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Mandibular condyle fracture malunion and tooth loss can cause functional and esthetic problems. A patient with restricted mouth opening associated with muscle atrophy required prosthetic rehabilitation. Since the remaining teeth had a poor prognosis and the patient had difficulty adapting to the interim denture, complete mouth rehabilitation with implants was chosen. The implants were placed by using nerve lateralization and an autogenous bone graft. Prosthetic rehabilitation combines digital diagnosis and conventional prosthetic restorations. The definitive prosthesis was fabricated to ensure adequate oral hygiene and functional adaptation of the orofacial structures. Treatment resulted in stable masticatory function, occlusion, and esthetics and restored the function of the atrophied lips and restricted mouth opening., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the fracture load of monolithic zirconia crowns with implant screw holes, focusing on variations in occlusal and axial thicknesses, and to assess the interaction between these variables., Materials and Methods: Six different prostheses were designed using CAD software, varying in occlusal thickness (0.5 mm, 1.0 mm) and axial thickness (0.4 mm, 0.8 mm, 1.2 mm) based on the height and thickness differences of the titanium implant abutment. Twelve specimens per design were created by milling zirconia blocks and titanium abutments. These specimens were cemented with resin and subjected to thermomechanical aging (50 N, 200,000 cycles, 5°C-55°C, 30 seconds dwell time) using a chewing simulator. Static loading was applied using a universal testing machine at a rate of 0.5 mm/min until fracture occurred, and the load value (N) at the moment of the initial fracture was recorded. Fracture pattern and surface analyses were performed. Statistical analyses included two-way analysis of variance, Tukey HSD test, multiple regression analysis, and Fisher's exact test., Results: Both occlusal and axial thicknesses significantly influenced the fracture load (P < .05), with a significant interaction between them (P < .05). An occlusal thickness of 1.0 mm exhibited a significantly higher fracture load compared to 0.5 mm (P < .05). An axial thickness of 1.2 mm showed a significantly higher fracture load compared to 0.4 mm and 0.8 mm (P < .05). The difference in axial thickness between 0.8 mm and 1.2 mm had a more substantial impact on fracture load than the difference in occlusal thickness between 0.5 mm and 1.0 mm (P < .05). Fractographic analysis showed that the thin axial wall exhibited twist hackles without involvement of the crown margin, whereas the thick axial wall exhibited no hackles and a more catastrophic failure involving the crown margin., Conclusion: For monolithic zirconia crowns with implant screw holes, when sufficient occlusal thickness cannot be achieved, an axial thickness of at least 1.2 mm is recommended to ensure higher fracture resistance.

Purpose: To determine whether food texture affects chewing side preference (CSP) and to investigate the relationship between CSP and masticatory factors, such as occlusal contact area, bite force, and masticatory performance., Materials and Methods: Forty-seven adults (20 women and 27 men; mean age: 24 years) participated in this study. Three types of food (chewing gum, beef jerky, and peanuts) were provided to assess CSP. Occlusal contact area was measured at various ranges of interocclusal distance, and the bite force was measured. Masticatory performance was assessed according to the median particle size. Asymmetry indices of each measurement were calculated and analyzed using Pearson correlation coefficient (α &#61; .05)., Results: The CSP for beef jerky and peanuts were significantly correlated with each other, whereas the CSP for chewing gum was not correlated with other food. The proportion of participants who chewed equally on both sides was higher for chewing gum than for beef jerky. There was a significant correlation between the CSP for beef jerky and occlusal contact area, especially at interocclusal distance ranges of 0 to 89 μm and 0 to 109 μm (r &#61; 0.41). Bite force and masticatory performance were not significantly correlated with CSP., Conclusions: Food texture seemed to affect CSP, and masticatory laterality was greater for tough foods. Moreover, CSP for tough food was closely related to the occlusal contact area at an interocclusal distance level of about 0.1 mm.

Purpose: Bilayered restorations have both the strength of the substructure material and the esthetics of the veneer material; however, they should have appropriate bonding between the two materials. This study aimed to evaluate the shear bond strength (SBS) according to the substructure material and veneering technique used in bilayered restorations., Materials and Methods: The experimental group was divided into four groups (n = 15 per group) based on the substructure materials (cobalt-chromium [Co-Cr] alloy and 3 mol% yttrium-stabilized tetragonal zirconia polycrystal [3Y-TZP]) and veneering techniques (pressing and layering). Veneering was performed with disk shape (diameter: 5 mm, height: 2 mm) on a substructure using each veneering technique. Shear stress was applied to the interface of the substructure and the veneering ceramic using a universal testing machine. The shear bond strength, according to the substructure and veneering technique, was analyzed using a two-way analysis of variance with a post-hoc Tukey's honestly significant difference test. The failure mode was observed, and the surface was analyzed using a scanning electron microscope and energy-dispersive spectroscopy., Results: The shSBS of the Co-Cr alloy and 3Y-TZP substructure was not different (p > 0.05); however, the pressing technique showed a higher SBS than the layering technique (p < 0.05). The SBS did not differ depending on the veneering technique in the Co-Cr alloys (p > 0.05), whereas the SBS in the pressing technique was higher than that in the layering technique for 3Y-TZP (p < 0.05). In the layering technique, the Co-Cr alloy showed a higher SBS than 3Y-TZP (p < 0.05). In the failure mode, mixed failure occurred most frequently in all groups. Extensive elemental interdiffusion was observed through the opaque layer in the Co-Cr alloy, regardless of the veneering technique. In 3Y-TZP, a wider range of elemental interdiffusion was observed in the pressing technique than in the layering technique., Conclusions: In bilayered restorations with a 3Y-TZP substructure, the pressing technique yielded higher bonding strength than layering. Using the layering technique, 3Y-TZP showed a lower SBS than the Co-Cr alloy. In bilayered restorations using 3Y-TZP as a substructure, the veneering technique and thermal compatibility of the materials must be considered., (© 2024 The Author(s). Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.)

Objective: This in vitro study aimed to evaluate the flexural strength (FS) and translucency parameter (TP) of resin nanoceramics (RNCs) with barium silicate for additive manufacturing., Materials and Methods: An RNC slurry was prepared by mixing a barium silicate filler and resin monomer. For the FS tests, specimens with three filler contents (0, 50, and 63 wt%) were designed according to ISO6872 for dental ceramics and ISO10477 for dental polymers. These specimens were then formed into discs with thicknesses of 1 and 2 mm for TP measurement., Results: In the specimens prepared according to ISO6872, the FS increased significantly depending on the filler content. However, in the case of ISO10477, there was no significant difference between the FSs of the specimens with 0 and 50 wt% filler contents. The increase in thickness affected translucency, and the lowest translucency was obtained at a filler content of 63 wt%. The filler distribution was dense in the specimen with 63 wt% filler and uniform but relatively sparse in the specimen with 50 wt% filler. More voids were observed in the specimen with 63 wt% filler. The thickness and filler content of the specimen affected its TP. The TP of the specimen with 63 wt% filler was similar to that of human enamel., Conclusion: The FS was significantly higher at a filler content of 63 wt%. The lowest translucency was obtained at a filler content of 63 wt% for all tested thicknesses., Clinical Significance: Increasing the filler content was advantageous for the mechanical properties of the RNCs. A high filler content led to low translucency in the RNCs. Therefore, the esthetics of human teeth can be reproduced if layering according to the filler content is performed in areas where esthetic characteristics are required., (© 2023 Wiley Periodicals LLC.)

