• Title/Summary/Keyword: Subgingival margin

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Clinical accuracy of impression technique using digital superimposition of customized abutment with subgingival margin: A case report (치은연하 변연을 가지는 맞춤형 지대주에서 디지털 중첩기술을 이용한 인상채득술의 임상 적용 증례)

  • Kim, Jin-Wan;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Lee, Hyeonjong;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.2
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    • pp.169-175
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    • 2020
  • Traditionally, gingival retraction has been performed to obtain customized abutment impressions with subgingival margins of the implant supported prosthesis. However, gingival retraction may have side effects such as gingival recession and bleed, leading to an inaccurate impression. In order to prevent these problems, in this case, the new technique has been introduced; a customized abutment which is designed for superimposition is used. Before the connection of the abutment to the implant fixture, pre-scanned shape data are stored, and then the optical impression without gingival retraction is obtained after connecting to the fixture. The suprastructure is fabricated by superimposing the two data. This technique showed the clinical efficacy of fabricating the implant supported prosthesis with subgingival margin, which satisfied the aesthetics, convenience, and clinically acceptable marginal and internal fit.

A STUDY ON THE DEPOSITION PATTERN OF SUBGINGIVAL CALCULUS (치은연하 치석의 침착양상에 관한 연구)

  • Kang, In-Ku;Kim, Byung-Ok;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • v.24 no.1
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    • pp.1-14
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    • 1994
  • Dental calculus which is calcifing and/or calcified dental plaque is divided into supragingival calculus and subgingival calculus according to the position of deposit to gingival margin. Subgingival calculus has more important clinical significance in diagnosis and treatment of periodontal disease than supragingival calculus. In order to investigate the deposition pattern of subgingival calculus on each root surface of different tooth type, extracted 192 teeth due to excessive destruction of periodontal tissue were divided according to tooth type and the deposition pattern of subgingival calculus was classified into linear type, veneer type, scattered type, and aggregated type according to the configuration and the extent of deposit. The difference of percentage between each deposition pattern was statistically analyzed by Chi-Square test. Following results were obtained : l. In maxillary incisors, linear type and aggregated type were predominant deposition pattern of subgingival calculus on labial(45.5%, 36.4%) and palatal(36.4%, 36.4%) root surface, aggreated type(72.7%) was on mesial surface, and aggregated type(54.5%) and scattered type(36.4%) was on distal suface. 2. In mandibular incisors, scattered type, linear type and aggregated type were predominant deposition pattern of subgingival calculus on labial(33.3%, 30.6%, 27.8%) and lingual(36.1%, 30.6%, 25.0%) root surface, aggregated type(33.3%), scattered type(27.8% ), and veneer type(27.8%) were on mesial surface, and aggregated type(38.9%) and scattered type(33.3%) on distal surface. 3. In maxillary peremolars, the predominant deposition patterns of subgingival calculus were linear type(28.6%) on buccal root suface, scattered type(35.7%) and linear type(28.6%) on palatal surface, scattered type(39.3%) on mesial surface, aggregated type(46.4%) on distal surface, and aggregated type(53.6%) on furcation area. 4. In mandibular premolars, scattered type was predominant deposition pattern of subgingival calculus on buccal(39.3%) and lingual(50.0%) root surface, scattered type(32.1%) and aggregated type(32.1% ) were on mesial surface, and aggregated type(42.9%) was on distal surface. 5. In maxillary molars, aggregated type(40.0%) and scattered type(32.5%) were predominat deposition pattern of subgingival calculus on buccal root surface, aggregated type was on distal(40.0%) and furcation area(50.0%), but there was no predominat pattern on palatal and mesial root surfaces. 6. In mandibular molars, aggregated type(39.5%) and scattered type(28.9%) were predominant deposition patterns of subgingival calculus on buccal root surface, aggregated type(36.8%) was on lingual surface, linear type(39.5%) and aggregated type(34.2%) were on furcation area, but there was no predominant pattern on mesial and distal root surfaces.

