Internai ion J i Coiiege of Prosthodortisls

The Eighth Meeting of the International College of Prosthodontists

Stockholm, Sweden
luly 7-10, 1999
Co-Chairmen: Dr Terry Walton and Professor Brian Monteith

Poster Presentation Abstracts

The abstracta for (he Poster Presentations sre in tilphabetical order ijy the firsl auliior's last name. Focus and Short Paper Session
abstracts were published m the previous, issue of the journal (Volume 12, Number 5, 1999).

T. AbdelHalim, M. El-Sibaie, 5. Campbell,

Chicago, Illinois
Internal Dimensional Changes During Setting
o/Oentai Casling Investment
Tiie flimensionai changes that occjr internally
during the setting ot dentai casting investment
are rot fully understood. Emsting studies have
either used external measurements ol expansion or have not inciiided a wax pattern as part
ot the exprimentt design. The puipose of this
stLidy was to e!<amine the internal dimensional
changes that occur in the investment and wax
pattem during investment setting. A modilied
unidirectional strain gauge and thermocouple
were used to monitpr the strain and thermal
changes in the wax pattern and investment during setting of the investment materiai. Statistical
analysis r tests) revealed a signiticant difference
twtween the liorizontal |0.354%) and vertical
(0.211 %) expansion of tlie investment (P< 0.01 ]
and between the wax (0.160%) and the investment (0.354%] in the horizontal direction. The
wax and investment appear to contribute to jiitemal expansion independent ot each other during the setting process.

T. Abe, N. Nabeta, A. Tamura, K. Hashimolo,

Y. Ito, Nagoya, Japan
The CAD System is Used 'or Assessment oi
the Tooth Plaster Model Carved by the
Students
The tooth plaster models carved by students foi
practical training are assessed subjectively by
one or more instructors. Tlieretore. we tried to
assess tlie toolh plaster models objectively
using a computer-aided design (CAD) system
The students constructed models ot tlie left
lirst molar on the plastic demonstrative model
Ten carved models chosen at random and the
onedemonstrative model were scanned tor assessment by the laser-scanning system. The
pictures ai I lie can/ed model and the demonstrative model were placed on top ol eaoh other
on the CRT, and Ihe gap was measured trom
the digital data. Therefore, ten can/ed models
were assessed using ttie CAD system The
torms of the models cculd be digiti?ed, making
assessment possible. The assessments by instmdors are not always the same as the assessments using the CAD system.

. Aliagawa, M. Wadamolo, V. Sato, H.

ami, T. Kubo, M. Shrgekawa, Hiroshima,
Japan
In Vim Three-Dimensional Compulenzed Bone
Structure Around Severai Osseointegraied
impianis

The international !o

Knowledge ot bone structure around the osseointegrated implant in vivo is ot great importance tor better understanding o( osseointegration and implant Biomectianics. However,
our present knowledge is mostly based on the
results ol 2-dimensionai histoiogic and histamorphometric studies, and 3-dimensional bone
structure around osseointegrated implants remains uncertain This study was theretore designed to evaluate the initial 3-D bone structure
around several endosseous implants (oommercially pure titanium screw, plasma-sprayed
titanium cylinder, zirconia ceramic screw, and
h ydroxyapat lie-coated titanium cylinder) D'/
computer graptiics and morphometry. These
submerged implants were piaced in the
mandibuiar edentulous area of adult monkeys
(Macaca luscala) and allowed to heal lor 3
months. The animals were sacrificed and tissue blocks containing the implant were prepared. The block was automatically ground
buccolingually at 75-|jm intervals with a grinding machine (Exakt Mioro-Gnnding System,
Exakt). Each bony structure around the implant was traced and digitized. This procedure
was repealed Icr each 75-(jm intervai from the
medial to the distai structure of the impiant.
Computerized integration was performed with
80 accumulated traces by a previously descnbed method {Akagawa et al, 1992) to construct 3-D computer graphics of bony structure.
The implants were osseointegrated and 3-D
bone structures were visually shown. Morphometri cai I y, variation s of the 3-D bone structure
were detected among the design and surface
characteristics of the implants. Such information may be applicable tor development of a
mimic 3-D finite element model o osseoinlegration for implant biomechanics.

This study was supported by grant No.

0345450 and No. 09470437 from the Ministry
of Education. Science and Culture, Japan.
B. Bergendal, G. Hallberg, J n k p i n g ,
Sweden
Oral Status in Thirly Swedish Individuals with
Incontinenlia Pigment!
Incontinenlia pigmenti is one ot severai eciodermal dysplasia syndromes. The organs predominantly affected are eyes, skin, and teeth. At
the annual meeting of the patient organization
lor incontinentia pigmenti in 1998 in Sweden, all
diagnosed carriers were odontolgicaily examined. There were 30 individuals29 females
and one maleaged from 1 to 56 years, who
represented one to 3 generations oM 7 families.
Diagnosis had been set by a clinicai geneticist

554

rn ccoperation with an ophthalmoiogist and a

dermatoicgist. Of the individuals. 13 (43%) had
severe and sight-threaten ing eye manifestations. Many ol the mothers received Ihe diagnosis aitei giving birth to a child with obvious
skin symptoms in the neonatal period. Some of
fhese mothers had no or very discreet oiinical
dentai symptoms. Aii 30 individuals were clinicaily en a mined, and an orthopanthomogram
was taken ol aii but 4 individuis [3 children
below the age ot 5 and one chiid with severe
mental retardation). Denial photographs, impressions for study casts, and evaluation of
stimulated whoie saiiva were aiso performed.
The dominating denfal symptom was tooth agenesis, which appeared in 22 of the individuis
and varied Irom agenesis of one to -18 teeth
(mean 6). Atypical tooth form was found in the
primary as weli as the permanent dentition.
Generally smaiier footh size than normai and
paraiiel proximal surfaces were also a common
finding Salivaiysecrefion rafes were examined
by sampiing of slimulafed whole saliva for 5
minutes. Of the 25 examined individuals, 13
had normai saiivary secretion rafes, and in 12
individuals secrefion rates were lower fhan riormai < 0.7 mUmin). Some of the adult individuals had undergone extensive prosihcdontic
treatment, eg, bone augmentation preceding
impiani therapy. The high prevaience o impaired saiivary tu nction has not earlier been described in the literature and calis for speciai attention in the treatment pianning and
maintenance care for fhis group of pafienfs. It is
also ol utmost imporfance thaf the diagnosis is
set early, and here the dental profession has a
great responsibiiily since the dentai conditions
areoftentheoniyreasoncare is sought. Referral
to an ophthalmologist is mandatory to diminish
the risk ot impaiiment of sight or even blindness.
To date, only singie cases and singie families
with incontinentia pigmenfi have been descn bed
in the dentai literafure.
T. Bergendal, T. fMsgnusson. Jon ko ping,
Sweden

Changes in Signs anfl Symptoms of

Temporomanaibular Disorders After
Treatment with Implant-Supported Fixed
Prostheses
The aim of ttie present investigation was to see
if freatment with impiant-supported fixed prosfheses (IFP) had any infiuence upon signs and
symptoms ot temporomandibuiaf disorders
(TfilD). Seventy-eight patienfs, 46 women and
32 men, wifh a mean age of 63 years (range 40
lo 80 y), were treated with IFPs. Sevenfy-five of
the pafients were edentuious in at leasf one jaw

Volume 12, Number 6. ' "'"'

tional College ot Prosthodontists

and were thus treated with a ccmplete-arch IFP

inthatiaw. Three patients received partial IFPs
Eighteen of the IFPs (23%) were placed in the
maxilla and 60 (77%) in the mandible The number ot implants vaned from 2 lo B (median 6.
and the number of bridge units was between 6
and 14 (median 12). No implants were lost after
leading. All patienis were eamined with re^MCt to signs and symptoms of TMD betre the
startottreatment and atter 1 and 3years. From
these examinations, clinical (Oi) and anamnestic (A!) indices according to Helkimo (1974) were
constructed. Before the start of treatment 20.5%
of the patients had moderate (15.4%) or severe
{5.1.a) Clinical signs of dysfunction These figures had decreased to 10,4% and 1.3%, respectively, at the 3-year follow-up. The most
ccmmcn clinical signs at all 3 examinations
were joint sounds and palpatory tenderness in
jaw muscles. Subiective symptoms ot TfulD
were reported by 44.9t of Ihe patients at Ihe
Stan 0 treatment, and in 10 3% these symptoms
were severe. Three years after treatment,
27.7o ofthe patients still had one or more subjective symptoms of TMD, of which S.B", were
severe. The most common subiective symptom at the start of treatment was joint sounds
(37.2%), while pain dunngiaw movements and
pain in the face or laws were repcned only rarely
(6.4% and 7 7.-^. respectively). At the fnal examination, reports of [Oint sounds, pain on aw
movements, and pain in the face or jaws had decreased to 20.5%. 0%, and 2.6%, respectively.
Before treatment 60.0% judged their chewing
ability to be fairiy (28.2%) or very poor (30.8%).
Almost all patients (93.4%| reported that their
chewing ability had improved atter treatment,
and al the 3-year fcllcw-up, 25.3% udged it to
be fairly good and 72.4% as very good. All patienis were completely (90,7%) or fairly (9,3%)
satisfied with the treatment received. The presenl results seem to warrant the conclusion that
many patienis treated with IFPs will improve
with respect to both signs and symptoms cf
TMD, and that the vast majority will expenenco
an improvement ot their chewing ability.

H. Bevilaqia. P. Pera, F. Bassi, G. Schierano.

5. Carossa, Turin, Italy
Evaluation of Condylar Movements with a New
Computed Method
Many methods for recording mandibular movements are reported in the literature. The technique based cn the computed system "Elitehas been successfully applied by D. Wang
Kahg et al (1993). but it only records the mterincisive point, not the conflyles. A method is reported that allows Ihe condylar movements to
be evaluated in Ihe 3 planes of space, modifying the Elite system. The new method has
been tested on 10 young Caucasian adults
who were not suffering from temporcmandibular disorders and were chosen at random from the students of Ihe Dental School ot
Turin University, The condylar movements
were evaluated, using both the new method
and the graphic registration method; data obtained from Ihe 2 methods were compared.
Tiie mcditied Elite system attords graphic registration cf condylar movements that is suitable
tor studying mandibular kinematics
M. Beyli, O. Sakar, M. Ates, Istanbul, Turkey
Fabricating a New Removable Partial Denture
Framework lo Fit an Existing Crown Using an
Extracoronai Precision iCekaj Attachment

Major connectors occasionally fracture, and

in such casesa new removable partial denture
(RPD) must be made. Remaking RPDs with a
Ceka precision attachment (Precision
Attachments! is very time ccnsuming and expensive because of the extensive crown work.
This presentation describes an easy technique
to tabricate an RPD framework using a Ceka
attachment without removing the crown from
the abutment tool h.
J. Bizar, X, Gil, M. Anglada, M. Peraire, J.
Salsench, Barcelona, Spain
Ettects ot Melt Temperature and HeatTreatment on Hsraness of Some Dental Alloys
Hardness is one ot the most important characteristics of all alloys used in proslhoflontics because of Its influence on failure mechanisms.
Hardness can be detined as the resistance ota
material tc indentation. In this study we tested
the Vickers hardness of difterent alloys used in
prcsthcdontics in relation to melt temperature
and time andtemperatureofhsat treatment. We
usedthreecommeicialalloysfordentaluse.one
Type IV gold alloy (Pontor 4CF, Falor-Metalor).
one palladium-based ailoy (Cerapall 6. Falortuletaio'), and one nickel chrcmium-based al[cy
(Nibon. Madespa-Ventura) The specimens
were cast at different temperatures: Cerapall 5
at1260,1320, and 1420-0; Pontor 4CFat 1000,
1060, and 1160=0; and Nibon at 1420. 1480,
and 1S80C. In all cases the temperatures were
the manufacturers' recommended temperature,
60C under the recommended temperature,
and 1OOC oi/er it. Also, we subjected all samples to heat treatment at 700, 800, and 900"C
for5, to. 2, 30, and 120 minutes for each temperature and compared the hardness ol each
sample with this grain size. Two different loads
were used. 0.5 kP tor Nibon and Cerapall 6, and
10 kP for Pontor 4CF. Fcr none of the alleys did
the cast temperature have any influence on
hardness. For Nibon and Cerapall 6, the heat
treatmenthad ncetlect on hardness. For Pontee
4CF, an initial decrease in hardness was noticed Results suggest that melt temperature
had no effect on Cerapall 6, Nibcn, and Pontor
4CF hardness, and heat treatment atfects only
Pontcr 4CF hardness

A. Bol si, F. Bass i, P. Pera, G. Schierano,

Turin, Italy
In VIVO Evaluation of Itie Adhesion of Bsclerial
Piaque to tiie Surfaces ot Different Materials
Used in Prosthodontics
Bactenal plaque forms not only cn denial tissues,
but also on the surfaces of articial materials in
the mcuth. The study is aimed to evaluate
plaque adhesion to a chrome-cobalt alloy, titanium, and ceramics Disks ot 10-mm diamater
and 3-mm thickness were constmcted from titanium, chromium-cobalt alloy, and ceramics
following the suppliers' instructions. Ten disks
were madefram each material in the same dental laBoratory. Each disk was examined for surface roughness with atomic torce micrcsccpy.
Nine voiunteers (fully dentate Caucasians, age
range 24 to 32 y. five women and four men) chosen at random took part in the study. A removable acrylic device was prepared on lhe
mandiBular cast cf each volunteer, cn which
two of the disks could be fitted Subjects wore the
plates for 7days, removing them only for meals
and hygiene procedures, afier which the disks
were removed from the plates. Ttie plaque was
analyzed by spectrcphotometry. No significant

Volume 12, Numbers, 1999

555

ditference was found in plaque adhesion lo the

ditferent materials.
A. Bordovskyi, Lviv, Ukraine
The Eiperimenlal Investigations ol a Nev/ly
Developed CSB Veneering
Composite
Material "Oftsoma[-4"
The development and clinical use of advanced
ccmpositemalenaIs IS one of the current trends
in dentistry. The purpose of this sludy was to
evalale the properties cf a new light-cured
composite material, Oksomat-4, which was developed by Cksomat in collaboration with Dipol,
This composite is recommended by the manufacturer for the veneering cf metal substructures in crcwn-and-bridge prosthodonlics and
IS delivered in Vita Lumin Vacuum shades,
Flexural (PS) and diametral tensile (TS)
strengths, resilience modulus (Rfifl), depth of
curing (DC), solubility (SB), curing time (CT),
and waler absorption (WA| were measured acccrding to Intemational Standards Organization
specification 10477 The mean values were. FS
= 69.0 MPa, TS = 34.2 MPa, Rful = 50.2 MPa.
DC = 2,0 mm, SB = 5.0 mgim=, CT = 3.0 min.
and WA = 50.0 mg/m^. The results of experimental studies (compared with the properties
of well-known composite brands) permita ccnclusicn about the possibility of clinical applications of this veneering composite. The clinical
investigations are being studied

M. Borsum, A. Jokstad, Oslo, Norway

Strain on Abutment Teeiti Supporting a
Removable Lower Class I Partial Dsniure. a
Filot Sludy
A remcvable partial denture produces various
degrees of stress-strain relationships in and
around the supporting teeth depending cn cohstnicticn details. The cb|eclive of this sludy was
to assess Ihe strain from a removable Class I
partial denture in the mandible results in increased mobility of the suppciting teeth, and if
this varies wilh 2 different occlusal rest configurations. Patients at the Faculty of Oentistry in
Oslo were invited to participate. Inclusion critenon was the need fcr a removable free-end partial denture in the mandible Only patients with
either a denture or a balanced ccclusion in the
maxilla were included New chromium-cobalt
dentures were made with occlusal rests on the
abutment teeth placed randomly mesially on
one side and distally on the reciprocal side. The
mobility ot the supporting teeth was assessed
subjectively and with a Penctest apparatus
(Siemens), fulcbility was measured betre, and
after 1 week. 2 weeks, 1 mcnih, and 3 months.
The Periotest values of me 2 abutment teeih
were compared using paired nests. Preliminary
results indicate that the mobility of the supporting teeth increases slighily after starting to use
a new partial deniuie (mean Periotest difference. Baseline-1 week = 2, baseline-1 month
:^ 1.2. P > 0.05). The changes were not detectable subjeotively. Future measurements
may show whether the increased mobility is reversible. Using a Penctest apparatus io measure tocth mobility after the placement cf a removable denlure seems feasible. The specitic
construclion design studied in the present experiment had no influence on tooth mobility.

R. Branchi, Florence, Italy

Ectodermal Dysplasia in a Completely
Edentulous Child Patient. The Prosthesis
Betiabilitalion and Five-Year Follow-up Period

The International lournal of Prostliodontic

International College of Prosthodontists

Ectndermai dyspiasia is a syndrome characterized in the oral qaviry by the partiai or total lack
ot dental elements. Ttiis presents the clinician
with the problem o rehabilitating the patient's
moulhfiorr an early age This clinical report follows a completely edentulous palient from ttie
age of 41 to 9, The problems ot a case siioti as
this one are technical because ol difiicjities in
realizing a total prosthesis in the uery young patient. There are also biologic and psychologic
problems because ct (he growth of the patient
and subsequent modification of Ihe prosthesis
(remaking and realigning ol the bases, the vertical dimensions, the choice pf the artificial
teeth). The clinical results are appreciable.

The obtained results of 85Q N tor the dynamic

resistance pointed out that the Duceragold-ceramduo system is improved in compaiison to the
other ceramometal systems Because otthe relatively high obtained values of the dynamic resislance. The thermocyciing significantly lowered the dynamic resistance of Ihe tested
syslem [P < 0.05), The thermocycled samples
exhibited tailureoftheceramomelal interlace at
30% to 50% tewer eye les for the same dynamic
loading values in comparison with the ncnthermocycled samples. This finding suggests that
the sudden temperature ohanges in the oral
cavity can significantly shorten the life span and
the durabiiity of this metal ceramic.

S, Catapano, M, Franchi, R. ScottI, Ferrara,

Italy
Evaluation of Air Inclusion of Irreversible
Hyrocoiioids Mixed with Three Different
Spatuiation Techniques

H, Cho, J, Lee. T, Jin. Iksan, South Korea

A Sludy on the Fracture Strength and Strain of
Implant Restoration Using Ceramic Abutment
and All-Ceramic Crown

The aim of this study was to compare the presence of air inclusion in an irreversible hydrocolloid mixed with three flifferent techniques: mechanic, vacuum-mechanic, and rnarual. Three
metal trays, with shape and dimensions proposed by StackhcuSB, were used. Ten mixings
group A) were executed using Ihe mechanical
device Orthora Migma IMikrora), ten (group B|
using a Whip Mi vacuum spatulator (SilkyRock), and ten (group C] manually. The irreversible hydrocolloid used was the Calginat 3
(Pierre Roland), which was miied by the same
operator. For each impression's Iray, len uniform
rectangular sections of 2 mm' were obtained
and putrnan appropriate rectangular card They
were then photographed and subsequently an.
alyzed by a second operator through a computerized picture analysis system. The number
ol bubbles for group A ranged from 0 to 6 (median 4) with a mean surtace of 0.65 mm^ and an
SDot 0,65; the number tor groups ranged from
6 tp 15 (median 11 ) with a mean surtace of 5.64
mm^ and an SD cf t.27; and the numtier for
group C ranged trom 29 to 73 (median 42) with
a mean surface ot 11.80 mm' and an SD cf 2.
The analysis of variance and the test ot Bonterroni were performed foi the values of surtace
occupied biy the air bubbles; for the numbei of
bubbles tne Kmskal-Wallis test was pertormed.
The irrereisibie hydrocclloids mixed mechanically or vacuum mechanically contain inclusions
or air that make them considerably inferior to the
hydrocoltoids prepared t>y hand mixing
A. C t o v i c , R, P o l j a k - G u b e r i n a , V,
Jerolimov, Zagreb, Croatia

Does Thermai Cycling Affect Dynamic

Strength Between Ag.p Ailoy and
Hydrothermal Ceramics?
The failure of the ce ramie-to-meta I interface
produces an uncomfoj1at>le situation to/ both the
patient and the clinician. The aim of this study
was to detemiine the dynamic resistance characteristics of the interface of hydrothermal ceramics (Duceragold, Degussa) and Ag-Pd alloy
(ceramduo) Thetestedspecimensoonsisted
of metal trames (45 mm x ta mm -: 4 mm)
upon which tfie ceramic was fused (25 mm y
12 mm y. 2 mm). The specimens were divided
into 2 groups; the fiist with thermocycled samples (t ,000 times at 0*C and 55C), and the second group wilh nonthermocycled samples. The
3-point dynamic loading test of the samples
was pertormed in Amsler's high-frequency puisator within the loading range ol 550 to 1,200 N.

