• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.258-263
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• 2017

Purpose: In this study, the retrospective radiographic study is executed to evaluate amount of bone loss of various conditions in patients using customized abutment for 4 years of follow-up. Materials and methods: The subjects of this study were implant fixed dental prosthesis using CAD/CAM customized abutments. CAD/CAM customized abutment and fixed dental prosthesis were manufactured by the Prosthodontics Department of Chosun University Dental Hospital from August 1, 2011 to July 31, 2012. Radiological assessments were performed on the patients who were treated by the fixed prosthodontics. After each treatment, a retrospective study was performed for a total of 4 years at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years. Results: As a result of the study, the customized abutment using CAD/CAM showed less bone loss than the results of existing research. There was no statistically significant differences at alveolar bone loss between splinting group and non-splinting group (respectively 0.27 mm, 0.5 mm). Also, there were statistically significant differences at alveolar bone loss in mx. anterior, mx. posterior, mn. anterior and mn. posterior part (respectively 1.37 mm, 0.39 mm, 0.00 mm, 0.30 mm). Conclusion: The customized abutment using CAD/CAM showed less bone loss than the results of existing research, there were statistically significant differences at alveolar bone loss in implant positions.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.253-268
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• 2012

Full-mouth reconstruction of a patient using dental implants is a challenge if there is vertical and horizontal bone resorption, since this includes the gingival area and restricts the position of the implants. however, hard- and soft-tissue grafting may allow the implants to be placed into the desired position. Although it is possible to regenerate lost tissues, an alternative is to use fixed detachable prostheses that restore the function and the esthetics of the gingiva and teeth. Various material combinations including metal/acrylic, metal/ceramic, and zirconia/ceramic have been used for constructing this type of restoration. Other problems include wear, separation or fracture of the resin teeth from the metal/acrylic prosthesis, chipping or fracture of porcelain from the metal/ceramic or zirconia/ceramic prosthesis, and fracture of the framework in some free-end prostheses. With virtually unbreakable, chip-proof, life-like nature, monolithic zirconia frameworks can prospectively replace other framework materials. This clinical report describes the restoration of a patient with complete fixed detachable maxillary and mandibular prostheses made of monolithic zirconia with dental implants. The occluding surfaces were made of monolithic zirconia, to decrease the risk of chipping or fracture. The prostheses were esthetically pleasing, and no clinical complications have been reported after two years.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.337-346
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• 2013

It is necessary to consider the median lingual foramen carefully to prevent the bleeding due to the damage of the sublingual artery for implant surgery. This study is to evaluate the frequency, location, diameter and the number of the Mandibular median lingual foramen regarding gender and age in the CBCT. Sixty two images of cone beam computed tomography (CBCT) whose visited the Chonnam National University Dental hospital from Sept. 2010 to Apr. 2011 were evaluated. Frequency, number, location and the diameter of Mandibular median lingual foramen shown in the CBCT image were evaluated. Sixty two patients (100%) had at least one median lingual foramen and fifty six patients (90.32%) had multiple foramens. Forty patients (66.13%) showed the median lingual foramen on the location between Mn. central incisors. The mean vertical position of the genial spine and the median lingual foramen was 24.21 mm and 14.52 mm, respectively. And the relative mean vertical dimension of median lingual foramen was 0.45. The mean diameter of the foramen was 0.93 mm. CBCT demonstrated the frequency, location, diameter and the number of median lingual foramen. It is necessary to take CBCT before implant placement to prevent the bleeding.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.314-321
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• 2016

Conventional removable partial dentures (RPDs) with distal extensions are associated with some problems, including lack of stability that calls for frequent relining, and cantilever actions of claps that can produce excessive loading to abutment teeth, and the need for unesthetic retentive arm clasps. Therefore, IARPDs (Implant-assisted RPD) that use implants to support or retain RPDs has been reported to improve stability, esthetics and masticatory performance of RPDs. Also, an IARPD that has zirconia occlusal table can prevent the incongruity of occlusal plane and the extrusion of antagonistic tooth. In this case of partially edentulous patient with crossed occlusion, each edentulous area was restored with implant fixed prosthesis and implant retained partial denture to suit each situation. Through the procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.267-275
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• 2011

