• 제목/요약/키워드: Edentulous mandibles

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Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws

  • Carlsson, Gunnar E.
    • The Journal of Advanced Prosthodontics
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    • 제6권4호
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    • pp.245-252
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    • 2014
  • PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

CAD-CAM assisted flapless 수술법으로 식립된 임플란트의 안정성 : 기초연구 (Implant stability installed with CAD-CAM assisted flapless surgery : A pilot study)

  • 박찬진;김대곤;조리라
    • 구강회복응용과학지
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    • 제27권4호
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    • pp.405-413
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    • 2011
  • CAD-CAM기법과 CT의 도움으로 무판막임플란트 치료술식이 가능하게 되었다. 본 연구의 목적은 1년간 전향적 연구를 통해 이러한 술식의 신뢰성을 검토하고자 하였다. 하악무치악상태의 연속적인 환자 12명이 포함되었다. 71개의 임플란트가 이공사이에 $NobelGuide^{TM}$법을 이용하여 식립되었고 환자는 정해진 주기에 따라 검사되었다. 한 개의 임플란트가 조기실패하였으며 나머지는 만족할 만한 기능을 보였다. 연구기간 중 평균적인 변연골흡수량은 중앙부($0.3{\pm}0.1$ mm), 견치부($0.5{\pm}0.1$ mm), 원심부($0.7{\pm}0.2$ mm)였으며 임플란트 안정성 수치의 변화량은 중앙부($-1.05{\pm}2.76$ mm), 견치부($-0.85{\pm}2.59$ mm), 원심부($-1.27{\pm}2.18$ mm)를 나타내었고 위치간 통계학적인 차이는 없었다(P>.05). 본 전향적인 기초조사연구에서 CAD-CAM기반의 무판막임플란트 치료술식은 하악무치악환자에게 신뢰성 있는 술식이 될 수 있을 것으로 사료되었다.

하악 무치악 부위의 임플란트 이식을 위한 전산화단층촬영 영상의 비교 평가 (Comparative evaluation of computed tomography for dental implants on the mandibular edentulous area)

  • 선경훈;정호걸;박혁;박창서;김기덕
    • Imaging Science in Dentistry
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    • 제39권1호
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    • pp.27-33
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    • 2009
  • Purpose: The purpose of this study was to evaluate the clinical usefulness of the recently developed multi-detector computed tomography and cone beam computed tomography in pre-operative implant evaluation, by comparing them with the single detector computed tomography, already confirmed for accuracy in this area. Materials and Methods: Five partially edentulous dry human mandibles, with $1{\times}1mm$ gutta percha cones, placed in 5mm intervals posterior to the mental foramen on each side of the buccal part of the mandible, were used in this study. They were scanned as follows: 1) Single detector computed tomography: slice thickness 1mm, 200mA, 120kV 2) Multi-detector computed tomography: slice thickness 0.75mm, 250mA, 120kV 3) Cone beam computed tomography: 15mAs, 120kV Axial images acquired from three computed tomographies were transferred to personal computer, and then reformatted cross-sectional images were generated using V-Implant $2.0^{(R)}$ (CyberMed Inc., Seoul, Korea) software. Among the cross-sectional images of the gutta perch a cone, placed in the buccal body of the mandible, the most precise cross section was selected as the measuring point and the distance from the most superior border of the mandibular canal to the alveolar crest was measured and analyzed 10 times by a dentist. Results: There were no significant intraobserver differences in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). There were no significant differences among single detector computed tomography, multi-detector computed tomography and cone beam computed tomography in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). Conclusion: Multi-detector computed tomography and cone beam computed tomography are clinically useful in the evaluation of pre-operative site for mandibular dental implants, with consideration for radiation exposure dose and scanning time.

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파노라마방사선사진 지수와 임플란트 실패와의 관계에 관한 연구 (The relationships between panoramic indices and dental implant failure)

  • 조현정;이원진;허민석;안창현;이진구;이삼선;최순철
    • Imaging Science in Dentistry
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    • 제34권1호
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    • pp.25-30
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    • 2004
  • Purpose: Several panoramic indices have been suggested to assess bone quality from the morphology and width of mandibular cortex on panoramic radiography. The purpose of this study was to compare dental implant failure group with control group in panoramic mandibular index (PMI), mandibular cortical index (MCI), and gonion index (GI) and to determine the effect of these panoramic indices on dental implant failure. Materials and Methods: A case-control study was designed. Test group (n=42) consisted of the patients who had their implants extracted because of peri-implantitis. Control group (n=139) consisted of the patients who retained their implants over one year without any pathologic changes and had been followed up periodically. They had dental implants installed in their mandibles without bone augmentation surgery from 1991 to 2001. The following measures were collected for each patients: 1) PMI, MCI, and GI were measured twice at one-week interval on preoperative panoramic views; and 2) age, sex, implant length, implant type, installed location, occluding dentition state, and complication were investigated from the chart record. Results: The PMI showed moderate level of repeatability. The intra-observer agreement of MCI and GI were good. There was statistically significant difference in PMI between two groups. There were significant different patterns of distribution of MCI and GI between two groups. Among the panoramic indices, PMI and MCI showed significant correlation with dental implant failure. Conclusion: Panoramic indices can be used as reference data in estimating bone quality of edentulous patients who are to have implants installed in their mandibles.

