Ching Chang Ko

Bone stress and interfacial sliding analysis of implant designs on an immediately loaded maxillary implant: a non-linear finite element study.

OBJECTIVES This study investigated the surrounding bone stress and the implant-bone interfacial sliding of implant designs and implant sizes of immediately loaded implant with maxillary sinus augmentation by using three-dimensional (3D) non-linear finite element (FE) analysis. METHODS Twenty-four FE models including four implant designs (cylindrical, threaded, stepped and step-thread implants) and three implant dimensions (standard, long and wide threaded implants) with a bonded and three levels of frictional contact of implant-bone interfaces were analyzed. The maxillary model was constructed from computer tomography (CT) images of a human skull and all 3D implant models were created via the computer-aided design (CAD) software. RESULTS The use of threaded implants decreased the bone stress and sliding distance obviously about 30% as compared with non-threaded (cylindrical and stepped) implants. Increasing the implants length or diameter reduced the bone stress by 13-26%. Employing a immediately loaded implant with smooth machine surface (mu=0.3, mu represents frictional coefficient) increased the bone stress by 28-63% as compared with the osseointegrated (bonded interfaces) implants. Roughening the implant surface (mu>0.3) did not reduced the bone stress, however it did decrease the interfacial sliding between implant and bone. CONCLUSIONS For an immediately loaded implant placed with sinus augmentation, using threaded implant could decrease both the bone stress and implant-bone sliding distance which may improve the implant initial stability and long-term survival. Rough surface of implants shows no benefit to reduce the bone stress but they could lower the interfacial sliding. On the contrary, employing long or wide implants decrease the bone stress but they cannot diminish the interfacial sliding.

Quantitative skeletal maturation estimation using cone-beam computed tomography-generated cervical vertebral images: a pilot study in 5- to 18-year-old Japanese children

ObjectivesThe purpose of this study was to establish multivariable regression models for the estimation of skeletal maturation status in Japanese boys and girls using the cone-beam computed tomography (CBCT)-based cervical vertebral maturation (CVM) assessment method and hand-wrist radiography.Materials and methodsThe analyzed sample consisted of hand-wrist radiographs and CBCT images from 47 boys and 57 girls. To quantitatively evaluate the correlation between the skeletal maturation status and measurement ratios, a CBCT-based CVM assessment method was applied to the second, third, and fourth cervical vertebrae. Pearsons correlation coefficient analysis and multivariable regression analysis were used to determine the ratios for each of the cervical vertebrae (p < 0.05).ResultsFour characteristic parameters ((OH2 + PH2)/W2, (OH2 + AH2)/W2, D2, AH3/W3), as independent variables, were used to build the multivariable regression models: for the Japanese boys, the skeletal maturation status according to the CBCT-based quantitative cervical vertebral maturation (QCVM) assessment was 5.90 + 99.11 × AH3/W3 − 14.88 × (OH2 + AH2)/W2 + 13.24 × D2; for the Japanese girls, it was 41.39 + 59.52 × AH3/W3 − 15.88 × (OH2 + PH2)/W2 + 10.93 × D2.ConclusionsThe CBCT-generated CVM images proved very useful to the definition of the cervical vertebral body and the odontoid process. The newly developed CBCT-based QCVM assessment method showed a high correlation between the derived ratios from the second cervical vertebral body and odontoid process.Clinical relevanceThere are high correlations between the skeletal maturation status and the ratios of the second cervical vertebra based on the remnant of dentocentral synchondrosis.

Cervical Vertebral Body’s Volume as a New Parameter for Predicting the Skeletal Maturation Stages

This study aimed to determine the correlation between the volumetric parameters derived from the images of the second, third, and fourth cervical vertebrae by using cone beam computed tomography with skeletal maturation stages and to propose a new formula for predicting skeletal maturation by using regression analysis. We obtained the estimation of skeletal maturation levels from hand-wrist radiographs and volume parameters derived from the second, third, and fourth cervical vertebrae bodies from 102 Japanese patients (54 women and 48 men, 5–18 years of age). We performed Pearsons correlation coefficient analysis and simple regression analysis. All volume parameters derived from the second, third, and fourth cervical vertebrae exhibited statistically significant correlations (P < 0.05). The simple regression model with the greatest R-square indicated the fourth-cervical-vertebra volume as an independent variable with a variance inflation factor less than ten. The explanation power was 81.76%. Volumetric parameters of cervical vertebrae using cone beam computed tomography are useful in regression models. The derived regression model has the potential for clinical application as it enables a simple and quantitative analysis to evaluate skeletal maturation level.

