Kim, Na-Hong;Lee, Kyu-Won;Moon, Ji-Kyung;Park, Pil-Kou;Lee, Dong-Woon
Journal of the Korean Academy of Esthetic Dentistry
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v.24
no.1
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pp.13-24
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2015
With the development of treatment of hard and soft tissue around the implants, the implant restoration is increasingly used in the maxillary anterior region which is very important aesthetically. However, the aesthetic reconstruction of the maxillary anterior region is still challenged. Three following conditions should be fully satisfied for aesthetic prosthesis restoration; reconstruction of hard tissue, soft tissue and harmonic prosthesis. In this case report, hard and soft tissue augmentations were performed at atrophied maxillary incisor. Additionally, customized impression coping and provisional restoration were used to make the final restoration.
In conventional bar- and clip-retained overdentures, all errors during impression making and cast fabrication result in non-passive fit of bars. SFI bar is prefabricated and assembled in the patient's mouth without the use of soldering, laser welding or conventional bonding techniques, thus reducing stress transmission to, bone loss around the implants and leading to fewer errors and lower costs. A clinical case will be presented below to demonstrate the use of the SFI Bar (Stress Free on Implant Bar) to restore an severe atrophy edentulous maxilla. In this case, no lateral stress could be applied to the implants due to the telescopic design of the bar joints. However, periodic recall check is necessary and long-term clinical results are required.
Kim, Seong-Kyun;Yoo, Soo-Yeon;Park, In-Phil;Lee, Joo-Hee
The Journal of the Korean dental association
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v.49
no.2
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pp.77-84
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2011
The benefits of implant supported overdenture are readily apparent for the fully edentulous patients and have been well documented, however, there is deficiency of the studies regarding the combination of implants with removable partial dentures for partially edentulous patients. The purpose of this article is to review the literature concerning implants with removable partial dentures and evaluate the evidence for this clinical approach. Through many clinical case reports and studies we have searched from a broad variety of journals, we present the six considerations needed to contemplate respecting implants with removable partial denture in partially edentulous patients. First, the connection between abutment tooth and removable partial denture has to be rigid and the link between implant and removable partial denture should be hinged. Second, a mesial rest acts better in the point of force distribution for distal extension removable partial denture and splinting between implants is also a favorable choice. Third, T bar has an advantage for implants which are used as abutments in distal extension removable partial denture. Forth, as we all known functional impression is better way to reproduce movement for distal extension removable partial denture. Fifth, indirect retainer and guiding plane on the proximal surfaces of terminal abutment teeth are important in preventing denture base lifting. Sixth, implants in conjunction with removable partial denture is superior in the esthetic and phonetic as well as cost-effective point of view. We also suggest that which place we should install implants for force distribution and which diameter and length of implants should be used. in this review article, we recommend to locate the implant near of the abutment tooth for esthetics or near of first molar position for good stress distribution. The diameter and length of implant also influence to stress distribution. When we compare to conservative partial denture, patients go for removable partial denture using implants due to convenience, better support and retention according to several studies. But it is true that we need to study more on this subject and collect long term follow up cases before we discuss on it. So it is enough to bring this subject into the surface of prosthetic treatment by this article.
The Journal of Korea Assosiation for Disability and Oral Health
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v.13
no.2
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pp.95-98
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2017
Due to hypodontia, poor oral hygiene, and significantly more prevalent periodontal disease, patients with Down syndrome show higher incidence of edentulism. Oral rehabilitation of such patients is imperative but challenging as high rates of prosthesis failure are reported due to malocclusion, high masticatory force, and parafunctional habits. As CAD/CAM(Computer-Aided Design and Computer Aided Manufacturing) is the recent trend in prosthodontics, this report discusses the application of CAD/CAM in a Down syndrome patient. A 25-year-old patient with Down syndrome was presented to the Department of Pediatric Dentistry, Yonsei University Dental Hospital for oral examination. 5 maxillary teeth were missing, 3 were fully impacted, and 4 had grade III mobility. The patient underwent general anesthesia for extraction of impacted and mobile teeth, implant surgery, and final impression for prosthesis. Afterwards, CAD/CAM was used to design and manufacture a 10-unit zirconia bridge. However the bridge was fractured after 18 months due to the patient's bruxism and high masticatory force. Final impression taking, bite registration, cast fabrication, cast scanning, and prosthesis designing were not needed as CAD/CAM data remained. Previous CAD/CAM design was used to remanufacture the zirconia bridge. Down syndrome patients have malocclusion, high masticatory force, and parafunctional habits which increase the possibility of prosthesis fracture. CAD/CAM is beneficial for Down syndrome patients as previous digital records can be utilized for prosthesis repair or remake. In detail, application of CAD/CAM in remanufacturing decreases patient's discomfort of impression taking, shortens and simplifies dental laboratory procedures, and reduces clinician's effort of taking detailed final impressions or accurate bite registration. In conclusion, oral rehabilitation using CAD/CAM provides not only satisfactory levels of comfort, stability, and esthetics, but also easier repair or remake compared to conventional prostheses.
