• Title/Summary/Keyword: 치조골 상실

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Full mouth rehabilitation of fully edentulous patient using implant hybrid prosthesis (완전무치악 환자에서 임플란트 하이브리드보철물을 이용한 전악 수복 증례)

  • Park, Sang-Yong;Kim, Yoon-Young;Park, Won-Hee;Lee, Young-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.3
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    • pp.228-233
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    • 2015
  • Loss of teeth may not only imply impaired oral function and loss of alveolar bone but is also often accompanied by reduced self-confidence. This results in a larger problem with the fully edentulous patient. The patient introduced in this study showed multiple missing teeth and mobility of remaining teeth and wanted to have fixed dental prosthesis using implants. Remaining teeth were extracted because of periodontally bad prognosis. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using implant hybrid prosthesis in fully edentulous patient.

Comparison of Radiographic Measurement and Clinical Parameters of Periodontal Condition on Premolars and Molars (소구치 및 대구치의 치주임상지수와 방사선학적 측정과의 상관관계에 대한 연구)

  • Lim, Hyun-Sook;Choi, Seong-Ho;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.161-175
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    • 1998
  • 치주상태의 진단은 일반적으로 치주탐침과 같은 임상적 검사와 보조적으로 방사선 검사를 이용한다. 방사선학적인 검사가 치주조직의 파괴정도와 골 흡수를 진단하는데 유용하지만 실제적인 골 흡수를 정확하게 나타나는데는 한계가 있다고 하였다. 그리고 임상적 측정과 방사선 사진을 비교연구하여 이들간의 관계를 알아보고자 하는 노력이 있었다. 방사선이 임상에서 참고사항으로는 중요하지만 절대적 신뢰를 주는데는 문제가 있는 것으로 생각되어왔다. 방사선학적 측정과 임상지수 측정간의 상관관계에대하여 계속적인 연구를 통해 규명하는 것이 중요하다고 생각되어 저자는 연세대학교 치과 대학병원 치주과를 내원한환자중 연령 및 성별에 관계없이 전신질환이 없는 환자 130명을 대상으로 소구치의 원.근심부, 대구치의 원.중.근심부에서 치주낭의 깊이와 (P.D), 부착상실 (A.L)을 측정하였다. 방사선 사진상의 원.근심부에서 백악 법랑질 경계부에서 치조골능 상부까지의 치조골 수준 (Rx.B.L)을 측정하였고 이개부 부위에서는 이개부의 천정으로부터 나타나는 골 흡수의 방사선 투과상을 측정하였다. 이를 기초로 임상지수와 방사선학적 측정간에 상관관계를 연구하여 다음과 같은 결론을 얻었다. 1. 원·근심부의 P.D와 Rx.B.L을 비교 했을 때 상관관계는 모든 치아에서 높게 나타났다(r=0.897$\sim$r=0.725, p<0.01). 2. 원·근심부의 A.L와 Rx.B.L을 비교 했을 때 상관관계는 모든 치아에서 높게 나타났다 (r=0.915$\sim$r=0.732, p<0.01 ). 3. 대구치 769개가 실험 대상인었다. 상악 대구치중(356개) 40%가 이개부 병소를 나타냈고 (146개), 하악 대구치중(413개) 41%가 이개부 병소를 나타냈다(170개). 4. 대구치의 이개부 병소의 중앙부에서 측정한 P.D와 Rx.B.L을 비교 하였을 때 상관관계는 상악 제1대구치를 제외한 모든 치아에서 높게 나타 났다(r=0.811$\sim$r=0.435, p<0.01). 5. 대구치의 이개부 병소의 중앙부에서 측정한 A.L와 Rx.B.L을 비교 하였을 때 상관관계는 상악 제1대구치를 제외한 모든 치아에서 높게 나타 났다(r=0.906$\sim$r=0.479, p<0.01). 이상의 결과를 종합하여 볼 때 임상지수와 방사선학적 측정을 비교한 바, 이들의 상관관계는 모든 치아에서 밀접하게 나타났다. 따라서 방사선학적 측정은 임상지수와 더불어 치주질환의 진단과 치료계획에 크게 기여할 수 있을 것으로 사료된다.

