• 제목/요약/키워드: Total dental rehabilitation

검색결과 115건 처리시간 0.026초

원광대학교 산본치과병원에서 770명의 환자에 식립한 2158개의 골유착성 임플란트의 보철 전 초기 생존율에 관한 후향적 연구 (Retrospective study on survival rate of 2158 osseointegrated implants placed in 770 patients in Sanbon dental hospital of Wonkwang University)

  • 선화경;지영덕
    • 구강회복응용과학지
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    • 제30권4호
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    • pp.278-288
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    • 2014
  • 목적: 이 연구의 목적은 상악 및 하악의 완전 무치악 및 부분 무치악 부위에 식립된 골유착성 임플란트의 보철 전 초기 생존율 및 생존과 관련된 요소를 평가하고 실패를 야기하는 요인에 대해 알아보는 것이다. 연구 재료 및 방법: 2004년부터 2013년까지 770명의 환자에서 총 2158개의 골내 임플란트를 식립하였다. 임플란트의 소실과 환자의 연령 및 성별, 식립 위치, 임플란트 시스템, 길이 및 직경, 그리고 골이식 방법과의 연관성을 평가하기 위해 임상적 비교를 시행하였다. 결과: 임플란트 식립 위치에 따라 상악 전치부에서 98.23%, 상악 구치부 96.97%, 하악 전치부 97.85%, 하악 구치부 98.75%의 임플란트 생존율을 보였다(P < 0.05). 임플란트의 종류 및 표면처리 기법은 임플란트 생존율과 특이성을 보이지 않았다. 임플란트 매식체의 직경에 따라 3.0 mm 이하의 임플란트에서 100%, 3.0 - 3.5 mm 97.09%, 3.5 - 4.0 mm 98.19%, 4.0 - 4.5 mm 98.29%의 생존율을 보였고, 5.0 mm 이상의 직경을 가진 넓은 폭경의 임플란트에서 75%의 비교적 낮은 생존율을 보였다(P < 0.05). 임플란트 매식체의 길이에 따라 9 - 11 mm 및 11 - 13 mm의 길이를 가진 임플란트에서 각각 98.12% 및 98.17%의 높은 생존율을 보였으나 통계학적 유의성을 가지진 못하였다. 골이식술의 방법에 따라 상악동 골이식술을 단독으로 시행한 부위에서 임플란트 생존율은 89.05%, 골유도 재생술을 단독으로 시행한 경우 98.28%, 상악동 골이식술과 골유도 재생술을 동시에 시행한 경우 98.34%, 골이식술이 동반되지 않은 경우 99.28%의 생존율을 보였다(P < 0.05). 결론: 이번 연구에서 임플란트 식립 후 최종 보철물 시적 전 초기단계에서의 임플란트 생존율은 임플란트의 식립위치, 임플란트 매식체의 직경, 그리고 골이식 방법과 관련이 있었다. 이러한 결과에 따라 각각 상악 구치부, 5.0 mm 이상의 넓은 임플란트, 그리고 상악동 골이식술을 단독으로 시행한 부위에서 현저하게 낮은 생존율을 확인할 수 있었다.

초음파 진동이 주조금관의 변연형태와 시멘트의 결합강도에 미치는 영향 (The effect of ultrasonic vibration on bond strength of cemented crown according to margin types and cements)

  • 이윤경;방몽숙;박하옥
    • 구강회복응용과학지
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    • 제18권3호
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    • pp.225-233
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    • 2002
  • This study was aimed to evaluate the effects of ultrasonic vibration on margin types and cements by comparing bond strength of cemented crown. In this study, margins of each metal die, which were chamfer, shoulder and shoulder with bevel, were prepared using computer milling machine. Specimens were cemented with zinc phosphate cement or resin cement. The specimens were divided by the finish line and cement used, ultrasonic vibration. I made total 84 specimens. All specimens were divided into two groups. One group was not vibrated, the other group was subjected to ultrasonic vibration for 12 minutes. Tensile bond strength was measured using Universial testing machine. The changes of bond strength in groups were statistically analyzed by t-test or One-way ANOVA. The results were as follows : 1. Ultrasonic instrumentation diminished the bond strength of crown cemented with zinc phosphate cement and resin cement after 12 minutes application. 2. In case of zinc phosphate cement, the bond strength of a vibrated group was showed significantly decreased(p<0.05). In vibrated groups with zinc phosphate cement, shoulder with bevel exhibit a significant difference to chamfer and shoulder(p<0.05) 3. Resin cement was more resistant to ultrasonic vibration than zinc phosphate cement and showed no significant differences according to ultrasonic vibration and margin type. In conclusion, These results revealed that zinc phosphate cement was most affected and resin cement was the least affected by ultrasonic vibration. Especially shoulder with bevel design was most affected in zinc phosphate cement groups. we should consider these results and be taken in the application of ultrasonic vibration to any teeth restored with crowns.

