Yonsei University Dental Hospital

BACKGROUND: The sinus lift technique may be difficult to perform if an aberrant sinus anatomy is encountered during surgical exposure, such as when a septum is present on the sinus floor. The objective of this study was to determine the prevalence, size, location, and morphology of maxillary sinus septa in the atrophic/edentulous and non-atrophic/dentate maxillary segments. METHODS: The sample population consisted of 100 patients (41 women and 59 men, with a mean age of 50 years, ranging between 19 and 87 years) for whom treatment was being planned for implant-supported restorations. Reformatted computerized tomograms (CT) from 200 sinuses were analyzed using imaging software. RESULTS: The prevalence of one or more septa per sinus was found to be 26.5% (53/200), 31.76% (27/85), and 22.61% (26/115) in the overall study population and the atrophic/edentulous and the non-atrophic/dentate maxillary segments, respectively. In the analysis of the anatomic location of the septa within the sinus, it was revealed that 15 (25.4%) were located in the anterior region, 30 (50.8%) in the middle region, and 14 (23.7%) in the posterior region. The measured heights of the septa varied among the different areas. The mean heights of the septa were 1.63 +/- 2.44, 3.55 +/- 2.58, and 5.46 +/- 3.09 mm in the lateral, middle, and medial areas, respectively. CONCLUSIONS: It can be inferred that there is a wide anatomical variation in the prevalence, size, location, and morphology of maxillary sinus septa, irrespective of the degree of atrophy. Therefore, to prevent the likelihood of complications arising during sinus augmentation procedures, a thorough and extensive understanding of the anatomic structures inherent to the maxillary sinus is indispensable.

OBJECTIVE: The aim of this systematic multiscale analysis was to evaluate the effects of thermoforming on the physical and mechanical properties of thermoplastic materials used to fabricate transparent orthodontic aligners (TOAs). METHODS: -test. RESULTS: After thermoforming, the transparency of Duran and Essix A+ decreased, while the water absorption ability of all materials; the water solubility of Duran, Essix A+, and Essix ACE; and the surface hardness of Duran and Essix A+ increased. The flexure modulus for the 0.5-mm-thick Duran, Essix A+, and eCligner specimens increased, whereas that for the 0.75-/1.0-mm-thick Duran and eClginer specimens decreased. In addition, the elastic modulus increased for the 0.5-mm-thick Essix A+ specimens and decreased for the 0.75-mm-thick Duran and Essix ACE and the 1.0-mm-thick Essix ACE specimens. CONCLUSIONS: Our findings suggest that the physical and mechanical properties of thermoplastic materials used for the fabrication of TOAs should be evaluated after thermoforming in order to characterize their properties for clinical application.

Helicobacter pylori causes diseases ranging from gastritis to peptic ulcer disease to gastric cancer. Geographically, areas with high incidences of H. pylori infection often overlap with areas with high incidences of gastric cancer, which remains one of the leading causes of cancer-related deaths worldwide. Strains of H. pylori that carry the virulence factor cytotoxin-associated gene A (cagA) are much more likely to be associated with the development of gastric cancer. Moreover, particular C-terminal polymorphisms in CagA vary by geography and have been suggested to influence disease development. We conducted a large-scale molecular epidemiologic analysis of South Korean strains and herein report a statistical link between the East Asian CagA EPIYA-ABD genotype and the development of gastric cancer. Characterization of a subset of the Korean isolates showed that all strains from cancer patients expressed and delivered phosphorylatable CagA to host cells, whereas the presence of the cagA gene did not strictly correlate to expression and delivery of CagA in all noncancer strains.

