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 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

Statement of problem. Primary implant stability has long been identified as a prerequisite to achieve osseointegration. So the application of a simple, clinically applicable noninvasive test to assess implant stability and osseiointegratation are considered highly desirable. Purpose. The purpose of this study was to evaluate the ISQ value and the insertion torque of the 3 different implant system, then to evaluate whether there was a correlation between ISQ value and insertion torque; and to determine whether implant design has an influence on either insertion torque or ISQ value. Material and method. The experiment was composed of 3 groups: depending on the implant fixture design. Group1 was Bra.nemark type parallel implant in 3.75*7mm. Group2 was Oneplant type straight implant in 4.3*8.5mm. Group3 was Oneplant type tapered implant in 4.3*8.5mm. Depending on the density of the bone, 2 types of bone were used in this experiment. Type I bone represented for cortical bone, type II bone represented for cancellous bone. With the insertion of the implant in type I and type II bone, the insertion torque was measured, then the ISQ value was evaluated, and then the correlation between insertion torque and ISQ value was analyzed Result and conclusion. Within the limitations of this study, the following conclusions were drawn. 1. Within the 3 different implants, the insertion torque value and ISQ value were higher in type I bone, when compared with type II bone.(p<0.05) 2. In type I and type II bone, Oneplant type tapered implant has the highest value in insertion torque.(p<0.05) 3. In type I and type II bone, there was no difference in ISQ values among the 3 types of implant. (p>0.05) 4. Significant linear correlation was found in Bra.nemark type parallel implant: 3.75*7mm in type II bone.
Osseointegration ; Torque*

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).
Dental Implants ; Denture, Complete ; Denture, Overlay ; Dentures ; Electric Impedance ; Humans ; Prostheses and Implants ; Splints ; Sprains and Strains

STATEMENT OF PROBLEM: Unreasonable distal cantilevered implant-supported prosthesis can mask functional problems of reconstruction temporarily, but it can cause serious strain and stress around its supported implant and surrounding alveolar bone. PURPOSE: The purpose of this study was to evaluate strain of implants supporting distal cantilevered fixed prosthesis with two different cantilevered length under distal cantilevered static load. MATERIAL AND METHODS: A partially edentulous mandibular test model was fabricated with auto-polymerizing resin (POLYUROCK; Metalor technologies, Stuttgart, Swiss) and artificial denture teeth (Endura; Shofu inc., Kyoto, Japan). Two implants-supported 5-unit screwretained cantilevered fixed prosthesis was made using standard methods with Type III gold alloy (Harmony C & B55; Ivoclar-vivadent, Liechtenstein, Germany) for superstructure and reinforced hard resin (Tescera; Ivoclar-vivadent, Liechtenstein, Germany) for occlusal material. Two strain gauges (KFG-1-120-C1-11L1M2R; KYOWA electronic instruments, Tokyo, Japan) were then attached to the mesial and the distal surface of each standard abutment with adhesive (M-bond 200; Tokuyama, Tokyo, Japan). Total four strain gauges were attached to test model and connected to dynamic signal conditioning strain amplifier (CTA1000; Curiotech inc., Paju, Korea). The stepped 20-100 N in 25 N increments, cantilevered static load 8mm apart (Group I) or 16mm apart (Group II), were applied using digital push-pull gauge (Push-Pull Scale & Digital Force Gauge, Axis inc., Seoul, Korea). Each step was performed ten times and every strain signal was monitored and recorded. RESULTS: In case of Group I, the strain values were surveyed by 80.7 ~ 353.8 micrometer/m in Ch1, 7.5 ~ 47.9 micrometer/m in Ch2, 45.7 ~ 278.6 micrometer/m in Ch3 and -212.2 ~ -718.7 micrometer/m in Ch4 depending on increasing cantilevered static load. On the other hand, the strain values of Group II were surveyed by 149.9 ~ 612.8 micrometer/m in Ch1, 26.0 ~ 168.5 micrometer/m in Ch2, 114.3 ~ 632.3 micrometer/m in Ch3, and -323.2 ~ -894.7 micrometer/m in Ch4. CONCLUSION: A comparative statistical analysis using paired sample t-test about Group I Vs Group II under distal cantilevered load shows that there are statistical significant differences for all 4 channels (P<0.05).
Adhesives ; Alloys ; Axis, Cervical Vertebra ; Dentures ; Hand ; Liechtenstein ; Masks ; Prostheses and Implants* ; Seoul ; Tooth

