• Title/Summary/Keyword: 교합압

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치과이식을 위한 성공적인 임프란트 시술 - Implant를 성공시키는 요점 -

  • Ji, Gwang-Won
    • The Journal of the Korean dental association
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    • v.25 no.8 s.219
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    • pp.735-739
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    • 1987
  • implant라는 것은 생리학적으로 생체에 있어서 이물이라는것을 인식해야 한다. 또 그 일부를 상부구조물을 제작하기 위하여 구강내에 노출시킴으로써 연조직과의 접촉부위가 감염으로 염증상태를 지속하고 있다. 그뿐아니라 저작시에 교합압에 의한 위격으로 골내에 여러 가지 변화를 일으킨다. 이와같이 생체내에 이물를 implant 하였을 때 생기는 반응은 생체의 방어기전으로서 염증을 일으키는데 이 염증의 진도에 따라 동화, 흡수, 배제중의 어느 하나로 결말짓게 된다. 따라서 implant를 시술하였을때 생기는 조직의 반응을 최소한으로 감소하기 위한 생물학적 적응조건으로서 재료, 약물, 기구, 시술방법 등을 잘 선택하는 것이 implant의 임상응용에 요절이 되는것이다. implant의 종류는 실로 다양다종이다. 그러나 어떤 implant와 시술방법을 선택하든지 악골에 접착, 또는 식위하여 견고하게 장착되어 그 implant된 자체를 통하여 가장 천연치에 가까운 기능을 얻는것이 implant의 시술목적이다. 임상의가 implant를 시술하면서 이것이 과연 성공할것인가? 즉 저작효율과 내구연한이 얼마나 갈것인가 우려하지 않을수 없다. 그러므로 그 우려를 덜고 성공으로 이끄는 임상상의 문제점을 찾아 논하기로 한다.

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THE EFFECTS OF DENTIN BONDING AGENT THICKNESS ON STRESS DISTRIBUTION OF COMPOSITE-TOOTH INTERFACE : FINITE ELEMENT METHOD (상아질 접착제의 두께가 치아와 복합레진 경계의 응력발생에 미치는 영향에 관한 유한요소법 연구)

  • Park, Sang-Il;Kim, Ye-Mi;Roh, Byoung-Duk
    • Restorative Dentistry and Endodontics
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    • v.34 no.5
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    • pp.442-449
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    • 2009
  • The aim of this study was to examine that thick dentin bonding agent application or low modulus composite restoration could reduce stresses on dentin bonding agent layer. A mandibular first premolar with abfraction lesion was modeled by finite element method. The lesion was restored by different composite resins with variable dentin bonding agent thickness ($50{\mu}m$, $100{\mu}m$, $150{\mu}m$). 170N of occlusal loading was applied buccally or lingually. Von Mises stress on dentin bonding agent layer were measured. When thickness of dentin bonding agent was increased von Mises stresses at dentin bonding agent were decreased in both composites. Lower elastic modulus composite restoration showed decreased von Mises stresses. On root dentin margin more stresses were generated than enamel margin. For occlusal stress relief at dentin boning agent layer to applicate thick dentin bonding agent or to choose low elastic modulus composite is recommended.

Effects of occlusal load on the cervical stress distribution: A three-dimensional finite element study (교합하중이 치경부 응력분포에 미치는 영향에 관한 3차원 유한요소법적 연구)

  • Lee, Hyeong-Mo;Hur, Bock;Kim, Hyeon-Cheol;Woo, Sung-Gwan;Kim, Kwang-Hoon;Son, Kwon;Park, Jeong-Kil
    • Restorative Dentistry and Endodontics
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    • v.31 no.6
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    • pp.427-436
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    • 2006
  • The objective of this study was to investigate the effects of various occlusal loads on the stress distribution of the buccal cervical region of a normal maxillary second premolar, using a three dimensional fnite element analysis (3D FEA). After 3D FE modeling of maxillary second premolar, a static load of 500N of three load cases was applied. Stress analysis was performed using ANSYS (Swanson Analysis Systems, Inc., Houston, USA). The maximum principal stresses and minimum principal stresses were sampled at thirteen nodal points in the buccal cervical enamel for each four horizontal planes, 1.0 mm above CEJ, 0.5 mm above CEJ, CEJ, 0.5 mm under CEJ. The results were as follows 1. The peak stress was seen at the cervical enamel surface of the mesiobuccal line angle area, asymmetrically. 2. The values of compressive stresses were within the range of the failure stress of enamel. But the values of tensile stresses exceeded the range of the failure stress of enamel. 3. The tensile stresses from the perpendicular load at the buccal incline of palatal cusp may be shown to be the primary etiological factors of the NCCLs.

