STATEMENT OF PROBLEM: While patient-centered outcomes are usually not reported, these may represent major aspects of the implant success for the patient. Use of a well-designed patient survey form can be an invaluable asset to the implant practitioners. PURPOSE: The objective of this study was to investigate patient satisfaction after implant therapy by means of a questionnaire. MATERIAL AND METHODS: South Korean patients (n = 100), who visited the dental examination center of Soon Chun Hyang university hospital, were asked to fill out the satisfaction questionnaire regarding aspects of cost, comfort, esthetics, chewing, gingival health, food impaction, phonetic aspect, screw loosening, and general satisfaction. Responses to statements were given on the Likert response scale. Four experimental groups of patients were distinguished with various location (A1, A2, A3), year (B1, B2, B3), number of implant replacements (C1, C2, C3), and treatment cost (D1, D2, D3). The reliability of the response scales was measured by calculation of its internal consistency, expressed as Cronbach's alpha. The scales were distinguished by means of factor analysis method. Possible differences in scale scores among the groups were assessed by One-way ANOVA (alpha = 0.05). RESULTS: Patients responded to most of the statements with high satisfaction. But the mean scale score of statement about cost was low. After the verification of internal consistency and factor analysis, five components, e.g. general satisfaction, comfort, chewing efficiency, esthetics, and phonetic aspect were grouped together. These components could be explained with common meaning and the first factor was named as 'general satisfaction' . Differences in patient satisfaction on the scale with esthetics were present between patients who have been wearing the implant prosthesis less than three years and those more than seven years (B1 < B3). CONCLUSION: The patients were generally satisfied with the outcome of implant treatment. But the patients' major complaint was high cost and while the statistically significant difference was not shown, the satisfaction scale about food impaction and esthetics was low. So the continuing efforts to make improvements about these problems are needed for the implant practitioners.
Dental Implants ; Esthetics ; Factor Analysis, Statistical ; Health Care Costs ; Humans ; Mastication ; Patient Satisfaction ; Prostheses and Implants ; Surveys and Questionnaires ; Weights and Measures

PURPOSE: The purpose of this study was to investigate the accuracy of the interocclusal relationship between upper and lower teeth according to the buccal interocclusal record scan using various intraoral scanner systems. MATERIALS AND METHODS: The upper and lower full arch Models with normal occlusion were scanned with 5 intraoral scanners (Cerec Omnicam, CS3500, iTero, Trios, True Definition). Buccal interocclusal record scan was taken only at the left side while occlusion was intentionally raised by 1 mm, 2 mm, 3 mm, and 4 mm with metal cylinder core embedded within polyvinylsiloxane bite registration material at the right molar region. The superimposition analysis was done to evaluate overall three-dimensional deviation and cross-section analysis was done to evaluate the degree and the direction of deviation of interocclusal relationship. RESULTS: From the superimposition study, Cerec Omnicam showed the least deviation (165.5 µm) and CS3500 (369.0 µm) showed the largest (P < 0.01). And the deviation was greater in 3, 4, 2 mm group than 1 mm (P < 0.01). From the cross-section study, Cerec Omnicam showed the farthest deviation (−242.8 µm) and CS3500 showed the closest deviation (312.5 µm) and a significantly high value was shown in 3 mm group. CONCLUSION: Every intraoral scanner has different accuracy in reproducing interocclusal relationship.
Intention ; Jaw Relation Record ; Molar ; Tooth

Nowadays, digital dentistry is generally applied to prosthodontics with fabrication of inlays or any other fixed prostheses by utilizing CAD/CAM (computer-aided design/computer-aided manufacturing) technology and intraoral scanner. However, in fabricating removable prosthesis, there are some limitations for digital technology to substitute conventional casting method. Therefore, approaching removable prostheses fabrication with CAD/CAM technology would be a meaningful trial. In this case report, Kennedy class III mandibular edentulous patient who was in need of increasing the vertical dimension of occlusion was treated with removable partial denture using CAD and rapid prototyping technique. Surveying and designing the metal framework of the partial denture was performed with CAD, and sacrificial plastic pattern was fabricated with rapid prototyping technique. During the follow up period of nine months, the removable partial denture has provided satisfactory results in esthetics and function.
Computer-Aided Design* ; Dentistry ; Denture, Partial ; Denture, Partial, Removable ; Esthetics ; Follow-Up Studies ; Humans ; Inlays ; Methods ; Plastics ; Prostheses and Implants ; Prosthodontics ; Vertical Dimension

PURPOSE: The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. MATERIALS AND METHODS: A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of alpha=.05. RESULTS: The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 microm/m at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. CONCLUSION: Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit.
Eye ; Polyurethanes ; Prostheses and Implants ; Sprains and Strains

PURPOSE: The aim of this study was to evaluate the interface accuracy of computer-assisted designed and manufactured (CAD/CAM) titanium abutments and implant fixture compared to gold-cast UCLA abutments. MATERIALS AND METHODS: An external connection implant system (Mark III, n=10) and an internal connection implant system (Replace Select, n=10) were used, 5 of each group were connected to milled titanium abutment and the rest were connected to the gold-cast UCLA abutments. The implant fixture and abutment were tightened to torque of 35 Ncm using a digital torque gauge, and initial detorque values were measured 10 minutes after tightening. To mimic the mastication, a cyclic loading was applied at 14 Hz for one million cycles, with the stress amplitude range being within 0 N to 100 N. After the cyclic loading, detorque values were measured again. The fixture-abutment gaps were measured under a microscope and recorded with an accuracy of +/-0.1 microm at 50 points. RESULTS: Initial detorque values of milled abutment were significantly higher than those of cast abutment (P<.05). Detorque values after one million dynamic cyclic loadings were not significantly different (P>.05). After cyclic loading, detorque values of cast abutment increased, but those of milled abutment decreased (P<.05). There was no significant difference of gap dimension between the milled abutment group and the cast abutment group after cyclic loading. CONCLUSION: In conclusion, CAD/CAM milled titanium abutment can be fabricated with sufficient accuracy to permit screw joint stability between abutment and fixture comparable to that of the traditional gold cast UCLA abutment.
Computer-Aided Design ; Joints ; Mastication ; Titanium* ; Torque

