• Title/Summary/Keyword: 심한 치조골 흡수

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The effect of Actinobacillus actinomycetemcomitans lipopolysaccharide on rat periodontal tissues (Actinobacillus actinomycetemcomitans 내독소가 백서 치주조직에 미치는 영향)

  • Kim, Chong-Cheol;Cui, De-Zhe;Kim, Young-Joon
    • Journal of Periodontal and Implant Science
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    • v.37 no.sup2
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    • pp.297-310
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    • 2007
  • 치조골 흡수는 파골세포와 matrix metalloproteinases (MMPs)에 의한 골의 무기질과 유기질의 파괴로 일어나는 과정이다. 세균성 산물, 주로 내독소는 치은조직 내에서 염증세포의 유주, 사이토카인 생산, 조직파괴 효소 분비 및 파골세포 활성 등의 국소 면역반응을 유도한다. A. actinomycetemcomitans는 급진성 치주염의 원인 균주중 하나로 그 내독소는 치조골의 흡수와 관련된다. MMP-13은 세균성 산물이나 염증성 사이토카인의 자극에 의해 분비되며, 최근의 연구 결과들은 MMP-13이 치주질환의 진행과 골 흡수 과정에서 일정한 역할을 담당하는 것으로 보고하고 있으나, A. actinomycetemcomitans 내독소와 MMP-13과의 관련성에 대한 연구는 미미하다. 이에 이번 연구에서는 A. actinomycetemcomitans 내독소에 의한 MMP-13의 발현과 파골세포 형성을 세포배양을 통하여 관찰하였고, 백서 구개부 치은에 A. actinomycetemcomitans 내독소를 주입하여 흡수가 진행되고 있는 치조골에서 파골세포의 분화와 MMP-13의 발현을 TRAP 염색, 면역조직화학적 방법 등을 통해 관찰하여 다음과 같은 결과를 얻었다. MMP-13 mPNA의 발현은 A. actinomycetemcomitans 내독소 (1ug/ml)로 24시간 자극한 마우스 치주인대 섬유모세포에서 생리식염수로 자극한 세포에 비하여 약 2.6배 증가하였으며 마우스 대식세포에서는 TRAP 양성 세포가 대조군보다 더 많이 나타났다. A. actinomycetemcomitans 내독소를 주입한 백서 치주조직에서는 대조군보다 더 심한 골소실을 보였다. TRAP-양성 다핵 파골세포 유사세포는 치주염군과 대조군 모두 치조골에서 관찰되었다. TRAP-양성 다핵 파골세포 유사세포는 치주염군에서 대조군보다 유의하게 많은 숫자가 관찰되었으며, 치주염군에서 대조군보다 유의하게 많은 숫자가 관찰되었다. MMP-13 면역양성 반응은 치주염군에서 거친 골연을 갖는 치조골상에 배열된 조골세포와 그 인접한 치주인대에서 관찰되었으며 대조군에서는 MMP-13 면역 양성 반응이 치조골 표면에서만 일부 관찰되었다. 이상의 결과는 A. actinomycetemcomitans 내독속가 MMP-13의 발현을 증가시키며 파골세포의 활성을 통하여 치조골의 흡수를 유도함을 시사한다. 또한 A. actinomycetemcomitans 내독소 투여에 의한 실험적 모델은 백서에서 중등도의 골 소실을 동반한 만성 치주염 모델로 향후 치주질환 치료제의 효과를 평가하는데 유용하게 사용될 수 있으리라 기대된다.

Implant placement in severely atrophic mandible using alveolar ridge splitting procedure and small block bone graft: A case report of 4-year follow-up (심하게 위축된 하악 구치부에 치조제 분할술과 블록형 골이식술을 이용한 임플란트 식립: 4년 관찰 증례보고)

  • Kim, Na-Hong;Bang, Joo-Hyuk;Lee, Dong-Woon
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.64-73
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    • 2019
  • Various techniques have been developed, and the development of piezo electric devices have made it possible to widen the alveolar ridge even if the residual bone is dense or if there is a lack of cancellous bone between the cortical bones. In the operation of the mandibular posterior area, the flap is easily accessible to the ramus bone, from which high quality autogenous bone can be obtained, compared to other parts. A small autologous bone block can be used with particulated bone graft material using one screw for bone regeneration instead of a large autologous bone with two screws. The tapered implant design can minimize buccal bone fracture, even in severely atrophic mandibular areas. We report a case of 4 years following implant placement with ridge splitting and small autogenous bone graft in severly atrophic mandible. This report demonstrates a case of functional and aesthetic restoration in a patient through a collaboration.