Influence of DPSS Laser on Polymerization Shrinkage and Mass Change of Resin Composites

OBJECTIVES This study evaluated the effectiveness of the diode-pumped solid state (DPSS) laser as a light source for light-curing dental resin composites. BACKGROUND DATA A DPSS laser of 473  nm may be useful because of its match with the absorption peak of camphorquinone (CQ), the photoinitiator. MATERIALS AND METHODS A DPSS laser (LAS) of 473  nm and a quartz-tungsten-halogen (QTH) light-curing unit (OP) were used as the light sources for light curing six different resin composites (four nanocomposites and two hybrid composites). Polymerization shrinkage and mass change (water sorption and solubility) were measured during and after light curing to determine the degree of polymerization. Mass change was evaluated by following the ISO 4049 standard. RESULTS According to the evaluation, the specimens light cured using LAS showed similar maximum polymerization shrinkage (12.3∼18.1  μm for LAS; 13.2∼16.2  μm for OP) and water sorption (11.4∼24.1  μg/mm(3) for LAS; 11.3∼22.8  μg/ mm(3) for OP) to the cases light cured using OP. The specimens light cured using LAS showed a significantly higher solubility than the cases light cured using OP (2.4∼6.6  μg/ mm(3) for LAS; 0.8∼1.6  μg/ mm(3) for OP). However, the maximum water sorption and solubility obtained from the specimens were lower than the values permitted by the ISO 4049 standard. CONCLUSIONS The results may suggest that the DPSS laser with an emission wavelength of 473  nm can be used as a light source for light-curing dental resin composites.

Diagnosis and staging of caries using spectral factors derived from the blue laser-induced autofluorescence spectrum

OBJECTIVE The aim of this study was to identify the factors derived from the 405nm laser-induced autofluorescence (AF) spectra that could be used to diagnose and stage caries. MATERIALS AND METHODS Teeth (20 teeth per stage) were classified as sound, stage II, III, and IV based on a visual and tactile inspection. The specimens were re-examined and reclassified based on micro-CT analysis. From the teeth, the AF was obtained using a 405nm laser. Three spectral factors (spectral slope at 550-600nm, area under the curve at 500-590nm, and two-peak ratio between 625 and 667nm) were derived from the AF spectra. Using these factors, the diagnosis and staging of caries were tested, and the results were compared with those of DIAGNOdent. RESULTS After micro-CT analysis, only 13, 11, and 13 teeth were reclassified as stages II, III, and IV, respectively. The reclassified groups showed less data overlap between the stages, and the spectral slope was 40.1-74.6, 27.5-39.6, 11.1-27.4, and 1.0-9.7 for sound, stage II, III, and IV, respectively. The differentiation of stages III and IV using DIAGNOdent appeared to be difficult due to the considerable data overlap. CONCLUSION Among the factors tested, the spectral slope at 550-600nm showed the best match with the caries specimens, in which their stage had been identified precisely. CLINICAL SIGNIFICANCE The 405nm laser-induced AF spectra can be applied to the diagnosis and staging of caries alone or in conjunction with conventional methods, such as visual, tactile, and X-ray inspection.

Comparison of postoperative changes in the distal and proximal segments between conventional and sliding mini-plate fixation following mandibular setback

Objective The purpose of the present study was to evaluate the postoperative three-dimensional (3D) changes in the proximal segments after mandibular setback sagittal split ramus osteotomy and to compare the changes between the conventional mini-plate fixation and semi-rigid sliding plate fixation. Methods Cone-beam computed tomography (CBCT) images were used to evaluate the postoperative 3D changes in the proximal segments during the healing process. CBCT images were superimposed using the symphysis and the lower anterior mandible as references. Results There were no statistically significant differences between the conventional mini-plate and semi-rigid sliding plate groups (p > 0.05). With respect to the distribution of changes greater than 2 mm in the landmarks, the right condylion, right coronoid process, and left condylion showed ratios of 55.6%, 50.0%, and 44.4%, respectively, in the semi-rigid sliding plate group; however, none of the landmarks showed ratios greater than 30% in the conventional mini-plate group. Conclusions There were no statistically significant differences in postoperative changes in the segments between the conventional mini-plate and semi-rigid sliding plate groups. Nevertheless, while selecting the type of fixation technique, clinicians should consider that landmarks with greater than 2 mm changes were higher in the semi-rigid sliding plate group than in the conventional mini-plate group.