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- Esthetic Retreatment of Old Restorations with Cervical Discolorations - (구 보철물 치경부 변색의 심미 재수복)

  • Kim, Hak-Su;Kim, Uk-Jung;Jo, Mun-Sang;Lee, Jong-Yeop
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.11 no.2
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    • pp.33-36
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    • 2002
  • As patients have concerned the esthetics of dental restorations, the porcelain fused to metal restorations have gain their popularity due to their strength and esthetic appearance for many years. However, metal collar in subgingival level of porcelain fused to metal restoration often causes black shadows. Inadequately positioned metal collar causes plaque depositions, gingival inflammations, black shadows, and discolorations of margin area. Those problems can be avoided by a clear finishing line, well-fabricated provisional restorations with precise margin and fine polishing, collarless porcelain fused to metal restoration, and all ceramic restoration. In this case report, collarless porcelain fused to metal restoration was used to treat cervical discoloration from old restorations.

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A technique for fabricating abutment replica with hot melt adhesive material to minimize residual cement in implant restoration: a case report (임플란트 보철 합착 시 잔여 시멘트 최소화를 위해 열가소성 접착제를 이용한 복제 지대주 제작 방법: 증례보고)

  • Seo, Chi-Won;Han, A-Reum;Seo, Jae-Min;Lee, Jung-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.3
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    • pp.240-245
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    • 2016
  • Removal of excess cement is important to prevent biological complication in cementation of implant restoration with subgingival margin. It can be difficult to completely remove excess cement. Several techniques have been introduced to minimize excess cement using abutment replica. In this case report, a simple method for making abutment replica with hot melt adhesive material in dental office was described. This technique is simple and effective because it can be used for pre-fabricated or custom abutment without additional laboratory procedure. In addition, it can minimize excess cement after cementation of implant restoration.

Morphometric study of the calculus and periodontal tissues adhered to the root surfaces in periodontitis (치주염이환 치아표면에 부착된 치석과 치주조직의 형태 계측학적 연구)

  • Kim, Chong-Kwan;Yi, Seung-Won
    • Journal of Periodontal and Implant Science
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    • v.27 no.3
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    • pp.621-631
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    • 1997
  • To verify the effect of subgingival calculus on the periodontal tissues in periodontitis and the effectiveness of supragingival scaling to remove the calculus, 30 teeth from healthy group (Probing pocket depth:$PPD{\leq}mm$: HP group), 15 teeth from moderate group ($4{\leq}PD<7mm$:MP group), 30 teeth from advanced group (PPD>7mm: AP group) were selected and supragingival scaling was performed before extraction of all experimental teeth. After careful extraction, the teeth were cleaned with saline and disclosed with toluidine blue and carefully examined the relationship and distance between the calculus attached on the root surface and periodontal tissues. As a result, it was; 1. The calculus was not discovered on the root surface of teeth in HP group, but was in MP and AP group, mostly on interproximal surface and furca area. The shape of the attached calculus was ovoid, trepazoid and polygonal and the calculus was distributed randomly over the root surface. 2. PPD was more than the distance between the gingival margin to the level of attached connective tissue in AP group rather than in HP and MP group. 3. The length of calculus was $2.7mm{\pm}.44mm$ in HP group and $4.1{\pm}.89in$ AP group. 4. The distance between the apical margin of calculus and the level of attached connective tissue was $2.4{\pm}.33mm$ in MP group and $3.4{\pm}.89mm$ in AP group. 5. The length of subgingival calculus was tended to increase in relation to the probing pocket depth. Therefore, it can be concluded, the calculus in periodontal pocket can not be removed completely with supragingival scaling. As the terminal part of calculus was far away with limited distance from the periodontal tissue, it can be said that the calculus was not a direct factor in destroying the periodontal tissue. In this study, the extent of the plaque was not verified but the location of calculus can be used in clinical practice for complete removal of calculus when the distance relation bewteen calculus and plaque will be known.

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An influence of operator's posture on the shape of prepared tooth surfaces for fixed partial denture (진료자세가 고정성 국소의치의 지대치 삭제에 미치는 영향)

  • Won, In-Jae;Kwon, Kung-Rock;Pae, Ah-Ran;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.1
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    • pp.38-48
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    • 2011
  • Purpose: Dentists suffer back, neck and shoulder pain during their careers due to bad operating posture. If dentists have a good operating posture ergonomically, there would be less pain and discomfort in the shoulder and back. Therefore, dentists should learn the Home position which enables dentists to approach a stable posture ergonomically. This study was to compare tooth preparation in the Home position and the Random position, and evaluate the clinical efficacy of the Home position. Materials and methods: Tooth preparation for fixed partial denture was performed on the maxillary left 2nd premolar and maxillary left 2nd molar at the two different operating positions were compared. The amount of occlusal reduction, marginal width, subgingival margin depth, and convergence angle were measured. A T-test was performed separately to compare the results of the Random position and the Home position. Results: 1. The amounts of average thickness of occlusal reduction on fossa were deficient to the ordered ones in the Random position and the Home position (P > .05). 2. The average subgingival margin depth of prepared margin on maxillary left 2nd premolar, maxillary left 2nd molar were excessive in the Random position than in the Home position. On the maxillary left 2nd premolar, there was no statistical difference in the Random position and the Home position except Distal midline, DL line angle, Lingual midline, ML line angle (P< .05). On the maxillary left 2nd molar, there was no statistical difference in the Random position and the Home position (P < .05). 3. Average convergence angle in the Random position and the Home position were excessive compared to the ordered angle. There was no statistical difference in the Random position and the Home position (P > .05). 4. Analysis of pearson correlation : In the Random position, the amounts of average thickness of occlusal reduction, the average subgingival margin depth of prepared margin, convergence angle were significantly associated with each other (P < .05). But in the Home position, they were not significantly associated with each other (P < .05). 5. The time needed for preparation in the Home position was faster or equal than that of the Random position as time went on. Conclusion: In conclusion, there were no significant differences between Home position and Random position in measures of occlusal reduction, marginal width, marginal depth, convergence angle. However, preparation time and incidence of damaging adjacent teeth were less in Home position than in Random position. Therefore, if trained properly, Home position which is more ergonomically stable can be adopted for clinical use.

Deep proximal margin rebuilding with direct esthetic restorations: a systematic review of marginal adaptation and bond strength

  • Hoda S. Ismail;Ashraf I. Ali;Rabab El. Mehesen;Jelena Juloski;Franklin Garcia-Godoy;Salah H. Mahmoud
    • Restorative Dentistry and Endodontics
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    • v.47 no.2
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    • pp.15.1-15.18
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    • 2022
  • This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.

Correlation between different methodologies used to evaluate the marginal adaptation of proximal dentin gingival margins elevated using a glass hybrid

  • Hoda S. Ismail;Brian R. Morrow;Ashraf I. Ali;Rabab El. Mehesen;Franklin Garcia-Godoy;Salah H. Mahmoud
    • Restorative Dentistry and Endodontics
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    • v.47 no.4
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    • pp.36.1-36.17
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    • 2022
  • Objectives: This study aimed to evaluate the effect of aging on the marginal quality of glass hybrid (GH) material used to elevate dentin gingival margins, and to analyze the consistency of the results obtained by 3 in vitro methods. Materials and Methods: Ten teeth received compound class II cavities with subgingival margins. The dentin gingival margins were elevated with GH, followed by resin composite. The GH/gingival dentin interfaces were examined through digital microscopy, scanning electron microscopy (SEM) using resin replicas, and according to the World Dental Federation (FDI) criteria. After initial evaluations, all teeth were subjected to 10,000 thermal cycles, followed by repeating the same marginal evaluations and energy dispersive spectroscopy (EDS) analysis for the interfacial zone of 2 specimens. Marginal quality was expressed as the percentage of continuous margin at ×200 for microscopic techniques and as the frequency of each score for FDI ranking. Data were analyzed using the paired sample t-test, Wilcoxon signed-rank test, and Pearson and Spearmen correlation coefficients. Results: None of the testing techniques proved the significance of the aging factor. Moderate and strong significant correlations were found between the testing techniques. The EDS results suggested the presence of an ion-exchange layer along the GH/gingival dentin interface of aged specimens. Conclusions: The marginal quality of the GH/dentin gingival interface defied aging by thermocycling. The replica SEM and FDI ranking results had stronger correlations with each other than either showed with the digital microscopy results.

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.