Journal of Dental Rehabilitation and Applied Science
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v.27
no.2
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pp.223-231
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2011
The purpose of this case report is to introduce new attachment system(milled titanium bar with $Locator^{(R)}$ attachment) for implant supported overdenture in maxillary edentulous patients. A 56-years-old male patient visited the hospital due to the mobility of his maxillary fixed partial dentures(10-unit bridge). Including temporomandibular joint(TMJ), there was no specific PMHs to influence dental treatment. In radiographic and clinical evaluation, there was a severe bone resorption and mobility in maxillary teeth. Accordingly all the remaining maxillary teeth was extracted and fabrication of implant supported overdenture was planned. The milled titanium bar with $Locator^{(R)}$ was designed as an attachment system, considering the stability and retention of denture, masticatory efficiency, oral hygiene care, esthetics, pronunciation, and patient's financial state. The milled titanium bar was manufactured using CAD/CAM technology, and $Locator^{(R)}$ attachment connected to the bar by tap & drill method. For over 1-year, in terms of function and esthetics, satisfactory result was obtained.
Purpose: The purpose of this study was to evaluate the clinical acceptability of the marginal and internal gap of Co-Cr metal copings fabricated with stereolithography (SLA). Methods: Titanium master dies were milled after scanning of the prepared tooth (n=30). For group I, Co-Cr metal copings were made from conventional lost-wax technique(LWT, n=10). For group II, the master dies were scanned and designed with CAD system. Then, metal copings were milled with Co-Cr(SUB, n=10). For group III(ADD, n=10), the scanning and design procedures were same as group II and burn-out resins were fabricated with SLA device. The marginal and internal discrepancies were measured under an optical microscope(100x) on ten reference points and were statistically analyzed with one-way ANOVA(${\alpha}=.05$). Results: The mean total discrepancies were $53.76{\pm}12.42{\mu}m$ in the LWT group and $69.82{\pm}15.48{\mu}m$ in the ADD group. The SUB group showed the largest total mean value $110.33{\pm}13.77{\mu}m$. There was statistically significant difference between the SUB and the other groups(P<0.05). Conclusion : Co-Cr metal copings fabricated with SLA technology showed clinically acceptable value on marginal and internal gap and there was no statistically significant difference between conventional lost-wax technique and SLA.
In the case of excessively worn dentition, there is often insufficient space for the prosthesis, and if physiologically acceptable, the prosthesis can be fabricated by increasing the vertical dimension of occlusion. Various methods have been introduced to determine the vertical dimension of occlusion. Clinicians have to choose a method that can comfort the patient among several methods. A removable appliance can be used as a reversible method to ensure that the determined vertical dimension of occlusion does not cause physiological problems. When making impressions of many teeth, it is often difficult to make accurate impressions at once. In this case, after making an accurate impression of the individual teeth, a transfer coping was made and a pickup impression was taken in the oral cavity to create a master cast. In this case, a fixed partial denture was fabricated and full mouth rehabilitation was performed by increasing the vertical dimension of occlusion in a patient with excessively worn dentition and lack of space for restoration. As a result of follow-up of the patient for 7 years, satisfactory results were obtained both esthetically and functionally.
Using computer-aided design and manufacturing technique improve quality of treatment in many aspect. This case reports the complete mouth rehabilitation of a patient with amelogenesis imperfecta utilizing digital technology. Clinical examination revealed loss of mastication due to insufficient occlusal stop, missing teeth, interdental spacing due to microdontia, insufficient overbite, and etc. Full veneer crowns for teeth were selected, followed by a fixed partial denture and implant placement was done using CAD-CAM guide template with bone graft for partially edentulous space. Definitive restorations were duplicated by double scanning provisional restorations and successfully delivered to the patient. These full mouth rehabilitation procedures resulted in satisfactory outcomes for the patient functionally and aesthetically.
