• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권5호
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• pp.406-414
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• 2001

현재 악안면 보철 제작에 있어 재료로 실리콘이 제일 많이 사용되고 있으나 이 재료는 시간이 지남에 따라 점차 굳어져 가고 탄력성을 잃으며 원래의 색도 노랗게 변색되어 간다는 단점이 있다. 이러한 재료의 화학적 구성 단점 때문에 보철 생명력을 유지하기 위하여 환자들은 매 3년마다 새로운 보철물을 재 제작하여야 한다. 그렇다면 복잡했던 악안면 기공 과정을 다시 반복해야 하는 시간적, 물질적 손실을 감수해야 했다. 이러한 단점들을 보완하고 환자 피부색과 적합이 잘 되는 다양한 색의 실리콘 개발과 아울러 눈동자를 깜빡일 수 있는 인공 눈동자의 개발 등이 필요하며, 눈동자를 만드는데 사용되는 인공 수정체의 발전이 향후 악안면 보철 분야의 큰 과제라 할 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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• pp.383-396
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• 2000

Before the advent of early plastic or maxillofacial reconstructive surgery, facial features could only be replaced and mimicked by prosthetic, artificial means. Facial deformity or dysfunction, whether congenital or acquired by trauma or mutilating disease, has long been an area of constant research, development and innovation in many cultures of the world. One of the greatest contributors to the need for maxillofacial prosthetics has been physical conflict and warfare. The use of maxillofacial prostheses is not merely the replacement of a missing or disfigured aspect of the face, but the rehabilitation of that individual back into the society from which they originate. Rehabilitation includes the restoration of the person's self worth and confidence, not just physically but psychologically. In sixteenth century, Ambroise Pare, French military surgeon, first have tried many maxillofacial prosthetics for injured war soldiers with papier-mache, silver, gold and copper. According to patient's demand who lost their maxillofacial figures, maxillofacial personnel have increased and prosthetic's skill have been advanced all of the world. Over the last decade, there has been a very rapid development in technical possibilities to provide patients with facial prostheses retained by skin penetrating implants. This article will present overall history of maxillofacial prostheses and some background information on the materials used from the old world. And to overcome still many limitation of prosthetic, new minds and new ideas for technique and materials should be developed.

• 구강회복응용과학지
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• 제16권2호
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• pp.123-132
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• 2000

The field of maxillofacial prosthetics is concerned with the prosthetic reconstruction of missing head and neck tissue. Currently, facial prostheses are usually applied in cases of defects caused by the surgical removal of tumors or congenital defects. While silicone has been most widely used for the reconstruction of missing maxillofacial defects, it does not have ideal physical properties. Therefore, bonding a thin polyurethane sheet to silicone prostheses was recommended. In this case skin adhesives were used for the retention of maxillofacial prostheses. But retention of devices has always been problematic. The contributions of implants can be made to solve these problems. Implants have reduced the need for adhesive use, simplifying cleaning procedures and thus extending the life of the prostheses. For implant-retained prostheses, retentive matrix is necessary to hold attachments and/or magnets. The retentive matrix is usually fabricated with autopolymerizing acrylic resin or visible light- polymerized resin. The purpose of this study was to compare the adhesion-in-peel force of silicone adhesive to autopolymerizing acrylic resin and polyurethane sheet with two different surface textures : pumice polish only or retention groove, and three surface primers : Dow corning 1205 primer or Dow corning S-2260 primer or FactorII A-304 primer, and two polymerization methods : room temperature or dry heat oven. The t-peel bond strength of specimens was determined as described in ASTM Standard D1876-72. The results were statistically analyzed using the ANOVA test, multiple range test and t-test The results were as follows. 1. The t-peel bond strength of A-304 primer was the highest and statistically higher than that of S-2260(p<0.05). 2. The t-peel bond strength of specimens with retention groove was statistically higher than that of specimens polished with pumice(p<0.05). 3. The t-peel bond strength of specimens polymerized in dry heat oven was statistically higher than that of specimens in room temperature(p<0.01).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.41.1-41.6
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• 2019

Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권5호
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• pp.278-286
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• 2023

Objectives: This review assessed the performance of implant-supported fixed hybrid prostheses in 21 patients who received a total of 137 implants between 2003 and 2010. The implants were evaluated for marginal bone resorption, complications, success rate, and survival rate based on their vertical angularity, type of bone graft, and measured implant stability. Materials and Methods: One-way ANOVA and chi-square tests were used to analyze the relationships among long-term evaluation factors and these variables. The mean initial bone resorption in the implant group with a vertical angle of more than 20° was 0.33 mm and mean final bone resorption was 0.76 mm. In contrast, the mean initial bone resorption in the implant group with a vertical angle of less than 10° was 1.19 mm and mean final bone resorption was 2.17 mm. Results: The results showed that mean bone resorption decreased with an increase in the vertical placement angle of the implants used in fixed hybrid prostheses, as well as in the group without additional bone grafts and those with high implant stability. The success rate of implants placed after bone grafting was found to be higher than those placed simultaneously. Conclusion: These results suggest that implant-supported fixed hybrid prostheses may be an effective treatment option for edentulous patients, and intentionally placing implants with high angularity may improve outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권6호
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• pp.297-303
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• 2013

Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권1호
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• pp.43-50
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• 1994

