advantages of incorporating autogenous blocks into the simultaneous GBR procedure.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.37.1-37.7
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• 2018

Background: Fibrous dysplasia (FD) is characterized by the replacement of normal bone by abnormal fibro-osseous connective tissue and typically treated with surgical contouring of the dysplastic bone. When dysplastic lesions involve occlusion, not only is surgical debulking needed, orthognathic surgery for correction of dentofacial deformity is mandatory. However, the long-term stability of osteotomized, dysplastic bone segments is a major concern because of insufficient screw-to-bone engagement during surgery and the risk of FD lesion re-growth. Case presentation: This case report reviewed two patients with non-syndromic FD that presented with maxillary occlusal canting and facial asymmetry. Le Fort I osteotomy with recontouring of the dysplastic zygomaticomaxillary region had been performed. The stability of osseous segments were favorable. However, dysplastic, newly formed bone covered the previous plate fixation site and mild bony expansion was observed, which did not influence the facial profile. Including the current cases, 15 cases of orthognathic surgery for FD with dentition have been reported in the literature. Conclusion: The results showed that osteotomy did not appear to significantly reduce the long-term stability of the initial fixation insufficiency of the screw to the dysplastic bone. However, based on our results and those of the others, long-term follow-up and monitoring are needed, even in cases where the osteotomized segment shows stable results.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.2
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• pp.237-244
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• 2021

Dentinogenesis imperfecta (DI) is a hereditary disorder of dentinal defect. It is generally inherited as a single autosomal dominant trait. DI usually affects both the primary and permanent dentition. Affected teeth have various types of discolorations, rapid destruction of the dentin, and severe attrition. In radiologic view, the affected teeth have bulbous crowns, short roots and narrow or closed pulp chambers. The treatment objective is to prevent additional attrition and recover the vertical dimension of occlusion. The aim of this report was to present the long-term prognosis in 15 years in a pair of siblings. Both the patients had DI with tooth attrition and discoloration. Different treatment procedures were used, depending on the difference in the timing of intervention. The first patient saved most of his teeth. The second patient had all of her teeth extracted. This report could be helpful for early diagnosis and overall treatment of DI.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.537-549
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• 1998

The purpose of this study was to evaluate the influence of root resection and retrograde cavity preparation methods on the apical leakage in endodontic surgery. To investigate the effect of various root resection and retrograde cavity preparation methods on the apical leakage, 71 roots of extracted human maxillary anterior teeth and 44 mesiobuccal roots of extracted human maxillary first molars were used. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. Three millimeters of each root was resected at a 45 degree angle or perpendicular to the long axis of the tooth according to the groups. Retrograde cavities were prepared with ultrasonic instruments or a slow-speed round bur, and occlusal access cavities were filled with zinc oxide eugenol cement. Three coats of clear nail polish were placed on the lateral and coronal surfaces of the specimens except the apical cut one millimeter. All the specimens were immerged in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using two-way ANOVA and Duncans Multiple Range Test. The results were as follows: 1. No statistically significant difference was observed between ultrasonic retrograde cavity preparation method and slow-speed round bur technique, without apical bevel (p>0.05). 2. Ultrasonic retrograde preparation method showed significantly less apical leakage than slow-speed round bur technique, with bevel (p<0.0001). 3. No statistically significant difference was found between beveled resected root surface and non-beveled resected root surface, with ultrasonic technique (p>0.05). 4. Non-beveled resected root surface showed significantly less apical leakage than beveled resected root surface, with slow-speed round bur technique (p<0.0001). 5. No statistically significant difference in apical leakage was found between the group of retrograde cavity prepared parallel to the long axis of the tooth and the group of one prepared perpendicular to the long axis of the tooth (p>0.05). 6. Regarding isthmus preparation, ultrasonic retrograde preparation method showed significantly less apical leakage than slow-speed round bur technique, in the mesiobuccal root of maxillary molar, without bevel (p<0.0001).

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.585-601
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• 1994