Effect of 457 nm Diode-Pumped Solid State Laser on the Polymerization Composite Resins: Microhardness, Cross-Link Density, and Polymerization Shrinkage

OBJECTIVE The purpose of the present study was to test the usefulness of 457 nm diode-pumped solid state (DPSS) laser as a light source to cure composite resins. MATERIALS AND METHODS Five different composite resins were light cured using three different light-curing units (LCUs): a DPSS 457 nm laser (LAS), a light-emitting diode (LED), and quartz-tungsten-halogen (QTH) units. The light intensity of LAS was 560 mW/cm(2), whereas LED and QTH LCUs was ∼900 mW/cm(2). The degree of polymerization was tested by evaluating microhardness, cross-link density, and polymerization shrinkage. RESULTS Before water immersion, the microhardness of laser-treated specimens ranged from 40.8 to 84.7 HV and from 31.7 to 79.0 HV on the top and bottom surfaces, respectively, and these values were 3.3-23.2% and 2.9-31.1% lower than the highest microhardness obtained using LED or QTH LCUs. Also, laser-treated specimens had lower top and bottom microhardnesses than the other LCUs treated specimens by 2.4-19.4% and 1.4-27.8%, respectively. After ethanol immersion for 24 h, the microhardness of laser-treated specimens ranged from 20.3 to 63.2 HV on top and bottom surfaces, but from 24.9 to 71.5 HV when specimens were cured using the other LCUs. Polymerization shrinkage was 9.8-14.7 μm for laser-treated specimens, and these were significantly similar or lower (10.2-16.0 μm) than those obtained using the other LCUs. CONCLUSIONS The results may suggest that the 457 nm DPSS laser can be used as a light source for light-curing dental resin composites.

Mechanical properties and polymerization shrinkage of composite resins light-cured using two different lasers.

OBJECTIVE The purpose of the present study was to investigate the usefulness of 457 and 473 nm lasers for the curing of composite resins during the restoration of damaged tooth cavity. BACKGROUND DATA Monochromaticity and coherence are attractive features of laser compared with most other light sources. Better polymerization of composite resins can be expected. MATERIALS AND METHODS Eight composite resins were light cured using these two lasers and a light-emitting diode (LED) light-curing unit (LCU). To evaluate the degrees of polymerization achieved, polymerization shrinkage and flexural and compressive properties were measured and compared. RESULTS Polymerization shrinkage values by 457 and 473 nm laser, and LED ranged from 10.9 to 26.8, from 13.2 to 26.1, and from 11.5 to 26.3 μm, respectively. The values by 457 nm laser was significantly different from those by 473 and LED LCU (p<0.05). However, there was no statistical difference between values by 473 and LED LCU. Before immersion in distilled water, flexural strength (FS) and compressive modulus (CM) of the specimens were inconsistently influenced by LCUs. On the other hand, flexural modulus (FM) and compressive strength (CS) were not significantly different for the three LCUs (p>0.05). For the tested LCUs, no specific LCU could consistently achieve highest strength and modulus from the specimens tested. CONCLUSIONS Two lasers (457 and 473 nm) can polymerize composite resins to the level that LED LCU can achieve despite inconsistent trends of polymerization shrinkage and flexural and compressive properties of the tested specimens.

Influence of a Blue DPSS Laser on Specimen Thickness of Composite Resins

OBJECTIVE The purpose of the present study was to investigate the effect of 473 nm diode-pumped solid state (DPSS) laser on the curing depth of composite resins. BACKGROUND DATA Within the turbid media, light attenuates significantly because of the absorption and scattering. MATERIALS AND METHODS For the study, three different composite resins and light-curing units (LCUs) (a quartz-tungsten-halogen [QTH], light-emitting-diode [LED], and DPSS laser) were used. The number of photons transmitted through the specimens, degree of conversion (DC), microhardness, and refractive index of the specimens on different thicknesses were evaluated. RESULTS The incident light exponentially decreased within the specimens. Among the LCUs, QTH showed the least photon loss. The DC obtained using the DPSS laser and QTH was significantly greater (p<0.001) than that obtained using LED. The specimens light cured using the DPSS laser showed slightly lower microhardness than that cured by the other LCUs. On each depth, the mean refractive index was not significantly different for the LCUs used. DC, microhardness, and refractive index had inverse linear correlation with specimen thickness despite exponential decrease of photons number. On the other hand, DC, microhardness, and refractive index were linearly correlated to each other regardless of LCUs. CONCLUSIONS The DPSS laser of 473 nm achieved a similar level of polymerization within the specimens as those of the other LCUs even with much lower light intensity. This laser can be applied as a light source for light curing of composite resins.