• 구강회복응용과학지
• /
• 제32권4호
• /
• pp.314-321
• /
• 2016

기존의 후방 연장 국소의치는 재이장을 위한 잦은 내원의 필요성, 클래스프에 의한 지대치로의 과도한 응력, 클래스프의 노출에 의한 비심미성 등의 단점이 있다. 이에 임플란트를 이용하여 부가적인 지지나 유지를 얻는 Implant-assisted RPD(IARPD)는 국소의치의 안정성과 심미성, 그리고 저작 효율 증진에 도움을 줄 수 있다. 또한 의치의 교합면을 지르코니아로 교체한다면 인공치 마모로 인한 대합치의 정출 및 교합평면의 부조화를 예방할 수 있을 것이다. 본 증례는 엇갈린 교합을 가진 상하악 부분 무치악 환자에서 임플란트 고정성 보철물과 임플란트 유지 국소의치를 제작하여 전악 재건 시행한 증례로 주기적인 내원을 통해 기능적, 심미적으로 만족할만한 결과를 얻었기에 보고하고자 한다.

• 구강회복응용과학지
• /
• 제33권3호
• /
• pp.207-215
• /
• 2017

총의치 치료에서는 지지, 유지, 안정, 교합, 심미 등 고려할 요소가 많으나 치조골 흡수가 심한 경우, 해당 요인을 갖추기 어렵다. 해부학적 치아를 사용할 경우 좋은 저작효율과 심미성을 기대할 수 있으나, 흡수된 치조골에서는 안정이 저하될 수 있으며 비해부학적 치아는 이와 반대의 효과를 나타낸다. 이에 치아를 혼용하는 설측 교두 교합이 제시되었다. 설측 교두 교합에서 상, 하악 협측 교두는 중심위, 측방위에서 접촉되지 않고 교합접촉위치가 설측화 또는 중심화되어 의치의 안정성이 증대될 수 있다. 본 증례는 상하 치조제의 흡수가 진행되어, 상악에서 편평한 치조제를 보이는 경우로, 설측 교두 교합을 이용한 총의치를 이용하여 치료함으로써 의치의 안정성과 환자의 만족도를 높였기에 이를 보고하는 바이다.

• 구강회복응용과학지
• /
• 제16권3호
• /
• pp.171-185
• /
• 2000

The treatment objectives of the complete oral rehabilitation are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. There may be many roads to achieving these objectives, but they all convey varing degrees of stress and strain on the dentist and patient. There are no "easy" cases of oral rehabilitation. Time must be taken to think, time must be taken to plan, and time must be taken to perform, since time is the critical element in both success and failure. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. Firstly, we must evaluate the mandibular position. The results of a repetitive, unstrained, nondeflective, nonmanipulated mandibular closure into complete maxillomandibular intercuspation is not so much a "centric" occlusion as it is a stable occlusion. Accordingly, we ought to concern ourselves less with mandibular centricity and more with mandibular stability, which actually is the relationship we are trying to establish. The key to this stability is intercuspal precision. Once neuromuscular passivity has been achieved during an appropriate period of occlusal adjustment and provisionalization, subsequent intercuspal precision becomes the controlling factors in maintaining a stable mandibular position. Secondly, we must evaluate the planned vertical dimension of occlusion in relationship to what may now be an altered(generally diminished), and avoid the hazard of using such an abnormal position to indicate ultimate occlusal contacting points. There are no hard and fast rules to follow, no formulas, and no precise ratios between the vertical dimension of occlusion. Like centric relation, it is an area, not a point.

