• Title/Summary/Keyword: Total dental rehabilitation

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Analysis of splint weaning in temporomandibular disorder patients (측두하악장애 환자에서 장치치료 테이퍼링 및 종료시기에 대한 분석)

  • Kim, Bok Eum;Min, Kang Ryul;Kim, Hyung Tack;Ahn, Hyung-Joon;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.225-231
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    • 2021
  • There are many studies on the indications and efficacy of splint therapy commonly used in patients with temporomandibular disorders (TMD). However, there have been no studies on the splint weaning in terms of the splint use tapering period in relation to symptom improvement of TMD. This retrospective study aims to analyze a proper splint weaning method in patients with TMD based on symptom improvement. Materials and Methods: The authors examined 130 TMD patients with TMJ disorders, masticatory muscle disorders, and clenching/bruxism who had received splint therapy (occlusion stabilization splint, anterior positioning splint) of patients who visited the Department of Orofacial Pain and Oral Medicine at Yonsei University Dental Hospital from 2015 to 2020. They were evaluated according to the method to wean splints. Results: The mean splint therapy period was 29.0 months, during which patients wore splints 7 days a week for 8.4 months, 3 - 4 days a week for 9.5 months, and finally 1 - 2 days a week for 11.1 months (a total of 29.0 months, about 2.5 years). Conclusion: It seems that TMD symptoms can be alleviated and side effects such as occlusal change can be minimized if patients wear a splint 7 days a week for the first 6 months, followed by 3 - 4 days a week for the next 6 to 18 months, and finally 1 - 2 days a week after 18 months.

Regeneration of total tissue using alveolar ridge augmentation with soft tissue substitute on periodontally compromised extraction sites: case report (치주질환 원인의 심한 골소실을 동반한 발치와에 대한 치조제 증강술과 연조직 대체제를 이용한 조직 재생 효과: 증례보고)

  • Yerim Oh;Jae-Kwan Lee;Heung-Sik Um;Beom-Seok Chang;Jong-bin Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.276-284
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    • 2023
  • After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aesthetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal disease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.

Efficacy evaluation dental plaque and halitosis removal of mouthwash containing sodium chloride (염화나트륨 함유 구중청량제의 치면세균막 및 구취 제거 효능평가)

  • Lee, Jong-Cheon;Cho, Ja-Won;Yoo, Hyun-Jun;Kim, Chan-Ho;Choe, Byeong-Gi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.1
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    • pp.1-8
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    • 2022
  • Purpose: The purpose of this study was to evaluate the effects of mouthwash containing sodium chloride on dental plaque, gingival inflammation index, and bad breath through clinical trials. Materials and Methods: This trial was designed as 12 weeks and subjects were instructed to put an appropriate amount of the provided standard detergent on a toothbrush and brush their teeth 3 times a day. They were instructed to gargle a mouthwash provided to each group after brushiung. Efficacy was evaluated by performing gingival and periodontal-related index tests, dental plaque changes, and bad breath tests a total of 5 times. All data were statistically analyzed using 2-sample t-test, paired t-test to compare between groups at 95% significance level using IBM SPSS Statistics 24.0. Results: As a result of the PMA index measurement, the gingivitis improvement effect rate of the experimental group compared to the control group was 107.63% after 8 weeks and 73.08% after 12 weeks. As a result of the PHP index measurement, the plaque improvement effect rate of the experimental group compared to the control group was 79.37% after 8 weeks and 74.06% after 12 weeks. As a result of measuring volatile sulfur compounds using Oral Chroma, the effectiveness of improvement in bad breath in the experimental group was 65.06% after 8 weeks and 99.33% after 12 weeks, compared to the control group. Conclusion: As a result of this study, it was confirmed that effective gingivitis alleviation, plaque removal effect and bad breath removal effect can be expected when a mouthwash containing sodium chloride, green tea extract, and sodium monofluorophosphate is used.

Periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to kidney transplant surgery (투석을 받고 있으며 신장 이식 수술 전 구강내 평가를 위해 의뢰된 말기 신장 질환 자의 치주 상태)

  • Youn-Kyung Choi;Hye-Mi Jeon;Ji-Young Joo;Hyun-Joo Kim;Eun-Young Kwon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.2
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    • pp.46-54
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    • 2024
  • Purpose: The purpose of this study was to compare the periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to renal transplantation surgery with those having normal kidney function. Materials and Methods: Patients who had been undergoing dialysis for end-stage renal disease and been referred to the Dental Clinic Center by the Department of Nephrology at University Hospital for intraoral evaluation prior to kidney transplantation surgery. For comparison of periodontal status, subjects without abnormalities in kidney function were matched with the patients by age and gender and selected as healthy controls. The patients' age, gender, comorbidities, type of dialysis received, and duration of dialysis were investigated by reference to their medical records, and data on their periodontal status were analyzed via the relevant periodontal records. Results: A total of 102 patients, including 51 dialyzed patients and 51 healthy control group subjects, participated in this study. In the patients with end-stage renal disease undergoing dialysis with periodontal probing depth of 5 mm or more, percentage of sites with clinical attachment level of 4 mm or more, percentage of teeth with bleeding on probing, number of missing teeth, and ratio of moderate to severe periodontitis were all significantly greater than in the healthy controls. Conclusion: The periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to kidney transplantation was worse than that of healthy controls.