Various alloplastic materials have been used on the periodontally diseased ossous defects. Hydroxyapatite, which is used the most common alloplastic material is a non-resorbable form of calcium phosphate and natural coral which is a biodegradable by carbonic anhydrase in osteoclast was introduced recently. The purpose of the present study was to evaluate the clinical effects of porous hydoxyapatite and natural coral on the human periodontal defects. Four males and three females who had adult periodontitis were selected for this study. The teeth that had similar bone loss radiographically and periodontal pocket deeper than 5mm were selected. Gingival recession, pocket depth, plaque index(Silness & Loe), sulcus bleeding index and tooth mobility (measured by Periotest$^{(r)}$) were examined before graft. Before insertion of alloplastic materials, the depth from CEJ to bone crest and from CEJ to base of the osseous defect was recorded. Porous particulate hydroxyapatite(Interpore 200$^{(r)}$, A group) was place on the defect and natural coral(Biocoral$^{(r)}$, B group) was placed on the defect of the opposing tooth. Six months post-surgically the same parameters were recorded by reentry procedures. A and B group showed 0.6mm of mean recession. Mean reduction of pocket depth were 5mm for A group and 4.9mm of B group. Reduced SBI and tooth mobility were recorded. Osseous defect fills of the original defects were 2.9mm for A and 3mm for B group. Percentage defect fills were 71% for A and 59% for B group. The difference of defect fill between pre- and post-insertion was statstically significant(p<0.05). But the difference between the two groups was not significant statistically(p<0.05). The clinical impression at 6 month re-entry and the numerical date indicate that natural coral as well as porous particulate hydoxyapatite has a definite potential as an alloplastic implant in the treatment of periodontal osseous defects.
The purpose of the present investigation was to compare the effectiveness of porous hydroxyapatite (PHA) and coralline based porous calcium carbonate(PCC) as implant materials in human periodontal osseous defects. 10 adult patients having periodontitis and 2 similar angular osseous defects ${\ge}$5mm as verified by radiographic analysis and clinical probing depth ${\ge}$4mm were selected. The measurements were recorded just before surgery and after 6 month. Clinical parameters used in this study included gingival recession, pocket depth, probing attachment level, Sulcus Bleeding Index, Plaque Index, tooth mobility and bone defect depth measurements. After initial therapy, patients were treated with mucoperiosteal flap surgery. The contralateral bony defects in each patient randomly assigned to either bone graft material, one with PHA(Interpore 200) and the other with coralline based calcium carbonate(Biocoral). After 6 month both groups showed statistically significant reduction of pocket depth, Sulcus Bleeding Index, Plaque Index and significant improvement in probing attachment level. No statistically significant differences were found between the groups. There were 3.0mm or 68% of bone repair with PHA and 3.1mm, 61% with PCC. These values were likewise not significantly different. The data and clinical impression strongly suggest that both PHA and PCC are alloplastic implants with clinically apparent acceptance by the soft and hard tissue and that they can be used as bone graft materials successfully.
Journal of Dental Rehabilitation and Applied Science
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v.33
no.4
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pp.252-259
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2017
Purpose: The purpose of this study was to compare and analyze the wear of a prosthesis for 6 months after restoration with implant-supported fixed dental prosthesis made of either zirconia or gold. Materials and Methods: This study was conducted on patients requiring implant-supported fixed dental prostheses on first or second molar from January, 2015 to January, 2016. A total of 47 prostheses and antagonists were examined. Occlusal surface was recorded by impression of each prosthesis and antagonist 1 week and 6 months after prosthesis delivery. The digital files were created by impression scan. Occlusal shapes of 1 week and 6 months were compared and wear of prostheses and antagonists was analyzed. The Mann-Whitney test was used to analyzed the result data underwent normality test using SPSS (Version 23.0, IBM Corporation) Results: Mann-Whitney test revealed that there was no statistically significant difference in the median amount of mean vertical wear for 6 months in zirconia ($50.84{\mu}m$) and gold ($42.84{\mu}m$) prostheses (P > 0.05). When the opposing teeth were natural, the median amount of mean vertical wear of zirconia and gold prostheses was $47.72{\mu}m$ and $41.97{\mu}m$, respectively, and the median amount of mean vertical wear of enamel was $47.26{\mu}m$ and $44.59{\mu}m$, respectively. Statistical analysis showed no significant difference (P > 0.05). Conclusion: Despite the short study period and the small number of experimental groups, zirconia and gold showed no significant difference in wear during the first 6 months. Opposing natural enamel also showed no significant difference in the wear.
