Journal of Dental Rehabilitation and Applied Science
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v.26
no.3
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pp.359-371
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2010
Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.
Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Yang, Yeon-Mi;Park, Jeong-Yeol
Journal of the korean academy of Pediatric Dentistry
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v.35
no.1
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pp.65-72
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2008
Pulse oximeter to monitor oxygen saturation during pediatric dental sedations enables early detection of hypoxemia. The purpose of this study was to monitor the hemoglobin oxygen saturation level and pulse rate of nonmedicated pediatric patients during routine restorative procedures to study the effect of procedure and treated jaw. We obtained data from 53 children treated at the Department of Pediatric Dentistry, Chonbuk national university hospital. Pulse rate and oxygen saturation were measured and recorded using pulse oximetry at each step of treatment. The results are as follows: 1. In non-anesthesia group, steep increase of pulse rate was observed during rubber dam application in the maxilla and during cavity preparation in the mandible. 2. In anesthesia group, pulse rate started to decrease after the rubber dam application in the maxilla, while its decrease observed since cavity preparation step in the mandible. 3. In non-anesthesia group, oxygen saturation level was relatively constant during all steps in the maxilla, but in mandible, it was higher during operation compared to its pre and post operation baseline. 4. In anesthesia group, oxygen saturation level was observed at 99% level through all steps in both jaw groups, and there was no statistical significance between the maxilla and the mandible groups(p>0.05). The purpose of this study was to evaluate the effect of routine dental treatment on the pulse rate and oxygen saturation level in nonmedicated pediatric patients during routine restorative procedures in the maxilla and mandible.
Statement of problem: A clinically successful color match is one of the important factor to get an esthetic dental restoration. Dental shade guides are commonly used to evaluate tooth color in restorative procedure. But numerous reports have indicated that common shade guides do not provide sufficient spectral coverage of the natural tooth colors. To address issues associated with the shade guide, distinct avenues have been pursued objective spectrophotometric / colorimetric assessment. Purpose: This study compared the accuracy of tooth color selection of spectrophotometer with that of human visual determination. Three main factors were investigated, namely, the effect of light, the individual variation and the experience of the observer. Material and methods: At the first experiment, on ten patients, one operator independently selected the best matching shade to the unrestored maxillary central incisor, using a Vita Classical Shade Guide in the morning, at noon and in the afternoon. The same teeth were measured by means of a reflectance spectrophotometer. At the second experiment, on ten patients, ten operators (5 experts, 5 novices) selected and measured by the same method above at noon. At the third experiment, the results of the second experiment were divided into two groups, expert and novice, and analyzed. Results: 1. There was significant difference between visual and spectrophotometric assessment (mean ${\Delta}E$ values) in experiment 1, 2, 3 (P < .05). 2. There was no significant difference between experts and novices group, when comparing with each visual and spectrophotometric assessment (mean ${\Delta}E$ values). Conclusion: Spectrophotometer could be used to analyze the shade of natural tooth objectively. Thereby, this method offers the potential tominimize considerably the need for corrections or even remakesafter intraoral try-in of restoration. Furthermore, to achieve its advantage, both the shade-matching environment and communication between dentist and technician should be optimized with use of visual and instrumental shade-matching systems.
Iatrogenic injury following dental treatments and the use of local anesthetics may cause taste disorders. The aims of this study were to investigate quantitative and qualitative changes of taste due to unilateral inferior alveolar nerve block anesthesia and further to evaluate potential effects on taste function related to anesthesia or hypoesthesia of inferior alveolar nerve, possibly occurring after dental procedure. 30 healthy volunteers in their twenties participated in this study (male to female = 1:1, mean age of $24.0{\pm}1.8$ years). Each subject received inferior alveolar nerve block anesthesia on his or her right side with 2% lidocaine HCl containing 1:100,000 epinephrine. Before and after anesthesia, electrogustometric test and chemical localized test for salty, sweet, sour and bitter tastes were performed on the eight sites in the oral cavity; right and left anterior and lateral tongue and circumvallate papilla of the tongue and soft palate. Unilateral inferior alveolar nerve anesthesia produced elevation of electrical taste threshold and reduction of intensity ratings for all 4 tastes (salty, sweet, sour and bitter) over anterior and lateral tongue and circumvallate papilla on the ipsilateral side (p<0.05). Contralateral sides exhibited decreased intensity ratings for salty and sweet taste (p<0.05) on anterior and lateral tongue while there was no significant difference in electrogustometric testing. Based on the results of this study, it is assumed that unilateral local anesthesia on inferior alveolar nerve can affect chorda tympani and glossopharyngeal nerves on the same side, leading to taste deficits. Taste intensity on the contralateral side may, in part, be deteriorated as well.