The International

All-ceramic abutments and crowns have become an attractive altemative to metailic im.
piant prostheses, but their strength and stress
transfer needs more documentation The aim
of the present study was to compare ditferent
abutment-crown combinations lor single-implant restoration and, as a control, a conventional metal-ceramic crown cemented on the
CeraOne abutment (Nobel Bicoare). Ceramic
aOutments were copy milled from the CeraOne
abutment using the In-Ceram sintered aiumina
blocks (Vident) The ceramic crowns were
milledwithln-CeramandCelay feldspar blocks.
Design groups were: (1) In-Ceram crowns cemented on the CeraOne abutmeni, (2) Delay
leldspar crowns cemented on the CeraOne
abutment, (3) Ir-Oeram orowns cemented on
Ihe ceramic abutment, and (4) Celay leldspar
crowns cemented on the ceramic abutment, A
10-mm-long Brnemark implant (Nobel
Biocare) was placed into a resin block and the
restoration was cemented to the implant. Tne
specimen was loaded at 0- and 45-degree angles tc the long axis, and the load values at the
moment of tracture were recorded using an
Instron machine. Two rosette gauges were
placed 2 mm latiial and lingual to the implant,
and strain indicator readings were recorded
underuerticaiandoblique loading at 100N The
fradure strength of the ceramic abutment was
somewhat lower than expected. There was no
significant difiere nee between the Iracture
strength oi the In-Ceram and Ceiay teldspar
crowns on the ceramic abuiments or among the
fracture strength oi the three ditferent crowns
on the conventional CeraOne atjutment. On
oblique loading, ceramic crowns usmg the cera mrc abutment showed iower fracture strength
than the conventional CeraOne abutment. The
weakest portion oi crowns using the CeraOne
abutment on oblique loading was the abutment
screw, and the briltie iracture of the ceramic
abutment was shown on oblique leading. The
Strain on the supporting tissue was higher with
oblique loading than with uertical loading, and
the highest compressive stress was measured
on the labiai side oi the implant restoration on
oblique loading.

Y, Ciltci, S, Canay, Ankara, Turkey

The Effect of Stress Distribution of the
Veneering Materiais on the Implant-Supported
Fixed Prosthetic Restorations
in this study the effeot of various rnaterials used
in fabricating implant-retained fixed partial dentures on stress distribution around peri implant

I of Proithodontics

556

Volume T2, Number

tissues was investigated. Five different malhematic models consisting of 11 361 nodes and
54,59 elements were constructed lo study
porcelain, metal, composire resin, relntorced
composite resin, and acrylic resin veneering
materials using a three-dimensionai finite eiement stress analysis method. MARC K7,2/
Mentat 3.2 (MARC Analysis Research] stress
anaiysis software was used for the analyses.
Reference points were determined on cortical
bone, where perpendicular, oblique, and horizontal forces were applied. Stress values created by oblique and horizontal forces appeared
to be higher thah those created by vertical
forces Stress seemed to concentrate at the
cortical bone around the cervicai region of the
implant Melaland porcelain produced the highest stress values in this region. Stresses created
by acrylic resin and reinforced composite resin
were 25% and 15% lower, respectively, compared 10 porcelain and metal. Porcelain and
metal produced stress values at the lingual implant sites reaching the ultimate stress values
of cortical bone.

E, C o n s e r v a , P. P a g l l a r i , D, Chembrl,
Alb eng a, Italy
Composite-Fissk: A New System for LightCuring Materiais ih Prosthodontics
The Composite-Flask (Ribas) is an innovative,
transparent acryiic glass flask that, with respect
to the common manual technique used to make
prosthetic restorations with light-curing materials, gives us the iollowing advantages: (1) a
constant and homogenous compression of the
composite material also on a melal framework;
2) Ihe photopolymerization occurs in lack oi
oxygen so that the composite surface will be
very compact and glossy: and (3) in the case oi
a metal-composite resloration. we can check the
tooth shape, trying the wax pattern direcUy in the
mouth ot Ihe patient. The aim ot this work was
to verify these statements. We made 12metalcomposile single crowns using the DiamondCrown liglit-ouring material (DRM Laboratories),
6 using the transparent tiask and S using the
common manual technique. We quantified the
degree oi photopolymerization and ihe amount
of waler sorption, and then each restoration
was sectioned by a faser machine and scanning
eledron microscopy (SEM) analysis was performed. The analysis oi the degree ot photopolymerization (dual-band technique) showed
100% polymerization in all specimens. The
analysis of the water sorption (specimens immersed in 37C water for 7 days and weighed
by an analytio Giberiini balance) showed no increase in volume of the specimens There was
a 0 03% mean increase in volume oi the specimens made using ihe oommon manual technique. The SEM analysis (LEO 420) revealed
that the restorations made using the Iransparent ilask showed better adhesion between
opaque and composite, iess internal porosity,
and betler surtace compactness.
E. C o n s e r v a , F, Pagllari, D. Chembri,
Albenga, Italy
Diamond Crown Composite Resin: A New
Light-Curing Materiai for Restorative and
Prosthetic Dentistry
Diamond Crown composite resin (DHM
Laboratories) is a light-curing materiai composed of an epoxy-phenoiic; t is a silica-filled
glass-ceramic with a orystalline microstriicture. Its physical and mechanical properties

International College of Prosthodontists

are: Young's modulus (E)^2-\ ,0D0 MPa: compressive strengtb = 552 MPa; liexural strength
T^ 231 MPa: water sorption = 0.35%: wear < 3
|jm/y; diametral tensile strength = 79 MPa:
poiymerization shrinkage = 0,20%; and depth
ot proiymerizatlon = 5 5 mm This material can
be used lor (1) direct and indirect anterior/posterior teetti restorations, (21 repairing resin or
ceramic crowns, (3/ metal-composite crowns
or bridges, (41 metal-free composite crowns or
3.unit bridges. (5JendodQnticaiiy treated teeth
restored with posts, and (6) custom teeth tor
dentures. Twenty-one consecutive meta!-com.
posite crowns were placed in B patients with a
mean age ot 50.S years, and 25 ocnsecutive
metal-iree crowns were piaced in t9 patients
wilh a mean age o 39.1 years. Crowns were
made witti the Composite-Fiasii procedure
(Ribas) in a 6-month period. The crowns were
evaiuated using the CaiiFornia Dentai
Association (CDA) quality assessment evaiuation system 1 month aftercemenlation and at
1 year. At tbe 1-year recaii 20 ot the originai 21
metal-composite crowns and 23 ot the original
S5 metal-free composite crowns could be euaiualed. No statislicaify significant difterences
in CDA scores between the 1-monlh and 1year assessments were tound tor surface and
color, anatomic form, or marginal Integrity. The
Diamcnd Crown composite system could produce quality witb or without metal, especially
if used with a transparent ccmposite tiash.

H, Denissen, Amsterdam, The Netherlands

Procura Onlays: A Preliminary Report
The favorable periodontal, functional, and material aspects ot cast gold onlays are well ioiown.
IHowever, major drawbaciis have been the color
of gofd and the hand-made production. Procera
computer technology (Nobel Biocare) has enriched dentistry with new ways of producing
strong AljOj complete-crown copings. We teit
thatitalsowouid be advantageous (oronlays to
combine a Procera-produced coping veneered
with porceiain. Maxillary and mandibuiar moiars
were prepared wrth an occlusai seat and deep
gingival chambers rn the proximal boxes and
around the functional cusps (buccal of mandibuiar and paiatal of maxiiiary teeth). The nonfunctional cusps {lingual ot mandibular and buccai ct
maxillary leelh) were prepared wiBi broad bevefs
tollowing tlie inclined occlusal plane pattem.
Hydrocolioid impressions were taisen and sifong
dies were produced. The surfaces of the dies
were scanned with the contact probe, and the
data produced the interrordesfgn ofthe copings.
Tfie exterior design ot the copings was created
byscanning wax copings. Asphericai phantom
was scanned as well, and cup-shaped copings
were made as controls. The AI^O^ copings were
porcelain veneered for optfmLZing tit, function,
and esthetics. After cementation oitheoniayin
the mouth of Ifie patient, a hydrocolioid impresa'on was taken and a stone model was produced. The marginal cement width on the stone
modef was calcufaled by microscopic digitai
measurements. Onlay preparations were complex surfaces for computer surface digitization
by the Procera scanner probe. The die had tc be
aligned to the scanner in such a way that no interference with the probe holder occurred. The
inner angies of the seat and Ihe boxes had to be
rounded by applicafcn of dental wax, and these
regions had to be veneered iater with core
buildup porcelain material to optimize internal Tit
The mean marginal gap ot ihe onlays on the
stone dies was 68 pm (SD 53). The mean

cement width on the stone model was 81 pm

(SD 64) The cosmetic aspect and the function
of the onlays were eiceiient because o the
poiceiain veneenng. Ttie aim ot this study was
to delemiine whether the Procera system is
compatible with a proposed onlay design and
capable ot producing AI^O^ copings. Our results for marginal fit of onlays compare weli willi
ttiose reported for Procera complete crowns.
Nevertheless, crattsmanship was necessary to
optimize tit by intemal and marginal porceiain veneering to obtain a mean cement width of 8t |im.
, Desaki, V, Tanaka, , Nakamura, Nagoya,
Japan
Development of New Reintorced Artificial
Resin Teeth Specialty Designed for a
Removable Partial Denture and a Magnetic
Attachment
Magnetic attacbments were tirst introducen inio
Japanese dentistry in 1992, At Ihe last ICP
meeting in Malta, we showed various clinicai
cases indicating that complete and paiiai overdentures with magnetic attachments aie a very
usetui clinicai approacb, especialiy for a patient
with only a limited number of remaining feelh.
Although a magnetic denture is marvelous, it stiil
creates some ci mica i probiems. These concem
artificia i teeth. Today, reinforced resin teeth are
popular for dentures because of their eicellenl
abrasive resistance. But wtien rt comes to their
use in magnetic dentures, an excessive scraping of the tooth bottom is oflen necessary. This
causes a fracture of the artificial teeth By ioosening the thin iayer of acrylic resin provided at
the bottom to secure adhesion to the denture
base. We have recently developed new arWcial
teeth that are intended for use with magnetc
dentures. The new reinforced resin leelh have
a unique scooped bottom shape tbat mal<es
additional grinding unnecessary From our clinical and basic expenments, the new teelb have
proven to be veiy useful not only in magnetic
dentures, but also in general removable partial
dentures.

L, Diaz. E, Willaert, J, Gil, J, Noguera, J,

Satsench, Barcelona, Spain
Evaluation of Mechanical Properties of a
Palladium Dental AHoy Modifying tbe
Microstructure with Heat Treatments
When making a fixed prosthesis, the alioy choice
is an important factor to predict the success or
faiiure ol treatment. Tfie aim of this sludy is to get
information about the mechanical property variations (hardness, deformation, eiastic limit, resistance) when the samples are treated with different temperatures. An alioy is obtained by
mixing the fused metals. Once solidification is
achieved, ttiere is a specific grain size for each
alloy. Later, heattreatmentwiii improve ttie prop.
erles of Ihe materai (iii<e corrosion) because
there is a homogenlation of tbe structure. The
introduction cf Ihis energy produces a grain
growth wilh a variation in Ihe mechanical properties. Forthis study we used a palladium alloy
(Cerapall S, Faior-Metalor) treated tc 700, 800,
and900ClorO, 5,10,20,30, and 120 minutes.
We also observed the microstructure by optic
and electronic microscope and determined the
mechanicai properties using an electromechanical Inslron 4507 machine and hardness
assays, connected to MT software The results
were: elastic limit for a 2-|jm grain diameter = 510
MPa and for 325 pm = 3a5 MPa, Resistance fcr
a 2-pm grain diameler = 740 MPa and 675 MPa

Ji:olumeI2, Number6, 1999

557

for a ZZb-vm diameten deformation foi a 2-pm

gram diameler = 240 and 201 HVNfora325-|jm
fliameler. When increasing temperature, there is
a grain growth and a decrease in tbe mechanical properties and hardness.
J. Dong, S, Oh, Iksan, South Korea
1 Simpte Method of Analyzing the Occlusal
Plane
The Broadnci< Occlusai Piane Analyzer is used
lo establish the cun/e ol Spee (antercposterior
curve) in the final preparation and diagnostic
waxup when teeth have supraempted or when
other occiusal piane discrepancies exist.
iHowever, this method of analysis is difficult
and restnctive. The use of templates thai have
a spherical form, based on Monson's sphencai theory. Is an altemative method of analyzing the occiusal piane This method estabiishes not only the cufve of Spee but aisc the
curve of Wiiscn, These tempiates make analysis cf the occlusal piane simpler and more etfective, but the procedure is still somewhat
complicated and difficult. Therefore, we have
designed a special ruier to estmale the occ i usai plane, which is even simpler and in additlon is poitabie and aiiows easier estimation.
This ruler has convex and concave arcs with
10-cm radii. Using Ihis simpie ruler, we can
easily analyze the cuive of Spee and Ihe curve
of Wilson, This rulei is a simple, portable, and
inexpensive tool to analyze Ihe occlusal plane.

S, Eckert, P, Wollan, Rochester, Minnesota

Endosseous Implant Experience Follcning
Changes in Prosthodontic Components
Dental implant manufacturers oflen provide
modifications tc designs. Modifications may involve implant shape, thread pattem, material,
surface coating, or Ihe components used to create the proslhesis. This study was cohducled tc
determine the impact of prosthetic component
design changes upon the clinical performance
of implanl-supported prostheses. A retrospective before-and-atler review was performed to
detennine the time until implant fracture, prosIhetic screw Icosening, and prosthetic screw
fracture when implants were used to support
and retain prostheses in partialiy edentuious
jaws. Compilation lates were estimated by
Kaplan-Meier curves and significance of effects
on failure rates was tested using Cox propoitionaifiazard models. The robust standard error
methcd was used to account for possible dependence caused by multipie impiants per sutlect A totai of 1,170 impiants was fcilowed, with
333 implants restored with earty prosthetic componenl designs and 837 impiants restored with
newly redesigned components. The use of new
components resulted in significant reductions in
implant fraclure rate (P = D 0054), screw ioosening rate (P^O.OOOI), and screw(racturc rate
(P = 0.0013]. Implant survival rate wilh the
newer components was suggestive ot improvement (P = 0.05131, Implanl-supported
prostneses demonstrated improvements in performance with newiy designed prosthetic components. The use of appropriately designed
prosthetic components may positively impact
clrnicai performance.

J, Emmanouil, A, Sofou, Thessaloniki,

Greece
Measuring the Hardness ol Acrylic Teeth
Before and After itie Construction of a Full
Denture

The International lournal of Prosthodontii

International Collets of Prdslhoduntisls

Full den lu res are normellv constructed with

acrylic teeth Tliese leelh are made from the
polymenialion o power-liquid methyl-methacrylate resin, usually witti crosslinked bonding.
Their eicellent mechanical properties and esttietics give Ihem many advantages. Hoi^euer,
the presence o( monomer anfl the eothermic
reaction of polymenalion during the consiruction of a tu II denture may cause crazing and thus
affect Ihe hardness of the teelh. To measure
this, we compared Ihe hardness ol acrylio teeth
before and atter the conslruclion of a full denlure. The acrylic teelh mere manufactured by
Vivodent. iuoclar, and Vila Vitapan. We measured the hardness ol teeth as supplied by Ihe
manufacturer and then measured Ihe hard ness
atter the construolion of the full denlure We
also measured (he hardness of teeth thai had
been boded for Z hours in the absence of acrylic
resin used for a tull denture base. From Ihese
parameters we mere able to draw some conclusions abcut how the hardness of acryiic teeth
IS affecled by denlure construction.

M. Ferrero. P. Doglio, S. Lombardo, S.

Carossa. G. Preti, Turin, Italy
Correlations Between Intraoral Nitric Oxide
Production an Toottorustting Systems
(Manual and Electrical^ in Pstienis with Fixed
Prdsli^odorttics
Etfectiue eral hygiene isimporianHormainlaining oral health. Denial bacterial plaque oan be
removed by manual or eleclno inslruments.
Severai studies were designed to compare the
efficacsiofelectricversusrnanual toothbrushes,
bul their results were controversial In all cf
these studies, Plaque Index and Gingii/al Inde
were used to evalale the oral hygiene level. In
general medicine, several studies showed a
correlalion belween presenoe of inflammation
and a production of nilric oiide. A method for
measunng the intraoral nitric oide level was sel
up. and a preliminary study showed a correlalion bet^/een nitric oxide and Ihe presence of
bacterial plaque. The aim of (his work is to compare the etficacy ot electric versus manual toothbrushes in patients wilh iixed prosthodonlics,
measunng the intraoral nilric oxide levels in afldilion to Plaque Indei. Gingival Index, and gingival bleedingindei Fcrapenodof SOdays, 15
patients wilh fixed proslhodontics used alternately a manual foothbrush (Oral-B Indicator
35, Oial-B Latioratoriesl and an eleclnc one
llnleiplak. Bausch 5 Lomb) in randomrzed sequence. Al the end of each experimental lime,
the Plaque Index, the Gingival Index, and Ihe
gingival bleeding inde were recorded and Ihe
intraoral nilric oxide levei was measured.

n. Gallo, A. Solsi, F. Bassi, P. Pera, A.

