• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.3
• /
• pp.133-145
• /
• 2023

Class III malocclusion with mandibular protrusion can be divided into skeletal and pseudo malocclusion due to tooth displacement. For skeletal malocclusion, favorable treatment results can be obtained by establishing an appropriate vertical and horizontal intermaxillary relationship in order to secure a restoration space and obtain aesthetic and functional results. In this case, complete mouth rehabilitation was performed using an implant and a fixed prosthesis in a patient with mandibular protrusion and anterior teeth wear and reduced occlusal vertical dimension. After cast analysis and digital diagnosis, a provisional restoration with increased vertical dimension was fabricated to secure posterior support and evaluate stable centric occlusion. With the definitive prosthesis reflecting the provisional restoration, favorable function and aesthetics were obtained.

• The Journal of Korean Academy of Prosthodontics
• /
• v.62 no.1
• /
• pp.64-71
• /
• 2024

The most critical aspect of full-arch prosthodontic treatment is evaluating whether the patient's vertical occlusal dimension is appropriate, and if necessary, restoring it through increasing vertical dimension. If the vertical occlusal dimension is too low, it can lead to reduced chewing efficiency, as well as not only aesthetic concerns but also potential issues like hyperactivity of muscles and posterior displacement of the mandible. This report is about the patient dissatisfied with pronunciation and aesthetics due to an inappropriate vertical occlusal dimension resulting from prior prosthetic interventions, underwent full-arch prosthodontic restoration treatment. Through the utilization of digital diagnostic apparatus, a comprehensive evaluation was undertaken for patient's vertical occlusal dimension, occlusal plane orientation, and the condition of prosthetic restorations. Through 3D facial scanning, the facial landmarks were discerned, and subsequently, the new occlusal plane was established. This provided the foundation for a digitally guided diagnostic wax-up. An elevation of 5 mm from the incisor was determined. Comprehensive dental rehabilitation was then executed for all remaining teeth, excluding the maxillary four incisors. The treatment protocol followed a systematic approach by initially creating implant-supported restorations on both sides of the dental arch to establish a stable occlusal contact. Subsequently, prosthetic restorations for the natural dentition were generated. Diagnostic and treatment planning were established through the utilization of facial scanning. This subsequently led to a reduction in treatment complexity and an expedited treatment timeline.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.267-275
• /
• 2023

To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors. Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.

• The korean journal of orthodontics
• /
• v.29 no.6 s.77
• /
• pp.673-688
• /
• 1999

This study was conducted in order to analyze the mechanical characteristics of multiloop edgewise archwire (MEAW). The purposes were 1) to compare load deflection rate (LDR) of MEAW with that of various other arch wires in the individual interbracket span, 2) to compare the wire stiffness in the interbracket span with that in the multi-L-loop region (the span from distal border of the bracket of the lateral incisor to the mesial border of the buccal tube of the second molar), and 3) to verify the experimental results with theoretically derived formula. The single L-loops of five different horizontal lengths and multi-L-loops for the upper and lower arches were made out of .$016\times.022$ permachrome stainless steel wire. Straight segment of plain stainless steel, TMA and NiTi wire of the same dimension were prepared. The LDR was measured using Instron model 4466 with the load cell of 50N capacity at cross head speed of 1.0mm/min, and maximum deflection of 1.0mm. Five specimens were tested under each experimental condition. The wire stiffness number for each interbracket region and multi-L-loop region was calculated from the LDR and the interbracket spans. By dividing the theoretical model of multi-L-loop into 35 linear segments, the energy stored in each segment was obtained. Then the LDR and wire stiffness of single L-loop and multi-L-loop were calculated and compared. The findings were as follows : 1) The average LDR of MEAW in the individual interbracket region was 1/1.53 of that of the NiTi,1/2.47 of TMA and 1/5.16 of the plain stainless steel wire. 2) The wire stiffness of MEAW in the multi-L-loop region was 1.53 times larger than that in the interbracket region, and the LDR was almost twice as large as that of NiTi in that region. 3) According to the theoretically derived equation, the wire stiffness of the single L-loop was lower than that of multi-L-loop. The results of this study suggest that MEAW has the unique mechanical Property which could allow individual tooth movement and transmit elastic force effectively through the entire arch wire.

• The Journal of Korean Academy of Prosthodontics
• /
• v.46 no.4
• /
• pp.381-395
• /
• 2008

Purpoose: For decades dental implants have been used widely in the field of prosthetic dentistry. However there is confusion when establishing treatment plans in cases where some teeth are remained but an insufficient number of implants can be used due to limited anatomical status and ecomomical problems. Many clinicians have tried to connect natural teeth and implants, and it still has controversy. But, there have been few studies on mechanical analysis of connecting natural teeth and implants with konus telescopic removable partial dentures. The purpose of this study was to analyze the stress distribution of prosthesis, abutment and alveolar bone when teeth and implants were connected with the konus telescopic denture, by means of 3-dimensional finite element analysis. Material and methods: The assumption of this study was that there were 2 mandibular canine (11 mm in length, 4 mm in diameter) and 2 implants(10 mm in length, 4 mm in diameter) which are located in the second premolar region. The mandible, teeth, implants, abutments, and connectors are modeled, and analyzed with the commercial software, ANSYS Version 8.1(Swanson, Inc., USA). The control group used implants instead of natural teeth. 21038 elements, 23544 nodes were used in experimental group and 107595 elements, 21963 nodes were used in control group, Stress distribution was evaluated under 150 N vertical load on 3 experimental conditions - between teeth and implants (Load case 1), posterior to implants (Load case 2), between natural teeth (Load case 3). Results: 1. In all load cases, higher von mises stress value was observed in the experimental group. 2. Maximum von miss stress observed in all load cases and all locations were as follows ; a. 929.44 Mpa in the experimental group, 640.044 Mpa in the control group in outer crown and connector - The experimental group showed 1.45 times high value compared with the control group. b. 145,051 Mpa in the experimental group, 142.338 Mpa in the control group in abutment - The experimental group showed 1.02times high value compared with the control group. c. 32.489 Mpa in the experimental group, 25.765 Mpa in the control group in alveolar bone - The experimental group showed 1.26times higher value compared with the control group. 3. All maximum von mises stress was observed in load case 2, and maxim von mises stress in alveolar bone was 32.489 Mpa at which implant failure cannot occur. 4. If maximum von mises stress is compared between two groups, the value of the experimental group is 1.02 times higher than the control group in abutment, 1.26 times higher than the control group in alveolar bone. Conclusion: If natural teeth and implants are connected with the konus telescopic denture, maximum stress will be similar in abutment, 1.26 times higher in alveolar bone than the control group. With this result, there may be possible to make to avoid konus telescopic dentures where natural teeth and implants exist together.

• The korean journal of orthodontics
• /
• v.37 no.2 s.121
• /
• pp.98-113
• /
• 2007

Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini Implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.