• Title/Summary/Keyword: Maxillary edentulous

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Prosthetic rehabilitation of partially edentulous patient after maxillectomy: A case report (상악골 부분절제술 시행한 부분 무치악 환자에서 폐쇄 장치를 이용한 보철 수복 증례)

  • Heo, Kyung-Hoi;Lim, Young-Jun;Kim, Myung-Joo;Kwon, Ho-Beom
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.2
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    • pp.167-171
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    • 2016
  • Patients undergone partial maxillectomy experience post-operative masticatory, phonetic, and swallowing difficulties. They also encounter social and psychological challenges due to changes in their facial appearances. Thus, functional and esthetic recovery through maxillofacial prosthesis becomes significant for these patients. The objective of an appropriate obturator is to restore palate and improve phonetic and swallowing ability by separating the oral cavity, nasal cavity, maxillary sinus, and nasopharynx. In this case report, an obturator was fabricated for a patient who had partial resection from the maxillary posterior region to the pharynx due to squamous cell carcinoma. The purpose of this case study is to describe the results because the patient was successfully improved both functionally and esthetically.

Full mouth rehabilitation of fully edentulous patient with implant-supported fixed prosthesis preceding bone graft: A case report (전악 무치악 환자에서 골이식술을 선행한 임플란트 고정성 보철 수복 증례)

  • An, Ju-Nam;Lee, Jung-Jin;Seo, Jae-Min;Kim, Kyoung-A
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.77-87
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    • 2018
  • Prosthetic treatment using implants in fully edentulous patients includes implant-supported fixed prosthesis, implant hybrid prosthesis, implant retained- or supported-over-denture and implant supported fixed prosthesis has advantages such as psychological stability, pronunciation. If an implant supported fixed prosthesis is planned, the implants should be placed in consideration of pronunciation, esthetics, and oral hygiene. For this, clinical and radiological diagnosis is indispensable. When placing the prosthetic driven implant at the site determined from the diagnosis, a sufficient amount of alveolar bone and soft tissue support are required. If these requirements found to be insufficient, a wide range of bone grafting should be performed in advance. In this case, a fully edentulous patient with severe alveolar bone resorption due to periodontal disease was treated with a full mouth rehabilitation using implant-supported fixed prosthesis preceding maxillary sinus graft and alveolar bone augmentation. We report this patient were satisfied with esthetic and function.

Fixed prosthesis restoration in edentulous patient fully implanted without considering definitive prosthesis: A case report (최종 보철물에 대한 고려 없이 전악 임플란트 식립된 환자의 고정성 보철 수복 증례)

  • Chun, Young-Hoon;Pae, Ahran;Kwon, Kung-Rock;Kim, Hyeong-Seob
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.4
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    • pp.427-435
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    • 2017
  • The most important factor in the treatment of fully edentulous patients using implants is the shape of the definitive prosthesis. After the shape of the definitive prosthesis is determined, residual bone analysis and selection of the implant type, number and position should be followed. In this case, for restoration of an edentulous patient fully implanted (except the maxillary right lateral incisor) without considering definitive prosthesis, facial esthetics and possibility of fixed type prosthesis were evaluated using complete denture. It was determined that the fixed type prosthesis was possible. Implants that could not be used for the definitive prosthesis were excluded from the treatment plan and fixed type provisional restorations were fabricated. After four months of provisional restorations, the patient showed stable occlusion and esthetic satisfaction. Definitive prosthesis was made of zirconia using CAD/CAM (computer aided design and computer aided manufacturing). The results were satisfactory during the 3 months of follow-up period after termination of treatment.

A RETROSPECTIVE MULTICENTER CLINICAL STUDY OF INSTALLED US II / SS II IMPLANTS AFTER MAXILLARY SINUS FLOOR ELEVATION (상악동저 거상술 후 Osstem Implant (US II / SS II)의 다기관 후향적 임상연구)

  • Kook, Min-Suk;Park, Hong-Ju;Kim, Su-Gwan;Kim, Young-Kyun;Cho, Yong-Seok;Choi, Gab-Lim;Oh, Young-Hak;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.341-349
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    • 2008
  • Purpose: The purpose of this study was to evaluate the $Osstem^{(R)}$ implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the $Osstem^{(R)}$ implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.