임플란트 주위염 치료시 이산화탄소 레이저의 효과 (The Effect on Treatment of Peri-implantitis with Carbon Dioxide Laser: An Experimental Study in Dogs)

  • 김학균;김수관;강동완;임성철
    • 구강회복응용과학지
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    • 제23권1호
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    • pp.43-53
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    • 2007
  • The purpose of this experimental study was to examine the effect of the decontamination of carbon dioxide ($CO_2$) laser in treatment of ligature-induced peri-implantitis in dogs. A total 24 implants with a sandblasted with large-grit and acid-etched (SLA) surface were inserted in six mongrel dogs. After a 3-month healing period, experimental peri-implantitis characterized by a bone loss of about 3mm was established by inducing with wires. And then wires were removed and plaque control was implemented. Surgical treatment involving flap procedure + debridement of implants surface with chlorhexidine and saline (group 1), flap procedure + GBR with absorbable collagen membrane (Bio-Gide) and mineralized bone graft (Bio-Oss) (group 2), and flap procedure + $CO_2$ laser application + GBR (group 3) was performed. The animals were killed 8 weeks and 16 weeks after treatment, respectively. A histomorphometric analysis confirmed statistically considerable new bone formation within the limit of the 5 most coronal threads in group 3 compared with group 1 at 16 weeks (P<0.05). And intragroup analysis showed considerable increase of new bone formation in group 3 at 16 weeks compared with 8 weeks (P<0.05). The present study demonstrates considerable new bone formation after treatment of experimental peri-implantitis with flap procedure, $CO_2$ laser application and GBR.

A torque-measuring micromotor provides operator independent measurements marking four different density areas in maxillae

  • Di Stefano, Danilo Alessio;Arosio, Paolo;Piattelli, Adriano;Perrotti, Vittoria;Iezzi, Giovanna
    • The Journal of Advanced Prosthodontics
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    • 제7권1호
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    • pp.51-55
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    • 2015
  • PURPOSE. Bone density at implant placement site is a key factor to obtain the primary stability of the fixture, which, in turn, is a prognostic factor for osseointegration and long-term success of an implant supported rehabilitation. Recently, an implant motor with a bone density measurement probe has been introduced. The aim of the present study was to test the objectiveness of the bone densities registered by the implant motor regardless of the operator performing them. MATERIALS AND METHODS. A total of 3704 bone density measurements, performed by means of the implant motor, were registered by 39 operators at different implant sites during routine activity. Bone density measurements were grouped according to their distribution across the jaws. Specifically, four different areas were distinguished: a pre-antral (between teeth from first right maxillary premolar to first left maxillary premolar) and a sub-antral (more distally) zone in the maxilla, and an interforaminal (between and including teeth from first left mandibular premolar to first right mandibular premolar) and a retroforaminal (more distally) zone in the lower one. A statistical comparison was performed to check the inter-operators variability of the collected data. RESULTS. The device produced consistent and operator-independent bone density values at each tooth position, showing a reliable bone-density measurement. CONCLUSION. The implant motor demonstrated to be a helpful tool to properly plan implant placement and loading irrespective of the operator using it.

인상채득 후 시간경과와 반복주입에 따른 부가중합형 실리콘 인상재의 체적변화 (Evaluation of the Time and Pouring Frequency Dependent Dimensional Stability of Additional Silicone Impression Materials.)

  • 최미라
    • 구강회복응용과학지
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    • 제23권3호
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    • pp.239-248
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    • 2007
  • The accuracy and dimensional stability of rubber impression materials are very important for the fitness of the final restoration. The purpose of this investigation was to evaluate the effects of the storage time and pouring frequency of the additional silicone materials on dimensional stability. Total 30 impressions were made of tooth prepared single crown. The dies had 1 buccolingual, 1 mesiodistal and 1 occlusogingival lines. Two additional silicone materials(examixfine, aquasil) were included. 15 specimens were made of each impression material and poured by type IV stone over times(1hour, 24hours, 72hours) after mixing. 5 impressions poured after 1 hour were used for second pouring after 24hours and third pouring after 72hours. The same examiner measured each specimen 3 times after lazer scanning. All statistical tests were performed with the level of significance set at 0.05. The results indicated that significant difference at any measuring point of stone dies except the buccolingual and mesiodistal lines of the specimen made at 1hour after mixing with examixfine when measurements at 1hour, 24hours and 72hours were campared. There were significant difference between two impression materials and at every measuring point of stone dies made at second and third pouring. The length of measuring point increased significantly as time passed by and increase of the pouring frequency. However, this results are clinically acceptable except the dies of the third pouring. Under the conditions of this study, the shrinkage rate of the additional silicone rubber impression materials significantly increased as time passed by and increase of the pouring frequency.