Surgical management of oral cancer results in compromised masticatory and swallowing function which affects patient in social and psychological aspects due to reduced phonetic ability and facial deformity, thus, it is imperative to provide applicable prosthetic treatment to overcome such complications. This clinical study describes rehabilitation of a patient with squamous cell carcinoma treated with marginal mandibulectomy and implantation on preserved posterior portion of mandible to provide stability and support for subsequent denture treatment. Kennedy class IV removable partial denture has provided satisfactory results in esthetics and function. Bone level stability around implants was reported to be maintained during eight months of clinical observation.
Carcinoma, Squamous Cell ; Congenital Abnormalities ; Deglutition ; Denture, Partial, Removable* ; Dentures ; Esthetics ; Humans ; Mandible ; Mouth Neoplasms ; Rehabilitation*

Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient’s adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.

Background: Interscalene brachial plexus block (ISBPB) is commonly used with general anesthesia for postoperative pain management in shoulder surgery. This study investigated the incidence of hypothermia and changes in the body temperature in patients undergoing arthroscopic shoulder surgery under ISBPB with propofol sedation. Methods: This retrospective study enrolled 220 patients who underwent arthroscopic shoulder surgery. Patients were divided into general anesthesia (n = 34) and ISBPB with propofol sedation (n = 186) groups, and medical records were retrospectively compared. In addition, patients from the ISBPB group were further divided according to age (elderly, [≥ 65 years]; n = 98 vs. young, [< 65 years]; n = 88), and the incidence of hypothermia and changes in the body temperature were compared. Results: Twenty-seven patients (12.3%) experienced perioperative hypothermia (range; 35.3–35.9℃). The incidence of perioperative hypothermia was 29.4% and 9.1% in the general anesthesia and ISBPB groups, respectively, and there was a significant difference between the two groups (P = 0.002). The incidence of perioperative hypothermia according to age in the ISBPB group was 9.2% and 9.1% in the elderly and young groups, respectively, and there was no significant difference between the two groups (P = 0.983). Conclusions The incidence of perioperative hypothermia during arthroscopic shoulder surgery under ISBPB with propofol sedation is lower than that under general anesthesia. Furthermore, when using ISBPB with propofol sedation, the incidence of perioperative hypothermia in elderly patients is similar to that in younger patients.

Purpose: The purpose of this study was to examine the correlation between the finish line designs and the marginal adaptation of nonprecious metal alloy coping produced by different digital manufacturing methods. Materials and methods: Nonprecious metal alloy copings were made respectively from each master model with three different methods; SLS, milling and casting by computer aided design and computer aided manufacturing (CAD-CAM). Twelve copings were made by each method resulting in 72 copings in total. The measurement was conducted at 40 determined reference points along the circumferential margin with the confocal laser scanning microscope at magnification ×150. Results Mean values of marginal gap of laser sintered copings were 11.8 ± 7.4 μm for deep chamfer margin and 6.3 ± 3.5 μm for rounded shoulder margin and the difference between them was statistically significant (P < .0001). Mean values of marginal gap of casted copings were 18.8 ± 20.2 μm for deep chamfer margin and 33 ± 20.5 μm for rounded shoulder margin and the difference between them was significant (P = .0004). Conclusion: Within the limitation of this study, the following conclusions were drawn. 1. The variation of finish line design influences the marginal adaptation of laser sintered metal coping and casted metal coping. 2. Laser sintered copings with rounded shoulder margin had better marginal fit than deep chamfer margin. 3. Casted copings with deep chamfer margin had better marginal fit than rounded shoulder margin. 4. According to the manufacturing method, SLS system showed the best marginal fit among three different methods. Casting and milling method followed that in order.

This study aimed to compare the surface characteristics and the shear bond strength of veneering porcelain of 3D printed 4Y-TZP with milled 4Y-TZP. Thirty disks with 10 mm diameter and 1.2 mm thickness were fabricated. Fifteen were fabricated by 3D printing (Experimental group), and another 15 by milling (Control group). In each group, five were assigned to surface analysis. Surface roughness was measured using a confocal laser microscope. Surface energy was calculated by measuring the contact angles of water and diiodo-methane with a drop-shape analyzer. Another ten specimens were used to evaluate the shear bonding strength of veneering porcelain on the surface of 4Y-TZP. The surface of 3D-printed 4Y-TZP was very smooth, and the surface roughness (Ra, Rq) was significantly lower than that of milled 4Y-TZP (p<0.001). 3D-printed 4Y-TZP showed low wettability compared with milled 4Y-TZP, i.e., the water contact angle was significantly high (p=0.008), and the surface free energy was low (p=0.008). The shear bond strength to veneered porcelain of 3D printed 4Y-TZP was significantly lower than that of milled 4Y-TZP (p<0.001). The surface characteristics of 4Y-TZP were quite different by the manufacturing process. The smooth surface and low wettability of 3D-printed 4Y-TZP could affect its low shear bonding strength to veneering porcelain.