• Title/Summary/Keyword: 보철거

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Neutral zone approach for rehabilitation in a patient who underwent mandibulotomy: A case report (하악골 이단술을 시행한 환자에서 중립대를 활용한 상하악 총의치 수복 증례)

  • Heedo Shin;Hag-Young Lee;Jee-Hwan Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.18-25
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    • 2023
  • We present the case of a 65-year-old man with maxillary and mandibular complete dentures prepared using neutral zone technique after undergoing mandibulotomy due to tonsil cancer 10 years ago. The patient had a short edentulous period; hence, there was minimal absorption of the alveolar ridge and no abnormality in the motor function of the tongue. However, the retromolar pad was located inside the hamular notch, and the posterior alveolar ridge was relatively turned inward. If the artificial teeth would have been aligned conventionally, the functional space of the tongue would have been invaded, which would have moved the tongue posteriorly thereby reducing the stability of the denture. Therefore, applying the concept of the neutral zone can be a good reference point in such cases. The neutral zone was registered using tissue conditioner, and tooth alignment was performed by making a silicone putty index. The biggest advantage of using neutral zone concept is denture stability. In this case, the neutral zone technique was applied to obtain the lingual alignment limit of the posterior teeth to avoid invasion of the tongue space by the left posterior part of the mandible. Particularly, in case of a patient in which denture stability is difficult to obtain due to absorption of the alveolar ridge, it is believed that better results can be obtained using neutral zone technique.

Periodontal prosthesis on medically compromised patient with few remaining teeth: hybrid telescopic double crown with friction pin method (의과적 문제가 있고 소수 잔존치를 가지는 환자에서의 치주보철 임상증례: 프릭션핀을 이용한 하이브리드 텔레스코픽 이중관법)

  • Ha, Seok-Joon;Lee, Cheong-Hee;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.4
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    • pp.359-365
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    • 2014
  • Successful results of treatments using double crown prostheses for the partially edentulous patients who have a few remaining teeth have been reported in several journals. A double crown removable partial denture can be an alternative treatment for the patients with a poor periodontal condition of remaining teeth. Since a double crown removable partial denture can be applied without the risk of surgical operation to the medically compromised patients with a poor periodontal condition which is inadequate for dental implants, it has psychological and economical advantages. In this case, there were sufficient remaining teeth to be restored with fixed prostheses in maxilla, while there were a few remaining teeth with a very poor periodontal condition so that it was almost impossible to restore with a clasp removable partial denture using these remaining teeth in mandible. In addition, the patient had the medical history of surgical operation due to osteomyelitis in the mandibular anterior areas a year ago, thus difficult to conduct an implant placement. The main objective of this report is to introduce our case because a double crown partial denture using a few mandibular remaining teeth showed satisfactory results in functional and esthetical aspects during more than two years follow-up period in this unfavorable condition.

A three-dimensional finite-element analysis of influence of splinting in mandibular posterior implants (스프린팅이 하악 구치부 임플랜트 보철물의 응력분산에 미치는 영향에 관한 삼차원 유한요소분석 연구)

  • Baik, Sang-Hyun;Jang, Ik-Tae;Kim, Sung-Kyun;Koak, Jai-Young;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.157-168
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    • 2008
  • Statement of problem: Over the past two decades, implant supported fixed prosthesis have been widely used. However, there are few studies conducted systematically and intensively on the splinting effect of implant systems in mandible. Purpose: The purpose of this study was to investigate the changes in stress distributions in the mandibular implants with splinting or non-splinting crowns by performing finite element analysis. Materials and methods: Cortical and cancellous bone were modeled as homogeneous, transversely isotropic, linearly elastic. Perfect bonding was assumed at all interfaces. Implant models were classified as follows. Group 1: $Br{{\aa}}nemark$ length 8.5mm 13mm splinting type Group 2: $Br{{\aa}}nemark$ length 8.5mm 13mm Non-splinting type Group 3: ITI length 8.5mm 13mm splinting type Group 4: ITI length 8.5mm 13mm Non-splinting type An load of 100N was applied vertically and horizontally. Stress levels were calculated using von Mises stresses values. Results: 1. The stress distribution and maximum von Mises stress of two-length implants (8.5mm, 13mm) was similar. 2. The stress of vertical load concentrated on mesial side of implant while the stress of horizontal load was distributed on both side of implant. 3. Stress of internal connection type was spreading through abutment screw but the stress of external connection type was concentrated on cortical bone level. 4. Degree of stress reduction was higher in the external connection type than in the internal connection type.

