• The Journal of Korean Academy of Prosthodontics
• /
• 제60권1호
• /
• pp.44-54
• /
• 2022

Without proper treatment on the multiple tooth missing area, the lack of posterior support and the supra-eruption of the teeth cause many severe complications of occlusion, vertical dimension and masticatory function. This report is a case of full-mouth rehabilitation of a patient with loss of posterior support and collapsed occlusion due to missing teeth area left untreated for a long time. The patient who is 68-year old male patient had some teeth fallen out while removing his old maxillary denture and was complaining about pain in the region of anterior teeth due to traumatic contact. The vertical dimension was corrected by 4 mm from the top cervical point of the canine through various evaluations and the edentulous area was treated with the implant fixed prostheses through computer guided implant surgery based on the diagnosis and treatment plan for definitive prostheses supported by computed tomography (CT) data analysis and CAD-CAM (Computer-aided design/computer-aided manufacturing) technique. After full mouth rehabilitation, the patient was very satisfied with remarkable improvements in mastication, function, and aesthetics.

• Journal of Dental Rehabilitation and Applied Science
• /
• 제38권4호
• /
• pp.249-256
• /
• 2022

The implant prosthesis of anterior maxilla requires careful consideration in planning. In order to satisfy both esthetic and functional needs of a patient, fusion of intra-oral scan in Cone-beam computed tomography (CBCT) and facial scan can be considered. Bony structures and soft tissues captured in CBCT and occlusal surfaces of intra oral scan were incorporated into personal characteristics from facial scan. The patient had insufficient buccal bone on maxillary anterior area. The maxillary implants could not be placed on the most ideal position. However, the "top down" approach completed by computer-generated arranging of teeth in implant planning and surgery with surgical guide resulted in esthetically and functionally satisfying result regardless of the limitation. Careful diagnosis with digital technique and the usage of surgical guide resulted in successful surgery and esthetic restoration. The temporary fixed prostheses were designed, restored and evaluated. The patient was not satisfied with the first design of temporary prosthesis, which showed uneven space distribution between teeth due to the position of maxillary implant. The design was modified by changing proximal emergence contours and line angle to alter the perceived since of incisors. The patient was satisfied with the new design of provisional restoration. A digital occlusion analyzer (Arcus Digma II, KaVo, Leutkirch, Germany) was used to measure inherent condylar guidance and anterior guidance of a patient to provide a definitive prosthesis.

• Journal of the Korean Society for Precision Engineering
• /
• 제23권12호
• /
• pp.95-102
• /
• 2006

A product is designed through the collaboration among engineers in several fields such as design, analysis, and manufacturing. These series of functions are performed repeatedly during the design process. An easy access and exchange of the model data is one of the important elements that help to shorten production development time. Especially, the importance of data exchange between CAD and CAE applications is increasing in the field of verification and estimation of the products. However, information and knowledge of model which is generated by a CAD software cannot be transferred by a function of CAE software, as an exchange of product data between CAD and CAE applications. It causes a delay in design analysis and eventually discourages a designer's effort in improving his design. Therefore, we need to integrate a commercial CAD and CAE applications effectively and to use the same interface on a product model obtained in a distributed environment. This paper shows how to implement a model exchange between CAD and CAE by a web-service and how to provide a communication environment among engineers.

• The Journal of Korean Academy of Prosthodontics
• /
• 제44권4호
• /
• pp.394-404
• /
• 2006

Statement of problem: A conventional 3-unit fixed partial denture design with a pontic between two retainers is the most commonly used. However in cases where the mental nerve is in close proximity to the second premolar, a cantilever design can be considered. As such, logical and scientific evidence is lacking for the number and position of implants to be placed for partially edentulous patients, and no clear-cut set of treatment principles currently exist. Purpose : The purpose of this study was to evaluate prognosis of implant-supported fixed partial dentures and to compare changes in bone level which may rise due to the different factors. Material and method : The present study examined radiographical marginal bone loss in patients treated with implant-supported fixed partial dentures (87 prostheses supported by 227 implants) and evaluated the influence of the span of the pontic, type of the opposing dentition. Clinical complications were studied using a retrospective method. Within the limitation of this study. the following result were drawn Result, 1. Seven of a total of 227 implants restored with fixed prostheses failed, resulting in a 96.9% success rate. 2. Complications encountered during recall appointments included dissolution of temporary luting agent (17 cases), porcelain fracture (8 cases), loosened screws (5 cases), gingival recession (4 cases), and gingival enlargement (1 case). 3. Marginal bone loss, 1 year after prosthesis placement, was significant(P<0.05) in the group that underwent bone grafting, however no difference in annual resorption rate was observed afterwards. 4. Marginal bono loss, 1 year post-placement, was greater in cantilever-type prostheses than in centric pontic protheses (P<0.05). 5. Marginal bone loss was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. The degree of marginal bone loss was proportional to the length of the pontic (P<0.05). Conclusion: The success rate of implant-supported fixed partial dentures, including marginal bone loss, was satisfactory in the present study. Factors influencing marginal bone loss included whether bone graft was performed, location of the pontic (s), location of the surgical area in the arch pontic span. Long-term evaluation is necessary for implant-supported fixed partial dentures, as are further studies on the relationship between functional load and the number of implants to be placed.