Purpose: The purpose of this in vitro study was to compare the tensile bond strength (TBS) of resin nanoceramics (RNC), zirconia, and lithium disilicate (LS2) restorations cemented to titanium abutments before and after thermomechanical aging., Materials and Methods: Twelve specimens per group were fabricated to determine the TBS between a titanium abutment and four types of crown materials (2 RNCs, LS2, and translucent zirconia crowns for the maxillary molar). After milling, the abutments and crowns were cemented with resin cement after air-particle abrasion. In addition, thermomechanical aging (200,000 cycles, 50 N, 2 Hz) was applied to half of the specimens by using a mastication simulator. TBS was measured by using a universal testing machine. The interface between the crown and the cement was observed by using scanning electron microscopy (SEM). Two-way ANOVA was performed to analyze the effects of crown materials and thermomechanical aging. Failure-mode and interface analyses were also conducted., Results: After thermomechanical aging, the TBS decreased in the LS2 specimens and increased in RNCs (p < 0.001). The ratio of mixed failure and debonding with the hole-sealing resin increased in the RNC group. SEM images showed the reduced gap between the crown and the resin cement after thermomechanical aging in the RNC group., Conclusions: Differences in TBS were affected by the crown materials after thermomechanical aging. After thermomechanical aging, the RNC crowns showed increased TBS, whereas LS2 and zirconia crowns exhibited decreased or similar TBS., (© 2023 by the American College of Prosthodontists.)

Purpose: The mechanical and physical properties of implant screw access opening deteriorate if composite resin is not polymerized properly. Therefore, this study aimed to analyze the effect of using composite resin in implant access opening on the degree of conversion (DC)., Materials and Methods: Two prosthetic materials (Co-Cr and zirconia), two types of composite resin (low and high viscosity), two light-cured resin depths (2 and 3 mm), and two polymerization methods (max-mode 10 s and mid-mode 20 s: 16 and 22 J/cm 2 , respectively) were considered (n = 192). The DC of the polymerized composite resin was measured through Fourier-transform infrared spectroscopy. The top and bottom surfaces of the polymerized composite resin body were observed through scanning electron microscopy. Multiple linear regression analysis and analysis of variance were used to identify significant differences in DC (α = 0.05)., Results: The DC was lower when the low-viscosity composite resin (β = -0.431), light-polymerized resin depth of 2 mm (β = -0.430), zirconia prosthesis (β = -0.191), and mid-mode polymerization method (β = -0.164) were used. The resin type, depth of resin to be light-cured, prosthesis material, and polymerization method had an effect on the DC., Conclusions: Low-viscosity composite resin should be polymerized at a low irradiance and long polymerization time (such that the light-cured resin depth does not exceed 2 mm) to ensure proper composite resin polymerization in implant screw access opening., (© 2022 by the American College of Prosthodontists.)

Purpose: The aim of this study was to classify the shapes of retromolar pads and assess their morphometric differences using a 3D model., Materials and Methods: Two hundred fully edentulous or Kennedy Class I partially edentulous patients (400 retromolar pads) were enrolled. Scan data of the definitive mandibular casts produced through functional impressions were obtained using a 3D laser scanner. Seven parameters (transverse diameter, longitudinal diameter, transverse-contour length, longitudinal-contour length, longitudinal/transverse diameter ratio, longitudinal/transverse-contour length ratio, and angle of the retromolar pad line to the residual alveolar ridge line) were measured using image analysis software. Subsequently, the pads were classified according to the shape. Statistical analyses were performed using 95% confidence intervals., Results: Classifying the retromolar pads into three shapes led to high intra-examiner reliability (Cronbach's alpha = 0.933). The pear shape was the most common (56.5%), followed by oval/round (27.7%) and triangular (15.8%) shapes. There were no significant differences between the left and right sides according to the shape and no significant differences in any parameter according to age. The transverse diameter and longitudinal/transverse diameter ratio differed between sexes ( P < .05). The triangular shape had a significantly different transverse diameter, transverse-contour length, longitudinal/transverse diameter ratio, and longitudinal/transverse-contour length ratio compared with the pear and oval/round shapes ( P < .05)., Conclusion: From a clinical reliability standpoint, classifying retromolar pads into three shapes (oval/round, pear-shaped, and triangular) is effective. The differences in the sizes among the shapes were attributed to the transverse measurement values., (© 2023 The Korean Academy of Prosthodontics.)

Statement of Problem: Lithium disilicate and 5 mol% yttria partially stabilized zirconia (5Y-PSZ) are commonly used for anterior restorations. However, studies comparing the durability of 5Y-PSZ and lithium disilicates are sparse., Purpose: The purpose of this in vitro study was to investigate the fracture load of anterior monolithic crowns made of 2 lithium disilicates and a 5Y-PSZ under dynamic loading., Material and Methods: Titanium abutments of the maxillary incisors were prepared (N=48, 8 for each group). Monolithic anterior crowns were made from the lithium disilicates (e.max CAD, Rosetta SM) and 5Y-PSZ (Katana UTML). After cementation, the specimens were stored in water for 24 hours and then thermocycled 10 000 times. Dynamic loading (70 N, 200 000 cycles, 1 Hz) was applied to half the specimens. The fracture load was measured by using a universal testing machine. The fracture patterns were analyzed and fractography applied. Two-way ANOVA and the Fisher exact test were used for statistical analysis (α=.05)., Results: The material and dynamic loading affected the fracture load of the anterior monolithic crowns (P<.05). However, there was no interaction between the material and the dynamic loading (P=.079). Both lithium disilicates had higher fracture loads than 5Y-PSZ (P<.05). The fracture load of each specimen was reduced after dynamic loading (P<.05). Lithium disilicate showed marginal and bulk fractures, and 5Y-PSZ presented catastrophic fractures (P<.001)., Conclusions: 5Y-PSZ materials with large grains and low flexural strength may be less resistant to fractures under dynamic loading than lithium disilicates., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Studies that compared the fracture strength of monolithic lithium disilicate and 5-mol% yttria partially stabilized zirconia multiunit fixed dental prostheses are sparse., Purpose: As the connector is the weakest part of a fixed dental prosthesis, the purpose of this in vitro study was to investigate the effect of connector designs and material on the fracture strength of 3-unit monolithic fixed dental prostheses., Material and Methods: Resin-ceramic canine and premolar teeth (N=144) were prepared for fixed dental prosthesis abutments. Prostheses with 3 connector designs (width=height, widthheight) were made from 2 types of lithium disilicate (IPS e.max CAD and Amber Mill) and 5-mol% yttria partially stabilized zirconia (3M Lava Esthetic and Katana Zirconia UTML). Fracture strengths were measured after 200 000 cycles of dynamic loading of 50 N and thermocycling at 5 °C and 55 °C, and the fracture patterns were analyzed. Two-way analysis of variance and the Fisher exact test were used for statistical analysis (α=.05)., Results: The material and connector design affected the fracture strength of fixed dental prostheses (P<.05), and a significant interaction was found between the material and connector design (P<.05). The IPS e.max CAD material had significantly lower fracture strength than Amber Mill, 3M Lava Esthetic, or Katana Zirconia UTML (P<.05). Connector designs with a greater width versus height showed significantly lower fracture strengths than other designs (P<.05)., Conclusions: The connector design of 3-unit fixed dental prostheses, particularly the connector height, may affect fracture strength depending on the prosthesis material., (Copyright © 2022 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to investigate the effect of barium silicate filler contents on mechanical properties of resin nanoceramics (RNCs) for additive manufacturing (AM)., Materials and Methods: Additively manufactured RNC specimens were divided into 4 groups depending on the content of ceramic fillers and polymers: 0% barium silicate and 100% polymer (B0/P10, control group); 50% barium silicate and 50% polymer (B5/P5); 60% barium silicate and 40% polymer (B6/P4); 67% barium silicate and 33% polymer (B6.7/P3.3). The compressive strength (n = 15) and fracture toughness (n = 12) of the specimens were measured, and scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDS) analyses were performed. Independent sample Kruskal-Wallis tests were performed on the compressive strength and fracture toughness test results, and the significance of each group was analyzed at the 95% confidence interval through post-tests using the Bonferroni's method., Results: B6/P4 and B6.7/P3.3 exhibited much higher yield strength than B0/P10 and B5/P5 ( P < .05). Compared to the control group (B0/P10), the other three groups exhibited higher ultimate strength ( P < .05). The fracture toughness of B6/P4 and B6.7/P3.3 were similar ( P > .05). The content of barium silicate and fracture toughness showed a positive correlation coefficient (R = 0.582). SEM and EDS analyses revealed the presence of an oval-shaped ceramic aggregate in B6/P4 specimens, whereas the ceramic filler and polymer substrate were homogeneously mixed in B6.7/P3.3., Conclusion: Increasing the ceramic filler content improves the mechanical properties, but it can be accompanied by a decrease in the flowability and the homogeneity of the slurry., (© 2022 The Korean Academy of Prosthodontics.)

