• 대한치과보철학회지
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• 제55권3호
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• pp.279-285
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• 2017

구강암에 대한 외과적 처치로 구강 내 광범위한 경조직, 연조직을 제거한 환자는 저작, 연하, 발음 등의 기능적 문제와 치열, 안모의 심미적 문제를 갖게 된다. 악골 재건 후에도 치조골 등 합병증으로 인해 가철성 보철물의 유지 및 지지를 받는데 제한적이다. 임플란트 지지 고정성 보철물은 이러한 환자들에게 적절한 보철수복 방법이 되어 왔다. 본 증례는 하악 재건 후 computer-aided design과 computer-aided manufacturing을 이용하여 지르코니아 프레임워크 상부에 단일 구조 지르코니아 크라운을 제작하여 현재 치열의 기능적, 심미적 회복을 하여 이에 보고하고자 한다.

• 대한치과보철학회지
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• 제54권3호
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• pp.253-258
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• 2016

최근 CAD-CAM과 지르코니아를 이용한 보철물의 제작이 증가하고 있으며 구강스캐너의 발달로 임상 및 기공과정이 단순화되고 있다. 균열치 혹은 치아의 일부가 파절된 경우, 구강스캐너를 사용하여 치아 삭제 전에 치아의 형태를 미리 스캔하고, 추후 수복물 제작 시 중첩을 통해 단일체 지르코니아 전장관을 제작하면 원래 환자의 자연치 형태와 교합을 재현할 수 있다. 본 증례에서는 균열 및 파절된 치아에서 구강 스캐너, CAD-CAM 및 단일체 지르코니아 전장관을 사용하여 삭제 전 치아의 형태와 교합을 재현한 수복물을 제작하였으며, 교합조정을 최소화할 수 있었다. 또한 임상적으로 기능적이고 심미적인 결과를 얻을 수 있었다.

• 대한치과교정학회지
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• 제46권4호
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• pp.212-219
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• 2016

Objective: The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. Methods: Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, $23.9{\pm}5.52years$) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001. Results: The mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001). Conclusions: The mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.

• 대한치과교정학회지
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• 제46권1호
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• pp.42-54
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• 2016

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

• The Journal of Advanced Prosthodontics
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• 제7권3호
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• pp.257-263
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• 2015

PURPOSE. In this study, we aimed to evaluate the amount of marginal gap with two different substructure materials using identical margin preparations. MATERIALS AND METHODS. Twenty stainless steel models with a chamfer were prepared with a CNC device. Marginal gap measurements of the galvano copings on these stainless steel models and Co-Cr copings obtained by a laser-sintering method were made with a stereomicroscope device before and after the cementation process and surface properties were evaluated by scanning electron microscopy (SEM). A dependent t-test was used to compare the mean of the two groups for normally distributed data, and two-way variance analysis was used for more than two data sets. Pearson's correlation analysis was also performed to assess relationships between variables. RESULTS. According to the results obtained, the marginal gap in the galvano copings before cementation was measured as, on average, $24.47{\pm}5.82{\mu}m$ before and $35.11{\pm}6.52{\mu}m$ after cementation; in the laser-sintered Co-Cr structure, it was, on average, $60.45{\pm}8.87{\mu}m$ before and $69.33{\pm}9.03{\mu}m$ after cementation. A highly significant difference (P<.001) was found in marginal gap measurements of galvano copings and a significant difference (P<.05) was found in marginal gap measurements of the laser-sintered Co-Cr copings. According to the SEM examination, surface properties of laser sintered Co-Cr copings showed rougher structure than galvano copings. The galvano copings showed a very smooth surface. CONCLUSION. Marginal gaps values of both groups before and after cementation were within the clinically acceptable level. The smallest marginal gaps occurred with the use of galvano copings.

• The Journal of Advanced Prosthodontics
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• 제8권2호
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• pp.150-157
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• 2016

PURPOSE. The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors. MATERIALS AND METHODS. Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure. RESULTS. Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates. CONCLUSION. Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.

• The Journal of Advanced Prosthodontics
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• 제3권4호
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• pp.196-203
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• 2011

PURPOSE. This study evaluated marginal fit of glass infiltrated alumina cores fabricated using two techniques and their marginal stability after firing cycles of veneering porcelain. MATERIALS AND METHODS. Fifteen standardized all-ceramic crowns were fabricated on a metal die using each technique: slip cast technique of VITA In-Ceram sprint Alumina (Group A as control) and plastic foil matrix technique of Turkom-Cera fused alumina core system (Group B). Copings were compared between groups and within groups at coping stage and after firing each layer of veneering porcelain. A device was used to standardize seating of copings on the metal die and positioning of the specimens under the microscope after each stage of fabrication. The specimens were not cemented and marginal gap was measured using an image analyzing software (Imagepro Express) on the photographs captured under an optical microscope. Two tailed unpaired 't test' was used to compare marginal gaps in two groups and one way ANOVA was used to analyze marginal distortion within each group at 95% confidence interval. RESULTS. The marginal gap was smaller at the coping stage in group B ($60+30{\mu}M$) than group A ($81+21{\mu}M$) with statistical significance. After firing of veneering porcelain the difference was insignificant. At the final stage, both groups exhibited lower mean marginal gaps than at the initial coping stage with the difference of $11.75{\mu}M$ for group A and $11.94{\mu}M$ for group B, but it was statistically insignificant due to high value of standard deviation. CONCLUSION. Within the limitations of this study, it was concluded that both techniques produced copings with comparable and acceptable marginal fit and marginal stability on firing veneering porcelain.

