• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.364-373
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• 2019

Unlike class I patients, skeletal class II patients have unstable occlusion thus leading to instability of mandibular complete denture. Therefore, mandibular implant overdenture has been the standard of care due to its advantages in stability and retention. The types of attachments can be divided into two categories: solitary and bar type. The indications vary between two categories. In this clinical report, digital technology was utilized from the implant planning to the choice of appropriate attachment. Implants were placed at the desired location as previously planned in terms of angle and depth. Maxillary removable partial denture and mandibular implant overdenture are expected to have fair prognosis.

• The Journal of Advanced Prosthodontics
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• v.10 no.2
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• pp.122-127
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• 2018

PURPOSE. This study evaluated the dimensional stability of a complete-arch prosthesis processed by conventional method in water bath or microwave energy and polymerized by two different curing cycles. MATERIALS AND METHODS. Forty maxillary complete-arch prostheses were randomly divided into four groups (n = 10): MW1 - acrylic resin cured by one microwave cycle; MW2 - acrylic resin cured by two microwave cycles: WB1 - conventional acrylic resin polymerized using one curing cycle in a water bath; WB2 - conventional acrylic resin polymerized using two curing cycles in a water bath. For evaluation of dimensional stability, occlusal vertical dimension (OVD) and area of contact points were measured in two different measurement times: before and after the polymerization method. A digital caliper was used for OVD measurement. Occlusal contact registration strips were used between maxillary and mandibular dentures to measure the contact points. The images were measured using the software IpWin32, and the differences before and after the polymerization methods were calculated. The data were statistically analyzed using the one-way ANOVA and Tukey test (${\alpha}=.05$). RESULTS. The results demonstrated significant statistical differences for OVD between different measurement times for all groups. MW1 presented the highest OVD values, while WB2 had the lowest OVD values (P<.05). No statistical differences were found for area of contact points among the groups (P=.7150). CONCLUSION. The conventional acrylic resin polymerized using two curing cycles in a water bath led to less difference in OVD of complete-arch prosthesis.

• The Journal of Advanced Prosthodontics
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• v.15 no.6
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• pp.281-289
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• 2023

PURPOSE. This study aimed to predict the positional coordinates of incisor points from the scan data of conventional complete dentures and verify their accuracy. MATERIALS AND METHODS. The standard triangulated language (STL) data of the scanned 100 pairs of complete upper and lower dentures were imported into the computer-aided design software from which the position coordinates of the points corresponding to each landmark of the jaw were obtained. The x, y, and z coordinates of the incisor point (X_P, Y_P, and Z_P) were obtained from the maxillary and mandibular landmark coordinates using regression or calculation formulas, and the accuracy was verified to determine the deviation between the measured and predicted coordinate values. Y_P was obtained in two ways using the hamularincisive-papilla plane (HIP) and facial measurements. Multiple regression analysis was used to predict Z_P. The root mean squared error (RMSE) values were used to verify the accuracy of the X_P and Y_P. The RMSE value was obtained after crossvalidation using the remaining 30 cases of denture STL data to verify the accuracy of Z_P. RESULTS. The RMSE was 2.22 for predicting X_P. When predicting Y_P, the RMSE of the method using the HIP plane and facial measurements was 3.18 and 0.73, respectively. Cross-validation revealed the RMSE to be 1.53. CONCLUSION. Y_P and Z_P could be predicted from anatomical landmarks of the maxillary and mandibular edentulous jaw, suggesting that Y_P could be predicted with better accuracy with the addition of the position of the lower border of the upper lip.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.63-70
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• 2021

Using computer-aided design and manufacturing technique improve quality of treatment in many aspect. This case reports the complete mouth rehabilitation of a patient with amelogenesis imperfecta utilizing digital technology. Clinical examination revealed loss of mastication due to insufficient occlusal stop, missing teeth, interdental spacing due to microdontia, insufficient overbite, and etc. Full veneer crowns for teeth were selected, followed by a fixed partial denture and implant placement was done using CAD-CAM guide template with bone graft for partially edentulous space. Definitive restorations were duplicated by double scanning provisional restorations and successfully delivered to the patient. These full mouth rehabilitation procedures resulted in satisfactory outcomes for the patient functionally and aesthetically.

• The Journal of Advanced Prosthodontics
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• v.7 no.1
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• pp.8-14
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• 2015

PURPOSE. To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS. Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS. Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION. Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.32 no.2
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• pp.54-68
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• 2023

Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.369-373
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• 2013

PURPOSE. The objective was to evaluate canine positions, intercanine tip width (ICTW) and width of distal surface of canine (WDC), related to facial landmarks including interalar width (IAW), intercommissural width (ICoW), and distance between left and right projection lines drawn from inner canthus of eyes to alae of the nose (DPICa) in a group of Thai. MATERIALS AND METHODS. One hundred Thai subjects aged 18-35 years were selected. IAW and ICoW were measured on subject's face using digital vernier caliper. Irreversible hydrocolloid impression of the upper arch was taken, and a cast was poured with dental stone. Silicone impression material was used to take imprint of the incisal edge of upper six anterior teeth. DPICa was obtained from the subject's face using custom-made measuring equipment and marked on the silicone incisal imprint. The marks were then transferred from the imprint to the stone cast and measured with digital caliper. The ICTW and WDC were also measured on the stone cast. Pearson's correlation was used to determine the correlation. RESULTS. The results revealed that the correlation between ICTW-ICoW was 0.429 and ICTW-DPICa was 0.573. The correlation between WDC-ICoW was 0.426 and WDC-DPICa was 0.547. However, IAW did not show any correlation with ICTW or WDC (P>.05). CONCLUSION. The correlation between canine position and facial landmarks was found. ICTW and WDC had relationship with ICoW and DPICa. DPICa showed stronger correlation with the position of maxillary canine than that of ICoW.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.330-337
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• 2018

In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.2
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• pp.71-90
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• 2021

The virtual patient dataset is a collection of diagnostic data from various sources acquired from a single patient into a coordinate system of three-dimensional visualization. Virtual patient dataset makes it possible to establish a treatment plan, simulate various treatment procedures, and create a treatment planning delivery device. Clinicians can design and simulate a patient's smile on the virtual patient dataset and select the optimal result from the diagnostic process. The selected treatment plan can be delivered identically to the patient using manufacturing techniques such as 3D printing, milling, and injection molding. The delivery of this treatment plan can be linked to the final prosthesis through mockup confirmation through provisional restoration fabrication and delivery in the patient's mouth. In this way, if the diagnostic data superimposition and processing accuracy during the manufacturing process are guaranteed, 3D digital smile design simulated in 3D visualization can be accurately delivered to the real patient. As a clinical application method of the virtual patient dataset, we suggest a decision-making method that can exclude occlusal adjustment treatment from the treatment plan through the digital occlusal pressure analysis. A comparative analysis of whole-body scans before and after temporomandibular joint treatment was suggested for adolescent idiopathic scoliosis patients with temporomandibular joint disease. Occlusal plane and smile aesthetic analysis based on the virtual patient dataset was presented when treating patients with complete dentures.

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.41-47
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• 2015

Purpose: This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. Material and Methods: Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. Results: The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. Conclusion: The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets.