Journal of Dental Rehabilitation and Applied Science
/
v.26
no.2
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pp.145-156
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2010
Loss of posterior support may cause overloading and excessive wear of remaining teeth. Moreover, the extrusion of antagonistic teeth leads to the destruction of the occlusal plane. The loss of vertical dimension of occlusion (VDO) also emerges clinically, which may bring the loss of esthetic appearance and function. These patients who suffer from the loss of posterior support, often require vigorous periodontal treatments (osteotomy, crown lengthening) and extensive oral rehabilitation. Sixty three years old female patient visited for the prosthetic treatment of the posterior edentulous area. She had no other systematic disease and parafuctional habits for prosthetic treatment. Intraoral and radiographic examinations were done. The evaluation of VDO and vertical dimension of rest position were evaluated for proper prosthetic procedures and diagnostic wax up was done. As a result of diagnosis, VDO was increased by 2 mm considering the loss of VDO and space for the prosthetic treatment. After the pretreatments, initial preparation of teeth and provisionalization were carried out. Six weeks later of provisionalizaion, final preparation and impression was performed. Using the duralay resin copings, jaw relation was registered. The master cast was mounted and definitive restoration was fabricated. After the evaluation of esthetic and function, pick up impression for clinical remounting was done. Lucia jig was made for new jaw relation and occlusal adjustment on the articulator. Definitive restoration was delivered and the patient was periodically recalled for additional occlusal adjustment. From this case, the satisfactory functional and esthetic results through full mouth rehabilitation with increase vertical dimension were achieved.
The purpose of this study was to evaluate in vitro effects of the loss of tooth substance and root surface changes following root planing with various periodontal instruments. The 39 extracted human teeth due to severe periodontal disease were included. The total 50 root surfaces of 30 teeth were root planed with following instruments : Group 1, with Gracey curette, Group 2, with ultrasonic scaler, Group 3, with rotating root planing bur, Group 4, with Gracey curette plus rubber cup polishing, and Group 5, with ultrasonic scaler plus rubber cup polishing. Following root planing, the amount of tooth substance loss was evaluated by measuring the weight of the removed tooth substance and then 5 specimens ($5{\times}5{\times}2mm$) were randomly selected from the each group for roughness measurement. Root planed areas of each specimen were subjected to five measurements using the Profilometer and an average surface roughness values(Ra) for each group was obtained. Statistical difference for roughness values of each group was analyzed using oneway ANOVA and student t-test. For scanning electron microscopic(SEM) examination of root surface changes following root planing, 15 root surfaces of remaining 9 teeth were root planed and 3 specimens were randomly selected. The mean loss of tooth substance removed was Group 1, $7.0{\pm}1.09mg$, Group 2, $1.3{\pm}1.00mg$, Group 3, $5.8{\pm}1.72mg$, Group 4, $8.7{\pm}1.34mg$, and Group 5, $4.5{\pm}1.68mg$ following root palning, respectively. These results indicate that curette is effective instrument in the respect of diseased root substance removal. The average surface roughness values are following results : Group 1 and Group 4 were the smoothest surface ($Ra=0.34{\pm}0.06{\mu}m$, $Ra=0.34{\pm}0.04{\mu}m$, respectively) and Group 2 was the roughest surface ($Ra=2.09{\pm}0.06{\mu}m$). Statistical analysis of roughness values demonstrated a highly significant difference (P<0.05) between each experimental groups. However, no statistically significant difference in roughness values were observed between the Group 1 and Group 4. The results in this study suggest that curette and/or polishing procedure should be done after root planing with ultrasonic scaler and caution should be used with dia-mond-coated bur during routine root planing procedure.
This study intended to examine the health status and quality of life among the elderly patients who stayed in geriatric hospitals for a long period of time. The study involved 222 elderly who were older than 65-year-old, an oral examination was conducted in 10 geriatric hospitals located in the metropolitan area and Chungcheong-do. Cross-tabulation, one-way ANOVA, t-test, and Stepwise multiple regression were performed for analysis. The average number of teeth among the subjects was 11.22 and that of dental caries was 1.17. Also, the average number of teeth mobility was 0.93 and halitosis was detected among 81.9%. Only 29.70% reported absence or a kind of systemic disease and 70.31% of the subjects was shown to have more than two kinds of complex disease. In addition, 87.8% of the subjects had depression and among them, 55.40% showed serious depression. The average score on quality of life was 2.62 points and as for the related factors, the number of remaining teeth and dental caries were counted along with care grade, hospitalization period, and age. According to such results, the oral health status among the elderly patients staying long in geriatric hospitals were not good in general; also they showed high level of systemic disease and depression and low quality of life.
Patients with cleft lip and palate have several problems such as oro-nasal communication, dental cross-bite caused by the insufficient growth of maxilla, poor pronunciation and esthetic problem. Removable denture with maxillary double crown near cleft palate and with clasp in the posterior teeth was used to solve the problems of the patient with cleft lip and plate. Double crowns make up for the insufficient mucosal support caused by the mucosa and alveolar bone loss in cleft lip and palate. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 55-year-old female patient had bilateral cleft lip and palate and few remaining teeth on anterior maxilla. Prosthetic treatment was done for patient with bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture. As a result, oro-nasal communication was effectively closed and the cross-bite was easily corrected by double crown and clasp retained denture. In addition, pronunciation and appearance were also improved.
In removable partial dentures, many types of retentive systems have been studied and applied in clinical treatment. One of those systems is the double crown denture system which is widely used in European countries such as Germany and Sweden. Telescopic double crown dentures have several advantages such as convenience in maintaining oral hygiene, enabling to transfer occlusal force along the long axis of the abutment, and secondary splinting effect between the abutments which leads to higher clinical performance compared to conventional removal partial dentures. In this clinical case, the patient was initially restored with a maxillary hybrid telescopic double crown denture with friction pin using remaining natural teeth as abutments. After 7 years, due to lack of recall check-up and poor oral hygiene, the abutment teeth were affected by periodontitis and 4 out of 5 of the abutment teeth had to be extracted. 3 additional implants were placed and the original abutment tooth with the inner crown was maintained. The mandible had fixed prostheses including implants but nevertheless, with strategic implant placement, the patient adapted well and was satisfied with the new maxillary tooth-implant combined double crown denture.
Hyuksoon Lee;Seong-A Kim;Joo-Hyuk Bang;Sung Yong Kim;Hee-Won Jang;Keun-Woo Lee;Yong-Sang Lee
The Journal of Korean Academy of Prosthodontics
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v.62
no.2
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pp.140-145
/
2024
Removable partial denture wearers are exposed to the risks that remaining teeth get damaged by caries, attritions, erosion, and fracture. In the case of damaged abutment tooth which should fit to Removable partial denture (RPD), the fabrication of surveyed crown is followed by the making of RPD. However, making new denture takes a long time, and needs several processes and costs. Also, patients should get used to new denture. If other abutment teeth and edentulous ridges provide the existing denture with support, retention, and stability, use of existing denture is considered clinically acceptable. In this situation, fabricating retrofit crowns to an existing removable partial denture makes patient use existing denture, cuts costs, and reduces discomfort. In this case, severely worn teeth were restored using monolithic zirconia crown which fit to an existing removable partial denture by CAD-CAM. Moreover, support, retention, and stability of the denture were improved, and both doctor and patient were satisfied with the result.
Implant assisted removable partial denture (IARPD) has been practiced in various forms for a long time, and among them, implant surveyed crown RPD is gaining predictability as well as being considered as a treatment option for patients with anatomical and financial disadvantages. The position of implant could be divided as posterior placement or anterior placement according to the purpose of the treatment and should be planned in consider to the alveolar ridge of patient, anticipated prognosis of remaining teeth, and opposing dentition. This case report describes a treatment for mandibular Kennedy class I partial edentulous patient with two implant-supported surveyed crown and implant assisted removable partial denture. Given the difficulty of posterior placement in this patient and the prognosis of the residual teeth, the plan was to place two implants in close proximity to the residual teeth, which were placed in the planned position, angle, and depth using guided surgery. The process of fabricating the fixed prosthesis was carried out in parallel with the maxillary edentulous tooth arrangement process to increase predictability, and when fabricating the localized tooth, the implant was designed in a form that allows the patient to perform functional movements by preventing excessive loading as the last supporting tooth, and was fabricated through a secondary impression process. Each treatment procedure was proceeded as planned, with aesthetically and functionally satisfactory results for both patient and operator.
Purpose: Root resection can be a valuable procedure when the tooth in question has a high strategic value. The prognosis of root resection has been well documented in previous studies, but the results focused on the palatal root resection have not been discussed in depth. I represent here the short term effectiveness of palatal root resection of maxillary first molars. Methods: Palatal root resection was performed on maxillary first molars of three patients. All the palatal roots were floating state on the radiographic finding and showed full probing depth and purulent exudation at initial examination. Reduction of palatal cusp and occlusal table was performed concomitantly. Endodontic therapy was completed after root resection. Results: Compromised maxillary first molars were treated successfully by palatal root resection in 3 cases. The mobility of resected tooth was decreased a little bit. The probing pocket depth of remaining buccal roots was not increased compared to initial depth. All the patients satisfied with comfort and cost effective results and the fact they could save their natural teeth. Conclusions: Within the above results, palatal root resection is an effective procedure treating compromised maxillary first molar showing advanced palatal bone loss to root apex with or without pulp involvement when proper case selection is performed.
Journal of the korean academy of Pediatric Dentistry
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v.8
no.1
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pp.55-63
/
1981
The purpose of this study is to observe the effect of formocresol and glutaraldehyde to tooth germs and periapical tissues after perforation of interradicular portion of pulpal floor and application of physiological saline solution in control groups, formocresol and glutaraldehyde in experimental groups. The following results were obtained 1. In control groups, normal healing processes were seen, and, on the sixteenth day, the epithelization of injured areas was completed. Inflammatory reactions were limited to the injured surface, and the underlying alveolar bone were normal and successive tooth germs were normal. 2. In both formocresol groups and glutaraldehyde groups, tissue reactions were identical. Inflammatory reactions were slightly compared with control groups, but the surface epithelizations were delayed compared with control group. 3. In both formocresol and glutaraldehyde groups, necrosis was seen in superficial tissue of bone marrow, and, at 24th day, center area of bone marrow on the successive tooth germs were losed and replaced with connective tissue, and superficial soft tissue of the injured area was connected with soft tissue on the successive tooth germ. In remaining alveolar bone, osteoclastic reaction was remarkable. 4. In both formocresol and glutaraldehyde groups, there is no injury to the successive tooth germs. 5. In both formocresol and glutaraldehyde groups, periodontal membrane was normal, but the partial resorption of cementum and dentin near the injured area were seen.
Ameloblastoma is the most agrressive ofht odontogenic tumors and it arises from the dental lamina or the derivatives of lamina. Ameloblastoma is a benign but locally invasive neoplasm consisting of proliferating odontogenic epithelium lying in a fibrous stroma. Usually the ameloblastomas are diagnosed in the forth and fifth decardes. Over 80% of them occur in the mandible, the remainder in the maxilla. The preferred treatment for ameloblastoma is radical excision, conserving(when possible. the inferior border of the mandible. The functional and esthetic rehabilitation of the partially edentulous patient may prevent the remaining structures from supporting conventional prosthetic treatment. Patients with long edentulous spans, malpositioned teeth, residual ridges defects and high muscle attachments may be offered an osseointegrated fixed prosthesis. Osseointegrated dental implants provide a viable alternative of tooth replacement. This is a case report of 16 year old female with ameloblastoma. We treated patient with radical excision, conserving the inferior border of the mandible and allogenous bone graft. The defected residual ridge area was reconstructed implants(Steri-Oss Implant System). the result was satisfactory.
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