The delivery of hyperthermic thermoseeds to a specific target site with minimal side effects is an important challenge in targeted hyperthermia, which employs magnetic method and functional polymers. An external magnetic field is used to control the site-specific targeting of the magnetic nanoparticles. Polymer-coated magnetic nanoparticles can confer a higher affinity to the biological cell membranes. In this study, uncoated, chitosan-coated, and starch-coated magnetic nanoparticles were synthesized for use as a hyperthermic thermoseed. Each sample was examined with respect to their applications to hyperthermia using XRD, VSM, and FTIR. In addition, the temperature changes under an alternating magnetic field were observed. As in vitro tests, the magnetic responsiveness of chitosan- and starch-coated magnetite was determined by a simple blood vessel model under various intensities of magnetic field. L929 normal cells and KB carcinoma cells were used to examine the cytotoxicity and affinity of each sample using the MTT method. The chitosan-coated magnetic nanoparticles generated a higher DeltaT of 23 degrees C under an AC magnetic field than the starch-coated magnetite, and the capturing rate of the particles was 96% under an external magnetic field of 0.4 T. The highest viability of L929 cells was 93.7%. Comparing the rate of KB cells capture with the rate of L929 cells capture, the rate of KB cells capture relatively increased with 10.8% in chitosan-coated magnetic nanoparticles. Hence, chitosan-coated magnetic nanoparticles are biocompatible and have a selective affinity to KB cells. The targeting of magnetic nanoparticles in hyperthermia was improved using a controlled magnetic field and a chitosan-coating. Therefore, chitosan-coated magnetic nanoparticles are expected to be promising materials for use in magnetic targeted hyperthermia.

It is well known that cracked teeth occur most frequently in the mandibular molars with large or poor restorations, in those over 50 years of age. However, with increasing knowledge and experience with cracks of teeth, cracks appear to be found frequently in intact teeth without restorations. The aim of this study is to analyze the cases of tooth cracks in a dental hospital in a year, and to find out the characteristic features of cracks of teeth. For 1 year, each tooth that were identified as a cracked tooth was recorded and analyzed in terms of the classification of cavity and restorative material, the nature of opposing tooth, the location in the arch, the age and gender, and the clinical signs and symptoms, and treatment result. Cracked teeth were observed most frequently in the teeth with no restorations (60.4%) and with class I restorations (29.2%). The most prevalent age was in those over 40 years of age (31.2% in their 40s, 26.6% in their 50s) and the prevalence was similar in men (53.9%) and women (46.1%). Cracked teeth were found most frequently in the maxillary molars (33.8% in first molar, 23.4% in second molar) than in the mandibular molars (20.1% in first molar, 16.2% in second molar). 96.1% of the cracked teeth responded to the bite test, and 81.1% of the cracked teeth were observed in the mesiodistal direction. The prevalence of cracked tooth was highest in the intact teeth with no restoration, in maxillary molars, and in those over 40 years of age. When examining a intact maxillary posterior tooth that is sensitive to a bite and thermal change, crack in the mesiodistal direction need to be considered one of the causes.

Biocompatibility is important for the 3D printing of resins used in medical devices and can be affected by photoinitiators, one of the key additives used in the 3D printing process. The choice of ingredients must be considered, as the toxicity varies depending on the photoinitiator, and unreacted photoinitiator may leach out of the polymerized resin. In this study, the use of ethyl (2,4,6-trimethylbenzoyl) phenylphosphinate (TPO-L) as a photoinitiator for the 3D printing of resin was considered for application in medical device production, where the cytotoxicity, colour stability, dimensional accuracy, degree of conversion, and mechanical/physical properties were evaluated. Along with TPO-L, two conventional photoinitiators, phenylbis (2,4,6-trimethylbenzoyl) phosphine oxide (BAPO) and diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide (TPO), were considered. A total of 0.1 mol% of each photoinitiator was mixed with the resin matrix to prepare a resin mixture for 3D printing. The specimens were printed using a direct light processing (DLP) type 3D printer. The 3D-printed specimens were postprocessed and evaluated for cytotoxicity, colour stability, dimensional accuracy, degree of conversion, and mechanical properties in accordance with international standards and the methods described in previous studies. The TPO-L photoinitiator showed excellent biocompatibility and colour stability and possessed with an acceptable dimensional accuracy for use in the 3D printing of resins. Therefore, the TPO-L photoinitiator can be sufficiently used as a photoinitiator for dental 3D-printed resin.

This study reports a synthetic polymer functionalized with catechol groups as dental adhesives. We hypothesize that a catechol-functionalized polymer functions as a dental adhesive for wet dentin surfaces, potentially eliminating the complications associated with saliva contamination. We prepared a random copolymer containing catechol and methoxyethyl groups in the side chains. The mechanical and adhesive properties of the polymer to dentin surface in the presence of water and salivary components were determined. It was found that the new polymer combined with an Fe(3+) additive improved bond strength of a commercial dental adhesive to artificial saliva contaminated dentin surface as compared to a control sample without the polymer. Histological analysis of the bonding structures showed no leakage pattern, probably due to the formation of Fe-catechol complexes, which reinforce the bonding structures. Cytotoxicity test showed that the polymers did not inhibit human gingival fibroblast cells proliferation. Results from this study suggest a potential to reduce failure of dental restorations due to saliva contamination using catechol-functionalized polymers as dental adhesives.

Titanium is commonly used as a biomaterial for dental implants. In this study, we investigated the antibacterial properties of titanium samples following treatment with a non-thermal atmospheric pressure plasma jet (NTAPPJ) on bacteria with two different cell wall structures, including gram-positive and gram-negative bacteria. The hydrophilicity and surface energy of titanium surfaces were significantly increased after NTAPPJ treatment without altering topographical features. Changes in the chemical composition and reductive potential were observed on the NTAPPJ-treated titanium surfaces. The adhesion and biofilm formation rate of bacteria were significantly reduced on the NTAPPJ-treated titanium surfaces compared with the untreated samples, which was confirmed by fluorescent imaging. Regarding the comparison between gram-positive and gram-negative bacteria, both adhesion and the biofilm formation rate were significantly lower for gram-negative bacteria than gram-positive bacteria on samples treated for longer durations with the NTAPPJ. Transmission electron microscopy imaging showed a comparably more disruptive membrane structure of gram-negative bacteria than gram-positive bacteria on the NTAPPJ-treated surfaces. Our results indicated that the NTAPPJ treatment could be useful for preventing bacterial adhesion and biofilm formation on titanium dental implant surfaces, while the reductive potential on surfaces treated by the NTAPPJ could cause oxidation of bacteria, which could be more sensitive to gram-negative bacteria due to differences in the cell wall structure.

When irradiated under near-ultraviolet (UV) light, TiO(2) exhibits strong bactericidal activity. The TiO(2) photocatalyst would be effective on orthodontic appliances after its antibacterial effect on the carcinogenic microorganism Lactobacillus acidophilus is evaluated. To compare the antibacterial effect of two crystalline forms of TiO(2), rutile and anatase, thermal oxidation and anodic oxidation were employed to form each structure, respectively. The antibacterial effect of TiO(2) film on TiAg was also compared with that on Ti. Bacterial solutions were pipetted onto the TiO(2)-coated specimen and illuminated with UVA (2 x 15 W, black light, 356 nm) up to 100 min and the reaction solutions were incubated to count the colony-forming units. The antibacterial activity of the coated specimens was similar to that of the uncoated group. The antibacterial activity of the coated specimens of TiAg was not different from that of Ti. TiO(2) coatings formed on both Ti and TiAg specimens did not exhibit cytotoxicity on the L-929 cells of mice.

Aesthetics has become an essential element when choosing orthodontic fixed appliances. Most metallic brackets used in orthodontic therapy are made from stainless steel (SS) with the appropriate physical properties and good corrosion resistance, and are available as types 304, 316 and 17-4 PH SS. However, localized corrosion of these materials can frequently occur in the oral environment. This study was undertaken to evaluate the accuracy of sizing, microstructure, hardness, corrosion resistance, frictional resistance and cytotoxicity of commercially available Mini-diamond (S17400), Archist (S30403) and experimentally manufactured SR-50A (S32050) brackets. The size accuracy of Mini-diamond was the highest at all locations except for the external horizontal width of the tie wing (P < 0.05). Micrographs of the Mini-diamond and Archist showed precipitates in the grains and around their boundaries. SR-50A showed the only austenitic phase and the highest polarization resistance of the tested samples. SR-50A also had the highest corrosion resistance [SR-50A, Mini-diamond and Archist were 0.9 x 10(-3), 3.7 x 10(-3), and 7.4 x 10(-3) mm per year (mpy), respectively], in the artificial saliva. The frictional force of SR-50A decreased over time, but that of Mini-diamond and Archist increased. Therefore, SR-50A is believed to have better frictional properties to orthodontic wire than Mini-diamond and Archist. Cytotoxic results showed that the response index of SR-50A was 0/1 (mild), Mini-diamond 1/1 (mild+), and Archist 1/2 (mild+). SR-50A showed greater biocompatibility than either Mini-diamond or Archist. It is concluded that the SR-50A bracket has good frictional property, corrosion resistance and biocompatibility with a lower probability of allergic reaction, compared with conventionally used SS brackets.

PURPOSE: The aim of this study was to measure the flexural strength and the elastic modulus of composite resin with and without reinforcing fibers and to evaluate the reinforcing effect of various fibers. MATERIALS AND METHODS: A polyethylene fiber (Ribbond), a polyaramid fiber (Fibreflex), and three glass fibers (FibreKor, GlasSpan, Vectris) were used to reinforce composite resins. The flexural strength and elastic modulus of specimens in the three-point bending mode were measured using a universal testing machine at a cross-head speed of 1 mm/min after storage in water at 37 degrees C for 24 hours. All tests were carried out in a water bath at 37 degrees C. The data were analyzed using analysis of variance and the Sheffé test at P= 0.05. After testing, the fractured surface was evaluated using a scanning electron microscope at 50x, 500x, and 3,000x magnifications. RESULTS: Yield flexural strengths of nonreinforced resins were 48 to 56 MPa, and those of reinforced resins were 56 to 134 MPa. Ultimate flexural strengths of nonreinforced specimens were 96 to 119 MPa, and those of reinforced ones were 203 to 386 MPa. Elastic modulus of nonreinforced resin was 6 to 9 GPa, and fiber reinforcing increased the value to 9 to 15 GPa, while it had no effect in Ribbond. CONCLUSION: Most of the fibers used in this study increased both yield and ultimate flexural strengths of composite resins, with the exception of the yield strength of Vectris. GlasSpan, Fibreflex, and FibreKor were effective in reinforcing elastic modulus, while Ribbond had no effect on it. Unidirectional glass fibers and polyaramid fiber were effective in reinforcing both flexural strength and elastic modulus of composite resin.

Prostaglandins and nitric oxide produced by inducible cyclooygenase (COX-2) and nitric oxide synthase (iNOS), respectively, have been implicated as important mediators in the processes of inflammation and carcinogenesis. These potential COX-2 and iNOS inhibitors have been considered as antiinflammatory and cancer chemopreventive agents. In this study, we investigated the effect of natural sesquiterpenoids isolated from plants of the Zingiberaceae family on the activities of COX-2 and iNOS in cultured lipopolysaccharide (LPS)-activated mouse macrophage cell RAW 264.7 to discover new lead compounds as COX-2 or iNOS inhibitors. Xanthorrhizol, a sesquiterpenoid, isolated from the rhizome of Curcuma xanthorrhiza Roxb. (Zingiberaceae), exhibited a potent inhibition of COX-2 (IC50 = 0.2 microg/mL) and iNOS activity (IC50 = 1.0 microg/mL) in the assay system of prostaglandin E2 (PGE2) accumulation and nitric oxide production, respectively. Western blot analyses revealed that the inhibitory potential of xanthorrhizol on the COX-2 activity coincided well with the suppression of COX-2 protein expression in LPS-induced macrophages. In addition, sesquiterpenoids beta-turmerone and ar-turmerone isolated from the rhizome of Curcuma zedoaria Roscoe (Zingiberaceae) also showed a potent inhibitory activity of COX-2 (beta-turmerone, IC50 = 1.6 microg/mL; ar-turmerone, IC50 = 5.2 microg/mL) and iNOS (beta-turmerone, IC50 = 4.6 microg/mL; ar-turmerone, IC50 = 3.2 microg/mL). These results suggest that natural sesquiterpenoids from C. xanthorrhiza and C. zedoaria might be lead candidates for further developing COX-2 or iNOS inhibitors possessing cancer chemopreventive or anti-inflammatory properties.

