Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with post-traumatic mandibular defect. A split-thickness skin graft was performed prior to implant placement and prefabricated acrylic stent was placed to hold the graft in place. The esthetic and functional demands of the patient were fulfilled by implant-supported screw-retained fixed prosthesis using CAD-CAM technology.
Computer-Aided Design ; Dental Implants ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Prostheses and Implants ; Skin ; Skin Transplantation ; Stents ; Transplants ; Zirconium

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 postion 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.
Bicuspid ; Dentists ; Denture, Partial, Fixed ; Humans ; Incidence ; Molar ; Neck ; Posture ; Shoulder ; Shoulder Pain ; Tooth ; Tooth Preparation

PURPOSE: The objective of this study was to investigate the biologic effects of enamel matrix derivative (EMD) with different concentrations on cell viability and the genetic expression of human gingival fibroblasts (HGF) to zirconia surfaces. MATERIALS AND METHODS: Immortalized human gingival fibroblasts (HGF) were cultured (1) without EMD, (2) with EMD 25 microg/mL, and (3) with EMD 100 microg/mL on zirconia discs. MTT assay was performed to evaluate the cell proliferation activity and SEM was carried out to examine the cellular morphology and attachment. The mRNA expression of collagen type I, osteopontin, fibronectin, and TGF-beta1 was evaluated with the real-time polymerase chain reaction (RT-PCR). RESULTS: From MTT assay, HGF showed more proliferation in EMD 25 microg/mL group than control and EMD 100 microg/mL group (P<.05). HGFs showed more flattened cellular morphology on the experimental groups than on the control group after 4h culture and more cellular attachments were observed on EMD 25 microg/mL group and EMD 100 microg/mL group after 24h culture. After 48h of culture, cellular attachment was similar in all groups. The mRNA expression of type I collagen increased in a concentration dependent manner. The genetic expression of osteopontin, fibronectin, and TGF-beta1 was increased at EMD 100 microg/mL. However, the mRNA expression of proteins associated with cellular attachment was decreased at EMD 25 microg/mL. CONCLUSION: Through this short term culture of HGF on zirconium discs, we conclude that EMD affects the proliferation, attachment, and cell morphology of HGF cells. Also, EMD stimulates production of extracellular matrix collagen, osteopontin, and TGF-beta1 in high concentration levels. CLINICAL RELEVANCE: With the use of EMD, protective barrier between attached gingiva and transmucosal zirconia abutment may be enhanced leading to final esthetic results with implants.
Cell Proliferation ; Cell Survival ; Collagen ; Collagen Type I ; Dental Enamel* ; Extracellular Matrix ; Fibroblasts* ; Fibronectins ; Gingiva ; Humans ; Osteopontin ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Transforming Growth Factor beta1 ; Zirconium

STATEMENT OF PROBLEM: Problem of matching the appearance of porcelain restorations with the patient's natural dentition has always been a concern to dental clinicians. Recently, demands for esthetics, even in restorations requiring strength, has brought a revolution to dentistry and increased use of zirconia. Among the various factors, shade and translucency of the core can significantly affect the overall esthetics of the restoration and should be considered when selecting an all-ceramic system. PURPOSE: The purpose of this study was to spectrophotometrically evaluate the influence of different zirconia systems and core thickness on the final shade of all-ceramic restorations using the CIEL*a*b* system. MATERIAL AND METHODS: Core specimens (n = 20 per group) of In-Ceram Alumina, In-Ceram Zirconia, Digident CAD/CAM Zirconia, Cercon Zirconia were fabricated 20mm in diameter. 10 specimens of each group were fabricated at core thickness of 0.5mm and 0.7mm. These core specimens were veneered with shade A1 and A3 porcelain of the recommended manufacturer. CIEL*a*b* coordinates were recorded for each specimen with a spectrophotometer (Model CM-2600d, Minolta, Japan). Color differences were calculated using the equation delta E*=[(delta L*)2+(delta a*)2+(delta b*)2]1/2. RESULTS: 1. Specimens of core thickness 0.5mm and 0.7mm did not exhibit clinically perceived color difference. 2. Regarding shade reproducibility, In-Ceram Alumina and In-Ceram Zirconia showed significant difference within each group. 3. Cercon Zirconia group showed the highest L* value and Digident Zirconia group showed lowest a* and b* value. 4. Generally, the shade difference between materials was higher in the A3 shade group than in the A1 shade group. CONCLUSION: Within the limitations of this study, there was no color difference after increase in core thickness and every all-ceramic system has color characteristics that clinicians have to consider when selecting materials. Also, manufacturers of different porcelain systems must make every effort to achieve color reproducibility.
Aluminum Oxide ; Ceramics* ; Dental Porcelain ; Dentistry ; Dentition ; Esthetics

