• Title/Summary/Keyword: 심한 치조골 흡수

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TOOTH REPLANTATION AFTER TRAUMATIC AVULSION: A 8-YEAR FOLLOW UP. (재식된 상악 중절치의 장기간에 걸친 추적례)

  • Lee, Dong-Woo;Kwak, Ji-Youn;Kim, Sung-Oh;Choi, Byung-Jai;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.729-733
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    • 2004
  • Tooth avulsion usually causes inflammatory root resorption and ankylosis, and ankylosis cause severe functional and esthetic problems, especially in childhood. A 7-year-old female visited the Dept. of Pediatric Dentistry, Yonsei University with the chief complaint of avulsive trauma to the upper right incisor which was left dry for 40 minutes. Tooth was irrigated with saline and replanted immediately and splinted. Anti bacterial agent and anti inflammatory agent were prescribed. After 4 months of replantation slight external root resorption and apical radiolucency was seen at radiographic examination, therfore pulp extirpation and calcium hydroxide($Vitapex^{TM}$) canal filling were carried out. After 16 months, root canal was filled with gutta-percha, and bleaching treatment was done. Treatment results were satisfactory both esthetically and functionally for 8 years and 5 months.

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Periodontal Regeneration Using the Mixture of Human Tooth-ash and Plaster of Paris in Dogs (성견에서 치아회분말과 연석고를 이용한 치주조직재생술)

  • Gu, Ha-Ra;Jang, Hyun-Seon;Kim, Su-Wan;Park, Joo-Cheol;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.15-26
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    • 2006
  • 흡수성 차페막을 이용한 조직 유도 재생술시 차폐막의 견고성으로 미루어 보아 재생을 위한 공간의 유지가 어려울 수 있다. 조직 유도 재생술과 함께 골이식술을 시행함으로써 공간 확보와 함께 적절한 혈병의 유지를 도모할 수 있고 이식된 골은 선생골 형성을 위한 핵으로 작용할 수도 있다. 최근에 사람의 치아회분말과 연석고를 혼합한 골이식재가 여러 연구를 통해 좋은 골이식재로 평가되었다. 본 연구에서는 성견 하악 소구치 2급 치근이개부위에 외과적으로 형성하여 흡수성 차폐막과 치아회분말-연석고 혼합 이식재를 이용한 조직유도재생 술을 시행하여 치주 조직 재생의 양상을 조직학적으로 관찰하고자 한다. 생후 12개월에서 16개윌 된 체중 15 Kg 내외의 성견 4마리를 이용하였다. 실험 재료로 생체흡수성 차폐막 (Biogide(R), Swiss) 를 사용하였고, 골이식재로 치아회분말-연석고를 혼합매식 하였다. 양측 상악 소구치 부위에 변연 치조골하방에 4 mm ${\times}$ 4 mm ${\times}$ 4 mm, (깊이 ${\times}$ 근원심 ${\times}$ 협설폭경) 깊이로 골내낭을 형성하였다. 형성된 골내낭의 기저부위 치근 표면에 1/4 round bur로 notch를 형성하여 참고점으로 하였다. 무작위로 선택된 한 쪽의 결손부를 대조군으로 오직 생체 흡수성 차폐막을 사용하였고, 실험군으로 치아회분말-연석고와 생체 흡수성 차폐막을 결손부로부터 2 mm 이상 덮을 수 있도록 다듬어 결손부 위에 위치시킨 후 협측 판막을 덮고 봉합하였다. 4주 후 2마리 ,8주 후 2마리를 희생시키고 통상의 방법으로 고정, 탈회, 포매의 과정을 거쳐 광학 현미경으로 검경하였다. 그 결과, 1. 4주 대조군에서 Bio-gide(R)는 완전한 흡수를 보였고, 치근이개부내에는 큰 공간이 존재하였다. 2. 4주 실험군에서 역시 Bio-gide(R)는 완전한 흡수를 보였고, 골 결손부내에 더 많은 신생골 관찰되었다. 그러나 아직까진 기존골과 신생골간에 명확한 차이가 있어서 쉽게 구분할 수 있었다. 또한 골이식재 주변으로 파골세포가 다수 관찰되며 이로 미루어 보아 활발한 골흡수가 일어남을 알 수 있었다. 3. 8주 대조군에서 결손부내에서는 기존골에 인접하여 신생골 형성이 부분적으로 일어났으나 연조직 침입이 관찰되었다. 4. 8주 실험군은 신생골이 기존골과 매우 유사한 형태로 관찰되었고, 신생골 형성 부위에 신생 혈관 증식이 관찰되었다. 또한 골내낭 기저부위에서는 백악질과, 치주인대가 재생됨이 관찰되었다. 이상의 결과에서 치아회분말-연석고 혼합매식은 골재생을 위한 골전도성이 있는 재료로 사료되며, 이를 이용히여 치주조직재생술시 흡수성 차폐막과 병행하여 사용한다면 더 많은 골재생이 있을 것으로 기대된다.