Angeretti, Turin, Italy
Efficacy ola New Dip-Slis Test m Deteimining
the Presence of Bacteria in Salwa and Oral
Plaque
Theetlioaoyoiaip-slidetestsinaelerminingthe
presence o lactobacilli (LB) and Strsptoaxcus
mutans (SM) in saljva has been reponed in the
literature. The aim of this study was to evaluate
Ihe eftioaoy of a new dip-siide fesl. CFT Baoteria
(Vivadent), indelerminmglhenumberof LBsnd
SM in saliva and in orai bactenal plaque, and fo
compare bacterial concenlralions in saliva and
piaque. Saliva samples were taken from 16 palienls m treatment at ihe Proslhodontio
Department of the Dentai School of Turin. Ttie
CRT Bacteria lesi was performed following fbe

manufacturer's instructions. Plaque samples

were taken with a sterile curette from the lingual
surface of the mandibular teeth, diluted lilOO
w/v. and Ihen tested as above. The results were
compared wilh those obtained from classic culture (fvlSB agar on a pelri dish for SM and
Rogosa SL agar on a petri Oish for LB) Analysis
of Ihe results showed that Ihe CRT Bacteria test
isaneftectivemethodtodeteimineie presence
of SM and LB. both in saliva and in bacterial
plaque A correlation was iound between bactenal concentrations in plaque and saliva.
E. Gassino, G. Schierano. K. Marescbi, F.
Bassi, G. Preti, Turin, Italy
In Vitro Anaiysis of Molecules involved m
Attachment of Gingival Ceils to Titanium
implani Surface
The longevity of an implant depends not only on
its osseointegration, but also on the aiiohorage
of epithelial and conneclive tissues to the lilanium surface. In this in vitro model, we Iried to
identify the molecules involved in Ihe inlefaction
between gingival fibrobiasts and a lila ni um implant. Gingivai mucosa samples we re obtained
trom compielely edentulous patients who bad
undergone prosthetic implant rehabililation of
the mandible (overdenture). Cells cultured in
the presence ot a litanium support were analyzed ior the expression o adhesion moleoules
and enfraoellular malrix proteins. Results
showed that gingival cells adhere to abutments
by sorne integrins (CD51, CD61, CD49), interoeliular adhesion molecule CD54, and CD44 rece plor. Treatment wilh 3 isoforms of TGF0,
which, as our slifdy confirmed, are locally released in variable quantities during impiant integration, increased the expression o adhesion
molecules and extraoellular matrix proteins
suoh as iaminin, fibroneotin, and collagen. Flow
cylofluorimetric anaiysis demonslraled different
intensity activities in relation to the Isoform
used. The identification ot turther structures involved in gingival adhesion to the impiant wiii
explain mechanisms that contribute to complete implant integration, and will enable iuture
clinical use o these molecules in modulating
host tissue response fo prosthetic support

P. Getirke, J. Neu ge bau er, P. Becker, K.

Lotzkat, G. Bayer, P. Brabant, Mannlieim.
Germany
immediate Loading cf Cylinder Screw implants
with Overaentures
in Itie
Mandibular
Sympfiysis: A Revisited Technique
A strict surgical protoool requires a stress-free
healing period of 3 to 6 months for osseointegration. The ievel of predictability and high success of current impiant therapy have provided
cause to reevaluate both the surgical and prosthetic protoooi. in 1988, P. D. Ledermann described a technique of loading 4 ngidly barsplinted implants in the edentulous mandible.
The presentation will revisit the approach of immediately loaded cylinder impiants by a Ushaped bar in the edentuious mandible. Four
gnt-blasted and acid-etohed screw implants
(Frialoc, Friateoj are piaoed in the nterforaminal area ofthe mental symphysrs. Immediately
after implant piacement, an impression is made
forthe fabrication of a mesio-bar superstructure.
The implants are loaded as early as 1 day after
surgery with an impiant-retained overdenture. it
will be demonstrated that osseointegration can
be achieved with a high levei of predictabiiity ii
Ihe technique is properly appiied. The resuits of

The Inlernatronai lourn^ii of Ptcsthodontic^

558

Volume 12, Number!

25 cases of immediale ioading will be presented

and discussed on the basis cf clinical slides
and practical hands-on models. The surgical
and prosthetic managemeni o mandibular implant-supported overdenture cases may be
greally simplified with the use ot this technique
in a carefully selected group of patients. Dental
rehabilitation time is shortened, with relevant
satisfaolion for patients and improved tunction
immediately after implant placement
R. Ghaderi, Tehran, Iran
Ini/esligalion About Size of 6 Upper Anterior
Teelh in Iranian Pcptilation with Regard to
tnterala Distance and Distance of Mouth Comers
The results o the sludy were as toliows:
Y = 0.45X t 3 (in women]
and
Y = 0.24X + 4 (in men
where Y = cun/e length of 6 anterior teeth in cm,
and X - distance between mouth corners in cm.
Y = a . l 9 x + 2.6
where Y = length of 6 anterior leeth in a straight
line, and x = distance between mouth corners
in cm.
R. Ghaderi, Tehran, Iran
Maxiliofaciai Prosthesis
First case report: Nose prosthesis
A 50-year-old man had lost his nose because
of sguamous ceil carcinoma 17 years ago. I
made an acryiic prosthesis using minimal tacilities. The color matching method was unique
and interesting; that is, colored pencils and selfcured acrylic resin were used I used glasses for
holding the prosthesis in place.
Second case report
A 27-year-old woman had a Class IV cleft
palate. Teeth 65/7 were present. Seventeen
years ago, I made a prosthesis for her after an
orthodonticexpansiondoneby Prof Fannandal
the Orthodontios Department, Tehran University. The maierials used were wrought wire,
acryiic resin, and normal impression materials.
C, Gil, A. Nakamae, R. Tamaki, Sao Paulo,
Brazil
Evaiualion oi Prosthodontic Therapy Quality
Applying PQiPrcsthodonlic Oualily Index
Methodology
In spite o Ihe faol Ihat there are some ciinicai
evaluation studies about removable partial denture (RPD] settlement, none of them has employed standard or widely applicable measurements involving either RPD biomechanical
aspects 01 the olinicai con sequences olprosthodontio treatment. The proslhodontic therapy
quaiity index (PQI) was both developed and
tested bythe authors, aiming to compensate tor
the abovemenlioned problems. The index may
be applied to 3 parameters: biomechanics,
moulh preparation, and clinical evaluation of
RPD wearers Hence, seeking to prove the PQI
test s effectiveness, 2S subjects with RPDs thai
were al least 3 years oid were selected. They
were anaiyzed and treated onoe more at the
FOUSP RPD discipline clinio according to
preestablished parameters based on that institution's own concept. However, Ihe methodologies using score systems are viabie whenever
specifying concepi validation, methodology oonslruclion validation, and methodology criteria
validation. The sub|ects were then instructed to
return orafurtherevaiua(ionafter2 years. After
the statistical analysis, it was concluded that

International Coiiege ofl'rosthodontists

the main issues interfenng with both the quality

ot RPD rehabilitation and its final result may be
reliably anaiy;ed with ttie FQI method.

significanfiy different and influenced the shear

bonding sfrength of the CerAdapi abutment to
all-ceramic materials with the Varioiink system

L. Grilll, M. Franchi, S. Catapano, Ferrara,

Italy
Experimental Evaluation ot the Influence oi
the Guide Plan on the Retention ot Removable
Partial Prostheses Clasps

J. Han, D. Kim, M. Lee, Seoul, Korea

A Comparative Study oi Mechanical Properties
of Alumina and Zirconia/Alurnina Composite
Abutment

The purpose ot our research is to test it the addition of a guide plan can increase the retention
ol standard over-equatoral clasps. We made
two Identical modeis fo reproduce an edentulous
ridge between 4.4 and 4.7; on these teeth, once
they were adequately prepared, were cemented
two Cr-Co oniwns. Ttie two crowns have 0.25
mm of undercut, in one of these models, two
guide plans were prepared on the proximal
crown surfaces near the edentuious ridge. Five
Cr-Co twin frameworks were made for each
modei. Every framework is composed of two
Ackers clasps: one on 4.4, the ether on 4.7. The
two Ackers ctasps are linked by a secondary
connector. A iittte ring is joined on ttie rest cf
each gauge to permit the traction. The traction
tests were performed with an insfron machine.
The anchorage between the Irameworli and the
machine is obtained by a steel wire gauged to
the little nngs. The instron machine records the
maximum ioad for a complefe separation ol the
framework from the model Ten traction lests
were done for each sampie to obfain 50 vaiues
of maximum load ior separation. The machine
shows a graphic (time/load applied), the maximum load, the mean applied loads, and the
standard deviations. Fmm Uiese data we can
see that fhe addifion of a guide pian increases
the tracfion resistance by more than 20%.

Y. Hagiwara, N. Hinokiyama. f^. Koizumi, T.

Igarashi, Tokyo. Japan
A Study o CerAdapt Abutment (Part I: Shear
Bonding Strength of Resin Cement in Various
Surface Conditions)
WHh increasing interest in esthetics, pafients
and denffsfs have been looking for metai-free
restorations in implanf dentistry. On many occasions, metai abutments fail to meet esthetic
requirements. The all-ceramic abufment
(CerAdapt, Nobei Biocare) was deveiopedfor a
single unif and allows good esfhetics and biocompafibittly. tt is important fo evaluate the biologic and mechanical perfonnance of a new
restoration method. The purpose ol this sfudy
was to evaluate bonding sfrength of the
CerAdapf abutment to various all-ceramic materials, resin cements (inciuding bonding system), and surface conditions. A CerAdapt abutment was ground with a diamond disk to create
3 flat surfaces for a shear bond fest. These surlaces were polished flat fo 800 grid by siiicone
carbide waterproof abasive paper in wafer. The
CerAdapf abutment was affached fo a Lab
Analog af 32 Ncm by a torque wrench The
CerAdpat-Lab Analog complex was embedded in low temperafure melting-metai alloy
block fhaf allowed loading exactly paraliei to
the long axis of the abutment. Ceramic specimens (IPS-Empress, Ivoclar) 3.00 mm in diameter by 2.00 mm high were fabricafed. Ceramic
specimens were cemenfed wilh Variolink
(Ivoclar) for shear bond tesling in various surface conditions The results indicated that fhe
control (no treatment) mean strength was 12.8
fiflPa. Other treafments such as sandblasfing,
phosphoric acid, and hydrotluoric acid were

Ceramic applications in restorative dentistry

have been highlighted because of ceramic's
high esthetic qualities. A tooth-colored ceramic
matenalwifh high strength and biocompatibility
can be a solution tor esthetic demands; the application of aiumina for all-ceramic crowns and
impiant abutments is a good example of this. A
new zirconia/aiumina composite ceramic was
deveioped for implant abutments The purpose
ot this study was to compare the new matenai
with commerciaiiyavaitabte alumina abutments
in terms of mechanical properties. Ten barshaped specimens (1.0 mm X 0.7 mm X 9.0
mm) were prepared irom five CerAdapf (Nobei
Biocare) and five cold isostatic-pressed zirccnia/alumina biocks. A 3-poinl bending fesf was
performed using a universai lesfing machine
under a spcial jig with a crosshead speed of
0.07 mm/min. Also, fracture toughness was
measured using indentation methods. The results of the 3-point lieiurai strength lest lor alumina and zirconia/alumina composite showed
mean values ot 620 MPa and 768 fulPa, respectively. The fracture toughness o zirconia/alumina composite ceramic specimens (9.2
MPa-m") was almost 3 times greater than iat
of alumina (3 1 fulPa-m'-'^). Within the limits cf
this study, fhe zircon la/ai um ma composite ceramic showed supe nor mechanicai properties to
alumina. This zirconia/aiumina composite ceramic might be used for clinical purposes

M. Hayashida, M. f^atsuyama, R. Ohta, K.

Koyano, Fukuoka, Japan
Functional Evaluation o Oral Retiabilitation
of Patients with Maxillofacial Prosthesis Part
Two: Improvements of Masticatory Function
It is important to assess fhe outcome of prosIhetic treatment both subiectiveiy and objecfively. The purpose cfthis study was to identify
fesfs for improvement of masticatory function by
maxiiiofaciai prosfheses and to evaiuate the
outcome of our cases treafed by maxillofacial
prostheses. The Part 1 repcrt showed that swailowing and speech abilities were improved by
wearing maxillofacial prosfheses. In Ihis paper.
the masticatory iuncfion was studied. Sixteen
postoperative patients (10 female and 6 male)
with maxillary detects were selected Irom our
university hospital. Ali subjects had been infomied about the nature ot the study and consent was cbtained In additicn, 1 i edentuious
patients without maxiliary defects 6 femaie and
5 male) with compiete dentures were selected
as a control group (CD). The subjects with maxillofacial prostheses (MFP group) were classified
info edentuious subjects (fulCD group) and dentafe sub)ects (fulPD group). Occlusai torce testing was performed by dentai presea ie [Fuji Fiim)
and occiusai fcrce and contact area were anaiyzed. Tue occiusai force dala for the nondefect
side in the MFP group and the chewing-side
dafa in the CO group were analyzed and compared. Subjective patient evaluations were done
by satisfaction score and chewing ability score
obtained from a questionnaire (Satoh et ai,
1989) Statisficai analyses revealed that there
was significant difference between the MCD

Volume 12, Number 6, 1W9

559

The Intern aliona I

and fiiPDgroupsin occlusal force, contact area,

and chewing ability score, aithough no ditfeience was found in satisfaction score. There
was nc difference between the MCD and CD
groups in any ol the 4 parameters. It is suggested that dentate subjects have an advantage
in occlusai fcrce and chewing ability when ccmpared with edentuious subjects, however, subjective satisfaction was not aifected.
S. Heo, J. Choi, K. Kim, J. Chung, A.
Wennerberg, Seoul, Korea
The Effect of Various Surlace Treatment
Methods on the Osseointegration
The puipcse of ihis sludy was to compare the
effects of various surface treatments on bone
heaiingbymeasuring removal torque around titanium impianls. Forty screw-shaped ccmmerciaiiy pure titanium implants witli a iength of 4
mm. outer diameter of 3 75 mm, and pitch height
ot 0.5 mm were used. Group 1 was left as machined [control), group 2 was tilasted with 50|jm AljOj, group 3 was blasted and elched in
etching solution (NHAOHiHjOjiHjO = 1:1 ;5) at
90X for 1 mm, and group 4 was blasted and oxidated under pu re oxygen at B0OC. The impiant
surface roughness was analyzed with a scanning electron microscope (SEM) and a conlocal
laser scanning microscope (CLSM), and implants were placed in the proximal tibial metaphyses of 10 New Zeaiand white rabbits. After
3 months of heaiing, removal torque ot each implant was measured lo compare bone healing
around Ihe implanfs In an SEM view, blasting
increased the roughness of the surface, but
etching ot that rough surface decreased the
roughness because cf the removal ot the tip of
the peak. Oxidation also decreased the roughness because of the formation of needie-like
oxide grains on the impiant surlace. The surface
toughness value from the CLSM was ieast in the
machined group (0 4 pm) and greatest in the
blasted group (1.25 |im), and the vaiue decreased after etching (0.91 ijm) and oiidaticn
(0 94 |im). The removal torque ct the etched
group (245 Ncm) was greater than that of the
machined group (16.7 Ncm) (P < 0 05), and
was greatest in the oiidated group (40.3 Ncm)
and the Biasfed grcup (347 Mem).

This study was supported by the Biogrsnt

(HMT-9S-G-E26) of fhe 97. Goodheaith-RND
pmject. Ministry of Heaith S Welfare, Korea.
H. Hersek, S. Canay, G. U i u i i , Ankara,
Turkey
Microleakage
Evaluation ot Porcelain
Laminate Veneers Luted with Three Different
Cements An Autoradiographic StuOy
Microleakage is a maicr problem that can lead
to staining and discoloration of the restoration as
well as postoperative sensitivify The eent of
microieakage between porcelain iaminate veneer restorations cemented by three ditferent
types of cement was observed. Two composite
luting cements (Varioiink, ivociarandTwiniook,
Kuizer) and a giass-icnomer cement (Vocolonotil U) were obsen/ed in vitro, using 30 extracted centrai incisor teeth that were tree of
caries and any observabie fracture iines. Atter
cementation the teelh were subjected to 2,500
thermccycies between two water baths af13^C
and 53C and piaced in Ca(45) isotope fof- 24
hours The teelh were embedded in separate
seif-cured acrylic resin blocks, sectioned longitudinaiiy, and piaced on radiographie fiims to

internalionai College of Prosthodoniiis

prcduce autoradiographs. The teeth were subsequently subjected to radioistopo penetration

tests. Ca(45) was used as a tracer and autoradiography was used for detecting the microleakage. The extent of penetration of Ca(45)
in each material was assessed and the degree
of microleakage was measured cn an ordinai
scale. No material was found tc seal the tooth
su da ce completely. Microleakage occurred
mosttrequently atthe laminate veneer-tooth interface near cervical and insical margins.
Significant differences were observed among
cements. The materials were compared to each
other using the Kruskal-Wallis test (11 = 15.78,
P = O.0002). The significance between the
groups was determined with the multiple comparisons method. Nostalistically signilicant difference in microieakage was revealed between
the Twin look and Vanolmk composite luting cemenls (P > 0.05), bul there was a statistically
significant difference in microleakage when
glass-ionomer cement was compared with
Twinlcck and Variolink cements (P < 0.05).
Glass-ionomercement exhibited far greater microleakeage when compared with two luting
composite resin cements.

Y. Higuchi, Y. Gonda, Osaka, Japan

A Complete Denture Treatment Case of the
Patient with Oral Dyskinesia
We appiied nitrous oiids-oxygen anesthesia
(GO) to the complete denture treatment of an
87-year-old Japanese tmale patient wilh oral
dyskinesia. Her chief complaint was masticatory disturbance from instabiiily of Ihe denture,
which was caused by the oral dyskinesia. In Ihe
process of producing new dentures, taking a
bite impression under GO was tned in hopes
of easing the tension and diminishing the oral
dyskinesia by sedation. GO was maintained
with 40 minules oxygen-20 minutes nitrous
oxide. The treatment was completed in 60 minutes with few oral dyskinesia episodes. Based
on visual inspection, the eral dyskinesia clearly
decreased after weanng the new denture produced with GO. There was a significantly
higher stabilization of the jaw tracing when
wearing Ihe new denture, as compared with the
old dentures by means of a Gnolh hexagraph
(jaw movement in 6 degrees of freedom. GCJ.
It IS suggested that GO be avaiiabie for the acquisition cf the reproducible bite relationship of
patients with oral dyskinesia.

K. Hiklla. Y. Uchiyama, Sapporo, Japan

The Fabrication of Crown and Bridge Used by
CAD/CAM System
We fabricated crowns and bridges with the new
dental computer-aided design/manufacturing
(CAD/CAM) system (Nikon, GC, and Hitachi
Seiko), and clinical application was done. First,
we did tooth preparation and impressions in the
mouth ol a patient, made a piaster cast, and put
it on an articuiator. The cast was measured by
a nonoonlact-type measurement system that
used a spot laser, and 3-dJmensional data were
constnjcted. A crown or a bridge model was designed using a CAD system in Ihe measurement
data. In the designing process, we chose crown
data of the most suitable standard tooth-crown
model from a database, and adjusted margin
line, ccntact points, quantity of contact, and
fcrm on the computer screen. The crown or
bridge data were converted into data for noncontact miiiing, and a ciown or a bridge was fabricated. We can select titanium or composite

biock as crown materials, but only preformed titanium blocks (32 mm ' 14 mm X 12 mm) can
be used fcr bridges. Finally, the crowns or
bridges we re cemented to the abutment tooth in
the mouth o the patient The mean nonconiact
milling time tor a crown was 71.8 minutes, and
ittock 177 minutes fcr a cne-piece bridge.
y. lelri, K. fHatsuo, K. Okimoto, Y. Terada.
FuKuoKa, Japan
Salivary Secretion and
Stomatognathic
Function in Radiai Denture Wearers
A balanced diet with good masticatory ability
are important factors to promote happiness and
weltare of the aged. Previous studies showed a
decrease in salivary secretion with aging and
taking drugs. Salivary secreticn is very important
in stomatognathic functions such as chewing,
tasting, and the stability of dentures. To investigate the salivary secretion and stomatognathic
function in partial denture wearers, we measured the salivary flow rate in stalic and stimulated status by paraffin-pellet chewing, salivary
butfer capacity, and preference for the taste of
food. Twenty-seven partial denture wearers,
aged between 62 and 74 years, and twelve volunteers in their twenties (control group) participated in this study. Twelve of the subjects had
worn tlieir dentures in good condition (PD
group), showing a mean masticatory ability of
B7,3 and a bigh satisfaction index (over 7); the
remaining eight complained o discomfort when
wearing their dentures. There was a significant
difference in the static salivary fiow rate between
the PD group (1.5B 0.33 mU5 min) and the
control group (1.71 0.B4 mL'5 min) (P< 0.05,
f lest). However, there was no significant difference in the stimulation status between the
groups. In the PD group, the stimulated salivary
flow rate increased when compared with that before wearing the partial denture The salivary
bufter capacity showed a lew pH (e 4.0) in ten
members of the PO group, and in the control
group, high pH (> 5.0) was dcminant. In the PD
group, the resuits of a questionnaire regarding
their ccnsciousness of salivary secretionsuch
as xerostomiawere consistent with the physiolcgic results. Thus, the abcve results suggest
thatstimulatedsalivarysecretion by mastication
may recover y weanng dentures under gcod
management cf the denture, regardless ol aging

Y.lgarashi, A. Kuroiuva.T. Kozawa, Nagano.

Japan
Human Mandibles Will Displace Witiiout
Posterior Occlusal Supports in SDA Patients
Kayser et al (1981 ) proposed the concept of the
shortened dental arch (SDA), pointing out that
it was unnecessary to restore the distal extension edentulous space extensively to the second
molars; establishing the occlusion only to the
second premolars was possible if palients did
not have excess chewing force. They reported
manycasescf "premolar occlusion" as the SDA
without any risk of temporomandibuiar disorders (TMD) DeBoever (1996) aiso agreed to
this concept, on the condition that "If occlusal
stability is sliil present, the clinical and tunctionai ccnsequences of molar (premoiar) ioss
seems to be an etioiogic importance for TMD
only in a minimal number of patients." C. Gil and
fl, Todescan (1997) reported many cases ol
craniomandibular disorders in Kennedy Class ii
(SDA) patients at an iCP meeting. We wonder
if the SDA can weli support the mandibular position in many patients. Since 1985. we have

The International lournal ot FroilhodoJitits

560

Volume 12. Numbe

measured how the mandibles and the condyles

displaced under ocniusal forces by measurements in patients with a jaw-tracking system
wilh 6 degrees of freedom r/M-JI-E, Shotu)
and an ooclusai lorce-araly^ing system
(Occluzer. Fuji Film) atthe siinie lima. Ocolusal
torces showed graduai decrease in spite of the
increase of the condylar displacement. These
resuits indicate that the possibility of mandibular and condylar displacements exists in distal
extension cases without Qcclusal supports, even
in low-level occluding forces.
T. Ikeda, S. Shigemoto, M. Nakano. E.
Bando, Tokushima, Japan
Measremen!
ot Flexural Loading on
Mandibular Cross-Arch Superstruclure of
Dental Implanl
Several researchers have speculated that the
mandible undergoes substantial strain based on
measurement of its flexure during jaw opening.
However, the nature and extent of this strain,
which induces the flexure, have not been directly
measured. The aim of this study was to develop and evaluate the measurement system ol
flexural loading in the mandibular completearch superstructure of a dental implant during
eccentric jaw movements. The cross-arch elastic rod was attached via goid screws directiy to
a pair of biiateral implants. Strain between those
implants was determined dynamicallywith 2
adhered strain gaugeswilh both surfaces of
the center portion ot this elastic rod. The strain
gauge oulput was converted to aclual force.
with the strain-force curve thai was recorded at
applying flexural loading, by a loading instrument using a forceps and load cells. To evaluate Ihis system, a single patient (a 77-year-old
woman) who had multiple ossecus implants in
the edentulous mandible participated. Loadings
were measured between bilateral molarer premolar impianis during various eccentric jaw
mcvements. The experimental protocol involved
the subject making each mcvement 10 times.
The calibration study revealed that there were
high correlations between the strain gauge cutput and the flexural loading in intermolar
(gamma = 0 985) and interpremclar (gamma =
0.930). The data for the intemiclar leadings during maximum jaw opening, maximum faleral
position, andpctrusionwere2t.92.5N (mean
1 SD), 4 1 . 5 7 3 N, and 14.8 2.4 N, respectively. The data tor the I nterpremclar loadings were570.59 N . 7 S 1 . 1 N, and 5.4
1.0 N. respectively. There were significant differences in flexural loadings between each portion and jaw movement in this subject (P< 0,01,
Mann-Whitney U test). These results suggest
that Ihis measurement system could measure
flexural ioading preciseiy, and we expecl it to
evaluate Ihe tiexural ioading of the mandible by
data recordings from additional subjects
H. Inoue, N. Kihara. Osaka, Japan
Effect o Vertical Cuspa/ Interferences on
Occlusal Force
This study v/as conducted to investigate the influence ot Ihe mandibularfirst premolar on the
appearance of occlusal force dunng maximum
cienching and tapping motions, Occiusai torce
was measured using e 3-dimensional transducer piaced on unilateral mandibular first molars. Cuspal interference was appiied with
stainless foils (10, 30, 50, 70, 100, 200, 500,
1000, and 2000 Mm in thickness) on the tiat occiusai tabie. At a height of cuspal interference

International Coiiege of Prosthodontists

of10-1tX)tim, the impulse of occlusal force irv

creased by me centralization of force with the
increase in height dunng clenching and tapping, Electromyographio (EMG) activity, however, was not signifcantly changed At a heighl
oi 100-200 pm, the mandible became unstable, with marked changes in Ihe occlusal torce,
EMG activity, and mandibular position. In 2 ot
3 subjects, the increase of the occlusal force
was inhibited, and in the other subject the force
increased. These iindings indicate that cuspal
interiererice is a very serious, acute problem
iorthe concerned teeth
S, Inoue. K, Kiyona, Y, Nakagawa, J. Otsuka,
F. Takashlma, T, Maruyama. Osaka, Japan
The Eect of Mandibuiar Deviation on Speech
Function
Speech is accomplished by integrated function
ot organs of the stomalognalhio system.
Recent studies suggest that abnormal ocolusion causes abnormality in mandibular movement during speech, which might include
speech dislurtiances The aim of this stuOy is
to investigate the relationships between
mandibular movements during speech and tne
deviation of the mandible at the intercuspal
position, Subiects were selected from among
patients who visited the Hospital of Osaka
University, Faculty ot Dentistry belween
November 1996 and December 193B with a
complairtoftemporomandibjiar disorders. All
patients undenivent clinical and roentgeoographic examinations. Mandibular movements
durfng speaking oi the standard test sentences
were recorded with the Sirognathograph
Analyzing System III (Siemens). Study casts
were used lo assess the 3-dlmensional deviaton of the mandible. The results of this study
suggest that ihe analysis oi mandibular movements during speech could be clinically used
in diagnosis of Ihe mandibular position.
Y, Istiiura, D, Higuchi, H, Fukunaga, K,
Warita, R, Furuya, T, Kawawa, Ohta-ku,
Tokyo, Japan
Effect oflnciination of Implant Abutment on the
Accuracy of implant Working Cast
The purpose oi this stuOy was to investigate the
accuracy ot working casts made from 2 types of
models, a parallel lype and an angled type, A 3dimensional measuring microscope was used to
measure reference points on Ihe master model
ana woriung oasts. The master model was made
fromcartion steel and stainless steel, Slandard
points A, B, and 0 were located on the base of
the master model. Reference points were provided on the occlusal suriace and on the measuring jigs for implants. Impressions were taken
and working casts were made. Subsequently,
the working casts were measured and compared to the master model. In the implant area,
the distance between the 2 implants was greater
than that of the master model for both types oi
woildng casts. Rotation of Ihe implants was observed in both types of working casts. For the
angled type of working oasts, reference points
otthe remainingteethmoved toa lower position.
M, Iwasaki, T, Nanami. T, Watanabe, T,
Gotoh, J. Shimizu, Tokyo. Japan
New Clinical Method of Occiusai Adjustment
for Complete Dentures: Third Report
It is important to make adjustments to Ihe denture base and ocolusion tor the proper function

of dentures. Complete dentures are especially

easy 10 move il there is premature contact because they are retained and supported by the
residual ndge membrane. Also, if the mandibular position IS not stable, il may be guided by the
premature contact, Ttierefore, we devised an
auxilliary device using the repulsive lorce ol
magnets for occlusal equilibration, "MAG-balancer," and we have gotten some good results
with it We will describe this device with a case.
A patienl, an 87-year-old woman, came to our
deparlmenl and complained about pain in the
residual lidge membrane when she occluded.
The maxillary residual ndge was iiabby tissue
at the inoisor region and the mandibular one
wasilat. She had oral dyskinesia. Although we
made a denture adjustment with occlusal equilibration and Ihe tissue conditioner, it was difficult to eliminate Ihe denture movement because the mandibular position was not stable.
Theretore, ft was also difficult to remove the deoubital ulcer at the lingual side because oi the
deriture movement In Ihis case we set the
MAG-balancer into Ihe tongue room oithe maxillary and mandibular dentures. After it pressed
Ihe denture 10 the residual ridge when tne patienl bil and it made the mandibular positon stable, we made an occlusal equilibration wilh articulating paper as usual. We made a long and
wide centric occlusion and we guided the maxillary incisois and the mandibular molars to
make balancing contacts for the anterior and
lateral mandibular movemenL In this case tne
complete denture was stable on the residual
ridge with tne MAG-balancer, and the oral dyskinesia disappeared. The decubital ulcer also
disappeared because we made a long and
wide centric occlusion, causing the dentures to
nol move as they had before. The repulsive
force ot the magnets between Ihe maxillary
and mandibular dentures makes dentures stable in Ihe oral cavity, and it may be useful to
guide the mandibular position to the physically
correct position,

T, Iwala, Y, Tanaka, K, Nakan, Nagoya,

Japan
Pre-Prosthetic Surgsry^The Evaluation of
Attached Gingiva
Both prosthodontists and patients nave a great
inleresl in the long-term function of prosiheses
and the longevity of the residual teeth, principally with prostheses for partial edentulism. We
prosthodontists notice n daily treatment thai the
prognosis of a prosthesis depends on healthy
and stable abutment teeth and their surrounding soft tissue. The role ot the attached gingiva
oi the abutmeni is to gain vestibular space for
a retainer, aiiow easy access oi the tooth-cleaning instmments, and maintain the healthy residual teeth as a biologic barrier We consider ihe
attached gingiva oi Ihe abutmeni loolh to be
one of the factors inlluencing the longevity of
the prosthetic structure. We therefore esamine
the Periotest (Siemens) value oi the teeth as
one ot the evaluation parameters ot the abutment, related to Ihe presence or absence oi a
quantrty of attached gingiva.
K. J a n g . Kangnung-City, Kangwon-do,
Republic of Korea
Measurement ol Orai Uaiodcr Associated with
Denture Wearing
Denlure stomatitis is one oi the common sequeiae of denture wearers. There are many
possibie causes for this compiication, among

Volumei2, Number 6,1999

561

them, denture cleanliness has been considered a critical local factor. Therefore, it is very
important ior patients to clean their dentures
and denture-bearing tissues. However, insufficient and improper education have made denIjre wearers un motivated to clean their dentures As a result, we can notice oral malodor
associated with denlure stomatitis. Oral malodor IS very unpleasant and sometimes makes
denture wearers embarrassed. For the adequate education and motivation to prevent denlure stomatitis and subsequent alveolar bone
rsorption, obiective measurement of oral malodor is needed. Oral malodoi is also used as
an indicator oi general health status. We measured oral malodor oi 20 maxillary and
mandibular complete dehture wearers (10
male, 10 tmale) using the HaNmeter model
RH-17 (InterScan) The Halimeter can detect
volaiile sullide compounds (VSC) in oral malodor The mean age of the subjects was 59,2
(range 31 to 72), and the mean denture-wearing period was 26 5 months (range 10 lo 72
mo). Measured conditions were as iollows: (1)
wearing denture, m denture removed, (3) 30minute immersion in commercial denture-cleaning agent, and (4} 24-hour immersion in commercial denture-cleaning agent. The values of
VSO were: (IJ 425.4 37.5, (2)272.6 119.9,
(3; 204,7 24 1,and (dj 112,2 24 6 ppb, respectively. The Scheff multiple range test
showed that there were statistically significant
differences among the 4 conditions (P< 0.05),
There was no signiticant difference between
male and female subjects as determined by 2tailed test (P? 0 05),

K, Kajiwara, E, Morishlge, S, Ishigaki, T,

Maruyama, Osaka, Japan
Modulation of Cf)BWing Movement in Patients
Treated with Osseointegrated implants
The aim oi this study islooblain the functional
guideline lor Ihe occlusion oi implanls by revealing the modulation of chewing movements.
Subjects were composed of 3 groups; ('; subjects wii natural dentiiion (control group): 2)
patients with implant-supported fixed complete
bridges in both jaws: and, (31 patients with implant-supported fixed prostheses m ihe
mandibular molar region. Subjects were instructed to chew a piece ol gum that contained
a small hard pasta. The movement of the
mandible was recorded and analyzed with the
Sirognathograph Analyzing System IH
(Siemens). The results of this study revealed
that implant patents snowed a longer occluding
phase than the control group and that the closing movement during chewing tended to continue in implant patients even after contacting a
hard material in the food. It was suggested that
the occlusion of palients with implants should
nol be considered the same as Ihat of dentate
individuals, and that the occlusion should be
caretuliy examined through functional analysis

N, Ka*ahata, M, Kajii, Y, Kamashiia, M,

Haruno, E, Nagaoka, Kagoshlma. Japan
Effect of Loading Conditions on the Aitered
Cast impression Technique
The purpose oi this study was to examine the
dierences in the casi shape of distal extension
edentulous ridges obtained by 6 kinds oi altered cast impression technique The subject
was a 75-year-old woman who wore a bilateral
maxillary free-end partial denture and a complete mandibular overdenlure. The master cast

ernational journal of Froiihodontics

International College of Proslliodonlists

was acquired using siiicone rubber impression

materiais and a custom tray witb 1,5 mm cf
space in the edentulous area and 3.0 mm of
space in the dehtate area. Tfie framework for the
aitered cast impression techniques had 2 embrasure clasps al Ihe bilateral premoiars and the
retenticn iattice w o * with Oasepiates, under
which there was 0.46 mm of space. The impressions were taken under 2 ioading conditions' digilai pressure Ic the rests on the premoiars (ioading condition A), and occlusal
pressure using occlusion rims with shaiiow indentations of opposing artificial tooth cusps
(loading condition B). Impression materiais used
in this study were siiicone ruOtjer, poiysuilide
rubber, and zinc-oxide-eugenol paste The impressions were taken 5 times under each ccnditicn. The casts were measured at 0.5-mm intervals lateraiiy and antercpcstericriy by a
semiconductor iaser (LC-2320, Keyence), and
the heights cf the left distal-extension edentulous iidge were evaiuated. The measurement
results were examined by unpaired tlest (Ps
0,05). The resuits showed Ihat there were significant differences in ai most aii areas ofthe left
edentulous ridge, between the 2 ioaOing conditions with the respective impression materials,
and among the 3 kinds of impression materiai
In ioading condition A However, the significant
difference was almost not recognized amcng
the 3 kinds of impression materiai in icading condition B. The loading conditions on the aitered
cast impression techhique may affecl the cast
shape ol the distal eitension edentulous ridge.

Y, Kim, A, Fenton, G. Zarb. Seoul, Korea

Osseointegrated Implant Angulations in
Edentulous Patients
Impiants have to De positioned and prostheses
designed to withstand occiusai and parafuncticnai loads. The angirlation of the implant relative tc the occiusai piane is important, since
large deviations from vertical can significantly
increase the stress ih the implant-abutment pillar. This can create overloads and fractures of
components, including implants. Tlie purpose
of this study was to measure ttie angulations of
impiants reialivetothe occiusal piane Flecords
from 50 patients frcm the Toronto Study were
examined (25 maxiliary models with 133 implants, and 25 mandibuiar models with 123 implants) A custom Jig and leveling bubbie wedge
were designed to horizontally orient the occiusal piane of each mcdei parallei to Ihe stage
of a Mitutoyo toolmaker's measuring micro.
scope. The stage v/as then moved to focus on
the top and bottom of guide screws in each im.
plant, and the slage position was recorded.
These positions were then solved with a
trigonometric function to calculate the angle of
each implant. The mean value of the inclina,
tiens ot the implants in each position, mea.
sured by the 2 components ofthe angle (in degrees) seen against the frontal piane |a) and
the sagittai plane (|i], was:

Maxilla
R3 R2 R1 L1
Lateral
4.1 4,6 4.2 5.1
angle (a)
Anterior 14,7 15.5 15.Q 15.5
angle (p)
Mandible
Lateral
angle (o)
Anterior
angle ()

L2
7.B

L3
B.B

15.4 145

R3
47

R2
3.5

full
2.4

LS
0,03

L3
1.7

-0.3

4.2

3,4

2.2

0.4

The resulting mean anguiations raiative to

the occiusai piane were claculated as toi lows:
iabiai = 5% maxilla and 55% mandible. Vertical
orientations were found in 10% of the maxillary and 24% of the mandibular impiants.
Anatomy and rsorption appear to create differences between the mandible and maulla.
This study has found data that will be applied
for creation of more realistic modeis to study
impiants, prostheses, and their loads under
function,
H, Koshino, M. Hattori, T, Hirai. T. Ishijima,
Hokkaido, Japan
Tongue t\^otor Behavior and Mandibular
Movement in Chewing
To elucidate the relationship between tongue
motor behavior and mandibular movement in
chewing, 8 healthy, fully dentate males were
analyzed fcr their tongue and mandibular
movements with and without an exprimentai
lingual plate (ELP) while chewing 3 grams of
peanuts. Masticatory efficiency was also evaluated by the seiving method at the same time.
Tongue movements and mandibular movements were recorded simultaneously by ultrasound diagnostic equipment with a 5-MHi
electron convex section scanning probe and
the MKGimmediateiyatter 1,3.6,12, 24. and
48 hours of ELP insertion. From simuitaneous
recordings, aii chewing strokes from Ihe first to
the last were measured by a digitizer and caicuiated for the cycle time of tongue and
mandibular movement with a persona i computer. The masticatory efficiency immediately
after ELP insertion decreased significantly
compared to betre ELP insertion in s\l subjects ( P = 0.01). The cycle times cf tongue
movement and the mandibuiar movement
were extended significantiy compared to before the insertion ot the ELP in aii subjecis (P
< 0 01 ). The masticatory efficiency, cycle time
of tongue movement, and the mandibuiar
movement with (he ELP graduai iy recovered to
the i eve i s prior to ELP insertion. The crrela.
tion coeflicient between the cycle time of
tongue movement and the cycle time of the
mandibular movement was statistically significant ( P i 0.01). it was suggested that the insertion ot the ELP reduced the tongue space,
and therefore obstructed the tongue movement Rhythm of mandibular movement was
also disturbed. As a result of the lack of harmony in the movements, the masticatory efficiency seemed to decrease, it is emphasized
that the tongue space shouid be secured in ail
prosthetic treatments to harmonize the tongue
and mandibuiar movement. Tbis action brings
about a satisfactory i eve i of masticatory func-

S. Kraljevic, K, Kraljevic, J, Panduric, R,

Celic, T, Badel, Zagreb, Croatia
Axiographic Recording and Measurement of
Lower Jaw Movements
In this study, both pnjtrusive and retruslve
movements of the aw joint, which represent
one ot its basic functions, were recorded and
measured. The study was conducted by
means of the eiectronic axiography method.
The totai sample included 94 subjects divided
ihtc 2 groups. The first group comprised 50
subjects who had signs and symptoms ot dysfunctions of the stomatognathic system. The
second, asymptomatic group comprised 44
subjects. All subjects were recorded by the

The International Journal of Prosthodonlic

562

Volume 12, Number 6

Gamma Cadiax system, which consists Of a

conventional SAM axiograph, an electronic
device for drawing curves, diagnostic computer software, and a perscnai computer. The
achieved resuils saved in the computer were
anaiyzed and statistically processed In the
grcup cf symptomatic subjects, the maximal
value of the length of the right jaw joint protrusive paths amounted to 4.73 to 15.27 mm
(mean value 10,06 mm), and in the group of
asymptomatic subjects Ihis value was from
5.12 to 15.08 mm (mean value 10 31 mm).
The corresponding values for the left jaw joint
amounted to 5,01 to 15.94 mm (mean value
11.19 mm) in Ihe symptomatic subjects, and
in the asymptomatic subjects trom 5.31 to
15.21 mm (mean vaiue 10.78 mm). The aim
of the statistical analysis was to determine if
there was a significant difference in the ma"imal length of protrusive and retrusive mandibular paths in the symptomatic and asymptomatic subjects, as well as differences
between male and female subjects. The results of 2-factor analysis ot variance show
that there is no statisticaiiy important difference in the length of the protrusive or retrusive paths between subjects with signs and
symptoms of craniomandibular disorders and
asymptomatic subjects. There is aiso no statisticaiiy important difference between male
and femaie subjects. We can also conciude
that the interaction of these factors shows no
Statisticaiiy significant difference.

