The aim of treatment of cleft lip and palate is to correct the cleft and associated problems surgically and thus hide the anomaly so that patients can lead normal lives. This correction involves surgically producing a face that does not attract attention, a vocal apparatus that permits intelligible speech, and a dentition that allows optimal function and esthetics. In neonatal periods, gross distortion of tissues surrounding the cleft requires considerable effort and time due to post operative functional defect and scarring and induces milk feeding problem, malocclusion of deciduous or permanent dentition, congenital missing teeth, skeletal dysplasia. The occurrence of a cleft deformity is a source of considerable shock to the parents of an afflicted baby, and the most appropriate approach is very important things. Thus we tried to analysis of dental arch, shape and size of deformity in cleft patients. The results were obtained as follows. 1. When the cast measurements of UCLP subjects at first visit it was found that the mean length was 9.29mm at the alveolar cleft width, also that was 11.7mm at the anterior width and 14mm at the posterior cleft width. 2. Comparison of UCLP group at first visit and just lip surgery, it was found that the older group showed a insignificant reduction in the width of the cleft in the alveolar, canine, and tuberosity regions. 3. The maxillary casts of the UCLP group at 6 months differ Significantly from those of the at 3 months in both length and width. but there was no statistical difference except anterior ridge length of nonclefted site. 4. Comparison at 6 months and 18 months, there was a greater change in length of the alveolar cleft width, intercanine width, and anterior cleft width. Maxillary arch became wider at both the canine region and intertuberosity region. also posterior anteroposterior length was increased but anterior AP length was decreased from 8.1mm to 7.7mm. There was meaningful increase at intertuberosity length; however, a significant reduction in width t-t'
The selection of the maxillary anterior artificial teeth is made primarily for esthetics and they must be in harmony with the surrounding oral environment. However the selection of artificial teeth is based on the large degree of subjective judgement or the dentists, therefore, this is one of the most unscientific processes. This study was performed to determine clinically whether there is correlation among the width of the maxillary central incisor(WMCI), the intercanine distance (ICD) the facial width(FW), and the interalar nasal width(IAW) in Korean adults, and to provide the selection standards for the maxillary anterior artificial teeth. The casts were obtained from 91 undergraduate dental students(49 males and 42 females) with Angle's class I occlusion presenting well-arranged intact anterior teeth. The WMCI and ICD were measured on the casts with a vernier calipers($Miltex^{(R)}$, Germany). The photographic procedures under standardized conditions were performed to record each subject's frontal face using digital camera($Olympus^{(R)}$, C-2500L, Japan). The FW and IAW were measured with image analyzer($Image-Pro^{(R)}$ PLUS. media cybermetrics. USA). The results were obtained as follows : 1. The mean WMCI was $8.11{\pm}0.67mm$, ICD was $37.88{\pm}2.15mm$, FW was $141.29{\pm}5.84mm$. and IAW was $37.85{\pm}2.29 mm$. 2. The ratios of FW/WMCI, FW/ICD, IAW/ICD were 17.4, 3.7, 1.0 respectively. 3. All measurements(WMCI, ICD, FW, and IAW) of male group were longer than those of female group significantly in Student's t-test(p<0.01). 4. There was significant correlation between WMCI, ICD, FW, and IAW in Pearson's correlation analysis(p<0.01). 5, The relationship between IAW and ICD shows the strongest correlation among six combinations in linear regression analysis($R^2$=0.753, Y=7.046+0.815X). The FW and IAW could be very reliable guides for the selection of the maxillary anterior artificial teeth.
Park, Jae-Hyun;Lee, Myung-Jin;Lee, Chang-Kon;Kim, Jong-Sub;Chin, Byung-Rho;Lee, Hee-Kyung
Journal of Yeungnam Medical Science
/
v.9
no.1
/
pp.189-196
/
1992
Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.26
no.6
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pp.628-635
/
2000
The purpose of this study was to evaluate the result after 2-phase surgical-orthodontic treatment without preoperative orthodontic treatment for the skeletal Cl III malocclusion patient and to obtain an adequate protocol on the bases of this result. This retrospective study of ten patients who underwent 2-phase treatment were done to evaluate 1) the surgical stability and relapse pattern 2) the facial esthetics 3) the TMJ problem 4) the total time of the treatment. Results were followed : 1) The horizontal relapse of the mandible was 26.8% and didn't show significant differences compared to the conventional 3-phase treatment. But, it was considered that this amount of relapse was the sum of true relapse and autoratation of mandible due to decreased vertical dimension during orthodontic treatment. 2) It was estimated that there's no difference on the ratio of anterior facial height between the subjects and the normal patients. On the horizontal analysis, the mandible of the subjects was located more anteriorly than that of the normal patients. This result showed that there was a need for the accurate preoperative esthetic evaluation and the additional methods for reducing the relapse due to the occlusal interference. 3) Wide variation was noted on the TMJ symptoms of the subjects, however, it was estimated that there's no significant differencees of symptoms compared to that of the conventional 3-phase treatment on literatures. 4) The average of the overall period of treatment was 20.8 months and we obtained reduction of the treatment time compaired to 3-phase treatment on many literatures. Most of the results of this study were similar to the findings of the 3-phase treatment(preoperative orthodontic-orthognathic surgery-postoperative orthodontic), but total time of the treatment was shorter in patients with 2-phase treatment than in those with the conventional 3-phase treatment. With 2-phase treatment, we experienced many advantages compared to the conventional method considering that it was favarable conditions for the teeth, it had the flexibility for the treatment, and it could be the adequate treatment approach for the stomatognathic system. Although this retrospective pilot study had some limitations, due to small samples, the authors would hope that it could serve as a guide for the future researches, and the clinical applications.
Journal of Dental Rehabilitation and Applied Science
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v.28
no.3
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pp.309-318
/
2012
In advanced stages of periodontal disease, a lot of the periodontal tissue support are usually lost. The tissue destruction around some teeth is progressed to a level which requires either spontaneous exfoliation or extraction of several teeth due to their excessive mobility. In such cases, a comprehensive treatment plan encompassing the adequate periodontal and maintenance therapy, as well as perio-prosthetic treatment involving occlusal equilibration, is needed in order to restore health, function, and esthetics. Cross-arch fixed partial dentures(CAFPDs), one of the perio-prosthetic treatments, are used to stabilize the teeth with severely reduced periodontal tissue support. Unfortunately, however, a little is known about the occlusal scheme and biomechanical concept of CAFPDs. This paper will demonstrate summaries of the trauma from occlusion(TFO), Ante's law revisited, the treatment principles, the role of occlusion, and the long-term consequences for CAFPDs, and the possibility of CAFPDs through a case presentation.
Journal of the Korean Academy of Esthetic Dentistry
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v.22
no.1
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pp.30-46
/
2013
Porcelain fused to metal crown has been used mostly over the last 50 years for restorations in dentistry. However, the patients' awareness of aesthetic aspect, biocompatibility and the problems such as an allergy to metals led to the growing interest in the 'metal free restoration'. In particular, the price of the precious metals that have been mainly used to date has risen drastically, which made them impossible to play their role as oral restorative materials anymore, and in addition, the PFM restoration has intrinsic problems of chipping and fracture. Therefore, the CAD/CAM has been drawing more attention than ever due to the popular needs for the material that is more aesthetic and stronger for restoration of the molar implant. Considerations in carrying out the full zirconia restoration are as follows: 1) strength, 2) combination work, 3) light penetrability, 4) treatment of cracks, 5) the color reproducibility of the block, 6) the abrasivity of antagonistic tooth, 7) low temperature degradation. In this presentation, the color reproducibility of the block will be discussed. One of the biggest reasons for avoiding the full zirconia restoration is that it is difficult to reproduce the natural color compared to the conventional PFM restoration. Thus, many clinicians show reluctance due to the exposure of the ugly block when the coloring on the surface is removed after occlusal adjustment. From the experience of using blocks by Zirkonzahn for more than 4 years, it is considered that these problems can be addressed to some degrees. Accordingly, how to make restorations that are well in harmony with surrounding prosthesis or natural teeth will be discussed.
