• Journal of the Korean Academy of Esthetic Dentistry
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• v.27 no.1
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• pp.41-50
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• 2018

Guided implant surgery is useful in anterior implant case in terms of fixture installation and temporary crown delivery. For the aesthetic prosthetics in anterior implant, the position of the implant fixture is crucial. Guided surgery is the top-down procedure and we designed prosthetics first and then determine the position of the fixture. Guided surgery can reduce the stress of dentist with difficult anterior implant case.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.27 no.2
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• pp.97-104
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• 2018

Mandibular anterior region has high implant survival rates and better accessibility compared with any other region. Even if there are possibilities for perforation on lingual cortical bone due to improper drilling and bleeding caused by lingual artery damage, mandibular anterior region is a safe region because less amount of major anatomical structures exist compared with other regions. However, because of narrow bucco-lingual width of alveolar ridge, it is challengeable to obtain esthetic implant prosthesis. Although patients are less sensitive subjectively, mandibular anterior region is as difficult as maxillary anterior region in that implant placement location plays a critical role on the prognosis of implant prosthesis. One-piece implant is a very useful option for mandibular anterior region. Considering the narrow roots and thin alveolar bone of mandible, it is clinically difficult for implant diameter to be greater than 3mm In this case, we could approach the esthetic restoration in mandibular anterior region with one-piece implant and immediate loading.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.289-295
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• 2020

Improving implant esthetics is very difficult, especially in cases where unaesthetic problems are related to implants in the maxillary anterior dentition. A 69-year old male patient was referred by a prosthodontist for periodic pus discharge and an unaesthetic implant prosthesis (maxillary right lateral incisor). The implant was placed too deeply and showed soft tissue volume deficiency and a long clinical crown. After a clinical and radiographic examination, implant submergence and alveolar ridge augmentation were performed to enhance the aesthetics instead of an explantation. The treatment plan was as follows: extraction the adjacent teeth with tooth mobility, secondary caries, and poor prognosis; placement an additional dental implant with hard and soft tissue grafting; fabrication a fixed bridge using implant abutments. A fixed esthetic prosthesis using implants was fabricated, and the patient was satisfied with the prosthesis. A ridge augmentation with implant submergence may be an alternative for solving the problems of unaesthetic implant restorations in the esthetic zone.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.1
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• pp.24-32
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• 2021

Dental implant have been in use for a long time to restore at missing tooth. But, To place dental implant at good position very is difficult. Improperly positioned dental implants make some problems to have a good function of dental implant. so, To place dental implant at accurate position is the most important step throughout the whole process. Digital guided system of dental implant is very useful to have a accurate position of dental implant and it makes upper restoration more esthetic and funcional.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.18 no.1
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• pp.27-32
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• 2009

오늘날 단일치 임플란트의 식립은 현재 시행되고 있는 가장 일반적인 임플란트 술식 중 하나이며, 상악 전치부는 이중 가장 흔하게 시행되는 식립 부위 중하나이다. 그럼에도 불구하고 상악 전치부 단일 상실치에 대한 치료 계획은 구강 내 다른 어떤 부위보다 복잡하며 고도로 심미성을 요구하는 부위로서 아무리 경험이 많고 기술이 뛰어난 치과의사라 할지라도 시술할 때마다 큰 도전으로 여겨지는 경우가 대부분일 것이다. 상악 전치부에서 임플란트 보철의 심미적 성공을 이루기 위해서는 모든 구성 요소 하나하나에서 심미적 결과를 이룩하여야 하고 이 결과들이 완벽하게 조화를 이루게 하여야 하며 이는 결코 쉬운 일이 아닐 것이다. 시술 시 교과서의 그림처럼, 모형에 식립해 본 것처럼 쉽게 되지 않는 것은 물론 구강 내 환경이 모형과 다를 리 만무한 것이 당연한 첫 번째 이유이며 뿐만 아니라 환자 대부분의 경우 모형처럼 완벽한 경 연조직이 갖추어진 상태에서 치아만 상실된 경우는 거의 찾아볼 수 없기 때문인 이유도 크다. 즉, 원하는 위치에 식립을 하고 장기간의 심미적 유지를 위해서는 경 연조직에 대한 처치가 필수적인 경우가 대부분이라는 이야기이다. 이를 간과하고 식립한 경우 추후 심각한 bone의 resorption, 그에 따르는 gingiva의 끔찍한 recession, 용납할 수 없는 비심미적 보철물의 제작은 불을 보듯 뻔한 결과가 될 것이다. 따라서 상악 전치부 식립 치료계획 시 치과의사는 성공적 결과에 영향을 미칠 수 있는 모든 요소에 촉각을 곤두세우고 이들의 완벽한 처치에 최선을 다 해야할 것이다.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.221-225
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• 2013

