Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제46권2호
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pp.116-124
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2020
Objectives: Postoperative nausea and vomiting (PONV) is considered as one of the most incessant and anguishing factors for patients who have surgery under general anesthesia. The occurrence of PONV after orthognathic surgery can lead to dehydration, infection, bleeding at the surgical site, and patient discomfort, all of which leave a patient with a negative impression of anesthesia and surgery. The purpose of this study is to assess the incidence of PONV after orthognathic surgery and to correlate it with factors related to patient, anesthesia, and surgery. Materials and Methods: A 10-year retrospective survey was done for patients who underwent orthognathic surgery between January 2008 and March 2018. The incidence of PONV was evaluated, correlations with factors related to patient, anesthesia, and surgery were studied, and the duration between the end of surgery and the occurrence of the first episode of PONV was tabulated. Results: The medical records of 109 patients were screened, out of which 101 satisfied the inclusion criteria. Amongst these patients, 60 patients (59.4%) suffered from PONV. Patient's sex, induction agent used, intravenous fluids administered intraoperatively, duration and type of surgery, and the presence of a nasogastric tube were seen to have a significant influence on precipitating PONV. It was noted that among the patients who suffered from PONV, 61.7% of them experienced it 48-96 hours after the end of surgery. Conclusion: Despite the improved anesthetic equipments, drugs, and surgical techniques currently used, the incidence of PONV was high in our study. Certain factors that were seen to influence PONV in this study need to be considered in order to develop an efficacious protocol to reduce PONV in orthognathic surgeries.
Sometimes in clinic, we have found that cast crown construction is necessary to fit the existing partial denture clasp, when the abutment is involved with caries, a failing restoration, periodontal disease, or fracture. This is important not only to protect the abutment tooth from missing, but to restore retention, bracing and support for partial denture. For constructing the cast crown, several methods have been reported by many of previous authors. The number of techniques reported during the past are ideal but have uncertain results However, with more improved and practical technic developed by me, the problem becomes more successful. One method in which does not need the laboratory technecian is the wax pattern has been made in chairside waxing by doctor himself. The other in which requires the laboratory technician is to use special impression method and articulator for laboratory waxing. In one case of the reported here, we have successful results in restoring the abutment with cast crown for original denture clasp.
Statement of problem: A new implant impression technique which use abutments as impression coping, and use resin cement as a splinting material was described. Accuracy of this technique was compared with conventional closed tray and resin splinted open tray technique for a $15^{\circ}$ angled 3-implant model Material and methods: A dental stone master model with 3 linearly positioned implant analogue and a reference framework which was passively fitted to it were fabricated. The center analogue was perpendicular to the plane of model and the outer analogues had a $15^{\circ}$angulation forward or backward. 10 closed tray impressions, 10 resin splinted open tray impressions, 10 abutment-resin framework cementation impressions and 10 abutment-metal framework cementation impressions were made with additional silicone material and poured with dental stone. A light microscope with image processing was used to record the vertical gap dimension between reference framework and analogue of duplicated cast made with each 4 impression techniques. Statistical analysis used one-way ANOVA with post-hoc tests Tukey test of .05 level of significance Results: Significant difference in the vertical gap dimension was found between closed tray technique; 74.3 (${\pm}33.4$)${\mu}m$ and resin splinted open tray technique, and two other new technique. (P<.05) Abutment-metal framework cementation technique;42.5 (${\pm}11.9$)${\mu}m$ was significantly different from resin splinted open tray technique. (P<.05) Abutmentresin framework cementation technique;51.0 (${\pm}14.1$)${\mu}m$ did not differ significantly from resin splinted open tray technique;50.3 (${\pm}16.9$)${\mu}m$. (P>.05) Conclusion: Within limitations of this study, the accuracy of implant level impressions of resin splinted open tray technique was superior to that of closed tray technique. A new technique using abutment and metal framework cementation was more accurate than resin splinted open tray technique.