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Sandwich technique을 이용한 하악골 증대술의 치험 보고 (PIEZOELECTRIC VERTICAL BONE AUGMENTATION USING SANDWICH TECHNIQUE IN ATROPHIC MANDIBLE: TWO CASES REPORT)

  • 이지수;이정광;이현진;안미라;손동석
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권3호
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    • pp.276-282
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    • 2008
  • Objective: This is to report the efficacy of the sandwich technique for bone augmentation in a moderate atrophic posterior mandible through clinical and histological results in two cases. Subjects and Method: Two patients selected had moderate bone resorption in left lower edentulous area. Sandwich osteotomy using the piezosurgery was performed and the osteomized alveolar segments were elevated by 6mm in each two patients. The interpositional mineral allograft materials were inserted in the atrophic posterior mandibles. After four months healing period, bone biopsies in the grafted areas and placement of dental implants were performed. In both cases, panoramic views were taken preoperatively to measure the alveolar bone height for diagnosis, to monitor patient healing, and to evaluate bone healing and bone gain. Results: Sufficient vertical bone height was gained by using the sandwich technique and implants were placed successfully. In radiological evaluation, there was minimal resorption of bone height after the second operation and in histomorphometric evaluation, they showed favorable new bone formation without inflammation in the grafted areas. Conclusion: The sandwich technique can be an effective choice for augmenting vertical bone height in the atrophic mandible. More of cases and long term follow-up are needed to evaluate bone resorption and implant prognosis.

상악동의 형태에 관한 방사선학적 연구 (A RADIOGRAPHIC STUDY ON THE MORPHOLOGY OF THE MAXILLARY SINUS)

  • 김봉영;김재덕
    • 치과방사선
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    • 제21권2호
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    • pp.297-306
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    • 1991
  • The purpose of this study is to improve the availabilities of radiographic technics as diagnostic methods to evaluate maxillary sinus in dental clinic. For the morphologic study of maxillary sinus, 20 dry maxillas were used and intraoral standard views, orthopantomograms, and skull P-A views were taken. For measuring the vertical image magnification rates, 5 sites in maxillary molar regions of 5 dry mandibles were selected radndomly and 25 wires of the determined sizes for selected portions were attached to the sites, after then, intraoral radiograms with bisecting technic and orthopantomograms were taken. The acquired results were as follows: 1. The anterior extension of the maxillary sinus on orthopantomogram was the distal side of the canine in 45.45% of subjects, the mesial side of the canine in 27.27%, the lateral incisor in 9.09%, the mesial side of the 1st premolar in 9.09%, and the mesial side of the 2nd pre-molar in 9.09%. 2. The positional relationship between the floor of maxillary sinus and the apex of alveolar socket revealed superimposed type in 58.3% of subjects, approached type in 33.3%, and separated type in 8.4%. 3. The morphology of inferior border of maxillary sinus was simple V or U shape in edentulous stage and V or wide U shape in alveolar socket stage. 4. The vertical image length on intraoral film taken by bisecting technic was magnified by 27.23% on the average and the length on orthopantomogram by 12.35%. 5. The inferior borders of maxillary sinus coinciding with each of the areas bearing the anterior and the posterior teeth on skull P-A view were determined.

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The effect of fibronectin-coated implant on canine osseointegration

  • Kim, Sung-Tae;Myung, Woo-Chun;Lee, Jung-Seok;Cha, Jae-Kook;Jung, Ui-Won;Yang, Hyeong-Cheol;Lee, In-Seop;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • 제41권5호
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    • pp.242-247
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    • 2011
  • Purpose: The purpose of this study was to characterize the osseointegration of the fibronectin-coated implant surface. Methods: Sand-blasted, large-grit, acid-etched (SLA) surface implants, with or without a thin calcium phosphate and fibronectin coating, were placed in edentulous mandibles of dogs 8 weeks after extraction. All dogs were sacrificed forhistological and histomorphometric evaluation after 4- and 8-week healing periods. Results: All types of implants were clinically stable without any mobility. Although the bone-to-implant contact and bone density of the SLA implants coated with calcium phosphate (CaP)/fibronectin were lower than the uncoated SLA implants, there were no significant differences between the uncoated SLA surface group and the SLA surface coated with CaP/fibronectin group. Conclusions: Within the limits of this study, SLA surfaces coated with CaP/fibronectin were shown to have comparable bone-to-implant contact and bone density to uncoated SLA surfaces.

