• Title/Summary/Keyword: Contour Restoration

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An efficient way of communication between dentists and dental technicians to ensure optimum clinical outcome with implant restorations (임플란트 보철물 제작시 치과의사와 기공사가 효과적으로 소통하는 한가지 방법)

  • Kim, Chonghwa
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.29 no.2
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    • pp.66-74
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    • 2020
  • Communication and cooperation between dentists and dental technicians are two essential elements for the fabrication of high quality 'custom' prosthesis. For successful communication and cooperation between the two groups, however, dentists and dental technicians must share common understanding about clinical dentistry. Ironically, it is often noticed that they are not really sharing the same clinical knowledge. Although there is a strong association between 'Emergence Profile' of implant prostheses and periodontal health or esthetics, no definite guideline has ever been provided for ideal emergence profile of implant prosthesis in literature. Problems resulted from inherent differences between implants and natural teeth must be acknowledged and shared between dentists and dental technicians so that they can come up with desirable clinical results with implant prostheses.

Effect of the speed sintering schedule on the marginal and internal gaps of multi-layered zirconia prothesis (급속소결이 다층 지르코니아 치과보철물의 변연 및 내면 적합도에 미치는 영향)

  • Kim, Se-Yeon;Kim, Jae-Hong
    • Journal of Technologic Dentistry
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    • v.44 no.1
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    • pp.1-7
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    • 2022
  • Purpose: The purpose of this in vitro study is to evaluate the clinical acceptability of the marginal discrepancies and internal spacing of multi-layered zirconia prothesis by speed sintering. Methods: The two specimen types come from the same manufacturer but differ in the ingredients in layered zirconia and indication, that is anterior and posterior. The designs of both specimens were full contour crowns, and a total of 20 pieces were repeatedly fabricated, 10 for each group. The specimens were divided into two subgroups (n=10) and sintered with various total times (4 hours, 8 hours) at the maximum temperature (1,530℃). The gap between the two groups of multi-layered zirconia prostheses was measured using a silicone replica technique of 2D analysis method. The independent sample t-test was then used to compare and analyze the data obtained from the two groups (α=0.05). Results: The marginal and internal gap was superior in the 8-hour compared to the 4-hour group, and the results exhibited significant differences (p<0.05). All specimens showed that using the speed sintering schedule does not exceed the clinically permitted value of 120 ㎛, meaning zirconia prothesis using the speed sintering was adequate. Conclusion: The sintering condition is shown to affect the marginal and internal gaps of multi-layered zirconia restoration.

One-Stage Achilles Tendon Reconstruction Using the Free Composite Dorsalis Pedis Flap in Complex Wound (족배부 복합 피부-건 유리피판을 이용한 Achilles건의 일단계 재건술)

  • Kim, Sug Won;Lee, Won Jai;Seo, Dong Wan;Chung, Yoon Kyu;Tark, Kwan Chul
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.114-119
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    • 2000
  • The soft tissue defects including the Achilles tendon are complex and very difficult to reconstruct. Recently, several free composite flaps including the tendon have been used to reconstruct large defects in this area in an one-stage effort. Our case presents a patient reconstructed with free composite dorsalis pedis flap along with the extensor digitorum longus and superficial peroneal nerve for extensive defects of the Achilles tendon and surrounding soft tissue. A 36-year-old-man sustained an open injury to the Achilles tendon. He was referred to our department with gross infection of the wound and complete rupture of the tendon associated with loss of skin following reduction of distal tibial bone fracture. After extensive debridement, $6{\times}8cm$ of skin loss and 8cm of tendon defect was noted. Corresponding to the size of the defect, the composite dorsalis pedis flap was raised as a neurosensory unit including the extensor digitorum longus to provide tendon repair and sensate skin for an one-stage reconstruction. One tendon slip was sutured to the soleus musculotendinous portion, the other two were sutured to the gastrocnemius musculotendinous portion with 2-0 Prolene. The superficial peroneal nerve was then coaptated to the medial sural cutaneous nerve. The anterior tibial artery and vein were anastomosed to the posterior tibial artery and accompanying vein in an end to end fashion. After 12 months of follow-up, 5 degrees of dorsiflexion due to the checkrein deformity and 58 degrees of plantar flexion was achieved. The patient was able to walk without crutches. Twopoint discrimination and moving two-point discrimination were more than 1mm at the transferred flap site. The donor site healed uneventfully. Of the various free composite flaps for the Achilles tendon reconstruction when skin coverage is also needed, we recommand the composite dorsalis pedis flap. The advantages such as to control infection, adequate restoration of ankle contour for normal foot wear, transfer of the long tendinous portion, and protective sensation makes this flap our first choice for reconstruction of soft tissue defect including the Achilles tendon.

