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Full mouth Rehabilitation with Orthognathic Surgery in Facial Asymmetry Patient : Case Report (안면 비대칭환자의 악교정 수술을 동반한 완전구강회복)

  • Im, So-Min;Shin, Hyoung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • 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.

Fracture Resistance of Low Invasive Fixed Partial Dentures (수종 저 침습 고정성 국소의치의 수직하중에 대한 저항)

  • Choi, Jong-In;Kim, Yu-Lee;Shin, Chang-Yong;Dong, Jin-Keun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.241-251
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    • 2010
  • This study aims at contributing to the restorative dentistry by examining results in the vertical load test of four different low invasive fixed partial dentures. Based on a hypothesis on the right upper first molar is missing, three units of FPDs were made for the second premolar and the second molar abutment. that is, twelve metal dies and FPDs were made for resin bonded FPD and Two Key Bridges and Human Bridge without occlusal rest and Human Bridge with occlusal rest. By using universal test machine, the numerical maximum value were recorded during the vertical load test of each FPDs after the bonding process treated by Maxcem which is resin cement. The failure process and its result of prosthesis were also observed. The maximum load was 7,295 N, 4,729 N, 2,190 N, 3,073 N from groups of resin bonded FPD, Two Key Bridge, Human Bridge without occlusal rest and Human Bridge with occlusal rest respectively. There was a statistical significance among the groups of resin bonded FPD, Two Key Bridge and Human Brides. However, there was no significant difference between Human Bridge without occlusal rest and Human Bridge with occlusal rest. Regarding the failure of prosthesis, the groups of Resin Bonded FPD and Two Key Bridge showed that one of the abutment teeth in the both side of retention part was highly failed earlier than the other one (83.2% and 66.6% respectively). While, Human Bridge without occlusal rest and Human Bridge with occlusal rest showed high percentage of failure in the abutment teeth in the both side of retention part at the same time (91.6% and 58.3% respectively). This study demonstrates that the group of Human Bridges has low resistance to the vertical loads of low invasive FPDs in comparison with the groups of resin bonded FPD and Two Key Bridge. Nevertheless, the maximum occlusal load of the restorative position, resistance to diverse restoration failure, amount of tooth reduction and patients' cooperation should be considered when they are applied in the clinic in order to choose an appropriate restoration for each patient.

Comparison of the mechanical properties and microstructures of fractured surface for Co-Cr alloy fabricated by conventional cast, 3-D printing laser-sintered and CAD/CAM milled techniques (주조, 3-D printing을 활용한 laser sintered 및 CAD/CAM milled 기법을 이용하여 제작된 코발트-크롬 합금의 물리적 성질 및 파절 단면 관찰 비교 연구)

  • Choi, Yun-Jung;Koak, Jai-Young;Heo, Seong-Joo;Kim, Seong-Kyun;Ahn, Jin-Soo;Park, Dong-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.2
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    • pp.67-73
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    • 2014
  • Purpose: The purpose of present study is to compare mechanical properties and microstructural characteristics of fractured surface for cast, 3-D printing laser sintered and CAD/CAM milled cobalt-chromium (Co-Cr) alloy specimens and to investigate whether laser sintered technique is adequate for dental applications. Materials and methods: Thirty six flat disc shape Co-Cr alloy specimens were fabricated for surface hardness test and divided into three groups according to the manufacturing methods; 12 specimens for casting (n=12), 12 specimens for laser sintered technology (n=12) and 12 specimens for milled technology (n=12). Twelve dumbbell shape specimens for each group were also fabricated for a tensile test. Statistical comparisons of the mechanical properties for the alloys were performed by Kruskal-Wallis test followed by Mann-Whitney and Bonferroni test. The microstructural characteristics of fractured surfaces were examined using SEM. Results: There were significant differences in the mean Vickers hardness values between all groups and the cast specimen showed the highest (455.88 Hv) while the CAD/CAM milled specimen showed the lowest (243.40 Hv). Significant differences were found among the three groups for ultimate tensile strength, 0.2% yield stress, elongation, and elastic modulus. The highest ultimate tensile strength value (1442.94 MPa) was shown in the milled group and the highest 0.2% yield strength (1136.15 MPa) was shown in the laser sintered group. Conclusion: Different manufacturing methods influence the mechanical properties and microstructure of the fractured surfaces in Co-Cr alloys. The cast Co-Cr alloy specimens showed the highest Vickers hardness, and the CAD/CAM milled specimens revealed the highest tensile strength value. All alloys represent adequate mechanical properties satisfying the ISO standards of dental alloy.

