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CLINICAL AND STATISTICAL STUDIES ON FIXED BRIDGE (가공의치의 임상 통계적 연구)

  • Kim, Seung-Jae
    • The Journal of Korean Academy of Prosthodontics
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    • v.18 no.1
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    • pp.99-109
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    • 1980
  • An investigation was made Into 1,357 fixed bridges which had been performed at the Department of Prosthetic Dentistry, Seoul National University Hospital from 1973 to 1979. The purpose of this investigation was to establish a basic reference of the treatment with fixed bridges by obtaining statistical conclusions from the data concerning the patients who had been treated with fixed bridges. The following conclusions were obtained; 1. The ratio of the fixed bridges made on the maxillae to those made on the mandible was 1:1. 2. The cases of fixed bridges with one pontic were the most frequent, i.e., 946 cases out of total 1,357 cases, which were 69.7% of the total. 3. As the number of missing teeth increased, the number of the relevant cases of fixed bridges decreased. 4. The most frequent age group of the patients who had been treated with fixed bridges was the twenties, which was 40.8% of the total. As the age of the patients increased, the number of corresponding cases of fixed bridges decreased. 5. Most of the fixed bridges with more than three pontics were made at the anterior portion samely on the maxilla and on the mandible. 6. As for the retainers, the porcelain fused to metal crown and the partial veneer crown were frequently used at the anterior portion, while the full veneer crown was frequently used and the inlay and the attachment were used in some cases at the posterior portion. The locations of fixed bridges in the order of their frequency were: canine, lateral incisor, second bicuspid, central incisor, second molar, first bicuspid, first molar, and third molar on the maxilla; second bicuspid, second molar, first bicuspid, first molar, canine, third molar, lateral incisor, and central incisor on the mandible.

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Digital approach for fabrication of zirconia restoration with optimal gingival adaptation after tooth extraction: A case report (발치 후 지르코니아 보철물 제작에서 최적의 연조직 적합 형성을 위한 디지털 치료 증례)

  • Mai, Hang Nga;Lee, Du-Hyeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.217-220
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    • 2020
  • Conventionally, when a zirconia fixed dental restoration is planned, the interim restoration is made manually and the final restoration is fabricated by the silicone impression taking at the prosthodontic stage. This conventional workflow does not provide direct relation between interim and final restorations. Moreover, the predictability of the final restoration could be low. Nowadays, the CAD/CAM based restoration fabrication and related digital techniques are developed and being applied in dentistry in multiple ways. This case report introduces a digital workflow for fabricating an optimal gingival adaptation and predictability of monolithic zirconia restoration by using CAD/CAM interim restoration, intra oral scan, and image superimposition technique in a case that required tooth extraction.

Pontic site development with an implant submergence technique for unaesthetic implant in the anterior maxilla (상악 전치부 임플란트의 비심미성 개선을 위한 임플란트 침수(submergence)를 동반한 치조제 증대술)

  • Song, Yujeong;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.289-295
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    • 2020
  • Improving implant esthetics is very difficult, especially in cases where unaesthetic problems are related to implants in the maxillary anterior dentition. A 69-year old male patient was referred by a prosthodontist for periodic pus discharge and an unaesthetic implant prosthesis (maxillary right lateral incisor). The implant was placed too deeply and showed soft tissue volume deficiency and a long clinical crown. After a clinical and radiographic examination, implant submergence and alveolar ridge augmentation were performed to enhance the aesthetics instead of an explantation. The treatment plan was as follows: extraction the adjacent teeth with tooth mobility, secondary caries, and poor prognosis; placement an additional dental implant with hard and soft tissue grafting; fabrication a fixed bridge using implant abutments. A fixed esthetic prosthesis using implants was fabricated, and the patient was satisfied with the prosthesis. A ridge augmentation with implant submergence may be an alternative for solving the problems of unaesthetic implant restorations in the esthetic zone.

Comparative evaluation of peri-implant stress distribution in implant protected occlusion and cuspally loaded occlusion on a 3 unit implant supported fixed partial denture: A 3D finite element analysis study

  • Acharya, Paramba Hitendrabhai;Patel, Vilas Valjibhai;Duseja, Sareen Subhash;Chauhan, Vishal Rajendrabhai
    • The Journal of Advanced Prosthodontics
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    • v.13 no.2
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    • pp.79-88
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    • 2021
  • Purpose. To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion. Materials and methods. A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points. Results. In Group 1 for vertical load, maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1. Conclusion. In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.

