• Title/Summary/Keyword: Esthetics, dental

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A ROENTGENOCEPHALOMETRIC STUDY OF KOREAN SOFT TISSUE PROFILE (한국인 악안면 연조직에 관한 두부방사선 계측학적 연구)

  • Cheon Suck, Oh
    • The korean journal of orthodontics
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    • v.12 no.2
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    • pp.79-93
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    • 1982
  • The purpose of orthodontic treatment is to achieve normal occlusion and good facial esthetics for individual patients. To produce harmonized facial balance, treatment planning for patient who require orthodontic treatment should include both a hard tissue and soft tissue cephalometric analysis. Author studied to derive the normal standards of soft tissue profile in Koreans by roentgenocephalometric analysis. For this study 12 soft tissue profile landmarks were plotted and 23 linear length, 9 soft tissue thickness, 8 vertical height length, 12 angles of soft tissue profile, and 3 vertical proportion were measured. The subjects consisted of 166 males and 209 females from 7 to 19 years with normal occlusion and acceptable profiles, and were divided into five groups according to age. The obtained results were as follows; 1. From the basis of N-Pog (Nasion-Pogonion) plane, the growth of facial soft tissue in the middle region especially nose area was greater than others facial region. 2. From the basis of G-Pog' (Glabella-soft tissue Pogonion) plane, the values of linear measurement of soft tissue Nasion and Inferior labial sulcus decreased and nose tip grew forward as growing older. 3. The growth of the facial soft tissue thickness was greatest in superior labial sulcus and the thickness of soft tissue nasion gradually became thinner as growing old. 4. The thickness of upper and lower lip was 14.47mm, 14.57mm in adulr male, 12.76mm, 13.78mm in adult female. 5. The soft tissue thickness of the lower lip was thicker than that of upper lip in all age groups and both sexes, 6. The vertical length of the upper and lower lips were 25.04mm, 49.97mm in adult male and 23.50mm, 48.39mm in adult female. 7. By the significant test, there were significant difference between male and female in fifth adult group on all vertical length measurements of lower face. 8. In fifth adult group, the perpendicular distance from LS, LI to Steiner's line and Ricketts' esthetic line were as follow; Steiner line to LS, LI were 7.98mm, 5.84mm in male. Steiner line to LS, LI were 6.71mm, 5.08mm in female. Ricketts' esthetic line to LS, LI were -0.40mm, 1.72mm in male. Ricketts' esthetic line to Ls, LI were -1.38mm 0.65mm in female. 9. In fifth adult group, the facial convexity angle and lower facial component angle were $171.17^{\circ}142.94^{\circ}$ in male and $172.5^{\circ}$, $144.41^{\circ}$ in female.

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A STUDY OF CLINICAL RESULTS ON STERI-OSS ENDOSSEOUS IMPLANTS (Steri-Oss 임플랜트의 임상 결과에 관한 연구)

  • Min, Young-Kyu;Kweon, Hyeog-Sin;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.2
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    • pp.258-272
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    • 1998
  • This investigation evaluated patients who received Steri-Oss implants from the Dental Hospital of Chosun University during the period from March 1989 to August 1997. 346 fixtures of 127 patients were included in this study. The results were as follows ; 1.The follow-up period was defined as the period between the surgical placement of the implants and the last follow-up examination. The mean follow-up period was $2.17{\pm}1.21$ years. 2.The period between fixture installation and second surgery was $0.71{\pm}0.44$ years in the maxilla and $0.46{\pm}0.21$ years in the mandible. 3.The number of fixtures which were installed in the upper jaw(112) was less than that in the lower jaw(234) and in the posterior region(260) was more than in the anterior region(86). 4.The length of fixture which was most frequently used was 12 mm and least was 8mm. Screw implants were installed more than cylindrical implants. 3.8mm implant was the most common implans, followed by 4.5mm and 3.25mm. 5.The number of augmentation cases was more than that of non-augmentation cases and the rate of augmentation cases in the maxilla was more than that in the mandible. 6.Implant restorations for partial edentulos patients(94cases) were more than single- tooth implant restorations(33cases) or implant restorations for complete edentulos patients(10cases). 7.Free-standing prostheses for partially edentulous patients were more commom than any other type of connection between implants and natural teeth. 8.Plaque Index($0.95{\pm}0.74$) and Gingival Index($0.31{\pm}0.52$) were very similar around the natural teeth and reflected an acceptable level of plaque and gingivitis control. Mean value for keratinized mucosa index($1.93{\pm}1.20$) remained fairly constant around level 2(1-2 mm keratinized epithelium). 9.Patients were generally satisfied with implant in terms of comfort, function, speech and esthetics. 10.There was not a statistically significant differences in overall survial rate between implants placed in the maxilla (91.5%) and those placed in the mandible (93.8%). Fourteen implants lost before the prosthetic rehabilitation and eleven implants lost following variable periods in function after the prosthetic phase of the treatment. 11.Cause of implant failures was exfoliation or removal of fixture due to non-osseointegration before the prosthetic rehabilitation or due to fracture of fixture, masticatory pain after the prosthetic rehabilitation. 12.The survival rate of Steri-Oss implants using the Kaplan-Meier statistical analysis was 93.8% at 2 year and 86.6% at 5 year, In all cases, implant losses occured predominantly in the healing period. There was a steep decline in the rate of implant loss after the first year. 13.The survival rate of Steri-Oss implants in the anterior region was 94.8% at 2 year and 94.8% at 5 year and that in the posterior region was 92.8% at 2 year and 75.9% at 5 year. In conclusion, this study revealed a number of parameters and guidelines for achieving an optimal success rate in osseointegration.

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CONSERVATIVE TREATMENT OF A UPPER CENTRAL INCISOR WITH POOR PROGNOSIS (예후가 불량한 상악 중절치의 유지)

  • Lee, Doo-Young;Kim, Seung-Hye;Choi, Hyung-Jun;Choi, Byung-Jai;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.368-373
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    • 2010
  • The incisors function as instruments for biting and cutting food during mastication. They also support the lips and face and maintain vertical dimension. In addition, they contribute to overall normal arch appearance. They play important role during the articulation of speech and assist in guiding jaw closure. Extraction and space maintenance are the most common treatment for a tooth with poor prognosis. However, in the mixed dentition, extraction of the upper permanent incisors results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation, and mastication. Considering these various roles of incisors in oral cavity, approach for traumatized incisors, even the ones with poor prognosis, should be considered first prior to simple extraction. The dentist must take into account the age of the patient, growth potential, occlusion, oral hygiene status, economic status and motivation towards dental health in addition to patient compliance. In this case, although the prognosis was predicted to be unfavorable due to short root and mobility, we could save the central incisor using conservative treatment, reposition by orthodontic appliance instead of extraction.

MANDIBULAR DIFFERENTIAL PREMOLAR EXTRACTI0N IN GROWING PATIENTS (성장기 환자에서 하악의 차등적 소구치 발치)

  • Kim, Do-Hoon;Sung, Sang-Jin;Moon, Yoon-Shik
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.1-13
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    • 2001
  • The extraction lot orthodontic treatment can be adopted for aligning crowded dentition, improving facial esthetics and solving a skeletal discrepancy as alternative for a surgical option. Mandibular second premolar extraction was often selected as treatment plan when there we very little or no space shortage in lower arch or limited retraction of the lower incisors was required. The primary object of this study was evaluate a pretreatment condition and examine the amount of tooth movement ior a mandibular second premolar extraction in growing patients. Pretreatment and posttreatment lateral cephalograms of 14 cases that had their four first premolar extracted (4/4 group), 15 cases with upper first and lower second premolar extraction (4/5 group) were selected. Structural method superimposition was conducted to evaluate a difference of dental change between 4/4 and 4/5 group. The results were as follows, 1. Pretreatment factor for 4/4 extraction or 4/5 extraction choice included maxillary incisor axis to occlusal plane, Class II molar relationship, IMPA and interincisal angle. 2. The amount of molar anterior movement in 4/5 group was greater than that of 4/4 group(p<0.05). 3. There was no significant difference between 4/4 group and 4/5 group in aspects of maxillary tooth movement(p<0.05).

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A CEPHALOMETRIC STUDY ON CHANGES OF FACIAL MORPHOLOGY IN THE FRONTAL VIEW FOLLOWING MANDIBLE SETBACK SURGERY ( BSSRO ) IN PATIENTS WITH SKELETAL CLASS III DENTOFACIAL DEFORMITIES (골격성 제3급 부정교합환자의 하악지 시상분할 골절단술후 하안면 폭경 및 고경의 변화에 대한 두부계측 방사선학적 연구)

  • Jang, Hyon-Seok;Rim, Jae-Suk;Kwon, Jong-Jin;Lee, Bu-Kyu;Son, Hyoung-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.337-342
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    • 2000
  • Purpose : The purpose of this study was to analyze the lower third facial changes in frontal view after mandibular setback surgery. Materials and Methods : In this study, fifteen subjects(6 males and 9 females) with class III dental and skeletal malocclusions who were treated with BSSRO(Bilateral Sagittal Split Ramus Ostetomy) were used. Frontal cephalometric radiographs were taken preoperatively and more than 6 months postoperatively, and hard tissue(H2-Hl) and soft tissue changes (S2-S1) were measured on vertical and horizontal reference lines. In 15 cases, changes which developed more than 6 months after surgery were studied. Results : The results were as follows. 1. In the facial height, hard tissue $decreased(2.46{\pm}2.76mm)$ with statistical significance(P<0.01), and soft tissue also $decreased(1.64{\pm}3.66mm)$. As a result, the facial height generally becomes shorter after sagittal split ramus osteotomy. 2. In the mandibular width, hard tissue $decreased(2.08{\pm}3.59mm)$ with statistical sgnificance(P<0.05), but soft tissue $increased (2.14{\pm}5.73mm)$ without statistically significant difference(P>0.05) postoperatively. 3. In the facial index, hard tissue $decreased(0.23{\pm}2.21%)$, but soft tissue $increased(2.41{\pm}3.46%)$ with statistical significance. Conclusion : One of the main purpose of orthognathic surgery is to achieve facial esthetics and harmony. In order to fullfill this purpose, it is important to carry out a precise presurgical treatment planning by estimating the changes of frontal profile after surgery.