Objective: The aim of this study was to investigate the surface roughness of lithium disilicates (LS2s) polished using various polishing systems., Materials and Methods: Two types of LS2 (A, Amber Mill and E, IPS e.max CAD) were polished using LS2-specific polishing systems (L-Edenta, L-Jota), a zirconia-specific polishing system (Z-Jota), and a conventional ceramic polishing system (P-Shofu) (n = 8 per group). The compositions of different polishing systems were analyzed using EDS. Surface roughness was measured using confocal laser scanning microscopy and analyzed using EDS and SEM. ANOVA and Tukey's tests were used for the statistical analyses (p = 0.05)., Results: The polishing systems were mainly composed of C, O, and Si. The L-Jota group exhibited rougher surfaces than the other groups. Amber Mill exhibited higher surface roughness than IPS e.max CAD (p⟨0.001). Among the polishing systems, the L-Jota group presented the highest roughness value (pp⟨0.001). The surface roughness of the AL-Jota group was higher than that of the other groups., Conclusions: A sufficiently smooth surface can be achieved without a LS2-specific polishing system. Further, the same polishing system can have different effects depending on the type of LS2., (Copyright© 2022 Dennis Barber Ltd.)

Statement of Problem: Materials have been developed to reduce the chipping of ceramic veneer and improve the esthetics of anterior ceramic veneered restorations. However, studies of the effects of material and substructure design on fracture resistance are sparse., Purpose: The purpose of this in vitro study was to investigate the fracture resistance of metal-ceramic (MC), zirconia-feldspathic porcelain (ZC), and zirconia-lithium disilicate (ZL) anterior restorations and evaluate the effect of material and substructure design., Material and Methods: After preparing and scanning artificial maxillary central incisor teeth, titanium abutments and restoration specimens (n=90) were fabricated. MC, ZC, and ZL materials were prepared with substructure designs A (two-third coverage of the palatal surface) and B (one-third coverage of the palatal surface). After cementation, the specimens were thermocycled (10 000 cycles, 5 and 55 °C). Fracture load measurements, failure mode analysis, energy dispersive X-ray spectroscopy (EDS), line scan analysis, fractography, finite element analysis (FEA), and Weibull analysis were performed. Two-way ANOVA was used to identify the effects of material and substructure design on fracture load. One-way ANOVA was used to identify significant differences of fracture load (α=.05)., Results: MC and ZL showed significantly higher fracture load than ZC (P<.05). MC&#95;A showed a significantly higher fracture load than MC&#95;B (P<.05). ZC&#95;A exhibited the lowest Weibull modulus. FEA revealed that the maximum principal stress occurred near the loading area of the veneer. ZL displayed the lowest maximum principal stress among all the materials., Conclusions: ZL and MC&#95;A exhibited more favorable fracture resistance. The substructure design of MC, with increased metal coverage of the palatal surface, improved fracture resistance significantly., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: This study aimed to determine the correlation between occlusal contact area and masticatory performance using BiteEye ® , a photo occlusal analysis device and the multiple sieve method., Objectives: To calculate the occlusal contact area at various levels of interocclusal thicknesses and to measure masticatory performance with peanuts as the test material., Methods: Fifty-two adults (30 men and 22 women) were enrolled according to specific exclusion/inclusion criteria. The occlusal contact area was measured by obtaining the interocclusal record of the maximum intercuspal position (MIP) using silicone impression material. Occlusal contact area measurements were performed in the ranges of 0-149, 0-89, 0-59, 0-29 and 0-9 μm. Masticatory performance was measured by obtaining the median particle size (X 50 ) after converting the weight of comminuted peanuts into size using the multiple sieve method. Statistical analysis was performed at 95% significance level., Results: Interocclusal thickness comparison revealed the highest correlation with X 50 in the 0-149 μm range. Stronger correlations between the occlusal contact area and X 50 were observed in cases of 20 strokes of mastication (r = -.451) than in cases of 10 strokes (r = -.383), in the posterior occlusal contact area (r = -.456) than in the full arch occlusal contact area (r = -.451) and the molar area (r = -.478) than in the premolar area (r = -.296)., Conclusions: The larger the occlusal contact area, the higher the masticatory performance; this correlation was statistically significant. Regarding interocclusal thickness, the highest correlation between the occlusal contact area and masticatory performance was observed in the 0-149 μm range., Clinical Trial Registration Number: GWNUDH IRB 2020-A001., (© 2021 John Wiley & Sons Ltd.)

