Changes in masticatory performance during the retention period following 4-premolar extraction and non-extraction orthodontic treatment.

OBJECTIVES: To evaluate changes in masticatory performance (MP) during the retention period after extraction and non-extraction treatment and compare it with MP in individuals with normal occlusion. MATERIALS AND METHODS: Adult patients who had completed orthodontic fixed appliance treatment comprised the extraction and non-extraction treatment groups, and those with normal occlusion comprised the control group. Their mixing ability (MA), maximum bite force (MBF), and occlusal contact area (OCA) were recorded immediately after the fixed appliance was removed and at 1 month, 6 months, and 1 year post-treatment. The MA was measured via the two-color chewing gum MA test using ViewGum software, and the MBF and OCA were measured using Dental Prescale II system. RESULTS: MA immediately after orthodontic treatment was lower than that in the normal group but showed a time-dependent gradual increase during a 1-year retention period (P < 0.01). The MA at 1 month post-treatment was not significantly different between the three groups (P > 0.05). The MA revealed a significant correlation with the MBF and OCA (P < 0.01). CONCLUSIONS: The MP immediately after orthodontic treatment was lower than that in the normal group but increased gradually, with levels comparable to those of the normal occlusion group at 1 month post-treatment. Further, extraction did not affect the recovery of the MP after orthodontic treatment. CLINICAL RELEVANCE: No other study has evaluated the changes in MP during the retention period after orthodontic treatment. The findings show that compared with MBF and OCA, the patients' MP improved faster to levels found in normal occlusion.

Top-down design and fabrication with digital technology of removable partial dentures incorporating custom abutments: A dental technique.

A novel design of removable partial dentures (RPDs) is described wherein custom abutments are incorporated into the RPD framework. The artificial teeth and custom abutments are designed by using a computer-aided design (CAD) software program. Subsequently, the RPD framework is designed and merged to the custom abutments in the CAD software program to form a single unit. This modified framework is additively manufactured in metal by using a 3D printer. Thereafter, the framework is adapted to the definitive cast and scanned by using a laboratory scanner. The scanned file is imported into the CAD software program, and the artificial teeth are redesigned. After fabricating each artificial tooth from a polymethylmethacrylate disk and artificial tooth and denture-base assemblies from a wax disk, the RPD is injection molded. This RPD design and fabrication workflow enables a top-down approach by prioritizing the shape and arrangement of the artificial teeth and facilitates their replacement.

Comparison of the accuracy of a cone beam computed tomography-based virtual mounting technique with that of the conventional mounting technique using a facebow.

STATEMENT OF PROBLEM: The introduction of digital technology in dentistry has resulted in a shift from conventional methods to digital techniques. However, mounting a digitized dental cast on a virtual articulator is challenging. Several techniques have been suggested to resolve this problem, but in the absence of a standardized method, digitized dental casts are often mounted arbitrarily on a virtual articulator. PURPOSE: The purpose of this clinical study was to compare the accuracy of a novel virtual facebow transfer (VM) technique based on cone beam computed tomography (CBCT) with that of the conventional mounting (CM) technique using a facebow. MATERIAL AND METHODS: Five repeated mountings were performed with each technique for 15 participants. In the CM group, dental casts were mounted using a facebow record and scanned for transmission to the virtual dental space. In the VM group, digital dental casts were mounted on the standard tessellation language file of a reference articulator by reconstructing a file of the participant's skull from CBCT data. In this group, a virtual facebow, prepared by scanning the articulator and facebow complex, was used. After the CM and VM casts had been aligned, the coordinates of target points set on the maxillary right central incisor, maxillary right first molar, and maxillary left first molar were determined, and the mean ±standard deviation distance between the target points was calculated to compare the precision of the techniques. Additionally, vectors of the target point on the maxillary right central incisor were compared to analyze the spatial difference between the techniques. Finally, the occlusal plane angle was calculated. For the correlation analysis of repeated measured data, a 1-way repeated measures analysis of variance (ANOVA) was first performed. The Kolmogorov-Smirnov test was performed to determine normality, and a paired t test and the Wilcoxon signed rank test were performed for normally and nonnormally distributed variables, respectively (α=.05). RESULTS: The mean distance between target points was significantly greater in the CM group (4.72 ±1.45 to 5.17 ±1.54 mm) than in the VM group (2.14 ±0.58 to 2.35 ±0.60 mm) (P<.05). The standard deviation between target points was significantly greater in the CM group (1.60 ±0.64 to 2.30 ±0.87 mm) than in the VM group (0.74 ±0.23 to 1.12 ±0.45 mm) (P<.05). The maxillary right central incisor was located more anteriorly in the VM group than in the CM (100%, P<.05) group. The occlusal plane angle was significantly steeper in the CM group than in the VM group (8.14 degrees versus 2.13 degrees, P<.05). CONCLUSIONS: The VM technique was more precise than the CM technique. VM casts were positioned ahead of CM casts. Further, the occlusal plane angle tended to be steeper with the CM technique than with the VM technique.