IMMEDIATE IMPLANT PLACEMENT AFTER EXTRACTION OF RETAINED DECIDUOUS TEETH AND IMPACTED CANINES: REPORT OF A CASE (상악 전치부 잔존 유치와 매복 견치 발치 후 즉시 임플란트 식립: 증례 보고)

  • Yoo, Ji-Yeon;Kim, Yeo-Gab;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Young-Ran;Baek, Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.4
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    • pp.330-333
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    • 2009
  • Alveolar bone resorption after extraction impairs the necessary bone volume and complicates the case for implant surgery and aesthetic implant prosthesis. Immediate implant surgery after extraction decreases the number of surgical procedures and the duration of treatment, while allowing minimum alveolar bone resorption and preserving the residual bone volume. Although immediate implant holds many advantages such as preservation of hard and soft tissue around the extraction socket, greater implant survival rate and higher patient satisfaction, various complications and high failure rate are discouraging factors for the clinicians. In this case report, severe alveolar bone resorption with soft tissue changes were predicted after the extraction of prolonged retained deciduous incisors and impacted maxillary canines and thus decided on immediate implant procedure. Immediate implant surgery after extraction was carried out with minimal bone reduction and tapered wide-neck implant to establish initial stability. Simultaneous bone graft was done by filling the defect area with iliac cancellous bone with additional onlay-type bone graft and absorbable membrane on the labial bone for upper lip support. A stable and esthetic result was obtained with shortened treatment period.

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.

Technique for fabricating a mandibular suction denture with a plastic implant tray (임플란트용 플라스틱 트레이를 이용하여 하악 흡착의치를 제작하는 방법)

  • Lee, Ju-Hyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.36-42
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    • 2021
  • Even though implant overdentures are preferentially recommended to mandibular edentulous patients, many patients may select conventional complete dentures due to cost and general condition. Proper retention and stability of conventional complete dentures in patients with severe alveolar bone resorption is difficult to achieve. To overcome the limitations, mandibular suction dentures with the closed mouth impression technique have been used. However, the previous technique requires the Frame cut back tray, the Centric tray, and the Gnathometer M. This article introduces a technique for fabricating a mandibular suction denture with common dental materials.

Prosthetic restoration of a partially edentulous patient using double crowns: a clinical report (이중관을 이용한 부분 무치악 환자의 수복 증례)

  • Park, Minseo;Kim, Hyeong-Seob;Kwon, Kung-Rock;Woo, Yi-Hyung;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.21-27
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    • 2016
  • In removable dental prostheses, it is important to minimize impairment of residual tissue caused by wearing dentures. There are two factors that harm residual tissue. The first is functional load bearing of remaining teeth and alveolar ridges and the second is the effect of poor oral hygiene. Double crown retained removable dental prostheses provide rigid support, and it may reduce impairment caused by load bearing of alveolar ridges. Also, dental plaque and oral deposits, which are attached to outer crowns and dentures, can be easily managed extra-orally. In addition, it is beneficial to the health of the marginal gingiva because inner crowns have easy access for oral hygiene. In this case, double crown retained removable dental prostheses were used for the partially edentulous patient with severe residual alveolar bone resorption and poor oral hygiene, and the result was clinically satisfactory in terms of functional, esthetical, and oral hygiene aspects.

Prosthetic Treatment Strategies for Improving Denture Retention in Pediatric Patients with Hypohidrotic Ectodermal Dysplasia: a Report of Two Cases (저한성 외배엽 이형성증을 가진 소아 환자에서 의치 유지력 향상을 위한 보철 치료 전략: 두 가지 증례 보고)

  • Hongju Jeon;Seonmi Kim;Namki Choi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.4
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    • pp.483-494
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    • 2023
  • This report presents two cases concerning strategies for improving denture retention in pediatric patients with oligodontia caused by hypohidrotic ectodermal dysplasia (HED). Both patients presented with multiple missing teeth, conical canines, alveolar bone atrophy, and a skeletal Class III tendency. In the first case, a modified form of conical-crown-retained denture was used to cover the canines. This approach was carried out without tooth extraction or coping. In the second case of severe alveolar bone resorption and a distally tilted lower left canine, the tooth was restored with a hybrid ceramic crown. It was subsequently converted into a clasp-retained removable partial denture, utilizing a suction mechanism. Both patients are currently receiving regular check-ups for the maintenance of their prosthetic appliances and the evaluation of their growth patterns. This study presents innovative prosthetic treatment methods for pediatric patients with HED who have inadequate denture retention.