Palatal cancer 환자의 obturator착용전후 모음의 음향학적 특성과 말 명료도에 관한 연구

  • 정문규;김호중;최성희;표화영;심현섭;최홍식
    • Proceedings of the KSLP Conference
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    • 1999.11a
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    • pp.183-183
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    • 1999
  • 배경 : 주로 palatal defect 환자들의 상악(maxilla)의 결손으로 인한 형태와 기능을 복구시키기 위한 보철적 재활(prosthetic rehabilitation)방법으로 쓰이는 obturator는 비음의 초래를 막고 vocal tract의 모양에 영향을 줄 수 있으나, palatal cancer 환자를 대상으로 말산출(speech production)에 관한 obturator 장착 효과에 대한보고는 거의 없다. 또한 모음은 자음에 비해 더 nasality에 영향을 주며 모음 삼각도의 면적크기가 말 명료도의 객관적인 측정치로 사용될 수 있다. 연구목적 : Palatal cancer 환자의 obturator 장착 전후 모음 산출 측정치를 통해 모음 삼각도의 크기를 비교함으로써, obturator 장착이 말 명료도 개선에 어느 정도의 효과를 주는지 보고자 하였다. (중략)

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PALATOGRAPHIC STUDY ON MALOCCLUSION PATIENTS IN FRICATIVE SOUNDS (구개도(口蓋圖)에 의(依)한 부정교합자(不正咬合者)의 마찰음(摩擦音)에 관(關)한 연구(硏究))

  • Im, Chul-Joong
    • The Journal of Korean Academy of Prosthodontics
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    • v.8 no.1
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    • pp.56-64
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    • 1968
  • 저자(著者)는 구개도(口蓋圖)에 의(依)하여 한국어(韓國語) 마찰음(摩擦音)의 라, 사, 자, 차 사행(四行), 도합(都合) 40음(音)에 대(對)한 정당교합자(正堂咬合者) 오인(五人)과 부정교합자(不正咬合者) 십칠인(十七人)의 발음(發音)을 조사(調査)하여 다음과 같은 결과(結果)를 얻었다. 1) 라, 사, 자, 차 사행(四行)의 구개도(口蓋圖)는 V, H 및 C형(型)을 나타낸다. 2) 라행(行)의 구개도(口蓋圖)는 교합군(咬合群)에 관계(關係)없이 주(主)로 H형(型)을 보인다. 라행(行)에 있어서 전치(前齒)와 접촉부위간(接觸部位間)의 거리는 과개교합군(過蓋咬合群)에서 크고, 반대교하군(反對咬合群)에서는 작다. 3) 사행(行)은 주(主)로 V형(型)을 보이며 반대교합군(反對咬合群)에서만 C형(型)이 1/3정도(程度) 나타난다. 반대교합군(反對咬合群)에서의 V형(型)은 그 접촉부위(接觸部位)가 구치부(臼齒部)로 갈수록 두터워 진다. 4) 자, 차행(行)의 구개도(口蓋圖)는 라, 사행(行)에 비(比)하여 변화(變化)가 많다. a) 과개교합군(過蓋咬合群)은 H형(型)이 67%이고 나머지는 C형(型). b) 반대교합군(反對咬合群)은 거의 모두가 C형(型). c) 과개교합군(寡蓋咬合群)에서는 반이상(半以上)이 C형(型), 나머지는 H형(型)이나 간혹 V형(型)도 출현(出現)한다. 5) 구치부(臼齒部)에서의 측방반대교합(側方反對咬合)의 경우는 반대교합(反對咬合)이 있는 반대(反對)쪽의 접촉부위(接觸部位)가 넓다. 6) 과개교합군(寡蓋咬合群)에서의 접촉부위(接觸部位)는 정상군(正常群)이나 과개교합군(過蓋咬合群)에서 보다 일반적(一般的)으로 넓게 나타난다.

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Fabrication of palatal lift prosthesis using thermoplastic resin for a patient with velopharyngeal insufficiency (구개인두부전증 환자에서 열가소성레진을 이용해 연구개거상장치를 제작한 증례)

  • Jung, Hyun Jung;Kim, Jee Hwan;Lee, Sang-Hwy;Park, Young-Bum
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.286-290
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    • 2016
  • Recently, flexible removable prosthesis with thermoplastic resin clasp has increasingly become popular. In comparison with conventionally used acrylic resin, thermoplastic resin has lower flexural strength and elastic modulus. Thus, flexible removable prosthesis has low risk of fracture, so denture base can be made thin and light, increasing patient comfort. Also, it can passively sit at tooth undercut during rest, so abutment teeth need minimum or no preparation. In this case report, a 44 year old female patient with mild velopharyngeal insufficiency was treated with a palatal lift prosthesis made of polyester thermoplastic resin. Since the patient had no missing tooth and desired conservative treatment, the flexible removable prosthesis provided relatively satisfactory results.

