The effectiveness of dental implants in patients with disability, who are non-compliant during treatment, is controversial because of their poor oral health. Thus, oral health-care and management in such patients is concerning. Moreover, limited information is available on prognosis after implant placement. Herein, we describe a patient with schizophrenia who underwent dental implantation under multiple inductions of general anesthesia (5 times) and required conservative treatment and tooth extraction for multiple dental caries and retained roots because of inadequate oral health-care. Postoperatively, fracture of the prosthodontics and progression of dental caries were observed, and with 3 additional inductions of general anesthesia, conservative treatment, implant surgery, and prosthesis implantation were conducted. Postoperative 12-month follow-up since the last prosthesis implantation showed successful results. For patients with schizophrenia, multiple implantation can reduce horizontal bone loss and achieve aesthetic results compared to treatment with removable prosthodontics and could serve as an alternative treatment modality.
Objectives : The writer aimed to examine the dynamic aspect on damage and to be conducive to the swift cure according to right treatment to educate prevention of injury through surveying on the number of the damaged teeth given injury, tooth kind, type in damage, place and cause for being damaged, frequency by month and by time level, and location of the damaged tooth. Methods : Targeting 343 teeth of receiving injury in 201 patients who visited the department of pediatric dentistry, the department of preservation, and the oral and maxillofacial surgery in a dental hospital in Cheonan city from April 2007 to April 2009, by having the dental injury as the main reason, the following conclusions were obtained. Results : 1. Deciduous teeth were indicated to be the highest in imperfect luxation with 60.7%, and were indicated to be in order of crown fracture with 25.5%, root fracture with 12.4%, and perfect luxation with 1.4%. The permanent teeth were indicated to be the highest in crown with 58.1%, and were indicated to be in order of imperfect luxation with 27.3%, root fracture with 13.1%, and perfect luxation with 1.5%(p<0.001). 2. In case of deciduous teeth for a place with damage, the home was indicated to be the highest with 31.7%. The permanent teeth were indicated to be the highest(p<0.001) in the road and stairs with 40.4%. As to a cause for damage, both deciduous and permanent teeth were indicated to be the highest(p<0.001) in a cause for falling with 53.1% and 30.8%, respectively. 3. As for a treatment method, in case of deciduous teeth, the close observation was indicated to be the highest with 46.9%. In permanent teeth, the resin restoration was indicated to be the highest(p<0.001) with 22.2%. Dental injuries in deciduous teeth and permanent teeth are showing diverse aspects. Conclusions : It is important to arrange guidelines on cure of the damaged teeth by injury through continuing a dynamic research on these aspects. Also, the damage in deciduous teeth may have direct and indirect influence upon growth in successional permanent teeth. Thus, through careful treatment, the injury needs to be minimized. It is considered to be likely necessary for a right coping method when injury occurs, and above all, for enough prior education so that injury cannot occur.
