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Guide flange prosthesis for early management of reconstructed hemimandibulectomy: a case report.

Pravinkumar Gajanan PATIL ; Smita Pravinkumar PATIL

The Journal of Advanced Prosthodontics.2011;3(3):172-176. doi:10.4047/jap.2011.3.3.172

Surgical resection of the mandible due to presence of benign or malignant tumor is the most common cause of the mandibular deviation. Depending upon the location and extent of the tumor in the mandible, various surgical treatment modalities like marginal, segmental, hemi, subtotal, or total mandibulectomy can be performed. The clinicians must wait for extensive period of time for completion of healing and acceptance of the osseous graft before considering the definitive prosthesis. During this initial healing period prosthodontic intervention is required for preventing the mandibular deviation. This case report describes early prosthodontic management of a patient who has undergone a reconstructed hemi-mandibulectomy with modified mandibular guide flange prosthesis. The prosthesis helps patient moving the mandible normally without deviation during functions like speech and mastication.
Ameloblastoma ; Dental Prosthesis Design ; Humans ; Mandible ; Mandibular Osteotomy ; Mandibular Prosthesis ; Mastication ; Maxillofacial Prosthesis ; Moving and Lifting Patients ; Prostheses and Implants ; Prosthodontics ; Transplants

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Evaluation of shear bond strengths of gingiva-colored composite resin to porcelain, metal and zirconia substrates.

Hong Seok AN ; Ji Man PARK ; Eun Jin PARK

The Journal of Advanced Prosthodontics.2011;3(3):166-171. doi:10.4047/jap.2011.3.3.166

PURPOSE: The purpose of this study is to evaluate and compare the shear bond strength of the gingiva-colored composite resin and the tooth-colored composite resin to porcelain, metal and zirconia. MATERIALS AND METHODS: Sixty cylindrical specimens were fabricated and divided into the following 6 groups (Group 1-W: tooth-colored composite bonded to porcelain, Group 1-P: gingiva-colored composite bonded to porcelain, Group 2-W: tooth-colored composite bonded to base metal, Group 2-P: gingiva-colored composite bonded to base metal, Group 3-W: toothcolored composite bonded to zirconia, Group 3-P: gingiva-colored composite bonded to zirconia). The shear bond strength was measured with a universal testing machine after thermocycling and the failure mode was noted. All data were analyzed using the two-way analysis of variance test and the Bonferroni post-hoc test at a significance level of 0.05. RESULTS: The mean shear bond strength values in MPa were 12.39, 13.42, 8.78, 7.98, 4.64 and 3.74 for Group 1-W, 1-P, 2-W, 2-P, 3-W and 3-P, respectively. The difference between the two kinds of composite resin was not significant. The shear bond strength of Group 1 was the highest and that of Group 3 was the lowest. The differences among Group 1, 2 and 3 were all significant (P<.05). CONCLUSION: The shear bond strength of the gingiva-colored composite was not less than that of the tooth-colored composite. Thus, repairing or fabricating ceramic restorations using the gingiva-colored composite resin can be regarded as a practical method. Especially, the prognosis would be fine when applied on porcelain surfaces.
Ceramics ; Collodion ; Dental Porcelain ; Prognosis ; Zirconium

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Randomized clinical trial on the efficacy of Escherichia coli-derived rhBMP-2 with beta-TCP/HA in extraction socket.