Excessive tooth wear results in unacceptable damage to the occlusal surface and can cause pulpitis, occlusal disharmony, dysfunction, and unesthetic result. Patients with severe attrition have to be classified as several types relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. The patient in this case was a 80 - year - old woman who lost support of posterior occlusion and collapsed of the occlusal plane due to confrontation of the opposing teeth, accompanied by an increase in the number of remaining bristles, resulting in a loss of intermaxillary space for prosthesis. In this case, treatment with increased vertical dimension may have stability if the increase in vertical occlusal height is minimized within the required range, and a stable occlusal contact is provided after an increased vertical occlusal height stabilization period. After the new VDO had been confirmed under interim fixed restorations, definitive fixed restorations were produced. Through these treatment processes, we obtain satisfactory results that are functional and aesthetically pleasing.
Dental Occlusion ; Dentition* ; Female ; Humans ; Prostheses and Implants ; Pulpitis ; Rehabilitation* ; Tooth ; Tooth Wear ; Vertical Dimension

PURPOSE: Recent interest has focused on intentional replantation to restore an original tooth. Some studies have shown successful results with intentional replantation for periodontally involved teeth. For long-term success of replantation, a healthy periodontal status of the recipient site is required so that delayed replantation is more suitable for periodontally involved teeth. To reveal the ideal timing for delayed replantation of periodontally involved teeth, the healing process of extraction sockets after extraction of periodontitis-induced teeth in rats was evaluated. METHODS: Twenty-eight rats were randomly divided into two groups: a control group (n=8) and test group (n=20). In the test group, periodontitis was induced by a ligature around the cervix of the mandibular first molar of all of the rats. Two weeks later, the mandibular first molars were extracted in all of the animals. The animals were sacrificed on days 0, 3, 7, and 10 after extraction and histological and immunohistochemical analysis was performed. RESULTS: In histological analysis of the test group, inflammatory cell infiltrate was found abundantly in the remaining periodontium 3 days after tooth extraction and decreased gradually at later time points. In immunohistochemical analysis of the test group, both interleukin-6 (IL-6) and, tumor necrosis factor-alpha (TNF-alpha) were numerous in the furcation area at each postextraction day. IL-6 was stained more heavily between 3 and 7 days after extraction; at day 10 after extraction, little staining was observed. TNF-alpha staining was more intense at 3 days after extraction and gradually weakened at later points in time. CONCLUSIONS: Within the limits of this study, it takes at least 10 days to resolve periodontal inflammation in rat extraction sockets.
Animals ; Cervix Uteri ; Female ; Immunohistochemistry ; Inflammation ; Interleukin-6 ; Ligation ; Molar ; Periodontitis ; Periodontium ; Rats ; Replantation ; Tooth ; Tooth Extraction ; Tooth Socket ; Tumor Necrosis Factor-alpha

Systemic capillary leak syndrome is a rare disease characterized by life-threatening attacks of reversible plasma extravasation and vascular collapse accompanied by hypotension, hemoconcentration, and hypoalbuminemia. A 36-year-old woman was admitted to this hospital with a fever, along with symptoms consistent with an upper respiratory tract infection and hypotension. Initial laboratory tests revealed several abnormal findings, including an elevated leukocyte count and hematocrit, hypoalbuminemia, and acute renal failure. Here, we report a case of successful treatment of systemic capillary leak syndrome, which can be difficult to distinguish from septic shock.
Acute Kidney Injury ; Adult ; Capillary Leak Syndrome* ; Female ; Fever ; Hematocrit ; Humans ; Hypoalbuminemia ; Hypotension ; Leukocyte Count ; Plasma ; Rare Diseases ; Respiratory Tract Infections ; Shock, Septic*

Purpose: The purpose of this study is to compare the shear bond strength of 3D printing denture base resin according to surface treatment of artificial teeth. Materials and methods: 3D printing denture base resin was fabricated as specimens using 3D printer. The experimental group divided the surface treatment of artificial teeth into five groups according to the application of sandblasting and primer (n=10). Shear bond strengths between denture base and artificial teeth were measured by universal testing machine. All measurements were analyzed by one-way ANOVA and Turkey test (α=.05). Fracture mode of each specimen was analyzed. Microscopic evaluation was conducted by using a scanning electron microscope. Results: Unsurfaced treated group represented the lowest value. The primer groups had significantly higher result values (P<.05). Most specimens of the primer groups had cohesive failure. Conclusion In 3D printing denture base resin group, mechanical and chemical surface treatment of artificial teeth has increased the shear bond strength. Therefore, if dentures are produced using 3D printing, proper mechanical and chemical treatment of artificial teeth is necessary for adhesion of dentures and artificial teeth.

Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient’s occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient’s condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient’s condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

It is very difficult to achieve denture support, stability and retention in single-maxillary complete denture patients with flabby tissue. A 57-year-old male patient was uncomfortable with the existing denture and wanted treatment. The reduction of flabby tissue was confirmed using the treatment denture. Non-pressure impression was obtained using an intraoral scanner during the definitive denture process. This is reported because the resulting denture improved when observing the retention, support and stability of the denture during occlusion.