L, Lay, VI. Lai, C, Chen, Tainan. Taiwan

Use ot the Dental Implant Combined with the
Conventional Removable Partial Denture.
A Z-Ysar Clinical Report
Most dental implants are used to restore the
edentuious area with lixed prostheses or with
complete overdentures, but in some cases,
because of severe ridge rsorption or
anatomic iimitation, fabrication of fined implant prostbeses may be very difficult. The removable partial dentures (FiPD) may need to
restore the missing teeth, t)ut the conventional
distai extension RPD may cause more ridge
rsorption, mucosa ulcration, instabiiity, and
discomtort In this presentation. IMZTwin Plus
(Straumann] and Friaiit-2 (Friatec) implants
were used beneath the distai extension RPD
base as distai vertical support to improve the
function and comfort of the denture. During a
3-year foiiow-up period of B cases, 19 MZ
Twin-Piusand 13 Frialit-2 impiants were combined with the conventionai HPDs and different types of attachments. Only one implant
tailed at the initial healing period, and there
was no further implant loss after the prostheses were inserted, ih a case that uses ohiy one
implant benealh the demure base and a
doms-shaped abutment as a vertical stop, the
bone rsorption rate is more severe than when
2 or 3 implants are used In the cases that use
more than one implant in one edentulous area,
the implants can be connected with a milled
bar or ERA or ball-and-socket attacbments
combined with the fiPD, effectively improving
the RPD. At least 2 implants (especially for distai extension free-end edentulous areas) are
more useful to prevent overload on the implants. The conventional requirements of
RPDs, such as retention, stability, support.
and optimal denture base entension, are very
important tc provide more stabie and even
force distribution and reduced lateral torce on
impiants.

"

inlprnalional College O Prosthodontists

Z. Mach, J . Regent, K. M a r u s k o v a , D.
Housova. L. Mrkias. Prague, Czech Republic
Shear Bond Statiility of Bonded Glass-L eucite
Ceramics Inserts. Parr One: Short-Term
Evaluation
The formation of ihe overiap technique of glasseuce ceramic inserts camed new positive conditions, but also problems with extension ot the
tKindSd surfaoe between luting matenal and inserts. This in vitro study has been dealing with
ttie stability of this bond after 24 hours and 1
week. Two mioi'ofilled composite cements,
Panavia 21 (Kuiaray) and All-Bond CSB (B(soo).
were used as lutng matenal, and nonfilted adhesive Evicrol Dual Bond (Dental, CZ) was used
as a comparative sample. Shear bond slrengtn
specimens were prepared using the method described by Watanabe et al (factors, sandblasted
aluminum cylinders were used for sut)strates). A
thinj layer of the adhesive was applied to this surface in a well-defined standard area and a glassleucite ceramic insert with the same profile was
bonded to this surface. Specimens (n = 1 o each
adhesive groupl were stored at 37 C for A
hours and 1 vueek, and then shearimnd strength
was measured on the Autograph AG-5006 machine (Shimazdu) at a crosshead speed of 1
mm/min. Shear bond strengfi in MPa was:
24 h
Material NTD TD SD
NTD TD SD
All-Bond 10.6 9.1 5.1 s 17.3 15.0 7.1
CSB
Panavia
9.7 8.3 4 1 < 15.9 14.1 5.9
21
Evicrol
5.4- 4.3' 2.9
4.3' 3.5' 2.9
Dual Bond
"Signifioant differences versus other adhesives,
P<0.05.
(N)TD = (non)transfomied data: 50 standard
deviation: < = significant differences between
observed penods, P < 0.05.
After 1 week, shearbond strengths were signifcantly higher (Student s ! test] foi both microfilled luting cements than strengths atter 24
hours and strengths ot the comparabve sample.
Supported by Grant #4947-3 trom the IGA of
Ministry of Health ot the Czech Republic, and
Ncrdiska Dentai. Sweden
T. Maeda, K. Kuremoto, S. Takaoka, H.
I noue, DsaKa, Japan
Mandible Is Moving Around in Intercuspat
Position
Intercuspal position, or centric ocolusion, is defined as the centerea contact position ot the occiusal surfaces cf the mandibular teeth against
Ihe ooolusal surtaoes of the maxillary teeth.
The position is a static tooth contact position,
but in vivo there (s a relationship between the
degree of bile torce and the degree of inteicuspation and associated tooth movement
within the periodontal space. This expenment
investigated whether the mandible was static
while (eeth were occluding in interouspal position. The mandibular positions ol normal subjects with natural dentition were measured
when sitting upright wilh head straight and looking directly ionward, ihe teeth occluded in inlercuspal position for more than 1 minute A
gnatho hexagraph (Ono SokKiJa tracking system with a charge-coupled device camera that
didnotinterterewith natural tooth contactwas
used to measure mandibular movement in 6

degrees of freedom. Dala were stalislicallyanalyied. Although the ranges were nol defined
because o Ihe limitation of Ihe expenmenlal
system (S/N ratio, resolution, elc). it is clea: that
the mandible is slirring during clenching orocciuding in interouspal position.
J. Martinez-Go m IS, J. Bizar, J, Anglada, J.
Satsench, J. Samso, Barcelona, Spain
Preliminary Study ol Efficacy ol Four Polish
Systems on Ceramic Roughness
The objectives of this study weie to tesi and
oompare the efficacy of iour polish systems on
oeramic samples abraded by a diamond bu^.
Fort/ oeramic disks (Ivoclar) were used They
were distnbuled into four randomized groups.
eaoh group containing len disks Inital roughness of all samples increased with a diamond
bur (gram size 125 pml. Samples in group 1
were polished by Shofu njbbers (Shofii Durawhite stones + Standar + Ultra ^ Ultra II
(Cramiste points]}. Samples in group 2 were
polished by diamond burs {gram size 30 pm -i-15
pm). Samples in group 3 were polished by whie
silicon (Universal polie rer) and black rubber.
Finally, samples in group4 erepoiisned using
the 3fvl disk polish system (Sof-Lex. 19S2-C *
1982-ful + 1982-Fl. Afterward, all samples were
polished with Yeti diamond paste. We made
tour roughness recordings: after and before use
of ffie diamond bur, and after and betre using
Yeti paste Analysis of vanance was used to detemiine differences between different gioups
and in eaoh slate of Ihe different methods All
four methods used were capat>te of reducing the
average roughness o ceramic samples. The
most effective systems were 3ful disks and diamond burs, while the least effective method was
white siiicone plus black rubber. These results
suggest that the 3M polish system and diamond
burs may be more efficient than other methods
for reducing roughness of ceramic

M. Matsumoto, A. Sodeyama, S. Toda,

Tokyo, Japan
A Olinical. Periodical and Physiotogicsl
Evaiuation of Changes in Masticatory Load
Center of iJnilateral Shortened Arch ana Those
After RPD Treatments
The aim ot the study was to evaluate the unilateral shortened arch and occiusal reconstruction by removable partial denture [RPD) to elucdale the relation belween distribution of
occlusai contacts and me Incalion of the load
center ot masticatory musculature activiliss by
electromyography (MG) and Prescale (Fuji
Rim) Dislnbuticnoiocclusalcontactsandthose
loads, and also the location of lead center, were
measured by an eitra-thin layer of pressure indicator (Prescale). with an exclusive anaiyzing
computer system. The EMG of masticatory activities and ocolusal contacis were recorded
with Prescale at interproximal clenching. Ten biiateral shortened arch oases were used as the
control; fleen unilateral shortened dental arch
contacis, occiusal loads, and ccordinates o the
points were studied periodically in relation to
masticatory functions pte- and post-RPD treatment. These dala were analyzed and evaluated with those of the control group. The location of the occiusal load center in a dentate
mouth was in about the median line of the maillarv first molar region, but in a unilateral shortened arch the load center was biased by about
one premolar breadth anteriorly and inclined
toward the side with remaining dentition. Tne

Volume 12, Number b,199?l

563

center of the supporting area in a unilateral

shortened arch was biased toward Ihe remaining side and slightly incisally. After weanng an
RPD for over 1 yearin the unilateral edenlulous
atch, the location of the load cenler was improved iike a dentate arch, presuming physiologic and iunclional recovery and also activation
of masticatory musculature. The prosthodontic
restoration for unilateral edentulous cases (unilateral shortened arch) was quite effective from
clinical and physiologic standpoints tro m the
follow-up results at 1 year. 2 months
M. Matsuyama, M. Hayashida, R. Ohta, K.
Koyano, Fukuoka. Japan
Functional Evaluation of Oral RehaDilitation
of Patients with Maxiliofaciai Pmstheses
The concept ol evidence-based dentistry should
also be applied to maiiliotacial rehabilitalon.
Both subiective and objective assessments of
treatment outcome are necessary 10 improve
clinical treatment. The purpose of this study
was to identify functional assessments of maxiliofaciai prostheses and tc evaluate Ihe treatment outcome wilh these assessments. In this
study, 16 postoperative patients (10 female and
S malel with maxillary defects (MFP group) were
selected trcm our clinic. All sub)ecls had been
informed about and consented to our study.
The subjects were classified into edentulous
subiects (MCD group) and dentate subjects
(MPD group). In addition, 11 edentulous patients without maxillary defects (6 female and 5
male] with complete dentures participated as a
control group [CD group). Swallowing ability
was examined with a drinking test. A blowing
test, 100-single-sound lest, and 54-word test
were performed as Ihe evaluation of speech
ability. Nasalance in Svowel sounds was measured with a Nasomeler. All tests were performed with and without prostheses. The improvement o each ability was analyzed In the
fUlFP group 31.3% and 20.2o in the CD group
showed improved swallowing ability with a prosthesis. In the fulFP grcup 68.8% impicve inthe
hard blowing test. Soft blowing tme,nasalance
of all vowel sounds, and intelligibility score of ttie
single-sound test showed no statistical dierence between the futCP and MPD groups. By
weanng maxiliofaciai prostheses in the MFP
group, soft blowing time was prolonged by 11.8
s (P= 0.001), the intelligibility score o the single-sound test as increased by 36.0" (P <
0.001 ), and nasalance was reduced (P<: 0.005).
It IS concluded that abilities ot swallowing and
speech were distinctly improved by wearing
maxiliofaciai prostheses

G. Menicucoi. M. Lorenzetti, F. Bassi, M.

Mozzati, P. Pera, Turin, Italy
Toolh-Inilant Ocnnection- Biomechanical
Aspects and Olinicai Guidelines
When a load is applied (o a tooth rigidly connected to an implant, the resilience of the periodonlal ligament may determine the stress
concentration inside the implant. Masticatory
load distribution inside a iixed bndge rigidly
connecting 2 natural teeth and an implant was
investigated by finite element (FE) analysis o
a mathematiC model, siress concentration inside the tooth, implani. and peri implan I bone
were also investigated. The FE mcdel created
in this study (Menicucci et al, 1998) reproduced a human mandible wilh 2 natural abutments (canine and iirst premolar) rigidly connected toa distaliy placed implant. FE analysis

national lournal of Proithodontii

infernalional Coliee of Prosthodontists

contirms in vitro and in vivo results reported in

the iiterature. Some ciinical guidelines shouid
be followed when impiants and teeth are connected- t/ tooth-impiant connection is a clinicaiiy acceptabie conliguration when Ihe tooth
has good pericdontal support; (2) from a biomechanicai point of view, spimting one impiant
to 2 mesiai teelh favors a more uniform load
distribution; and (3)teeth and implants must be
ngidiy connectedthe lype of connection
shouid aiso prevent the intrusion of the tooth.
B. Miliar, London, United Kingdom
Two-Yesr Results with Direct, Single-Visit.
Ceramic inlays (Cerana)
Ceramic materials provide esthetic lesfcralion. but 2 appointments are needed to fabricate ceramic restoralicns by means of an indirect technique. Single-visit systems have
recently become available, and one such technique, Cerana (Nordiska Dental), uses
matched drilis wilii pre-etched and prosiianated leucite inlays in a range of sizes The
linai restoration consists of a ieucite inlay cemented with a restorative composite resin The
iniays are fabricated withouf any pigment additives, and the translucence of Ihe ieucite provides an acceptable color match. The interim
results, at 2 years, ol a prospective longitudinal study of 30 Cerana restorations (23 Class
I, 7 Ciass 111 are presented. Restorations were
reviewed and assessed lor: anatomic form
(AF, scoreof AtoG), marginal adaptation (MA,
A to D), surface roughness (SR, A tc D), marginal discoloration (MD, A to C), color match
(CM, A fo C), and patient discomfort (PD, A to
D). The percentage of A scores lor AF, MA,
SR, MD. CM, and PD at baseline (n = 30) was
100%. 100%, 79%, 100%, 14%, and 100%, respectively. After 1 year (n = 26), the respective
scoreswere100%,e9%, S1%, 100%, 6%.and
100%; and after 2 years (n = 20), the scores
were 10O%, 88%, 3%, 100%, 6%, and 100%,
respectiveiy. There were no scores less than
B, so all restorations remain ciinicaiiy acceptable and in tu nction. The results suggest that
Ihese restorations can be expected tc perform
weil, but that a gradual increase in surface
roughness is likely. The color of the inlays was
stable and the colcr match was acceptable.
There was a slight loss ot marginal adaptation
because of loss of marginal resin in a few
cases The initial resuits were encouraging in
terms of esfhetics, patient acceptance, ccclusai wear, and ease ol use, and they suggest
that this technique offers a promising alternative method for placing ceramic resfcrations.

fW, Miyake, T. Gomibuchi, S. Toshihide, K.

Koide, Nitgafa, Japan
The Influence of Occlusal Configuration on
Masticatory Function for Lingualized Occlusion
The purpose of this study is to ciarify the morphologic effecl on the masficatory tuncfion
caused by arlificiai posterior teeth with iinguatized occlusion. By using complete dentures thaf could change the tooth ol iingualized
ccciusion, we compared the chewing movement and subjective sensation of patients with
30-degree artiliciai leeth for iinguaiized occlusion (anatomic teelh), and with our modified
biaded teeth for lingualized occiusion
(nonanatomic teelh). Subjects consisted of tivo
maies and four females with an edentulous
jaw. Fouj test fcods (boiied fish pastes,
peanuts, raw carrots, and pickled Japanese

radishes) were seiected. The maximum iateral movement on chewing was measured
using MKG. The subjective sensation on chewing was summarized from questionnaire forms.
The results are as follows; ((the biaded teeth
reveaied a significantiy smaiier maximum iaterai movement in aii test foods; this was a
chopping type cf path of masticatory movement; and (2 all subjects could obtain a favorable sensation with biaded leeth, especially
while chewing hard foods (raw carrots and
pickied Japanese radishes), but no there was
no difference with boiled lish pastes and
peanuts.
T. fvilzumori, M. Iwasaki, S. Samma, Y. Hojo,
T. Maruyama, Osaka, Japan
Chewing Pattern Recognition Program
Our previous studies demonstrated the clinical
importance cf the eiamination ol the chewing
movement. Severai chewing patterns could be
assoclafed with Ihe specific condition of the
stomatognathic function. The recognition of the
chewing patlern, however, required some experience, and the consistency ot the recognition
might vary among examiners. To ciarify the
problems in ciassitying the chewing patterns, we
tried to devetop an anaiysis program featuring
chewing pattern recognition. The program aiso
has seme capabiiity to diagnose the stomatognathic function The Sirognathggraph Analyzing System lii (Siemens) was used to record
the mandibular incisai point movement. The Incisal Point Movement Analysis Program
(IFMAF) was developed under Micrcsoft Windows98 with Borland Ct+ Builder 3. IPMAP
can analyze the mandibular border movement,
the speech movement, and the chewing movement The chewing movement is analyzed Irom
rhythm, mandibuiar position, and speed.
Recognized chewing patterns are dispiayed.
Diagnosis of the stomatognathic function is accomplished based on this analysis of the chewing movement.

M. Moreno, Guadaiajara, Mexico

Frosthodontic Management of Velopharyngeal
Inadequacies
Prosthodontic management of veiopharyngeal
inadequacies wi I i be presented in fhis posfer. A
patient wilh veiopharyngeai incompetency was
treated with a paiafal lift A patient vjith veiopharyngeai insutficiency was treated with a palafai
liftand bulb. To assess the effectiveness of the
prostheses in improving speech Inteiiigibiiity,
both pafients were ciinically tested with TONAR
(the oronasal acoustic ratio). Speech tests were
performed with the prostheses in place and
again without the prostheses.
M. Mofonaga, S. Kasahara, R. Inagaki, K,
Watanable, M. Yoda, K. Kimura, Sendai,
Japan
Stress Analysis of Ceramic Crowns
The purpose of fhis sfudy was to investigate the
stress distribution of ceramic crowns in f uncfion,
using fracfure tests in reai and 3-dimensionai finite eiemenf mefhod (3-D FEM) analysis.
Conventionally, it was regarded that fhe complex crown-cemenf-abutment is a continuum
unit in 3-D FEM analysis. However, the results
of these analyses were not applicable to aspects
of a reai fracture situation. Therefore, in this
study, anaiysis was carried out under the condition that the complex crown-cement-abutment

The International lourn.il of Pnsthodonti

564

;12, Number f.

was regarded as a noncontinuum unit in 3-D

FEM analysis. Ceramic crowns used in this
study were porcelain jackal crowns luted wilh
adhesive resin or zinc-phosphate cemenf, and
porceiain-fused-to-metai crowns iuted with zincphosphate cement, tjsing a human maxillary
central inoisctmcdei, fracture tests were carried
out to measure fracture load and fo study fracture aspects. In each experiment, stress was applied to ceramic crowns at 45 degrees in fhe inoisal region. Using the fracture tests described
above, 3-D FEM anaiysis was carried out with
MARC K6.2 to study stress distribution. The results ot Iracture tests and 3-D FEM anaiysis
were compared and discussed. Regarding the
complex crown-cemenl-abutment as a noncontinuum unit, 3-D FEM analysis of ceramic
crowns showed more applicable resu its than fhe
conventional method. It was indicated that high
tensile sfrength was dislributed at the convex
portion ot the cervical proximal inner line ot ceramic crowns. The reason Ihat a porcelainfused-to-metal crown has a high tiacture ioad is
that distribution of high tensile stress was iccaiized in Ihe metal coping. It was indicated that
the use ot fhe adhesive sysfem improved the
fracture ioad ot ceramic crowns.