상아질 지각과민 완화법이 접착용 시멘트의 전단결합강도에 미치는 영향 (The Effect of Dentin Desensitization Treatment on the Shear Bond Strength of Luting Cements)

  • 박인호;이준석;조인호
    • 구강회복응용과학지
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    • 제22권3호
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    • pp.231-242
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    • 2006
  • Statement of problem: The sealing of the opened dentinal tubules that follows the tooth preparation for the prosthodontic restoration is considered as clinical process to reduce postoperative sensitivity. Purpose: This study investigated the effect of desensitization treatment on shear bond strength of luting cements. Materials and Method: Total 80 dentin specimens were divided into two groups according to the kinds of luting cements. Each groups was further divided into 4 subgroups with AQ $bond^{(R)}$, $Saforide^{(R)}$, Diode laser $MDL-10^{(R)}$ application and without desensitization treatment. After desensitization treatment application, Ni-Cr specimens were luted to dentin surface with Fuji $CEM^{(R)}$ and $Panavia-F^{(R)}$. Specimens were placed in distilled water at $37^{\circ}C$ for 24 hours and shear bond strength between metal and dentin was measured by a universal testing machine. Results: 1. In Fuji $CEM^{(R)}$ cemented groups, the combination of AQ $bond^{(R)}$ showed the greatest strength, followed by diode laser, no desensitizer treatment, and $Saforide^{(R)}$. Both AQ $bond^{(R)}$ and Diode laser groups had a significant difference than no desensitization treatment group and $Saforide^{(R)}$ group(p<0.05). 2. In $Panavia-F^{(R)}$ cemented groups, the combination of Diode laser showed the greatest strength, followed by AQ $bond^{(R)}$, $Saforide^{(R)}$, and No desensitization treatment. All desensitization treatment groups had a significant difference than no desensitization treatment group(p<0.05). 3. All $Panavia-F^{(R)}$ groups showed a significant higher shear bond strength than all Fuji $CEM^{(R)}$ groups(p<0.05). Conclusion: The results of this study showed possibility of bond strength increase after desensitization treatment. The application of desensitization treatments like AQ $bond^{(R)}$, $Saforide^{(R)}$, and Diode laser $MDL-10^{(R)}$ have advantages in exposed dentin surface after tooth prep.

안면 수기 마사지 후 안모의 변화 (The Change of Facial Contouring after Facial Massage)

  • 임은진;위수영;정다운;김성택
    • 구강회복응용과학지
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    • 제28권1호
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    • pp.103-108
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    • 2012
  • 본 연구는 안면수기 마사지 시술 후 얼굴 부피 및 두께의 안모 변화를 평가하기 위해 20~40대 여성 10명을 선정하여 주 2회, 20회의 시술을 10주간 진행하였으며, Vivid 9i$^{(R)}$ laser scanner(Minolta, Tokyo, Japan)를 사용해서 마사지 관리 전과 마사지 관리 후의 부피 변화를 비교하였다. 결과, 수기 마사지 후 얼굴 부피는 평균 $731mm^3$ 정도로 다소 감소하였으며(p>.05), 광대뼈 부위의 두께는 평균 0.40mm로 감소하였고(p<.05) 저작 부위의 두께 변화는 평균 0.44mm로 감소하였다(p<.05) 이에 얼굴 수기마사지에 의한 안모 변화는 부피와 광대뼈 및 저작 부위에서 변화가 나타났음을 알 수 있다. 이는 비침습적이면서 비교적 안전한 방법으로 비대칭 및 저작근 비대 등으로 인한 얼굴형 변화를 개선하는데 긍정적 효과를 줄 것으로 사료된다.