Journal of Dental Rehabilitation and Applied Science
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v.26
no.3
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pp.241-251
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2010
This study aims at contributing to the restorative dentistry by examining results in the vertical load test of four different low invasive fixed partial dentures. Based on a hypothesis on the right upper first molar is missing, three units of FPDs were made for the second premolar and the second molar abutment. that is, twelve metal dies and FPDs were made for resin bonded FPD and Two Key Bridges and Human Bridge without occlusal rest and Human Bridge with occlusal rest. By using universal test machine, the numerical maximum value were recorded during the vertical load test of each FPDs after the bonding process treated by Maxcem which is resin cement. The failure process and its result of prosthesis were also observed. The maximum load was 7,295 N, 4,729 N, 2,190 N, 3,073 N from groups of resin bonded FPD, Two Key Bridge, Human Bridge without occlusal rest and Human Bridge with occlusal rest respectively. There was a statistical significance among the groups of resin bonded FPD, Two Key Bridge and Human Brides. However, there was no significant difference between Human Bridge without occlusal rest and Human Bridge with occlusal rest. Regarding the failure of prosthesis, the groups of Resin Bonded FPD and Two Key Bridge showed that one of the abutment teeth in the both side of retention part was highly failed earlier than the other one (83.2% and 66.6% respectively). While, Human Bridge without occlusal rest and Human Bridge with occlusal rest showed high percentage of failure in the abutment teeth in the both side of retention part at the same time (91.6% and 58.3% respectively). This study demonstrates that the group of Human Bridges has low resistance to the vertical loads of low invasive FPDs in comparison with the groups of resin bonded FPD and Two Key Bridge. Nevertheless, the maximum occlusal load of the restorative position, resistance to diverse restoration failure, amount of tooth reduction and patients' cooperation should be considered when they are applied in the clinic in order to choose an appropriate restoration for each patient.
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.
Journal of Dental Rehabilitation and Applied Science
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v.26
no.3
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pp.221-239
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2010
Bone loss may occur depending on the loading conditions. careful treatment planning and prosthetic procedures are very important factors for the proper distribution of stress. Evaluate the stress distributions according to numbers and location of implants in three-unit fixed partial dentures. A mandible missing the right second premolar, first molar and second molar was modeled. Using the CT data. we modeled a mandible with a width of 15mm, a height of 20mm and a length of 30mm, 2mm-thickness cortical bone covering cancellous bone mallow. An internal type implant and A solid type abutment was used. A model with 3 implants placed in a straight line, offset 1.5 mm buccally, offset 1.5 mm lingually and another model with 3 implants offset in the opposite way were prepared. And models with 2 implants were both end support models, a mesial cantilever model and a distal cantilever model. Three types of loading was applied; a case where 155 N was applied solely on the second premolar, a case where 206 N was applied solely on the second molar and a case where 155 N was applied on the first premolar and 206 N was applied on the first and second molar. For all the cases, inclined loads of 30 degrees were applied on the buccal cusps and vertical loads were applied on the central fossas of the teeth. Finite element analysis was carried out for each case to find out the stress distribution on bones and implants. This study has shown that prostheses with more implants caused lower stress on bones and implants, no matter what kind of load was applied. Furthermore, it was found out that inclined loads applied on implants had worse effects than vertical loads. Therefore, it is believed that these results should be considered when placing implants in the future.