K, Murai, K. Okimoto, K. Matsuo, Y. Terada,

Fukuoka,Japan
Evaluation of Masticatory Ability in Elderly
People by Analysing Joules of Work Performed
With a recent increase in the aged population
in Japan, evaiuation of masticatory ability in
aged peopie shouid be established as soon as
possibie The usefuiness of a mefhod fo evaluafe masticafory ability by anaiyzing jouies of
wori! performed (cule-expression method) has
been studied with a test capsuie The presenf
study focused on the correlation between the
joule-expression mefhod, a sieve system, and
a tood intake questionnaire to further discuss
the uselulness of Ihe joule-expression methcd.
The subjects consisted of 9 pafients with a
mean age of 72 7. Ail subiecls had worn a
newiy prepared denture, andf heir denture conditions had been good The foiiowing measurements were performed. (1) Jouie-expression method-the patients were instrucfed to
masticate pigment 106-coated granules sealed
in a rubber capsule tor 20 strokes. The masBcatory ability, detined as the joules of work performed, was calculated by the concentration of
pigment leaked from the crushed granules. (2)
Asieve systemacconjing to Kapur's method,
the subjects were instructed to masticate 3 g of
peanuts for 20 strokes. (3) A food intake questionnaire methodaccording to Hirai's method,
the masticatery ability was obtained. Based on
the cbtained resuits, a statistical analysis was
made on Ihe correialion between the joute-expression mefhod, fhe sieve system, and the
food intake questionnaire by SPSS. There was
a correlation between the joule-expression
method and the sieve system (0 75, P< 0.02),
between the oule-expression method and the
questionnaire (0.74, P< 0.02), and between the
sieve system and the questionnaire (0.66, P<
0.05), indicatingthe highest ccefficient between
the|oule-expression method and the sieve sysfem. The joule-expression method provides
100% recovery of the test material and Simpiicity and accuracy because the granules are
contained in Ihe capsuie. Therefore, these results suggest that the jouie-expression method
should be useful and effective in evaluating the
maslicatory function.

international College of Prostiiodontists

E. Mushimoto, H. Tanaka, T. Furuyama.

Iwate. Japan
Eleclromyographic and Kinesiographic Sludy
of Swallowing by Evaluating the Jaw Opening
and Closihg Muscles
To evaluate the mastication, it is important to
analyze the whole process from ingeslion ot
foods to swallowing. Dunng food mastication,
multiple intermittent swallows may occur.
However, correlation ot masticatory sequence
with swallowing or tongue movements was
not dear. The purpose of this study was to
identfy whether a liming of electromyographic
(EMG) activity ct jaw opening and closing
muscles can ditterentiate chewing and the
swallowing motion. Five healthy young dentate sub|ects were asked to chew until swallowing the test toods (pudding, raisins, and
mixed situation) randomly. Tbe surtace EfuIGs
of the bilateral posterior temporal, masseter,
and mylohyoid antenor belly ot the digastric
muscles were simultaneously recorded with
mandibular movements using MKG (Myotronics). At the same time, synchronous
recordings were made using the accelerometer applied on the larynx for extracting the
swallowing cycles. Time difference ot burst
onset (TDBO) among working-side jaw opening and closing muscles was obsen/ed dunng
lhe whole sequence of mastication and analyzed The results were that TDBO in the 4
muscles increased dunng the sequence of
raisin chewing, however, those values decreased during pudding chewing. Thai ps,
TDBO increased during crushing and/or
chewing motions and decreased during swallowing motions. Evaluating TDBO among the
jaw opening and closing muscles might be
useful in examining swallowing behavior
K. Nakajima, H. Stiiga, Y. Kobayashi, Tokyo,
Japan
The Shape of CMD Palients ' Denial Arches
The width of craniomandibular disorder (CtvlD)
patients' dental arches and Ifieir tongue spaces
as seen in a horizontal plane were investigated
to clarify the possible effect of the shape cf the
dental arch on CMD Forty Cf^D patients (20
men and 20 women) m their twenties, and 40
normal subjects (20 men and 20 women) in their
twenties who tiad no masticatory or systemic afjnormalitieswere selected as subjects After fabricating a detailed mandibular model of each
subject, a horizontal plane picture of lhe
mandibular arch was taken using a charge-coupled device (CCD) camera. The area enclosed
by lines passing through the midpoint cf the lingual side of the incisai edge, the cusp ot ihe canine, and the maximum lingual prominence of
the first premolar and second molar were calculated by computer and compared between
the nomial subjects and CfulD patients. Also,
the distance between the maximum lingual
prominence of the bilateral firsi premolars and
the distance between bilateral second molars for
both maxillary and mandibular arches were calculated and compared between the 2 groups.
When seen in a horizontal plane, CMD patrents
had a smaller tongue space ihan normal subjects
and there was a statistically significant difference between the 2 groups. Also. CMD patients
had a shorter distance between the bilateral first
premolars than normal subjects, and a significant
ditference was found between the 2 groups.
From these results, it was concluded that the
dental arch of OMD patients is constricted.

A. Nakamae, R. Tamaki, C. CM, Sao Paulo,

Brazil
Incorporation of the Working Condyle Side
Shift When Adlustiog the Bennett Angle ol Ihe
TT Articulator in Endenlulous Patients
The Bennett angle established for ad|usting
the articulator Itirough Paterson's grinding technique is frequently smaller than those established through pantography. tjsually il is not
possible lo obtain adequate vestibuIation of the
aniculator's lower branch to provide contact
between the vestibular cusps ol the maxillary
and mandibular teeth. In a sample of 33 subjects, after the teeth ware settled, a corrective
maneuver was appiied for the Bennett angle's
adjustment; it provided the lateral sliding ofthe
working condylar sphere as far as the vestibular cusps of the maxillary and mandibular teelh
reached each other in lateral border movement For each degree of increase in [he
Bennett angle, there was a lateral sliding of 0 2
mm in the working cohdylar sphere. Increases
of 5 to 12.5 degrees were then applied in lhe
Bennett angle at intentais ot 2.5 degrees. Ttiere
was a frequency of tO.6 in the category of 5
degrees, 21.2 in 7.5 degrees, 53% in 10 degrees, and 15.2% in 12.5 degrees. The values
of Bennett angles obtained with this maneuver
were equivaleni to those resulting from pantography. thereby enforcing its practical application for refining the TTdegrees in articulator
programming.

For Ihis reason, a device was developed Ihat

transfers the dragging force of a thickness
gauge between Ihe teeth tc aloadcell. Ten volunteers with a healthy complement of teeth and
a normal arch form participated in the experiment. Dragging force intensity at each proximal
tooth contact betweer> thesecondpremolarand
first molar of the maxilla and mandible was assessed. These measurements were dene during slight opening and biting in intercuspal position using 20o cf the maximum voluntary level.
The stainless steel thickness gauge was set al
30 [im thick, 2 mm wide, and 20 mm long. Pilot
data demonstrated that at fcrces above 30% of
maximum, the thickness gauge could not always be withdrawn. Bite fores was mcnilored
with visual feedback of surtace electromyography taken from the masseter muscle Mean
(standard deviationi dragging force, and during
slight opening and biting in the mandibular aich
were 6.1 W (3 0 N) and 28 5 N (7 9 N), respectively. For the maxillary arch, these values were
5.7 N (3,4 N) (open) and 28.6 [J (13.5 N) (biting).
These data quantify the significant increase in
interproximai fcrces for both the mandibular and
maxillary arch during biting (Pe 0 01,Wilccxcn
test). Our results correspond with those of past
reports in which narrowing of both maxillary and
mandibular arches was reported during biting.
Further studies will investigate additional inlerproximal siles, additionai torces, and the relation
between the tendency to impact food interproximally and proximal contact force.

Y. NaKamura. Y. Tanaka, Y. Desaki, Nagoya,

Japan
Dynamic Analysis of a Magnetic Attachmeni
Using Finite Element Method

D. Nilsson, J. Smith, M. Latla. Omaha,

Nebraska
Clinical Evaluation of a Silrcone'Based Son
Denture Liner

Magnetic attachments have gained increasing

popularity in Japan in a comparatively short
time since they were intreduced into the market
in 1992, Aboul 1,000,000 magnetic attachments
have been used as denture retainers in Japan.
Mahy dentists and patients have recognized
the unique and valuable clinical characteristics
ot these magnetic atlachments; they are easy
tcuse, stable in function, very easy on the abutment teetb, and sc on. ven so, the dynamic
charactenstics of magnetic attachments themselves are not yet very clear. Si nee they are very
complicated and delicate, general mechanical
measurements are almost impossible. However, to assess the stress distribution of a magnetic denture and make a |udgmenl about
adequate denture design, the specific characteristics of the magnetic attachment should be
completely analyzed. Therefore, in this investigation the dynamic charactenstics of a magnetic
attachment, f^agfit (Aichi Steel), were analyzed
using a 2-dimensional finite element melhod
on a model with 180.000 elements. The analysis was to elucidate the basic functions of the
magnetic attachment Ihat until now had not
been clear.

Sotl liner materials are an important adjunct in

complete denture prosthodontics. Asotyet, no
material has been tound to meet the requirements of an ideal, long-term soft denture liner.
The purpose of this clinical study was to evaluate the performance of a silicone-based sott
denture liner. The experimental material was
laboratory processed with a compressionmolded (15 denlures) or injection-molded (10
dentures) technique and cured within a llask in
a temperature-controlled water bath. Twentytive completely edentulous patients witticut serious medical oonditions, such as primary or
secondary xerostomia or mucocutaneous diseases affecting the oral mucosa, were selected
for this study. Patients were evaluated for denture retention and stability (Kapur index) and for
tissue irritation (De Paola clinical intlammation
indei) at insertion, 3 months, and 1 year. The
bond ofthe silicone liner to lhe denlure base and
color stability, with comparison to a blank sample from the same lot, were evaluated at each
recall. At 1 year, subjective dala from a patienl
questionnaire were obtained with regard tc comfort, lack ot taste, odor, and overall satisfaction.
No stalistically significant change (KruskallWallace, P>0.05) in the Kapur index was noted.
Improvements in the De Paola index were noted
in 4 patients. All but 2 patients reported gocrtl or
very good satisfaction with the siiicone-based
soft denture liner.

M, Nakano, S. Shigemoto.T, fkeda, E. Bando,

Tokushima. Japan
Changes of Proximal Tooth Contact Slate
During Slight Opening and Biting
Proximal looth contact state is important in maintaining toolh arch and occlusion. It is also related
to food impaction, caries, and periodonlal disease Several pror studies have evaluated proximal tooth contacts at a slight opening position,
but iimited information exists regarding how
thesecontactschange during funclicnal loading.

Voiumef2,Number 6,1999

565

C. Oblak, T. Kosmac, P. Jevnikar, N.

Funduk, L Marioh, Ljubljana, Slovenia
Biaxial Plexural Strengih of Yttria-Stabilized
Tetragonal Zirconia Ceramic]
This study was conducted to evaluate the effect cf grinding and sandblasting on biaxial

Intemational lournal of Prosthodonlic

Internationl College of Proslliodontists

flexural strength and reliability of yttria-stabilized tetragonal zirconia (Y-TZP) ceramic. In

addition, the role oi micro structure in the mechanical properties and reliability oi suriaoetreated ceramics was invesligated. One hundred twenty disks were randomly divided into
6 groups oi 10. For each group a different
suriace treatment was applied. Biaxial ftexural
strength was obtained irom loading specimens to iracture. Data were analyzed using
one-way analysis cf variance (ANOVA), followed by the Tukey HSD test (P < 0.05), and
Weibuli statistics were used lo analyze the
vanatJility oi flexural strength After each surface treatment, the relative amount ot transformed monoclinic irconia was calculated
from data obtained by x-ray diffractometry,
and Ihe mean critical defect size was established. Significant differences (Ps 0.05) were
found belween the control group and ground,
fine-grained material ior both wet and dry
grinding Sandblastingsigniticantlyincreased
the strength. All suriace treatmenl procedures
reduced the Weibuli modulus, ie, the reliability o V-TZP ceramic The highest amount of
the monoclinic phase was found after sandblasting. Lower amounts oi the monoolinic
phase were obtained after both grinding procedures, where also the highest mean critical
defect size was calculaled. Our results indicate that sandblasting may provide a powerful technique for strengthening zirconia dental
ceramics in clinical practice. In contrast, grinding may lead to substantial strength degradation and reduced reliability ot preiabncated
zirconia elements.

R, Ohta, M, Matsuyama, f^, Hayashlda. R,

Siiemasu, K, Yamauchi, K. Koyano, Fukuoka,
Japan
improvement of Speech Abliity in Edentulous
Patients with Complete Dentures
hJotonly mastication, but aiso swallowing and
speech, are the importani iunctions ot the
stomatognathio system, in edentulous patients, quality of lite is disturbed li speech abiiity IS r o l well recovered with a complete denture (CD). Therefore, improvement oi speech
abilit/should be taken into consideraiion in Ihe
treatment of edentulous patients. However,
there have been few reports that assess ihe
improvement cf speech ability with CDs The
purpose of this study was to establish the
method of assessment for speech ability improvement and to assess the speech ability
improvement otthe edentu tous cases treated
in our clinic. Ten edentulous patients who
were treated in our clinic and agreed to the
purpose oi fhis sludy were seiected as the
subjects. Additionafly, 10 deniuious persons
were selecied from our staff as a conlrol
group. Objective assessment was performed
by a 100-single-sound test and a 54-word lest.
Inte I i ig lb I lily score (IS) was calculated based
on 5 dentists' diclation oi 100 sounds and 54
words. Statistical analyses revealed that IS
with CD was higher than that without CD both
in the 100-single-sound test (P= 0 0016-) and
in the 54-word test (P = o,58), however, IS of
the 54-word test showed significant difference
(P = 0.28'). The questionnaire on pronunciation was iaken as subjeclive assessment and
all of lOedentulous patients turned out to be
satisfied wilh their pronunciation with their
CDs. It is conciuded that speech abiiity is obvicusly improved by wearing complete denlures.

P, Owen. F, Da RIbeIra, Medunsa, South

Atrica
From Textbook to CD-ROM: Converting
Textbooits and Lecture izotes to ComputerBased interactive Learning Experiences
Increasingly and around the world, traditional didactic teaching melhods are being challenged
as being unable to keep pace with Ihe ever-increasing body of knowledge in Ihe health sciences. The move toward student-centered
learning is a welcome one, but it imposes
greater challenges on academics to create and
generate more appropriate learning materials.
While lectures may or may not serve a teaching purpose, there is general acceptance that
learning activities that are more project- or assignment-based have greater value. Learning
by discovery seems to contribute to long-term
memory retentionfarbenerthan the systematic
study oi texts. In addition, many studies have
shown ihai studehts in distance-learning situations, whether pre- or postdoctoral, enjoy an
approach that provides as great a variety oi
learning materials as possible. The use ot multimedia, computer-based materiais in education has now become quite commonplaoe, especially at the primary and secondary level.
However, there remains a paucity of material af
the terliaiy level, not least because the skills required to develop such material are rare among
academics who are already highly skilled in
their own fields ot expertise. Recogncing Ihis,
we have developed a software "engine" that
will convert traditional teaching matenal inio an
interactive computer-based environment. An introductory text on removable partial dentures
was used, and this presentation will give examples or the variety oi learning activities that
canbegeneratedinthisway Examples are the
use oi Mind Maps; Ihe use of quizzes and questions with remediation pointers to appropriate
parts oithe text; Ihe ability to delve into any part
oi the text at any time, and to see its relevance
to the whole; to be able to probe into the text and
biack out via the same route; and so on. In addition, better and more creative use can be
made of graphics than in the text-based situation. We have discovered through this development that the only limi! appears to be your, or
your students', imagination.

J, Paul, E, Naidu, Annapoorni, Chennai,

Tamil Nadu. India

indigenously Fabricated Mou!ri-Stici<

Appiiance for a Paralyzed Patient
The mouth-stick appliance can help quadriplegic patients to perform simple daliy tasks. An
indigenously fabricated appliance for a quadriplegic palient is detailed below. This appliance
consists of an intraoral mouthpiece and extraoral pencil-holding device, Tlie intraoral mouthpiece is an interocciusal splint that covers the occlusal surfaces oi ail of the leeth, and the
extension of the splint is just short oi fhe height
of contour. The entraoral pencil-holding device
s altached fothe interocclusal splint with a hollow oylindric rod 25 cm in length. Various working ends can be attached for different functions.

meial substruotures made witn 3 different alloys. Seventy-five gypsum dies were fabricated from a masler sleei die. They were randomly divided into 3 groups of 25 dies each.
A melal coping was prepared on each die
using a different technique lor each group:
Captek (Glidewell Laboratorios), AGC, and
cast high-noble alloy, Ceramio was baked on
all samples following the same protocol and
simulating the shape and size of a maxillary
central incisor. Ail sampies were fhen evaluated under a stereo micro scope with 2QQi<
magnification. The marginal gap was measured at 8 different points, one on each die,
before and after ceramic appiication, and also
on the master steel die, A totai of 3,S00 measurements was evaluated. The results were
statisticaiiy elaborated by means of Ihe
Bonierroni test and 2-way anaiysis oi vanance (ANOVA). The ANOVA revealed a significani difference in mean marginal gap before and after ceramic applicaiion, Captek
showed the smallesi gap compared to AGO
and high-noble alloy beiore ceramic application. AGC and high-noble alloy showed better
marginal adaptation after ceramic application
and Oh the masler steel die compared to
Captek. Marginal gaps are influenced by the
application oi ceramic and by the alloy used
for the substructure,

R, PIdlisnyi, Lviv, Ukraine

Clinical Evaluation of Fiber-Reinforced

Composite Periodoniai Spiints and SplintBridges
In recent years, patients' requirements ior esthetic, minimally invasive dental prostheses
(including periodontal splints) have increased.
The aim of ihis study was to evaluate the clinical eectiveness of esthetic adhesive fiber-reinforced composite periodonfal splints and
splint bndges. Fourteen splints and 16 splint
bridges in 27 patients wilh moderate to severe
periodontitis have been under our observation. Maxillary and mandibular splinis were
fabricated from high-modulus polyethylene
(Ribbond [Ribbond], Connect (Kerrj), ribbon
or fiberglass (Splint-lt [Jeneric/Pentron]), composite material (Charisma [Kulzerj, Valux Plus
[3Mj, or Sculpt-lt and Flow-It [Jeneric/Pentron])
and used to immobilize the anterior teeth
Splinl bridges made of Ribbond or Sptint-it reinforcement, Valux Plus or Sculpt-lt and FlowII restorative composites, and denture teeth
(Estodent |Stoma] or Vitapan [Vita]) according
lo a technique modiiied by us were used to immobilize the mandibular anterior teeth in patients wilh periodontitis and the absence of
one to 2 inasors These fixed prostheses were
observed from 6 io 24 months (1 to 2 years (or
splints and 6 to 12 months tor splint bridges)
using the periodontal and modiiied USPHS
criteria for examination. The results of clinical
evaluation showed Ihe high effectiveness of
prosthodontic treatment with the adhesive
fiber-rein forced composite periodontal splints
and splint bridges.

D. Petten. G, Ribero, M, Bresciano. F,

Bassi, S, Carossa. Turin. Italy
Ma rginal Deformation After Ceramic Baking of
Three Different Metal Substructures

C, Pinto Coelho, S, Zucoloto, Ribeiro Preto,

Brazil
Proiiferatfve Activity of Denture-induced
Fibrous inflammatory Hyperpiasia Analyzed by
Proliferating Ceil Nuclear Ahtigen Labeiing
Index

The aim of this study was tooompare the marginal deformation after ceramic baking oi

Denture-induced tibrous inflammatory hyperpiasia (FIH) occurs around the borders ot all

The International Joumal of ProsthodonLii

566

Voiume 2, Number

international College of Prosthodontists

ill-fitting dentures, Tbere has been no report in

the literature conceming epithelial proliferative
activity in FIH. The labeling index (LI) was assessed by using the proliferating cell nuclear
antigen (PCNA), a nuclear protein synthesizea mainly in the G1-S slages of Ihe ceil
cycle, that could be detected immunohistoCdemically by the monoclonal antibody PC1O
The PCNA LI was assessed in FIH specimens, in clinicaliy normal specimens 1 cm
from the FIH margin (adjacent group), and in
clinically normal specimens located at least 2
cm from the adjacent group (control group]
The mean PCNA LI values in the basal,
parabasat, and overall epithelium iayers were
similar m the FIH and the adjacent group and
were signiticantly higher than m the contrci
group. These data support the importance of
the surgicai treatment of FIH with a wide excision of 1 cm, since the ciinicaily normal tissue around the tesion could be histoiogicaliy
altered.

K. Rener Sitar, L, fUarion, L j u b l j a n a ,

Slovenia
The Relations Between Tooth Wear and
Temporomandibuiar Joint Morphology
The anatomic evaluation of the relationship
between the temporomandibular joint and attrition ai occlusion was the aim cf this study,
eighty-six adult skulls dating from the 3rd to
tfje 18th centuries, which were found in the
area known today as Slovenia, were used.
The degree of occlusal wear was measured
by using the scale devised by Molnar. Dental
nilers were used for 30 different measurements. Fourangularmeasurements were per.
formed through photography. The siope of
abraded occiusai facets from canine and first
molar teeth were classified. The scaie devised by Richards was used tor the assessment of the severity of degenerative changes
of the temporomandibular joints. The condyles were classified according tc the scales
devised by Mongini and by Oberg, Statisticai
analysis ot the relationsbips between tooth
wear and all other variables using the linear
regression method and Pearson correlation
test were performed The results indicate thai
tooth wear is a function of age (P < 0.001).
Males have on average more abraded teeth
than females of the same age group (P =
0,012). Tooth wear is conversely related to
the number of remaining teeth (r = 0 336),
Sk^es of the wear facets on the first molar
teeth (P=0,058torthe left side and P = 0.090
for the right side) and siope of the condyle
path (P = 0.096 for the left side and P= 0,008
for Ihe right side) were related to Ihe average
tooth wear index. The deplh ot the temporal
tossa (P= 0.064 for the right fossae and P =
0.040 for the lefl) and the condylar dimensions become bigger with higher tooth wear.
The loss ot the tooth crowns resuits in the loss
of the facial vertical dimension, which influences the articular surtaces of the joints (P =
0.020 for the right fossae and P = 0.024 for
the left). Goniai angle ( r = 0.207 for the right
angles and/= 0.279 for the left) and bigonial
width (P = 0,073) are statisticaiiy significantly
related to the extent of the tcoth wear. The
study confirmed the hypothesis that the bony
parts ot the temporomandibular joints are permanently subject to adjustment of the occlusion because of the abrasion otthe teeth.

J, Rubo, X. Lei, J. Curran, G, Zarb, Bauru

Brazil
Finite Element Analysis of Strass Distribution
on Dental Implants-A Study ot Seven Clinical
Variables. Part IIStresses on Implants.
Abutments and Framework
A finite element analysis program (I-DEAS
Structurai Dynamics Research) was used to
Simulate a human mandibie treated with an implant-supported proslhesis for studying stress
distributionondentaiimplants Thevanablesintroduced in the computer mcdei we re density of
cancellous bone, i engt h of autments and implants, length of cantilever, number and
arrangement of implants, degree of curvature of
mandible, and framework alloy (AgPdor CoCr)
The computer was programmed with physical
properties of the materials as derived from the
literature, and a 100-N vertical load was used to
simulate the occlusal force Images with the
fringes of stress were obtained, and the maximum stress at each site was plotted in graphs
for companson. Stresses tended tc be better
distributed among implants and abutments
placed in a nanower mandible (favoring a more
cun/ed arrangement), a shorter cantiiever aim,
ionger implants, and a stiffertfameworti. Density
of canee ilou s bone did not seem to affect stress
on implants. Reducing the number of implants
resulted in higher stresses on the remaining
abutments. Stresses in the framework were tne
same irrespective of the curvature of the
mandible, and were lower with longer abutments, longer implants, and Stifter alloy.
Stresses increased witb den ser cancellous bone
and when 2 implants were missing. A long cantilever may cause the tramewon< to bend.

This study was supported by Fundacao de

Amparo a Pesquisa do Estado de Sao Paulo
(FAPSP) and by an Implant Prosthodontics
Unit Research Grant from the Faculty of
Dentistry of the University of Toronto.
S, Sahin, M, Cehreli, Ankara, Turkey
A Dual-Purpose Stem for Correct LabioPalatal Positioning of Dental Implants
Success of functional and esthetic implant-supported prosthesis depends on precisely placed
implants in the predetermined 3-dimensionai
position and the design of Ihe final prostheses.
Whiie bone rsorption in the anterior maxilia
often necessitates more palatai positioning of
implants, the initial step in improving the gingival profile and enhancing the cervical esthetics
of the final restoration Is the correct piacement
ofimplants. Since place ment of impiants in the
anterior maxiiiaparticuiarly with questionable
bone supportis often a clinicai challenge, the
use of computed tomographic (CT) scanning
and surgicai stents wilh proper guides is essentiai. This poster describes a technique to
fafincate a duai-purpose stent for CT evaluation
ot the 3-D localization and angulation of an implant relative toan anticipated abutment whose
central axis was predetermined in accordance
with the superstnjcture Thereafter, modification
of the current sent was accomplished for further
use in the surgical phase of the treat men L
M, Saito, K, Notani, . fiura, T, Kawasaki,
Sapporo, Japan
Complications and Failures ot Removable
Partial Dentures A Clinical Evaluation ovsr a
12-Year Period

Volume12, Number 6, 1999

567

The purpose of this study was to cianfy the type

of retainers that causes compiicaiions and failures in removable partiai dentures (RPD),
Ninety-one RPDs were placed in 65 pabents
whc had wom them for more than 2 years after
insertion and who had had them checked at
least twice a year Three dentists who had more
than 10 years of clinical experience examined
the RPDs in these patients up to 12 years. The
patients' ages ranged from 27 to 82 years, and
32% were male. To ciarify the charactenstics of
complications and failures in RPDs, the RPDs
were classified ihto 4 categones: fi;telescopic
denture CTD), (2) ordinary clasp denture (OD),
iJJmodrfied clasp denture (MD), and (<i;combinaticn denture (CD) Complicationsand failures
ofTDsweregreaterthanthoseofODs, MDs,or
CDs. There were differences in the sites of compiication and failureamcngthe RPDs, The rates
of complication and failure at abutment teeth
and retainers were higher than those of connectors, denture bases, and artificial teeth. Althoughthefaiiure rate at abutment teeth, retainers, denture bases, and artiticiai leeth did not
diange signiflcantiy over the 12 years, that at
connectotssignificantly increased after 8 years,

K, Sasaki, M, Watanabe, S, Hashimoto, T,

Takasaka, Sedai, Japan
Audiological Assessment of Tinnitus in TMD
Patients Betre and After Occlusal Treatment
Twenty-five temporomandibuiar disorder (TMD)
patients [aged 16 to 69 years) with disabling tinnitus were treated with stabilization splints and
cccasionally with occlusal adjustment. Full ototogic eiam I nation, and audiologic assessment
with pure-tone audiogram, auditory brain stem
response, etc were made by an ear, nose, and
throat specialist before ana after TMD treatment. Subjective tinnitus severity was graded
as tinnitus score by a questionnaire, which inciuded occurrence, duration, loudness, and annoyance of tinnilus Before treatment, audiologic assessment revealed that 12 patients had
dystunction: 7 were diagnosed with sensoryneurai hearing loss, 3 with hearing loss within
normal range, and 2 were diagnosed as having
vestibuiar dysfunction. Tinnitus score in the patients diagnosed with aural dysfuncticn was
significantly higher (P= 0 05, ftest)thaninthe
patients without aurai dysfunction. TMD signs
resoived in 3 to 12 months after the start of
treatment in aii patients. After treatment, tinnitus was rescived or improved subjectively in 22
of 25 patients, Audiologic assessments showed
thatB of 10 patients with hearing ioss showed
improvement of hearing ievei in the audiogram.
Two patients with vestibular dysfunction also
showed improvement of equilibrium function
Tinnitus score was improved significantly ( P 0.005, f test) in the patients diagnosed with
aural dysfunction and in the patients without
dysfunction. There was no significant difference between the 2 groups. These resuits show
that some aural symptoms in TMD could be assessed objectively by means of audiologic assessment, and that the occlusal treatment for
TMD was effective on these objective findings
ot the aurai function. These aurai symptoms
couid be considered to be related to TMD
G, Schieraho, F, Bassi, M. Marinacci, G.
Menicucci, G. Preti, Turin, Italy
Influence ofthe Thickness otthe Resin Palatal
Vault on the Closest Speaking Space in
Complete Denture

Journal of Prosthodontics

International College of Prosthodontists

The closed speaking space (CSS) has been

considered stable over time and therefore useful to determine Ihe occiusal vertical dimension
(OVD) in edentulous patienls. Stoller has shown
[hat CSS IS correiated to overbite and to Ihe
presence or absence of diastema cf Ihe Iront
teeth. Clemenon affirms that in complete denture wearers CSS is not constant, but depends
en the thickness of the resin palatal vaulL and
that Ihe air volume needed to pronounce words
should remain constant The possibiiity of increasing CSS might be useful for increasing
OVD when necassary The aim of this study was
lo evalale Cemencn's hypotheses in a group
cf edenlulous patients rehabilitated with new
dentures. CSS was measured withtheold deniure and monitored with the new denture at 30,
SO, go, and 360 days from delivery.

A. Sedran, G. Gilardi, V. i^orani, G. Preti,

Turin, Itaiy
Monitoring the inteiocciusal Rest Position and
the Minimum Speaking Space After
Prosthodontic Restoration of the Vertical
Dimension of Occlusion in Patienls with
Collapsed Vertical Dimension df Occlusion
The free interocclusal rest space (1RS) and the
closed speaking space (CSS) have been used
as dim cal para meters to determine the vertical
dimension of occlusion (VDO) in prosthodcntic
rehabilitation of partially edentulous patients
who have undergone VDO collapse. Some
years ago, 1RS and CCSwereconsidered lobe
reliable parameters, but subsequent research
has shown that they are subject to variations.
The determination of the VDO is based en the
clinical evaluation of a number o parameters
and takes into consideration aspects such as
the physiologic rest position, phonelic tests,
and esthetic evaluation. The aim ot this research is to monitor changes in the RS and the
CSS in partially edentuious patients with VDO
ccllapse, and to establish the degiee of reliability cf the 2 parameters.

T. Shinogaya, M. r^atsumoto, Tokyo, Japan

Occlusai Load DistritMjtion in Distai Extension
Removable Partial Denlure Wearers
A measuring system (Dental Prescale System,
Fu)i Film) for recording and analyzing bite force
over dentition has been recently developed using
0.1-mm-thick pressure-sensitive foil. The information on the distributed occiusal load IS useful
tor diagnosis and assessment o prosthcdontic
treatment (Shinogaya and Matsumoto, 1998).
The purpose of this study was to invesligate the
effects cf clasp-retained distal extension removable partiai denlures (RPD)on the maximal
bite force and distributed occiusal ioad. Forty-two
patients participated and were divided into A
groups according to Eichner's oiassificaiion. (1)
B-1(fi^) = 15 patients who lost unilateral molar
support; 2} B-2(PM) = 6 palients who lost unilateral premolar and molar suppoiing ones:
(3! B-2(Mful) = 10 patients who lost bilateral
molarsupportingzones;and(4)B-3(Pfu1M) = i1
patients who lost uniiateral premolar and biiateral mofar supporting zones. The patients' maximal bile forces were recorded both ivith and
without the denluie m situ, within 2 to 4 weeks
after delivery of Ihe RPD. The dentition was divided into 5 regions of right and ieft molars, premoiars, and anterior teeth, and the distributed occlusai ioad (N) and relative load (%) in each
region were calculated for each patient and compared befween the state with and without the

dentureineachgroup. Toa grealer or lesser degree, Ihe de livery of the olasp-retained distal extension RPD caused an increase in the totai bite
force and a decrease in the distributed occiusal
ioad in the remaining teelh during the maximal
clench as compared with nc RPD in each patient
grcup These effects were clearly shown in the
palients in the B-3(Pfi1M) group.
A. Sotou, I, Emmanoull, T h e s s a l o n i k i ,
Greece
Examination and Comparisdn of the Amount
ct Residuai Monomer in Different Acrylic
Resins Aer Polymerization
Acrylic resin is a well-known material for fabrication of the bases o complete and partial dentures The proportion o polymer:monomer for
mixing heat-cured acrylic materiais is 3-3.5:1 by
vclume. As the monomer boils at lOO.S'Cand
the polymerization reaction is exothermic, the
initial heating process must take place at Ihe relatively iow temperature cf 72C for 2 hours, tolloweO by curing at IQO'Cicrat least a further 2
hours. Despite this curing, between 0.2 and
0.52 of residual mcnomer remains dispersed in
the mass cf the acrylic resin. In this experimental work we used liquid chromatography to try to
ascertain the percentage o residuai monomer
in resin polymers by Oi tie rent methods. The
amounts of residual monomer were measured
in 3 resins: T 15 Vivodent). Triplex (Vivodent),
and Paiadon 65 (Vivodent) The resuHs of the liquid Chromatographie examination of the 3 resins
were compared and discussed, enabling a series of conclusions to be drawn about the resins.

fW. Tanaka, T. Ogawa, S. fWalsuya, S. Aizaviia,

K. Koyano, Fukuoka, Japan
Characterization of Change of Fluidity in
Provisional Restorative Materials
Fluidity is a critical factor in the determination of
physical properties and ease of hartdltng o autopolymerizing methyl methacrylate resins for provisional restorations. No previous studies or the
manutaoturers' directions, however, have provided such information. This study investigated
the change of iiuidity indifferent materials while
they cured tc evaluate the hypolhesis that the reduction of fluidity differs amcng the materials and
that the curing time does not reflect the property
of fluidity reduction. Test materials were 5 commercial ly available autopolymerizing methyl
melhacryiate resins (Uniiasi II, ADFA. fuleta
Fast. Miky, and Tnm), and were supplied in a
powder and liquid iorm. After mixing the resin for
10 seconds, it was placed on Ihe stage of an oscillating rheometer that was developed originally in our school. Thefluiditywas measured as
an amplitude of rheometer record. The curing
time was defined as the time required to reach
0 in the amplHude. The half-life ot fluidity was defined as measunng an elapsed time in which the
amplitude reduced to half of its original reading
Statistical analysis of the data from 5 measurements for each material demo nsl rated that there
was a great variation in the curing time (one-way
anaiysis ofvariance [ANOVA], P i 0.001), showing that Uniiast I i was 3 times as quick as Trim
(Fisher's PLSD, P <: 0.001 ). Tt\e half-liie also
showed a great variation among the materials
(ANOVA, P< 0 001). However, the order ot materials numbered by the halt-life did not correspond to that numbered by the curing time. The
materiai with a long curing time did not necessariiy have a long half-life time. For instance,
Unifast maintained a long-lasting fluidity despite

568

its guick curing. It was conciuded that the character o change of fluidity varied among materiais, and was unprediclable trcm the ouring time.
The character of fluidity reduction should be
taken into consideration in the selection of an appropriate material for its purpose and the clinician's lechnical ability.
S. Tanaka, K. Kashiwagi, M. Tanaka, T.
Kawazoe, Osaka-shi, Japan

Changes of Coordination Patterns for

Masticatory Muscles in Elderly Denate
Volunteers in the Process oi Gum Ohewing
Depression of the masticatory muscle function
wiii ooour with age. There were few reports on
thisdepression in the elderly without tooth loss.
The purpose o this study was to investigate differences in changes of cccrdination patterns
for masticatory muscles belween elderly and
youngdentate volunteers in the process of gum
chewing. We used electrcmycgraphie linear envelopes (EMG LE), normalized with respect to
amplitude and stroke, icr masticatory muscles.
The study was performed or^ 9 elderly (mean
age 71.6 5.7 years, elderly group) and 12
young (mean age 24.6 2.3 years, young
group) dentate volunteers. EMG signals were
recorded trom bilateral masseter and anterior
tmpora! muscles on Ihe preierred chewing side
for 90 seconds. The incisai point movement
was tracked using a mandibular kinesiograph simultaneously. A series of 10 stable strokes was
selected every 15 seconds bythe incisai point
movement. Each stroke period was normalized
to 300 points. Each stroke was nonnalized by
setting the mean ensemi:ile value overa single
stroke to 100% Ten normalized EMG LEs were
averaged in each series. Averaged EMG LEs o
4 muscles in each period were evaluated by
cluster analysis. Changes of dendrograms of the
4 muscleswere different between the 2 groups.
In the young group the squared Euclidean distances between masticatory muscles increased
in the process of gum chewing, and after 0,30,
45, 60, and 75 seconds there were differences
between the distance between the working and
nonworking sides in the masseter muscie. There
were no ditferences ot distances between each
period in the elderiy group, it was suggested that
coordination patterns of masticatory muscles
in elderly dentate volunteers had smaller
changes than in the young group in the process
of gum chewing.