It is a generally known fact that the patient can experience mouth opening limitation, mandibular deviation and malocclusion as a result of injury of tissues around the articular disc and complications even after successful open reduction surgery for fractured mandibular condyle. We have experienced a rare case of reconstruction using metallic condylar prostheses for a patient with complications resulted by unsuccessful management of fractured mandibular condyle. The case strongly suggested to us that careful selection of treatment methods should be taken for patient with fractured mandibular condyle. Accordingly, we are presenting a case in conjunction with reviews of fractured mandibular condyle.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.133-142
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• 2020

Objectives: In this study, we determined the incidence and pattern of screw loosening in patients who received dental implants. Materials and Methods: Patients who received implants between January 2008 and October 2013 and completed their prosthetic rehabilitation were evaluated for the incidence, frequency, and onset of screw loosening using dental charts and radiographs. The association between each factor and screw loosening was analyzed using the chi-square test and a multivariate analysis with binary logistic regression models (P<0.05). Results: Total 1,928 implants were placed in 837 patients (448 males, 389 females), whose follow-up period after loading varied from 0.25 to 70 months (mean period, 31.5 months). Screw loosening occurred in 7.2% of implants. Most cases occurred less than six months after loading. Among those, 22.3% experienced recurrent screw loosening. Screw loosening was most common in the molar region (8.5%) and frequently associated with an implant diameter of ≥5 mm (14.2%). External implant-abutment connections (8.9%) and screw-retained implant prostheses (10.1%) showed higher incidence of problems than internal implant-abutment connections and cement-retained implants, respectively. Screw loosening was most common in implant prostheses with single crowns (14.0%). Conclusion: Within the limits of the current study, we conclude that the incidence of screw loosening differs significantly according to the position of implant placement, the type of implant and manufacturer, implant diameter, the type of implant-abutment connection, the type of retention in the implant prosthesis, and the type of implant prosthesis.

• 대한치과보철학회지
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• 제58권3호
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• pp.268-274
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• 2020

구강암 등의 병소로 인해 하악골의 절제를 시행한 환자는 구강악안면계의 재건을 통한 기능적, 심미적 회복이 중요하다. 하악골의 재건에 많이 사용되는 비골유리피판은 임플란트 식립을 동반한 보철적 수복에 있어 용이하다. 그러나 성장기 환자는 비골의 크기가 작고 잔여 성장이 남아있을 수 있어 임플란트를 이용한 치료 시 어려움이 존재한다. 본 증례는 골육종으로 하악골 절제술 및 비골유리피판을 이용해 하악골의 재건을 시행한 11세 여성 환자로, 임플란트 지지 고정성 보철물을 이용한 보철적 수복을 통해 기능적, 심미적 회복을 도모하였다. 임플란트의 식립 부위 및 개수, 보철물의 형태적 고려를 하였으며, 성장기인 13세에 임플란트 지지 고정성 보철 수복을 완료하였고, 추가로 1년간의 경과 관찰을 시행한 바 안정적인 결과를 얻었기에 보고하고자 한다. 그러나, 이후의 추가적인 검진을 통해 악안면계의 변화를 관찰하는 것이 필요하겠다.

• 대한치과의사협회지
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• 제47권12호
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• pp.823-829
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• 2009

Purpose : The aim of this study was to evaluate the survival rate of sintered porous-surfaced implants placed in the edentulous posterior mandibles, in relation to implant length and diameter, crown-to-implant ratio, and types of prostheses, for a maximum of eight years of functioning. Material and Methods : The study group consisted of 43 partially edentulous patients who visited Catholic University Hospital of Daegu and one private dental clinic. A total of 122 sintered porous-surfaced implants n $Endopore^{(R)}$ (Inn ova Life Sciences, Toronto, Ontario, Canada) -- were placed in the edentulous posterior mandibles, Two diameter sizes (4.1 mm and 5.0 mm) and four lengths (5.0 mm, 7.0 mm, 9.0 mm, and 12.0 mm) were used. One hundred and three implants were splinted and 21 implants were nonsplinted. The survival rates of the implants in relation to length, diameter, crown-to-implant ratio, and types of prostheses were investigated. Statistical data were analyzed using SPSS Win.Ver 14.0 software with the Chi-square test. Results : The survival rate of the 4.1mm diameter implants was 100% and 91.2% for the 5.0mm diameter implants. The survival rates of the implants of differing diameters were found to be statistically different (p=0.005). The survival rates of both the 5.0mm and 7.0 mm length implants were 100%. The survival rate of the 9.0mm length implants was 97.9% and for the 12.0mm length implants was 95.1%. There was no statistical difference in survival rates for the differing lengths of implants. Of the 103 prostheses that were splinted, the survival rate was 98.0%. The survival rate of splinted prostheses was higher than that of the non-splinted prostheses, but was found to be not statistically different. There were no failed cases when the crown-to-implant ratio was under 1.0. When the crown-to-implant ratio was between 1.0 and 1.5, the failure rate of the implants was 6.7%. No failure was recorded with the ratio range of 1.5 to 2.0. Relative to the crown-to-implant ratio of 1.0, the failure rates were statistically different (p=0.048). Discussion and Conclusion : The cumulative survival rate of the porous-surfaced implants placed in the edentulous posterior mandibles was 97.5%. Short porous-surfaced implants showed satisfactory results after a maximum of nine years of functioning in the edentulous posterior mandibles.