Morphological difference of symphysis according to various skeletal types using cone-beam computed tomography (안면골격 유형에 따른 하악 전치 치조골의 형태 차이: Cone-beam CT를 이용한 정량적 평가)

  • Kwon, Hyun-Jin;Chun, Youn-Sic;Kim, Min-Ji
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.215-222
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    • 2014
  • Purpose: The aim of this study was to investigate differences between the morphology of the mandibular symphysis and four facial skeletal types. Materials and Methods: 40 cone-beam computed tomographies were selected and classified in to 4 groups according to their vertical and anterior-posterior skeletal patterns. The bone volume ($mm^3$) of the symphysis, the cross sectional area corresponding to the 4 mandibular incisors' axis: the cross sectional area of total bone ($mm^2$), the area of the cancellous bone ($mm^2$) and the thickness (mm) of labial and lingual alveolar bone at 2 mm, 3 mm under the cemento-enamel junction (CEJ) were measured. General linear model (GLM), Kruskal-Wallis test and Tukey honestly significant difference (HSD) test were subsequently used for statistical analysis. Results: The lingual cortical bone thickness of the lateral incisors at 2, 3 mm under CEJ was greater in the Class I low angle group than the other 3 groups (P < 0.05). There were no statistically significant differences in the volume of the mandibular incisor bony support, cross-sectional area of total bone and cancellous bone at the mandibular incisor' axis. Conclusion: Patients in Class I, low angle group have a thicker lingual mandibular symphysis than Class I, high angle patients.

3-Year Survival Analysis of RBM and Acid-Etched Surface Implants (RBM 표면 임플란트와 산부식 표면 임플란트의 3년 생존율에 대한 비교 연구)

  • Yoon, Dae-Woong;Kim, Moon-Seob;Jang, Han-Seung;Jin, Soo-Young;Mah, Deuk-Hyun;Jeong, Gyeong-Dal;Park, Hyun-Chun;Kim, Hee-Jung;Kim, Hak-Kyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.4
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    • pp.393-403
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    • 2011
  • The purpose of this study was to analyze and compare survival rates of resorbable blast media(RBM) surface and acid-etched surface implants being usually used in clinics. RBM surface implants (USII, Osstem, Busan, Korea) or acid-etched surface implants ($Osseotite^{(R)}$, Biomet $3i^{[TM]}$, FL, USA) were placed in edentulous area of 140 patients between January of 2005 and March of 2007. The number of implants was 304, and 152 out of them were RBM surface implants while another 152 were acid-etched surface implants. According to the evaluation items, the survey was performed before and after the implants installations. The 3-year survival rates of both kind of implants were calculated. 1. Total of 152 RBM surface implants were placed. Among them, one implant was failed, which was implanted in the posterior mandible with D2 bone quality. The failure was resulted from fracture of the fixture. Others showed good results and survival rate of RBM surface implant was 99.34%. 2. Total of 152 acid-etched surface implants were placed. Seven implants of them were failed, thus, survival rate was 95.39%. The causes of the failures were considered as infection, overheat and the lack of initial stability. In this research, both implants showed good 3-year survival rate, although RMB surface implant represented a better result.

Stress distribution of implants with external and internal connection design: a 3-D finite element analysis (내측 연결 및 외측 연결 방식으로 설계된 임플란트의 3차원적 유한요소 응력 분석)

  • Chung, Hyunju;Yang, Sung-Pyo;Park, Jae-Ho;Park, Chan;Shin, Jin-Ho;Yang, Hongso
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.189-198
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    • 2017
  • Purpose: This study aims to analyze the stress distribution of mandibular molar restoration supported by the implants with external hex and internal taper abutment connection design. Materials and Methods: Models of external connection (EXHEX) and internal connection (INCON) implants, corresponding abutment/crowns, and screws were developed. Supporting edentulous mandibular bony structures were designed. All the components were assembled and a finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading. A total of 120 N static force was applied both by axial (L1) and oblique (L2) direction. Results: Peak von Mises stresses produced in the implants by L2 load produced 6 - 15 times greater than those by L1 load. The INCON model showed 2.2 times greater total amount of crown cusp deflection than the EXHEX model. Fastening screw in EXHEX model and upside margin of implant fixture in INCON model generated the peak von Mises stresses by oblique occlusal force. EXHEX model and INCON model showed the similar opening gap between abutment and fixture, but intimate sealing inside the contact interface was maintained in INCON model. Conclusion: Oblique force produced grater magnitudes of deflection and stress than those by axial force. The maximum stress area at the implant was different between the INCON and EXHEX models.