LONGEVITY AND FAILURE ANALYSIS OF FIXED RESTORATIONS SERVICED IN KOREA (국내에서 제작된 고정성 보철물의 수명과 실패 요인 및 양상)

  • Shin Woo-Jin;Jeon Young-Sik;Lee Keun-Woo;Lee Ho-Yong;Han Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.2
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    • pp.158-175
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    • 2005
  • Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.

Clinical effects of additional use of erythritol powder air polishing device on non-surgical periodontal treatment in moderate chronic periodontitis (중등도 만성 치주염 환자에서 erythritol 공기분말 연마기구를 부가적으로 이용하는 비외과적 치주치료의 임상적 효과)

  • Lee, Mun-Young;Park, Eon-Jeong;Kwon, Eun-Young;Kim, Hyun-Joo;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.1
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    • pp.39-45
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    • 2018
  • Purpose: The purpose of this study was to evaluate the clinical effects of erythritol powder air polishing device (EPAP) in addition to scaling and root planing (SRP) in non-surgical periodontal treatment in moderate chronic periodontitis patients. Materials and Methods: Clinical evaluation was performed at 21 sites treated with SRP (control) and 21 sites treated with the addition of SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Depth of the periodontal pocket, gingival recession, clinical attachment level, plaque index, and bleeding of probing were measured as clinical parameters. Results: In both test and control groups, there was a significant decrease in the depth of the periodontal pocket, plaque index, bleeding of probing, increased gingival recession, and gain of clinical attachment level at 1 month and 3 months after treatment. However, there was no significant clinical difference between the test group and the control group. Clinical result was improved after 1 month compared to the baseline; in contrast, results at 3 months after treatment were worse than at 1 month after treatment. Conclusion: In this study, we cannot suggest that SRP + EPAP is clinically more effective than SRP alone as non-surgical periodontal treatments. Periodic periodontal therapy, at intervals of at least every three months, is important for sustaining effects of this treatment.

A comparison study of the effects of handpiece speed on teeth in debonding procedure (탈접착 후처치시 핸드피스(handpiece) 속도가 치아에 미치는 영향에 대한 비교 연구)

  • Park, Soo-Byung;Kim, Gu-Ho;Ha, Man-Hee
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.83-91
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    • 2004
  • This study was performed to examine treatment efficiency and patient discomfort rate according to used handpiece speed in clean-up technique. Brackets were bonded to extracted human premolar(50 teeth). After debonding, 50 extracted human premolar were divided Into each two groups(low speed handpiece group with tungsten carbide bur and high speed handpiece group with ultra-fine diamond finishing bur) of 25 according to used handpiece speed in clean-up technique. In clean-up procedure, teeth vibration and pulp thermal changes were measured. After clean-up procedure, the enamel surfaces of randomly selected 10 teeth from each two groups were taken by SEM and evaluated. The findings of this study were as follows ; 1. During resin removal, tooth vibrations of various amplitude in low speed handpiece group were more than those of high speed handpiece. 2. The pulpal thermal changes of high speed handpiece group were significantly higher than those of low speed handpiece group, also the resin removal time in high speed handpiece group was almost as twice as in low speed handpiece group. 3. The figures of SEM to enamel surfaces after resin removal showed that notches and resin remnants in high speed handpiece group were more than those in low speed handpiece group.

A Qualitative Study on Reducing Dental Anxiety through Cognitive Behavioral Therapy (인지행동치료를 통한 치과불안 감소에 대한 질적 연구)

  • Koh, Boo-Il;Song, Youn-Mi;Bae, Soo-Myoung
    • Journal of dental hygiene science
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    • v.17 no.1
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    • pp.46-55
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    • 2017
  • Many people in Korea suffer from a fear of dental treatments; however, only a few studies have focused on this population. This study assessed the effectiveness of cognitive behavioral therapy (CBT) and its interventions in reducing dental anxiety, especially when administered by trained dental staff. Using case studies, the authors analyzed the content of each session and examined the process of reducing dental anxiety. First, the authors observed that the results of both dental fear scale and subjective unit of disturbance decreased significantly with changes in cognitive distortions related to dental anxiety and that rapid improvements were noted after two therapy sessions. Second, the study reported that practicing relaxation (deep-breathing) and muscle relaxation techniques; using hand signals to indicate anxiety or discomfort; establishing an empathic relationship with the therapist; making an anxiety list; and graded insensitive and exposure along with rehearsal, were effective in coping with dental anxiety and in changing negative thoughts towards the dentist. Third, a simple cognitive behavioral intervention can be effective in reducing dental anxiety. In summary, a short-term, five-session psychological intervention with CBT produced a sustained decrease in the symptoms of dental anxiety, allowing the patients to receive the required procedures. The authors discussed the study limitations and the implication of their results on future research.