Park, Ji-Man;Yi, Tae-Kyoung;Jung, Je-Kyo;Kim, Yong;Park, Eun-Jin;Han, Chong-Hyun;Koak, Jai-Young;Kim, Seong-Kyun;Heo, Seong-Joo
The Journal of Korean Academy of Prosthodontics
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v.48
no.4
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pp.294-300
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2010
Purpose: The template-guided implant surgery offers several advantages over the traditional approach. The purpose of this study was to evaluate the accuracy of coordinate synchronization procedure with 5-axis milling machine for surgical template fabrication by means of reverse engineering through universal CAD software. Materials and methods: The study was performed on ten edentulous models with imbedded gutta percha stoppings which were hidden under silicon gingival form. The platform for synchordination was formed on the bottom side of models and these casts were imaged in Cone beam CT. Vectors of stoppings were extracted and transferred to those of planned implant on virtual planning software. Depth of milling process was set to the level of one half of stoppings and the coordinate of the data was synchronized to the model image. Synchronization of milling coordinate was done by the conversion process for the platform for the synchordination located on the bottom of the model. The models were fixed on the synchordination plate of 5-axis milling machine and drilling was done as the planned vector and depth based on the synchronized data with twist drill of the same diameter as GP stopping. For the 3D rendering and image merging, the impression tray was set on the conbeam CT and pre- and post- CT acquiring was done with the model fixed on the impression body. The accuracy analysis was done with Solidworks (Dassault systems, Concord, USA) by measuring vector of stopping’s top and bottom centers of experimental model through merging and reverse engineering the planned and post-drilling CT image. Correlations among the parameters were tested by means of Pearson correlation coefficient and calculated with SPSS (release 14.0, SPSS Inc. Chicago, USA) ($\alpha$ = 0.05). Results: Due to the declination, GP remnant on upper half of stoppings was observed for every drilled bores. The deviation between planned image and drilled bore that was reverse engineered was 0.31 (0.15 - 0.42) mm at the entrance, 0.36 (0.24 - 0.51) mm at the apex, and angular deviation was 1.62 (0.54 - 2.27)$^{\circ}$. There was positive correlation between the deviation at the entrance and that at the apex (Pearson Correlation Coefficient = 0.904, P = .013). Conclusion: The coordinate synchronization 5-axis milling procedure has adequate accuracy for the production of the guided surgical template.
Purpose: The purpose of this study was to reduce the remake rate of dental prosthesis. We examined remake cause and major factor of dental prosthesis to determine methods for raising dental prosthesis satisfaction. Methods: Subjects included dental technicians in the metropolitan areas of the cities of Daegu and Gyeong-buk. Surveys were filled out by consenting dental technicians. Statistical analysis was done using SPSS version 19.0 for Windows. We determined frequencies and percentage, calculating means, and standard deviations, and determining statistical significance using t-tests, analysis of variance. Results: Impression or material transform is high among remake cause and margin is high among remake major factor. Crown class showed differences in General characteristics associated with age, number of employees, and number of connection dental. Porcelain class showed differences in General characteristics associated with age, number of employees, and number of connection dental. Denture class showed differences in General characteristics associated with age, monthly salaray, and career. Implant class showed differences in General characteristics associated with age, education, and career. Conclusion: In order to reduce remake rate of dental prosthesis, communication of dentist, dental technician, and the patient are require and correct information of patient and dental prosthesis are need.
Purpose: The purpose of this study was to verify the remake rate and cause of dental prosthesis and to investigate major factors of remake of dental prosthesis. Methods: This study carried out self-administered questionnaire survey from 126 nationwide dental laboratory CEO and directors, which was conducted from September to October in 2016. Results: Total remake rate of dental prosthesis was 10.1% at the nationwide dental laboratories. It was in order of remake rate of dental prosthesis 11.8% for CAD/CAM, 11.5% for porcelain and 11.0% for implant prosthesis. Error of clinical impression was the highest remake cause(63.7%). Nevertheless, dental laboratory take the responsibility of expense for remake of dental prosthesis, regardless of remake cause(67.4%). There was no relation between dental laboratory characteristics and the remake rate of dental prosthesis(p>.05). Conclusion : The remake rate of dental prostheses should be reduced to minimize the economic loss of dental laboratories and raise dental prosthesis satisfaction. It is required to communicate of dentist, dental technicians, and patients, moreover, undistorted information about oral environment should be provided to the dental technicians.
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