Jung Bo HUH ; Hyo Jung LEE ; Ji Woong JANG ; Myung Jin KIM ; Pil Young YUN ; Su Hong KIM ; Kyung Hee CHOI ; Young Kyun KIM ; Kyoo Sung CHO ; Sang Wan SHIN

The Journal of Advanced Prosthodontics.2011;3(3):161-165. doi:10.4047/jap.2011.3.3.161

PURPOSE: This randomized clinical trial was conducted to assess the safety and effectiveness of the ErhBMP-2 in alveolar bone regeneration as well as preservation of the beta-TCP bone graft material that contains ErhBMP-2. MATERIALS AND METHODS: This study involved 72 patients at the 3 study centers. The patients, who were divided into 2 groups: the experiment group who had ErhBMP-2 coated TCP/HA and the control group who had TCP/HA graft material alone transplanted immediately after tooth extraction. CT was taken before and 3 months after the transplantation and healing status was compared between the two groups. The efficacy endpoints that were used to measure the degree of bone induction included alveolar bone height and 3 measurements of bone width. The paired t test was used to determine the significance of the changes (P<.05). RESULTS: Changes in alveolar bone height were -1.087 +/- 1.413 mm in the control group and -.059 +/- 0.960 mm in the experimental group (P<.01). At 25% extraction socket length [ESL], the changes were 0.006 +/- 1.149 mm in the control group and 1.279 +/- 1.387 mm in the experimental group. At 50% ESL, the changes were 0.542 +/- 1.157 mm and 1.239 +/- 1.249 mm, respectively (P<.01 for 25% ESL, and P<.05 for 50% ESL). During the experiment, no adverse reactions to the graft material were observed. CONCLUSION: ErhBMP-2 coated beta-TCP/HA were found to be more effective in preserving alveolar bone than conventional beta-TCP/HA alloplastic bone graft materials.
Bone Regeneration ; Calcium Phosphates ; Escherichia ; Humans ; Tooth Extraction ; Transplants

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Effects of the immobilization of heparin and rhPDGF-BB to titanium surfaces for the enhancement of osteoblastic functions and anti-inflammation.

Jung Bo HUH ; Jeong Yol LEE ; Kyung Lae LEE ; Sung Eun KIM ; Mi Jung YUN ; Ji Suk SHIM ; June Sung SHIM ; Sang Wan SHIN

The Journal of Advanced Prosthodontics.2011;3(3):152-160. doi:10.4047/jap.2011.3.3.152

PURPOSE: This study was to investigate the effects of recombinant human platelet-derived growth factor (rhPDGF-BB) and heparin to titanium surfaces for enhancement of osteoblastic functions and inhibition of inflammation activity. MATERIALS AND METHODS: The anodized titanium discs, not coated with any material, were used as a control group. In heparinized- Ti group, dopamine was anchored to the surface of Ti substrates, and coated with heparin. In PDGF-Ti group, rhPDGF-BB was immobilized onto heparinized Ti surface. The surface morphologies were investigated by the scanning electron microscope in each group. The release kinetics of rhPDGF-BB were analyzed, and cytotoxicity tests for each group were conducted. The biocompatibilities were characterized by measuring cell proliferation, alkaline phosphatase activity, and calcium deposition using MG-63 cells. Statistical comparisons were carried out by one-way ANOVA tests. Differences were considered statistically significant at *P<.05 and **P<.001. RESULTS: The combination of rhPDGF-BB and heparin stimulated alkaline phosphatase activity and OCN mRNA expression in osteoblastic cells (*P<.05 and **P<.001). MG-63 cells grown on PDGF-Ti had significantly higher amounts of calcium deposition than those grown on anodized Ti (**P<.001). Heparinized Ti was more anti-inflammatory compared to anodized Ti, when exposed to lipopolysaccharide using the transcript levels of TNF-alpha and IL-6 of proinflammatory cytokine (*P<.05 and **P<.001). CONCLUSION: The result of this study demonstrated that the incorporation of rhPDGF-BB and heparin onto Ti surface enhanced osteoblastic functions and inhibited inflammation.
Alkaline Phosphatase ; Calcium ; Cell Proliferation ; Dopamine ; Electrons ; Heparin ; Humans ; Immobilization ; Inflammation ; Interleukin-6 ; Kinetics ; Osteoblasts ; Platelet-Derived Growth Factor ; Proto-Oncogene Proteins c-sis ; RNA, Messenger ; Titanium ; Tumor Necrosis Factor-alpha

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The effect of immobilization of heparin and bone morphogenic protein-2 to bovine bone substitute on osteoblast-like cell's function.

