• Title/Summary/Keyword: 치과 보철물

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Periimplant bone change after alveolar ridge preservation: radiographic retrospective study (발치와 치조제 보존술 후 식립한 임플란트 주위 골 변화: 후향적 방사선학적 분석)

  • Shim, Da-Eun;Pang, Eun-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.281-290
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    • 2021
  • Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

The study on the shear bond strength of resin and porcelain to Titanium (티타늄에 대한 레진과 도재의 결합 강도에 관한 연구)

  • Park, Ji-Man;Kim, Yeong-Soon;Jun, Sul-Gi;Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.1
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    • pp.46-52
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    • 2009
  • Statement of problem: Recently, titanium has become popular as superstructure material in implant dentistry because titanium superstructure can be easily milled by means of computer-aided design and manufacture (CAD/CAM) technique. But retention form such as nail head or bead cannot be cut as a result of technical limitation of CAD/CAM milling and bond strength between titanium and porcelain is not as strong as that of conventional gold or metal alloy. Purpose: The objective of this study was to evaluate the shear bond strength of three different materials: heat curing resin, composite resin, porcelain which were bonded to grade II commercially pure Titanium (CP-Ti). Material and methods: Thirty seven CP-Ti discs with 9 mm diameter, 10 mm height were divided into three groups and were bonded with heat curing resin (Lucitone 199), indirect composite resin (Sinfony), and porcelain (Triceram) which were mounted in a former with 7 mm diameter and 1 mm height. Samples were thermocycled for 1000 cycles at between $5-55^{\circ}C$. Shear bond strength (MPa) was measured with Instron Universal Testing Machine with cross head speed of 1 mm/min. The failure pattern was observed at the fractured surface and divided into adhesive, cohesive, and combination failure. The data were analyzed by one-way ANOVA and Scheffe's multiple range test (${\alpha}=0.05$). Results: Lucitone 199 ($17.82{\pm}5.13\;MPa$) showed the highest shear bond strength, followed by Triceram ($12.97{\pm}2.11\;MPa$), and Sinfony ($6.00{\pm}1.31\;MPa$). Most of the failure patterns in Lucitone 199 and Sinfony group were adhesive failure, whereas those in Triceram group were combination failure. Conclusion: Heat curing resin formed the strongest bond to titanium which is used as a CAD/CAM milling block. But the bond strength is still low compared with the bond utilizing mechanical interlocking and there are many adhesive failures which suggest that more studies to enhance bond strength are needed.

A study on the Shift of Burden of Proof in Medical Malpractice - Ruling of Jeonju Appellate Court 2017Na9346 - (의료과오소송에서의 증명책임에 대한 소고 -전주지방법원 2017. 7. 21. 선고 2017나9346판결-)

  • Lee, Soo-Kyoung;Yoon, Seok-Chan
    • 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."

Comparison of the retentive characteristics of two additional attachment used with an implant bar attachment (임플란트 bar 어태치먼트에 사용하는 두 가지 부가적인 유지장 치의 유지력 특성 비교)

  • Choi, Jae-Won;Chae, Sung-Ki;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.173-180
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    • 2021
  • Purpose: The purpose of this study was to evaluate the retentive characteristics of the additional attachments used with implant bar attachment under repeated insertion/removal cycles. Materials and methods: The newly developed attachment and the commercially available attachment were investigated: ADD-Lock (AL), Locator blue (LB). Two fixtures were placed parallel to each other on the custom lower mounting, and patrix of each attachment was fixed to the fixture. Also, the matrix of each attachment was placed on the opposing upper mounting. A universal testing machine was used to measure the retentive force during initial, 100, 250, 500, 1000, 2000, and 2500 repeated insertion/removal cycles. Wear and deformation of the attachment s were observed by scanning electron microscopy (SEM). Mann-Whitney U test (α=.05) and wilcoxon signed-rank test (α=.05) were performed to compare retentive force between each group and before and after 2500 repeated insertion/removal cycles. Results: In terms of initial retentive force and retentive force after 2500 repeated insertion/removal cycles, the AL group (15.24 ± 1.46 N and 9.74 ± 1.16 N) showed significantly smaller values than the LB group (43.53 ± 12.39 N and 22.99 ± 4.77 N) (P<.05). Also, in the loss of retentive force, the AL group (5.50 ± 1.08 N, 36.08%) showed a smaller value than the LB group (20.54 ± 11.89 N, 47.19%) (P<.05). Based on SEM analysis, The AL group showed noticeable wear and deformation in the patrix and the LB group in the matrix. Conclusion: Locator showed a higher initial retentive force than newly developed attachment, while the loss of retentive force was also higher. Both additional attachments are considered to have sufficient retentive force after repeated insertion/removal cycles.