Dae-Kyun Kim;So-Young Park;Jung-Jin Lee;Yeon-Hee Park;Kyoung-A Kim;Jae-Min Seo
Journal of Dental Rehabilitation and Applied Science
/
v.39
no.4
/
pp.204-213
/
2023
Invasive or non-invasive reduction of fractures could be conducted as treatments of traumatic maxillofacial bone fractures. But when suboptimal reduction or malunion of maxillofacial bone fracture occurs, malocclusion could occur as a result of the lost relationship of the mandible and midface. This malocclusion is called post-traumatic malocclusion and orthognathic surgery, orthodontic treatment, selective grinding and prosthetic reconstruction are suggested as treatments for post-traumatic malocclusion after securement of stable TMJ. Stable TMJ is essential for occlusal rehabilitation to prevent occlusal change and relapse of malocclusion. Centric relation and adapted centric posture are suggested as start points of occlusal rehabilitation because they are most stable TMJ position. This case report presents a case in which post-traumatic malocclusion occurred after reduction of panfacial fracture. To rehabilitate full mouth occlusion, selective grinding and prosthetic reconstruction of implant supported fixed prostheses were conducted in centric relation and showed satisfying results in functional and occlusal aspects.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.28
no.3
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pp.196-204
/
2002
For the study of its stability when the screw has been fixed after sagittal split ramus osteotomy(SSRO) of the mandible, the methods of screw arrangement are classified into two types, triangular and straight. The angles of screws to the bone surface are classified as perpendicular arrangements, the $60^{\circ}$ anterioinferior screw, known as triangular, and the most posterior screw, called straight arrangement, thus there are four types. The finite element method model has been made by using a three dimensional calculator and a supercomputer. The load directions are to the anterior teeth, premolar region, and molar region, and the bite force is 1 Kgf to each region. The distribution of stress, the von-Mises yield strength, and safety of margin refer to the total sum of transformed energy have been studied by comparison with each other. The following conclusion has been researched : 1. When shear stress is compared, in the triangular arrangement in the form of "ㄱ", the anterosuperior screw is seen at contributing to the support of the bone fragment. In the straight arrangement, substantial stress is seen to be concentrated on the most posterior angled screw. 2. When the von-Mises yield strength is compared, it seemed that the stress concentration on the angled anteroinferior screw is higher, it shows a higher possibility of fracture than any other screw. In the straight arrangement, stress appeared to be concentrated on the most posteriorly angled screw. 3. When the safety margins of the transfomed energy are compared, the energy conduction is much greater in the case of the angled screw than in the case of the perpendicular screw. The triangular arrangement in the form of "ㄱ" shows a superior clinical sign to that of the straight arrangement. Judging from the above results, when the screw fixation is made after SSRO in practical clinical cases, two screws should be inserted in the superior border of mandibular ramus and a third screw of mandibular inferior border should be inserted in the form of triangular. All screws on the bony surface should be placed perpendicularly-$90^{\circ}$ angles apparently best promote bony support and stability.
Purpose: This study compared the marginal bone loss around dental implant that were placed in the canine areas of the mandibles and finded the survival rate of implants, marginal bone loss around implants and prosthetic complications in 10 patients treated with overdentures retained with Locator attachments. Materials and methods: Ten patients who had received implant retained overdentures in the mandibules using two implants and Locator attachments at Daegu Catholic University Medical Center from 2004 to 2010 were included in this study. Evaluations of the survival rate of implants, marginal bone loss and prosthetic complications were performed. Results: Implants placed in this study showed a 100% survival rate and the average annual bone loss was 1.03 mm ${\pm}$ 0.20 mm in the first year. The patients have verbally indicated that they are comfortable and that their overdentures function well. But, implant retained overdentures had various prosthetic complications such as male change, relining, rebasing and denture fracture. Conclusion: Implant retained overdentures using two implant and Locator attachments in the fully edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.
Kwon, Hyuk Joon;Han, Joon;Kim, Jun Hyung;Jung, Ho Yoon;Kim, Jong Yeop;Yoon, Sin Hyuk;Song, Cheol Hong;Ryu, Min Hee;Kim, Yong Ha;Seo, Man Soo
Archives of Plastic Surgery
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v.34
no.3
/
pp.365-370
/
2007
Purpose: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. Methods: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. Results: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in-hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. Conclusion: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.
