• Title/Summary/Keyword: Edentulous mandible and maxilla

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Full-mouth rehabilitation with implant-supported fixed dental prostheses for the edentulous maxilla and partially edentulous mandible: A case report (상악 완전 무치악 및 하악 부분 무치악 환자에서 임플란트 지지형 고정성 보철물을 이용한 전악 수복 증례 보고)

  • Kim, Tae-Hyung;Oh, Kyung-Chul;Moon, Hong-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.374-381
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    • 2019
  • A conventional approach for the treatment of long-span edentulous areas is the use of removable dentures. However, placing implants in these areas results in superior functional outcomes by increasing the stability, support, and resistance of the prostheses and improving the masticatory efficiency. Treatment modalities utilizing implants can be further classified into either removable or fixed-type prostheses. Several factors such as the amount of alveolar bone resorption, inter-arch relationship, patient preferences, and socioeconomic status should be considered when determining the appropriate treatment approach. Monolithic zirconia has been considered a suitable material for implant-supported fixed dental prosthesis, because of the drastic improvement in its mechanical properties. It exhibits fewer incidences of fracture and chipping of the prostheses, and has greater bulk of material than metal-ceramic crowns and zirconia-veneered ceramics. Moreover, highly translucent monolithic zirconia is also available in the market, and its application is gradually increasing for anterior tooth rehabilitation. The present report describes a patient who underwent full-mouth rehabilitation with fixed dental prostheses (eight upper and three lower implant placements). All teeth, except bilateral mandibular canines and left mandibular first and second premolars, were extracted after the diagnosis of generalized chronic moderate-to-advanced periodontitis of the remaining teeth. The patient reported satisfactory esthetic and functional outcomes during the one-year follow-up visit.

Retrievable SCP (screw-cement prosthesis) implant-supported fixed partial dentures in a fully edentulous patient: a case report (완전 무치악 환자에서 나사-시멘트 보철물(SCP: screw-cement prosthesis)을 이용한 임플란트 보철 수복 증례)

  • Kim, Joo-Hyeun;Yun, Bo-Hyeok;Jang, Jung-Eun;Huh, Jung-Bo;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.318-323
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    • 2012
  • Implant prostheses were classified into screw-retained prosthesis and cement-retained prosthesis by their method of retaining, and there is screw and cement retained implant prosthesis (SCRP) which has been made reflecting the strengths of these two. The advantages of the SCRP technique are easy retrievability and passive fit of implant prostheses. However, the occlusal screw holes of implant prostheses can be thought as a disadvantage with respect to esthetics and occlusion. Inappropriately positioned implants also limited the use of the SCRP technique. The present study is reporting about the case where nine implants (US II, OSSTEM, Seoul, Korea) were placed in maxilla and eight in mandible respectively in fully edentulous patients. Then, the cement-retained prosthesis was applied for the part in which the screw hole positioned improperly, and screw-retained prosthesis for properly positioned implants so that the combined screw-cement prosthesis has been produced where the satisfying result has shown in both function and esthetics. Three-year follow-up has been done for the patient.

Biological stability of Zirconia/Alumina composite ceramic Implant abutment (지르코니아/알루미나 복합 지대주의 생물학적 안정성에 관한 연구)