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THE EFFECTS OF THE PLATELET-DERIVED GROWTH FACTOR-BB ON THE PERIODONTAL TISSUE REGENERATION OF THE FURCATION INVOLVEMENT OF DOGS (혈소판유래성장인자-BB가 성견 치근이개부병변의 조직재생에 미치는 효과)

  • Cho, Moo-Hyun;Park, Kwang-Beom;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.23 no.3
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    • pp.535-563
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    • 1993
  • New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

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DENTAL IMPLANT TREATMENT WITH ILIAC BONE GRAFT VIA TWO-STAGE APPROACH FOR AVULSED ALVEOLAR BONE DEFECTS; CASE REPORT (외상성 치조골 상실 후 장골 이식을 동반한 이회법 임플란트 치료; 증례보고)

  • Choi, Young-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.4
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    • pp.386-390
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    • 2007
  • This is about the case of loss of multiple teeth and alveolar bone caused by trauma, which needed alveolar bone augmentation before implant treatment. Alveolar bone was reconstructed using iliac bone graft, and thereafter first implant surgery was followed by consolidation period of 3 months. Iliac bone resorption was observed at the time of implant placement. And that resorption was more in the horizontal dimension than in the vertical. We conclude that additional treatment planning(e.g. using alveolar distraction osteogenesis or tissue expander) should be considered besides bone graft for vertical alveolar bone augmentation. For both maxilla and mandible, prosthodontic treatment was carried out $4{\sim}5$ months after implant placement. To compensate alveolar bone deficiency, partial hybrid overdenture on maxilla and implant-supported fixed bridge on mandible were fabricated, and the total treatment was finished.

Cases of screw-retained implant prosthesis in the anterior maxilla through multidisciplinary approach, including orthodontic teeth alignment (교정적 치아 재배열을 포함한 다학제적 접근(multidisciplinary approach)을 통한 상악 전치부의 나사 유지형 임플란트 보철 수복 증례)

  • Kim, Hyo-Seon;Lee, Won-Sup;Lee, Su-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.244-250
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    • 2020
  • The labio-palatal location of the implant in the maxillary anterior region is one of the important factors affecting the aesthetics of the implant prosthesis. However, the thin labial bone of maxilla could be absorbed in significant amounts after extraction of the teeth, which makes the implant be placed on the palatal side rather than the ideal location. In fact, in the cases of maxillary central incisor loss, UCLA was used for prosthetic restoration of palatally placed implant. In addition, with multidisciplinary treatment, GBR (Guided Bone Regeneration) was performed for compensating the absorbed alveolar bone and adjacent anterior tooth were aligned. Definitive restoration was performed after confirming aesthetic recovery of the gingiva with sufficient provisional restoration period. There were satisfactory results of functional and esthetic recovery of tooth loss through implant prosthesis.

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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Novel Connective tissue graft technique for Ridge Augmentation in case of Conventional fixed partial denture : Case reports (치조제 결손부 증대를 위한 새로운 결합조직 이식술)

  • Ahn, Myung-Hwan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.22 no.1
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    • pp.47-55
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    • 2013
  • There have been a great number of developments in clinical techniques and dental materials in dentistry to date. Looking at these developments, while it could be seen that functional elements such as mastication were prioritized rather than aesthetic aspect in the past, aesthetic needs of patients have steadily increased over time and accordingly the aesthetic has become considered a priority in the development of dentistry. Although the first to be considered in discussing the aesthetic in clinical dentistry will be the white aesthetic that is the tooth part of prosthesis, the pink aesthetic that refers to the harmony of such prosthesis with gingiva can be an important consideration not to be ignored aesthetically. However, the harmony with the gingiva often cannot be obtained only by the beautiful prosthesis, and in particular, the pontic and implant areas have poor conditions to achieve the gingival (pink) aesthetic due to the absorption of alveolar ridge compared to natural teeth. Among the most important elements of the gingival aesthetic are the gingival level and the interproximal papilla height. It is very difficult to make the gingival aesthetic in the case of insufficient alveolar ridge, and the recovery of ridge volume and contour is necessary in order to overcome this condition. To this end, the most widely used method is the "connective tissue graft". Many techniques of the connective tissue graft have already been introduced for the ridge augmentation, and each technique has different purposes, and advantages and disadvantages. Rather, due to the excessive amount of techniques, there is confusion about selecting the right technique at a certain time. However, the goal is clear. Ways to increase the success rates must be found, and at the same time, a more favorable way to the gingival aesthetic is to be chosen. Thus, in this study, considerations for the gingival aesthetic that makes harmony and the techniques to achieve it are discussed.