Statement of Problem: How axial displacement may be affected by the mechanical properties and internal discrepancy of a cement-retained implant-supported prosthesis is unclear., Purpose: The purpose of this in vitro study was to assess the difference in internal discrepancy and axial displacement according to the prosthesis material in cement-retained prostheses splinting nonparallel implants., Material and Methods: Computer-aided design and computer-aided manufacture (CAD-CAM) titanium abutments were fabricated for a vertically placed implant and a 15-degree tilted implant. Three types of prostheses, in zirconia, cobalt-chromium (Co-Cr) alloy, and polymethylmethacrylate resin (PMMA), were fabricated (n=10). The internal discrepancy between the CAD-CAM titanium abutment and the prosthesis was measured by using the replica technique. After luting with an interim cement, they were mounted in Type IV gypsum. The specimens were cyclic loaded, and axial displacement of the prosthesis was measured after 3, 10, 100, and 10 6 cycles. The internal discrepancy and cumulative axial displacement were assessed by using a 3-way analysis of variance and repeated measures analysis of variance (α=.05)., Results: The internal discrepancy of the prosthesis did not differ based on the prosthesis material (P=.869); however, it was significantly different based on the measurement location, with the occlusal discrepancy (224 ±29 μm) being greater than the axial discrepancy (21 ±10 μm) (P<.05). Implants with an angled placement exhibited less axial displacement than implants with vertical placement (P<.05). The PMMA prosthesis demonstrated significantly greater axial displacement than the zirconia or Co-Cr prostheses (P<.05), which were similar (P=.623)., Conclusions: Prostheses made with high-elastic moduli materials exhibited less axial displacement than PMMA prostheses, even though the internal discrepancy was not different. Moreover, vertically placed implants presented a greater axial displacement of the prosthesis than implants with angled placement., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The mechanical properties and residual stress of dental Co-Cr-Mo (CCM) alloy depend on the manufacturing and post-processing methods, which affect the prognosis of dental prostheses. Two CCM alloys manufactured by casting and selective laser melting (SLM) were compared, and the effect of heat treatment temperature for CCM alloys manufactured by SLM method was evaluated. Specimens were fabricated by casting (Cast Co-Cr) and SLM (SLM Co-Cr). SLM Co-Cr specimens were heat treated at 750, 950, and 1150 °C to compare their properties. Microstructures were analyzed via scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), and electron backscattered diffraction (EBSD), and the residual stress was measured via x-ray diffraction (XRD). Mechanical properties were evaluated by a Vickers hardness test and a tensile test; fractography was performed after this. The SLM Co-Cr group exhibited a decrease in porosity, grain size, increase in solid solution limit, and high residual stress compared to Cast Co-Cr; the ultimate tensile strength, yield strength, and hardness were also higher. The microstructures, residual stresses, and mechanical properties differed significantly depending on the heat treatment, and the strength and hardness showed a tendency inverse to that of the elongation. Type I residual stresses mostly decreased after 750 °C heat treatment, however type II and III residual stresses remained even after 1150 °C heat treatment. SLM presented superior mechanical properties to casting. Considering the reduction of tensile residual stress and increased ductility, CCM alloys should be heat treated at a temperature of 950 °C or higher., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: The occlusal force and occlusal contact area may be used to evaluate oral function following restoration of a missing tooth. This study aimed to monitor the initial changes in these factors after single molar implant restoration., Materials and Methods: Patients who underwent single implant restoration between December 2018 and September 2019 were recruited for this study. Occlusal force was measured before, immediately after, and 1 month after prosthesis placement. The occlusal contact area was evaluated immediately and 1 month after the placement. Data were grouped by sex, restored tooth, and restored side for analysis., Results: In most groups, occlusal force was significantly increased 1 month after the placement compared with that before placement (P < .05), and the change was more significant in the first molar group than in the second molar group. There was a significant difference in the occlusal contact area of the implant prosthesis immediately and 1 month after placement when a thickness of 9 μm was used. The occlusal contact area of the natural tooth in the mesial side was significantly increased 1 month after placement (P < .05)., Conclusion: Occlusal force was significantly increased 1 month after implant restoration, and restoration of the first molar had the most significant effect on the occlusal force. Occlusal contact areas may differ according to the occlusal indicator used in the clinical setting because the changes were significant with only 0 to 9 μm.

Purpose: To evaluate the effect of composite cement components and thermocycling on the bond strength of monolithic lithium-disilicate (LS2) glass-ceramic implant-supported restorations bonded to titanium (Ti) abutments., Materials and Methods: Eighty LS2 blocks were treated with five types of composite cement and primer, then divided accordingly into groups: M (Multilink hybrid abutment), G (G-CEM LinkAce), GP (G-CEM LinkAce with G-Multi PRIMER), P (Panavia F2.0), and U (RelyX U200). Half of the 16 specimens from each group were subjected to thermocycling (groups T-M, T-G, T-GP, T-P, and T-U). The tensile bond strength (TBS) of all specimens was measured using a pull-off test. The cross section of the LS2 block from which the Ti abutment was removed was examined for mode of failure. Two-way ANOVA and Tukey's HSD test (significance level = 0.05) were used to determine the effect of composite cement composition and thermocycling on TBS., Results: There was no difference in TBS between the five groups before thermocycling (p = 0.16). However, groups M (p < 0.001) and G (p = 0.014) showed significantly lower TBS than the corresponding thermocycled groups. Groups T-GP, T-P, and T-U did not show significant changes in TBS after thermocycling (p > 0.05). All failures occurred at the interface between the composite cement and Ti abutment and not between the cement and the LS2 block., Conclusion: Thermocycling can reduce the bond strength between the composite cements and Ti abutment. The composite cements containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) or methacrylate phosphate ester monomers stabilize bonding.

Purpose: The aim of this study is to compare the hardness according to the conditions of metal alloys. Moreover, the correlation between the cast crown hardness before and after wear testing and the degree of wear for each dental alloy was assessed., Materials and Methods: Cast crowns of three metal alloys (Co-Cr, gold, and Ni-Cr alloys) opposing smooth-surface monolithic zirconia were used. The Vickers microhardness of the ingot (which did not undergo wear testing) and the cast crown before and after wear testing were measured for each alloy. Two-way ANOVA and Scheffé tests were used to compare the measured hardness values. Moreover, the Pearson correlation coefficient was used to evaluate the relationship between the surface hardness and the wear of the cast crown (α=.05)., Results: There was no significant difference in the hardness before and after wear testing for the gold alloy ( P >.05); however, the hardness of the worn surface of the cast crown increased compared to that of the cast crown before the wear tests of Ni-Cr and Co-Cr alloys ( P <.05). Furthermore, there was no correlation between the wear and hardness of the cast crown before and after wear testing for all three metal alloys ( P >.05)., Conclusion: There was a significant difference in hardness between dental alloys under the same conditions. No correlation existed between the surface hardness of the cast crown before and after wear testing and the wear of the cast crown., (© 2021 The Korean Academy of Prosthodontics.)

Purpose: The effect of core design on the fracture resistance of zirconia-lithium disilicate (LS2) bilayered crowns for anterior teeth is evaluated by comparing with that of metal-ceramic crowns., Materials and Methods: Forty customized titanium abutments for maxillary central incisor were prepared. Each group of 10 units was constructed using the same veneer form of designs A and B, which covered labial surface to approximately one third of the incisal and cervical palatal surface, respectively. LS2 pressed-on-zirconia (POZ) and porcelain-fused-to-metal (PFM) crowns were divided into "POZ&#95;A," "POZ&#95;B," "PFM&#95;A," and "PFM&#95;B" groups, and 6000 thermal cycles (5/55℃) were performed after 24 h storage in distilled water at 37℃. All specimens were prepared using a single type of self-adhesive resin cement. The fracture resistance was measured using a universal testing machine. Failure mode and elemental analyses of the bonding interface were performed. The data were analyzed using Welch's t-test and the Games-Howell exact test., Results: The PFM&#95;B (1376. 8 ± 93.3 N) group demonstrated significantly higher fracture strength than the PFM&#95;A (915.8 ± 206.3 N) and POZ&#95;B (963.8 ± 316.2 N) groups ( P <.05). There was no statistically significant difference in fracture resistance between the POZ&#95;A (1184.4 ± 319.6 N) and POZ&#95;B groups ( P >.05). Regardless of the design differences of the zirconia cores, fractures involving cores occurred in all specimens of the POZ groups., Conclusion: The bilayered anterior POZ crowns showed different fracture resistance and fracture pattern according to the core design compared to PFM., (© 2020 The Korean Academy of Prosthodontics.)