Bone density in the recipient implant site seems to be an important factor for long term success of endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify suitable implant sites, thereby improving the success rate of the procedure. Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively with computerized tomography and histologically measured bone density by bone biopsy. Patients and methods; Twenty seven patients were selected. All the patients were in good health, with no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery 2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and insertion torque values were recorded. Results; The highest histomorphometric values was found in the posterior mandible $32.3{\pm}3.8$, followed by $29.9{\pm}2.6$ for the posterior maxilla, $29.4{\pm}2.6$ for the anterior maxilla, $28.6{\pm}2.3$ for the anterior mandible(p=0.214). The hounsfield unit was $989.2{\pm}258.1$ in the posterior mandible, $845.0{\pm}241.5$ in the anterior maxilla, $744.5{\pm}92.6$ in the anterior mandible, $697.3{\pm}136.9$ in the posterior maxilla(p=0.045). This results may suggest that there are strong correlation between the histomorphometric values and hounsfield unit(r=0.760, p<0.05). The RF measurements were $81.9{\pm}2.4$ ISQ in the posterior mandible, $79.0{\pm}1.4$ ISQ in the anterior mandible, $78.3{\pm}4.6$ ISQ in the posterior maxilla, $76.5{\pm}5.0$ ISQ in the anterior maxilla(p=0.048). The insertion torque values was $43.2{\pm}4.2\;Ncm$ in the posterior mandible, $42.0{\pm}0.0\;Ncm$ in the anterior mandible, $41.3{\pm}4.1\;Ncm$ in the posterior maxilla, $40.8{\pm}3.8\;Ncm$ in the anterior maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield unit and the insertion torque values(r=0.494, p<0.05), the histomorphometric values and the insertion torque values(r=0.689, p<0.05). But there was no correlation between histomorphometric values and ISQ. There was no statistical significance in age and gender effect on parameters. Conclusions; There was significant correlations between bone density and implant stability parameters. The bone density measurements using preoperative CT may help clinicians to predict primary stability before implant insertion, which is associated with implant survival rates.
Statement of problem: Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complications of fixed prostheses were found in the mouth of patients. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. Purpose: The purpose of this study was to evaluate the clinical status of fixed prostheses. Material and methods: In order to assess the clinical status of fixed prostheses, a total of 161 individuals(aged 17-85, 99 women and 62 men with 1596 unit of fixed prostheses, and 1169 abutments) who first visited the Department of Prosthodontics, Pusan National University Hospital, between April to September, in 2007 were examined. Results and conclusion: The results of this study were as follows: 1. Length of service of fixed prostheses was $8.6{\pm}0.6$ years(mean), 10.0 years(median). 2. Location of fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in posterior region and in mandible where the failure rate was high in combination(P<.05). 3. Longevity of fixed prostheses made of metal was longest(mean: $13.0{\pm}9.3$, median: 14.0), gold, precious ceramic, non-precious ceramic trailing behind(P<.05). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in Single-unit and the failure rate was high in over 3-unit(P<.05). 5. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in natural dentition(P<.05). 6. Defective margin(28.2%), dental caries(23.0%), periodontal disease(19.3%), periapical disease(16.9%) were frequent complications. In 30.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.
Journal of the korean academy of Pediatric Dentistry
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v.32
no.3
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pp.416-426
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2005
Intravenous sedation have many advantages of rapid onset and recovery, ability of control sedation levels and duration through titration. Midazolam is most commonly used intravenous medication for sedation in pediatrics, endoscopy, oncologic procedures and so on. But in dentistry, midazolam intravenous sedation is usually for adult, and there are few reports for children. Todays, children who need sedation become more and older, intravenous sedation technique is going a matter of concern in pediatric dentistry. The purpose of this paper is to evaluate the efficacy of sedation and clinical success for different initial dosage of midazolam in intravenous sedation for pediatric dental patients. 16 healthy children (male 10, female 6), mean age $54.7{\pm}10.7$ months, who needed at least two separate treatment visits requiring local anesthesia were chosen for this study. Every children were taken 0.3mg/kg, maximum 5mg of midazolam by intramuscular route, and then 30~50% $N_2O-O_2$ for 10 minutes was given. On every visits, one of the following 2 different initial dosage was given by intravenous route : (1) Group I : 0.1mg/kg Midazolam (2) Group II : 0.2mg/kg Midazolam. Additional dosage was half of the first dose. Physiologic parameters (oxygen saturation, heart rate, respiratory rate, end-tidal carbon dioxide pressure) was recorded by ten procedure steps. Behavior was videotaped and rated using Ohio State University Behavioral Rating Scale and Automated Counting System by one investigator, blind to administered dosage. After the treatment, operator evaluated the clinical success. Physiologic parameters were stable and within normal range during treatment in both groups. The analyzed sedative effect, in behavioral evaluation, ratio of favorable Quiet was higher in group II, and clinical success rate of group II was better than group I. Induction time was rapid in group II, and recovery time was rapid in group I. And there was no statistically difference between two groups in every results.