RESTORATION OF MISSED MAXILLARY CENTRAL INCISOR USING AUTOTRANSPLANTATION OF MESIODENS : A CASE REPORT (정중과잉치의 자가이식을 통한 상실된 상악 중절치의 수복 : 증례보고)

  • Kim, Hye-Kyoung;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.519-525
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    • 2007
  • Supernumerary tooth is developed from overgrowth of dental laminar and is mainly observed in the maxillary anterior area, named 'mesiodens. Mesiodens cause many problems such as malposition of permanent anterior tooth, diastema, formation of cyst, and eruption to oral or nasal cavity. Extraction, therefore, is generally recommended choice of treatment. This case report describes that the patient is a 9 years and 8 months old boy, whose unilateral maxillary incisor was missing due to trauma, and he had a mesiodens. We practiced autotransplantation of the mesiodens to the missing maxillary central incisor area and then restored with prosthetics, substantially kept out alveolar bony resorption and provided esthetic appearance. Mesiodens was too small to be used as an abutment because its length is totally 14mm, so that poor prognosis was anticipated due to bad crown/root ratio. However, we observed clinically acceptable result during the observation period of 8 months after operation.

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Full mouth rehabilitation on the patient with maxillary anterior diastema and posterior bite collapse with orthodontic treatment (상악 전치부 치간 이개와 구치부 교합지지 상실을 가진 환자에서 교정치료를 동반한 완전 구강회복 증례)

  • Lee, Seon-Ki
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.1
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    • pp.60-68
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    • 2022
  • A patient with severe periodontitis has causative factors that cause pathological tooth movement, the occlusion is disintegrated, and the vicious cycle of worsening periodontitis is repeated. In particular, when pathological tooth movement occurs in the maxillary anterior region, the patient has an aesthetic sense of atrophy, and the quality of life was reduced. Therefore, when orthodontic treatment was added to patients with severe periodontitis, it promotes the formation of new bone, reduces periodontal cysts, and obtains clinical attachment, which leads to favorable results in prosthetic restoration, thereby enabling ideal occlusion, function and aesthetics. Periodontal treatment, orthodontic treatment, natural tooth restoration, and implant prosthesis were planned for patients with pathological tooth movement in the anterior region due to loss of occlusal support in the posterior region. As a result, an ideal restoration space was secured, a stable restoration of occlusal contact was formed, and the maxillary anterior teeth were aesthetically improved.

ORAL FINDINGS AND TREATMENT OF A PATIENT WITH CYCLIC NEUTROPENIA (주기성 호중구 감소증 환자의 구강 내 소견과 치료에 대한 증례 보고)

  • Kang, Eun-Joo;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.133-140
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    • 2013
  • Cyclic neutropenia is a hematologic disorder characterized by a marked decrease in the number of circulating neutrophils occurring at regular intervals and after this period, the level of neutrophils usually recovers to a normal range. The clinical symptoms of cyclic neutropenia include fever, malaise, headaches and oral findings associated with painful soft tissue ulceration where lips, tongue and gingiva are typically involved. A 4 year 1 month old boy was presented to the hospital. His chief complaint was mobility of his teeth and swollen gums. The patient had suffered from cyclic neutropenia. Clinical examination revealed evident decay on all primary teeth except for the mandibular anterior teeth and localized alveolar bone loss around mandibullar right and left first primary molars which have mobility was notable. The patient was diagnosed with multiple dental caries, gingivitis and localized periodontitis associated with cyclic neutropenia and treated based on it. The dental treatment, including regular tooth care and appropriate treatment of dental caries or gingivitis, is essential for patients suffering cyclic neutropenia. Especially, proper care at an early stage is needed for young patients to minimize the unwanted consequences for permanent teeth development.