AN EXPERIMENTAL STUDY ON THE BOND STRENGTH OF THE LIGHT ACTIVATED COMPOSITE RESIN BONDED TO THE ETCHED PORCELAIN (부식된 도재와 광중합성 수지와의 접합강도에 관한 실험적연구)

  • Lee, June-Kyu;Kay, Kee-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.25 no.1
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    • pp.363-378
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    • 1987
  • 도재소부전장관에서 금속이 노출되지 않고 도재만이 파절시, 구강내에서 직접 행할 수 있는 심미적 수복 방법으로서 복합성 수지를 이용한 수복 방법이 널리 이용되고 있는데 본실험의 목적은 도재와 광중합성 수지간의 접합강도를 비교 측정코저 함에 있다. 본 실험에서는 주사전자 현미경을 사용하여 도재의 부식액 (5% 불화수소산용액, Excelco's porcelain etching gel) 및 부식 시간(2.5분, 5분, 10분, 20분)에 따른 부식양상을 먼저 관찰하였다. 그다음 각기 다른 시간에서 부식 처리된 도재와 대조군으로서 미부식 처리된 도재에 광중합성 수지를 부착시킬시, 첫째 Silane coupling agent(Scotch-Prime)도포후 광중합성 수지를 결합 시켰고 둘째 bonding agent(Scotch bond)도포후 광중합성 수지를 결합시켰으며 셋째 Silane coupling agent(Scotch-Prime)에 bonding agent(Scotch bond)를 도포후 광중합성 수지로 결합 시킨후, 인장강도 측정기 (Shimadzu universal testing machine)를 사용하여 결합력을 측정한 결과 다음과 같은 결론을 얻었다. 1. 부식처리된 도재가 미부식 처리된 도재 보다 결합력이 높았다. (p<0.05, P<0.001) 2. 부식 처리된 도재나 미부식 처리된 도재에 있어서 silane coupling agent 도포후 bonding agent로 처치한 경우 가장 결합력이 높았으며 그다음 silane coupling agent로 처치한 경우, bonding agent로 처치한 경우의 순이었다. 3. 도재부식 시간의 증가에 따른 결합력의 차이는 5% HF용액으로 부식 처리된 도재와 Excelco로 부식 처리된 도재에 있어서 5분 정도 까지는 결합력의 증가를 보였으나 그 후에는 결합력에 있어서 거의 증가하지 않는 양상을 보였다. 4. Excelco로 부식 처리된 도재와 5% HF 용액으로 부식처리된 도재간의 결합력 차이에 있어서 bonding agent만으로 처치한 경우에는 두결합력 사이에 서로 유의한 차이를 보이지 않았으나 (P>0.5) silane coupling agent만으로 처치한 경우와 silane coupling agent 도포후 bonding agent로 처치한 경우에는 두결합력 사이에 서로 유의한 차이를 보였다. (P<0.05, P<0.001) 5. Excelco로 부식처리된 도재가 5% HF 용액으로 부식처리된 도재보다 부식정도가 더 현저하였다.

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Treatment plan for missing mandibular 4 incisors (하악 4전치 상실시 치료 계획)

  • Hahn, Kwang Jin
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.25 no.1
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    • pp.25-34
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    • 2016
  • Treatment of missing mandibular 4 incisors is often thought to be easier then other place during surgical and prothetic procedure. But clinicians encounter unexpected difficulties such as restricted implant site due to mesio-distal width of mandibular incisors, limited space as a result of crowing and mesial drift, esthetic problem after severe alveolar bone resorption, and difficulties of provisionalization Through cases, possible treatment options for missing mandibular incisors would be discussed. Treatment options for missing mandibular 4 incisors Place narrow type implant or one body mini implant on exact tooth position when there is no bone resorption Regular size implant on interseptal bone area when there is severe bone resorption Consider using resin bonded bridge(resin retained bridge/resin bonded fixed partial denture) as a tentative prosthesis when patient resists extracting remaining incisors with poor prognosis.