A Clinicostatistical Study of 677 Mandibular Fractures (하악골 골절 667 증례의 임상통계학적 분석)

  • Lee, Sang-Han;Lee, Seoung-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.50-62
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    • 1989
  • This is clinicostatistical study of mandibular fractures. This study was based on a series of 677 patients with mandibular fracture during the period of 1982 to 1987. This results obtained were as follows : 1. In respect of incidence, there were high frequency in May and September, and in large city(63%). 2. The age frequency was the highest in the 20s-year old group (38.7%), and the ratio of male to female was 4.64 : 1. 3. The most common etiologic factor was blow(31.5%), but in children that was traffic accident followed by fall down. 4. The most common site of bone fractures was symphysis, followed by angle, condyle. In comparison of right and left sides, left side was more frequently involved(364 cases) than right side(257 cases). 5. The patients arrived in hospital immediately within 24 hours after accident were 62.9% of all, and 42.4% was arrived via private medical and dental clinic. 6. In respect of treatment, open reduction was 55.5% of all, closed reduction was 37.2%. In children, closed reduction was done in 50.6%.

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A statistical analysis study on the convergent common factors influencing saliva of physiologic malodor patients (생리적 구취환자의 타액요인에 영향을 미치는 융복합적 공통요인에 관한 통계적 분석 연구)

  • Hong, Hea-Kyung;Choi, Eun-Mi;Lee, Soo-Ryeon;Kim, Young-soo
    • Journal of the Korea Convergence Society
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    • v.9 no.4
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    • pp.99-110
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    • 2018
  • The data were collected from 171 physiologic malodor patients diagnosed in KUMC halitosis control clinic between 2008 and 2016. We selected 11 independent variables and 3 dependent variables, then planned to extract some convergent common factors affecting their physiologic malodor. We thought that those extracted convergent common factors could be utilized when preparing the contents of oral malodor preventive program. We used multiple regression analysis and path analysis method, for the analysis of influence of 11 independent factors to three salivary dependent factors(resting salivary flow rate, salivary buffering capacity, salivary precipitation rate). We have presented the physiologic malodor patients' chracteristics by descriptive statistical analysis, and also statistically analysed convergent common factors influencing directly or indirectly to their three dependent factors. We could reason that the sex, the character, the intake habit of breakfast, and the regular food intake habit could affect resting salivary flow rate, salivary buffering capacity and salivary precipitation rate.

MICROLEAKAGE OF DENTIN BONDING AGENTS IN PORCELAIN LAMINATE VENEER UNDER SIMULATED PHYSIOLOGIC PRESSURE (가상 생리적압력하에서 Porcelain Laminate Veneer 접착시 상아질 접착제의 변연 누출에 관한 연구)

  • Choi, Young-Jin;Lee, Ho-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.1
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    • pp.1-10
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    • 1993
  • The purpose of this study was to evlauate the microleakage of 3 dentin bonding agents using different dentin pretreatment method under simulated physilogic pressure in cementing the porcelain laminate veneer. Noncarious 60 human maxillary molars were selected and randomly assigned to 4 groups of 15 each. The group with the margin placed on the enamel was classified as the control and the groups with the margin placed on root surface were subdivided into 3 groups according to the dentin bonding agents used. The group using All Bond 2 was classified as experimental group 1, the group using Scotchbond MP was classified as experimental group 2, and the group using Gluma was classified as experimental group 3. Roots were removed at 3mm below the cementoenamel junction, and reductions of the teeth for the porcelain laminate veneer were done on the mesial 1/2 of the buccal surface of each teeth. The pulp was extirpated and the pulp chamber was cleaned with 37% phosphoric acid for the patency of dentinal tubule. Under simulated physiologic pressure, porcelain laminate veneers were cemented to the teeth using each dentin bonding agent and luting cement. After cementation, all samples were stored at 36t in water for 24 hours and thermocycled for 1500 cycles, then immersed in 0.5% basic fuchsin solution and the teeth were sectioned longitudinally by using diamond saw and the extent of microleakage was measured. The following results were obtained, 1. Microleakage was observed in a few samples of control group but all the samples of experimental groups. 2. The control group showed the less extent of microleakage than the experimental groups. In experimental groups the experimental group 1 & the experimental group 2 showed similiar extent of microleakage and the experimental group 3 showed the greater extent of microleakage than other groups. Conclusively, practicing the porcelain laminate veneers in the clinic, although the margin of the porcelain laminate veneer should be placed on enamel, in the case that it is inevitable to place the margin of the porcelain laminate veneer on the root surface, it is recommened to use dentin bonding agents which use no dentin pretreatment or a dentin pretreatment which can leave the smear plugs.

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