Complete denture treatment using lingualized occlusion scheme at the edentulous patient with severely absorbed flat residual ridges: a case report (심한 치조골 흡수로 인해 편평한 치조제를 보이는 완전 무치악 환자에서 설측 교두 교합을 이용한 의치 수복 증례)

  • Choi, Bum-Shik;Lee, Joon-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.207-215
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    • 2017
  • Many factors should be considered for successful denture treatment at edentulous patients: support, retention, stability, occlusion, esthetics, etc. The patient who has severely absorbed residual ridges, however, treatments are challenging to satisfy those factors. The dentures that use anatomic artificial teeth show good mastication efficiency and esthetics but, can easily lose stability at absorbed ridges. On the contrary, the dentures that use non-anatomic artificial teeth perform better stability but, lower masticatory efficiency and esthetics at absorbed ridges. The lingualized occlusion, using both anatomic and non-anatomic teeth, introduced for compromise those of the pros and cons. At lingualized occlusion, buccal cusps of the teeth do not contact on centric relation. Therefore, direction of the occlusal force towards lingually, then stability of dentures increases. This case report shows the results of the treatment flat residual ridges using complete dentures with ligualized occlusion to increase dentures stability and satisfactory of the patient.

Implant overdenture of mandible with severe unilateral atrophy: Report of two cases (심한 편측 하악 치조골 흡수를 보이는 환자에서의 임플란트 피개의치 수복 증례)

  • Kim, So-Yeun;Kwon, Eun-Young;Jung, Kyoung-Hwa;Jeon, Hye-Mi;Baek, Young-Jae;Yun, Mi-Jung;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.271-279
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    • 2019
  • There are several unfavorable conditions regarding alveolar bone condition that may compromise the denture patient's satisfaction. Chewing efficiency may not be satisfactory when alveolar bone is deficient, and the denture stability could hardly be achieved when alveolar bone shape is irregular. Implant overdenture can be useful to provide satisfactory denture experience compared to conventional denture. The attachment for implant overdenture can be classified into bar attachment and solitary attachment. When the positions of the implants are in the mandibular anterior region, bar attachment may be favorable to obtain a rigid support of the entire denture. When implants are distributed both on anterior and posterior region, a solitary attachment could be considered for ease of removal and maintenance. This report presents implant overdenture cases with the patients that had unilateral mandibular alveolar bone atrophy conditions. Different abutments were chosen based on the individual patient's mandibular alveolar bone condition and the treatments were successful in terms of patient satisfaction.

Zirconia removable prosthesis using a milled bar in patient with mandible anterior edentulous area with severe alveolar bone resorption: a case report (치조골 흡수가 심한 하악 전치부 부분 무치악 환자에서 Milled-bar를 이용한 지르코니아 가철성 보철물 수복 증례)

  • Jin-Young Park;Chang-Mo Jeong;Mi-Jung Yun;Jung-Bo Huh;So-Hyoun Lee;Dae-Sung Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.3
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    • pp.193-200
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    • 2024
  • In patients with severe alveolar bone resorption on mandibular anterior edentulous areas, it can be difficult to place implants in the location for crowns, and to create the fixed prosthesis having an adequate emergence profile or embrasure, which makes maintenance difficult. Fabricating a removable zirconia prosthesis with a milled bar on poorly positioned implants can be a good option because of easy maintenance. In this case, the patient had severe bone resorption on mandibular anterior region, and large vertical space. We report on the aesthetical and easy-to-maintain results by placing two implants and fabricating a zirconia prosthesis using milled bar.

Comparative observations of lingualized occlusion and monoplane occlusion in the treatment of severe atrophy of edentulous mandible (심한 하악 치조골 흡수를 보이는 환자에서 설측 교두 교합과 단일평면 교합을 비교 관찰한 의치 수복 증례)

  • Ahn, Gyo-zin;Lee, Joon-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.2
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    • pp.127-136
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    • 2018
  • The patient who has severely absorbed residual ridges, treatments are challenging to satisfy many factors: support, retention, stability, etc. The neutral zone or monoplane occlusion with non-anatomical tooth would be helpful to get additional retention and stability. The monoplane occlusion has been used long time because it can eliminate horizontal forces and many other advantages. The lingualized occlusion was introduced to improve chewing efficiency and esthetics. But from a stability aspect, it seems controversy between monoplane occlusion and lingualized occlusion. This case report shows the results of the treat two flat residual ridge patients using functional impression; piezography, and made 2 other dentures with monoplane and lingualized occlusion that patient can select denture.

A STUDY ABOUT ALVEOLAR CREST BONE HEIGHT BEFORE AND AFTER ORTHODONTIC TREATMENT BY USING BITEWING FILM (교익사진을 이용한 교정치료 전후의 치조골 높이 변화에 관한 연구)

  • Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.27 no.3 s.62
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    • pp.421-430
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    • 1997
  • Alveolar bone grows with development of tooth germs and roots; bone deposition occurs with tooth eruption. Bone components undergoes processes of resorption and deposition, and when the balance between them is disrupted, decrease in alveolar bone height or excessive bone deposition result. It has been hon that repositioning of teeth through orthodontic treatment can cause alveolar bone resorption which result in decreased alveolar bone height, and there have been many studies to evaluate such effects. X-ray films that could be replicated and standardized were chosen in clinical studies, and among them, bitewing films were used for objective evaluation of changes in alveolar bone level. Twenty subjects, 10 to 13-year- old (average 12.2) children with Cl I molar key, healthy oral condition, no congenital missing, no periodontal disease, and pre-and post-orthodontic bitewing films, were randomly selected for comparison of alveolar bone heights. Amounts of tooth and changes in alveolar bone heights were analyzed. The following results were obtained: 1. Amount of tooth movement in canine, premolar, and molar regions, changes in tooth axis, and changes in alveolar bone heights were measured, and the mean and median values were obtained. 2. When pre-and post-orthodontic alveolar bone levels were compared, larger changes were noticed in maxilla than mandible. 3. When mesio-distally compared, larger changes were observed in the distal sides of 3D3 and 4M3, mesial sides of 4M3 and 4D3, distal sides of 4D3 and 5M3, mesial sides of 5M3 and 5D3, md distal sides of 5D3 and 6M3. 4. When the amounts of tooth movements(TX, TY)and changes in tooth axis(A) were compared,34TX, 34TY, 34A of both sides in maxilla were greater, iud changes in alveolar bone level were greater than any other region.

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Implant placement simultaneously sinus augmentation using crestal approach in severely atrophic maxilla; minimally invasive approach (골 흡수가 심한 상악 구치부에서 치조정 접근법을 이용하여 상악동 골이식술 동시 임플란트 식립)

  • Kim, Hyun-Joo;Kwon, Eun-Young;Choi, Jeomil;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.47-54
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    • 2017
  • The atrophy of edentulous ridge and pneumatization of the maxillary sinus often limit the volume of bone available for implant placement on maxillary posterior teeth. Most clinicians suffer difficulties from poor bone quality and quantity on maxillary posterior site. Thus, the success of maxillary posterior implant surgery depends on the increase of the available bone and obtaining a good initial stability of the implant after maxillary sinus reconstruction. The maxillary sinus augmentation methods include a crestal approach and a lateral approach. Less morbidity and complications after operation is major advantage to sinus augmentation using crestal approach than lateral approach. However, when the residual ridge height is ${\geq}6mm$, it is known that crestal approach is appropriate. Also delayed implantation after sinus augmentation is recommended in severely atrophic ridge. We present the three cases of implant placement simultaneously sinus augmentation using crestal approach in posterior maxilla site with ${\leq}3mm$ of residual alveolar bone.

Implant supported fixed prosthesis for complete edentulous maxilla with severe alveolar ridge resorption: A case report (치조골 흡수가 심한 상악 완전 무치악 환자에서 임플란트 고정성 보철물을 이용한 수복 증례)

  • Choi, Yoon-Ji;Lee, Ji-Hyoun;Jhin, Min-Ju
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.2
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    • pp.152-159
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    • 2016
  • Implant fixed prosthesis for the complete edentulous maxilla provides significant benefits in the aspects of functions and esthetics compared with the conventional denture. Implant supported fixed prosthesis are totally supported by implant, and thus stabilizes the prosthesis to the maximum degree as possible. Also, the improved retention and stability of fixed prosthesis enhance patients' psychological and psychosocial health. This clinical presentation describes a maxillary full arch implant-supported fixed prosthesis in complete maxillary edentulous patient who showed vertical and horizontal alveolar bone resorption in the anterior ridge. To rehabilitate the esthetics and proper lip support, the zirconia framework was fabricated and the pink porcelain was veneered to reproduce the natural gingival tissue. After 9 months of follow up, the restorations were maintained without complications and the patient was satisfied with the restoration both functionally and esthetically.

DECORONATION ON ANKYLOSED PERMANENT INCISOR AFTER DENTAL TRAUMA (외상으로 유착된 영구 전치에서의 치관 절제술)

  • Kang, Yu-Jin;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.252-259
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    • 2010
  • Trauma commonly leads to ankylosis for the tooth whose periodontal ligaments have been injured. In growing patients, an ankylosed tooth can disrupt alveolar development, resulting in infraocclusion of the affected tooth. Consequently, this causes aesthetic problems during adolescence, interferes with prosthetic treatment due to the inclination of adjacent teeth, and complicates orthodontic dental movement. When the infraoccluded ankylosed tooth is extracted, a considerable amount of alveolar bone is lost, especially in the maxillary anterior region. Moreover, depression of the thin buccal alveolar bone compromises aesthetic restoration. In order to prevent alveolar bone loss, the ankylosed tooth should be treated by decoronation. In the present study, the traumatically injured maxillary incisors of 9-year-old and 10-year-old patients that present infraocclusion accompanied by ankylosis were treated with decoronation procedures. Decoronation procedures were performed when the affected teeth were 2-3 mm below relatively to the adjacent teeth. Moreover, the patients were treated before they get to 16 years old considering the maximum growth peak of the korean adolescents. As the results, there are favorable clinical results associated not only with preservation of horizontal alveolar volume but also with increase in vertical alveolar height after decoronation in growing individuals.