Journal of Dental Rehabilitation and Applied Science
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v.34
no.3
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pp.218-224
/
2018
Macroglossia is an obstacle in regard to general prosthodontic restoration. Not only is it difficult to obtain support and stability from dentures manufactured from normal protocol, obtaining efficacy from basic mastication is also difficult. In such cases, realizing harmony between the occlusion and surrounding muscle structures may be important with regard to manufacture of stable full dentures, and it is necessary to form the appropriate polished surface for this case. The neutral zone is defined as the potential area resulting from the neuromuscular function that results in equilibrium between the outward force exerted by the tongue and the inward force exerted by the lips and cheeks. The artificial teeth of the full denture lies in this area, and if the polished zone follows the anatomic form of the dynamic muscles, the movement of the muscles simply acts as an element of stabilizing the dentures improving the esthetics through facial support.
Excessive occlusal wear results in unacceptable damage to the occluding surfaces, and can cause pulpal injury, occlusal disharmony, impaired function, and aesthetic deformity. Patients with severely worn dentition need to be classified as several categories relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. When treating patients classified as those who have excessive wear without loss of occlusal vertical dimension but with limited space, we could consider treating them at an increased vertical dimension of occlusion. Treatments at an increased vertical dimension of occlusion may provide stability, given that the amount of its increase was minimal, and a perfected occlusion was achieved after enough stabilization period. A 50-year-old male visited the department of Prosthodontics in Yonsei University Dental Hospital with the chief complaint of worn teeth on lower anterior area. Reconstruction at an increased vertical dimension of occlusion was planned. After the compatibility of the new vertical dimension of occlusion had been confirmed under interim fixed restorations, definitive fixed restorations composed of full-contour monolithic zirconia prostheses were placed. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition at an increased vertical dimension of occlusion with an improvement in esthetics and function.
Esthetics is important in restoring maxillary anterior area. Alveolar bone resorption and loss of interdental papilla may be minimized by immediate implantation. Previous studies showed successful results with the immediate implantation in healthy extraction socket, while many of these studies objected the immediate implantation into extraction sites with periapical lesions. Recent studies, however, reported successful results of the immediate implantation into extraction sites with periapical lesions with careful debridement of extraction sockets and general medication of antibiotics prior to implantation. A 73-year-old female visited the department of Prosthodontics in ${\bigcirc}{\bigcirc}$ University Dental Hospital with the chief complaint of fallen post-core and crown on left maxillary incisor. Although the incisor was with vertical root fracture and periapical lesion, the immediate implantation following the extraction of tooth was planned. Thorough socket debridement, irrigation with chlorhexidine, and tetracycline soaking were followed by immediate implantation. The general medication of antibiotics (Moxicle Tab.$^{(R)}$, 375 mg) was prescribed before and after the surgery. Immediate provisional restoration was delivered two days after the surgery, and the definitive metal-ceramic restoration was placed about six months later after reproducing the emergence profile from the provisional restoration. This case presents satisfying result esthetically and functionally upto two years after the placement of prosthesis with the harmonious gingival line and no loss of marginal bone.
Journal of the korean academy of Pediatric Dentistry
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v.36
no.4
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pp.601-606
/
2009
Amelogenesis Imperfecta (AI) is a genetic disorder which retards the development of enamel and it can be classified into three types: hypoplastic, hypomaturation, hypocalcified type. This can occur both in deciduous and permanent dentition. A 8 year 8 month old patient with a chief complaints of delayed eruption on upper anteriors, calculus deposit on lower anteriors and anterior openbite visited the clinic. Anteriors had thin layer of enamel and were very narrow. Especially lower anteriors had rough surface and were in bad shape. Teeth were very hypersensitive to thermal changes. Upper and lower first molars showed severe attrition on the occlusal surface. Radiographs also verified hypoplastic enamel in the whole dentition including the teeth in the tooth bud. The patient was diagnosed as hypoplastic AI, and is being treated at the pediathc and prosthodontic department of the Kyunghee dental university hospital. To improve the function, esthetics, hypersensitivity of the AI patients, restorations on the posteriors and the anteriors with oral hygiene instruction are necessary, Constant follow-up check is needed until full growth and after full growth, cooperative care with the other department is needed.
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