Fracture resistance of zirconia and resin nano ceramic implant abutments according to thickness after thermocycling (지르코니아와 레진나노세라믹 임플란트 지대주의 두께에 따른 열순환 후 파절저항)

  • Lee, Jung-Won;Cha, Hyun-Suk;Lee, Joo-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.144-150
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    • 2017
  • Purpose: The aim of this in vitro study is to investigate load bearing capacity of esthetic abutments according to the type of material and wall thickness. Materials and methods: 70 specimens equally divided into seven groups according to their abutment wall thicknesses. The abutments prepared with titanium 0.5 mm wall thickness were used as a control group (Ti-0.5), whereas zirconia abutments and resin nano ceramic abutments with wall thickness 0.5 mm, 0.8 mm and 1.0 mm were prepared as test groups (Zir-0.5, Zir-0.8, Zir-1.0 and RNC-0.5, RNC-0.8, RNC-1.0). All specimens were tested in a universal testing machine to evaluate their resistance to fracture and all of them underwent thermo-cycling before loading test. Mean fracture values of the groups were measured and statistical analyses were made using two-way ANOVA. Results: Zir-1.0 showed the highest mean strength ($2,476.3{\pm}342.0N$) and Zir-0.8 ($1,518{\pm}347.9N$), Ti-0.5 ($1,041.8{\pm}237.2N$), Zir-0.5 ($631.4{\pm}149.0N$) were followed. The strengths of RNC groups were significantly lower compared to other two materials (RNC-1.0 $427.5{\pm}72.1$, RNC-0.8 $297.9{\pm}41.2$) and the strengths of all the test groups decreased as the thickness decreases (P < .01). RNC-0.5 ($127.4{\pm}35.3N$) abutments were weaker than all other groups (P < .05). Conclusion: All tested zirconia abutments have the potential to withstand the physiologic occlusal forces in anterior and posterior regions. In resin nano ceramic abutments, wall thickness more than 0.8 mm showed the possibility of withstanding the occlusal forces in anterior region.

FINITE ELEMENT ANALYSIS OF MANDIBULAR STRESSES AND DENTURE MOVEMENTS INDUCED BY VARIOUS DENTURE BASE MATERIALS (의치상 재료에 따른 하악응력 및 의치의 변위에 관한 유한요소법적 분석)