Mandibular second and third molar protraction with orthodontic mini-implants: case report (교정용 미니임플란트를 이용한 하악 제2, 3대구치의 전방이동 : 증례보고)

  • Choi, Sung-Kwon;Kang, Kyung-Hwa
    • The Journal of the Korean dental association
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    • v.57 no.11
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    • pp.654-663
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    • 2019
  • This case report describes the management of a 30-year-old woman with hopeless mandibular first molars and right maxillary second premolar. The treatment plan included mandibular second and third molar protraction after extraction of mandibular first molars. Mini-implants were placed between roots of first and second premolar. Sliding mechanics with lever arm was used to prevent inclination of molars. A good functional occlusion was achieved in 38 months without clinically significant side effects. Most of the extraction space of mandibular first molar was closed by protraction of second and third molars. The skeletal Class II pattern was improved by counterclockwise rotation of mandible through reduction of wedge effect. Mandibular molar protraction with orthodontic mini-implants in adequate cases would be a great alternative to prosthetic implant and reduce the financial and surgical burden of patients.

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SINUS AUGMENTATION WITH ${\beta}$-TCP (${\beta}$-TCP를 이용한 상악동 점막거상술)

  • Hwang, Kyung-Gyun;Song, Seung-Il;Kim, Sang-Woo;Lee, Sung-Hoon;Kim, Young-Muen;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.428-433
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    • 2004
  • Sinus floor augmentation has been proven an effective treatment procedure to increase bone volume in the posterior edentulous maxilla. Autogenous bone considered to be the best material for reconstructive bone surgery and has been successfully used as a graft material to augment posterior maxilla. However, the collection of autogenous bone required extra risks for morbidity and complaints. So, various bone graft materials included ${\beta}$-tricalcium phosphate(${\beta}$-TCP) has been introduced for replacing the autogenous bone. The objective of this clinical study was to determine the predictability of endosseous implant placed in a maxillary sinus with ${\beta}$-TCP grafting. We performed sinus elevation with ${\beta}$-TCP to install the implant in the 10 maxillary cases. The prosthetic procedure was performed 6-9 months after. The implant-prosthetics was checked about 1 year. We checked the implant and measured the maximum bite force to evaluate the function of the implant. There was not observed the specific problem and complication in dental implant and maxillary sinus in the grafted materials. The maximum bite force was 558N in case of natural tooth, 365N in implant without grafting, 318N in implant with ${\beta}$-TCP grafting. There was no significant difference between with and without sinus grafting on maximum bite force(p>0.05). As though the long term check-up is needed, the grafting of ${\beta}$-TCP as a osteoconductive materials can expand the volume and induce dense new bone formation in maxillary sinus. So, this short-term results support that ${\beta}$-TCP can be a suitable material for sinus augmentation.

EFFECT OF ANCHORAGE SYSTEMS AND PALATAL COVERAGE OF DENTURE BASE ON LOAD TRANSFER WITH MAXILLARY IMPLANT-SUPPORTING OVERDENTURES : A THREE-DIMENSIONAL PHOTOELASTIC STRESS ANALYSIS (상악 임플란트 overdenture에서 anchorage system과 의치상 구개피개가 하중전달에 미치는 영향)

