STATEMENT OF PROBLEM: The aim of this study was to study the effects of various surface treatments to a titanium surface on the expression of Runx2 in vitro. MATERIAL AND METHODS: Human Osteosarcoma TE-85 cells were cultured on machined, sandblasted, or anodic oxidized cpTi discs. At various times of incubation, the cells were collected and then processed for the analysis of mRNA expression of Runx2 using reverse transcription-PCR. RESULTS: The expression pattern of Runx2 mRNA was differed according to the types of surface treatment. When the cells were cultured on the untreated control culture plates, the gene expression of Runx2 was not increased during the experiments. In the case of that the cells were cultured on the machined cpTI discs, the expression level was intermediate at the first day, but increased constitutively to day 5. In cells on sandblasted cpTi discs, the expression level was highest in the first day sample and the level was maintained to 5 days. In cells on anodized cpTi discs, the expression level increased rapidly to 3 days, but decreased slightly in the 5-th day sample. CONCLUSION: Different surface treatments may contribute to the regulation of osteoblast function by influencing the level of gene expression of key osteogenic factors.
Durapatite ; Gene Expression ; Humans ; Osteoblasts ; Osteogenesis ; Osteosarcoma ; RNA, Messenger ; Titanium

BACKGROUND: In order to restore severely attrited teeth properly, surgical intervention in the form of a crown-lengthening procedure may be required. And also, proper diagnosis and treatment sequencing is critical to obtain a successful results. Adequate diagnostic wax-up ensures good esthetics and healthy periodontal tissue. CASE DESCRIPTION: This clinical case report describes a diagnostically based protocol for restoration on mandibular anterior teeth with crown lengthening procedure and the treatment of partially edentulous mandible combined with an edentulous maxilla. In addition, the effort to prevent the combination syndrome was described. CLINICAL IMPLICATION: An interdisciplinary diagnosis and examination through visualization of the desired results ensure conservative and more predictable outcome.
Crown Lengthening ; Crowns ; Dietary Sucrose ; Esthetics ; Humans ; Mandible ; Maxilla ; Mouth ; Mouth Rehabilitation ; Tooth

BACKGROUND: Though implant dentistry is very successful and predictable in treatment of patients with destroyed dentition, there are some cases with limitations to implant therapy. In these cases, alternative treatment modality should be considered. CASE DESCRIPTION: A patient with destroyed dentition was rehabilitated with a lateral rotational path removable partial denture. According to the diagnosis, we determined to raise vertical dimension for esthetic and functional restoration. The final restoration was performed after four months of provisional period. CLINICAL IMPLICATION: The edentulous patients with compromised esthetics and functions can be successfully treated with a rotational path removable partial denture through adequate treatment planning and precise laboratory procedure.
Dentistry ; Dentition ; Denture, Partial, Removable ; Esthetics ; Humans ; Mouth ; Mouth Rehabilitation ; Tooth Attrition ; Vertical Dimension

STATEMENT OF PROBLEM: The application of a simple, clinically applicable noninvasive test to assess implant stability are considered highly desirable. So far there is still a controversy about correlation of various tests and implant stability. PURPOSE: In order to assess implant stability, the development of a new method is critical. It' s possible to assess implant stability by calculating energy and angular momentum during implant installation. The purpose of this study is to evaluate the correlation of energy and implant stability. MATERIAL AND METHODS: Twenty three implants were installed in two different types of pig bone. Type I bone was retrieved from the distal aspect of the rib, with more cortical bone. Type II bone came from a more proximal region with less cortical components and a higher content of bone marrow and spongeous trabeculae. Insertion torque, removal torque, ISQ values and angular momentum and energy were measured. Pearson Correlation test was done to analyze the relation between RFA, maximum insertion torque, mean insertion torque, bone type, energy and removal torque. RESULTS: Type I bone showed higher removal torque than type II bone. Energy value was significantly correlated with maximum insertion torque and mean insertion torque. RFA values were related with insertion torques but the significance was lower than Energy value. CONCLUSION: Within the limitation of this study energy values were considered clinically predictable method to measure the implant stability.
Bone Marrow ; Dental Implants ; Porphyrins ; Ribs ; Salicylates ; Torque