  • Chung, Chae-Heon;Yoon, Chang-Keun
    • The Journal of Korean Academy of Prosthodontics
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    • v.25 no.1
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    • pp.281-302
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    • 1987
  • 의치상 재료 종류에 따라 의치, 점막 및 하악골에 발생되는 변위 및 응력을 연구하기 위하여 컴퓨터를 이용한 수치적 해석인 2차원 유한 요소법을 이용하였다. 2차원 유한 요소 모형으로선 표준 크기의 하악골 및 의치를 고려하여 231개의 사변형 요소 및 268개의 절점으로 분할한 후 각 구성 성분의 물리적 성질인 탄성률 및 프와송비를 대입시켰다. 사용된 의치로서는 일반 합성수지의치, 2mm후경의 탄성재를 의치상 하부에 이장한 합성수지의치, 2mm후경의 탄성재를 치아와 의치상 중앙에 삽입한 합성수지의치 및 0.5mm후경의 금속상의치의 4종류였으며, 하중시에 하악의 고정 부위로선 생체와 동일 조건을 부여하기 위하여 교근, 내측익돌근, 측두근등의 하악 폐구근이 부착되는 하악각 부위 및 하악 근돌기 부위의 16절점을 고정점으로 하였다. 하중 조건으로선 하악 제1대구치의 일점에 10kg의 수직 집중하중, 하악 중절치의 일점에 7kg의 수직 집중하중 및 하악 제 1소구치로 부터 하악 제2대구치까지의 교합면에 10kg의 수직 분산하중을 부여하여 분석한 결과는 다음과 같다. 1. 하중이 의치 교합면위의 가해진 부위에 따라 다양한 의치 회전 및 강하 현상을 보였으며, 탄성재를 이장 및 삽입한 합성 수지 의치의 변위가 일반 합성수지의치 및 금속상 의치의 변위보다 더 컸다. 2. 주응력을 고려할때 점막 부위에는 주로 압축 응력이 작용하였으며 치조제 부위는 압축응력과 인장 응력이 함께 작용하였다. 3. 탄성재를 삽입한 합성수지의치에 최고 등가 응력이 집중되었으며 그 다음은 탄성재를 이장한 합성수지의치, 일반 합성수지의치의 순이였으며 금속상의 경우는 금속을 따라서 높은 등가 응력이 넓게 분산되었다. 4. 의치상 종류에 관계없이 동일 하중 조건하에선 점막에 나타나는 등가 응력의 크기 및 분산양태는 유사하였다. 5. 하악골에서 등가 응력은 의치지지 부위에만 국한되지 않고 넓게 분산 되었으며 의치상 종류 및 하중 조건에 관계없이 치조제 후방 및 하악연의 후방 부위에 특히 높은 등가응력이 집중되었다. 6. 하악 중절치의 일점에 수직 하중을 가한 경우가 다른 하중 조건에 비하여 지지점과의 거리차이로 인하여 하악골에 가장 높은 등가 응력을 유발하였다. 7. 의치상 재료에 따른 하악 골에 발생되는 응력의 크기 및 분산에는 큰 차이가 없으나 금속상의 경우가 교합압을 분산하는데는 효과적이었다.

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A case of unexpected adjacent tooth extrusion after implant fixed prosthetic treatment, who had undergone mandibular resection and reconstruction due to ameloblastoma (법랑모세포종으로 하악골 절제 및 재건술 시행한 환자에서 임플란트 고정성 보철물 수복 후 원인 미상의 인접 치아 정출이 발생한 증례 및 고찰)

  • Kim, Su-Jin;Ha, Tae-Wook;Kim, Hyung Jun;Kim, Jee Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.448-455
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    • 2019
  • Ameloblastoma is a benign odontogenic epithelial tumor with high recurrence rate and requires extensive resection of the surrounding tissue and reconstruction of defect site. Because of the anatomical limitation of the reconstruction site, prosthetic treatment with implants is the first recommendation. This is a case of prosthetic restoration of the reconstruction site with implant fixed prosthesis in patient who underwent mandibular resection and iliac bone reconstruction due to ameloblastoma. However 14 months after completion of implant prosthesis, adjacent natural tooth erupted unexpectedly, resulting in 1mm infra-occlusion occurred including posterior implant prosthesis and anterior natural teeth. In adults, implant infra-occlusion may occur due to residual growth after placement of the maxillary anterior implant. But this case, hypo-occlusion of molar implant and open bite of anterior natural teeth is occurred due to extrusion of adjacent tooth, is rare. Thus we report the treatment process including orthodontic treatment with intrusion of the posterior tooth, and investigate the causes of sudden, unexpected tooth extrusion.

Adaptability of zirconia core fabricated by cold isostatic pressing (냉간 정수압 성형법으로 제작된 지르코니아 코어의 적합도에 관한 연구)

  • Seo, Yoon-Jeong;Yun, Kwi-Dug;Kim, Hyun-Seung;Park, Sang-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.2
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    • pp.143-150
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    • 2010
  • Purpose: The purpose of this study is to fabricate the new zirconia block (CNU block) and to evaluate fit of core and porcelain veneered zirconia crown. Material and methods: The experimental blocks were fabricated from the commercial ytrria-stabilized zirconia powder (KZ-3YE Type A). The powder was uniaxial pressing and the green bodies were conducted using the Cold Isostatic Pressing. The zirconia blocks were presintered at $1040^{\circ}C$ and the final sintering was performed at $1450^{\circ}C$. The Kavo Everest ZS $blank{(R)}$ (KaVo, Biberach/ $Ri{\beta}$.) was used as a control group. The linear shrinkage of CNU block and Kavo block were compared. Twenty-one cores for porcelain veneered crowns were fabricated with CAD/CAM system ($Everest{(R)}$, Biberach/ $Ri{\beta}$.). Group I; seven cores fabricated from Kavo blocks, Group II; seven cores fabricated from CNU blocks, Group III; seven cores from CNU blocks and porcelain veneering for crowns. All specimens were cemented and sectioned into two planes; diagonal and bucco-lingual. The measurement of the marginal, internal, and occlusal fit was carried out using SEM ($S-4800^{(R)}$) at $30{\times}$. The results were analyzed by one-way ANOVA test. Results: The linear shrinkage of the CNU block and the KaVo block was 19.00% and 20.09%. The marginal gap of cores ($29.67{\pm}6.58{\mu}m$) fabricated from CNU blocks showed significantly smaller than that of the cores of Kavo blocks ($36.84{\pm}7.18{\mu}m$) (P < .05). The internal gaps of the porcelain veneered crowns ($32.23{\pm}6.33{\mu}m$) were larger than those of the other two groups ($37.57{\pm}6.81{\mu}m$ and $38.14{\pm}6.81{\mu}m$). Conclusion: No statistically significant difference was found in between experimental groups and control group. The experimental groups in marginal gap showed significantly smaller than the control group.

Intrusion of the extruded maxillary central incisor using skeletal anchorage system and unilateral segmental intrusion arch (골성 고정원과 편측 분절호선을 이용한 정출된 상악 중절치의 압하 치료)

  • Kwon, Eun-Young;Baek, Young-Jae;Park, Soo-Byung;Kim, Seong-sik;Kim, Yong-il;Choi, Youn-kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.180-190
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    • 2019
  • Patients who have a moderate periodontitis with pathologic tooth migration of maxillary incisors, it is necessary not only periodontal treatment for reduce periodontal inflammation, but also orthodontic treatment to teeth repositioning. For orthodontic treatment, it is necessary to apply less force and careful considerations of the center of resistance of the tooth and optimal force of tooth movement. At this time, the segmental arch applied only to the target teeth, is more effective and predictable, because applied force and direction can be controlled. In addition, to design the orthodontic appliance that can prevent the unwanted tooth movement that used as an anchorage is important. In recent years, various types of skeletal anchorage system have been used for preventing loss of the anchorage. We reported the patient who had extruded maxillary central incisor due to pathologic tooth migration, treated by a successful periodontal-orthodontic multidisciplinary treatment using an orthodontic appliance designed to apply less traumatic force and reduce an anchorage loss.

Mandibular implant-supported overdenture using CAD-CAM Konus type attachment: A case report (CAD-CAM Konus type 부착장치를 이용한 하악 임플란트 피개의치 보철수복 증례)

  • Park, Jong-Hee;Kim, In-Ju;Kim, Kyoung-A;Song, Kwang-Yeob;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.259-266
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    • 2016
  • In edentulous mandible, implant supported overdenture was considered as a first treatment option. Konus type attachment supplies rigid support and cross arch stabilization so that more favorable force transmission and distribution can be attained. In the dentistry, computer aided design-computer aided manufacturing (CAD-CAM) system makes it possible to fabricate restorations with high precision and effectiveness. Recently, Palladium-silver (Pd-Ag) alloy which is millable has been developed. This article presents that application of CAD-CAM Konus type attachment can be provide satisfactory stability and function on four-implant supported mandibular overdenture.

Surgical orthodontic treatment of skeletal Class III malocclusion using mini-implant: correction of horizontal and vertical dental compensation (Mini-implant를 이용한 III급 부정교합의 수술교정치료: 수평, 수직적 치성 보상의 조절)

  • Im, Dong-Hyuk;Park, Hyun-Jung;Park, Jae-Woo;Kim, Jeong-Il;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.36 no.5
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    • pp.388-396
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    • 2006
  • Treatment of skeletal Class III malocclusion with mini-implant anchorage is discussed in relation to vertical control of the maxillary posterior dentoalveolar region and horizontal control of mandibular anterior teeth. A midpalatal mini-implant provided anchorage for intruding the maxillary posterior teeth. Mandibular mini-Implant implants were used to bring about labioversion of mandibular anterior teeth. After mandibular setback surgery, improvement of the facial profile was obtained both horizontally and vertically, Total treatment time was 11 months. Stable occlusion was maintained after 18 months of retention, The effectiveness and efficacy of mini-implants for the treatment of skeletal Class III malocclusion are also discussed.