Jung Bo HUH ; Sung Eun KIM ; Se Kyung SONG ; Mi Jung YUN ; Ji Suk SHIM ; Jeong Yol LEE ; Sang Wan SHIN

The Journal of Advanced Prosthodontics.2011;3(3):145-151. doi:10.4047/jap.2011.3.3.145

PURPOSE: This study was performed to investigate the ability of recombinant human-bone morphogenic protein-2 immobilized on a heparin-grafted bone substrate to enhance the osteoblastic functions. MATERIALS AND METHODS: The Bio-Oss(R), not coated with any material, was used as a control group. In rhBMP-2-Bio-Oss(R) group, rhBMP-2 was coated with Bio-Oss(R) using only deep and dry methods (50 ng/mL, 24 h). In heparinized rhBMP-2-Bio-Oss(R) group, dopamine was anchored to the surface of Bio-Oss(R), and coated with heparin. rhBMP-2 was immobilized onto the heparinized- Bio-Oss(R) surface. The release kinetics of the rhBMP-2-Bio-Oss(R) and heparinized rhBMP-2-Bio-Oss(R) were analyzed using an enzyme-linked immunosorbent assay. The biological activities of the MG63 cells on the three groups were investigated via cytotoxicity assay, cell proliferation assay, alkaline phosphatase (ALP) measurement, and calcium deposition determination. Statistical comparisons were carried out by one-way ANOVA test. Differences were considered statistically significant at *P<.05 and **P<.001. RESULTS: The heparinized rhBMP-2-Bio-Oss(R) showed more sustained release compared to the rhBMP-2-Bio-Oss(R) over an extended time. In the measurement of the ALP activity, the heparinized group showed a significantly higher ALP activity when compared with the non-heparinized groups (P<.05). The MG63 cells cultivated in the group with rhBMP-2 showed increased calcium deposition, and the MG63 cells from the heparinized group increased more than those that were cultivated in the non-heparinized groups. CONCLUSION: Heparin increased the rhBMP-2 release amount and made sustained release possible, and heparinized Bio-Oss(R) with rhBMP-2 successfully improved the osteoblastic functions.
Alkaline Phosphatase ; Bone Substitutes ; Calcium ; Cell Proliferation ; Dopamine ; Enzyme-Linked Immunosorbent Assay ; Heparin ; Immobilization ; Kinetics ; Osteoblasts

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Finite element study on the effect of abutment length and material on implant bone interface against dynamic loading.

Manish MISHRA ; Shogo OZAWA ; Tatsuhiko MASUDA ; Fumi YOSHIOKA ; Yoshinobu TANAKA

The Journal of Advanced Prosthodontics.2011;3(3):140-144. doi:10.4047/jap.2011.3.3.140

PURPOSE: Finite element study on the effect of abutment length and material on implant bone interface against dynamic loading. MATERIALS AND METHODS: Two dimensional finite element models of cylinderical implant, abutments and bone made by titanium or polyoxymethylene were simulated with the aid of Marc/Mentat software. Each model represented bone, implant and titanium or polyoxymethylene abutment. Model 1: Implant with 3 mm titanium abutment, Model 2: Implant with 2 mm polyoxymethylene resilient material abutment, Model 3: Implant with 3 mm polyoxymethylene resilient material abutment and Model 4: Implant with 4 mm polyoxymethylene resilient material abutment. A vertical load of 11 N was applied with a frequency of 2 cycles/sec. The stress distribution pattern and displacement at the junction of cortical bone and implant was recorded. RESULTS: When Model 2, 3 and 4 are compared with Model 1, they showed narrowing of stress distribution pattern in the cortical bone as the height of the polyoxymethylene resilient material abutment increases. Model 2, 3 and 4 showed slightly less but similar displacement when compared to Model 1. CONCLUSION: Within the limitation of this study, we conclude that introduction of different height resilient material abutment with different heights i.e. 2 mm, 3 mm and 4 mm polyoxymethylene, does not bring about significant change in stress distribution pattern and displacement as compared to 3 mm Ti abutment. Clinically, with the application of resilient material abutment there is no significant change in stress distribution around implant-bone interface.
Dental Implants ; Displacement (Psychology) ; Finite Element Analysis ; Titanium

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Flexural properties of a light-cure and a self-cure denture base materials compared to conventional alternatives.

