Hyeongil Kim

The biocompatibility of SLA-treated titanium implants

The titanium implant surface was sandblasted with large grits and acid etched (SLA) to increase the implant surface for osseointegration. The topography of the titanium surface was investigated with scanning electron microscopy (SEM) and a profilometer. The SLA implant demonstrated uniform small micro pits (1-2 microm in diameter). The values of average roughness (R(a)) and maximum height (R(t)) were 1.19 microm and 10.53 microm respectively after sandblasting and the acid-etching treatment. In the cell-surface interaction study, the human osteoblast cells grew well in vitro. The in vivo evaluation of the SLA implant placed in rabbit tibia showed good bone-to-implant contact (BIC) with a mean value of 29% in total length of the implant. In the short-term clinical study, SLA implants demonstrated good clinical performance, maintaining good crestal bone height.

Comparison of fracture resistance of pressable metal ceramic custom implant abutments with CAD/CAM commercially fabricated zirconia implant abutments

STATEMENT OF PROBLEM The adequacy of the strength of dental zirconia abutments under heavy occlusal load conditions is questionable, with degradation of the mechanical properties of zirconia having been reported. Therefore, some alternatives must be considered. PURPOSE The purpose of this study was to determine the efficacy of fabricating pressable metal ceramic custom implant (Pr) abutments, and to evaluate the fracture resistance of these abutments. MATERIAL AND METHODS Two groups of implant abutment specimens were fabricated (n=10). The experimental group consisted of Pr abutments, and the control group consisted of CAD/CAM-designed zirconia-based ceramic (Zr) abutments. For the experimental group, custom metal abutments were cast using a compatible metal alloy (Lodestar); this was followed by injection molding with lithium disilicate pressable ceramic (IPS e.max Press) around the metal column of the custom implant abutment. For the control group, 10 specimens were fabricated from CAD/CAM-designed zirconia abutments (Procera Zirconia). Following scanning, all-ceramic crowns with the average dimensions of a human central incisor were fabricated for the experimental and control abutments (n=20) using lithium disilicate pressable ceramic (IPS e.max Press). Each crown was cemented to the implant abutments with a resin luting agent (Variolink II). The crown-abutment test specimens were fixed to titanium implant analogs and placed in a test stand at 30 degrees from the vertical axis of the specimens in a computer-controlled universal testing device. The independent t test was used to detect if the mean values of the fracture load differed significantly (alpha=.05) between the 2 groups. RESULTS The mean (SD) fracture load was significantly higher in the Pr group (901.67 (102.05) N) than in the Zr group (480.01 (174.46) N, P<.005). CONCLUSIONS This study found that Pr abutments are stronger than Zr abutments.

Improved biocompatibility of hydroxyapatite thin film prepared by aerosol deposition

Technical development for an efficient coating of bioactive materials improves the characteristics of a fully functional implant. The aim of this study was to investigate the osteoinductive effect of a newly developed hydroxyapatite (HA)-coating technique using aerosol deposition without post-heat treatment [room temperature (RT) group] on the titanium (Ti) dental implant in vitro and in vivo, compared with that of HA coating with post-heat treatment (HT-400 group) or machined surface (control group). Cell proliferation or attachment on the HA-coated Ti surface was assessed using tetrazolium salt, WST-8 or scanning electron microscopy (SEM). Human osteoblasts (HOB) on RT group were well attached and grew alike in the control or HT-400 group. The alkaline phosphatase activity of HOB cultured on RT and HT-400 group was significantly higher than the control group (p < 0.05). Evaluation by SEM, TEM, and XRD demonstrated that aerosol deposition facilitated HA particles to form a dense and uniform HA layer in the RT group despite no post-heating. In a rabbit tibia model (n = 3), the ratios of bone implant contact and bone area in the RT group (49.88%, 86.05%) were greater than in the HT-400 group (38.82%, 77.34%) or the control (28.31%, 73.86%). The finding of this study showed that the HA coating using aerosol deposition without post-heat treatment has a good biocompatibility, and provide a promoting strategy to enhance osseointegration in the application of the dental implant.

Applying microwave technology to sintering dental zirconia

STATEMENT OF PROBLEM When sintering zirconia, conventional processing may not provide uniform heating and consumes more energy than an alternative method using microwave energy. PURPOSE The purpose of this study was to compare the surface quality, mechanical and physical properties, and dimensional stability obtained by sintering yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) in a conventional furnace versus a microwave furnace. MATERIAL AND METHODS Twenty bars of Y-TZP were prepared from Zircad blocks. Ten specimens were used for sintering in a conventional furnace. The remaining 10 specimens were sintered in a microwave furnace. The sintering temperature used for both techniques was 1500°C. The flexural strength of all specimens was measured with the 3-point bend test with a universal testing machine with a cross head speed of 1.0 mm/min. Density was measured by applying the Archimedes method, and specimen length, width, and thickness were measured with a digital micrometer. The phase composition and average grain size of these ceramics were examined by using X-ray diffraction, and microstructure characteristics were studied with scanning electron microscopy. Data obtained were analyzed by using independent t tests (α=.05). RESULTS No significant difference between conventional and microwave sintering for either flexural strength, t18=0.49 (P=.63) or density, t18=0.07 (P=.95) was found. Specimens in both groups exhibited a uniform firing shrinkage of approximately 24.6% in all dimensions. The surface of selected specimens examined with a scanning electron microscope showed no visible difference in grain shape or porosity size between the 2 sintering methods. CONCLUSIONS Under the conditions of this study, it appears that either microwave or conventional zirconia sintering may be used for processing zirconia for dental use. However, microwave energy provides uniformity of heating, allowing the use of higher heating rates, which can increase productivity and save energy.

Enhanced bone forming ability of SLA-treated Ti coated with a calcium phosphate thin film formed by e-beam evaporation

With an electron-beam evaporation process, a calcium phosphate (Ca-P) thin film of approximately 500 nm thick was deposited on sand blasted with large grits and acid etched (SLA) Ti without changing the typical morphology of the SLA surface. Dissolution behavior was investigated by measuring the amount of dissolved phosphate ions with ion chromatography after immersing the SLA Ti sample coated with a Ca-P film in 1 ml de-ionized water maintained at 37 degrees C for different periods of soaking time, and the surface morphology was observed with field emission scanning electron microscopy. The amount of phosphate ions increased quickly right after immersion but began to decrease after 2 days of immersion by redeposition with Ca ions as apatite, and the amount of biomimetic apatite increased with the extended soaking time. The Saos-2 cell was more attached on the coated surface, and the in vivo evaluation was that the Ca-P deposited SLA implant greatly improved the new bone formation ability.

Comparison of porcelain surface and flexural strength obtained by microwave and conventional oven glazing.

STATEMENT OF PROBLEM Although the superior qualities of microwave technology are common knowledge in the industry, effects of microwave glazing of dental ceramics have not been investigated. PURPOSE The purpose of this study was to investigate the surface roughness and flexural strength achieved by glazing porcelain specimens in a conventional and microwave oven. MATERIAL AND METHODS Thirty specimens of each type of porcelain (Omega 900 and IPS d.Sign) were fabricated and sintered in a conventional oven. The specimens were further divided into 3 groups (n=10): hand polished (using diamond rotary ceramic polishers), microwave glazed, and conventional oven glazed. Each specimen was evaluated for surface roughness using a profilometer. The flexural strength of each specimen was measured using a universal testing machine. A 2-way ANOVA and Tukey HSD post hoc analysis were used to determine significant intergroup differences in surface roughness (alpha=.05). Flexural strength results were also analyzed using 2-way ANOVA, and the Weibull modulus was determined for each of the 6 groups. The surfaces of the specimens were subjectively evaluated for cracks and porosities using a scanning electron microscope (SEM). RESULTS A significant difference in surface roughness was found among the surface treatments (P=.02). Follow-up tests showed a significant difference in surface roughness between oven-glazed and microwave-glazed treatments (P=.02). There was a significant difference in flexural strength between the 2 porcelains (P<.005), but no significant difference in flexural strength by surface treatment (P=.48). The Weibull modulus value for the Omega 900 microwave-glazed group was the highest (1.9) as compared to the other groups. CONCLUSIONS The surface character of microwave-glazed porcelain was superior to oven-glazed porcelain. Omega 900 had an overall higher flexural strength than IPS d.Sign. Weibull distributions of flexural strengths for Omega 900 oven-glazed and microwave-glazed specimens were similar. SEM analysis demonstrated a greater number of surface voids and imperfections in IPS d. Sign as compared to Omega 900.

Comparison of fracture resistance of pressable metal ceramic custom implant abutment with a commercially fabricated CAD/CAM zirconia implant abutment.

