• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.397-411
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• 2004

Purpose: The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-supported overdenture. Material and methods: Maxillary implant -supported overdentures in which 4 implants were placed in the anterior region of edentulous maxilla were fabricated, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional photoelastic stress analysis. Two photoelastic overdenture models were fabricated in each anchorage system to compare with the palatal coverage extent of denture base, as a result we got eight models : Hader bar using clips(type 1), cantilevered Hader bar using clips(type 2), Hader bar using clip and ERA attachments(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4). Result: 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. In every experimental models with or without palatal coverage of denture base, maximum fringe orders on the distal ipsilateral implant supporting bone in an ascending order is as follows; type 3, type 1, type 4, and type 2. 3. Each implants showed compressive stresses in all experimental models with palatal coverage of denture base, but in the case of those without palatal coverage of denture base, tensile stresses were observed in the distal contralateral implant supporting bone. 4. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant supporting bone on loaded side. 5. The type of anchorage system affected in load transfer more than palatal coverage extent of the denture base. Conclusion: To the results mentioned above, in the case of patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant, and poor bone quality, selecting a resilient type attachment or minimizing the distal cantilevered bar is considered to be an appropriate method to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

• The Journal of Korean Academy of Prosthodontics
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• v.30 no.1
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• pp.25-42
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• 1992

The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from a unilateral distal extention removable partial dentures with five kinds of the direct retainers, that is, the bilaterally designed bar clasp of the cross-arch lingual bar and the unilaterally designed bar clasp, circumferential clasp, mini-Dalbo attachment, and telescope retainer. A photoelastic model for mandible was made of the epoxy resin(PL-1) and hardner (PLH-1) with the acrylic resin teeth used and was coated with plastic cement-1 at the lingual surface of the model, and then five kinds of removable partial dentures were set, A unilateral vertical load of about 16Kg was applied on the first molar and the stress pattern of the photoelastic model under each condition was analyzed by the reflective circular polariscope. The following results were obtained: 1. The conventional removable partial denture with the bilaterally cross arch lingual bar produced the most favorable stress distribution on the residual ridge and supporting structure of abutment teeth than the unilaterally designed removable partial dentures. 2. The unilaterally designed removable partial denture with the bar clasp produced the stress distribution on the residual ridge, except sligtly higher stress concentration on the supporting structure of the abutment teeth, similar to the conventional removable partial denture with the bilaterally designed cross arch lingual bar. 3. On the unilaterally designed removable partial dentures, the bar clasp produced greater stress distribution on the residual ridge and supporting structure of the abutment teeth than the circumferential clasp. 4. On the unilaterally designed removable partial dentures, the mimi-Dalbo attachment produced relatively higher stress concentration on the residual ridge, but produced lesser stress concentration on the supporting structure of the abutment teeth than the other direct retainers. 5. On the unilaterally designed removable partial dentures, the telescope retainer produced uniform stress distribution on the residual ridge, but produced higher stress concentration at the root apex of the terminal abutment tooth than the other direct retainers. 6. On the unilaterally designed removable partial dentures the circumferential clasp and telescope retainer produced slightly higher stress concentration on the residual ridge and supporting structure of the abutment teeth than the bar clasp and mini- Dalbo attachment.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.261-270
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• 1994

The purpose of this study was to evaluate relationship of probing attachment levels, radiographic measurements and surgical measurements according to gingival inflammatory condition. Patients with incipient to moderate periodontitis were selected. Upper and lower premolar and molar teeth excluding third molars were measured. At first visit, gingival index and bleeding on probing were taken, and subjects were grouped into 4 categories as follows : Experimental group I : gingival index 1 and no bleeding on probing. Experimental group II : gingival index 2 and no bleeding on probing absent. Experimental group III : gingival index 1 and bleeding on probing present. Experimental group IV : gingival index 2 and bleeding on probing present. Probing attachment levels were measured with manual probe on mesial and distal surfaces from cementoenamel junctions to terminal ends of probe. Radiographic measurements were made to assess bone loss by measuring the distance from cementoenamel junction to the alveolar crest. After thorough scating, a flap was raised exposing the alveolar bone and surgical measurements were made from cementoenamel junction to alveolar bone. The results were as follows: 1. Differences between probing attachment level and radiographic measurements showed $1.01{\pm}0.73mm$ for experimental group I, $0.98{\pm}0.48mm$ for experimental group II, $0.59{\pm}0.66mm$ for experimental group III, $0.98{\pm}0.38mm$ for experimental group IV and with no significant difference between groups. 2. Differences between probing attachment level and surgical measurements showed $1.36{\pm}0.80mm$ for experimental group I, $1.47{\pm}0.54mm$ for experimental group II, $1.06{\pm}0.39mm$ for experimental group III, $1.41{\pm}0.40mm$ for experimental group IV and with no significant difference between groups. 3. Differences between surgical and radiographic measurements showed $0.36{\pm}0.48mm$ for experimental group I, $0.51{\pm}0.54mm$ for experimental group II, $0.57{\pm}0.72mm$ for experimental group III, $0.41{\pm}0.49mm$ for experimental group IV and with significant difference between experimental group I and experimental group II, III, IV(P<0.05).