Effect of cement space settings on the marginal and internal fit of 3D-printed definitive resin crowns.

STATEMENT OF PROBLEM: The cement gap setting affects the marginal and internal fits depending on the crown material and manufacturing method (subtractive or additive manufacturing). However, information on the effects of cement space settings in the computer-aided design (CAD) software program, which is used to aid the manufacturing with 3-dimensional (3D) printing-type resin material, is lacking, and recommendations for optimal marginal and internal fit are needed. PURPOSE: The purpose of this in vitro study was to evaluate how cement gap settings affect the marginal and internal fit of a 3D-printed definitive resin crown. MATERIAL AND METHODS: After scanning a prepared typodont left maxillary first molar, a crown was designed with cement spaces of 35, 50, 70, and 100 µm by using a CAD software program. A total of 14 specimens per group were 3D printed from definitive 3D-printing resin. By using the replica technique, the intaglio surface of the crown was duplicated, and the duplicated specimen was sectioned in the buccolingual and mesiodistal directions. Statistical analyses were performed using the Kruskal-Wallis and the Mann-Whitney post hoc tests (α=.05). RESULTS: Although the median values of the marginal gaps were within the clinically acceptable limit (<120 µm) for all the groups, the smallest marginal gaps were obtained with the 70-µm setting. For the axial gaps, there was no observed difference in the 35-, 50-, and 70-µm groups, and the 100-µm group showed the largest gap. The smallest axio-occlusal and occlusal gaps were obtained with the 70-µm setting. CONCLUSIONS: Based on the findings of this in vitro study, a 70-µm cement gap setting is recommended for optimal marginal and internal fit of 3D-printed resin crowns.

A comprehensive study on the mechanical effects of implant-supported prostheses under multi-directional loading and different occlusal contact points.

AIMS: To evaluate screw loosening and fracture load and angular deviation of a single implant-supported prosthesis under multi-directional loading condition at three different occlusal contact points. METHODS: A total of 40 metal crowns were cemented to external connection implants and were embedded vertically and obliquely. The occlusal surface of the crown was designed with three flat surfaces, contact a, b, and c, representing outer and inner 20-degree inclination for buccal and lingual cusps. The angular deviations of implant crown under static 50N of loading were measured. And screw removal torque was evaluated before and after 57,600 load cycles. Then, fracture load was measured for each specimen. Data analysis was performed using one-way analysis of variance test of significance followed by Tukey honest significant difference (HSD) test(p < 0.05). RESULTS: Angular deviation results showed statistical significance between all contact points in vertically embedded group compared to obliquely embedded group, which showed similar results between contact A and B compared to C. In the other hand, screw loosening evaluation did not show statistical significance among the tested groups. And for the fracture load evaluation the maximum values reached twice the yield values in all contact areas. CONCLUSIONS: Mechanical effects were different regarding to diverse loading direction and contact points. The results of this study suggest that the stress concentration might increase in unfavorable vector direction.

Accuracy of impression-making methods in edentulous arches: An in vitro study encompassing conventional and digital methods.

STATEMENT OF PROBLEM: Studies evaluating the accuracy of edentulous arch impressions encompassing conventional and digital methods are lacking. PURPOSE: The purpose of this in vitro study was to evaluate 8 impression-making methods for edentulous arches and to determine the effects of using a 3-dimensionally printed polyetheretherketone (PEEK) scanning aid on the accuracy of intraoral scanners. MATERIAL AND METHODS: Three sets of edentulous arch typodonts were scanned with an industrial scanner as a reference. Subsequently, a scanning aid for the edentulous arch was individually designed on each reference scan dataset by using a 3-dimensional modeling software program and fabricated in PEEK with a 3-dimensional printer. Each typodont was scanned with 2 intraoral scanners 12 times, with and without the assistance of a scanning aid for the edentulous arch. Impressions were made with 4 different conventional impression materials (irreversible hydrocolloid, polysulfide, polyether, and polyvinyl siloxane)-12 times for each typodont-the casts were poured and digitized with a tabletop scanner. Each scan data set was superimposed over the corresponding scan data set, and the original and absolute distance values from the paired surface points were obtained to measure the trueness and precision. These were expressed by using the mean, median, root mean square, and (90 percentile-10 percentile)/2 of the absolute distance value (NMT) concepts, based on the raw data extraction protocol. A repeated-measures ANOVA followed by a post hoc Bonferroni test was conducted (α=.05). RESULTS: The impression-making methods did not show statistically significant differences (P>.05) for either trueness or precision, particularly when the median values of the original and absolute distance values from the paired surface points were chosen as the standard values. One of the intraoral scanners used exhibited significantly superior outcomes to conventional impression materials when scanned with the scanning aid for the edentulous arch for both trueness and precision when the mean, root mean square, and NMT concepts were applied (P<.05). CONCLUSIONS: Intraoral scanners demonstrated accuracy comparable with that of conventional impression materials for making edentulous arch impressions, regardless of the concepts used to express the trueness and precision. The PEEK-based scanning aid for the edentulous arch did not improve the accuracy of the intraoral scanners; however, its application resulted in higher accuracy compared with that of conventional impression materials.

Fabrication of a removable partial denture combining conventional and digital techniques.

This article describes a combined conventional and digital workflow for fabricating removable partial dentures (RPDs). After scanning the dental cast and RPD framework assembly, artificial teeth and denture base regions were designed using computer-aided design software. The artificial teeth and denture base assembly was milled as a single structure by using a wax disk and then placed on the RPD framework. The artificial teeth were additionally milled from a polymethyl methacrylate disk. Conventional procedures were followed for denture investment until the wax elimination procedure, after which the assembly was replaced with the artificial teeth in the cope of the flasks, and the denture resin material was injected to process the RPD. This technique enabled the RPD to be fabricated in the same form as the design state.

Influence of shoulder coverage difference of abutment on stress distribution and screw stability in tissue-level internal connection implants: A finite element analysis and in vitro study.

STATEMENT OF PROBLEM: Tissue-level internal connection implants are widely used, but the difference in abutment screw stability because of the shoulder coverage formed by the contact between the shoulder of the implant collar and the abutment remains unclear. PURPOSE: The purpose of this finite element analysis (FEA) and in vitro study was to investigate stress distribution and abutment screw stability as per the difference in shoulder coverage of the abutment in tissue-level internal connection implants. MATERIAL AND METHODS: Abutments were designed in 3 groups as per the shoulder coverage of the implant collar, yielding complete coverage (complete group), half coverage (half group), no coverage (no group) groups. In the FEA, a tightening torque of 30.0 Ncm was applied to the abutment screw, a force of 250 N was applied to the crown at a 30-degree angle, and the von Mises stresses and the stress distribution patterns were evaluated. In the in vitro study, the groups were tested (n=12). A total of 200 000 cyclic loads were applied at 250 N, 14 Hz, and at a 30-degree angle. Removal torque values and scanning electron microscopy (SEM) images were assessed. Removal torque values were analyzed by ANOVA and paired t tests. RESULTS: The maximum von Mises stress of the abutment screw was the lowest in the complete group, slightly higher in the half group, and highest in the no group. High stresses were concentrated in 1 location in the implant abutment connection area of the no group. The removal torque values after loading were significantly lower in the no group than in the complete group (P=.047). The SEM images revealed concentrated structural loss and wear in 1 location of the no group. CONCLUSIONS: FEA and in vitro studies confirmed that the shoulder coverage of the abutment in the tissue-level internal connection implant helped improve screw stability. Cyclic loading reduced the removal torque of the abutment screw.