• 대한치과기공학회지
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• 제30권2호
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• pp.87-92
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• 2008

Purpose: In this study, we tried to compare marginal accuracy when produce ceramic crown using all ceramic materials and existent metal-ceramic system. Material and methods: All-ceramic systems were E-max (Ivoclar/Vivadent, Lichtenstein), Lava(3M, U.S.A.) and Wol-ceram(Teamziereis, Germany). Metal-ceramic system(PFG) was composed of Au-Pt alloy (Metalor, Switzerlandand) and overlying ceramic(D-sign, Ivoclar/Vivadent, Lichtenstein). We fabricated metal master die with upper diameter of 7.95mm, bottom diameter of 9.00mm, height of 5.00mm, and taper of $6^{\circ}$. All ceramic system used 0.5mm thickness ceramic coping, while metalceramic system used 0.3 thickness metal coping. By adding dentin and enamel ceramics on each coping, a crown with a proximal thickness of 1.0 mm and occlusal thickness of 2.0mm was fabricated. Pressure of 2kg was applied for 10 seconds on each crown with static load compressor. Before and after cementation, we measured the marginal gap at 4 points of each crown using optical microscope. The data was analyzed using a Student's t test and repeated-measures of analyses of variance(ANOVA) followed by a Bonferroni test. A p value<0.05 was considered significant. Results: As experiment results, marginal accuracy of wol-ceram and Lava is no good when compared with marginal accuracy of PFG. But marginal accuracy of E.max is good when compared with PFG. This result showed not significant. The marginal accuracy of E.max is good when compared with marginal accuracy of wol-ceram and Lava. Conclusion: The marginal accuracy of E.max is very good when compared with marginal accuracy of another group.

• 대한치과기공학회지
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• 제38권3호
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• pp.143-149
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• 2016

Purpose: The purpose of this study is to evaluate the effect of two different oblique mechanical loading to occlusal surfaces of cement retained implant on the stress distributions in surrounding bone, using 3-dimensional finite element method. Methods: A 3-dimensional finite element model of a cement retained implant composed of three unit implants, simplified ceramic crown and supporting bone was developed according to the design of ement retained implant for this study. two kinds of surface distributed oblique loads(100 N) are applied to following occlusal surfaces in the single crowns; 1) oblique load on 2 occlusal points(50N for each buccal cusp, 2 buccal cusps exist), 2) oblique load on 4 occlusal points(25N for each buccal and lingual cusp, 2 buccal and 2 lingual cusps exist) Results: The results of the comparison of the stress distributions on surrounding bone are as follows. In the condition of oblique load on 2 occlusal points, VMS was 741.3 Mpa in the M1(Ø$4.0{\times}13mm$) model and 251.2 Mpa in the M2(Ø$5.0{\times}13mm$) model. It means the stress on the supporting bone is decreased. The results of oblique load on 4 occlusal points are similar to this one. Conclusion: Increasing the diameter of the implant fixture is helpful to distribute the stress on the supporting bone. Also, to obtain the structural stability of the supporting bone, it is effective to distribute the load evenly on the occlusal surface of crown in producing single crown implant.

• The Journal of Advanced Prosthodontics
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• 제8권1호
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• pp.62-69
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• 2016

PURPOSE. The purpose of this study was to evaluate the effects of abutment screw length and cyclic loading on the removal torque (RTV) in external hex (EH) and internal hex (IH) implants. MATERIALS AND METHODS. Forty screw-retained single crowns were connected to external and internal hex implants. The prepared titanium abutment screws were classified into 8 groups based on the number of threads (n = 5 per group): EH 12.5, 6.5, 3.5, 2.5 and IH 6.5, 5, 3.5, 2.5 threads. The abutment screws were tightened with 20 Ncm torque twice with 10-minute intervals. After 5 minutes, the initial RTVs of the abutment screws were measured with a digital torque gauge (MGT12). A customized jig was constructed to apply a load along the implant long axis at the central fossa of the maxillary first molar. The post-loading RTVs were measured after 16,000 cycles of mechanical loading with 50 N at a 1-Hz frequency. Statistical analysis included one-way analysis of variance and paired t-tests. RESULTS. The post-loading RTVs were significantly lower than the initial RTVs in the EH 2.5 thread and IH 2.5 thread groups (P<.05). The initial RTVs exhibited no significant differences among the 8 groups, whereas the post-loading RTVs of the EH 6.5 and EH 3.5 thread groups were higher than those of the IH 3.5 thread group (P<.05). CONCLUSION. Within the limitations of this study, the external hex implants with short screw lengths were more advantageous than internal hex implants with short screw lengths in torque maintenance after cyclic loading.