• The Journal of Advanced Prosthodontics
• /
• 제1권1호
• /
• pp.19-25
• /
• 2009

STATEMENT OF PROBLEM. Primary stability at the time of implant placement is related to the level of primary bone contact. The level of bone contact with implant is affected by thread design, surgical procedure and bone quality, etc. PURPOSE. The aim of this study was to compare the initial stability of the various taper implants according to the thread designs, half of which were engaged to inferior cortical wall of type IV bone(Group 1) and the rest of which were not engaged to inferior cortical wall(Group 2) by measuring the implant stability quotient(ISQ) and the removal torque value(RTV). MATERIAL AND METHODS. In this study, 6 different implant fixtures with 10 mm length were installed. In order to simulate the sinus inferior wall of type IV bone, one side cortical bone of swine rib was removed. 6 different implants were installed in the same bone block following manufacturer s recommended procedures. Total 10 bone blocks were made for each group. The height of Group 1 bone block was 10 mm for engagement and that of group 2 was 13 mm. The initial stability was measured with ISQ value using Osstell $mentor^{(R)}$ and with removal torque using MGT50 torque gauge. RESULTS. In this study, we found the following results. 1. In Group 1 with fixtures engaged to the inferior cortical wall, there was no significant difference in RTV and ISQ value among the 6 types of implants. 2. In Group 2 with fixtures not engaged to the inferior cortical wall, there was significant difference in RTV and ISQ value among the 6 types of implants(P < .05). 3. There was significant difference in RTV and ISQ value according to whether fixtures were engaged to the inferior cortical wall or not(P < .05). 4. Under-drilling made RTV and ISQ value increase significantly in the NT implants which had lower RTV and ISQ value in Group 2(P < .05). CONCLUSIONS. Without being engaged to the inferior cortical wall fixtures had initial stability affected by implant types. Also in poor quality bone, under-drilling improved initial stability.

• Journal of Dental Rehabilitation and Applied Science
• /
• 제38권1호
• /
• pp.42-51
• /
• 2022

Esthetic restoration of maxillary anterior implant heavily depends on the direction of installation of implant fixture. In patients with malpositioned implant, it is crucial to communicate the limitations of prosthetic outcome with the patient before starting on a restoration. To facilitate the communication, three-dimensional virtual representation by superimposing facial and intraoral digital scans with Computed Tomography (CT, dicom file) was used for visualization of the limitations of prosthesis. Through digital diagnostic wax-up, the profile of right maxillary anterior incisor implant was expected to be protrusive, which the patient was not satisfied with. Since the patient already had done root canal treatment on left maxillary anterior incisor due to previous trauma, a new prosthetic design including both right and left maxillary anterior incisors was presented to the patient. The second design was chosen and his comments were delivered to dental lab. The patient was satisfied with the new prosthesis, aesthetically and functionally.

• The Journal of the Korean dental association
• /
• 제18권1호통권130호
• /
• pp.23-25
• /
• 1980

• Journal of Dental Rehabilitation and Applied Science
• /
• 제27권2호
• /
• pp.175-184
• /
• 2011

With a development of implant restoration technique, there are increasing use of computer-guided system for edentulous patients. It was carried out simulated operation based on CT information about patient's bone quantity, quality and anatomical landmark. However, there are some difference between the programmed implant and post-operative implant about it's position. If the deviation was severe, it could happen a failure of 'passive fit' and not suited for path of implant restoration. The aim of this presentation is to evaluate about a degree of deviations between programmed implant and post-operative implant. Five patients treated by 'NobelGuide' system (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden) in Department of Prosthodontics, Inha University were included in this study. The patients were performed CT radiograph taking and intra-oral impression taking at pre-operation. Based on CT images and study model, surgical stent was produced by NobelBiocareTM. To fabricated a pre-operative study model, after connected lab analog to surgical template, accomplished a pre-operative model using type 4 dental stone. At final impression, a post-operative study model was fabricated in the conventional procedures. Each study model was performed CT radiograph taking. Based on CT images, each implant was simulated in three dimensional position using $Procera^{(R)}$ software (Procera Software Clinical Design Premium, version 1.5; Nobel Biocare AB). In 3D simulated model, length and angulation between each implant of both pre- and post-operative implants were measured and recorded about linear and angular deviation between pre-and post-operative implants. A total of 24 implants were included in this study and 58 inter-implant sites between each implant were measured about linear and angular deviations. In the linear deviation a mean deviation of 0.41 mm (range 0~1.7 mm) was reported. In the angular deviation, a mean deviation was $1.99^{\circ}$ (range $0^{\circ}{\sim}6.7^{\circ}$). It appears that the both linear and angular mean deviation value were well acceptable to application of computer-guided implant system.

• The Journal of Advanced Prosthodontics
• /
• 제11권2호
• /
• pp.105-111
• /
• 2019

PURPOSE. Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS. A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with $0.7{\mu}L$ of polymicrobial culture (P. gingivalis, T. forsythia, T. denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (${\alpha}=.05$). RESULTS. Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in ${\mu}m$) of the groups were in the range of 2.7-4.0 (IC-Zr), 1.8-5.3 (IC-Ti), 6.5-17.1 (IT-Zr), 5.4-12.0 (IT-Ti), 16.8-22.7 (EH-Zr), and 10.3-15.4 (EH-Ti). CONCLUSION. The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design.

• The Journal of Korean Academy of Prosthodontics
• /
• 제62권1호
• /
• pp.38-46
• /
• 2024

In order to treat edentulous patients with fixed implant prosthesis, the final prosthesis form should be predetermined based on the anatomic structures of the arch, the opposing dentition, and the occlusal plane. The design and occlusion of the interim prosthesis can provide useful information when fabricating the definitive prosthesis. In this case report, scan data of the edentulous region and the interim prosthesis were superimposed through an intraoral scanning digital workflow. In this way, the interim prosthesis information was incorporated into the design of the final prosthesis. Furthermore, the interim prosthesis data acquired through intraoral scanning was utilized to plan the positions and angles of the implants based on the final prosthesis design. Surgical guides were used to accurately place the implants in the planned three-dimensional positions. In this case report, satisfactory esthetic and functional clinical outcomes were achieved through application of digital techniques.