The purpose of this study was to evaluate the ability of several intracoronal base materials to prevent cervical leakage of a bleaching agent into the dentinal tubules and along the root canal. In this study, thirty-two anterior teeth were used. After lingual access was prepared in each tooth, tooth was instrumented with a step-back technique to a Nos. 40-50 using K-type files. All teeth were obturated with a lateral condensation technique. Excess gutta percha was removed with a warm instrument to the facial level of the CEJ. Teeth were divided into four groups : Teeth in control group were not filled with base material. Teeth in groups 1, 2, and 3 had 2mm of gutta percha removed with a warm instrument, then Dycal, Fuki II LC and Z-100 were filled with palstic instruments on the top of the gutta percha respectively. All teeth were bleached for 7 days, fresh bleach was added for another 7 days, then a 10 % methylene blue dye was placed inside the access preparation. They were stored at $37^{\circ}C$ and $100^{\circ}C$ humidity for 5 days. Each tooth was sectioned perpendicular to the long axis using a diamond disk. Initial cuts were made at the most coronal level of facial and lingual CEJ's, then another cuts continued appically in the levels of 0.5mm, 1.5mm, and 2.0mm respectively. The amount of dye leakage through the dentinal tubules was determined at each cut section. In addition, when the cut specimen was determined to be last penetration of any dye, this level was recorded as depth of apical leakage from the coronal terminus of the gutta percha, Dycal, Fuji II LC and Z-100. The acquired data were analyzed by Tukey's Multiple Range Test adn Cochran-Mantel-Haenszel Test to see if there was any statistically significant difference in dye penetration and linear apical leakage among the groups. The results were as follows : 1. Control group at levels of CEJ and 0.5mm, group 3 at level of 1.5mm, and group 2 AND 3 at level of 2.0mm showed the least dye penetration through the facial or lingual dentinal tubules, but there were no significant difference among three groups. 2. Group 2 at levels of CEJ and 0.5mm, group 3 at level of 1.5mm, and group 2 and 3 at level of 2.0mm showed the least dye penetration through the proximal dentinal tubules, but there were no significant difference among control group, group 2, and group 3. 3. Group 1 showed the greatest dye penetration through the facial or lingual and proximal dentinal tubules at all levels, and there were significant difference with other three groups. 4. Control group and group 1 showed 2mm apical dye leakage at facial or lingual and proximal aspects, group 2 showed 1.5mm, and group 3 showed 0.5mm.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.5
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• pp.535-543
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• 2004

Purpose: The purpose of this study is to compare the effect of two fiber post systems and one metal cast post system on the fracture strength and fracture pattern of crowned, endodontically treated teeth with 2 mm-height of the reamining tooth structure. Materials and methods: A total of 36 recently extracted sound human mandibular premolars were selected Each tooth structure of the crown portion except 2mm-height of the one above the cementoenamel junction was removed. After being endodontically treated, they were randomly distributed into 3 groups: group 1, restored with quarts fiber post(D.T. Light-Post), group 2, with glass fiber post(FRC Postec), and group 3, metal cast post and core. All teeth were fully covered with nonprecious metal crowns. Each specimen was embedded in an acrylic resin block and then secured in a universal load-testing machine. A compressive load was applied at a 130 degree angle to the long axis of the tooth until fractured, at a crosshead speed 20mm/min. The highest fracture loads were measured and recorded as the fracture strength of each specimen. Fracture areas were measured on the mid-buccal and mid-lingual point from the crown margins. One-way analysis of variance and Turkey test were used to determine the statistic significance of the different fracture loads and areas among the groups (p<0.05). Results: The mean fracture loads were $1391{\pm}$425N(group 1), $1458{\pm}476N$(group 2) and $1301{\pm}319N$(group 3). The fracture loads among the three groups had no statistically signifiant difference (p>.05). The mean fracture area of the fiber post was closer to the crown margin than that of the metal cast post and core(p<.05). The metal cast post showed unrestorable and catastrophic fracture patterns. Conclusion: Within the limitations of this study, fracture loads with any statistically significant difference were not recorded for endodontically treated teeth restored with two fiber posts and the metal cast post. But teeth restored with the fiber posts typically showed the fracture pattern close to the crown margin, which was almost restorable.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.567-578
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• 2007

Statement of problem: The endodontically treated tooth is generally restored with post and core, owing to the brittle and the loss of large amount of tooth structure. As periodontal treatment was developed, there are many cases that periodontally involved teeth used in prosthetic treatment. Purpose: The purpose of this study was to analyze the stress distribution in the dentin and post structures by the various post materials and the amount of remaining alveolar bone height. Material and method: The 3-dimensional finite element models of mandible 1st premolars were divided into six types according to the various amount of remaining alveolar bone and post type. All types were modeled using equal length, diameter and shape of the post. Three types of post and core materials were used: prefabricated titaniumpost and amalgam core, prefabricated stainless steel post and amalgam core, and cast gold post and core. 300 Newton force was applied to functional cusp of mandible 1st premolar. Results: The results were as follows: First, there was no apparent difference in the pattern of stress distribution according to the alveolar bone condition concentrate on the post middle area. Second, there was difference in pattern of stress distribution according to the core materials, gold post and core generated same than amalgam core. Third, there was no apparent difference in the pattern of stress distribution within the dentin according to the post and core materials. But a cast gold post and core generated the lowest maximum stress value, a stainless steel post generated the highest maximum stress value. Fourth, in the reduced alveolar bone model, maximum stress value is 1.5 times than that of the normal alveolar bone model. Conclusion: Within the limitations of this study, to provide minimal stress to the root with alveolar bone reduced, the post length may be as long as apical seal was not destroyed. To prevent fracture of tooth, it is rational to use gold alloy which material was good for stress distribution for post materials.