PURPOSE. This study aimed to compare the marginal and internal fit of 3-unit monolithic zirconia restorations that were designed by using the data obtained with the aid of intraoral and laboratory scanners. MATERIALS AND METHODS. For the fabrication of 3-unit monolithic zirconia restorations using impressions taken from the maxillary master cast, plaster cast was created and scanned in laboratory scanners (InEos X5 and D900L). The main cast was also scanned with different intraoral scanners (Omnicam [OMNI], Primescan [PS], Trios 3 [T3], Trios 4 [T4]) (n = 12 per group). Zirconia fixed partial dentures were virtually designed, produced from presintered block, and subsequently sintered. Marginal and internal discrepancy values (in ㎛) were measured by using silicone replica method under stereomicroscope. Data were statistically analyzed by using 1-way ANOVA and Kruskal Wallis tests (P<.05). RESULTS. In terms of marginal adaptation, the measurements on the canine tooth indicated better performance with intraoral scanners than those in laboratory scanners, but there was no difference among intraoral scanners (P<.05). In the premolar tooth, PS had the lowest marginal (86.9 ± 19.2 ㎛) and axial (92.4 ± 14.8 ㎛), and T4 had the lowest axio-occlusal (89.4 ± 15.6 ㎛) and occlusal (89.1 ± 13.9 ㎛) discrepancy value. In both canine and premolar teeth, the D900L was found to be the most marginally and internally inconsistent scanner. CONCLUSION. Within the limits of the study, marginal and internal discrepancy values were generally lower in intraoral scanners than in laboratory scanners. Marginal discrepancy values of scanners were clinically acceptable (< 120 ㎛), except D900L.
Conventionally, when a zirconia fixed dental restoration is planned, the interim restoration is made manually and the final restoration is fabricated by the silicone impression taking at the prosthodontic stage. This conventional workflow does not provide direct relation between interim and final restorations. Moreover, the predictability of the final restoration could be low. Nowadays, the CAD/CAM based restoration fabrication and related digital techniques are developed and being applied in dentistry in multiple ways. This case report introduces a digital workflow for fabricating an optimal gingival adaptation and predictability of monolithic zirconia restoration by using CAD/CAM interim restoration, intra oral scan, and image superimposition technique in a case that required tooth extraction.
Journal of Dental Rehabilitation and Applied Science
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제19권3호
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pp.153-168
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2003
It is very important to arrange the artificial teeth correctly in bucco-lingual (labio- lingual) relation in reconstrcting dentition. Although many anatomic landmarks and techniques have been reported over the years, they are based on westerns. So this study was performd to examine the horizontal relations of mandibular teeth in Korean dentulous adults. 200 volunteers(mean age 22.9) who had natural dentition were selected. The impressions were taken with irreversible hydrocolloid impression material and mandibular study models were fabricated using class I dental stone. Then they were measured with 3-dimensional measuring device specially designed for this study. The results were as follows ; It is better to consider the lingual cusps of the lower posterior teeth as a guide than the linguoaxial surfaces of the lower posterior teeth, arranging the lower posterior teeth buccally to the line which starts from the mesial aspect of the lower canine and continue backward to the lingual aspect of the retromolar pad. It is better to arrange the fossae of the lower posterior teeth buccally to the line which starts from the cusp tip of the lower canine and continue backward to the top of the retromolar pad. The positions of the lower posterior teeth in the denture-bearing area ; considering the fossa as a guide, the 2nd premolar was positioned in center. considering the buccal cusp as a guide, the 1st molar and the 2nd molar were positioned in center. the distance ratio(d/a) was incresed constantly from the lower canine to the 2nd molar d ; the distance between the buccal vestibule(the lowest point) and the buccal cusp tips of the lower posterior teeth. a ; the distance between the buccal vestibule(the lowest point) and the lingual vestibule(the lowest point). The lower canine was positioned lingually($0.11{\pm}0.13$) than the labial vestibule, and the central incisor and the lateral incisor were positioned almost in the imaginary perpendicular plane of the labial vestibule(the lowest point).
The purpose of the present study was to examine dental hygienists' perception of the current national practical examination. This research was performed using 199 self-reported surveys answered by professors of dental hygiene studies and clinical dental hygienist. Frequency analysis, chi-square tests, and analysis of variance were performed by using IBM SPSS Statistics ver. 20.0. The results revealed that many of the respondents consider the current national practical examination to be neutral. They did not think that the current national practical examination questions are useful for assessing occupation-centric integrated clinical practice ability and counseling techniques for patient intervention. The professors of dental hygiene studies believed that among the research tasks required as mentioned in the national practical examination questions, dental polishing and tooth brushing education are of paramount importance, whereas clinical dental hygienists believed that ultrasonic scaling is the most important (p<0.05). Most of the professors of dental hygiene studies reported that they conducted skills education for dental polishing and tooth brushing education, while most of the clinical dental hygienists reported that tasks actually performed in the clinic included impression taking, model fabrication, ultrasonic scaling, and explaining treatment precautions (p<0.05). Therefore, these tasks can be effectively carried out with the improvement of the national dental hygienist practical examination.