Emre MUMCU ; Altug CILINGIR ; Burc GENCEL ; Tonguc SULUN

The Journal of Advanced Prosthodontics.2011;3(3):136-139. doi:10.4047/jap.2011.3.3.136

PURPOSE: A new light curing urethane dimethacrylate and a cold curing resin with simpler and faster laboratory procedures may have even improved flexural properties. This study investigated the 3-point flexural strengths and flexural moduli of two alternate base materials. MATERIALS AND METHODS: A cold curing resin (Weropress) and a light curing urethane dimethacrylate base material (Eclipse). Along with Eclipse and Weropress, a high impact resin (Lucitone199) and three conventional base materials (QC 20, Meliodent and Paladent 20) were tested. A 3-point bending test was used to determine the flexural strengths and flexural moduli. The mean displacement, maximum load, flexural modulus and flexural strength values and standard deviations for each group were analyzed by means of one-way analysis of variance (ANOVA) (with mean difference significant at the 0.05 level). Post hoc analyses (Scheffe test) were carried out to determine the differences between the groups at a confidence level of 95%. RESULTS: Flexural strength, displacement and force maximum load values of Eclipse were significantly different from other base materials. Displacement values of QC 20 were significantly different from Lucitone 199 and Weropress. CONCLUSION: The flexural properties and simpler processing technique of Eclipse system presents an advantageous alternative to conventional base resins and Weropress offers another simple laboratory technique.
Acrylic Resins ; Cold Temperature ; Denture Bases ; Dentures ; Displacement (Psychology) ; Light ; Methacrylates ; Methylmethacrylates ; Polyurethanes ; Urethane

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Occlusal scheme in a group of Thais.

Nattaya ASAWAWORARIT ; Somsak MITRIRATTANAKUL

The Journal of Advanced Prosthodontics.2011;3(3):132-135. doi:10.4047/jap.2011.3.3.132

PURPOSE: To study the distribution of various occlusal schemes as well as associated static occlusal relationship among Thais. MATERIALS AND METHODS: The subjects' occlusal schemes on the left and right sides were classified as canine protected occlusion, group function, or unclassified according to the definition from Glossary of Prosthodontic Terms (8th edition). In addition, the presence of occlusal interferences during mandibular excursions were recorded. The measurement of the horizontal overlap and vertical overlap was also performed. Chi-square, One-way ANAVA and Mann-Whitney U statistical tests were used with level of significance set at P=.05. RESULTS: Total of 104 subjects were included in this study. The ratio for male to female was 1.8 to 1. Average age of the population was 25.01+/-6.87 years old. The mean vertical overlap and horizontal overlap were 1.94+/-1.20 and 2.41+/-1.32 mm respectively. The majority of the populations (68.3%) possessed group function occlusal scheme. For the remaining, 17.3% possess canine protected occlusion and 12.5% possess combination of both occlusal schemes. We also found that occlusal interference was presented in 20.2% of the population. The most common was protrusive interference (57.14%), the second was balancing interference (38.1%) and the third was working interference (4.1%). CONCLUSION: Among Thais, the most common occlusal scheme was group function, however there were no significant occlusal factors related to any particular occlusal scheme.
Asian Continental Ancestry Group ; Female ; Humans ; Male ; Prosthodontics

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Curing efficiency of various resin-based materials polymerized through different ceramic thicknesses and curing time.