A retrospective comparison of clinical outcomes of implant restorations for posterior edentulous area: 3-unit bridge supported by 2 implants vs 3 splinted implant-supported crowns

  • Yi, Yuseung;Heo, Seong-Joo;Koak, Jai-Young;Kim, Seong-Kyun
    • The Journal of Advanced Prosthodontics
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    • v.14 no.4
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    • pp.223-235
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    • 2022
  • PURPOSE. To compare the clinical outcomes of two types of implant restoration for posterior edentulous area, 3-unit bridge supported by 2 implants and 3 implant-supported splinted crowns. MATERIALS AND METHODS. The data included 127 implant-supported fixed restorations in 85 patients: 37 restorations of 3-unit bridge supported by 2 implants (2-IB), 37 restorations of 3 implant-supported splinted crowns (3-IC), and 53 single restorations (S) as controls. Peri-implantitis and mechanical complications that occurred for 14 years were analyzed by multivariable Cox regression model. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success and survival of implants. RESULTS. Peri-implantitis occurred in 28.4% of 2-IB group, 37.8% of 3-IC group, and 28.3% of S control group with no significant difference. According to the implant position, middle implants (P2) of the 3-IC group had the highest risk of peri-implantitis. The 3-IC group showed a lower mechanical complication rate (7.2%) than the 2-IB (16.2%) and S control group (20.8%). The cumulative success rate was 52.8% in S (control) group, 62.2% in 2-IB group, and 60.4% in 3-IC group. The cumulative survival rate was 98.1% in S (control) group, 98.6% in 2-IB group, and 95.5% in 3-IC group. There was no significant difference in the success and survival rate according to the restoration type. CONCLUSION. The restoration type was not associated with the success and survival of implants. The risk of mechanical complications was reduced in 3 implant-supported splinted crowns. However, the middle implants of the 3 implant-supported splinted crowns had a higher risk of peri-implantitis.

Determining the reliability of diagnosis and treatment using artificial intelligence software with panoramic radiographs

  • Kaan Orhan;Ceren Aktuna Belgin;David Manulis;Maria Golitsyna;Seval Bayrak;Secil Aksoy;Alex Sanders;Merve Onder;Matvey Ezhov;Mamat Shamshiev;Maxim Gusarev;Vladislav Shlenskii
    • Imaging Science in Dentistry
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    • v.53 no.3
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    • pp.199-207
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    • 2023
  • Purpose: The objective of this study was to evaluate the accuracy and effectiveness of an artificial intelligence (AI) program in identifying dental conditions using panoramic radiographs(PRs), as well as to assess the appropriateness of its treatment recommendations. Materials and Methods: PRs from 100 patients(representing 4497 teeth) with known clinical examination findings were randomly selected from a university database. Three dentomaxillofacial radiologists and the Diagnocat AI software evaluated these PRs. The evaluations were focused on various dental conditions and treatments, including canal filling, caries, cast post and core, dental calculus, fillings, furcation lesions, implants, lack of interproximal tooth contact, open margins, overhangs, periapical lesions, periodontal bone loss, short fillings, voids in root fillings, overfillings, pontics, root fragments, impacted teeth, artificial crowns, missing teeth, and healthy teeth. Results: The AI demonstrated almost perfect agreement (exceeding 0.81) in most of the assessments when compared to the ground truth. The sensitivity was very high (above 0.8) for the evaluation of healthy teeth, artificial crowns, dental calculus, missing teeth, fillings, lack of interproximal contact, periodontal bone loss, and implants. However, the sensitivity was low for the assessment of caries, periapical lesions, pontic voids in the root canal, and overhangs. Conclusion: Despite the limitations of this study, the synthesized data suggest that AI-based decision support systems can serve as a valuable tool in detecting dental conditions, when used with PR for clinical dental applications.

LONGEVITY AND FAILURE ANALYSIS OF FIXED RESTORATIONS SERVICED IN KOREA (국내에서 제작된 고정성 보철물의 수명과 실패 요인 및 양상)

  • Shin Woo-Jin;Jeon Young-Sik;Lee Keun-Woo;Lee Ho-Yong;Han Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.2
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    • pp.158-175
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    • 2005
  • Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.