  • Je, Hong-Ji;Jeon, Young-Chan;Jeong, Chang-Mo;Lim, Jang-Seop;Hwang, Jai-Sug
    • The Journal of Korean Academy of Prosthodontics
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    • v.42 no.4
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    • pp.397-411
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    • 2004
  • Purpose: The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-supported overdenture. Material and methods: Maxillary implant -supported overdentures in which 4 implants were placed in the anterior region of edentulous maxilla were fabricated, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional photoelastic stress analysis. Two photoelastic overdenture models were fabricated in each anchorage system to compare with the palatal coverage extent of denture base, as a result we got eight models : Hader bar using clips(type 1), cantilevered Hader bar using clips(type 2), Hader bar using clip and ERA attachments(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4). Result: 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. In every experimental models with or without palatal coverage of denture base, maximum fringe orders on the distal ipsilateral implant supporting bone in an ascending order is as follows; type 3, type 1, type 4, and type 2. 3. Each implants showed compressive stresses in all experimental models with palatal coverage of denture base, but in the case of those without palatal coverage of denture base, tensile stresses were observed in the distal contralateral implant supporting bone. 4. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant supporting bone on loaded side. 5. The type of anchorage system affected in load transfer more than palatal coverage extent of the denture base. Conclusion: To the results mentioned above, in the case of patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant, and poor bone quality, selecting a resilient type attachment or minimizing the distal cantilevered bar is considered to be an appropriate method to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

The esthetic prosthodontic treatments in maxillary anterior area, considering the gingival margin (치은 변연을 고려한 상악 전치부의 심미 수복 증례)

  • Son, Daheen;Paek, Janghyun;Woo, Yi-Hyung;Kim, Hyeong-Seob
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.438-444
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    • 2016
  • To enhance the esthetic appearance, the maxillary anterior area is important. It is possible to improve the esthetic appearance through the treatment of maxillary anterior area, which includes altering the color, form, and arrangement of teeth. When planning these treatments, clinicians should individualize personal demands, by using the information obtained from facial, dento-labial, dental, and gingival analysis. It is essential to properly prepare the gingival structure, which includes the height of gingival margin, the location of zenith, reconstruction of the interdental papillae, emergence profile, and symmetry. Clinicians often face unfavorable condition of the gingiva and the edentulous ridge, and appropriate management of the gingival structure is needed. In this case report, the patients were treated to improve the gingival conditions surrounding maxillary anterior teeth. By using conservative treatment without surgical intervention, such as application of pink porcelain, subgingival contour modelling and modification of pontic base, satisfactory esthetic results were gained.

FINITE ELEMENT STRESS ANALYSIS OF MAXILLARY TWO IMPLANTS-RETAINED OVERDENTURE ACCORDING TO POSITION OF IMPLANT FIXTURES (상악피개의치를 위한 임플랜트의 위치에 따른 응력분포에 대한 유한요소분석)

  • Ha, Heon-Seok;Kim, Chang-Whe;Lim, Young-Jun;Kim, Myung-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.193-200
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    • 2008
  • Statement of problem: There have been a few studies about unsplinted implant retainted maxillary overdenture. Purpose: The purpose of this study was to examine the effect of different position of implant for 2 implants-retained maxillary overdenture. Materials and methods: Three-dimensional finite element models were used to reproduce an edentulous human maxilla with an implant-retained overdenture. Two implants in the canine tooth positions on both side and in the second premolar tooth positions on both side models were examined. Axial loads of 100 N were applied to the occlusal surface at the right first molar tooth positions. Maximum stress at the implant-bone interface and stress at the cortical bone surface just under the loading point were observed. Results and conclusion: Within the limits of this study, maximum stresses were concentrated around implant of canine position at loading side. The second premolar area was thought to be more favorable to distribution of stress on mucosa, alveolar bone and implants than canine area for maxillary overdenture.

Survival analysis of dental implants in maxillary and mandibular molar regions; A 4$\sim$5 year report ($\cdot$하악 대구치 부위에 식립된 임플란트의 생존율에 대한 후향적 연구)

  • Jang, Jin-Wha;Ryoo, Gyeong-Ho;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.37 no.2
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    • pp.165-180
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    • 2007
  • Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the $4{\sim}5$ years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; $26{\sim}75$) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 1O.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94,8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(${\geq}5.75$ mm) and the survival rate was significantly lower for wider implant diameter(p