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.216-222
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• 2015

Purpose: After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. Methods: This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. Results: The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was $1.43{\pm}0.65mm$. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. Conclusions: After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.

• Imaging Science in Dentistry
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• v.41 no.3
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• pp.115-121
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• 2011

Purpose : This article is to describe a modified device for intraoral radiography which was developed to obtain reproducible radiographic images for assessment of distal osseous defects of the mandibular second molar (2 Mm) after impacted third molar (3 Mm) surgery. Materials and Methods : A commercial available alignment system for posterior region was modified by adding a reference gauge pin (millimetric) and threading a hollow acrylic cylinder at the ring of the radiographic positioner to attach the X-ray collimator. The design included customized resin acrylic stent for the occlusal surface of the 2Mm in maximum intercuspal position, individualizing the biteblock positioner. Periapical radiographs were taken before and after surgical extraction of 3 Mm, employing the radiographic technique of parallelism described by Kugelberg (1986) with this modified film holder and inserting the gauge pin on the deepest bone probing depth point. Results : This technique permitted to obtain standardized periapical radiographs with a moderate to high resolution, repeatability, and accuracy. There was no difference between the measurements on the pre- and post-operative radiographs. This technique allowed better maintenance of the same geometric position compared with conventional one. The insertion of the gauge pin provided the same reference point and localized the deepest osseous defect on the two-dimensional radiographs. Conclusion : This technique allowed better reproducibility in posterior radiographic records (distal surface of 2 Mm) and more accurate measurements of radiographic bone level by the use of a millimetric pin.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.53-60
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• 2017

When attempting to restore the oral function of a partially edentulous patient, there are a number of prosthetic treatment options available, depending on the structure of remaining teeth. For example, when only one set of maxillary and mandibular teeth are diagonally in place across from each other, it is difficult to gain stable occlusion. In this case, implants can be put in place at the corresponding edentulous area to achieve balance. By doing so, a stable occlusion can be achieved. For this case report, a patient with crossed occlusion after extraction was treated with maxillary RDP (removable dental prosthesis) and mandibular implant-supported RDP (removable dental prosthesis). Moreover, an implant fixture was placed under the posterior molar of the distal extension base diagonally across from the remaining maxillary teeth. Then, magnetic attachment was implemented. According to the patient who received the treatment, the result was functionally and aesthetically satisfactory.

• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.326-333
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• 2018

Purpose: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.

• Parasites, Hosts and Diseases
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• v.56 no.5
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• pp.463-475
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• 2018

The present study was performed to observe histopathological effects of Oculotrema hippopotami Stunkard, 1924 infection in the eye of Hippopotamus amphibius, as well as to reveal new details of morphology and structural features of this monogenean and its comparison between 2 age stages of the parasite. This was done using both light and scanning electron microscopy, energy dispersive X-ray analysis (EDXA) and histopathology. The presence of a mixture of different generations (adult and sub-adult) in one host individual is common for Oculotrema Stunkard, 1924 in contrast to Polystoma Zeder, 1800. New metrical and graphical information obtained for adults and sub-adults compared with the previous studies. Here we show the presence of genital papillae in adults, metrical data on the distal part of the vas deferens. SEM micrographs of sperm ejaculatory structures and information about the flattened dorsal side of the body provided for the first time. Histopathological changes, such as necrosis and hemorrhage in host tissues as a result of O. hippopotami attachment structures are described. Structural analysis of different body parts of O. hippopotami of both age groups are also included. We show qualitative differences in the presence of hardening ions (S, P, Ca) in attachment structures (oral and haptor suckers) that increase with the age of the worm. The presence of sub-adults and adults on the same host, together with high levels of infection without high pathogenicity may account for Oculotrema being one of the most successful parasites among the Monogenea.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.2
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• pp.185-199
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• 1999

This study was peformed to investigate the distribution and magnitude of stress at supporting tissue of abutment teeth and residual ridge tissue with remaining unilateral posterior teeth. Four types of removable partial dentures that included clasp retained removable partial denture, attachment retained removable partial denture, telescopic removable partial denture, and swing-lock partial denture were designed, and strain gauge was used for stress analysis. Each prosthesis was subjected to simulated vertical and oblique load. The following conclusions were drawn from this study. 1. The clasp retained removable partial denture generally distributed simulated vertical force more evenly to the supporting structure. 2. The stress at buccal side of 1st premolar was the lowest in swing-lock partial denture and that was highest in attchment retained removable partial denture. The stress at lingual side of 1st premolar was the lowest in telescopic partial denture. 3. In clasp retained removable partial denture, stress was lower at load site and ridge crest at mid-line, but it was higher at 1st premolar area on vertical load. 4. In attachment removable partial denture, stresses at buccal side of 1st premolar. lingual side of 1st premolar on vertical load, and ridge crest at midline on oblique load were higher. 5. In telescopic removable partial denture, stress at lingual side of 1st premolar was the least in all removable partial dentures, but the stress at load site was higher. 6. In swing-lock removable partial denture, stress at buccal side of 1st premolar was the lowest, and stresses at load site and distal end of residual ridge crest were higher.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.724-743
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• 2000

One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.