• Title/Summary/Keyword: 교합안정

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The use of implant surveyed fixed prosthesis for removable partial denture with a few unilateral remaining teeth: A case report (편측 소수 잔존치 증례에서 CAD software를 활용한 planning 및 임플란트 서베이드 고정성 보철물을 이용한 국소의치 수복: 증례보고)

  • Park, Jeongkeun;Kim, Jong-Eun;Park, Ji-Man;Kim, Jeehwan;Shim, June-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.254-262
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    • 2019
  • As implant can be covered by National Health Insurance Service (NHIS), it was increased the interest in the removable partial denture (RPD) with the surveyed fixed prosthesis supported by implant fixture. To achieve predictable result, it needs the prudent implant planning by basic principles of RPD and patient's residual ridge. This 67 years old age male had a few unilateral remaining teeth, and hoped the treatment covered by NHIS. As using CAD software, the position of implant is planned with regarding to occlusal table of provisional denture, basic principles of RPD, and resorbed residual ridge. The definitive prostheses can ensure the stability and retention of removable prosthesis. When planning implant fixed prostheses, the digital technique was utilized to consider basic principle of RPD and resorbed residual ridge. As a result, it provided satisfactory prostheses.

Implant-assisted removable partial denture using Milled-Bar and Attachment in partially edentulous maxilla: A case report (상악 부분 무치악 환자에서 Milled-bar와 어태치먼트를 이용한 임플란트 부분 피개의치 수복 증례 보고)

  • Jeong, Yun-Su;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.412-419
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    • 2022
  • For treatment of partially edentulous patients, a treatment using implant is widely used. Treatment method using implant are implant fixed prostheses and removable partial dentures, and for patients with severe bone resorption, removable implant overdenture with the effects of aesthetic and reducing cost can be used as treatment options. Specially, prosthesis with milled-bar and attachment has the effect of being splinted between implant fixtures, higher retention and stability than conventional removable partial denture. And it has the effect of improvement of aesthetic through lip support by denture base. In this case, the patient with severe alveolar bone resorption and partial edentulous maxilla and mandible was treated by implant-assisted removable partial denture using Milled-bar and ADD-TOC attachment. The esthetic was improved by removing the clasp because of effects of additional retention by using the attachment, and reducing palatal coverage of implant-assisted removable partial denture. The clinical results were satisfactory on the aspect of aesthetic and masticatory function.

Neutral zone and alveolar relation consideration for fabricating complete denture in a patient with severe alveolar bone resorption: a case report (치조제 흡수가 심한 환자에서 중립대 및 치조제 관계를 고려한 총의치 수복 증례)

  • Hyung-Jun Kim;Woo-hyung Jang;Chan Park;Kwi-dug Yun;Hyun-Pil Lim;Sang-Won Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.214-221
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    • 2023
  • In order to fabricate stable dentures in patients with severe resorption of residual ridges, various factors must be considered. One of them is the neutral zone, which is defined as the potential region in which the pressure of the tongue outward in the oral cavity and the pressure of the cheeks and lips directed inward from the outside of the oral cavity equalize during functioning. In patients with severe ridge resorption, if the teeth are usually arranged above the residual ridge, the teeth are located on the lingual side rather than the original position. Therefore, the functional space of the tongue is invaded, the tongue is positioned backward, and the sealing of the lingual border is broken, which acts as a factor reducing the maintenance of denture. In addition, it is also important for the stability of dentures to assume an interalveolar crest line connecting the maxillary and mandibular ridge crests, and to arrange the maxillary and mandibular artificial teeth to match the masticatory force to the interalveolar crest line. Therefore, good clinical results were obtained by fabricating dentures for the patient with poor alveolar residual ridge using neutral zone impression and ridge relationship analysis.

A Prospective Clinical Trial on the Mg Oxidized Clinical Implants (마그네슘 양극산화 임플란트의 성공률에 관한 전향적 임상연구)

  • Im, So-Min;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra;Um, Heung-Sik;Lee, Jae-Kwan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.1
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    • pp.25-39
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    • 2011
  • In animal studies, Magnesium (Mg) - incorporated oxidized implants showed significant enhancement of the bone response. This prospective clinical trial was performed to investigate the success rate, implant stability and marginal bone loss of Mg oxidized clinical implant. The experimental protocol was approved by Institutional Review Board of the Gangneung-Wonju National University Dental Hospital. Fifty healthy patients had partial edentulism were included in this study. Mg oxidized clinical implants (Implant M, Shinhung, Korea) were installed and restored with conventional protocol. The patients were recalled at 1, 3, 6 months after functional loading. Implant stability quotient (ISQ) was measured and periapical radiographic images were obtained. Amount of marginal bone loss was calculated with calibrated images from periapical radiographs. Repeated measured analysis of variance and post hoc Tukey test were used to compare the mean ISQ and bone level. A total of 101 implants were analyzed. The mean ISQ values increased continuously with time lapse from 68.4 at fixture installation to 71.5 at 6 months after loading. Implant stability was correlated with gender, fixture diameter, bone quality and implant sites. The mean marginal bone loss during 6 months after loading was 0.26 mm. There was no failed implant and six-month success rate was 100%. Within the limitations of this study, the six-month success rate of Mg oxidized implant was satisfactory. The implant stability and marginal bone level were excellent. However, further longer clinical studies will be needed to confirm the success of Mg oxidized clinical implant.