Statement of Problem: Materials used for dental restorations should cause wear similar to that of natural teeth. Studies on the wear of dental alloys against monolithic zirconia are lacking., Purpose: The purpose of this in vitro study was to compare the wear of Co-Cr, gold, and Ni-Cr alloys against monolithic zirconia of different surface roughness., Material and Methods: Cylindrical monolithic zirconia specimens were prepared by a sintering process. Sintered zirconia was then polished to prepare 30 zirconia substrate specimens with a smooth surface (Ra<0.1 μm) and 30 with a rough surface (3.5 μm

Purpose: To determine the effects of the total thickness and core/veneer thickness ratio of bilayered ceramics on their three-point flexural strength and translucency., Materials and Methods: Two groups of specimens were prepared with two different total thicknesses, 1.0 mm and 0.6 mm. These groups were divided into five and three subgroups with ten specimens each, respectively, having different core/veneer thickness ratios. Lithium disilicate was pressed on the zirconia surface using the "lost-wax technique." The translucency and three-point flexural strength were measured, and a one-way analysis of variance test (p < 0.05) was performed to determine whether the translucency and three-point flexural strength were affected by the total thickness and core/veneer thickness ratio of the specimens., Results: For the same total thickness, translucency decreased with a increase in the zirconia core proportion (p < 0.001). For the same core/veneer ratio, the translucency decreased with an increase in the total thickness (p < 0.001). If the zirconia thickness was less than half of the total thickness, the bilayered ceramic specimens containing zirconia cores and monolithic lithium disilicate specimens exhibited a similar translucency. The three-point flexural strength increased with the increasing proportion of zirconia; however, it did not change significantly with the total thickness. However, for the same total thickness, the flexural strengths of the bilayered ceramics were higher than those of the monolithic specimens., Conclusions: At the same total thickness, increasing the zirconia core thickness decreased the translucency and increased the three-point flexural strength. Bilayered ceramic specimens with low zirconia ratios exhibited translucency similar to that of monolithic lithium disilicate ceramic but a higher flexural strength., (© 2019 by the American College of Prosthodontists.)

Purpose: The purpose of this study was to evaluate axial displacement in cement-retained prostheses using computer-aided design/computer-aided manufacturing (CAD/CAM) abutments with three different types of implant-abutment connections., Materials and Methods: CAD/CAM abutments made with two types of titanium blocks (made by the same manufacturer as the implant manufacturer and by a manufacturer with a patent for CAD/CAM abutment fabrication) were connected with three types of implant connections: external, internal butt, and internal conical connection. Titanium custom abutments and zirconia prostheses were fabricated using the CAD/CAM system for each specimen. The geometries and surface morphologies of CAD/CAM abutments and ready-made abutments were comparatively evaluated using scanning electron microscopy. Cemented prostheses on abutments were mounted on a universal testing machine and subjected to 250-N sine wave cyclic loads. Cumulative axial displacement was measured at loading cycles of 3, 10, 100, and 10 6 and analyzed by repeated measures analysis of variance (ANOVA)., Results: Surface geometries and morphologies of CAD/CAM abutments varied according to the implant-abutment connection and manufacturers of the titanium block. The internal conical connection exhibited the greatest axial displacement, while the external connection showed the lowest axial displacement. The CAD/CAM abutment made with a compatible titanium block exhibited a greater axial displacement than that exhibited by the abutment fabricated using a titanium block made by the implant manufacturer., Conclusion: In implant connections with a vertical stop, axial displacement occurred primarily in the early loading period and was self-limited. However, long-term axial displacement can occur with internal conical connection implants. Therefore, in internal conical connection implants, axial displacement should be managed more carefully using a provisional restoration, with consideration of the abutment fabrication method.

Purpose: To compare the effect of 3 tray designs and 3 commonly used impression materials on the displacement of flabby tissue during maxillary edentulous impression by superimposition of 3D digital models., Materials and Methods: Fifteen maxillary edentulous casts with simulated flabby tissue were fabricated by modifying a standard maxillary edentulous acrylic resin cast. Three types of impression trays were fabricated: trays with conventional relief, trays with additional relief, and trays with an open window. Three impression materials were tested: light-body polysulfide, light-body vinylpolysiloxane, and zinc oxide eugenol paste. For the analysis of tissue displacement during impression making, the test and control stone casts were scanned using a 3D laser scanner, and the 3D digital models were superimposed using metrology software. Statistical analyses were performed with an α = 0.05., Results: Negative deviations were recorded at the areas of the alveolar crest, posterior part of flabby tissue, and middle of the palate. On the other hand, a positive deviation was recorded at the area of the anterior part of flabby tissue. A significant difference in the displacement of flabby tissue was found when using different tray designs (p < 0.0001). The tray with the open window showed significantly low tissue displacement at the flabby tissue region. Depending on sites, the amount of flabby tissue displacement showed different significances by the different impression materials used (anterior part: p < 0.0001; alveolar crest: p = 0.097; posterior part: p < 0.0001). Conventionally relieved trays showed significantly higher values of displacement at the anterior part of flabby tissue (p < 0.0001), while trays with open windows showed similar values of displacement at all measuring points, and no significant differences among different impression materials were found (p = 0.104)., Conclusions: There were significant differences in the displacement of flabby tissue with different tray designs, especially with displacement occurring at the anterior and posterior parts of flabby tissue. Tray designs should be considered in order to make proper impressions when flabby tissue is present., (© 2019 by the American College of Prosthodontists.)

Purpose: To evaluate the axial displacement of the implant-abutment assembly of different implant diameter after static and cyclic loading of overload condition., Materials and Methods: An internal conical connection system with three diameters (Ø 4.0, 4.5, and 5.0) applying identical abutment dimension and the same abutment screw was evaluated. Axial displacement of abutment and reverse torque loss of abutment screw were evaluated under static and cyclic loading conditions. Static loading test groups were subjected to vertical static loading of 250, 400, 500, 600, 700, and 800 N consecutively. Cyclic loading test groups were subjected to 500 N cyclic loading to evaluate the effect of excessive masticatory loading. After abutment screw tightening for 30 Ncm, axial displacement was measured upon 1, 3, 10, and 1,000,000 cyclic loadings of 500 N. Repeated-measure ANOVA and 2-way ANOVA were used for statistical analysis (α = 0.05)., Results: The increasing magnitude of vertical load and thinner wall thickness of implant increased axial displacement of abutment and reverse torque loss of abutment screw (p < 0.05). Implants in the Ø 5.0 diameter group demonstrated significantly low axial displacement, and reverse torque loss after static loading than Ø 4.0 and Ø 4.5 diameter groups (p < 0.05). In the cyclic loading test, all diameter groups of implant showed significant axial displacement after 1 cycle of loading of 500 N (p < 0.05). There was no significant axial displacement after 3, 10, or 1,000,000 cycles of loading (p = 0.603)., Conclusions: Implants with Ø 5.0 diameter demonstrated significantly low axial displacement and reverse torque loss after the cyclic and static loading of overload condition., (© 2017 by the American College of Prosthodontists.)

Statement of Problem: Zirconia prostheses show a high rate of retention loss, and more information is needed regarding the treatment of the intaglios of zirconia prostheses to improve the bond strength between zirconia and resin cement., Purpose: The purpose of this in vitro study was to evaluate the retention of titanium abutments and zirconia prostheses treated with silica-containing glass-ceramic liners. The effect of the abutment convergence angle on retention force was also examined., Material and Methods: Titanium abutments and zirconia copings (n=90) were fabricated with 3 different convergence angles (6, 12, and 24 degrees). Specimens were divided into 2 groups according to surface treatment: an airborne-particle-abraded control group and a group that was coated with a silica-containing glass-ceramic liner after airborne-particle abrasion (liner group). The thickness of the liner was measured, and the inner spacing of the zirconia coping was modified in the liner group. The coping was cemented, and the retention was evaluated with a tensile bond strength test by using a universal testing machine. Retention was analyzed by using a 2-way analysis of variance. Modes of failure were evaluated by examining the fracture surface. Elemental analysis of the interface was also performed., Results: The liner group showed a significantly higher retention force for the zirconia prosthesis (P<.05). Regardless of surface treatment, the retention force at a convergence angle of 6 degrees was higher than that at 24 degrees (P<.05). The control group showed mostly adhesive type failures, whereas the liner group exhibited mostly mixed type failures., Conclusions: Silica-containing glass-ceramic liner treatment increased the retention compared with airborne-particle abrasion treatment alone. Tensile bond strength increased with decreasing abutment convergence angle., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: The effect of silica-based glass-ceramic liners on the tensile bond strength between zirconia and resin-based luting agent was evaluated and compared with the effect of 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing primers., Materials and Methods: Titanium abutments and zirconia crowns (n = 60) were fabricated, and the adhesive surfaces of the specimens were treated by airborne-particle abrasion. The specimens were divided into 5 groups based on surface treatment: a control group, 2 primer groups (MP: Monobond Plus; ZP: Z Prime Plus), and 2 liner groups (PL: P-containing Liner; PFL: P-free Liner). All specimens were cemented with self-adhesive resin-based luting agent. After 24-hour water storage and thermocycling (5,000 cycles, 5℃/55℃), the tensile bond strength was measured using a universal testing machine. Failure mode analysis and elemental analysis on the bonding interface were performed. The data were analyzed using Kruskal-Wallis test, Dunn's post hoc test, and Fisher's exact test., Results: The liner groups and primer groups showed significantly higher tensile bond strengths than that of the control group ( P <.05). PFL showed a significantly higher tensile bond strength than the primer groups ( P <.05). The percentage of mixed failure was higher in the primer groups than in the control group ( P <.001), and all the specimens showed mixed failure in the liner groups ( P <.001). A chemical reaction area was observed at the bonding interface between zirconia and liner., Conclusion: The application of liner significantly increased the tensile bond strength between zirconia and resin-based luting agent. PFL was more effective than MDP-containing primers in improving the tensile bond strength with the resin-based luting agent.