This prospective study was designed to compare clinical outcomes of immediately loaded implant with delayed loaded implant in partially posterior edentulous patients. For test group, 42 GS III (Osstem, Korea) implants in 17 patients were loaded within 48 hours after the placement. Control group was 27 implants in 15 patients loaded at $2.6{\pm}1.7months$ from the placement surgery. Before loading, primary stability was evaluated by ISQ value. Clinical symptoms, mobility, soft tissue state was evaluated at baseline, 3 months, 6 months and 12 months of loading. Marginal bone level change was also measured with periapical radiographs. Mann-Whitney test (${\alpha}$=0.05) and repeated measured ANOVA (${\alpha}$=0.05) was used for marginal bone level change between two groups. At the baseline, mean ISQ value of test group and control group was $80.3{\pm}7.1$ and $69{\pm}17$ respectively. Test group showed 95.23% of success rate and 100% of control group was successful. At 3 and 6months of loading, significantly more bone resorption was observed in test group than in control group (p<0.05). However, there was no significant difference in the bone level change at 12months of loading between two groups (p>0.05). Marginal bone level change showed no significant difference with gender and location (p>0.05). Within the limitation of this study, when primary stability was obtained, immediate loading of GS III implant at posterior region could be predictable treatment option.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.239-245
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• 2016

Purpose: The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition. Materials and Methods: A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed. Results: The average of 3.4 implant-supported prostheses were used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification. Conclusion: All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPD for long-term result.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.156-163
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• 2017

People with class I intellectual disability need lifelong assistance and protection from their surroundings due to impaired adaptive functioning. They have poor oral health and show higher prevalence of dental caries, periapical inflammation and tooth loss that require proper prosthetic restoration. Because removable prostheses for intellectually disabled patients often lack stability, retention, and maintenance, fixed prostheses are essential and the only available option is dental implants. In this case, a 45 year-old male patient with class I intellectual disability had poor oral hygiene with most of his teeth missing and visited the clinic to recover his masticatory function. Due to such systemic conditions, the definitive restoration of choice was the implant-supported fixed dental prosthesis made of biocompatible and highly strong monolithic zirconia. In consequence of the treatment process, the patient was able to improve his oral environment aesthetically and functionally.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.317-322
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• 2018

The tongue, especially its lateral part, is the most common site of oral tumors. Patients who undergo glossectomy for the treatment of tongue cancer may experience difficulty in proper functioning for pronunciation, chewing, swallowing, and oral hygiene maintenance; therefore, a palatal augmentation prosthesis can be used to restore function of the tongue. In this case, an implant overdenture was used in a patient who had residual ridge resorption and obliteration of alveololingual sulcus after undergoing glossectomy for tongue cancer treatment. In addition, a palatal augmentation prosthesis with a metal framework, support, and retention part was fabricated. The palatal vault was reduced, so that even with limited tongue movement, adequate tongue-palate contact could be achieved. After placement of the definitive prostheses, the patient showed improvement in the functions of chewing, swallowing, and pronunciation.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.466-477
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• 2018

Orthopaedics is an area where 3-dimensional (3D) printing technology is most likely to be utilized because it has been used to treat a range of diseases of the whole body. For arthritis, spinal diseases, trauma, deformities, and tumors, 3D printing can be used in the form of anatomical models, surgical guides, metal implants, bio-ceramic body reconstruction, and orthosis. In particular, in orthopaedic oncology, patients have a wide variety of tumor locations, but limited options for the limb salvage surgery have resulted in many complications. Currently, 3D printing personalized implants can be fabricated easily in a short time, and it is anticipated that all bone tumors in various surgical sites will be reconstructed properly. An improvement of 3D printing technology in the healthcare field requires close cooperation with many professionals in the design, printing, and validation processes. The government, which has determined that it can promote the development of 3D printing-related industries in other fields by leading the use of 3D printing in the medical field, is also actively supporting with an emphasis on promotion rather than regulation. In this review, the experience of using 3D printing technology for bone tumor surgery was shared, expecting orthopaedic surgeons to lead 3D printing in the medical field.

• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.49-79
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• 2021

Due to defendant's wrongful act by implant surgery, plaintiff has been suffered serious damages to his face and teeth, and pain caused by establishing implanted teeth. Jeonju Appellate Court sentenced to pay future medical expenses and alimony to the plaintiff in compensation for breach of duty or torts. The ruling is designed to relieve the burden of proof because it is extremely difficult for non-experts to determine whether dentists violated their 'duty of care' or whether there was a causal relationship between damages to medial treatment. It was judged that if symptoms that contributed to the patient's significant outcome occurred during or after surgery, such symptoms could be presumed to have been caused by medical negligence if indirect facts were proven to be other than medical negligence. Originally, the shifting of burden of proof in Germany, has already been developed in medical malpractice case since 1940s. In order to guarantee the patients' right, §630h German Civil Code (BGB) - presumption of negligence in the realization of controllable risk- has been also legislated. BGH (Bundesgerichtshof) has been interested in ensuring that the principle of equality between patients and doctors. So, in this study, we wanted to refer to German precedent cases to analyzing Korean medical malpractice lawsuit. In particular, the decision could be significant in that it approaches closer to allows the shifting burden of proof in drastically growing dental malpractice cases. This is clearly confirmed in the judgment of the dentist's "fault" that "if indirect facts about the symptom or occurrence are proven to be cause other than medical negligence, such symptoms can be presumed to be due to medical negligence."