• Title/Summary/Keyword: 심미 치과학

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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.

The Effective Utilization of GBR and VIP-CT(Vascularized Interpositional Periosteal Connective Tissue) graft in the Anterior Maxillary Immediate Implantation : A Clinical Case Report (상악 전치부 발치 즉시 식립시 골유도재생술과 혈관개재 골막-결합조직 판막술(VIP-CT graft)의 활용)

  • Lim, Pil
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.74-85
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    • 2019
  • The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. A newer technique, VIP-CT (Vacularized Interpositional Periosteal Connective Tissue) graft has been introduced as an alternative to these technique which allows the clinicians perform large volume soft tissue augmentation in esthetic sites with a single procedure. The advantages of the VIP-CT graft technique are that it allows the reconstruction of large soft tissue deficiency, with little constriction postoperatively. Furthermore, it facilitates improved hard tissue augmentation due to the additional blood supply and improved bone healing by mesenchymal cells. Moreover, this technique reduces patient discomfort and treatment time. This clinical report describes the procedure of bone augmentation during immediate implantation in facial dehiscence defect, especially Vascularized Interpositional Periosteal Connective Tissue(VIP-CT) graft for aesthetic anterior soft tissue.

Cases of screw-retained implant prosthesis in the anterior maxilla through multidisciplinary approach, including orthodontic teeth alignment (교정적 치아 재배열을 포함한 다학제적 접근(multidisciplinary approach)을 통한 상악 전치부의 나사 유지형 임플란트 보철 수복 증례)

  • Kim, Hyo-Seon;Lee, Won-Sup;Lee, Su-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.244-250
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    • 2020
  • The labio-palatal location of the implant in the maxillary anterior region is one of the important factors affecting the aesthetics of the implant prosthesis. However, the thin labial bone of maxilla could be absorbed in significant amounts after extraction of the teeth, which makes the implant be placed on the palatal side rather than the ideal location. In fact, in the cases of maxillary central incisor loss, UCLA was used for prosthetic restoration of palatally placed implant. In addition, with multidisciplinary treatment, GBR (Guided Bone Regeneration) was performed for compensating the absorbed alveolar bone and adjacent anterior tooth were aligned. Definitive restoration was performed after confirming aesthetic recovery of the gingiva with sufficient provisional restoration period. There were satisfactory results of functional and esthetic recovery of tooth loss through implant prosthesis.

Clinical cases of implant-supported fixed dental prosthesis using modified lingual screw system (T-screw system) (개선된 설측 고정 나사 시스템(T-screw system)을 이용한 임플란트 보철 수복 증례)

  • Hong, Tae-Young;Kim, Man-Yong;Yoon, Joon-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.423-430
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    • 2016
  • The implant prosthesis can be divided into the screw retained prosthesis and cement retained prosthesis. Each type has advantages as well as disadvantages which is unfavorable to maintain the implants. To overcome these drawbacks, T-screw system was developed. T-screw system which utilizes a lingual direction of the screw to retain the implant prosthesis, has advantages of retrievability of the prosthesis, passive fit, and possibility to form esthetic and functional occlusal surface. The prior prosthesis which utilized horizontal screws had difficulty in fabrication especially in the case of multiple units, and also limited use with all-ceramic prosthesis. In this case, fabricating the implant prosthesis by using the T-screw system showed superior results in easy maintenance, esthetics, and also functions. In addition, we are to report the method of using the T-screw system in implant prosthesis, such as multiple units of implant prosthesis and all ceramic prosthesis.

Full mouth rehabilitation with vertical dimension increase in patient with severly worn dentition (과도한 치아 마모를 보이는 환자에서 수직고경 증가를 동반한 전악 구강 회복 증례)

  • Jo, Wi-Sang;Kim, Seong-A;Kim, Sung-Yong;Bang, Joo-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.107-115
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    • 2021
  • Excessive pathological attrition over the entire dentition can cause decreased masticatory function, and pathological problems of the temporomandibular joint and the muscular nervous system. In this case, 71 year-old male patient with severe attrition and fracture across the entire tooth was treated by full mouth rehabilitation for regaining space of restoration. In order to determine the appropriate vertical dimension of the patient's occlusion, facial appearance, aesthetics, restoration space were evaluated, and provisional restoration of the raised vertical dimension was made. After 4 months of evaluation, the entire restoration of monolithic zirconia crown using CAD-CAM was completed. Through the above process, satisfactory aesthetic and functional results were obtained.

