• Title/Summary/Keyword: posterior attachment

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STRESS ANALYSIS AT SUPPORTING TISSUE OF ABUTMENT TEETH AND RESIDUAL RIDGE ACCORDING TO DENTURE DESIGN WITH REMAINING UNILATERAL POSTERIOR TEETH (편측 후방 치아 잔존시 의치 설계에 따른 지대치지지 조직과 잔존 치조제의 응력 분석에 관한 연구)

  • Ahn, Kwang-Ho;Jung, Young-Wan;Jin, Tai-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.2
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    • pp.185-199
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    • 1999
  • This study was peformed to investigate the distribution and magnitude of stress at supporting tissue of abutment teeth and residual ridge tissue with remaining unilateral posterior teeth. Four types of removable partial dentures that included clasp retained removable partial denture, attachment retained removable partial denture, telescopic removable partial denture, and swing-lock partial denture were designed, and strain gauge was used for stress analysis. Each prosthesis was subjected to simulated vertical and oblique load. The following conclusions were drawn from this study. 1. The clasp retained removable partial denture generally distributed simulated vertical force more evenly to the supporting structure. 2. The stress at buccal side of 1st premolar was the lowest in swing-lock partial denture and that was highest in attchment retained removable partial denture. The stress at lingual side of 1st premolar was the lowest in telescopic partial denture. 3. In clasp retained removable partial denture, stress was lower at load site and ridge crest at mid-line, but it was higher at 1st premolar area on vertical load. 4. In attachment removable partial denture, stresses at buccal side of 1st premolar. lingual side of 1st premolar on vertical load, and ridge crest at midline on oblique load were higher. 5. In telescopic removable partial denture, stress at lingual side of 1st premolar was the least in all removable partial dentures, but the stress at load site was higher. 6. In swing-lock removable partial denture, stress at buccal side of 1st premolar was the lowest, and stresses at load site and distal end of residual ridge crest were higher.

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TREATMENT OF HEAVY MANDIBULAR BUCCAL FRENUM USING APICALLY POSITIONED FLAP UNDER DEEP SEDATION IN CHILDREN (소아환자의 깊은 진정요법 하에서 근단변위 판막술을 이용한 거대협소대의 치료)

  • Kim, Jong-Bin;Yoon, Hyung-Bae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.69-76
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    • 1999
  • The mandibular buccal frenum is defined as a fold of mucous membrane at the posterior labial vestibule and attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem when its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourage plaque formation and interfere with tooth brushing. Especially, heavy buccal frenum mucogingivally results in insufficent attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular premolar. Frenotomy, frenectomy and mucogingival surgery are used in treating heavy buccal frenum. Frenotomy with autogenous free gingival graft has been used popularly because of its stable result. But, it is difficult in younger children because of inadequate donor site, difficulty in making recipient site and behavior management. Frenotomy with apically positioned flap is considered as more efficient way for a very young child with heavy buccal frenum. Additionally, modified deep sedation with $N_2O-O_2$ can be used as an adjunct for the effective treatment outcome. Decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth can be expected from this treatment approach.

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TREATMENT OF HEAVY BUCCAL FRENUM USING FRENOTOMY AND AUTOGENOUS FREE GINGIVAL GRAFT IN CHILDREN : A CASE REPORT (소아에서 소대절개술 및 자가유리치은이식술을 이용한 거대협소대의 치료증례)

  • Kweon, Hoon;Choi, Yong-Seong;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.533-539
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    • 1994
  • The mandibular buccal frenum is a fold of mucous membrane at the posterior labial vestibule, that attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem if its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourge plaque formation and interfere with tooth brushing. Heavy buccal frenum mucogingivally results in insufficient attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular second premolar. Frenectomy in various forms has been used for many years to remove the influence of the frenum. Unfortunately, the results are not always ideal and there is often postoperative relapse because of muscle pull. In this treatment, frenotomy was used in conjuction with autogenous free gingival graft with the object of removing the influence of the buccal frenum and creating an adequate and stable width of attached gingiva. We observed decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth in addition to progressive eruption of second premolar. Periodic follow-up is needed for evaluation of relapse, grafting gingiva and also space regaining for second premolar.