There are numerous kind of materials and techniques to regenerate the periodontal tissue which has been lost due to destructive periodontal disease, including bone graft material. Many bone graft materials have been reported and among these materials, synthetic material has been developed fin the long time because of its sufficient supply economically. Calcium sulfate which was evaluated as including much calcium, has been used in the clinical field. In the dental field calcium sulfate has been used as bone graft material and Kim reported that improved bone formation and more amount of new attachment after grafting calcium sulfate. but, because calcium sulfate has the problem that it generates the heat in setting period and resolves fast, we need to evaluate the effect of the improved calcium sulfate on periodontal tissue. The present study evaluates the effect of paste type calcium sulfate on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony defect in dogs. Four millimeter deep and four millimeter wide 3-wall defects were surgically created in the mesial or distal aspects of premolars or molars. the test group received paste-type calcium sulfate with a flap procedure and the control group underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results : 1. The length of epithelial growth(the distance from CEJ to the apical end of JE) was 0.52${\pm}$0.26mm in the control and 0.56${\pm}$0.25mm in the test group. there was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was 1.74${\pm}$1.06mm in the control and 1.28${\pm}$0.57mm in the test group. there was no statistically significant difference between the two groups. 3. The length of new bone was 2.01${\pm}$0.95mm in the control and 2.62${\pm}$0.81mm in the test group. there was no statistically significant difference between the two groups. 4. The length of new cementum was 1.86${\pm}$0.80mm in the control and 2.77${\pm}$ 0.86mm in the test group. there was a statistically significant difference between the two groups.(P<0.01) These results suggest that the use of paste type calcium sulfate in 3-wall intrabony defects has significant effect on new cementum formation , but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation. Finally, the paste type calcium sulfate that is used in this study is suggested to be the material that can have a significant effect on the periodontal healing, if its biocompatibility is improved.
Journal of the korean academy of Pediatric Dentistry
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v.31
no.1
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pp.11-18
/
2004
The eruption of permanent teeth represents the movement in the alveolar bone before appearance in oral cavity, to the occlusal plane after appearance in oral cavity, and additive movement after reaching th the occlusal plane. Tooth eruption is mostly controlled by genetic signals. The eruption stage is divided to preeruptive alveolar stage, alveolar bone stage, mucosal stage according to the process of growth and development. If the disturbance is occured in any stage of eruption, tooth does not erupt. The cause of eruption disturbance are ectopic position of the tooth germ, obstruction of the eruption path and defects in the follicle or PDL. In the treatment of eruption disturbance, surgical procedures are commonly used. There are three kind of surgical procedure ; surgical exposure, surgical repositioning, surgical exposure and traction Surgical exposure is basic procedure. This involves removal of mucosa, bone, lesion that are surrounding the teeth, dental sac when necessary to maintain a patent channel between the crown and the normal eruptive path into the oral cavity. To ensure this patency, many techniques including cementation of a celluloid crown, packing with gutta-percha or zinc oxide-eugenol, or a surgical pack, are used. When surgical exposure is conducted, operators should not expose any part of cervical root cement and not injure periodontium or root of adjunct tooth. After surgical exposure, tooth should be surrounded by keratinized gingiva. There is direct relationship between the extent of development of pathophysiologic aberrations and the intensity of the manipulative injury inflicted on the tooth by surgical treatment, so operator should consider this thing. In these cases, surgical exposure is conducted on Maxillary 1st milars that have a eruption disturbance and improve the eruption disturbance effectively.
Journal of Dental Rehabilitation and Applied Science
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v.27
no.2
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pp.141-147
/
2011
The aim of this study was to evaluate histomorphometrically and compare the efficiency of various bone graft material and autogenous tooth bone graft material which were used in sinus bone graft procedure. Subjects were the 24 patients who had treated with sinus bone graft using lateral approach from October 2007 to September 2009 at SNUBH. The average age was $52.51{\pm}11.86$ years. All cases was taken after 4month of procedure and divided into 3 groups according to bone graft material. Group 1: autogenous tooth bone graft material, Group 2: OrthoblastII(integra lifescience corp. Irvine, US)+Biocera(Osscotec, seoul, korea), group 3: DBX(Synthes, USA)+BioOss(Geistlich Pharm AG, Wolhusen, Switzerland). Total 37 implant placement area were included and evaluated(7 in group 1, 10 in group 2, 20 in group 3). Evaluation of new bone formation, ratio of woven bone to lamellar bone, ratio of new bone to graft material were performed on each tissue section. Kruskal-Wallis test was used for statistical analysis(SPSS Ver. 12.0, USA). New bone formation were $52.5{\pm}10.7%$ in group 1, $52.0{\pm}23.4%$ in group 2, $51.0{\pm}18.3%$ in group 3. There were no statistical significant differences between each groups. Ratio of woven bone to lamella bone were $82.8{\pm}15.3%$ in group 1, $36.7{\pm}59.3%$ in group 2, $31.0{\pm} 51.2%$ in group 3. Ratio of new bone to graft material were $81.3{\pm}10.4%$ in group 1, $72.5{\pm}28.8%$ in group 2, $80.3{\pm}24.0%$ in group 3. After 4 month of healing period, all group showed favorable new bone formation and around graft material and implant. Within limitation of our study, it is suggested that autogenous tooth bone graft material might be used as novel bone graft material for sinus bone graft.
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