나선형 단층방사선사진촬영에서 촬영조건이 악골 단면상의 높이, 폭 및 인지도에 미치는 영향 (The effect of different radiographic parameters on the height, width and visibility of cross-sectional image of mandible in spiral tomography)

  • 이태완;한원정;김은경
    • Imaging Science in Dentistry
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    • 제33권1호
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    • pp.43-49
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    • 2003
  • Purpose : To evaluate the differences in bone height, bone width, and visibility of posterior spiral tomographic images according to various exposure directions, image layer thickness, and inclination of the mandibular inferior border. Materials and Methods: Six partially and completely edentulous dry mandibles were radiographed using Scanora spiral tomography. Spiral tomography was performed at different exposure directions (dentotangential and maxillotangential projection), image layer thicknesses (2 mm, 4 mm and 8 mm), and at various inclinations to the mandibular border (+ 100, 00 and -10°). The bone height and width was measured using selected tomographic images. The visibility of mandibular canal, crestal bone, and buccal and lingual surfaces were graded as 0, 1, or 2. Results : The bone width at the maxillo-tangential projection was wider than at the dento-tangential projection (p < 0.05). The visibility of buccal and lingual surface at the maxillo-tangential projection was higher than at the dento-tangential projection (p<0.05). Thinner image layer thicknesses resulted in greater visibility of buccal and lingual surfaces (p < 0.05). Bone height was greatest in the -10° group, and at the same time the bone width of the same group was the narrowest (p < 0.05). The visibility of alveolar crest and buccal surface of the + 10° group was the highest, while the visibility of the mandibular canal was greatest in the 00 group. Conclusion: When spiral tomography is performed at the mandibular posterior portion for visualization prior to implant surgery, it is important that the inferior border of mandible be positioned as parallel as possible to the floor. A greater improvement of visibility can be achieved by maintaining a thin image layer thickness when performing spiral tomography.

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Comparison of the effects of horizontal and vertical micro-osteoperforations on the biological response and tooth movement in rabbits

  • Kim, Seok-gon;Kook, Yoon-Ah;Lim, Hee Jin;Park, Patrick;Lee, Won;Park, Jae Hyun;Bayome, Mohamed;Kim, Yoonji
    • 대한치과교정학회지
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    • 제51권5호
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    • pp.304-312
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    • 2021
  • Objective: This study aimed to compare the amount of tooth movement after multiple horizontal (MH) and single vertical (SV) micro-osteoperforations (MOPs), and evaluate the histological changes after orthodontic force application in rabbits. Methods: The mandibles of 24 white rabbits were subjected to two experimental interventions: MH and SV MOPs. Defect volume of the MOPs between the two groups was kept similar. A force of 100 cN was applied via a coil spring between the incisor teeth and the first premolars. The amount of tooth movement was measured. Differences in the amount of tooth movement and bone variables at three time points and between the two groups were evaluated using repeated-measures analysis of variance. Results: The first premolar showed a mesial movement of 1.47 mm in the MH group and 1.84 mm in the SV group, which was significantly different at Week 3 (p < 0.05). No significant difference was observed in bone volume and bone fraction between the groups. Tartrate-resistant acidic phosphatase-positive cell count was also significantly greater at Week 3 than at Week 1 in both the SV and MH groups. Conclusions: The amount of tooth movement showed significant differences between Weeks 1 and 3 in the SV and MH MOP groups, but showed no differences between the two groups. Therefore, SV MOP could be considered an effective tool for enhancing tooth movement, especially for molar distalization, uprighting, and protraction to an edentulous area.

Evaluation of adjacent tooth displacement in the posterior implant restoration with proximal contact loss by superimposition of digital models

  • Jo, Deuk-Won;Kwon, Min-Jung;Kim, Jong-Hee;Kim, Young-Kyun;Yi, Yang-Jin
    • The Journal of Advanced Prosthodontics
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    • 제11권2호
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    • pp.88-94
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    • 2019
  • PURPOSE. This study was conducted to investigate patterns of adjacent tooth displacement in the posterior implant with interproximal contact loss (ICL) by 3-D digital superimposition method. MATERIALS AND METHODS. Posterior partially edentulous patients, restored with implant fixed partial prostheses before 2011 and suffered from food impaction of ICL between 2009 and 2011, were included. Two dental casts, at the time of delivery and at the time of food impaction in a same patient, was converted into 3-D digital models through scanning and superimposition was performed to assess chronologic changes of the dentition. Directions of tooth displacement were evaluated and the amount of ICL was calculated. Correlations between the amount of ICL and elapsed time, or between the amount of ICL and age after function, were assessed at a significance level of P<.05. RESULTS. A total number of 13 patients (8 males, 5 females) with a mean age of $65.76{\pm}9.94years$ and 17 areas (4 maxillae, 13 mandibles) were included in this retrospective study. Teeth adjacent to the implant restoration showed complex displacements but characteristic tendency according to the location of the arch. The mean amount of ICL was $0.33{\pm}0.14mm$. Elapsed time from function to ICL was $61.47{\pm}31.27months$. There were no significant differences between the amount of ICL and elapsed time, or age (P>.05). CONCLUSION. Natural teeth showed various directional movements to result in occlusal change in the arch. The 3-D superimposition of chronologic digital models was a helpful method to analyze the changes of dentition and individual tooth displacement adjacent to implant restoration.