Statement of Problem: Little information is available for the strength of bonding between zirconia and lithium disilicate as affected by surface pretreatment methods., Purpose: The purpose of this in vitro study was to investigate the shear bond strength (SBS) between zirconia core and lithium disilicate (LS 2 ) veneered ceramic after surface pretreatments., Material and Methods: Fully sintered yttrium oxide partially stabilized tetragonal zirconia (Y-TZP) disk specimens were fabricated from zirconia ceramic materials. Specimens were divided into 4 groups with surface pretreatments applied (the as-received group, the liner group, the airborne-particle abrasion group, and the airborne-particle abrasion-plus-liner group). After pressing LS 2 on a zirconia disk, shear force was applied perpendicular to the zirconia-LS 2 interface. Data were analyzed using 2-way ANOVA and Tukey test (α=.05). For each group, the failure modes were measured by using optical microscopy, scanning electron microscopy, energy dispersive x-ray spectroscopy, and x-ray diffraction., Results: Airborne-particle abrasion induced significantly lower interfacial strength between zirconia and lithium disilicate (P<.05). After airborne-particle abrasion of the surface, the increased monoclinic volume fraction and reduced coefficient of thermal expansion of zirconia may weaken the interfacial strength between zirconia and LS 2 . The liner treatment significantly improved the adhesion between zirconia core and veneering LS 2 (P<.05). The SBS values decreased in the following order: liner group > airborne-particle abrasion-plus-liner group > airborne-particle abrasion group. The interfacial image of zirconia and LS 2 showed a fusion of crystal structure between the 2 materials. Some components of the silica-containing glass-ceramic liner led to an increase in SBS as diffusion occurred on the zirconia surface., Conclusions: The bond strength between zirconia and veneering LS 2 was significantly increased by application of silica-containing glass-ceramic liner but was decreased with airborne-particle abrasion., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To compare the bone responses of chemically modified implants using the plasma immersion ion implantation and deposition method with those of blasted implants., Materials and Methods: The titanium implants were blasted with resorbable blasting media (RBM) and designated as controls. The ion-implanted implants were divided into two test groups, namely, calcium (Ca) and magnesium (Mg) implants. Six implants (two implants per group) were placed into the proximal tibias of 11 New Zealand white rabbits. Fluorochrome labeling was administered at 2 and 4 weeks after surgery. Resonance frequency analysis (RFA) was conducted immediately after surgery and at 6 weeks of healing. The removal torque was measured in half of the tibiae. The implants in another tibia were subjected to fluorescence analysis and histologic and histomorphometric evaluations., Results: The fluorescence analysis suggested that osteoconductivity was improved in the early osseointegration stages in the Ca and Mg implants. In the cortical region, the bone-to-implant contact in the Mg implants and the bone area % in the Ca and Mg implants were higher than those in the RBM implants (P < .05). All groups demonstrated similar biomechanical strengths with respect to the RFA and the removal torque measurements., Conclusion: The osseointegration speed and the bone contact were positively affected by the Ca and Mg ion implantation, especially in the Mg implants, because of the synergistic effect. However, no remarkable differences were found in biomechanical strength in the later osseointegration stages.

Statement of Problem: The relationship between surface roughness and the optical characteristics of zirconia prostheses may be affected by the type of shaded block., Purpose: The purpose of this in vitro study was to investigate changes in surface roughness and brightness of monolithic zirconia blocks of different shades after polishing., Material and Methods: The surface roughness averages of 3 different kinds of shaded zirconia blocks (Zenostarof T0 [T0], Zenostar sun [Ts], and Zenostar sun chroma [Tsc]) were compared after surface polishing. Fifteen specimens of differing thicknesses were produced per block. (1 mm and 3 mm). Surface morphology and compositions were analyzed by using filed emission scanning electron microscopy (FE-SEM) and energy dispersive spectrometry. A 1-way ANOVA and the post hoc Scheffé test were performed (α=.05). The correlations between surface roughness and brightness were determined using the Pearson correlation analysis (α=.01)., Results: After phased polishing, Ts had the highest average roughness, followed by T0 and then Tsc. A statistically significant difference in roughness was observed between Ts and Tsc (P<.05). Ts exhibited multiple distinct layers in the FE-SEM image. Carbon was detected in the Ts specimens only. Brightness was highest in T0, followed by Ts and then Tsc. A positive correlation was observed between brightness and surface roughness for all specimens (P<.01). This correlation was stronger in the thicker specimens., Conclusions: The results of this study suggest that polishing affects monolithic zirconia differently depending on shade. The polishing of monolithic zirconia reduces both surface roughness and brightness. The optical properties of monolithic zirconia vary by thickness and can be opaque or translucent., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To investigate the stress distribution in an implant-abutment complex with a preloaded abutment screw by comparing implant-abutment engagement features using three-dimensional finite element analysis (FEA)., Materials and Methods: For FEA modeling, two implants-one with a single (S) engagement system and the other with a double (D) engagement system-were placed in the human mandibular molar region. Two types of abutments (hexagonal, conical) were connected to the implants. Different implant models (a single implant, two parallel implants, and mesial and tilted distal implants with 1-mm bone loss) were assumed. A static axial force and a 45-degree oblique force of 200 N were applied as the sum of vectors to the top of the prosthetic occlusal surface with a preload of 30 Ncm in the abutment screw. The von Mises stresses at the implant-abutment and abutment-screw interfaces were measured., Results: In the single implant model, the S-conical abutment type exhibited broader stress distribution than the S-hexagonal abutment. In the double engagement system, the stress concentration was high in the lower contact area of the implant-abutment engagement. In the tilted implant model, the stress concentration point was different from that in the parallel implant model because of the difference in the bone level., Conclusion: The double engagement system demonstrated a high stress concentration at the lower contact area of the implant-abutment interface. To decrease the stress concentration, the type of engagement features of the implant-abutment connection should be carefully considered.