OBJECTIVES: We compared the effective dose from panoramic radiography with that from cone beam CT (CBCT) using dose area product under adult and child exposure conditions. METHODS: The effective doses of the cephalo, panorama, implant and dental modes of Alphard 3030 (Asahi Roentgen Ind., Co. Ltd, Kyoto, Japan) CBCT and the Jaw, Wide, Facial and temporomandibular joint modes of Rayscan Symphony (RAY Co., Ltd, Hwaseong, Republic of Korea) CBCT were compared with those of CRANEX(®) 3+ CEPH (Soredex Orion Corporation, Helsinki, Finland) panoramic radiography equipment under adult and child exposure conditions. Each effective dose was calculated using a conversion formula from dose area product meter measured values (VacuTec Messtechnik GmbH, Dresden, Germany). The conversion formulae used were suggested by Helmrot and Alm Carlsson and Batista et al, and they were applied with the tube voltage taken into consideration. RESULTS: The maximum effective doses from the Alphard 3030 and Rayscan Symphony were 67 and 21 times greater than that from panoramic radiography, respectively. The ratios of the effective dose under the child setting to that under the adult condition were 0.60-0.62 and 0.84-0.95, and the maximum differences in effective doses between the adult and child exposure settings were equivalent to 27 and 4 times greater than a panoramic examination in the Alphard 3030 and Rayscan Symphony, respectively. CONCLUSIONS: The effective CBCT doses were higher than those of panoramic radiography. The differences in effective doses between the adult and child CBCT settings were dependent on equipment type and exposure parameters. Therefore, adequate mode selection and control of exposure as well as further research are necessary to minimize the effective dose to patients, especially for radiosensitive children.

The purpose of this study is to evaluate the effects of botulinum toxin type A (BoNT-A) for managing sleep bruxism (SB) in a randomized, placebo-controlled trial. Thirty SB subjects were randomly assigned into two groups evenly. The placebo group received saline injections into each masseter muscle, and the treatment group received BoNT-A injections into each masseter muscle. Audio–video–polysomnographic recordings in the sleep laboratory were made before, at four weeks after, and at 12 weeks after injection. Sleep and SB parameters were scored according to the diagnostic and coding manual of American Academy of Sleep Medicine. The change of sleep and SB parameters were investigated using repeated measures analysis of variance (RM-ANOVA). Twenty-three subjects completed the study (placebo group 10, treatment group 13). None of the SB episode variables showed a significant time and group interaction (p &gt; 0.05) except for electromyography (EMG) variables. The peak amplitude of EMG bursts during SB showed a significant time and group interaction (p = 0.001). The injection decreased the peak amplitude of EMG bursts during SB only in the treatment group for 12 weeks (p &lt; 0.0001). A single BoNT-A injection cannot reduce the genesis of SB. However, it can be an effective management option for SB by reducing the intensity of the masseter muscle.

Valproic acid (2-propylpentanoic acid, VPA) has been widely used as an anticonvulsant drug and is a choice drug for seizure treatment. VPA is also used as a short-chain fatty acid HDAC inhibitor that affects proliferation and differentiation and induces cell apoptosis in both solid and haematologic malignancies. Here, we observed that VPA treatment inhibited HDAC1/2 activity and induced autophagy in gastric cancer cells, leading to apoptosis. VPA-induced apoptosis occurred through inhibition of the HDAC1/PTEN/Akt signalling pathway and involved alterations in Bcl-2 and Beclin-1. The antitumour effects of VPA were verified in vivo using SGC-7901 xenograft models. Moreover, we evaluated the expression of HDAC1/2 in gastric cancer patient samples and revealed a positive correlation between HDAC1/2 overexpression and poor prognosis. These findings indicate that VPA may serve as a potential therapeutic agent for gastric cancer and that HDAC1/2 might be a promising therapeutic biomarker for the disease.

With the development of ceramic technology, prosthodontic ceramics are becoming a useful option for improving esthetic outcomes in dentistry. In this paper, various ceramic materials were reviewed and evaluated, and their advantages and disadvantages and indications in oral prosthodontics were analyzed objectively. The properties of resin-based ceramics, polycrystalline ceramics, and silicate ceramics were compared and analyzed. Resin-based ceramics may replace other ceramic materials in the CAD/CAM field.

Gastritis, peptic ulcer disease, and gastric cancer are a few of the diverse disease manifestations that have been shown to be associated with infection by Helicobacter pylori. Why some individuals develop more severe forms of disease remains largely unknown. In this study, 225 South Korean strains were genotyped for vacA and then analyzed to determine if particular genotypes varied across disease state, sex, or cagA allele. Of these strains, 206 strains carried an s1/i1/m1 allele, 11 strains carried an s1/i1/m2 allele, and 8 strains carried an s1/i2/m2 allele. By using Fisher's exact test, a statistical association between variations in the cagA and vacA alleles was identified (P = 0.0007), and by using log linear modeling, this variation was shown to affect the severity of disease outcome (P = 0.027). Additionally, we present evidence that variation within the middle region of VacA contributes significantly to the distribution of vacA alleles across gender (P = 0.008) as well as the association with disease outcome (P = 0.011). In this South Korean population, the majority of H. pylori strains carry the vacA s1/i1/m1 allele and the CagA EPIYA-ABD allele. These facts may contribute to the high incidence of gastric maladies, including gastric cancer.

Objective . This review aims to summarize different kinds of applications of minimally invasive surgery in improving facial aging to provide a comprehensive and accurate introduction on the issue of esthetic treatment of facial skin. Overview . In the twentieth century, facial rejuvenation has become a new beauty trend. Facial cosmetology has entered a period of antiaging and rejuvenation therapies and microplastic surgery. The pursuit of beauty has promoted the development of minimally invasive plastic surgery. This review introduces the possible causes of facial aging and its related topics with a focus on facial injectable drugs, such as botulinum toxin, main filler materials (hyaluronic acid, calcium hydroxyapatite, poly L‐lactic acid, collagen, autologous fat, and polymethyl methacrylate), and some current antiwrinkle technologies, such as thread lift and radiofrequency rhytidectomy. Conclusions . Despite the difference in mechanisms of action, each technique can address facial aging involving the loss of collagen, displacement and enlargement of fat, and muscle relaxation. Combinations of these treatments can provide patients with reasonable, comprehensive, and personalized treatment plans.

As computer-aided design and computer-aided manufacturing (CAD/CAM) technologies have matured, three-dimensional (3D) printing materials suitable for dentistry have attracted considerable research interest, owing to their high efficiency and low cost for clinical treatment. Three-dimensional printing technology, also known as additive manufacturing, has developed rapidly over the last forty years, with gradual application in various fields from industry to dental sciences. Four-dimensional (4D) printing, defined as the fabrication of complex spontaneous structures that change over time in response to external stimuli in expected ways, includes the increasingly popular bioprinting. Existing 3D printing materials have varied characteristics and scopes of application; therefore, categorization is required. This review aims to classify, summarize, and discuss dental materials for 3D printing and 4D printing from a clinical perspective. Based on these, this review describes four major materials, i.e., polymers, metals, ceramics, and biomaterials. The manufacturing process of 3D printing and 4D printing materials, their characteristics, applicable printing technologies, and clinical application scope are described in detail. Furthermore, the development of composite materials for 3D printing is the main focus of future research, as combining multiple materials can improve the materials' properties. Updates in material sciences play important roles in dentistry; hence, the emergence of newer materials are expected to promote further innovations in dentistry.

Herein we evaluate the effect of nanodiamond (ND) incorporation on the mechanical properties of poly(methyl methacrylate) (PMMA) nanocomposite. Three quantities of ND (0.1, 0.3, and 0.5 wt.%) were tested against the control and zirconium oxide nanoparticles (ZrO). Flexural strength and elastic modulus were measured using a three-point bending test, surface hardness was evaluated using the Vickers hardness test, and surface roughness was evaluated using atomic force microscopy (AFM), while fungal adhesion and viability were studied using Candida albicans. Samples were also analyzed for biofilm thickness and biomass in a saliva-derived biofilm model. All groups of ND-PMMA nanocomposites had significantly greater mean flexural strengths and statistically improved elastic modulus, compared to the control and ZrO groups (P &lt; 0.001). The Vickers hardness values significantly increased compared to the control group (P &lt; 0.001) with 0.3% and 0.5% ND. ND addition also gave significant reduction in fungal adhesion and viability (P &lt; 0.001) compared to the control group. Finally, salivary biofilm formation was markedly reduced compared to the ZrO group. Hence, the incorporation of 0.1–0.5 wt.% ND with auto- polymerized PMMA resin significantly improved the flexural strength, elastic modulus, and surface hardness, and provided considerable fungal resistance.