Mounting casts on a mechanical articulator by using digital multisource data: A dental technique.

A facebow transfer is typically used for mounting a maxillary gypsum cast in an ideal location in a mechanical articulator. However, the facebow transfer procedure is difficult and may cause the patient discomfort. This proposed technique uses a patient's cone beam computed tomography (CBCT) data to reproduce the occlusal plane in relation to digital articulator scan data, align the patient's gypsum cast or intraoral scan data on the reproduced plane, and then transfer the data to a mechanical articulator.

Digital approach for production of interim implant-supported fixed restoration with a prefabricated implant component library.

During production of an immediate interim implant-supported fixed restoration with interim cylinders, the formation of an access hole in the dentures is critical. Traditional access hole formation involves repeated prosthesis insertion and removal in the oral cavity, primarily through trial and error, to adjust the hole position and size. The presented technique simulates the interim cylinder position based on the healing abutment position, enabling confirmation of the access hole position and ensuring more precise seating of the interim implant-supported fixed restoration.

Denture-reversing technique for assessing the soft tissue dimensional changes according to artificial tooth position in completely edentulous patients.

A digital workflow to assess the soft tissue dimensional changes in completely edentulous patients is described. Diagnostic casts obtained at 2 time points and the complete denture were scanned by using a desktop scanner. The denture scan was inverted by using a metrology software program to obtain the soft tissue contour. Using this reversed file as a reference, the file and 2 scan files obtained at different time points were aligned individually with the best fit alignment function. The scanned denture file and the 2 realigned scan files were imported into the same software. A plane vertical to the occlusal plane was determined such that it moved anteroposteriorly. The distance between the contours of the 2 realigned files was measured by selecting a point and a vector based on the artificial tooth positions of the denture. This technique of using a reversed denture file may provide a quantitative evaluation of soft tissue changes and further aid in determining appropriate intervals for denture relining or rebasing.

A generation process for a three-dimensional digital cast that simulates the oral cavity by using an existing maxillary obturator.

To simulate the current oral status of patients, including maxillofacial defects, the digital method described uses a method based on multisource data. These include data recorded from scans made with and without wearing an obturator and data obtained by scanning the surgical or interim obturator. This method eliminates the need for preliminary impressions and complex border-molding steps during the process of creating a definitive obturator, thereby greatly simplifying the fabrication process.

Ephemeroptericola cinctiostellae gen. nov., sp. nov., isolated from gut of an aquatic insect.

A Gram-stain-negative, catalase- and oxidase-positive, non-motile bacterium, designated F02T, was isolated from of gut of Cincticostellalevanidovae (Tshernova). Growth occurred at a temperature range of 4-30 °C, at pH 6-9 and in the presence of 0-0.5 % (w/v) NaCl. Phylogenetic analysis demonstrated that the 16S rRNA gene sequence of strain F02T shared the highest similarity to that of the type strain of Hydromonas duriensis A2P5T (96.82 %). The major isoprenoid quinone was Q-8. The polar lipids were diphosphatidylglycerol, phosphatidylglycerol and phosphatidylethanolamine. The major cellular fatty acids were summed feature 3 (C16 : 1ω7c/C16 : 1ω6c) and iso-C13 : 0 3-OH. The polyamines were cadaverine and putrescine. Combined data from phylogenetic, phenotypic and chemotaxonomic analyses demonstrated that strain F02T represents a novel genus and species, for which the name Ephemeroptericolacinctiostellae gen. nov., sp. nov. is proposed. The type strain of Ephemeroptericola cinctiostellae gen. nov., sp. nov. is F02T (=FBCC 500047T=KCTC 62567T=JCM 32722T).

Flavobacterium sangjuense sp. nov. isolated from sediment.