The marginal fidelity of $Procera^{(R)}$ AllCeram alumina copings and crowns of patients ($Procera^{(R)}$ AllCeram 을 이용한 도재관의 임상적 변연적합도에 관한 연구)

  • Song, Young-Gyun;Cho, In-Ho;Lee, Jong-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.470-478
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    • 2008
  • Statement of problem: Use of all-ceramic prostheses fabricated with CAD/CAM systems is increasing in the dentistry. Marginal fidelity in production of all-ceramic restoration has important clinical implications and is a key consideration issue in CAD/CAM production as well. Purpose: The objective of this study was to analyse marginal fidelities of $Procera^{(R)}$ Allceram Crown. Material and methods: On 56 patients treated with $Procera^{(R)}$ system Allceram Crown at Dankook Dental Hospital, marginal discrepancies of 101 abutments were measured by stereomicroscope at coping and final restoration stages. Paired t-test and one-way analysis of variance on marginal discrepancy data were conducted to determine the presence of significant differences between measurement and measuring point stages. Results: Marginal discrepancies of final restoration ($45.82{\pm}30.84\;{\mu}m$) were lower than alumina coping ($53.84{\pm}38.83\;{\mu}m$). Furthermore, the differences were found to be statistically significant at 95% confidence level. Anterior marginal discrepancies were lower than posterior marginal discrepancies, but they were not statistically significant. Lingual marginal discrepancies were higher than other measurement sites, and the differences were found to be statistically significant at 95% confidence level. Conclusion: Within the conditions of this study, marginal fidelities of $Procera^{(R)}$ Allceram Crown were acceptable, and after porcelain build-up, marginal fitness improved over alumina coping. More careful scanning is needed for better results.

Influence of implant misplacement on the success of the final prosthesis: Subjective evaluation by a prosthodontist of dental implants placed by an oral and maxillofacial surgeon (임프란트 식립오류가 최종 보철물의 성공에 미치는 영향: 구강악안면외과의사에 의해 식립된 치과임프란트에 대한 보철의사의 주관적 평가)

  • Kim, Young-Kyun;Hwang, Jung-Won;Lee, Hyo-Jung;Yeo, In-Sung;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.437-441
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    • 2009
  • Purpose: In many cases, the erroneous placement of a dental implant brings about undesirable results. Here, the effect of dental implant placement on the success of the final prosthesis was evaluated from the point of view of the prosthodontist. Materials and Methods: All surgical operations were performed by the same oral surgeon with the same surgical protocol and all prosthodontic procedures were performed by the same prosthodontist. The problems faced by the prosthodontist, their causes, and their effect on prosthesis success were identified. The success of the final prostheses was evaluated by the same prosthodontist. Results: Only 53% (238 implants in 105 patients) of dental implants were not associated with prosthodontic problems. Multiple implant placement (more than three implants) was associated more frequently with prosthodontic problems. Conclusions: The data indicate that the satisfactory construction of a prosthesis is highly dependent on the placement of the dental implant in the best possible position. It is strongly recommended that the oral surgeon and the prosthodontist engage in pre-operative discussions to establish a top-down treatment plan, as this will improve implant placement and ultimately the success of the prosthesis.

Evaluation of Marginal and Internal Gap of Temporary Prosthesis Fabricated by 3D Printing Method According to Rinsing Method and Rinsing Time (세척 방법 및 세척 시간에 따른 3D 프린팅 방식으로 제작된 임시 보철물의 변연 및 내면 적합도 평가)