STATEMENT OF PROBLEM: Changes of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. It was proposed that bone-retention elements such as microthreads at the coronal part of implant might help maintain the marginal bone level. PURPOSE: This study was designed to evaluate the effect of microthread configuration within the marginal coronal portion of the implant fixture at the marginal bone changes after loading around two different external hex implants. MATERIAL AND METHODS: Twenty-four patients were included and randomly assigned to treatment with Branemark system implants (Group 1, rough-surfaced implants, n=20) and Oneplant system implants (Group 2, rough-surfaced neck with microthreads, n=20). Clinical and radiographic examinations were conducted at baseline (implant loading) and 1 year postloading. Data analysis was performed by the SAS statistical package version 9.1.3 (SAS Institute, Cary, NC, USA) and the final model was calculated by the MIXED procedure (three-level ANCOVA) for marginal bone change of each test group at baseline and 1 year follow-up. RESULTS: Comparing to baseline, significant differences were noted in marginal bone level changes for the 2 groups at 1 year follow-up (P<0.05). Group 1 had a mean crestal bone level changes of 0.83+/-0.31mm; Group 2 had a mean crestal bone level changes of 0.44+/-0.36mm. Rough-surfaced with microthreads implants showed significantly less marginal bone loss than rough surfaced neck without microthread implants. CONCLUSION: A rough surface with microthreads at the implant was beneficial design to maintain the marginal bone level against functional loading.
Bone Resorption ; Dental Implants ; Follow-Up Studies ; Humans ; Neck ; Phenothiazines ; Statistics as Topic

STATEMENT OF PROBLEM: Over the past two decades, implant supported fixed prosthesis have been widely used. However, there are few studies conducted systematically and intensively on the splinting effect of implant systems in mandible. PURPOSE: The purpose of this study was to investigate the changes in stress distributions in the mandibular implants with splinting or nonsplinting crowns by performing finite element analysis. MATERIALS AND METHODS: Cortical and cancellous bone were modeled as homogeneous, transversely isotropic, linearly elastic. Perfect bonding was assumed at all interfaces. Implant models were classified as follows. Group 1: Branemark length 8.5mm 13mm splinting type Group 2: Branemark length 8.5mm 13mm Nonsplinting type Group 3: ITI length 8.5mm 13mm splinting type Group 4: ITI length 8.5mm 13mm Non-splinting type An load of 100N was applied vertically and horizontally. Stress levels were calculated using von Mises stresses values. RESULTS: 1. The stress distribution and maximum von Mises stress of two-length implants (8.5mm, 13mm) was similar. 2. The stress of vertical load concentrated on mesial side of implant while the stress of horizontal load was distributed on both side of implant. 3. Stress of internal connection type was spreading through abutment screw but the stress of external connection type was concentrated on cortical bone level. 4. Degree of stress reduction was higher in the external connection type than in the internal connection type.
Crowns ; Finite Element Analysis ; Mandible ; Prostheses and Implants ; Splints

The purpose of this study was to investigate the cytotoxicity and mutagenicity of denture ase resins. According to manufacturer's instructions, resin specimens were made. Group 1: heat-polymerizing acrylic resin (Luciton 199(R)). Group 2: heat-polymerizing acrylic resin containing polyhedraloligosilsesquioxane(POSS esin). Group 3: auto-polymerizing acrylic resin (Repair Acrylic(R)). Group 4: direct relining auto-polymerizing acrylic resin (Tokuso Rebase(R)). Fresh specimens, 24 hrs. and 72 hrs. soaked specimens in distilled water were made. Responses with metabolic assay and mutagenesis assay to eluates from resin specimens were measured. Cultures with medium alone provided controls. Cytotoxicity was assessed with agar overlay test. The results were as follows: 1. Group 4 showed higher cytotoxicity than Group 1, Group 2 and Group 3 in fresh, 24-and 72-hour immersion cases (p<.05). Group 3 showed higher cytotoxicity than Group 2 in fresh cases and showed higher cytotoxicity than Group 1 and Group 2 in 24-and 72-hour immersion cases (p<.05). Group 1 and Group 2 showed no significant difference. 2. All acrylic denture base resins showed significant increase of cell activity as immersion time increased (p<.05). 3. Auto-polymerizing acrylic denture base resins showed higher cytotoxicity than heat-polymerizing acrylic denture base resins (p<.05). 4. All acrylic denture base resins showed lower mutagenicity than controls (p<.05).
Agar ; Denture Bases* ; Dentures* ; Immersion ; Mutagenesis ; Water

Shortened dental arch (SDA) as a treatment goal is the concept that stable occlusion and enough masticatory force can be achieved by restoration to the second premolars when the situation is not favorable. SDA could be applied both natural teeth and implant supported fixed prostheses. This case dealt with a patient who has grade 2 intellectual disability and a lot of missing teeth. Because of intellectual disability, patient cooperation during treatment could not be expected. Therefore every treatment should be done under general anesthesia. In addition to that, ridge resorption around molar area was severe and there were maxillary sinus pneumatization and maxillary sinusitis which increased failure probability. SDA concept was adopted to reduce risk factor and minimize general anesthesia. After the treatment, functional and esthetic improvement was achieved and oral hygiene was fortified by periodic recall check and education.
Anesthesia, General ; Bicuspid ; Bite Force ; Dental Arch ; Humans ; Intellectual Disability ; Maxillary Sinus ; Maxillary Sinusitis ; Molar ; Mouth ; Mouth Rehabilitation ; Oral Hygiene ; Patient Compliance ; Prostheses and Implants ; Risk Factors ; Tooth