Influence of bearing surface angle of abutment screw on mechanical stability of joint in the conical seal design implant system (내부 원추형 연결형태 임플란트에서 지대주 나사머리의 좌면각도가 연결부 기계적 안정성에 미치는 영향)

  • Kim, Joo-Hyeun;Huh, Jung-Bo;Yun, Mi-Jung;Kang, Eun-Sook;Heo, Jae-Chan;Jeong, Chang-Mo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.206-214
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    • 2014
  • This study is to evaluate how different bearing surface angles of abutment screw affect the mechanical stability of the joint in the conical seal design implant system. Materials and Methods: Internal connection type regular implants, two-piece cemented type abutments and tungsten carbide/carbon-coated titanium alloy abutment screws were selected. Titanium alloy screws with conical ($45^{\circ}$) and flat ($90^{\circ}$) head designs which fit on to abutment were fabricated. The abutments were tightened to implants with 30 Ncm by digital torque gauge. The loading was applied once to the central axis of abutment. The mean axial displacement was measured using micrometer before and after the tightening and loading (n = 5). The abutment was tightened to implants with 30 Ncm and T-shape stainless steel crown was cemented. Then the change in the amount of reverse-torque was measured after the repeated loading to the central axis, and the place 5 mm away from the central axis. Compressive bending and fatigue strength were measured at the place 5 mm away from the central axis (n = 5). Results: Both groups showed the largest axial displacement when abutment screw tightening and total displacement was greater in the flat head group compared to conical head group (P < 0.05). However, there were no significant differences in reverse torque value, compressive bending and fatigue strength (P > 0.05). Conclusion: Within the limitations of this study, the abutment screw head design had no effect on two groups regarding the joint stability, however the conical head design affected the settlement of abutment resulting in the reduced total displacement.

The Biological Stability of Immediate Placement of Tapered Implants in Tooth Extraction Sites (발치와에 즉시 식립한 쐐기형 임플란트의 생물학적 안정성에 관한 전향적 연구)

  • Park, Ja-young;Bae, Ahran;Kim, Hyung-Seub;Kwon, Yong-Dae;Lee, Baek-Soo;Kwon, Kung-Rock
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.2
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    • pp.139-155
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    • 2009
  • Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.

Effect of Bone Quality on Insertion Torque during Implant Placement; Finite Eelement Analysis (임플란트 식립 시 골질이 주입회전력에 미치는 영향에 관한 삼차원 유한요소 분석)

  • Jeong, Jae Doug;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.2
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    • pp.109-123
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    • 2009
  • The aim of the study was to assess the influence of insertion torque of bone quality and to compare axial force, moment and von Mises stress using finite element analysis of plastoelastic property for bone stress and strain by dividing bone quality to its thickness of cortical bone, density of trabecular bone and existence of lower cortical bone when implant inserted to mandibular premolar region. The $Br{\aa}nemark$ MKIII. RP implant and cylindrical bone finite model were designed as cortical bone at upper border and trabecular bone below the cortical bone. 7 models were made according to thickness of cortical bone, density of trabecular bone and bicortical anchorage and von Mises stress, axial force and moment were compared by running time. Dividing the insertion time, it seemed 300msec that inferior border of implant flange impinged the upper border of bone, 550msec that implant flange placed in middle of upper border and 800msec that superior border of implant flange was at the same level as bone surface. The maximum axial force peak was at about 500msec, and maximum moment peak was at about 800msec. The correlation of von Mises stress distribution was seen at both peak level. The following findings were appeared by the study which compared the axial force by its each area. The axial force was measured highest when $Br{\aa}nemark$ MKIII implant flange inserts the cortical bone. And maximal moment was measured highest after axial force suddenly decreased when the flange impinged at upper border and the concentration of von Mises stress distribution was at the same site. When implant was placed, the axial force and moment was measured high as the cortical bone got thicker and the force concentrated at the cortical bone site. The influence of density in trabecular bone to axial force was less when cortical bone was 1.5 mm thick but it might be more affected when the thickness was 0.5 mm. The total axial force with bicortical anchorage, was similar when upper border thickness was the same. But at the lower border the axial force of bicortical model was higher than that of monocortical model. Within the limitation of this FEA study, the insertion torque was most affected by the thickness of cortical bone when it was placed the $Br{\aa}nemark$ MKIII implant in premolar region of mandible.

