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In recent years, a wide variety of materials have been used in dental implant treatment. In selecting the superstructures and abutments to be used it is important to consider their potential effect on the stability and durability of the planned implant. Excessive force applied to an implant during maintenance commonly results in complications, such as fracture of the superstructure or abutment, and loosening or fracture of the screws. This report describes a case of implant treatment for a 23-year-old man with esthetic disturbance due to trauma to the maxillary anterior teeth. The left maxillary central incisor could not be conserved due to this trauma, which had been caused by a traffic accident. After extraction, the tooth was restored with an anterior bridge. The crown of the left maxillary lateral incisor was fractured at the crown margin and, at the patient's request, implant treatment was selected as the restorative treatment for the missing tooth. A thorough preoperative examination was performed using placement simulation software. One titanium screw-type implant was placed in the maxillary left central incisor under local anesthesia. An all-ceramic crown with a zirconia frame was placed as a screw-fixed direct superstructure. At one year postoperatively, however, the superstructure and abutment became detached due to trauma. The fractured zirconia abutment was removed and replaced with a remanufactured abutment and superstructure. The patient has reported no subsequent dental complaint over the last 11 years. In this case, a surface analysis of the fractured zirconia abutment was performed. The scanned images revealed a difference in the fracture surfaces between the tensile and compressive sides, and electron probe microanalysis demonstrated the presence of titanium on the fracture surface. It was inferred that the hard zirconia abutment had scraped the titanium from the internal surface of the implant.

The purpose of this study was to evaluate whether change in cuspal inclination influences the fracture load values of composite resin computer-aided design/computer-aided manufacturing (CAD/CAM) crowns. Abutment teeth and CAD/CAM crowns were prepared as they would be for treating a mandibular first premolar with two cusps. The CAD/CAM crowns were designed so that 1) the principal stress lines would be radially distributed from the two points of contact with the indenter to the occlusal area of the abutment (Type I), or 2) the principal stress lines would pass outside the occlusal area of the abutment (Types II and III). The CAD/CAM crowns were mounted on the abutments using one of two types of resin or polycarboxylate cement. Fracture load values were measured using a universal tester. The Type I CAD/CAM crowns exhibited the highest mean fracture load value, followed by the Type II crowns and then the Type III crowns, with significant differences seen between all types (p<0.05). The luting agent used (resin or polycarboxylate cement) showed no effect on the fracture load value. With the Type II and Type III crowns, significant differences in the fracture load value were observed between the Super-Bond and Hy-Bond polycarboxylate cement groups (p<0.05).

Occlusal reconstruction comprising orthodontic treatment, autotransplantation, and implant treatment was performed in a 30-year-old woman with missing maxillary anterior teeth. An initial examination revealed marked root resorption of the maxillary anterior teeth. Both the maxillary canines were missing, causing constriction of the dental arch. Conserving the right maxillary central and lateral incisors, which were dislocated due to trauma, was considered to be too difficult, and a bridge was not selected as there was insufficient load bearing capacity in the adjacent abutment teeth, making the prognosis uncertain. Partial dentures were rejected due to the patient's age and esthetic demands. First, the right mandibular lateral incisor was extracted to relieve crowding in the mandibular anterior teeth, leaving the patient with 3 mandibular incisors. Orthodontic treatment was then performed to harmonize the occlusal relationship between the mandibular and maxillary anterior teeth. Next, the right mandibular lateral incisor was transplanted to the extraction site of the right maxillary lateral incisor. After fixation of the autotransplanted tooth, the shape of the bone around the implant site improved. The final prosthesis for the right maxillary central incisor was provided via implant treatment. As seen in a follow-up 16 years later, the interproximal dental papilla was intact, and the patient's esthetic demands were fulfilled. Utilizing the functions of the periodontal ligament of the natural teeth was a useful part of orthodontic treatment and autotransplantation.

Mechanical overloading of the temporomandibular joint (TMJ) promotes both the initiation and progression of TMJ osteoarthritis (OA). New preclinical animal models are needed for the evaluation of the molecular basis of cellular load transmission. This would allow a better understanding of the underlying mechanisms of TMJ-OA pain and disability, and help identify new therapeutics for its early diagnosis and management. The purpose of this study was to evaluate the role of mechanical loading in the progression of TMJ-OA in surgical instability arising from unilateral partial discectomy (UPD) in a murine model. In the theoretical modelling employed, lower joint reaction forces were observed on the chewing (working) side of the TMJ in the murine craniomandibular musculoskeletal system. Hypofunction was induced secondary to UPD through surgically manipulating the working side using an unopposed molar model. When the working side was restricted to the same side as that on which UPD was performed, late-stage degeneration of the cartilage showed a significant reduction (p<0.05), with diminished fibrillation and erosion of the articular cartilage, cell clustering, and hypocellularity. Condylar remodelling and proteolysis of proteoglycans were less affected. Thus, select and specific late-stage changes in TMJ-OA were contextually linked with the local mechanical environment of the joint. These data underscore the value of the UPD mouse model in studying mechanobiological pathways activated during TMJ-OA, and suggest that therapeutically targeting mechanobiological stimuli is an effective strategy in improving long-term biological, clinical, and patient-based outcomes.