STATEMENT OF PROBLEM The predictable nature of the hot pressing ceramic technique has several applications, but no study was identified that evaluated its application to the fabrication of custom implant abutments. PURPOSE The purpose of this study was to compare the fracture resistance of an experimentally designed pressable metal ceramic custom implant abutment (PR) with that of a duplicate zirconia abutment (ZR). MATERIALS AND METHODS Two groups of narrow platform (NP) (Nobel Replace) implant abutment specimens were fabricated (n=10). The experimental abutment (PR) had a metal substructure cast with ceramic alloy (Lodestar) and veneered with leucite pressable glass ceramic (InLine PoM). Each PR abutment was individually scanned and 10 duplicate CAD/CAM ZR abutments were fabricated for the control group. Ceramic crowns (n=20) with the average dimensions of a human lateral incisor were pressed with lithium disilicate glass ceramic (IPS e.max Press) and bonded on the abutments with a resin luting agent (Multilink Automix). The specimens were subjected to thermocycling, cyclic loading, and finally static loading to failure with a computer-controlled Universal Testing Machine. An independent t test (1 sided) determined whether the mean values of the fracture load differed significantly (α=.05) between the 2 groups. RESULTS No specimen failed during cyclic loading. Upon static loading, the mean (SD) load to failure was significantly higher for the PR group (525.89 [143.547] N) than for the ZR group (413.70 [35.515] N) for internal connection narrow platform bone-level implants (P=.025). Failure was initiated at the screw and internal connection level for both groups. CONCLUSIONS It is possible to fabricate PR abutments that are stronger than ZR abutments for Nobel Biocare internal connection NP bone-level implants. The screw and the internal connection are the weak links for both groups.

Prosthetic Failure in Implant Dentistry

Although osseointegrated dental implants have become a predictable and effective modality for the treatment of single or multiple missing teeth, their use is associated with clinical complications. Such complications can be biologic, technical, mechanical, or esthetic and may compromise implant outcomes to various degrees. This article presents prosthetic complications accompanied with implant-supported single and partial fixed dental prostheses.

NFIB Regulates Embryonic Development of Submandibular Glands

NFIB (nuclear factor I B) is a NFI transcription factor family member, which is essential for the development of a variety of organ systems. Salivary gland development occurs through several stages, including prebud, bud, pseudoglandular, canalicular, and terminal. Although many studies have been done to understand mouse submandibular gland (SMG) branching morphogenesis, little is known about SMG cell differentiation during the terminal stages. The goal of this study was to determine the role of NFIB during SMG development. We analyzed SMGs from wild-type and Nfib-deficient mice (Nfib−/−). At embryonic (E) day 18.5, SMGs from wild-type mice showed duct branching morphogenesis and differentiation of tubule ductal cells into tubule secretory cells. In contrast, SMGs from Nfib−/− mice at E18.5 failed to differentiate into tubule secretory cells while branching morphogenesis was unaffected. SMGs from wild-type mice at E16.5 displayed well-organized cuboidal inner terminal tubule cells. However, SMGs from Nfib−/− at E16.5 displayed disorganized inner terminal tubule cells. SMGs from wild-type mice at E18.5 became fully differentiated, as indicated by a high degree of apicobasal polarization (i.e., presence of apical ZO-1 and basolateral E-cadherin) and columnar shape. Furthermore, SMGs from wild-type mice at E18.5 expressed the protein SMGC, a marker for tubule secretory cells. However, SMGs from Nfib−/− mice at E18.5 showed apicobasal polarity, but they were disorganized and lost the ability to secrete SMGC. These findings indicate that the transcription factor NFIB is not required for branching morphogenesis but plays a key role in tubule cell differentiation during mouse SMG development.

Size-dependent strength of dental adhesive systems

OBJECTIVE The aim of this study is to explain the influence of peripheral interface stress singularities on the testing of tensile bond strength. The relationships between these theoretically predicted singularities and the effect of specimen size on the measured bond strength are evaluated. METHODS Finite element method (FEM) and boundary element method (BEM) analyses of microtensile bond strength test specimens were performed and the presence of localized high stress concentrations and singularities was analyzed. The specimen size effect predicted by the models was compared to previously published experimental data. RESULTS FEM analysis of single-material trimmed hour-glass versus cast cylindrical specimens showed different theoretical stress distributions, with the dumbbell or cylindrical specimens showing a more homogeneous distribution of the stress on the critical symmetry plane. For multi-material specimens, mathematical singularities at the free edge of the bonded interface posed a computational challenge that resulted in mesh-dependence in the standard FEM analysis. A specialized weighted-traction BEM analysis, designed to eliminate mesh-dependence by capturing the effect of the singularity, predicted a specimen size effect that corresponds to that published previously in the literature. SIGNIFICANCE The results presented here further support the attention to specimen dimensions that has already broadened the empirical use of the microtensile test methods. FEM and BEM analyses that identify stress concentrations and especially marginal stress singularities must be accounted for in reliable bonding strength assessments. Size-dependent strength variations generally attributed to the effects of flaw distributions throughout the interfacial region are not as relevant as the presence of singularities at bonded joint boundaries - as revealed by both FEM and BEM analyses, when interpreted from a generalized fracture mechanics perspective. Furthermore, this size-dependence must be considered when evaluating or designing dental adhesive systems.