Comparison of the effect of removing artificial dental plaque depending on various interdental cleaning products on the interdental surface of zirconia crowns (치간 세정 용품에 따른 지르코니아 크라운 인접면의 인공 치면 세균막 제거 효과)

  • Kim, Hyun-Wook;Song, Ha-Kyung;Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.291-298
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    • 2021
  • Purpose. The purpose of this study is to compare five interdental cleansing products' effectiveness on removing artificial dental plaque on the interdental space of zirconia crowns. Materials and methods. A model with abutments on the right mandibular second premolar and first molar were prepared. 10 zirconia crowns for each abutment were fabricated. After applying artificial dental plaque between the zirconia crowns, a single clinician attempted to remove the plaque with five products: interdental toothbrush, end-tuft toothbrush, dental floss, Easypick, Water pik. They were conducted 10 times per group. The aspect and area of removed surfaces were analyzed using images taken with a digital camera. One factor analysis of variance was performed as a statistical analysis, and a post-hoc test was performed using the Scheffé method (P < .05). Results. There were differences in the area and the pattern according to the characteristics of the products. The largest area, including the marginal portion, was removed in the dental floss group. Interdental toothbrush group was the most effective in removing the dental plaque at the marginal portion. Easypick was less effective than the interdental toothbrush. The end-tuft toothbrush showed better results than other products in cleansing mesiobuccal and distobuccal area, but could not cleanse the area directly below the contact point. In Water pik group, artificial dental plaque was scarcely removed. The removal rate of artificial dental plaque was in the order of floss (69.47%), end-tuft toothbrush (49.36%), interdental toothbrush (44.20%), Easy pick (13.04%), and Water pik (0.59%). Conclusion. Dental floss showed the highest removal rate in the interdental space restored with zirconia crowns, while interdental toothbrush was the most effective in removing the dental plaque at the marginal portion.

3-D Finite element stress analysis in screw-type, cement-type, and combined-type implant fixed partial denture designs (임플란트 상부보철물의 유지형태에 따른 3차원 유한요소 응력분석)

  • Lee, Sung-Chun;Kim, Seok-Gyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.365-375
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    • 2009
  • Statement of problems: Stress analysis on implant components of the combined screw- and cement-retained implant prosthesis has not investigated yet. Purpose: The purpose of this study was to assess the load distribution characteristics of implant prostheses with the different prosthodontic retention types, such as cement-type, screw-type and combined type by using 3-dimensional finite element analysis. Material and methods: A 3-dimensional finite element model was created in which two SS II implants (Osstem Co. Ltd.) were placed in the areas of the first premolar and the first molar in the mandible, and three-unit fixed partial dentures with four different retention types were fabricated on the two SS II implants. Model 1 was a cement-retained implant restoration made on two cement-retained type abutments (Comocta abutment; Osstem Co. Ltd.), and Model 2 was a screw-retained implant restoration made on the screw-retained type abutments (Octa abutment; Osstem Co. Ltd.). Model 3 was a combined type implant restoration made on the cement-retained type abutment (Comocta abutment) for the first molar and the screw-retained type abutment (Octa abutment) for the first premolar. Lastly, Model 4 was a combined type implant restoration made on the screw-retained type abutment (Octa abutment) for the first molar and the cement-retained type abutment (Comocta abutment) for the first premolar. Average masticatory force was applied on the central fossa in a vertical direction, and on the buccal cusp in a vertical and oblique direction for each model. Von-Mises stress patterns on alveolar bone, implant body, abutment, abutment screw, and prosthetic screw around implant prostheses were evaluated through 3-dimensional finite element analysis. Results: Model 2 showed the lowest von Mises stress. In all models, the von Mises stress distribution of cortical bone, cancellous bone and implant body showed the similar pattern. Regardless of loading conditions and type of abutment system, the stress of bone was concentrated on the cortical bone. The von-Mises stress on abutment, abutment screw, and prosthetic screw showed the lower values for the screw-retained type abutment than for the cement-retained type abutment regardless of the model type. There was little reciprocal effect of the abutment system between the molar and the premolar position. For all models, buccal cusp oblique loading caused the largest stress, followed by buccal cusp vertical loading and center vertical loading. Conclusion: Within the limitation of the FEA study, the combined type implant prosthesis did not demonstrate more stress around implant components than the cement type implant prosthesis. Under the assumption of ideal passive fit, the screw-type implant prosthesis showed the east stress around implant components.