Effects of bisphosphonate and indomethacin on alveolar bone remodeling in rats (Bisphosphonate와 Indomethacin이 백서 치조골의 골개조에 미치는 영향)

  • Cho, Myeong-Sook;Kim, Jong-Chul
    • The korean journal of orthodontics
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    • v.26 no.2 s.55
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    • pp.163-174
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    • 1996
  • The purpose of this study was to examine the effects of bisphosphonate and indomethacin, blockers of bone resorption with different mechanisms, on alveolar bone remodeling. Male rats were divided into control, bisphosphonate and indomethacin groups, and then each group was divided info an experimental side and a control side according to the force application. Bisphosphonate(6.3mg/kg,$2.52x10^{-2}mol/L$) and indomethacin (9mg/kg, $2.52x10^{-2}mol/L$) were injected 6 hours and 1 hour before or 24 hours after the force application. The rats were killed 72 hours after the force application and histologic examination was perfomed. The values of serum acid phosphatase and lactate dehydrogenase were also measured in the control md experimental groups treated with bisphosphonate or indomethacin 1 hour before the force application. In the experimental side, the least number of osteoclasts was noted in the groups treated 1 hour before the force application with indomethacin or bisphosphonate, while there were no differences between the control and the groups treated with drugs 6 hours before or 24 hours after the force application. In the control side, the number of osteoclasts was not inecreased with no differences among the groups. Histologic examination revealed a severe alveolar bone resorption in the control group and the groups treated with indomethacin 6 hours before or 24 hours after the force application. Indomethacin treatment 1 hour before the force application and bisphosphonate treatment at any time significantly attenuated the bone resorption. Electron microscopically, ruffled border and clear zone of osteoclasts were observed in the control and indomethacin groups, while some osteoclasts were detached from the bone surface and exhibited dull cellular projections in the bisphosphonate groups. The bisphosphonate and indomethacin groups showed lower values of acid phosphatase and lactate dehydrogenase than the control group. The acid phosphatase value in the bisphosphonate group was lower than that in the indomethacin group, whereas there was no difference in the lactate dehydrogenase value between the groups. These results suggest that bisphosphonate reduces the activity of osteoclasts as well as the number of osteoclasts and that indomethacin reduces the number of osteoclasts without affecting the activity of osteoclasts. Bisphosphonate has a larger inhibitory effect on bone resorption md thus less limitation in the application time than indomethacin.

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Complete denture making in a patient of partial glossectomy using polished surface impression taking and direct metal laser sintering method: A case report (부분 설절제술을 받은 환자에서의 연마면 인상 및 Direct Metal Laser Sintering 을 이용한 총의치 제작 증례)

  • Jung, Yeon-Wook;Lee, Gyeong-Je;Kim, Hee-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.350-355
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    • 2019
  • For the success of complete denture, three essential requirements such as retention, stability and support are needed. Moreover, due to the absorption of residual ridge and scarring due to the surgery, when making a complete denture, which is difficult to form the mandibular lingual margins, various considerations such as the arrangement of the Non-anatomical dl non-anatomical teeth, the polished surface impression, the internally weighted metal framework and the use of the denture adhesive cream are necessary. In this case report, the patient has a severely resorbed edentulous ridge from severe periodontitis and has some soft tissue problems after the glossectomy due to tongue cancer. To obtain additional retention and stability, some trials such as polished surface impression taking, internally weighted metal insertion and minimal pressure impression were done for the better result. Moreover To make a metal framework that precisely shapes the desired three-dimensional shape and reduces the complicated process, minimal pressure impression method and direct metal laser sintering technique were used.

Replantation of autotransplanted mature third molar in anterior open bite patient: case report (개방 교합 환자에서 자가 이식된 치아의 재식)

  • Hee-Jin Kim
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.1
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    • pp.52-60
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    • 2023
  • Autotransplantation of third molars with completely formed roots is known to be effective and provide a high long-term success rate. However, in case of severe mobility or unexpectedly extraction is observed during the monitoring period after surgery, it is generally considered as a failure. This case report describes successful replantation of autotransplanted mature third molar into surgically created molar socket. 1 year follow up of transplanted tooth showed clinically normal periodontal pocket depth and tooth mobility. Root resorption or bone loss were not observed. Provided that there is no apparent sign of inflammation, re-insertion into socket is a viable alternative to immediate determination of extraction.