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All-Inside Technique of Anterior Cruciate Ligament Reconstruction using Central Quadriceps Tendon and Patella Bone Block (관절강 내에서 모든 수술 과정을 시행하는 관절경적 전방십자인대 재건술)

  • Jeong, Hwa-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.66-71
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    • 1997
  • The all inside anterior cruciate ligament reconstruction technique places an anterior ligament substitutes within two bony sockets rather than hone tunnel. This approach is accomplished through arthroscopic three portal which avoids the surgical exposure and morbidity associated with creating traditional bone tunnel. This technique has several distinct advantages when compared with the traditional ACL reconstruction through the bone tunnels. It offers the surgeon a less morbid method for ACL reconstruction that positions an ACL substitute at the anatomic attachment sites of the original ACL with two bone sockets, obviating the need for traditional bone tunnels. Graft fixation at or near the anatomic attachment points of the original ACL minimizes creep with early range of motion and reduces the abrasive 'wind-shield wipe' motion of the graft which occur with bone plugs positioned inside bone tunnels. The sagittal posterior angle to the tibial socket increases fixation strength to pullout with anterior translation force for the tibia on the femur. This technique is not graft specific and can accomodate any graft in which graft length can be customized to the intraarticular native ACL length.

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Effect of implant- and occlusal load location on stress distribution in Locator attachments of mandibular overdenture. A finite element study

  • Alvarez-Arenal, Angel;Gonzalez-Gonzalez, Ignacio;deLlanos-Lanchares, Hector;Martin-Fernandez, Elena;Brizuela-Velasco, Aritza;Ellacuria-Echebarria, Joseba
    • The Journal of Advanced Prosthodontics
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    • v.9 no.5
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    • pp.371-380
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    • 2017
  • PURPOSE. The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS. Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS. Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION. The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

Implant supported removable dental prosthesis with magnetic attachment in crossed occlusion: A case report (엇갈린 교합에서 implant와 magnetic attachment를 이용한 국소의치 증례)

  • Lee, Yu Jin;Lee, Richard sungbok;Lee, Suk Won;Park, Su Jung;Ahn, Su Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.53-60
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    • 2017
  • When attempting to restore the oral function of a partially edentulous patient, there are a number of prosthetic treatment options available, depending on the structure of remaining teeth. For example, when only one set of maxillary and mandibular teeth are diagonally in place across from each other, it is difficult to gain stable occlusion. In this case, implants can be put in place at the corresponding edentulous area to achieve balance. By doing so, a stable occlusion can be achieved. For this case report, a patient with crossed occlusion after extraction was treated with maxillary RDP (removable dental prosthesis) and mandibular implant-supported RDP (removable dental prosthesis). Moreover, an implant fixture was placed under the posterior molar of the distal extension base diagonally across from the remaining maxillary teeth. Then, magnetic attachment was implemented. According to the patient who received the treatment, the result was functionally and aesthetically satisfactory.

Single Bundle PCL Reconstruction with Remnant Preservation (잔여 조직을 보존한 단일 다발 후방십자인대 보강재건술)

  • Lee, Dong Chul;Kim, Won-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.125-131
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    • 2011
  • Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

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Full mouth rehabilitation on the patient with maxillary anterior diastema and posterior bite collapse with orthodontic treatment (상악 전치부 치간 이개와 구치부 교합지지 상실을 가진 환자에서 교정치료를 동반한 완전 구강회복 증례)

  • Lee, Seon-Ki
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.1
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    • pp.60-68
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    • 2022
  • A patient with severe periodontitis has causative factors that cause pathological tooth movement, the occlusion is disintegrated, and the vicious cycle of worsening periodontitis is repeated. In particular, when pathological tooth movement occurs in the maxillary anterior region, the patient has an aesthetic sense of atrophy, and the quality of life was reduced. Therefore, when orthodontic treatment was added to patients with severe periodontitis, it promotes the formation of new bone, reduces periodontal cysts, and obtains clinical attachment, which leads to favorable results in prosthetic restoration, thereby enabling ideal occlusion, function and aesthetics. Periodontal treatment, orthodontic treatment, natural tooth restoration, and implant prosthesis were planned for patients with pathological tooth movement in the anterior region due to loss of occlusal support in the posterior region. As a result, an ideal restoration space was secured, a stable restoration of occlusal contact was formed, and the maxillary anterior teeth were aesthetically improved.

Arthroscopic Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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Foramen of Morgagni Hernia in Adult - Report of 1 Case - (성인에서 발생한 Morgagni 공 탈장 -1예 보고-)

  • 김성수
    • Journal of Chest Surgery
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    • v.22 no.6
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    • pp.1088-1091
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    • 1989
  • Foramen of Morgagni hernia is the least common type of all congenital diaphragmatic hernias. These foraminal hernias result from a congenital defect in the development or attachment of the diaphragm to the sternum and costal arch. They occur most commonly on the right side, possibly because of pericardial reinforcement of the left. In our case, occurred on the right side and the contents of the hernial sac were omental fat and a part of transverse colon. We performed transthoracic approach for reduction and repair of foraminal hernia with ligation and interrupted mattress sutures of the margin of the defected diaphragm to the posterior part of the sternum and costal cartilage. The postoperative course was uneventful except posttraumatic delirium and discharged at 21st postoperative day.

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