Purpose: This study evaluated the detorque values of screws in a multiple implant-supported superstructure using stone casts made with 2 different impression techniques. Material and methods: A fully edentulous mandibular master model and a metal framework directly connected to four implants (Br${\aa}$nemark $System^{(R)}$; Nobel Biocare AB) with a passive fit to each other were fabricated. Six experimental stone casts (Group 1) were made with 6 non-splinted impressions on a master cast and another 6 experimental casts (Group 2) were made with 6 acrylic resin splinted impressions. The detorque values of screws ($TorqTite^{(R)}$ GoldAdapt Abutment Screw; Nobel Biocare AB) were measured twice after the metal framework was fastened onto each experimental stone cast with 20 Ncm torque. Detorque values were analyzed using the mixed model with the fixed effect of screw and reading and the random effect of model for the repeated measured data at a .05 level of ignificance. Results: The mean detorque values were 7.9 Ncm (Group 1) and 8.1 Ncm (Group 2), and the mean of minimum detorque values were 6.1 Ncm (Group 1) and 6.5 Ncm (Group 2). No statistically significant differences between 2 groups were found and no statistically significant differences among 4 screws were found for detorque values. No statistically significant differences between 2 groups were also found for minimum detorque values. Conclusion: In a multiple external hexagon implant-supported prosthesis, no significant differences between 2 groups were found for detorque values and for minimum detorque values. There seems to be no significant differences in screw joint stability between 2 stone cast groups made with 2 different impression techniques.
Purpose. The purpose of this study was to evaluate the currently published literatures investigating the accuracy of computer-aided design and computer-aided manufacturing removable partial denture (CAD-CAM RPD) framework with different manufacturing techniques and methods. Materials and methods. A comprehensive search for literatures was conducted in PubMed database using specific keywords with the patient, intervention, comparison, and outcome (PICO) question, "Is there a difference in accuracy of RPD frameworks manufactured using digital workflow according to the manufacturing process and methods?" Results. A total of 7 articles were selected. Two studies compared intraoral scanning and laboratory scanning for RPD frameworks and had heterogenous results. In the studies using different manufacturing process, RPD frameworks had clinically acceptable accuracy in both subtractive and additive manufacturing. Polyetheretherketone (PEEK)-milled RPD frameworks showed higher fit accuracy than traditionally casted or 3D printed RPDs. Direct milling method showed a higher accuracy than indirect milling method. However, in rapid prototyping, indirect method showed higher accuracy than direct method. Conclusion. The RPD frameworks fabricated using CAD-CAM technology showed a clinically acceptable level of accuracy regardless of manufacturing process or techniques. Consistent results have not been reported regarding the digital impression methods, which were intra oral scanning or laboratory scanning, and further studies are needed.
Purpose: This study evaluated the effect of different screw tightening sequences and methods on detorque values in a well-fitting implant superstructure. Materials and methods: A fully edentulous mandibular master model and a metal framework directly connected to four parallel implants (Astra Tech) with a passive fit to each other were fabricated. Six stone casts were made with a splinted impression technique to represent a 'well-fitting' situation with the metal framework. Detorque values were measured twice after screw tightening using 20 Ncm. Detorque values and minimum detorque values for three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and for two tightening methods (two-step and one-step) were analyzed using multi-way analysis of variance and two-way analysis of variance, respectively, at a .05 level of significance. Results: The mean detorque values for screw tightening sequences ranged from 12.8 Ncm (2-4-3-1) to 13.1 Ncm (2-3-1-4), and for screw tightening methods were 13.1 Ncm (two-step) and 11.8 Ncm (one-step). The mean of mimimum detorque values for screw tightening sequences were 11.1 Ncm (1-2-3-4) and 11.2 Ncm (2-4-3-1 and 2-3-1-4), and for screw tightening methods were 11.2 Ncm (two-step) and 9.9 Ncm (one-step). No statistically significant differences among three screw tightening sequences were found for detorque values and for mimimum detorque values. But, statistically significant differences between two screw tightening methods were found for two values. Two-step screw tightening method showed higher detorque value (P = .0003) and higher minimum detorque value (P = .0035) than one-step method. Conclusion: Within the limitations of this study, the screw tightening sequence was not a critical factor for the detorque values in a well-fitting implant superstructure by the splinted impression technique. But, two-step screw tightening method showed greater detorque values than one-step method.
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