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The Efficacy of Bioabsorbable Mesh in Craniofacial Trauma Surgery

  • Choi, Won Chul;Choi, Hyun Gon;Kim, Jee Nam;Lee, Myung Cheol;Shin, Dong Hyeok;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Craniofacial Surgery
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    • v.17 no.3
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    • pp.135-139
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    • 2016
  • Background: The ultimate goal of craniofacial reconstructive surgery is to achieve the most complete restoration of facial functions. A bioabsorbable fixation system which does not need secondary operation for implant removal has been developed in the last decade. The purpose of this study is to share the experience of authors and to demonstrate the efficacy of bioabsorbable mesh in a variety of craniofacial trauma operations. Methods: Between October 2008 and February 2015, bioabsorbable meshes were used to reconstruct various types of craniofacial bone fractures in 611 patients. Any displaced bone fragments were detached from the fracture site and fixed to the mesh. The resulting bone-mesh complex was designed and molded into an appropriate shape by the immersion in warm saline. The mesh was molded once again under simultaneous warm saline irrigation and suction. Results: In all patients, contour deformities were restored completely, and bone segments were fixed properly. The authors found that the bioabsorbable mesh provided rigid fixation without any evidence of integrity loss on postoperative computed tomography scans. Conclusion: Because bioabsorbable meshes are more flexible than bioabsorbable plates, they can be molded and could easily reconstruct the facial bone in three dimensions. Additionally, it is easy to attach bone fragments to the mesh. Bioabsorbable mesh and screws is effective and can be easily applied for fixation in various craniofacial trauma reconstructive scenarios.

ALVEOLAR BONE LOSS AFTER THE EARLY LOSS OF UPPER CENTRAL INCISOR IN GROWING CHILDREN (성장기 어린이에서 상악 중절치 조기 상실 후 치조골 소실)

  • Na, Hye-Jin;Song, Je-Seon;Lee, Jae-Ho;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.1
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    • pp.51-57
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    • 2012
  • The anterior maxillary incisor is the most traumatized region in the mouth and trauma is frequent between the ages of 8-10. Traumatic loss of teeth, can lead to many complications in children. Thus, as possible to keep traumatic teeth, but if you need extractions There may be. Complications occur and early tooth loss is frequent. Complications of early loss of central incisors are esthetic compromise, loss of vertical and horizontal width, height, contour of alveolar bone, tilting of adjacent teeth, arch length loss. Alveolar bone loss may affect normal function and stability, and results in esthetic problem for future prosthesis restoration. The 9-year-old girl and 6-year-old boy got early loss of upper central incisor. The amount of alveolar bone resorption was measured using cone beam computed tomograph and cast analysis.

Mandibular reconstruction with a ready-made type and a custom-made type titanium mesh after mandibular resection in patients with oral cancer

  • Lee, Won-bum;Choi, Won-hyuk;Lee, Hyeong-geun;Choi, Na-rae;Hwang, Dae-seok;Kim, Uk-kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.35.1-35.7
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    • 2018
  • Background: After the resection at the mandibular site involving oral cancer, free vascularized fibular graft, a type of vascularized autograft, is often used for the mandibular reconstruction. Titanium mesh (T-mesh) and particulate cancellous bone and marrow (PCBM), however, a type of non-vascularized autograft, can also be used for the reconstruction. With the T-mesh applied even in the chin and angle areas, an aesthetic contour with adequate strength and stable fixation can be achieved, and the pores of the mesh will allow the rapid revascularization of the bone graft site. Especially, this technique does not require microvascular training; as such, the surgery time can be shortened. This advantage allows older patients to undergo the reconstructive surgery. Case presentation: Reported in this article are two cases of mandibular reconstruction using the ready-made type and custom-made type T-mesh, respectively, after mandibular resection. We had operated double blind peer-review process. A 79-year-old female patient visited the authors' clinic with gingival swelling and pain on the left mandibular region. After wide excision and segmental mandibulectomy, a pectoralis major myocutaneous flap was used to cover the intraoral defect. Fourteen months postoperatively, reconstruction using a ready-made type T-mesh (Striker-Leibinger, Freibrug, Germany) and iliac PCBM was done to repair the mandible left body defect. Another 62-year-old female patient visited the authors' clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular squamous cell carcinoma (SCC), reconstruction was done with a reconstruction plate and a right fibula free flap. Sixteen months postoperatively, reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair the mandibular defect after the failure of the fibula free flap. The CAD-CAM T-mesh was made prior to the operation. Conclusions: In both cases, sufficient new-bone formation was observed in terms of volume and strength. In the CAD-CAM custom-made type T-mesh case, especially, it was much easier to fix screws onto the adjacent mandible, and after the removal of the mesh, the appearance of both patients improved, and the neo-mandibular body showed adequate bony volume for implant or prosthetic restoration.