The Class III malocclusion classified in two types of Skeletal Class III and Pseudo Class III. In the case of the maxillary deficiency, the protraction H-G(facemask) with Bonded RPE can be used. For children with A-P and vertical maxillary deficiency, the preferred treatment is to move the maxilla into a more anterior and inferior position, which also increases its size as bone is added at the posterior and superior sutures. Successful forward repositioning of the maxilla can be accomplished before age 8. To resist tooth movement as much as possible, the maxillary teeth should be splinted together as a single unit. The maxillary appliance must have hooks for attachment to the facemask that are located in the canine-primary molar area above the occlusal plane. The facemask usually worn until a positive overjet of 2-5mm is achieved interincisally. Occipital chin cup is successful in those patients who can bring their incisors close to an edge-to-edge position when in centric relation. This treatment is particularly useful in patients who begin treatment with a short lower anterior facial height, as this type of treatment can lead to an increase in lower anterior facial height. If the pull of the chin cup is directed below the condyle, the force of the appliance may lead to a downward and backward rotation of the mandible.

Composite resin have very important roles as a esthetic fillng material. Today we are confusing by a numerous number of the polymer options in the market. Are there any complications such as tooth sensitivity? Do they have stabilization in the long term aspect? These are the reasons why many dentists don't use composite resin in my country. But the problems can be overcome by choosing the best suited materials and meticulous clinical procedures. So that we are able to expand our clinical boundary. I would like to introduce the clinical techniques of Dr.Gordon Christensen in Utah, and overall clinical cases under the base of CRA newsletter.

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

아름다움이라는 것은 완전히 객관적이기도 하지만 극히 주관적인 표현의 결과일 수 있다. 심미치의학은 얼굴에서 표현되는 이러한 주관적인 면과 객관적인 면을 조화시킬 수 있는 학문이기에 21세기에도 여전히 치과 치료에 있어서 중요한 화두 중의 하나임에 틀림이 없다. 과거 심미적인 치료로 행하였던 많은 치료 술식들(open faced crown, resin faced crown,3/4 crown,7/8crown등)이 치과 치료 술식의 발달과 함께 재료와 치아 보철물 제작술 등의 발달로 인해 점차 사라지거나 변화하고 있는 것이 사실이다. 지금 소개하는 증례들은 현재 치과계에서 심미적인 치료 술식으로 인정하고 있기에 이러한 치료 술식에 대한 이해가 필요할 것이다. 우리 임상가들의 최종목표는 환자들에게 자연스러운 얼굴과 웃음을 회복시켜주는 것이다. 각 증례에 대한 한계에 대해 미리 알 수 있는 방법을 모색해 보고, 예측 가능한 치료를 시행하기위한 과정들을 살펴보고자 한다.

The use of resin-bonded fixed partial dentures described in the early 1980s caused an conservative way to preserve tooth structure in the restorative dental community. The treatment of patients with requires long term analysis of clinical application and basic research. Failure rates of these prosthesis ranged from 3% to 55%. These varieties were orginated by different techniques, materials, tooth preparation methods and diverse clinical situations. This article review was focused on the standard long term results and in vitro studies on bond strength between metal and teeth. From this, many useful clinical guidelines to RBFPD could be adopted to clinical dentistry. For successful results, careful case selection and good clinical skills are needed. And appropriate techniques for each situations should be adopted. Also, RBFPD using new materials like all-ceramics, FRC/Ceromer was introduced.

To maintain the strength obtained with metal ceramic restorations, excellent gradient of translucency, wear resistance in the same range as enamel and good marginal integrity, all ceramics have been developed with many advantages in recent years. Authentic (Ceramay, Germany) is a type of low fusing, leucite-reinforced pressable ceramic that allows both the laying technique and the staining technique or the combination of the two. Two-phase glass ceramic will allow achieving unmatched esthetics even with the simplest laying or staining technique. The ingots and laying porcelain come in Vita shades. Case selection has to be the most crucial thing to achieve optimal esthetics, and cooperation with technician has to be emphasized to satisfy patient's highest esthetic demands.

전치부 발치 증례에서 기존의 통상적인 보철 시술은 발치 후 발치창이 치유되기까지 최소 1 개월 이상을 심미적 결함을 안고서 기다려 한다는 불편함이 있었다. 발치 부위의 치조제는 수평, 수직적 흡수가 일어나 차후 보철물 pontic design에 악영향을 미치게 되어 심미적 결함뿐 아니라 발음, 구강 청결의 측면에서도 좋지 않은 결과를 미치게된다. 그러나, 발치 직후 ovate pontic을 이용한 immediate fixed restoration으로 수복하면, 치아 상실로 인한 환자의 기능적 심미적 불편함을 해소하고, 치료 과정은 물론 치료 후에도 보다 나은 심미 치료가 가능하며, 치료의 공백 기간 없이 치료 기간을 줄일 수 있다.

This article described a procedure for fabricating an esthetic gingival porcelain restoration as an implant-supported fixed prosthesis for edentulous maxilla. Alternative treatments for fully edentulous patients include an implant-supported overdenture or a fixed implant-supported prosthesis with bilateral distal cantilevers. But, from a functional and biomechanical point of view, the fixed implant-supported prosthesis with posterior cantilevers or implant-supported tissue-borne overdenture do not significantly improve masticatory effectiveness compared with a distributed implant restoration as a fixed implant-supported prosthesis. The fact that the prosthesis is supported by distributed implants over eight for edentulous maxilla in general, provides increased masticatory efficiency as a fixed restoration and similar gingival appearance with esthetic gingival porcelain. It is also detachable by dentist to allow easier after-care of soft tissue and the prosthesis.