Jung Won LEE ; Hyun Suk CHA ; Joo Hee LEE

The Journal of Advanced Prosthodontics.2011;3(3):126-131. doi:10.4047/jap.2011.3.3.126

PURPOSE: The aim of this in vitro study was to examine the curing efficiency of various resin-based materials polymerized through ceramic restorations with 3 different thicknesses. Curing efficiency was evaluated by determining the surface microhardness (VHN) of the resin specimens. MATERIALS AND METHODS: Four kinds of resin materials were used. Z350 (3M ESPE Filtek(TM) Z350: A2 Shade), Z250 (3M ESPE Filtek(TM) Z250: A2 Shade) and Variolink(R) II (VL: Ivoclar vivadent, base: transparent) either with or without a self-curing catalyst (VLC: Ivoclar vivadent, catalyst: low viscosity/transparent) were filled into the silicone mold (10 mm diameter, 1 mm thick). They were cured through ceramic discs (IPS e.max Press MO-0 ingot ivoclar vivadent, 10 mm diameter, 0.5, 1 and 2 mm thicknesses) by LED light-curing units for 20 and 40 seconds. Vicker's microhardness numbers (VHNs) were measured on the bottom surfaces by a microhardness tester. Data were analyzed using a 3- way analysis of variance (ANOVA) at a significance level of 0.05. RESULTS: The thickness of ceramic disc increased, the VHNs of all four resin types were decreased (P<.05). The mean VHN values of the resins light cured for 40 seconds were significantly higher than that of LED for 20 seconds in all four resin materials (P<.05). VLC showed significantly higher VHN values than VL regardless of other conditions (P<.05). Z350 and Z250 showed higher values than VL or VLC (P<.01). CONCLUSION: Thinner ceramic disc with increased curing time resulted higher VHN values of all resin materials. The use of a catalyst produced a greater hardness with all polymerization methods. Restorative resin materials (Z350, Z250) showed higher VHN values than resin cement materials (VL, VLC).
Acrylic Resins ; Ceramics ; Composite Resins ; Fungi ; Hardness ; Light ; Polymerization ; Polymers ; Polyurethanes ; Resin Cements ; Silicones ; Waxes

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Influence of cement thickness on resin-zirconia microtensile bond strength.

Tae Hoon LEE ; Jin Soo AHN ; June Sung SHIM ; Chong Hyun HAN ; Sun Jai KIM

The Journal of Advanced Prosthodontics.2011;3(3):119-125. doi:10.4047/jap.2011.3.3.119

PURPOSE: The aim of this study was to evaluate the influence of resin cement thickness on the microtensile bond strength between zirconium-oxide ceramic and resin cement. MATERIALS AND METHODS: Thirty-two freshly extracted molars were transversely sectioned at the deep dentin level and bonded to air-abraded zirconium oxide ceramic disks. The specimens were divided into 8 groups based on the experimental conditions (cement type: Rely X UniCem or Panavia F 2.0, cement thickness: 40 or 160 microm, storage: thermocycled or not). They were cut into microbeams and stored in 37degrees C distilled water for 24 h. Microbeams of non-thermocycled specimens were submitted to a microtensile test, whereas those of thermocycled groups were thermally cycled for 18,000 times immediately before the microtensile test. Three-way ANOVA and Sheffe's post hoc tests were used for statistical analysis (alpha=95%). RESULTS: All failures occurred at the resin-zirconia interface. Thermocycled groups showed lower microtensile bond strength than non-thermocycled groups (P<.001). Differences in cement thickness did not influence the resin-zirconia microtensile bond strength given the same resin cement or storage conditions (P>.05). The number of adhesive failures increased after thermocycling in all experimental conditions. No cohesive failure was observed in any experimental group. CONCLUSION: When resin cements of adhesive monomers are applied over air-abraded zirconia restorations, the degree of fit does not influence the resin-zirconia microtensile bond strength.
Adhesives ; Ceramics ; Dentin ; Molar ; Resin Cements ; Water ; Zirconium

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