  • Ji-Hyeon Bae;Jae-Won Choi
    • Journal of the Korean Society of Industry Convergence
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    • v.26 no.4_2
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    • pp.561-570
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    • 2023
  • This study was to evaluate the effect of different rinsing times and methods on the accuracy of temporary prostheses fabricated by 3D printing method. Sixty temporary prostheses were fabricated with LCD types of 3D printer(Halot-Sky, Creality, Shenzhen, China) and divided into six groups (n = 10) based on rinsing times and methods. All specimens were rinsed with 99% isopropanol alcohol for 5 and 10 min using three methods-hand washed, ultrasonic cleaning, and automated washing. All specimens were polymerized for 3 minutes under the same conditions. The marginal and internal gaps of specimens were examined using a replica technique. The light-body silicone thickness was measured at 6 reference points(Absolute marginal discrepancy, Marginal, Chamfer, Axial, Angle, and Occlusal gap). All measurements were performed by a stereomicroscope. Reference point images were taken at 100× magnification and then measured using an image analysis program. Statistical analysis was performed using Two-way ANOVA, One-way ANOVA, and the Kruskal-Wallis test (p = .05). The marginal and internal gaps were statistically different according to the rinsing methods and rinsing times(p < .001). In the rinsing time, the temporary prosthesis rinsed for 5 minutes group showed higher accuracy than 10 minutes group. In the rinsing method, the hand washing group showed higher accuracy than the automated washing group.

Full mouth rehabilitation in a severe worn dentition with vertical dimension gaining: A case report (마모가 심한 환자에서 수직 고경 증가를 동반하여 수복한 증례)

  • Kim, Ji-Sun;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.132-139
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    • 2016
  • The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.

Reestablishing the occlusal plane in full mouth rehabilitation patient, using Shilla system (전악수복환자에서 Shilla system을 이용한 교합평면 재구성 증례)

  • Yang, Min-Soo;Vang, Mong-Sook;Park, Sang-Won;Lim, Hyun-Phil;Yun, Kwi-Dug;Yang, Hong-So
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.33-38
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    • 2013
  • Occlusal plane is a sagittal expression of dental arch form, and it composes the shape of occlusion, which is one of the most important elements of Maxillo-oral system. In this case, vertical, horizontal coordinates of bionic-median-sagittal plane was produced in articulator, and to achieve relation of left and right position of upper, lower teeth and deficits in alveola, Shilla system was used to reconstruct occlusal plane. In this case, a 41 year-old male patient visited for fracture of 10 unit metal-ceramic fixed partial denture of upper anterior teeth and for overall treatment. Clinical, radiographical, model examination was held, full mouth rehabilitation was achieved by placing dental implant. Maxillo-oral relation was recorded using Gothic arch Tracer complex and were mounted. And for the next step, we estimated original occlusal plane using Shilla system. After analysis we produced diagnosis wax pattern. On the basis of this, radiography stent was manufactured and dental implant was placed, and temporary prosthesis was made by using diagnosis wax pattern. Cross mounting and anterior guiding table were performed in order to reproduce temporary restoration morphology and bite pattern, followed by final restoration made of all ceramic crown with zirconia coping. As stated above, appropriately esthetic and functional results can be seen in using Shilla system in diagnosis and treatment procedure of full mouth rehabilitation patient.

Effect of various casting alloys and abutment composition on the marginal accuracy of bar-type retainer (합금의 종류와 지대주 성분이 바형 유지 장치의 변연 적합도에 미치는 영향)

  • Lee, Yun-Hui;Song, Young-Gyun;Lee, Joon-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.2
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    • pp.85-91
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    • 2012
  • Purpose: The object of this study was to determine if the low-priced alloy and metal UCLA abutment could be available for manufacturing bar-retained framework of implant prosthesis. Materials and methods: Bar structure was classified into 4 groups, The specimen of group 1 and 2 were based on casting high noble metal alloys and noble metal alloys with gold UCLA abutment. The specimen of group 3 and 4 were based on casting noble metal alloys and base metal alloys with metal UCLA abutment. Cast bar structure was installed in an acrylic resin model and only the screw on the hexed abutment side was tightened to 20 Ncm. On the opposite side, vertical discrepancy was measured with stereo microscope from front, back, and lateral side of the implant-abutment interface. One-way ANOVA was performed to analyze the marginal fit discrepancy. Results: One-way ANOVA test showed significant differences among all groups ($P$<.05) except for Group 1 and 3. Among them, difference between Group 1 and 2 was noticeable. Measured vertical discrepancies were all below $70{\mu}m$ except to Group 2. Conclusion: Base metal alloy and metal UCLA abutment could be used as an alternative to high-priced gold alloy for implant bar-retained framework.