Soldering is the usual method used to correct an unstable fixed partial denture framework at patient's try-in; However, presoldering base metal alloys is technique-sensitve and results are unstable because it is difficult to maintain uniform heat distribution and to prevent oxidation of an alloy. A cast-joining technique has been developed by Weiss and Munyon for repair, correction and addition to base metal framework. This joining technique eliminates the problem with presoldering of non-precious frameworks. The object of this study was to 1) compare the relative flexure strength and the joining effectiveness of Ni-Cr-Be cast in two pieces and 'pre-soldered' versus in two pieces and 'cast-joined'. 2) determine the effect of increasing the number of retentive grooves on the face of the cast and 3) determine the effect of the relative matched position of groove patterns on flexure strength. The joining effectiveness can be expressed by the ratio of the mean flexure stress of soldered or cast-joined specimens to that of one-piece cast. Resin rods 3mm in diameter were used as pattern of specimens for one-piece casted, presoldered, and cast-joined groups. Cast-joined specimens had two different patterns of retentive grooves on the joined faces. Type A had cross-shaped grooves 1mm in depth. 0.6mm in width. Type B was the same except for the addition of one more retentive groove. In the experiment connecting cast-joined specimens, half of specimens with type A pattern had their patterns on the faces of paired casts matched with each other as mirror image. With the rest pairs, it was proceeded that one of paired casts turned 45 degrees so that the patterns crossed. Half of specimens with type B pattern also had the patterns matched as mirror image; However, here, one of paired casts turned 90 degrees with the other pairs. Retentive groove in this study lacked the intentional undercuts, in contrast with the suggestion of Weiss and Munyon. The specimens were subjected to four-point flexural loading in an Instron testing machine. The midspan flexural stress was calculated at the point of initial plastic strain as determined from a strip-chart recorder or at the point of failure if this occured at a lower stress level. Within the scope of this study, the following results were obtained. 1. The presoldered group showed flexural strength at least 2 times higher than the cast-joined groups. Its joining effectiveness was 82%. 2. In cast-joined groups, the flexural strength of joints with type B patterns exhibited 1.5 times that of joints with type A patterns. Joining effectivenesses were 38% for type B patterns, 25-26% for type A patterns. 3. The relative matched position of groove patterns did not have any significant effect on flexural strength of the cast-joined specimens with either type A patterns or type B patterns(p>.05).
Statement of problem: There has been a eat interest in the use of titanium for fixed and removable prostheses in recent because of its excellent biocompatibility. However, the melting temperature and chemical reactivity of titanium necessities casting system different from those used in conventional casting. The current titanium casting systems are based on an electric-arc design for melting the metal in an argon atmosphere and its exclusive investment. Despite the new development in Ti casting system, inadequate mold filling and internal porosity are frequently observed casting defects. Purpose : The purposes of this study were to compare the castibility and reaction layer of the casting titanium under the two casting machines and their investment condition. Material and method: coping and machine-milled titanium coping according to the casting methods and the marginal configurations. The total 28 specimens were used, and these are divided into 4 groups according to 2 casting machines and 2 investments. The castings were analyzed using x-ray microanalysis and microhardness testing. The reaction layer between margin of titanium casting and the investments was observed and analyzed with scanning electron microscope. Result: 1. Castabiliy of casting titanium specimen was best in the group of centrifugal casting machine and Selevest $CB^{\circledR}$ and good that of Selevest CB and pressure differential casting machine, Rematitan plus and centrifugal casting machine, Rematitan plus and pressure differential casting machine in order. 2. There was no significanct correlation in titanium castability in respect of casting machine. However ANOVA indicated that Selevest $CB^{\circledR}$ groups had significantly better castability than Rematitan $plus^{\circledR}$ groups.(p<0.05) 3. There was a significant microhardness difference between centrifugal casting machine groups and pressure differential groups.(p<0.05) Titanium castings in centifugal groups had significantly harder than those in pressure differential groups. 4. The addition of zirconia decreased interfacial reactivity. Conclusion: above result revealed that of the castability of titanium casting specimens had little correlation in casting machines and was better in magnesia-based investment contained ZrO2 groups. However in order to practice casting titanium in clininic, its castability should be improved, also there should be more research on factor of castability so that long-span prothesis and removable partial denture metla frame may be casted completly.
Ko, Eunjin;Ahn, Sujin;Lee, Sukwon;Park, Sujung;Lee, Richard Sungbok
The Journal of Korean Academy of Prosthodontics
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v.53
no.2
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pp.150-156
/
2015
As dental implant treatment becomes popular for both partial and complete edentulous patients, old people with complex systemic diseases also tend to prefer implant-assisted-overdenture or implant-supported-fixed prostheses to conventional complete denture. In this case, 77-year-old female who was on medication for hypertension and osteoporosis and paralyzed on right side due to stroke visited for implant-assisted-overdenture on lower jaw. After oral and radiographic examination, root-assisted magnet overdenture on upper jaw and implant-assisted magnet overdenture on lower jaw are planned. Consequently, overdentures using self-adjusting magnetic attachment(SA) system on both jaws resulted in recovering satisfying function and retention, which is enable to insert and remove with only one hand.
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