Purpose: To evaluate the effect of the chemical formulation of liners on the shear bond strength (SBS) between lithium disilicate veneering ceramic and zirconia core., Materials and Methods: Four experimental groups (n = 12) were designed according to liner composition: negative control group (lithium and phosphorus removed from the conventional liner), Li group (lithium added to the negative control group), P group (phosphorus added to the negative control group), and Li+P group as the positive control (conventional liner). After applying the liner, lithium disilicate was pressed on zirconia. Specimens were stored in distilled water (37°C, 24 h) before testing the SBS. To test the SBS, shear force was applied perpendicular to the lithium disilicate-zirconia interface. The differences in the SBS between the veneer lithium disilicate and zirconia substructure were evaluated with one-way ANOVA (significance level of 0.05)., Results: The presence or absence of lithium and phosphorus influenced the efficacy of the liner. The negative control and P groups showed mainly cohesive failures, and the Li group mainly showed mixed failures. Both adhesive and mixed failures were observed in the Li+P group. The groups including lithium showed significantly higher SBS than the negative control or Li+P group (p < 0.05). The group including phosphorus, which showed higher crystallinity, showed significantly lower SBS than the negative control and Li+P groups (p < 0.05)., Conclusions: The differences in the composition of the liner can affect the wettability and reactivity, and as a result, the SBS was different.

Surface characteristics and cellular response to titanium surfaces that had been implanted with calcium and magnesium ions using plasma immersion ion implantation and deposition (PIIID) were evaluated. Three different titanium surfaces were analyzed: a resorbable blast media (RBM) surface (blasted with hydroxyapatite grit), a calcium ion-implanted surface, and a magnesium ion-implanted surface. The surface characteristics were investigated by scanning electron microscopy (SEM), surface roughness testing, X-ray diffraction (XRD), and Auger electron spectroscopy (AES). Human bone marrow derived mesenchymal stem cells were cultured on the 3 different surfaces. Initial cell attachment was evaluated by SEM, and cell proliferation was determined using MTT assay. Real-time polymerase chain reaction (PCR) was used to quantify osteoblastic gene expression (i.e., genes encoding RUNX2, type I collagen, alkaline phosphatase, and osteocalcin). Surface analysis did not reveal any changes in surface topography after ion implantation. AES revealed that magnesium ions were present in deeper layers than calcium ions. The calcium ion- and magnesium ion-implanted surfaces showed greater initial cell attachment. Investigation of cell proliferation revealed no significant difference among the groups. After 6 days of cultivation, the expression of RUNX2 was higher in the magnesium ion-implanted surface and the expression of osteocalcin was lower in the calcium ion-implanted surface. In conclusion, ion implantation using the PIIID technique changed the surface chemistry without changing the topography. Calcium ion- and magnesium ion-implanted surfaces showed greater initial cellular attachment., Competing Interests: The authors have no financial conflicts of interest related to this study.The authors have no ethical issues for human and animal right.

Purpose: The aim of this study was to investigate the effect of reinforcing materials on the fracture resistances of glass fiber mesh- and Cr-Co metal mesh-reinforced maxillary complete dentures under fatigue loading., Materials and Methods: Glass fiber mesh- and Cr-Co mesh-reinforced maxillary complete dentures were fabricated using silicone molds and acrylic resin. A control group was prepared with no reinforcement (n = 15 per group). After fatigue loading was applied using a chewing simulator, fracture resistance was measured by a universal testing machine. The fracture patterns were analyzed and the fractured surfaces were observed by scanning electron microscopy., Results: After cyclic loading, none of the dentures showed cracks or fractures. During fracture resistance testing, all unreinforced dentures experienced complete fracture. The mesh-reinforced dentures primarily showed posterior framework fracture. Deformation of the all-metal framework caused the metal mesh-reinforced denture to exhibit the highest fracture resistance, followed by the glass fiber mesh-reinforced denture ( P <.05) and the control group ( P <.05). The glass fiber mesh-reinforced denture primarily maintained its original shape with unbroken fibers. River line pattern of the control group, dimples and interdendritic fractures of the metal mesh group, and radial fracture lines of the glass fiber group were observed on the fractured surfaces., Conclusion: The glass fiber mesh-reinforced denture exhibits a fracture resistance higher than that of the unreinforced denture, but lower than that of the metal mesh-reinforced denture because of the deformation of the metal mesh. The glass fiber mesh-reinforced denture maintains its shape even after fracture, indicating the possibility of easier repair.

Purpose: To evaluate the effect of implant coronal wall thickness on load-bearing capacity and screw joint stability., Materials and Methods: Experimental implants were customized after investigation of the thinnest coronal wall thickness of commercially available implant systems with a regular platform diameter. Implants with four coronal wall thicknesses (0.2, 0.3, 0.4, and 0.5 mm) were fabricated. Three sets of tests were performed. The first set was a failure test to evaluate load-bearing capacity and elastic limit. The second and third sets were cyclic and static loading tests. After abutment screw tightening of each implant, vertical cyclic loading of 250 N or static loading from 250 to 800 N was applied. Coronal diameter expansion, axial displacement, and removal torque values of the implants were compared. Repeated measures analysis of variance (ANOVA) was used for statistical analysis (α = .05)., Results: Implants with 0.2-mm coronal wall thickness demonstrated significantly low load-bearing capacity and elastic limit (both P < .05). These implants also showed significantly large coronal diameter expansion and axial displacement after screw tightening (both P < .05). Greater vertical load and thinner coronal wall thickness significantly increased coronal diameter expansion of the implant, axial displacement of the abutment, and removal torque loss of the abutment screw (all P < .05)., Conclusion: Implant coronal wall thickness of 0.2 mm produces significantly inferior load-bearing capacity and screw joint stability.

A model with simulated flabby tissue was fabricated by modifying the standard maxillary edentulous acrylic resin cast to evaluate the effect of maxillary impression tray design on the displacement of flabby tissue. Seven groups of trays were fabricated using different combinations of relief spaces and escape holes. After impression taking, test and control casts were scanned and three-dimensional digital models were superimposed. Negative deviations were recorded at the point of the alveolar crest, the posterior part of the flabby tissue, and the middle of the palate, while positive deviations were recorded at the point of the anterior part of flabby tissue. The amount and characteristics of tissue displacement differed with tray design and the relief method used.

Statement of Problem: Although a well-polished monolithic zirconia surface is essential, insufficient comparative studies on the constituents and efficacy of polishing systems have been conducted., Purpose: The purpose of this in vitro study was to analyze the abrasive constituents and compare the polishing effectiveness of 6 zirconia polishing systems, including their potential influence on the phase transformation of monolithic zirconia., Material and Methods: The compositions of 6 zirconia polishing systems were analyzed using energy dispersive spectroscopy (EDS). Sintered and high-speed ground monolithic zirconia specimens were used as control groups (n=14 specimens per group). Test groups (n=168) were pretreated identically to the control group and arbitrarily divided into 12 groups to examine 6 polishing systems for 2 polishing periods (60 or 120 seconds). The surfaces were characterized by a surface profiler and various analytic techniques, including x-ray diffraction (XRD) analysis. The data were analyzed using 2-way ANOVA and multiple comparisons and the Bonferroni method (α=.05)., Results: The abrasives were primarily composed of C, O, and Si. Diamond was identified as the main abrasive and SiC as the supplementary abrasive in the polishing systems. No significant differences were observed for the 60- or 120-second polishing times (P>.05). Four products had significantly lower surface roughness values than the other 2 (P<.001). The occlusal-adjustment-simulating pretreatment and polishing processes did not cause phase transformations in the zirconia specimens., Conclusions: The monolithic zirconia polishing systems contained diamond and SiC abrasives. All zirconia polishing systems showed clinically acceptable results, and 4 systems exhibited lower surface roughness. Phase transformation did not occur during polishing procedure., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site., Materials and Methods: Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex., Results: The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration., Conclusion: 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla.

This study investigated stress distribution in four different implant-abutment interface conditions in the internal tapered connection implant system. Four different implant diameters (3.5 mm, 4.0 mm, 4.5 mm, and 5.0 mm) and two abutment types (hexagonal and conical) were simulated. Four unique implant-abutment interface conditions were assumed based on wall thickness, mating surface length, distance to the vertical stop, and abutment shape. Axial and oblique loading was applied during abutment screw preload, and the Von Mises stresses were measured at the implant-abutment and abutment-screw interfaces. The implant-abutment interface stress decreased as the wall thickness increased. As the mating surface increased, the stress distribution trended downward, and when the distance to the implant vertical stop was 0 μm, the Von Mises stress was extremely high at the vertical stop. Despite their different shapes, the abutments showed similar stress distributions. However, the maximum Von Mises stress was higher in the conical connection than in the hexagonal connection, particularly at the contralateral side to loading. To decrease the stress distribution at the implant-abutment interface, the implant wall thickness, mating surface contact length, distance to the vertical stop, and abutment shape should be carefully considered.

Purpose: The aim of this study is to evaluate the appropriate impression technique by analyzing the superimposition of 3D digital model for evaluating accuracy of conventional impression technique and digital impression., Materials and Methods: Twenty-four patients who had no periodontitis or temporomandibular joint disease were selected for analysis. As a reference model, digital impressions with a digital impression system were performed. As a test models, for conventional impression dual-arch and full-arch, impression techniques utilizing addition type polyvinylsiloxane for fabrication of cast were applied. 3D laser scanner is used for scanning the cast. Each 3 pairs for 25 STL datasets were imported into the inspection software. The three-dimensional differences were illustrated in a color-coded map. For three-dimensional quantitative analysis, 4 specified contact locations(buccal and lingual cusps of second premolar and molar) were established. For twodimensional quantitative analysis, the sectioning from buccal cusp to lingual cusp of second premolar and molar were acquired depending on the tooth axis., Results: In color-coded map, the biggest difference between intraoral scanning and dual-arch impression was seen (P<.05). In three-dimensional analysis, the biggest difference was seen between intraoral scanning and dual-arch impression and the smallest difference was seen between dual-arch and full-arch impression., Conclusion: The two- and three-dimensional deviations between intraoral scanner and dual-arch impression was bigger than full-arch and dual-arch impression (P<.05). The second premolar showed significantly bigger three-dimensional deviations than the second molar in the three-dimensional deviations (P>.05).

Purpose: The aim of this study was to evaluate the effect of metal primers on the bonding of dental alloys and veneer resin. Polyvinylpyrrolidone solution's tarnish effect on bonding strength was also investigated., Materials and Methods: Disk-shape metal specimens (diameter 8 mm, thickness 1.5 mm) were made from 3 kinds of alloy (Co-Cr, Ti and Au-Ag-Pd alloy) and divided into 4 groups per each alloy. Half specimens (n=12 per group) in tarnished group were immersed into polyvinylpyrrolidone solution for 24 hours. In Co-Cr and Ti-alloy, Alloy Primer (MDP + VBATDT) and MAC-Bond II (MAC-10) were applied, while Alloy Primer and V-Primer (VBATDT) were applied to Au-Ag-Pd alloys. After surface treatment, veneering composite resin were applied and shear bond strength test were conducted., Results: Alloy Primer showed higher shear bond strength than MAC-Bond II in Co-Cr alloys and Au-Ag-Pd alloy (P<.05). However, in Ti alloy, there was no significant difference between Alloy Primer and MAC-Bond II. Tarnished Co-Cr and Au-Ag-Pd alloy surfaces presented significantly decreased shear bond strength., Conclusion: Combined use of MDP and VBATDT were effective in bonding of the resin to Co-Cr and Au-Ag-Pd alloy. Tarnish using polyvinylpyrrolidone solution negatively affected on the bonding of veneer resin to Co-Cr and Au-Ag-Pd alloys.

This clinical report describes the fractured hexagonal part of an implant abutment. The initial clinical sign was a loose abutment screw. Upon further clinical evaluation, the abutment was seen to have fractured and had wedged inside the implant body. Because the implant was a bone-level internal conical connection system, access and visibility were limited. A simple and economical technique with modified round-tip scissors was used to retrieve the fractured titanium abutment., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants., Materials and Methods: Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading., Results: Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants., Conclusion: Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading.

Objectives: The purpose of this study was to evaluate the axial displacement of the abutments during clinical procedures by the tightening torque and cyclic loading., Materials and Methods: Two different implant-abutment connection systems were used (external butt joint connection [EXT]; internal tapered conical connection [INT]). The master casts with two implant replicas, angulated 10° from each other, were fabricated for each implant connection system. Four types of impression copings were assembled and tightened with the corresponding implants (hex transfer impression coping, non-hex transfer impression coping, hex pick-up impression coping, non-hex pick-up impression coping). Resin splinted abutments and final prosthesis were assembled. The axial displacement was measured from the length of each assembly, which was evaluated repeatedly, after 30 Ncm torque tightening. After 250 N cyclic loading of final prosthesis for 1,000,000 cycles, additional axial displacement was recorded. The mean axial displacement was statistically analyzed (repeated measured ANOVA)., Results: There was more axial displacement in the INT group than that of the EXT group in impression copings, resin splinted abutments, and final prosthesis. Less axial displacement was found at 1-piece non-hex transfer type impression coping than other type of impression copings in the INT group. There was more axial displacement at the final prosthesis than resin splinted abutments in the INT and the EXT groups. After 250 N cyclic loading of final prosthesis, the INT group showed more axial displacement than that of the EXT group., Conclusion: Internal tapered conical connection demonstrated a varying amount of axial displacement with tightening torque and cyclic loading., (© 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.)

Purpose: The objective of this study was to analyze orthotropic bone formation and remodeling of three different dental implant surfaces with and without recombinant human bone morphogenetic protein 2 derived from Escherichia coli (ErhBMP-2) in a rabbit model., Materials and Methods: Resorbable blasting media (RBM); sandblasted, large-grit, acid-etched (SLA); and magnesium-incorporated oxidized (MgO) implant surfaces were coated with ErhBMP-2 (1.5 mg/mL). The implants were placed into the proximal tibia in six New Zealand White rabbits. Each rabbit received six different implants (three coated with ErhBMP-2 in one tibia and three uncoated implants in the other tibia), and the sites were closed, submerging the implants. The animals received alizarin (at 2 weeks), calcein (at 4 weeks), and tetracycline (at 6 weeks) fluorescent bone markers, and were euthanized at 8 weeks for histomorphometric analysis., Results: The amount of ErhBMP-2 coating was 9.6 ± 0.4 μg per MgO implant, 14.5 ± 0.6 μg per RBM implant, and 29.9 ± 3.8 μg per SLA implant. Clinical healing was uneventful. Mean bone-to-implant contact (± standard deviation) for the ErhBMP-2/RBM (35.4% ± 5.1%) and ErhBMP-2/MgO (33.4 % ± 13.2%) implants was significantly greater compared with RBM (23.6% ± 6.2%) and MgO (24.9% ± 2.7%) implants (P < .05). Considering the mean bone-to-implant contact in cortical bone, ErhBMP-2/SLA implants (32.9% ± 7.8%) showed lower bone-to-implant contact in cortical bone than all other implant variations (range, 39.9% ± 18.1% to 51.3% ± 9.2%; P < .05). There were no remarkable differences in new bone area, with minor differences between implants., Conclusions: Within the limits of study, it was found that the absorbed ErhBMP-2 dose varied with implant surface characteristics, influencing local bone formation and remodeling.