Maxillary tuberosity connective tissue graft for restoration of gingival depression in the anterior implant region (전치부 임플란트 영역 치은 함몰 회복을 위한 결체조직 이식술에서 상악결절 수여부의 선택)

  • Lee, Dong-Woon;Jung, Gwang-Young;Bang, Joo-Hyuk;Lee, Keun-Woo
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.102-111
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    • 2021
  • Implant placement in the anterior region is performed in several stages, and harmonization of both hard and soft tissues is essential. In addition, adequate esthetic and functional evaluations are necessary in the process of transitioning from the provisional to the final prosthesis to attain patient satisfaction. Although gingiva can be molded in the anterior region, depression in the occlusal view can yield good results through the augmentation procedure. However, the harvesting of connective tissue from the palate is not suitable for various reasons, such as postoperative discomfort and intraoperative bleeding. Compared to the palatal area, the harvesting of connective tissue from the maxillary tuberosity can easily result in relatively thick tissue and quick healing of the donor site, thus proving to be a good modality for graft procedures. The purpose of this report is to examine the relevant evidence from previous studies and evaluate the process of soft tissue augmentation through a case presentation.

Digital duplication of provisional prosthesis to fabricate definitive prosthesis for full mouth rehabilitation using double scan technique (잠정수복물의 최종수복물로의 디지털 복제를 통한 완전구강 회복 증례: Double scan technique)

  • Hong, Young-Tack;Koak, Jai-Young;Kim, Seong-Kyun;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.63-70
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    • 2021
  • Using computer-aided design and manufacturing technique improve quality of treatment in many aspect. This case reports the complete mouth rehabilitation of a patient with amelogenesis imperfecta utilizing digital technology. Clinical examination revealed loss of mastication due to insufficient occlusal stop, missing teeth, interdental spacing due to microdontia, insufficient overbite, and etc. Full veneer crowns for teeth were selected, followed by a fixed partial denture and implant placement was done using CAD-CAM guide template with bone graft for partially edentulous space. Definitive restorations were duplicated by double scanning provisional restorations and successfully delivered to the patient. These full mouth rehabilitation procedures resulted in satisfactory outcomes for the patient functionally and aesthetically.

Implant-supported milled bar overdenture with two implant surgical guides (두 개의 수술용 가이드와 Milled-bar를 이용한 임플란트 피개 의치 수복 증례)

  • Pill-Sang Yun;Sunjai Kim;Se-Wook Pyo;Jae-Seung Chang
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.55-62
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    • 2023
  • For fully edentulous patients, implant-supported overdenture can be considered to enhance chewing efficiency and denture stability. Implant planning software can be used to fabricate a surgical guide for a more precise consideration of anatomic factors and prediction of the shape of definitive prosthesis. Though there are many possible attachments for implant overdenture, milled bar can be useful due to its splinting effect of implants and rigid support of overdenture. This report presents a case of implant-supported milled bar overdenture after guided implant surgery performed with two surgical guide that was fabricated before and after bone reduction.

ORAL REHABILITATION IN ECTODERMAL DYSPLASIA WITH OLIGODONTIA

  • Kim, Ryoung;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.4
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    • pp.636-643
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    • 1999
  • Ectodermal dysplasia is a genetic birth defect in which at least abnormally develop two structures derived from the ectoderm. It is usually inherited in autosomal dominant or autosomal recessive pattern. Oral manifestations are oligodontia, anodontia, dysmorphic teeth(conical shape), decreased occlusal vertical dimension and alveolar bone. Extraoral signs may include decreased or absent sweat glands, sparse and fine hair, saddle nose, hearing loss and decreased production of body fluids including saliva. Most affected children require extensive dental treatment to restore their appearance and help the development of a positive self image. The patient's overclosed profile was due to a decreased vertical dimension. The use of overdenture is to preserve erupted teeth, to accomodate the newly constructed occlusal plane, to improve retention and stability of denture and to maintain the remaining alveolar bone. The restoration of vertical dimension improved the child's speech, swallowing, and eating. Growth continue until the age of approximately 18. As child grows, replacement dentures will have to be fabricated primarily to accomodate increasing vertical dimension and changing dentition. Implants may be indicated later if the alveolar bone is adequate. Periodic recall visits are advised, to monitor the dentures during periods of growth and development, and eruption of the permanent teeth.

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RPD framework fabrication using computer-aided design (CAD) and rapid prototyping (Computer-aided design (CAD) 및 쾌속조형술을 이용한 가철성 국소의치 수복 증례)

  • Park, Seon-Ah;Koak, Jai-Young;Heo, Seong-Joo;Kim, Seong-Kyun;Park, Ji-Man
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.94-99
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    • 2017
  • Nowadays, digital dentistry is generally applied to prosthodontics with fabrication of inlays or any other fixed prostheses by utilizing CAD/CAM (computer-aided design/computer-aided manufacturing) technology and intraoral scanner. However, in fabricating removable prosthesis, there are some limitations for digital technology to substitute conventional casting method. Therefore, approaching removable prostheses fabrication with CAD/CAM technology would be a meaningful trial. In this case report, Kennedy class III mandibular edentulous patient who was in need of increasing the vertical dimension of occlusion was treated with removable partial denture using CAD and rapid prototyping technique. Surveying and designing the metal framework of the partial denture was performed with CAD, and sacrificial plastic pattern was fabricated with rapid prototyping technique. During the follow up period of nine months, the removable partial denture has provided satisfactory results in esthetics and function.