Kim, Taek-Kyun;Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
Archives of Craniofacial Surgery
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v.9
no.2
/
pp.105-109
/
2008
Temporomandibular joint(TMJ) and dental occlusion are important in functional aspect as well as in cosmetic aspect for craniofacial surgery such as orthognathic and traumatic surgery. During these operations, appropriate maxillomandibular fixation(MMF) is especially necessary to conserve or reconstruct, dynamic TMJ and functional occlusion. Arch bar is one of the most popular method to gain proper MMF. Seventeen patients including 5 patients with mandibular fracture, 12 patients with orthognathic surgery(6 patients had relatively normal occlusion, however 6 patients had facial anomalies such as hemifacial microsomia with irregular occlusal plane.) were joined in this study. Arch bar was contoured on the dental cast, which was prepared for model surgery, prior to apply it on the facial anomaly patient. On using pre-contoured arch bar, patients felt better during the procedure and surgeons saved time. Moreover, well-contoured arch bar promises precise transmission of force on the bone, which implies surgeons do not need to worry about the occlusion while fixing bony structures. Authors suggest how to apply arch bar to satisfy basic theories about dental row and occlusion based on the experience. In addition, it is proposed to contour arch bar on the dental impression prior to apply it on the patient who has irregular and complex occlusal plane.
Lee, Hyun Rok;Shin, Hea Kyeong;Lee, Dong Lark;Jung, Gyu Yong
Archives of Craniofacial Surgery
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v.17
no.4
/
pp.229-232
/
2016
None of the reports of delayed infection mentioned a latent period exceeding 13 months. we report an infection that developed 18 months after implantation of an absorbable plate. A 16-year-old adolescent girl had undergone reduction and fixation with an absorbable plate for Lefort I and zygomaticomaxillary complex fractures 18 months prior at our hospital. In her most recent hospital visit as an outpatient, abscess was observed in periocular area. Computed tomography revealed sinusitis with an abscess above the infraorbital rim. Wound culture yielded methicillin-resistant Staphylococcus aureus. Despite conservative treatments, wound state did not improve. Therefore, our department decided to perform surgery. Absorbable plate had been mostly absorbed but remained a bit. Bony depression of infraorbital rim and mucosal exposure of maxillary sinus anterior wall were observed. After the surgery, the patient recovered. We believe that the reason the wound infection and sinusitis manifested at the same time is because of several factor such as alcohol abuse, smoking, and mucosal exposure of maxillary sinus anterior wall. Absorbable plate takes 9 months to 3 years to be completely absorbed, thus we suggest studies with a follow-up of at least 3 years be undertaken to determine the outcomes of patients with many risk factors.
Journal of Dental Rehabilitation and Applied Science
/
v.24
no.2
/
pp.183-192
/
2008
Modern dental reconstructions do not only aim at restoring the patient's mastication, but rather at improving general well-being and quality of life, especially in terms of esthetics. The media, the internet, advertising, and many other facts of society contribute to an increased cosmetic awareness. A 35-year-old male patient presented with as follows: 1) the porcelain fracture of ceramo-metal restoration on #11 and #23, 2) the inclination of incisal plane to horizontal reference plane, 3) the dental midline deviation to facial midline, and 4) the lack of symmetry on upper anterior dentition. The patient requested an aesthetic improvement using fixed prosthodontics including implant-supported restorations. In the upper anterior region, one of the goals of the conventional as well as implant prosthesis is to achieve restorations with the dental attractiveness and beauty in the respect of dental, dentofacial, and facial compositions. This case report presents geometrically improvement of dental esthetics using conventional and implant prosthesis with soft and hard tissue augmentation.
Dental implant has been increasingly used to recover the masticatory unction of tooth. It has been well known that the success of dental implant is heavily dependent on initial stability and long-term osseointegration due to optimal stress distribution in the surrounding bones. The role of periodontal ligament, removed during operation, is to absorb impact force and to distribute them to alveolar bone. or this reason, the study for artificial periodontal ligament has become an important issue in this field. In this study, chitosan was coated on dental implant or the purpose of replacing the role of intact periodontal ligament. The results by experiment and FEM analysis showed : I) Initial stability of dental implant was significantly increased(35%) when the implant was coated with chitosan. II) The coated implant showed higher impact absorption, more even stress distribution and lower stress magnitude under impact force than uncoated implant. Accordingly, the micro-fracture of the surrounding bones due to impact force would be lessened by chitosan coating on dental implant.
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