Many types of interdental instrument, such as dental floss and interdental brushes, can be purchased easily and sell in large numbers. Many studies have compared the effects of such instruments. Few studies have investigated their relationship with regions of residual plaque, however. The purpose of this study was to compare rates of plaque removal from the mesial and distal surfaces of the bilateral maxillary and mandibular premolars and molars among 3 types of interdental instrument: finger-winding-dental floss, holder-type dental floss, and an interdental brush. Prior to the experiment, the artificial teeth in a jaw model were removed for application of artificial plaque. The teeth were then replaced and the model attached to a phantom. An operator brushed the teeth in a posture close to that adopted in actual tooth brushing with each type of instrument, after which the plaque removal rate was compared among them. The rate of plaque removal using finger-winding floss was the highest, although this type of instrument is less easy to hold than the others. The rate with a handle-equipped interdental instrument showed a decrease in some regions, although it is easy to hold. The results of this study suggest that the type of interdental instrument used should differ depending on the region to be cleaned.

The goal of the present study was to clarify the status of training in clinical dentistry at training facilities belonging to Tokyo Dental College by investigating trainee quota fill rates and analyzing the relationship between selection of training program and subsequent career pathway. The trainees were divided into 4 groups based on career pathway after training: those entering graduate school; those becoming residents; those remaining at the college or hospital to take specialized clinical courses or for other purposes; and those starting work outside the college. The trainee quota fill rate was highest at the Suidobashi Hospital, followed by the Ichikawa General and Chiba Hospitals. A total of 8 training programs have been implemented at these facilities (Chiba: A, B, C, and D; Suidobashi, A, B, and C; and Ichikawa, A). A comparison among training programs revealed that the fill rate exceeded 60% in all cases, except for Chiba D, where it was markedly lower, at 25%. Career pathway after training significantly varied between training facilities. Among trainees selecting the Chiba Hospital, the highest proportion was occupied by those starting work outside the college. The proportion of those entering graduate school was also high in this group. Similarly, among trainees selecting the Suidobashi Hospital, the highest proportion was occupied by those starting work outside the college. The proportion of those entering graduate school was low in this group, however. Among trainees selecting the Ichikawa General Hospital, the proportions of those entering graduate school and those becoming residents were particularly high, while the proportion of those starting work outside the college was low. A comparison of career pathways revealed a significant difference only between Chiba Programs B and C. In conclusion, training facility showed a markedly stronger influence on career pathway than training program.

The purpose of the present study was to investigate the validity of incorporating a para-periodontal ligament in the test mold used in a basic fracture test of a zirconia all-ceramic fixed partial denture (FPD). A simplified three-dimensional finite element analysis model was designed based on the three-unit FPD fracture test. Two types of model, one with and one without a para-periodontal ligament between the abutment and base mold, were fabricated. Microfocus CT of the missing first molar area in a dry human mandible was performed. A three-dimensional model was then fabricated based on the data obtained. A load of 600 N was applied to the center of the pontic and stress distribution observed. The model with the para-periodontal ligament showed stress dispersion to the dental root with rotation of the abutment mold. Stress distribution in the finite element analysis model with a para-periodontal ligament showed greater similarity with that in the mandibular model than with that in the other two models without a para-periodontal ligament.

The purpose of the present study was to determine the relationship between cross-sectional design and fracture load using a static load bearing test in yttria-stabilized tetragonal zirconia polycrystal ceramic frameworks on a molar fixed partial denture. The test framework was designed as a 3-unit bridge with two abutment teeth at the second premolar and second molar of the mandible. The cross-sectional area of the connector was 9.0, 7.0, or 5.0mm(2). In terms of shape, the cross-section was either circular or oval, with a height/width ratio of 1:1, 3:4, or 2:3. For each of the 9 combinations of cross-sectional area and shape, 5 frameworks were prepared (45 in total). Frameworks were cemented to a metallic test model with adhesive resin cement. After fracture load was measured, the percentage of fracture sites was determined and the fracture surfaces observed. In terms of cross-sectional area, there was a statistically significant difference in fracture load between 9.0, 7.0, and 5.0mm(2). No significant difference in fracture load was observed between any two shapes of connector (p>0.05). The fracture load of all frameworks with a cross-sectional area of 9.0 or 7.0mm(2) was over 880 N, which was recognized as parafunctional occlusal force. Fracture occurred at the distal connector in 82.2% of all frameworks on average. Fracture load decreased as cross-sectional area of the connector became smaller. The cross-sectional shape used in the present study was less influential on fracture load. It appears to be clinical possible to apply a connector with a cross-sectional area of 7.0mm(2). Fracture often occurred at the distal connector between the pontic and the abutment, corresponding to the second molar.

The purpose of this study was to investigate the influence of anteroposterior postural change on electromyography (EMG) activity in the lateral pterygoid muscle. Subjects consisted of 7 patients attending this hospital for close examination. The inferior heads of the lateral pterygoid and masseter muscles were chosen as evaluation sites. For the EMG recordings, the test movement was opening and closing of the mouth; postural conditions were the upright and supine positions. The mean value of EMG activity in the inferior head of the lateral pterygoid muscle was calculated. During mouth-opening in 5 out of the 7 patients, and during mouth-closing in 2 out of the 7 patients, mean value of EMG activity differed significantly with body position. Mean value of EMG activity was reduced in the supine position. The results revealed that anteroposterior postural change affected mean value of EMG activity in this muscle.