Dental anomalies associated with Axenfeld-Rieger syndrome (Axenfeld-Rieger 증후군과 연관된 치과적 이상)

  • Kim, Ki-Rim;Lee, Doo-Young;Kim, Seung-Hye;Lee, Sang-Hui;Choi, Byung-Jai;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.6 no.2
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    • pp.94-98
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    • 2010
  • Axenfeld-Rieger syndrome is a rare autosomal dominant disorder characterized by various ocular and extraocular malformations. The incidence of Axenfeld-Rieger syndrome has been estimated to be 1 per 200,000. The syndrome is characterized by short body stature, delayed bone age, and deficient or arrested development of neural crest cells involving the anterior chamber of the eyes, facial bones, teeth, periumbilical skin, and cardiovascular system. This is a case of a 6 year-old girl, who came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of multiple congenital missing permanent teeth. The patient presented typical dental, craniofacial, and systemic features of Axenfeld-Rieger syndrome, such as glaucoma, oval pupil, heterochromatic iris, umbilical hernia, and delayed bone age. On the panoramic view, 3 primary teeth were missing and 13 permanent tooth germs were absent. On the lateral cephalograph, underdevelopment of the maxilla and normal growth pattern of the mandible were confirmed. Periodic dental follow-up is planned for evaluation and interceptive treatment of her dental and craniofacial problems. Denture or removable space maintainer with a pontic is considered for esthetic and functional restoration. In addition, orthognathic surgery is also planned in future to prevent further midfacial skeletal deformation. Early diagnosis of Axenfeld-Rieger syndrome is very important to prevent exacerbation of complications, such as glaucoma and skeletal deformities.

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Geologic Structure of the Anatolian Peninsula: Tectonic Growth of Collisional Continental Margins (아나톨리아 반도의 지질구조: 대륙 충돌에 따른 구조적 성장)

  • Ryu, In-Chang
    • Economic and Environmental Geology
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    • v.45 no.4
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    • pp.465-476
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    • 2012
  • The Anatolia peninsula consists of several continental fragments that include the Pontide Block in north and the Anatolide-Touride Block in south as well as the Arabian Platform in southeast. These continental blocks were joined together into a single landmass in the late Tertiary. During most of the Phanerozoic these continental blocks were separated by paleo-oceans, such as Paleo-Tethys and Neo-Tethys. The Pontide Block in north show Laurasian affinities, and was only slightly affected by the Alpide orogeny; they preserve evidence for the Variscan and Cimmeride orogenies. The Pontic Block is composed of the Strandja, Istanbul and Sakarya zones that were amalgamated into a single terrane by the mid Cretaceous times. The Anatolide-Tauride Block in south shows Gondwana affinities but was separated from Gondwana in the Triassic and formed an extensive carbonate platform during the Mesozoic. The Anatolide-Tauride Block was intensely deformed and partly metamorphosed during the Alpide orogeny; this leads to the subdivision of the Anatolide-Tauride Block into several zones on the basis of the type and age of metamorphism and deformation. The Arabian Platform in southeast forms the northernmost extension of the Arabian Plate that shows a stratigraphy similar to the Anatolide-Tauride Block with a clastic-carbonate dominated Palaeozoic and a carbonate dominated Mesozoic succession. A new tectonic era started in Anatolia Peninsula in the Oligocene-Miocene after the final amalgamation of these continental blocks and plate. This neotectonic phase is characterized by extension, and strike-slip faulting, continental sedimentation, and widespread calcalkaline magmatism, which played a very important role in producing beautiful landscapes of the Anatolia Peninsula today.

Novel Connective tissue graft technique for Ridge Augmentation in case of Conventional fixed partial denture : Case reports (치조제 결손부 증대를 위한 새로운 결합조직 이식술)

  • Ahn, Myung-Hwan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.22 no.1
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    • pp.47-55
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    • 2013
  • There have been a great number of developments in clinical techniques and dental materials in dentistry to date. Looking at these developments, while it could be seen that functional elements such as mastication were prioritized rather than aesthetic aspect in the past, aesthetic needs of patients have steadily increased over time and accordingly the aesthetic has become considered a priority in the development of dentistry. Although the first to be considered in discussing the aesthetic in clinical dentistry will be the white aesthetic that is the tooth part of prosthesis, the pink aesthetic that refers to the harmony of such prosthesis with gingiva can be an important consideration not to be ignored aesthetically. However, the harmony with the gingiva often cannot be obtained only by the beautiful prosthesis, and in particular, the pontic and implant areas have poor conditions to achieve the gingival (pink) aesthetic due to the absorption of alveolar ridge compared to natural teeth. Among the most important elements of the gingival aesthetic are the gingival level and the interproximal papilla height. It is very difficult to make the gingival aesthetic in the case of insufficient alveolar ridge, and the recovery of ridge volume and contour is necessary in order to overcome this condition. To this end, the most widely used method is the "connective tissue graft". Many techniques of the connective tissue graft have already been introduced for the ridge augmentation, and each technique has different purposes, and advantages and disadvantages. Rather, due to the excessive amount of techniques, there is confusion about selecting the right technique at a certain time. However, the goal is clear. Ways to increase the success rates must be found, and at the same time, a more favorable way to the gingival aesthetic is to be chosen. Thus, in this study, considerations for the gingival aesthetic that makes harmony and the techniques to achieve it are discussed.