Proper management of provisional prosthesis is key to success in prosthodontics. Provisional restoration on maxillary anterior missing area frequently come across a incident of falling off especially in patients with long span pontics and oval arch shape. This is because maxillary anterior teeth are more exposed to horizontal force than the posterior teeth and additional anterior cantilever effect will negatively affect to the retention of provisional prosthesis. Beside that maxillary anterior provisional prosthesis should provide proper incisal guidance during the mandibular functional movements. However occlusal contacts on the prosthesis in maximum intercuspal position are located on opposite side of fulcrum line of prosthesis which will cause removing force against the provisional prosthesis. This case report present that provisional implant prevent pre-described harmful effect on maxillary anterior fixed provisional prosthesis and provide comfort and satisfactory result during post-extraction healing period.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.103-109
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• 2016

Purpose: This study is to evaluate the clinical significance of implantation with simultaneous bone graft by comparing the marginal bone loss around maxillary anterior implants with or without bone graft. Materials and methods: Patients treated with implant-retained restorations on maxillary anterior region at Implant Center, Dental Hospital, Wonkwang University between June 2011 and May 2014 were included in this study. Date of implant placement, implant diameter, implant length, implant-abutment connection type and whether the bone graft was done were investigated. The patient's periapical radiographs taken immediately after implantation and at the most recent visit were compared. Marginal bone loss was measured using Emago advanced v5.6 program (Oral diagnostic systems, Amsterdam, Netherlands). Statistical analysis was done in independent t-test by using SPSS 22.0 program. Results: As a result of observing on 83 implants (without bone graft: 44, with bone graft: 39) of 52 patients for 6 - 45 months (average: 18.4 months), implants without bone graft showed $1.42{\pm}0.42mm$, implants with bone graft showed $1.28{\pm}0.45mm$ of marginal bone loss. Conclusion: In limitations of this study, implants with simultaneous bone graft had significantly less marginal bone loss than implants without bone graft.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.3
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• pp.255-265
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• 2009

Recently many studies have been published on application of immediate loaded implants. However, the immediate loading protocol has not been well documented. The purpose of the present study was to evaluate the stress distribution between bone-implant interfaces and the effect of implant length in the anterior maxilla using 3 dimensional finite element analyses. The diameter 4.0 mm threaded type implants with different length(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) were used in this study. The bone quality of anterior maxillary bone block was assumed to D3 bone. Bone-implant interfaces of immediately loaded implant were constructed using a contact element for simulating the non osseointegration status. For simplification of all the processing procedures, all of the material assumed to be homogenous, isotropic, and linearly elastic. The 178 N of static force was applied on the middle of the palatoincisal line angle of the abutment with $120^{\circ}$ angle to the long axis of abutment. Maximum von Mises stress were concentrated on the labial cortical bone of the implant neck area, especially at the cortical-cancellous bone interfaces. Compared the different length, highest peak stress value was observed at the 8.5 mm implants and the results indicated a tendency towards favorable stress distribution on the bone, when the length was increased. Presence of cortical bone was very important to immediate loading, and it appears that implants of a length more than 13 mm are preferable for immediate loading at the anterior maxilla.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.4
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• pp.403-409
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• 2017

In the case of an extraction in the maxillary anterior region, immediate placement of implant-supported fixed prosthesis can be considered as a treatment option. Fewer surgical operations, reduced treatment time, and optimal availability of existing bone are obvious advantages of the method; however, when applied in the continuous maxillary anterior region, inter-implant distance must be carefully considered, as well as accurate diagnosis and treatment planning for predictable outcome. In this case report, immediate placement of two implants in the continuous maxillary anterior along with bone graft following the extraction of root rests, and the restoration of provisional and implant-supported fixed prosthesis on a 63-year-old patient had resulted in both esthetically and functionally satisfactory clinical outcomes.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.24 no.1
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• pp.39-48
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• 2015

The critical factors affecting the esthetics of anterior implants can be summarized as following: 1) Correct positioning of implant fixture, 2) Enough amount of alveolar bone, 3) Optimum volume of soft tissue. The position of implant is probably the most important factor in obtaining esthetic treatment outcome. The 3-dimensional orientation of implant is determined by the position on the alveolar ridge and its direction. Clinicians often try to mimic natural teeth when fabricating restorations. During the course of esthetic diagnosis and treatment, however, one should not forget to consider the correlation between facial pattern, lips, gingiva, alveolar ridge, as well as remaining dentition. Since anterior region is biologically unfavorable when compared with posterior region, one minor discrepancy in positioning of implant can cause esthetically undesirable treatment outcome. If one understands the biological and prosthetic meaning of implant' s 3-dimensional position, he or she can achieve superior esthetic outcome in anterior region.