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The Occlusal Evaluation and Treatment Planning for Prosthodontic Full Mouth Rehabilitation (보철학적 교합 재구성을 위한 교합진단과 치료계획)

  • Lee, Seung-Kyu;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.149-159
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    • 2000
  • Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

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Occlusal Adjustment and Prosthodontic Reconstruction on the Open-bite Patient. - Intentional Decrease of Occlusal Vertical Dimension - (자연치 교합조정에 의한 전치, 구치 개교합의 보철적 수복 - 수직고경의 의도적 감소증례)

  • Lee, Seung-Kyu;Kwon, Kung-Rock;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.133-147
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    • 2000
  • A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

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Full Mouth Rehabilitation (완전 구강 회복술)

  • Lee, Seung-Kyu;Lee, Sung-Bok;Kwon, Kung-Rock;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.3
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    • pp.171-185
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    • 2000
  • The treatment objectives of the complete oral rehabilitation are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. There may be many roads to achieving these objectives, but they all convey varing degrees of stress and strain on the dentist and patient. There are no "easy" cases of oral rehabilitation. Time must be taken to think, time must be taken to plan, and time must be taken to perform, since time is the critical element in both success and failure. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. Firstly, we must evaluate the mandibular position. The results of a repetitive, unstrained, nondeflective, nonmanipulated mandibular closure into complete maxillomandibular intercuspation is not so much a "centric" occlusion as it is a stable occlusion. Accordingly, we ought to concern ourselves less with mandibular centricity and more with mandibular stability, which actually is the relationship we are trying to establish. The key to this stability is intercuspal precision. Once neuromuscular passivity has been achieved during an appropriate period of occlusal adjustment and provisionalization, subsequent intercuspal precision becomes the controlling factors in maintaining a stable mandibular position. Secondly, we must evaluate the planned vertical dimension of occlusion in relationship to what may now be an altered(generally diminished), and avoid the hazard of using such an abnormal position to indicate ultimate occlusal contacting points. There are no hard and fast rules to follow, no formulas, and no precise ratios between the vertical dimension of occlusion. Like centric relation, it is an area, not a point.

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Full mouth rehabilitation of a partially edentulous patient with crossed occlusion using implant-retained RPD with zirconia occlusal table (엇갈린 교합을 가진 부분 무치악 환자에서 지르코니아 교합면을 가지는 Implant-Retained RPD 이용한 전악 수복 증례)

  • Kwon, Tae-Min;Seo, Chi-Won;Kim, Kyung-A;Ahn, Seung-Geun;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.4
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    • pp.314-321
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    • 2016
  • Conventional removable partial dentures (RPDs) with distal extensions are associated with some problems, including lack of stability that calls for frequent relining, and cantilever actions of claps that can produce excessive loading to abutment teeth, and the need for unesthetic retentive arm clasps. Therefore, IARPDs (Implant-assisted RPD) that use implants to support or retain RPDs has been reported to improve stability, esthetics and masticatory performance of RPDs. Also, an IARPD that has zirconia occlusal table can prevent the incongruity of occlusal plane and the extrusion of antagonistic tooth. In this case of partially edentulous patient with crossed occlusion, each edentulous area was restored with implant fixed prosthesis and implant retained partial denture to suit each situation. Through the procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

Comparative evaluation of the subtractive and additive manufacturing on the color stability of fixed provisional prosthesis materials (고정성 임시 보철물 재료의 색 안정성에 대한 절삭 및 적층가공법의 비교평가)

  • Lee, Young-Ji;Oh, Sang-Chun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.2
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    • pp.73-80
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    • 2021
  • Purpose: The purpose of this study is to compare the color stability of provisional restorative materials fabricated by subtractive and additive manufacturing. Materials and Methods: PMMA specimens by subtractive manufacturing and conventional method and bis-acryl specimens by additive manufacturing were fabricated each 20. After immersing specimens in the coffee solution and the wine solution, the color was measured as CIE Lab with a colorimeter weekly for 4 weeks. Color change was calculated and data were analyzed with one-way ANOVA and the Tukey multiple comparisons test (α = 0.05). Results: PMMA provisional prosthetic materials by subtractive manufacturing showed superior color stability compared to bis-acryl provisional prosthetic materials by additive manufacturing (P < 0.05), and showed similar color stability to the PMMA provisional prosthetic materials by conventional method (P > 0.05). Conclusion: It is recommended to fabricate provisional restorations by subtractive manufacturing in areas where esthetics is important, such as anterior teeth, and consideration of the color stability will be required when making provisional prosthetic using additive manufacturing.