STATEMENT OF PROBLEM: A biochemical approach for surface modification has offered an alternative for physicochemical and morphological methods to obtain desirable bone-implant interfaces. PURPOSE: The purpose of the present study was to investigate cell responses to poly (D,L-lactide-co-glycolide) (PLGA)/1alpha, 25-(OH)2D3 coating with reference to cellular proliferation and differentiation in vitro. MATERIAL AND METHODS: 96 titanium discs were fabricated and divided into four groups. Group 1 was anodized under 300 V as control. Group 2, 3 and 4 were anodized then coated with 3 ml PLGA/1alpha, 25-(OH)2D3 solutions. Amount of the solutions were 2 ul, 20 ul and 200ul respectively. The osteoblast-like Human Osteogenic Sarcoma (HOS) cells were seeded and cultured for 1, 3 and 7 days. MTSbased cell proliferation assay and ALPase activity test were carried out. RESULTS: PLGA nanoparticles were observed as fine, smooth and round and HOS cells attached to the anodized surfaces through strand-like and sheet-like filopodia. After 3 days of culture, the dendritic filopodia were exaggerated and sheet-like cytoplasmic projections covered the coated titanium surfaces. After 3 days of culture, all of the groups showed increased cellular proliferation and the lowest proliferation rate was measured on group 2. Higher amount of incorporated 1 alpha, 25-(OH)2D3 (Group 3 and 4) improved cellular proliferation but the differences were not significant statistically (P > .05). But they increased the rate of ALP activities than the control group at day 3 (P < .05). CONCLUSION: Biodegradable PLGA nanoparticles incorporated with vitamin D metabolite positively affected proliferation and differentiation of cells on the anodized titanium surface.
Calcitriol ; Cell Proliferation ; Cytoplasm ; Humans ; Lactic Acid ; Nanoparticles ; Osteosarcoma ; Polyglycolic Acid ; Pseudopodia ; Seeds ; Titanium ; Vitamin D

STATEMENT OF PROBLEM: In the partially edentulous patients, removable partial dentures have been working as a important treatment modality. Clasps, a kind of direct retainers, received some amount of stresses during the insertion and removal of partial denture on the abutment tooth. PURPOSE: The study is to investigate stresses of the different clasps. MATERIAL AND METHODS: In order to investigate the degree of stresses, maxillary partial edentulism (Kennedy Class II, modification 1) was assumed and removable partial dentures were designed on it with three kinds of metallic materials; cobalt-chromium alloy, type IV gold alloy and commercially pure (c.p.) titanium. Aker's clasp was applied on the left second molar, RPA (mesial rest-proximal plate-Aker's) clasp was on the left first premolar and wrought wire clasp was on the right first premolar. Three dimensional, non-linear, dynamic finite element analysis method was run to solve this process. RESULTS: 1. Cobalt-chromium alloy had the highest von Mises stress value and c.p. titanium had the lowest one irrespective of the types of clasps. 2. In the Aker's clasps, stress on the retentive tips was shown shortly after the appearance of stresses of the middle and minor connector areas. These time lag was much shorter in the RPA clasps than in the Aker's clasp. 3. In general, retentive tips of wrought wire clasps had much less amount of stress than other clasps. CONCLUSION: The amount of stress was the highest in the RPA clasp and the lowest in the wrought wire clasp, in general.
Alloys ; Bicuspid ; Denture, Partial ; Denture, Partial, Removable* ; Finite Element Analysis ; Humans ; Molar ; Titanium ; Tooth

PURPOSE: This study investigated the influence of bone quality and surgical technique on the implant stability quotient (ISQ) value. In addition, the influence of interfacial bone quality, directly surrounding the implant fixture, on the resonance frequency of the structure was also evaluated by the finite element analysis. MATERIALS AND METHODS: Two different types of bone (type 1 and type 2) were extracted and trimmed from pig rib bone. In each type of bone, the same implants were installed in three different ways: (1) Compaction, (2) Self-tapping, and (3) Tapping. The ISQ value was measured and analyzed to evaluate the influence of bone quality and surgical technique on the implant primary stability. For finite element analysis, a three dimensional implant fixture-bone structure was designed and the fundamental resonance frequency of the structure was measured with three different density of interfacial bone surrounding the implant fixture. RESULTS: In each group, the ISQ values were higher in type 1 bone than those in type 2 bone. Among three different insertion methods, the Tapping group showed the lowest ISQ value in both type 1 and type 2 bones. In both bone types, the Compaction groups showed slightly higher mean ISQ values than the Self-tapping groups, but the differences were not statistically significant. Increased interfacial bone density raised the resonance frequency value in the finite element analysis. CONCLUSION: Both bone quality and surgical technique have influence on the implant primary stability, and resonance frequency has a positive relation with the density of implant fixture-surrounding bone.
Bone Density ; Finite Element Analysis ; Ribs