V. Tanaka, Y. Nakamura, Y. Desaki. Nagoya,

Japan
Dynamic Analysis oi a Complete Overdenlure
Using the Finite Element Method: Pari I
Although the cverdenture is not a new concept.
It has recently been reevaluated for its clinical advantages, such as favorable retention, preservation of supporting tissues, and tunctionai physio iogic feedback via ftie periodontal membrane.
Because o insufficient research data on the
overdenture, there remains a wide spectrum of
unexpiored domain. Therefore, our present research aims at obtaining more fundamental
knowiedge. Considering one of the most typical
indicaticnsforoverdentures, a 2-dimensional finite eiement modei was designed. This uniiateral
model simulated a mandible wilh only one canine
remaining. Analyses were performed on overdentures with various types of copings on abutment sites Including the denture area, the total
number of finite element method elements was
13,113. Stress distribution was analyzed under

Volume 12, Number f ' " i " "

Internattonji Coiiege of Prosthodontists

various fypes ot occiusal [orces. The results are

summanzedasfollows; (If fhe height of the coping very cleariy atfecfed the stability of the overdenture; (2) the iateral taper of the coping was
not seen fo have a significant effect on denture
stability; and iS) loading sites on ie overdenture
were seen to have the most cntical etiects on fhe
stress distnbution on the basal seat tissues.
J. Tanner, P. Vallittu, E. Sderling, Turku,
Finland
Protein Absorption to f^aterials Used in a
Dental Glass-Fiber Polymer Composite
Inour previous studies with fiber polymer composites we tound hat a saliva pellicle promoted
adhesion ot Streptococcus mutans to glass
fibers in companson with the polymer matrix of
fhe composite [Tanner et ai. 1998). The aim of
Viis in vitro study was to assess quantitative
and qualitative differences in protein abso^tion
properties to these materiais. Cmshed E-glass
(Ahlssfrom) and denture base poiymer
(Palapress. Kulzer) (panicle size 500 to 800
(jm), titanium powder, and spheroidai hydroxyapatite heads with a grain size of 200|jm were
used as fest mate nais in protein absoipGon tests.
Human semm and human parotid saliva were
used as protein solutions in the absorption tests.
Test matenals were incubafed with 1 mL of protein sciution prepared in phosphafe-buHered
saline (P8S1 in Nunc Cyro tubes ay end-overendrotationat room temperature for 30 minutes.
After railing, the specimens were washed twice
with 1 5 mL of PBS by nulling end over end for
1 minute The proteins absorbed to the materials were detennined by sodium dodecyi sutphafe-polyacrylamide gei electroforesis (SDSPAGE) (PhastGel. PhastSystem, Pharmacia)
To detach the absorbed proteins, the specitnwis were heated to lOO^C lor 5 minutes in BO
[JL distilied water and 20 |iL denatunng buffer
The cieared solutions were subjected to SDSPAGE, followed by silver staining. The present
method can be used to study ditterences in the
absorption spectra of silver-stainabte proteins.
However, specific adhesion-associated proteins
are not detectable with the current method. All
studied materials showed poor binding of proteins Irom parod saliva, t-tydrcxyapatite showed
a broad protein absorption profile from senjm.
E-glass. polymer, and titanium absorbed mainty
albumin Irom seium. and only minor ditferences
were observed in their protein absorption profiles. No maicr differences were found in the
profein absorption profiles cf E-glass and denture base poiymer.
T. Tojyo, N. Ohnuki, T. Hosoi, N. Shina, H.
Hurata, Y. Nashyama, Yokohama, Japan
Punctional Evaluation from Ihe Impulse of
Blling Force and Masticatory Efficiency in
Complete Denture Wearers
Wehavedeveloped a mefhod of calculating the
bibng force fiom integrated elecfromyograms
(EMG) and evaluating Ihe function of complete
dentures on the basis cf the biting torce. An impulse defined Ihe integiateQ biting forces, and an
increase of the impulse suggested a recovery of
Ihe denture-suppoiting abiiity The purpose oi
this study was fo eiamine Ihe relafionship befween fhe impulse and masticatory efficiency.
The subjects consisted of 3 complete demure
wearers who were treated at fhe Departmenf of
Prosthetic Dentistry in Tsunimi University Dentai
Hospital Their new dentures were evatuated by
the use of a sysfem lor caiculafing the bitng

force from EfulG. Af the same f ime, we had them

eat some peanuts and judged their masticatory
etticiency in addition, the patients' satisfaction
was determined by a visual analogue scaie As
a resuit, it was recognized that patient satisfaction and masticatory function increased The
strongest ccrreiation was found between the
imputse and masticalory efticiency. and an increase in the impulse suggested an improvement of the masticatory function.
fi/l. Ugryn, Lviv, Ukraine
The Use of Automyelotransplantaticn in Dental
Implantology
Today dental implantoiogy occupies an important place in the dental practice A sufficient
quantity of bone in Ihe impiant site is one of the
important conditions tor successfui implantation. This IS especially true in the bone regions
near the paranasat sinuses and mandibuiar
canai. Differenf methods for bone mass increase in this region are used, including mandibular osteoplasty, raising the ftoor ot the paranasai sinuses (sinus iitting). coriicotcmy, etc, m
combination with Uie different nalurai or artificial
osteogenesis-promoting materials. Autogenous
bone marrow is one of Ihese matenals. Being
heterotopically transplanted, it has a marked
osteogenous influence in the transpiant site,
combined with a bicod-forming effect This
process is performed because of the osteopoetic precursor cells Ihat are present in the bone
marrow. Osteogenous action of these ceiis is
manifested without any additional inductive influence on the recipient bone We gained experience in performing dentai impiantaticn wifh
a 2-stage combined-biade impiant design in patients without posterior mandibuiar teeth
(Kennedy Ciass i) and with a narrow atveotar
ndge. This impiantation was done with a simuitanecus osteopiasty of the mandibular body by
means ol bone marrow (then entempore from
the wing of the ftank bone) autotransplantation
and biologic membrane (speciaiiy treated corticai bone of the splif aiiogenic rib) use. The resuifs of dentai impiantation with simultaneous
automyeiotransplantation proved that tjone marrow is one of Ihe best matenals for osteoplasty.

S. tJkon. Y. Sugano, M. tshikawa, K. Hisama,

H. Sato, Pukuoka, Japan
The Development of Simple Eeclric ManOiOular
t^ovement Tracing Device Using Touch Sensor
There have been devetoped many accurate
jaw-tracing devices; however, they have been
seldom used in fhe clinic, except in Ihe research
iaborafory. because of difficuity in handling,
heaviness, and cost. It was aiso difficult for students, residents, and patients to realize optimal
jaw position. The purpose ol Ihis study is fo develop a new simple electnc jaw movement-tracing device using a touch sensor as a supporting
system ot bite registration. The device consisted
ot touch sensors (30 30 x 0.5). a styius, and
a personai computer with a touch screen and
pnnter. Positonai coordination ol dynamic tracing of the styluses at incisai and bilaterai condylar points could be dispiayed and anaiyzed on
the monitor during ciinical procedures, and Ihe
data could aiso be stored and controiied by our
system. The iight kinematic facebow attached to
the iabiai surface of the lower anterior did not distuib intercuspation and clinicai technique. This
system ccutd give us quantitative information
about the continuous repeated jaw movements.
The measuring accuracy must be nof over 0 1

569

mm. As a result, residents and students could

determine jaw position easily and quickly while
taking a bite registration, and palients could
identity their most comtortable |aw position by visuai feedback training with this supporting system in real time
I. V. Wagner. S. Koch, B. Kordass, W.
Schneider, S. Sei pel, Uppsala, Sweden
New Concepts of Multimedia- and Virtual
Reality-Based Support al the Chairside
A vanetyolinnovativemultimedia-and virtual reai ity-based fools lor support of Ihe ctinicat work
atchairside has been deveioped and infegrated
on astandardized tT ptattoim that is direcHy impiemented into a dental unit. Thisaii-in-one concept, realized in an ergoncmicaiiy optimized way
on the Prostyte Compact dentai unit (Pianmeca),
presently ccmprises- i'J a complete clinical dental record system; (2) a charge-coupled device
(CCD)-*ased digital radiograph system; f3i procedures for assessment and improvement of
the quality of digital radiographs; (41 an intracrai and extraoral radiograph database with a
cognitive-ergonomically optimized user interface; (5)a decisicn support lor the interpretation
of radiographs; (6) a digitai camera system; (7)
an image database with a cognitive-ergonomically cptimized user interface; (8) a decision
suppcrtlordiagnosis and treatment of orai mucosal iesions; 19) faculties for telematic seccnd
opinion support, ( JO)facilities fortelematic-based
collaboration between dentists and dental technicians; 0 V multimedia-ttased pafient mo^vafion using DVD technclogy; and "f^i quality assessment sottware modules, in addition, this
poster-videopresentation demonstrates a most
innovative support for use both in education and
clinical practice, the virtual articulatcr.

E. Willaert, L. Diaz, J. Gil, J. Samso, J.

Salsench, Bacelona, Spain
Characterization of the Pseudoelastic Ni-Ti-Cu
Shape Memory Alloy Used in Prosthodontics
Nickel-litanium-copper (Ni-Ti-Cu) is the iatest
biccompatible shape-memory aiioy. in previous
studies it was shown that Ni-Ti alloy exhibits
great variation in its propenies witii iittte variation
in Its chemical composition. The present work investigates the effect ot the addition of copper tc
Ni-Ti alloy upon fhe transformation stresses and
temperatures of Ihe materiai. We studied 5 NiTi-Cu alloys with different chemical composifion (in atomic percentage)-IJ48.9%Ni, 45 1%
Ti, 5.0%Cu, (2)49-1% NI, 45.2% Ti, 5.7% Cu;
(3) 49 5% Ni, 45.0%Ti, 5.5% Cu; 4;49.6% Ni.
45.0%Ti,5.4%Cu; and (5)49.9% Ni, 4E.1%Ti,
5.0% Cu. The transformation temperatures (M,
Mr, A, Ar) were detennined using differenfial
scanning calonmetry. The transformation (bSIM) and retran s formation (SIM-b) stresses
were evaiuated using an MTS-Bionix machine
with a crossbar speed of 1 mm/min and computer data acquisition speed of 10 points/seg.
MT software was used lor treatment of data The
results for Uie transformation temperatures (in
' O for the 5 alloys were; 0)M - 18.7. Mr = 2.1,
A = 14.0, Ar = 37 1 ; (2) f^ = 17.S, Mr = 1.7, A =
Ar = 36.8: (4) M = 17.9. Mr = 1.9, A - 14.3, Ar =
36.9; and (5) ful = 17.6. Ml - 2.3, A =. 14 2. Ar =
37.0. The results for fhe transformation and retransfonnation stresses, respectiveiy. (in MPa)
lor the 5 ailcys were; (I 29. 21; (2) 29, 22; 3)
30.22; f4; 29, 22; and (5 29,21. In all Ni-Ti-Cu
aiioys. Ira nstormation temperatures do nof show

i ol Prosthodontics

International College of Prosthodontists

significant changes The stability of the transformation temperatures of the t^li-Ti-Cu alleys is
a consequenoe of the stability of the transformalion and re transform ation stresses. This
means that litlle variation in the chemical composition of Ni-Ti-Cu retainers wiii not have great
consequence on the stresses carried out by the
retainer upon the abutment tooth.
Y. Yonehata, Y. f^aeda, S. Murakami, Suilashi Osaka, Japan
Condyle Displacement Resulting from
ti/louthguard Placement: A Radiographic and
Biomechsnical Analysis
fuloulhguards influence the temporomandihular joini (TMJ) because they alter vertical dimension and allow mioromovement as a result
of the mouthguard's elasticily, even in maximum clenching (Maeda et al, 1995), Litlle is
known about actual condyle displacement resulting from mouthguard placement This study
measured condyle displacement caused by
placement olamouthguard We also estimated
the change in stress distribution within the TMJ
using 2-dimensional finite element analysis.
Ethyiene vinylacetate mouthguard s were fabricated using a thermovacuum system on casts
mounted in an arlicuiator. Four male volunteers
participated in the study. Simultaneous multisectional TMJ parasagitlal tomcgraphic radiographs (Polytom-U, Philips) were taken as the
subjects held 3 different jaw positions (centric
occlusion without mouthguard, light closing with
mouthguard, and maximum clenching with
mouthguard). Geometry fcr the finite element
models was provided from a lateral cephalometric radicgraph of each subject. Forces computed from the electromyographic data measured on each subject were applied to the
model, and siress distribution in the TMJ was
analyzed. Effects of changing the material properties of the mcuthguard to a rigid bite plane
were also evaluated in the finite element analysis. Results showed that condyle displacement
varied between different jaw positions and ditferent subjects Larger stress concentration in
the TMJ was observed in the finite element
models with the flexible moulhguard material
when compared to Ihe rigid material. The study
suggests that the TfulJ can be affected when
moultiguards are worn for long periods ot time,
particuiariy with clenching. The study also indicates the need for studying Hie relation between
moulhguard use and TMJ dysfundion.

y. Yoneyama, D. Lovelock, A. Ledcamber,

T. tlosoi, Newcastle upon Tyne, UK
Organ Absorbed Doses from Radiographic
Examination for Dental Implanl Planning
Radiographie imaging techniques are essential in the planning of dental implant treatment.
In particular, the cross-sectional image is
mandatory to assess the shape of Ihe alveolar
crest and the buccelingual width at the implant
site. Recently, dental panoramic tomography
(DPT) equipment with the added faciiity to provide various modes of tomography has beeome
avaiiabie. Previously, computed tomography
(CT) has often been the radiographie technique
of choice in implantology. The aim of this study
was to compare organ-absorbed doses when
using DPTwiththetransversal slicing system or
CT, as well as the diagnostic yield associated
with each protocol. DPT (PM 2002 CC PROLINE, Planmeca) and CT(E1scint Excel Twin CT
Scanner, Elscint) were used to irradiate a Rando

anthropomorphic phantom containing thermoluminescent dosimeters (TLD), Dosimetry was

performed using a total cf 258 TLDs to estimate radiation doses lo all radiosensitive organs of interest Standard mandibular protoccls for dentai implant pianning were used with
either DPT or CT imaging modes. All TLDs were
read using a Harshaw 5500 Senes Automatic
TLD Reader (Harshawiicron Solon) to give
organ absorbed and eftective doses. The greatest individual organ doses for any exposure
were measured in the saiivary tissue. The total
etleotive doses of panoramic, cephalometric,
and transverse slices with the DPT were 0.004
mSV, 0.003 mSV. and 0.002 mSv, respectively,
whereas with the OT it was 0.632 mSv. The OT
technique provides images of very high quality
and information content, but at the cost ot organ
doses that are much greater Uian those associated with a DPT exposure. For dentai implant
planning, the information yield from a DPT with
a transverse slice facility may prove sutticientto
meet diagnostic needs at a considerably lower
dose burden than Ihe equivaleni CT protocol

Y. Y o n e y a m a , J, WlcCabe. T, H o s o l ,
Newcastle upon Tyne, tJK
The Comparison of Age Change on 6 Soll
Lining Matenals
The purpose of this study was to determine the
effect cf aging on 6 established long-term sott lining materials for dentures. Penetration, contact
angle, and water absorption of soft lining materials were measured. Penetration and elastic recovery were measured according tc Intemational
Standards Organization (ISO) DIS 10139-2. The
materials used were Super Solt (SS, GC).
Denture Relining (DR, GC), Molloplast B (MB,
Regnen). Molteno (fulT, fulolten Medical), Soft
Relining (SR, Tokuyama), and Sofreliner (SO,
Tokuyama), Test specimens (5 for each material) were 30-mm-diameter disks that were 44
mm thick. They were tested at room temperature
after storing in distilled water at 37C Measurements ot penetration and water absorption were
laken at 24 hours and 7.14, 28, 42, 56. 70, S4.
and 90 days; ccntact angle was measured at 24
and 90 days after curing. Depth of penetration
(and standard deviation, in mm) at a loading
lime of 5 s after 24 hours was SS 0.50 (0.07), DR
0.53 (0.03), MB 0,51 (O.OE), fulTO.18 (0.05), SR
0.56 (0,02), and SO 1,48 (0.06). SS, DR, MB,
and SR were classified medium, SO was ciassified as sott, and MT was classified faiied because it was too hard as defined by the iSO. The
value of the penetration ratio (penetration at 30
s divided by penetration at 5 s) was SS 1,60
(0.12), DR 1.03 (0.01), MB 1.01 (0.01), MT 1.02
(0.05), SR 1.06(0.01), and SO 1.05 (0.01). SS
is significantly iess instantaneously elastic than
the other materials (P<0.05), When soaked in
water, SS, DR, and SO after 90 days were significantiy Stifter Ihan at 24 hours (P< 0.05). The
contact angle between the surtace of the material and water after 24 hours was SS 79.4 (5 74)
degrees. DR a6.5 (2.45) degrees, fJB94 7 (9.16)
degrees, MT87 3 (5.26) degrees, SR 85.9 (5,12)
degrees, and SO 86,3 (3,53) degrees. MB, SR,
and SO produced a weight loss after 90 days,
whereas the weight ot SS, DR, and MT increased by water absorption after 90 days

K. Yoshida, R. Kaji, J. Kimura, H. Shibasaki,

T. Tizuka, Kyoto, Japan
Jaw-Deviation
Dystonia:
Task-Specifio
Abnormality in Movement-Related Conical
Potentials and Muscle Afferent Block Therapy

The Internstiohai Journai of Prosthodoni ii

570

Voiume 12, Number

Jaw-deviation dystonia is characterized by lateral shift of the mandible because of involuntary

lateral pterygoid muscle contraction, causing
difficulties in speech or mastication. We evaluated a 36-year-old patienl with jaw-deviation
dystonia by recording movement-related cortical
potentials (MRCP) belore and after muscle afferent block (MAB) treatment by in|ectien of lidocaine and ethanol into the lateral pterygoid
musel. MRCP asseciated with mandibular
movements (mouth opening, closing, and lett
and right lateral movements) was recorded with
11 electrodes (F3, Fz, F4, T3, C3. C?, C4, T4.
P3, Pz, and P4) in this patient and in 10 agemalched healthy subiects. MRCPs for each
movement were obtained by averaging the electroencephalogram, using the Electromyographic
(EMG)onset as a tngger point. We injected5 mL
of 0.5% lidooaine and 0 5 mL of 99.5% ethanol
into the inferior head of the lefl lateral pterygoid
muscle at one site using a hollow EMG needle
anda standard MG instrument tor guidance. In
the control subjects, the cortical map ol MRCPs
prior to mouth opening and closing showed symmetric distribution, whereas that of lateral movements showed a slight predominance in the ipsilateral hemisphere. The patient showed lower
amplitude as compared with control subjects.
The right lateral movement (homonymous task)
showed task-specific markedly reduced potentials. After MAB, the deviation was abolished and
severity of speeeh and mastication impairment
was significantly improved. fulRCP recording associated with mandibular movements is useful
to evaluate oromandibular dystonia. This study
demonstrated the potential use ot MAB for jawdevialion dystonia.

M. Yoshida, V. ftkagawa, V. Sato, Y. Abe, K.

Tsuga, Hiroshima, Japan
Swallow of the Elderly Edentulous and Dentate

Tcoth contact in occlusion stabilizes the

mandible to make the activity ofthe suprahyoid
muscles efficient tor elevating tfie hyoid bone
during swallowing. Therefore, it is hypothesized
that loss of tooth contact may afleot the process
ef swallowing. Deereased swallowing function
IS also shown with increased age. However,
eomparative evaluation of swallowing in edentulous and dentate elderly persons is quite laeking. To clarify the ditference in swallowing
among sueh persons, the swallowing of a liquid was evaluated cinefluoroscopically Six totally edentulous and 3 dentate elderly persons
(> 75 years old) voluntariiy participated in the
study. The swallowing of 10% barium was
recorded using cinefluoroscopy, and oral transit time (OTT) Irom the initiation of posterior radie paque bolus movement untii the moment at
which the tail of this bolus passed the mandibular ramus was measured. Five of 6 edentulous
persons without eomplete dentures showed
abnormal laryngeal penetralion associated with
disharmony of oropharyngeal movement, and
some of Ihem did show improved swallowing
with the dentures. Mean OTT ofthese persons
was significantiy ionger than Ihat of the denlate
subjects (P< 0.05). It is suggested that wearing cemplete dentures for the achievemeht of
occlusion might improve deereased tunction ot
swallowing in elderly edentulous persons.
This study was supported by Grant No
08877299 and No. 10771081 from the lulihistry
of Education, Science and Culture, Japan.