A yellow-pigmented bacterial strain, GS03T, was isolated from sediment in a branch of the Nackdong River in Sangju, Korea. Cells were observed to be Gram-negative, aerobic and rod-shaped with gliding motility, and to be positive for catalase and oxidase. Growth was found to occur at 4-30 °C (optimum 25 °C), at pH 7.0-8.5 (optimum pH 7.5) and at NaCl 0% (optimum NaCl 0%, w/v). The major cellular fatty acids (> 10% of the total) were identified as iso C15:0, iso C15:1 G, C15:1ω6c, iso C15: 0 3-OH and iso C17: 0 3-OH. The major respiratory quinone was found to be menaquinone MK-6. The genome sequence of GS03T is 3.1 Mb with G+C content of 36.1 mol%. The major polar lipids of the isolate were identified as phosphatidylethanolamine, three unidentified aminolipids, two unidentified phospholipids, an unidentified lipid and an unidentified aminophospholipid. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain GS03T clusters with Flavobacterium paronense KNUS1TT, with similarity of 96.8%. The phenotypic, phylogenetic, and chemotaxonomic characteristics indicate that strain GS03T represents a novel species of the genus Flavobacterium, for which the name Flavobacterium sangjuense sp. nov. is proposed. The type strain is GS03T (= FBCC 502459T = KCTC 62568T = JCM 32764T).

Computer-based implant planning involving a prefabricated custom tray with alumina landmark structures.

The purpose of this technical report was to describe a method for the fabrication of a custom tray with landmark structures to coordinate cone beam computed tomography and scan data for use in guided implant surgery in patients with numerous artifact-causing metal prostheses. The fabricated custom tray can be used to coordinate cone beam computed tomography data and scan data from the dentition, as well as to fabricate the prostheses.

Enamel wear and aging of translucent zirconias: In vitro and clinical studies.

STATEMENT OF PROBLEM: Zirconia is a widely used restorative material. However, phase transformation on clinical application of zirconia has not yet been studied. PURPOSE: The purpose of this study was to evaluate the wear, surface roughness, and aging associated with polished translucent zirconia in both in vitro and clinical experiments. MATERIAL AND METHODS: In vitro experiments were performed with Rainbow and Katana zirconia blocks and natural tooth enamel as the control. They were subjected to 100 000 loading cycles with a maxillary premolar antagonist. All specimens were analyzed for wear, and the zirconia specimens were evaluated for surface roughness and monoclinic phase (m-phase) transformation by X-ray diffractometry before and after cyclic loading. The clinical study included participants who required single-crown implant-supported restorations replacing the first or second molar. The participants received Rainbow or Katana zirconia prostheses (n=15, each). For wear analysis, impressions of each prosthesis, antagonist, and adjacent tooth were made at 1 week and 6 months after crown delivery. The occlusal relationship of the crowns in maximum intercuspation was evaluated by using the T-Scan 8 occlusal diagnostic system. The degree of transformation of zirconia to the m-phase was measured by using X-ray diffractometry of the crowns after 6 months of use. RESULTS: Zirconia induced significantly greater enamel wear than the natural tooth control. Katana specimens exhibited significantly greater wear and surface roughness than the Rainbow specimens. The degrees of antagonistic wear and zirconia phase transformation in the clinical experiment were significantly greater than those in the in vitro experiment. The Katana groups showed significantly higher m-phase levels than the Rainbow groups. CONCLUSIONS: Phase transformation of zirconia occurs within 6 months of clinical use, and the wear and degrees of phase transformation varied according to the zirconia product used.

A digital implant custom tray fabrication method using the design process for simulating the position of the impression copings and 3D printing technology.

The technique described allowed an implant custom tray to be fabricated referencing the location of connected impression copings. The technique uses dental computer-aided design (CAD) software and 3D printing technology. The method controls the thickness of the impression material around the impression copings, improving the impression-making process.

Accuracy of Scanned Stock Abutments Using Different Intraoral Scanners: An In Vitro Study.