Histomorphometry and Stability Analysis of Loaded Implants with two Different Surface Conditions in Beagle Dogs (하중을 가한 두 가지 표면의 임플란트에 관한 조직형태학적 분석 및 안정성 분석 (비글견을 이용한 연구))

  • Kim, Sang-Mi;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.337-349
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    • 2008
  • Despite an improved bone reactions of Mg-incorporated implants in the animals, little yet has been carried out by the experimental investigations in functional loading conditions. This study investigated the clinical and histologic parameters of osseointegrated Mg-incorporated implants in delayed loading conditions. A total of 36 solid screw implants (diameter 3.75 mm, length 10mm) were placed in the mandibles of 6 beagle dogs. Test groups included 18 Mg-incorporated implants. Turned titanium Implants served as control. Gold crowns were inserted 3 months. Radiographic assessments and stabilitytests were performed at the time of fixture installation, $2^{nd}$ stage surgery, 1 and 3 months after loading. Histological observations and morphometrical measurements were also performed. Of 36 implants, 32 displayed no discernible mobility, corresponding to successful clinical function. There was no statistically significant difference between test implants and controls in marginal bone levels (p=0.413) and RFA values. The mean BIC % in the Mg-implants was $54.4{\pm}20.2%$. The mean BIC % in the turned implant was $48.9{\pm}8.0%$. These differences between the Mg-implant and control implant were not statistically significant (P=0.264). In the limitation of this study, bone-to-implant contact (BIC) and bone area of Mg-incorporated oxidized implant were similar to machine-turned implant. The stability analysis showed no significantly different ISQ values and marginal bone loss between two groups. Considering time-dependent bone responses of Mg-implant, it seems that Mg-implants enhanced bone responses in early loading conditions and osseointegrated similarly to cp Ti implants in delayed loading conditions. However, further investigations are necessary to obtain long-term bone response of the Mg-implant in human.

Effect of polishing methods on color change by water absorption in several composite resins (여러 복합레진에서 수분 흡수에 의한 색변화에 연마가 미치는 영향)

  • Kim, Hye Jin;Kim, Mi-yeon;Song, Byung-chul;Kim, Sun-ho;Kim, Jeong-hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.1
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    • pp.1-10
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    • 2019
  • Purpose: The aim of this study was to evaluate the influence of polishing methods on the color stability of composite resins. Materials and Methods: Two bulk-fill and four conventional resin composites were filled in cylindrical molds (6 mm diameter, 4 mm height) and light-cured. The specimens were stored in $34^{\circ}C$ distilled water for 24 h. Spectrophotometer was used to determine the color value according to the CIE $L^*a^*b^*$ color space. Each group was divided into three groups according to polishing methods (n = 5). Group 1 was control group (Mylar strip group), group 2 was polished with PoGo, and group 3 was polished with Sof-Lex Spiral wheels. Color evaluation was performed weekly for 4 weeks after immersion in $34^{\circ}C$ distilled water. The results were analyzed by generalized least squares method (P < 0.05). Results: Generalized least squares analysis revealed that Sof-Lex Spiral wheels group showed the significantly lower ${\Delta}E$ values compared to PoGo and control group (P < 0.05). The ${\Delta}E$ values of polished group showed the significantly lower than the ${\Delta}E$ values of unpolished group (P < 0.05). Regarding color changes of composite resins, there was no significant difference between the ${\Delta}E$ values of Filtek Z250 and Filtek Z350 XT Universal restorative in all time intervals (P < 0.05). Tetric N-Ceram Bulk Fill showed the significantly lower ${\Delta}E$ values compared to other composite resins in 1, 2, 3 weeks (P < 0.05). Conclusion: Within the limitations of this study, polishing methods influence the color stabilities of composite resins. The group polished with Sof-Lex Spiral Wheels showed more resistance to discoloration than group polished with PoGo.

The risk factors for implant survival and marginal bone loss: a retrospective long-term study (임플란트 장기간 유지와 변연골 소실에 영향을 주는 요인들에 대한 후향적 연구)

  • Lee, Eun-Woo;Jung, Ha-Na;Jo, Yujin;Kim, Ok-Su
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.2
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    • pp.97-109
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    • 2022
  • Purpose: This study aims to investigate the risk indicators contributing to implant failure, and analyze the relationship between risk indicators and marginal bone loss (MBL) through long-term follow-up over 3 years. Materials and Methods: From 2003 to 2017, patients' medical charts with a history of dental implant surgery at Chonnam National University Dental Hospital were reviewed retrospectively. The patient's demographic variables, and clinical variables were recorded. Periapical radiographs were used to evaluated the changes in MBL around implants. And we analyzed implant survival rates. Multiple regression analysis with backward elimination was conducted to correlate the patient's clinical variables and implant failure and Pearson correlation analysis was performed to the correlated between implant long-term survival rates and MBL and initial stability. Results: In multiple regression analysis, there was a statistically significant negative correlation between abutment connection type (β = -.189, P < .05), with or without SPT (β = -.163, P < .05), diabetes (β = -.164, P < .05), osteoporosis (β = -.211, P < .05) and MBL. Anticoagulant medication influenced the long-term success rate of implants. PTV values at the second implant surgery showed a statistically significant negative correlation with long-term implant survival (P < .05). Conclusion: For the long-term success of the implant, the appropriate abutment connection type must be selected and the periodic SPT is recommended. Systemic diseases such as diabetes and osteoporosis and anticoagulant medication should be considered. Furthermore, since high PTV at the second implant surgery correlated with the long-term survival rates of the implant, initial stability should be carefully considered before undergoing the prosthetic procedure.