Early Marginal Bone Loss around Submerged Implants According to the Patterns of Cover Screw Exposures (Submerged 임플란트에서 덮개나사 노출 양상에 따른 조기 변연골 상실)

  • Choi, Mee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.175-182
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    • 2013
  • The purpose of this study was to observe and analyze the initial marginal bone resorption changes according to the patterns of cover screw exposures during healing period followed by implants installation. Total 64 fixtures(TiUniteTM, NobelBiocare, Sweden) were installed in partially edentulous jaws of 28 patients, who were selected retrospectively and were shown at least one cover screw exposure. Cover screw exposures were defined at 1 month recall. According to the patterns of exposures, groups were categorized into group 1 (No exposure), group 2 (pin-point exposure), group 3 (less than 1/2 of cover screw), group 4 (more than 1/2 of cover screw), group 5 (total exposure). Periapical radiographs were taken in purpose of changes of marginal bone level between installation and 2 month recall. Healing abutments were secured on the exposure groups at 2 month recall. Results were as follows: 1. Marginal bone resorptions were identified whenever cover screws were exposed. 2. Group 2 and 3 were shown significantly increased bone loss more than other group (P <.05). 3. Group 4 and 5 were shown significantly increased bone loss more than group 1, however, less than other groups ( P <.05). Conclusionally, cover screw exposure may cause marginal bone resorptions, therefore, early connection of healing abutment is clinically helpful.

Symptoms of Temporomandibular Disorders in the Korean Adults: An Epidemiological Study (19-65세 한국 성인의 악관절질환의 증상에 관한 실태조사)

  • Kim, Ah-Hyeon;An, So-Yeon;Kim, Min-Jeong;Lee, Eon-Hwa
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.277-284
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    • 2011
  • This study is based on the data of adults between ages of 19~65 yrs of the National Health and Nutrition Survey 4th in year of 2009, which includes symptoms of temporomandibular disorder within gender and age. Subjects included in this study were 2,738 males and 3,427 females, total of 6,165. All statistical analysis was measured by Window SPSS 17.0K Program (SPSS Inc., Chicago, USA). Prevalence of analysis of gender, age, and symptoms of temporomandibular disorder was measured by descriptive statistics, and in order to find relationship among gender, age, and symptoms of temporomandibular disorder was based on crosstabulation analysis. As results, prevalence of TMJ sound was 10.1%, of TMJ pain was 1.5%, and of TMJ limitation was 2.0%. Among the three symptoms of temporomandibular disorder, subjects who have at least one symptom was 1.2%. Prevalence of TMJ sound, of TMJ pain, and of TMJ limitation in female were 10.7%, 1.8% and 2.2%, respectively, which were greater than in male 9.3%, 1.2% and 1.6% respectively but it was stastically insignificant (p>0.05). Prevalence of TMJ sound, of TMJ pain, and of TMJ limitation in ages between 19~24 yrs were 18.7%, 3.4% and 4.2% respectively, which were higher than any other ages (p<0.05). Also prevalence of having at least one symptom of temporomandibular disorder, at least two, and three all were higher in females but stastically insignificant (p>0.05). On the other hand, prevalence of having at least one symptom of temporomandibular disorder, at least two, and three all were greater in age below 45 yrs and was stastically significant (p<0.05).

Radiographic change of grafted sinus floor after maxillary sinus floor elevation and placement of dental implant (상악동저 거상술과 임플란트 식립 후 상악동저 변화에 대한 연구)

  • Cho, Sang-Ho;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.345-359
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    • 2006
  • Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by $Br\ddot{a}gger$ et al). The result was like that; Sinus graft height decreased significantly in both lateral approach and crestal approach in first 12 months (p$MBCP^{TM}$ had minimum height loss. Class III and Class II was increased by time in both lateral and crestal approach and Class I was decreased by time. SGRI was increased statistically significantly from baseline to 3 months and 3 months(p<0.05) to 12 months(p$ICB^{(R)}$ single use, more reduction of sinusgraft height was appeared. Therefore we speculated that the mixture of graft materials is preferable as a reduction of graft materials. Increasing of the SGRI as time goes by explains the stability of implant, but additional histologic or computed tomographic study will be needed for accurate conclusion. From the radiographic evaluation, we come to know that placement of dental implant with sinus floor elevation is an effective procedure in atrophic maxillary reconstruction.