PURPOSE: To determine the accuracy of a digital manufacturing method for dental implant restorations on stock abutments using intraoral scanners and prefabricated stock-abutment libraries. MATERIALS AND METHODS: Two dental implants with internal hexagonal connections were placed in the mandibular second premolar and second molar areas of a partially edentulous dentoform model; stock abutments with a diameter of 5 mm, abutment height of 5.5 mm, and gingival cuff height of 2 mm were connected. The study model was scanned 10 times using a reference tabletop scanner and 5 types of intraoral scanners (IOSs). The data collected by 5 types of IOSs were divided into 3 groups, based on the type and matching of stock abutment library data: no library, optical library, and contact library groups. A total of 160 data files were analyzed, including reference data. The resulting data were used to evaluate trueness and precision. RESULTS: Trueness and precision values in the group in which library data of the stock abutment were not used were 42.0 to 76.3 µm and 30.5 to 99.7 µm; corresponding values when the library data using an optical scanner were matched were 51.2 to 73.4 µm and 26.3 to 62.8 µm, and those when contact scanner library data were used were 30.1 to 62.4 µm and 15.5 to 55.9 µm. Thus, the accuracy of the contact library group was significantly higher than the accuracies of the no library (p < 0.001) and optical library groups (p < 0.001). CONCLUSION: The application of prefabricated library data of stock abutments using a contact scanner improved the accuracy of scan data. Scan accuracy of the stock abutments differed significantly based on the type of scanner.

Paucibacter aquatile sp. nov. isolated from freshwater of the Nakdong River, Republic of Korea.

A Gram-negative, aerobic, motile, and rod-shaped bacterial strain designated CR182T was isolated from freshwater of the Nakdong River, Republic of Korea. Optimal growth conditions for this novel strain were found to be: 25-30 °C, pH 6.5-8.5, and 3% (w/v) NaCl. Phylogenetic analysis based on 16S rRNA gene sequence indicates that the strain CR182T belongs to type strains of genus Paucibacter. Strain CR182T showed 98.0% 16S rRNA gene sequence similarity with Paucibacter oligotrophus CHU3T and formed a robust phylogenetic clade with this species. The average nucleotide identity value between strain CR182T and P. oligotrophus CHU3T was 78.4% and the genome-to-genome distance was 22.2% on average. The genomic DNA G+C content calculated from the genome sequence was 66.3 mol%. Predominant cellular fatty acids of strain CR182T were summed feature 3 (C16:1 ω7c and/or C16:1 ω6c) (31.2%) and C16:0 (16.0%). Its major respiratory quinine was ubiquinone Q-8. Its polar lipids consisted of diphosphatidylglycerol, phosphatidylethanolamine, and two unidentified phospholipids. Its genomic DNA G+C content was 66.3%. Based on data obtained from this polyphasic taxonomic study, strain CR182T represents a novel species belonging to genus Paucibacter, for which a name of P. aquatile sp. nov. is proposed. The type strain is CR182T (= KCCM 90284T = NBRC 113032T).

Effect of Serial Use of Bone Morphogenetic Protein 2 and Fibroblast Growth Factor 2 on Periodontal Tissue Regeneration.

PURPOSE: This study evaluates the synergistic effect of serial application of bone morphogenetic protein 2 (BMP2) and fibroblast growth factor 2 (FGF2) on both new bone formation and periodontal tissue regeneration using 1-wall intrabony defect in mongrel dogs. MATERIALS AND METHODS: One-wall defects were created at the mesial aspect of the mandibular first molars of 6 male mongrel dogs. Each mandibular defect received 1 of the 2 experimental treatments randomly (BMP2 or BMP2 + FGF2), and it was allowed to heal for either 4 or 8 weeks postoperatively. Histologic and histomorphometric analyses were performed for the evaluation of the overall healing patterns of new bone formation and periodontal tissue regeneration. RESULTS: The results showed that after 8 weeks, serial application of BMP2 and FGF2 significantly improved the periodontal tissue regeneration, whereas application of BMP2 only showed greater new bone formation after 4 weeks. CONCLUSIONS: The serial application of BMP2 and FGF2 may have synergistic effects on periodontal tissue regeneration over time.