• Title/Summary/Keyword: 구강 회복술

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Increase of the Width of Peri-implant Keratinized Tissue using Apically Positioned Flap: Case Report (근단 변위 판막술을 사용한 임플란트 주위 각화조직 폭경의 증대: 증례보고)

  • Chee, Young-Deok;Seon, Hwa-Kyeong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.407-417
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    • 2013
  • The one of peri-implant soft tissue problems seen during the maintenance phase of implant therapy is an inadequate zone of keratinized tissue. Keratinized tissue plays a major role around teeth and dental implants, helping in maintaining and facilitating oral hygiene. A free gingival graft (FGG) is chosen to correct the soft tissue defects and provide optimal peri-implant health in order to increase the long-term prognosis of the implant reconstruction. However, the patient treated with FGG has pain and discomfort on donor site such as palate. It is also technically demanding, time consuming, and the color match of the tissue is often less than ideal. An apically positioned flap (APF) is selected for increasing the keratinized tissue simply while or after the second stage implant surgery. This case report shows successfully increasing the width of peri-implant kenratinized tissue through APF procedure on small site of dental implant instead of FGG.

Prosthetic rehabilitation of partially edentulous patient after maxillectomy: A case report (상악골 부분절제술 시행한 부분 무치악 환자에서 폐쇄 장치를 이용한 보철 수복 증례)

  • Heo, Kyung-Hoi;Lim, Young-Jun;Kim, Myung-Joo;Kwon, Ho-Beom
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.2
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    • pp.167-171
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    • 2016
  • Patients undergone partial maxillectomy experience post-operative masticatory, phonetic, and swallowing difficulties. They also encounter social and psychological challenges due to changes in their facial appearances. Thus, functional and esthetic recovery through maxillofacial prosthesis becomes significant for these patients. The objective of an appropriate obturator is to restore palate and improve phonetic and swallowing ability by separating the oral cavity, nasal cavity, maxillary sinus, and nasopharynx. In this case report, an obturator was fabricated for a patient who had partial resection from the maxillary posterior region to the pharynx due to squamous cell carcinoma. The purpose of this case study is to describe the results because the patient was successfully improved both functionally and esthetically.

Occlusal Adjustment (교합조정)

  • Heo, Yeong-Gu
    • Journal of Dental Rehabilitation and Applied Science
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    • v.17 no.3
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    • pp.189-193
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    • 2001
  • 교합조정은 비가역적인 술식이므로 예방적인 목적으로 사용하는 것은 바람직하지 않으며 환자가 증상을 호소하거나 환자의 구강검사시 교합간섭으로 인한 증상이 확인된 경우라도 자연치에서의 교합조정술은 반드시 신중을 기해야 한다. 교합조정술을 시행하기 전에 먼저 하악의 위치가 안정되어야 한다는 것을 명심하고 이를 위해 치과의사는 하악의 중심위에 대한 이해와 중심위로의 하악유도 방법에 대한 숙지도 필요하다. 또한 심한 악관절 장애나 통증 및 불안정한 하악의 위치를 보이는 경우 구강내 교합상이나 교합 안정장치가 선행되어야 하는 경우가 있다. 교합조정술을 시행해야 하는 치과의사 자신이 교합조정술에 대한 지식을 충분히 습득하고 있어야 하며, 교합조정술의 적응증을 분명하게 확인한 뒤 조심스럽고 정확하게 시술을 시행해야 한다. 즉, 잘못된 교합조정으로 오히려 교합간섭을 야기할 수도 있음을 명심해야 한다. 그러나 교합조정에 대해 올바로 이해하고 일반적인 교합조정의 원칙을 지켜 정확히 시행한다면 교합조정은 결코 환자에게 해를 주지 않고, 자유로운 하악운동을 가능케 하며, 교합의 안정성을 유지해 줄 것이다.

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Horizontal Ridge Augmentation using Ridge Expansion and Autogenous Tooth Bone Graft: A Case Report (치조능확장술과 자가치아골이식술을 이용한 치조능 수평증대술: 증례보고)

  • Kim, Young-Kyun;Yi, Yang-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.1
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    • pp.109-115
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    • 2011
  • Implants were placed after performing ridge expansion by inserting screws of gradually increasing thickness. Favorable clinical outcome was obtained. During surgery, buccal cortical plate fracture did not occur. Autogenous tooth bone graft material was grafted around the implant dehiscence defects and over the buccal cortical plate. The method involving the insertion of screws for ridge expansion is a successful and predictable technique for implant placement in narrow alveolar bone. Autogenous tooth bone graft material can be used for ridge augmentation and GBR.

Full mouth rehabilitation of a patient with excessive worn dentition by increasing vertical dimension of occlusion: a case report (과도한 치아 마모 환자에서 교합수직고경 증가를 동반한 완전구강회복 증례)

  • Jong Seok Lee;Ji Suk Shim;Jae Jun Ryu
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.234-244
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    • 2023
  • Tooth wear refers to the loss of dental hard tissue caused by various physiological and pathological causes, and excessive pathological wear can cause complications such as pathological changes in dimensions, occlusal disharmony, loss of function, and aesthetic problems. The cause of tooth wear can be caused by attrition, abrasion, corrosion and abfraction, and it is known to act in a multifactorial etiology in interocclusal activity. In patients with excessive pathological wear, it is important to determine whether or not the vertical dimension of occlusion is reduced, and complete oral rehabilitation should be achieved with the adaptation of the neuromuscular and temporomandibular joint through accurate diagnosis and analysis. The patient in this case was a 63-year-old male patient, who presented discomfort to cold beverage due to severe tooth wear. After analysis of the patient's vertical dimension of occlusion, a full mouth rehabilitation was performed with increasing vertical dimension of occlusion. The goal of treatment was to improve the occlusal plane with the equal-intensity contact of all teeth, harmonious anterior guidance and immediate disclusion of all posterior contacts. After rehabilitation, the patient was satisfied with function and esthetic appearance.

Prosthetic rehabilitation by double-processing technique for edentulous patient with soft palate defect after maxillectomy: A case report (연구개를 포함한 상악골 절제술을 받은 완전 무치악 환자에서 이중 온성법으로 제작한 구개 폐색장치를 통한 보철수복: 증례 보고)

  • Park, Jin-Yong;Wang, Yuan-Kun;Song, Kwang-Yeob;Park, Ju-Mi;Lee, Jung-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.356-363
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    • 2019
  • A patient who went through maxillectomy can have soft palate defects including oronasal fistulas and suffer from dysphagia and dysarthria due to velopharyngeal insufficiency. This defect causes the food to enter nasal cavity and creates hypernasal sound which debilitates a quality of life. An obturator can rehabilitate the substantial oral tissue defects. The maxillary obturator separates the nasopharynx from the oropharynx during speech and deglutition by closing of the defect. For edentulous obturator patient, it is difficult to obtain proper retention due to reduced peripheral sealing. Therefore, the contours of the defects must be used to maximize the retention, stability, and support. Hollow type obturator can improve physiologic function by reducing weight than the traditional obturator. This case report describes a patient with hemi-maxillectomy who recovers mastication, speech, deglutition, and appearance with a maxillary obturator using physiological border molding of the velopharyngeal area and double-processing method.