• 대한구순구개열학회지
• /
• 제16권1호
• /
• pp.9-18
• /
• 2013

Distraction osteogenesis is useful treatment which the gradual separation of cut bone edges results in the generation of new bone. It is effective treatment for correcting maxillofacial deformities. Patients with cleft lip and palate usually have maxillary hypoplasia due to scarring of lip and palate. To correct these deformities, we chose to use a 2-jaw orthognathic surgery or distraction osteogenesis. But despite improvements in surgical techniques for maxillofacial deformities, postoperative stability still leaves the question of when relapse may occur. This case report describes the Relapse after treatment of maxillary hypoplasia with cleft lip and palate by Rigid External distraction system over a 2-year treatment and follow-up period. In addition, we reviewed related articles about the influence of the occlusal stability on postoperative stability in patients with cleft lip and palate correction with Distraction osteogenesis.

• 대한치과보철학회지
• /
• 제34권4호
• /
• pp.657-664
• /
• 1996

The purpose of this study was to compare the dimensional stability, compression resistance, elastic recovery and surface hardness of elastomeric interocclusal recording materials. Five commonly used elastomeric interocclusal recording materials(Ramitec, Regisil, Blue-Mousse, Stat-Br, Coltoflax) were selected for this study. According to ADA specification No. 19, two types of specimen were fabricated. Cylinder type specimens were used to test compression resistance and elastic recovery and plate type specimens were used to evaluate dimensional stability and surface hardness. Paired t-test was applied to detect significance among the occlusal registration materials. The obtained results were as follows: 1. There were statistical difference in dimensional stability between the elastic interocclusal recording materials. The dimensional stability of silicone was higher than that of polyether tested(p<0.05). 2. Coltoflax was significantly less resistance to compression than the other elastic interocclusal recording materials(p<0.001). 3. The elastic recovery capacity of Blu-Mousse and Stat-Br is better than that of Coltoflax (p<0.01). 4. The surface hardness of Coltoflax was lower than that of Blu-Mousse and Stat-Br(p<0.05). 5. The percentage dimensional change of alll materials was acceptable according to the limid of 0.5% suggeted by ADA specificatin No. 19.

• 구강회복응용과학지
• /
• 제32권1호
• /
• pp.70-79
• /
• 2016

치주 질환이나 치아 우식으로 인해 구치부 치아가 상실된 환자들은 대합치 정출 및 인접치 경사가 발생하여, 교합평면의 붕괴나 수직 고경의 상실로 하악골 위치 변화가 나타날 수 있다. 특히 악교정 수술 환자에서, 이런 증상이 나타날 경우 하악과두가 관절와 내에서 안정화된 위치에 존재하여 술 후 안정성을 높일 수 있도록, 술 전 수직 고경을 재설정하는 치료가 필요하다. 따라서 보철, 교정, 구강악안면외과 등 다분야에서 진단 및 치료 계획에서부터 원활한 의사소통을 통한 양호한 치료 결과를 얻을 수 있도록 협력하는 것이 중요하다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제38권
• /
• pp.12.1-12.6
• /
• 2016

Background: Temporomandibular joint (TMJ) ankylosis can be accompanied by various degrees of functional and esthetic problems. Adequate mouth opening, occlusal stability, and harmonious facial form are the main goals of treatment for ankylosis. Distraction osteogenesis has proven to be an excellent treatment for lengthening the ramus-condyle unit. However, various timings for distraction have been suggested, and there is no consensus on selection criteria for performing the procedure in stages or simultaneously with other treatments. Case presentation: In this case report, concomitant intraoral distraction and gap arthroplasty was planned to treat TMJ ankylosis and associated facial asymmetry. After gap arthroplasty and 23 mm of distraction, the ramus-condyle segment was successfully lengthened and mouth opening range was significantly increased. The resultant interocclusal space was stably maintained with an occlusal splint for 4 months after distraction. Finally, good occlusion was achieved after prosthetic treatment. The remaining mandibular asymmetry was corrected with osseous contouring and augmentation surgery. The mouth-opening range was maintained at 35 mm 24 months after treatment. Conclusion: Gap arthroplasty with intraoral distraction as a one-stage treatment and subsequent contouring surgery can be applied to correct ankylosis with moderate malocclusion and facial asymmetry.