  • Bae, Kyu-Hyun;Han, Jung-Suk.;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Cho, Ki-Young;Chung, Chong-Pyoung;Han, Soo-Boo;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.555-565
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    • 2006
  • The purpose of the present study is to evaluate the biological stability of the zirconia/alumina composite abutment by histologic and radiographic examination in clinical cases. 17 partially edentulous patients (5 men and 12 women, mean age 47) were treated with 37 implants. The implants were placed following the standard two-stage protocol. After a healing period of 3 to 6 months, zirconia/alumina composite abutments were connected. All radiographs were taken using paralleling technique with individually fabricated impression bite block, following insertion of the prosthesis and at the 3-, 6-, 12 month re-examinations. After processing the obtained images, the osseous level was calculated using the digital image in the mesial and distal aspect in each implant. An ANOVA and t-test were used to test for difference between the baseline and 3-, 6-, 12 months re-examinations, and for difference between maxilla and mandible. Differences at P <0.05 were considered statistically significant. For histologic examination, sample was obtained from the palatal gingiva which implant functioned for 12 months. Sections were examined under a light microscope under various magnifications. Clinically, no abutment fracture or crack as well as periimplantitis was observed during the period of study. The mean bone level reduction(${\pm}standard$ deviation) was 0.34 rom(${\pm}\;0.26$) at 3-months, 0.4 2mm(${\pm}\;0.30$) at 6-months, 0.62 mm(${\pm}\;0.28$) at 12-months respectively. No statistically significant difference was found between baseline and 3-, 6-, 12-months re-examinations (p > 0.05). The mean bone level reduction in maxilla was 0.33(${\pm}0.25$) at 3-months, 0.36(${\pm}0.33$) at 6-months, 0.56(${\pm}0.26$) at 12-months. And the mean bone level reduction in mandible was 0.35(${\pm}0.27$) at 3-months, 0,49(${\pm}0.27$) at 6-months, 0.68(${\pm}0.30$) at 12-months. No statistical difference in bone level reduction between implants placed in the maxilla and mandible. Histologically, the height of the junctional epithelium was about 2.09 mm. And the width was about 0.51 mm. Scattered fibroblasts and inflammatory cells, and dense collagen network with few vascular structures characterized the portion of connective tissue. The inflammatory cell infiltration was observed just beneath the apical end of junctional epithelium and the area of direct in contact with zirconia/alumina abutment. These results suggest the zirconia/alumina composite abutment can be used in variable intraoral condition, in posterior segment as well as anterior segment without adverse effects.

A retrospective clinical study of single short implants (less than 8 mm) in posterior edentulous areas

  • Kim, Sang-Yun;Ku, Jeong-Kui;Kim, Hyun-Suk;Yun, Pil-Young;Kim, Young-Kyun
    • The Journal of Advanced Prosthodontics
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    • v.10 no.3
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    • pp.191-196
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    • 2018
  • PURPOSE. The goal of this study was to evaluate the clinical outcome of single short implants, less than 8 mm in length, placed in the posterior area. MATERIALS AND METHODS. A total of 128 patients (75 male and 53 female, mean age: $52.6{\pm}11.2years$) with 154 implants participated. Implant marginal bone loss, and survival and success rates were measured. RESULTS. The mean follow-up period was $51.35{\pm}24.97months$. A total of 128 implants, 8 mm in length, were placed in patients who had mean marginal bone loss of 0.75 mm. These implants had a survival rate of 95.3%. Twenty-six implants, 7 mm in length, were placed in areas with a mean marginal bone loss of 0.78 mm and had a survival rate of 96.2%. Both marginal bone loss and survival rate were not statistically different among the groups. In the maxilla, 34 implants showed a mean marginal bone loss of 0.77 mm and a survival rate of 97.1%. In the mandible, 120 implants showed a mean marginal bone loss of 0.75 mm and a survival rate of 95.0%. The average marginal bone loss around all implants was $0.76{\pm}0.27mm$ at the last follow-up review after functional loading. The survival rate was 95.6% and success rate was 93.5%. CONCLUSION. In our study, single short implants less than 8 mm in length in the posterior areas had favorable clinical outcomes.

Surgical Treatment for a Huge Maxillary Ameloblastoma via Le Fort I Osteotomy: A Case Report

  • Jung, Sang-pil;Jee, Yu-jin;Lee, Deok won;Kim, Hyung Kyung;Kang, Miju;Kim, Se-won;Yang, Sunin;Ryu, Dong-mok
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.86-91
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    • 2018
  • Ameloblastomaa are odontogenic benign tumors with epithelial origin, which are characterized by slow, aggressive, and invasive growth. Most ameloblastomas occur in the mandible, and their prevalence in the maxilla is low. A 27-year-old male visited our clinic with a chief complaint of the left side nasal airway obstruction. Three-dimensional computed tomography showed left maxillary sinus filled with a mass. Except for the perforated maxillary left edentulous area, no invaded or destructed bone was noted. The tumor was excised via Le Fort I osteotomy. The main mass was then sent for biopsy and it revealed acanthomatous ameloblastoma. The lesion in the left maxillary sinus reached the ethmoidal sinus through the nasal cavity but did not invade the orbit and skull base. The tumor was accessed through a Le Fort I downfracture in consideration of the growth pattern and range of invasion. The operation site healed without aesthetic appearances and functional impairments. However, further long-term clinical observation is necessary in the future for the recurrence of ameloblastoma. Conservative surgical treatment could be the first choice considering fast recovery after surgery and the patient's life quality.

Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function

  • Rinke, Sven;Rasing, Hajo;Gersdorff, Nikolaus;Buergers, Ralf;Roediger, Matthias
    • The Journal of Advanced Prosthodontics
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    • v.7 no.4
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    • pp.338-342
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    • 2015
  • PURPOSE. This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function. MATERIALS AND METHODS. A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ${\geq}3.5mm$) was evaluated by digital analysis of panoramic radiographs taken postoperative (baseline) and after 5-19 years of clinical function (follow-up). RESULTS. The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (P=0.58). Peri-implantitis was diagnosed for 12.4% of the implants in 37% of the patients. CONCLUSION. Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction.

Causes of failures of long-term used double crown denture and new rehabilitation with dental implant and tooth combined denture using remaining teeth and implants (장기간 사용한 이중관 의치의 실패원인 및 자연치와 임플란트를 이용한 이중관 의치 수복증례)

  • Seo, Jeong-Gyo;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.384-390
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    • 2018
  • Hybrid telescopic double crown have ever been good treatment option for patient with periodontally unfavorable few remaining teeth for successful prognosis. Tooth and implant combined telescopic double crown can be used for improving retention and support for denture with strategically placed implants on edentulous ridge. In this case, an 55-year-old female patient had chronic periodontitis with few remaining teeth on maxilla and fixed partial prosthodontics on mandible. Treatment of hybrid telescopic double crown with friction pin lasted 9.5 years only with natural teeth. After 9.5 years, additional implants was installed due to fracture of cast-posted abutment teeth. After implantation, tooth and implant combined double crown had fabricated. Through re-treatment, no complications of new denture has been found during 2 years follow up. This case presents fair prognosis of tooth and implant combined double crown denture in periodontally unfavorable condition.

Prosthetic treatment for patient with anterior overbite and partial edentulism using maxillary hybrid telescopic double crown RPD and mandibular fixed prostheses: A 11-yr follow-up (전치부 과개교합을 가진 상하악 부분 무치악 환자에서의 상악 하이브리드 텔레스코픽 이중관 국소의치와 하악 고정성 보철물을 이용한 치료의 11년 경과관찰 증례)

  • Choi, Hyunsuk;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.415-421
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    • 2021
  • The biomechanical prognosis of conventional removable partial denture is questionable in case of patient with few remaining teeth or periodontally compromised teeth. In this case, hybrid telescopic double crown RPD may be a successful treatment alternative. Hybrid telescopic double crown RPD has following advantages over conventional RPD: secondary splinting effect between abutments, more vertical stress direction and more convenient in repairing the denture after extraction of abutment tooth. In this clinical case, patient had deep overbite in anteriors and partially edentulous. The maxilla was restored with hybrid telescopic double crown RPD and the mandible was restored with implants and fixed prostheses. Long-term follow-up and supportive periodontal treatment were performed, and satisfactory results were achieved in terms of function and aesthetics.

Hybrid telescopic double crown denture on maxillary few remaining teeth and 2 mandibular implants in case of failed implant overdenture (상악의 소수 잔존치와 실패한 하악의 임플란트 오버덴처의 재수복 임상증례: 프릭션핀을 이용한 하이브리드 텔레스코픽 이중관법)

  • Ha, Seok-Joon;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.246-252
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    • 2016
  • Double crown prostheses can be used in patients who have a few remaining teeth and poor periodontal condition because of secondary splinting of abutments, vertical loading, decrease of the length of lever arm due to fulcrum line located on margin of inner and outer crown. Successful results of treatments using double crown prostheses for the partially edentulous patients who have a few remaining teeth and implant overdenture using a small number of implants have been reported. In this case, there were a few remaining teeth with a very poor periodontal condition in maxilla, and there were a failed implant with severe alveolar bone resorption and shrinkage in the mandible. The main objective of this report is to introduce our case because a double crown partial denture showed satisfactory results in functional and esthetical aspects during more than one-year follow-up period.

Oral health status and treatment need of institutionalized elderly patients (노인요양시설에 있는 노인환자의 구강실태 및 치료수요도)

  • Yang, Soon-Bong;Moon, Hong-Suk;Han, Dong-Hoo;Lee, Ho-Yong;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.455-469
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    • 2008
  • Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.