Prosthetic rehabilitation by obturator considering the biomechanics in partially edentulous patient after maxillectomy (상악골 절제술을 받은 부분 무치악 환자에서 생역학을 고려해 제작한 구개 폐색장치를 이용한 보철 수복 증례)

  • Lee, Kang-Shin;Park, Ju-Mi;Ahn, Seung-Geun;Seo, Jae-Min;Park, Yeon-Hee;Lee, Jung-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.281-293
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    • 2021
  • Patients who went through maxillectomy can have severely impaired swallowing, mastication, and pronunciation functions because of palatal defects. Leakage occurs through the nasal cavity while eating, chewing becomes difficult due to the loss of teeth and alveolar ridges, and oral and nasal passages are not separated, leading to hyper-nasal sound, and significantly reducing the quality of life. To prosthetically reconstruct the defect, the weight of the obturator should be reduced as much as possible to minimize dropout because of gravity, and the bulb of the obturator should be properly extended into the defect to get additional retention and stability. In this case of a partially edentulous patient who underwent additional maxillary resection because of tumor recurrence, a metal framework was designed by applying the basic design principles of removable partial dentures. An obturator with improved retention, stability, and support was fabricated through functional impressions. The patient was satisfied with the improved facial expression, mastication, swallowing, and pronunciation, and showed stable occlusion and oral hygiene management during the follow-up period.

Full mouth rehabilitation of the patient with severe tooth loss and tooth wear with vertical dimension gaining: A case report (구치부 지지의 상실과 마모로 인해 교합이 붕괴된 환자에서 수직고경 회복을 동반한 구강회복 증례)

  • Jo, Yu Jin;Jung, Sua;Yang, Hong-So;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-Dug;Park, Chan
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.302-307
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    • 2018
  • Multiple tooth loss and excessive occlusal wear can result in damage to occlusal disharmony, functional disorders and esthetic problems, requiring comprehensive prosthetic treatments. Changing vertical dimension harmonized with surrounding muscle tissue is important. In this case, the patient with loss of vertical dimension caused by severe tooth loss and tooth wear was treated with the analysis of vertical dimension, such as diagnostic model, radiography and various clinical exams. the patient was satisfied with favorable functions and esthetics for 1 years of follow-up.

Full Mouth Rehabilitation in a Patient with Limited Restorable Space (수복 공간이 부족한 환자에서의 완전구강회복)

  • Lim, Kwang-Gil;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.2
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    • pp.145-156
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    • 2010
  • Loss of posterior support may cause overloading and excessive wear of remaining teeth. Moreover, the extrusion of antagonistic teeth leads to the destruction of the occlusal plane. The loss of vertical dimension of occlusion (VDO) also emerges clinically, which may bring the loss of esthetic appearance and function. These patients who suffer from the loss of posterior support, often require vigorous periodontal treatments (osteotomy, crown lengthening) and extensive oral rehabilitation. Sixty three years old female patient visited for the prosthetic treatment of the posterior edentulous area. She had no other systematic disease and parafuctional habits for prosthetic treatment. Intraoral and radiographic examinations were done. The evaluation of VDO and vertical dimension of rest position were evaluated for proper prosthetic procedures and diagnostic wax up was done. As a result of diagnosis, VDO was increased by 2 mm considering the loss of VDO and space for the prosthetic treatment. After the pretreatments, initial preparation of teeth and provisionalization were carried out. Six weeks later of provisionalizaion, final preparation and impression was performed. Using the duralay resin copings, jaw relation was registered. The master cast was mounted and definitive restoration was fabricated. After the evaluation of esthetic and function, pick up impression for clinical remounting was done. Lucia jig was made for new jaw relation and occlusal adjustment on the articulator. Definitive restoration was delivered and the patient was periodically recalled for additional occlusal adjustment. From this case, the satisfactory functional and esthetic results through full mouth rehabilitation with increase vertical dimension were achieved.

Regeneration of total tissue using alveolar ridge augmentation with soft tissue substitute on periodontally compromised extraction sites: case report (치주질환 원인의 심한 골소실을 동반한 발치와에 대한 치조제 증강술과 연조직 대체제를 이용한 조직 재생 효과: 증례보고)

  • Yerim Oh;Jae-Kwan Lee;Heung-Sik Um;Beom-Seok Chang;Jong-bin Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.276-284
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    • 2023
  • After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aesthetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal disease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.