• 대한치과보철학회지
• /
• 제37권5호
• /
• pp.567-580
• /
• 1999

Accurate reproduction of intraoral tissue is essential in the fabrication of fixed prosthesis. This selection of impression material and method is very important. In this study, vinyl polysiloxane type impression material $Panasil^{(R)}$ was used. Three impression methods ; one-step technique, individual tray technique, and individual tooth tray technique using the vinyl polysiloxane type bite registration material $Futar^{(R)}$ Occlusion, were used to take horizontal and vertical impression. Improved stone models were fabricated. The amount of occlusal surface discrepaneies, interabutment distance discrepancies, amount of marginal defect were evaluated with the $X-PLAN360d^{(R)}$ and photoscanning. The results were as follows. 1. There was no significant difference in occlusal surface according to the directions and techniques of impression taking. 2. There was no significant difference in interabutment distance discrepancies according to the directions and techniques of impression taking 3. There was no significant difference in marginal discrepancies according to the direction of impression taking but there was significant difference between one-step technique and individual tray technique, individual tooth tray technique (P<0.05). Taken together, these results suggest that individual tray technique and individual tooth tray technique are more accurate for impression taking than one-step technique.

• 구강회복응용과학지
• /
• 제27권4호
• /
• pp.423-436
• /
• 2011

교합성 외상은 과도하거나 비정상적인 교합력으로 인한 치아의 주위에 발생하는 병적 변화를 말한다. 교합성 외상과 치주질환과의 관계에 대한 다양한 논쟁이 있었지만 위험요소임은 확실하기 때문에 교합조정을 하는 것이 치주치료의 결과를 개선시킬 수 있다. 정상적인 치주조직을 가진사람이라도 저작양태와 교합양상 및 전치피개의 양상에 따라 교합외상이 발생할 가능성이 있다. 치주질환으로 인해 이차적인 교합외상이 있으면 다양한 문제점을 유발할 가능성이 있는데 특히 구치가 상실되면 교합의 안정을 위협받게 된다. 상실된 구치를 수복하지 않아도 된다는 개념부터 반드시 회복시켜야 한다는 극단적인 주장이 있지만 양쪽의 주장 모두 교합의 안정성을 최우선의 목표로 한다는 점에서는 일치한다. 또한 구치가 상실되면 대합치의 변위나 정출 뿐 아니라 전치의 변위까지도 유발할 수 있기 때문에 교합성 외상을 제거하고 교합의 안정성을 확보하기 위한 치료가 필수적이다.

• 대한치과보철학회지
• /
• 제43권5호
• /
• pp.622-632
• /
• 2005

Statement of problem: Silicone Index Tooth Tray impression system which does not use gingicord has a shortcoming. It takes time to remove internal wall of Silicone Index Tooth Tray for space of wash impression material. Purpose: This study was to evaluate whether providing certain space to impression body can prevent from doing complicated laboratory work. Material and methods: After mounting metal dies with shoulder and chamfer margins arbiturarily, SITT was produced using $Blu-mousse^(R)$. In one experimental group, wash impression was taken using $Fit-tester^(R)$ without removing interior surface of SITT and in the other group, wash impression was taken using $Fit-tester^(R)$ providing 0.5mm space in the SITT and then compared the differences in two groups. Results: 1. There was no significant difference between a group which did not allow space and a group which granted equal 0.5mm space. 2. There was no significant difference between gingival diameter, occlusal diameter of metal die that has shoulder margin and gingival diameter, occlusal diameter of metal die that has chamfer margin. 3. There was no significant difference between a group which did not take pick-up impression and a group which took pick-up impression through relining method using SITT 4. There was no significant difference between a group that poured immediately after taking primary impression and a group that poured after removing poured stone die. Conclusions: When taking an impression of an abutment using SITT impression system, it is considered to obtain clinically identical results between a group that did not grant a 0.5mm space within SITT for wash impression and a group which invest a space. Furthermore, it is considered possible to produce an individual die through secondary pouring.