PURPOSE: The aim of this study was to investigate a comparison of implant bone bed preparation with Er,Cr:YSGG laser and conventional drills on the relationship between implant stability quotient (ISQ) values and implant insertion variables. MATERIALS AND METHODS: Forty implants were inserted into two different types of pig rib bone. One group was prepared with conventional drills and a total of 20 implants were inserted into type I and type II bone. The other group was prepared with a Er,Cr:YSGG laser and a total of 20 implants were inserted into type I and type II bone. ISQ, maximum insertion torque, angular momentum, and insertion torque energy values were measured. RESULTS: The mean values for variables were significantly higher in type I bone than in type II bone (P < .01). In type I bone, the ISQ values in the drill group were significantly higher than in the laser group (P < .05). In type II bone, the ISQ values in the laser group were significantly higher than in the drill group (P < .01). In both type I and type II bone, the maximum insertion torque, total energy, and total angular momentum values between the drill and laser groups did not differ significantly (P > or = .05). The ISQ values were correlated with maximum insertion torque (P < .01, r = .731), total energy (P < .01, r = .696), and angular momentum (P < .01, r = .696). CONCLUSION: Within the limitations of this study, the effects of bone bed preparation with Er,Cr:YSGG laser on the relationship between implant stability quotient (ISQ) values and implant insertion variables were comparable to those of drilling.
Mandrillus ; Ribs ; Salicylates ; Torque

PURPOSE: To date most of finite element analysis assumed the presence of 100% contact between bone and implant, which is inconsistent with clinical reality. In human retrieval study bone-implant contact (BIC) ratio ranged from 20 to 80%. The objective of this study was to explore the influence of bone-implant contact pattern on bone of the interface using nonlinear 3-dimensional finite element analysis. MATERIALS AND METHODS: A computer tomography-based finite element models with two types of implant (Mark III Branemark(R), Inplant(R)) which placed in the maxillary 2nd premolar area were constructed. Two different degrees of bone-implant contact ratio (40, 70%) each implant design were simulated. 5 finite element models were constructed each bone-implant contact ratio and implant design, and sum of models was 40. The position of bone-implant contact was determined according to random shuffle method. Elements of bone-implant contact in group W (wholly randomized osseointegration) was randomly selected in terms of total implant length including cortical and cancellous bone, while ones in group S (segmentally randomized osseointegration) was randomly selected each 0.75 mm vertically and horizontally. RESULTS: Maximum von Mises strain between group W and group S was not significantly different regardless of bone-implant contact ratio and implant design (P=.939). Peak von Mises strain of 40% BIC was significantly lower than one of 70% BIC (P=.007). There was no significant difference between Mark III Branemark(R) and Inplant(R) in 40% BIC, while average of peak von Mises strain for Inplant(R) was significantly lower (4886 +/- 1034 microm/m) compared with MK III Branemark(R) (7134 +/- 1232 microm/m) in BIC 70% (P<.0001). CONCLUSION: Assuming bone-implant contact in finite element method, whether the contact elements in bone were wholly randomly or segmentally randomly selected using random shuffle method, both methods could be effective to be no significant difference regardless of sample size.
Bicuspid ; Finite Element Analysis ; Humans ; Nitrogen Mustard Compounds ; Sample Size ; Sprains and Strains

PURPOSE: The purpose of present study is to examine the correlation between the accuracy of abutment preparation and the marginal adaptation of metal coping. With this view, this study compared the correlations regard to the three different manufacturing methods of selective laser sintering technique, milling and casting. MATERIALS AND METHODS: Two master models were made in a different way. First model with deep chamfer margin was prepared directly by a general clinician and the second model was designed by 3-D designing software program with the same abutment preparation principle and produced by computer aided manufacturing. 12 Co-Cr alloy copings were produced respectively with three different method; SLS system, CAD/CAM milling and conventional lost wax technique from each master model. The total 72 copings fully sit on the master model were stereoscopically evaluated at 40 points along the entire circumferential margin. RESULTS: Significant differences in the absolute marginal discrepancies of Co-Cr copings from SLS system (P=.0231) and casting method (P<.0001) were shown between hand preparation model and computer designed model. However, no significant difference was found between the two model groups from milling method (P=.9962). CONCLUSION: Within the limitation of this study, the effect of the accuracy of abutment preparation on the marginal adaptation of Co-Cr coping is statistically significant in SLS system and casting group. The copings produced by SLS system exhibited the lowest marginal discrepancies among all groups, and the marginal gap of this method group was influenced by the accuracy of the abutment preparation.
Alloys* ; Computer-Aided Design ; Dental Abutments ; Hand ; Tooth Preparation* ; Tooth*