임프란트 식립시 초기 안정성이 골유착에 미치는 영향 (THE INFLUENCE OF THE INITIAL STABILITY AFTER DENTAL IMPLANT INSTALLATION ON THE OSSEOINTEGRATION)

  • 이영훈;김여갑;최병준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권6호
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    • pp.518-528
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    • 2008
  • Purpose: The long-term experience of using osseointegrated implants for prosthetic rehabilitation of the edentulous patients shows that high success rates can be predictably achieved. Primary implant stability has been identified to be a prerequisite to achieve osseointegration. In this study, we set up the amount of removed bone so that it differed on implant installation site for each group. The influence of each initial stability on secondary stability and osseointegration was compared with time lapse using resonance frequency analysis and histomorphometric analysis. Materials and methods: A total 27 US $II^{(R)}$ (Osstem, Korea) implants were placed in the mandibular edentulous area of 3 beagle dogs. The implant site was prepared by the conventional technique with drills, and three experimental groups were divided into under-drilling group, normal-drilling group and over-drilling group. The Implant Stability Quotient (ISQ) was measured at intervals of immediately, 4, 8, 12 weeks after placement using $Osstell^{(R)}$ mentor RFA. After the animals were sacrificed, histomorphometric evaluation was executed for measuring BIC and BD. Results: 1) The under-drilled group showed most high ISQ value for whole experiment period. 2) Bone-to-implant-contact(BIC) showed the tendency to be increased gradually as the experiment period passed except the 8 weeks of the normal group. 3) The under-drilled group showed most high bone density(BD) level for whole experiment period, and it was expressed the aspect to be increased gradually according to an experiment period passage in the average of all group. 4) Resonance frequency analysis and histomorphometric analysis are presumed by generally proportional. Conclusions: As this research result, it seems that there are some correlation between resonance frequency analysis and histomorphometric analysis. As are accomplished osseointegration stably so that more superior at the region which the overpressure comes to add, it will be applicable method in clinical field.

콘빔CT (Cone beam computed tomography, CBCT)를 이용한 상악 대구치 에서의 C-형 치근 및 근관에 관한 연구 (A cone-beam computed tomographic study of C-shaped root and root canal in maxillary molars)

  • 김진우;지효진;조경모;김성민;박세희
    • 구강회복응용과학지
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    • 제31권2호
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    • pp.104-111
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    • 2015
  • 목적: 이 후향적 연구의 목적은 한국인에서 콘빔CT를 이용하여 상악 대구치에서 C-형 치근 및 근관의 발현빈도와 형태를 분류하기 위함이다. 연구 재료 및 방법: 총 357개 상악 대구치(제1대구치 186개, 제2대구치 171개)의 콘빔CT 영상을 두 명의 치과보존과 전문의가 평가하였다. 결과: 8가지의 C-형 치근 형태와 5가지의 C-형 근관형태로 분류할 수 있었으며, C-형 치근 및 근관의 발현빈도는 각각 21.0%와 5.3%였다. 결론: 이러한 해부학적 변이는 제1대구치보다 제2대구치에서 많이 발견되었다. 상악 대구치의 성공적인 근관치료를 위해 다양한 형태의 C-형 치근 및 C-형 근관에 대한 해부학적 지식이 필요하다.

3D 프린팅 금관과 임플란트 보조 국소의치를 이용한 엇갈린 교합의 전악 수복 증례 (Full mouth rehabilitation using 3D printed crowns and implant assisted removable partial denture for a crossed occlusion: a case report)

  • 이승훈;김성균;허성주;곽재영;박지만
    • 대한치과보철학회지
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    • 제61권4호
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    • pp.367-378
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    • 2023
  • 최근 CAD-CAM (computer-aided design-computer-aided manufacturing) 기술 및 3D 프린팅 기술의 발전과 함께 다양한 디지털 기법들의 도입으로 top-down 방식의 최종 보철 수복의 정확성과 효율성이 증대되고 있다. 본 증례는 전후 엇갈린 교합을 가진 환자에서 총 9개의 상하악 구치부 임플란트 식립을 통해 안정적인 교합 지지를 얻으면서 잔존 치조골의 고도 흡수 경향을 보인 상악 전치부 무치악 부위는 케네디 4급 임플란트 보조 국소의치로 수복함으로써 연조직의 심미성을 회복하였다. 전산화단층촬영 가이드 수술로 계획된 위치에 임플란트를 식립하고, 이중 스캔 기법으로 임시 수복 단계에서 안정화된 교합을 최종 보철물에 반영하며, 코핑과 프레임워크를 금속 3D 프린팅으로 제작하여 효율적이며 예측 가능한 top-down 방식의 전악 구강 수복을 달성하였기에 이를 보고하고자 한다.