• Title/Summary/Keyword: prosthetic rehabilitation

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Prosthetic rehabilitation of an oligodontia patient with atrophic maxilla (위축된 상악골을 가진 부분무치증 환자의 보철수복)

  • Chi, Seung-Seok;Kim, Ye-Jin;Kang, Hyeon-Goo;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.238-247
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    • 2021
  • Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.

Multiple fixed implant-supported prosthesis using temporary denture and scannable healing abutment: a case report (임시의치와 스캔가능한 치유지대주를 이용한 고정성 임플란트 보철 수복 증례)

  • Hyung-Jun Kim;Hyeon Kim;Woo-hyung Jang;Kwi-dug Yun;Sang-Won Park;Hyun-Pil Lim
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.250-259
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    • 2023
  • The use of digital technology in fixed prosthetic treatment using implants enables predictive treatment through diagnosis and virtual surgery by integrating clinical and radiological information of patients. Existing digital scanning methods require several components to be removed, such as removing the healing abutment and connecting the scan body. In the scannable healing abutment developed in consideration of this point, scanning is performed directly on the healing abutment, maintaining soft tissue sealing and simplifying scanning. Digital technology can also be used when obtaining the intermaxillary relationship. Recently, various digital technologies have been reported to acquire the intermaxillary relationship of edentulous patients using surgical guides, patient-specific scanning devices, or scans of the inside of temporary dentures. In this case, the implant-supported fixed prosthesis treatment was performed through scanning the scannable healing abutment and the inner side of the temporary denture to obtain the intermaxillary relationship, thereby simplifying the treatment process and obtaining aesthetically and functionally excellent clinical results.

Improvement of peri-implant complications through customized prosthesis restoration allowing soft tissue space: a case report (연조직 공간을 허용하는 맞춤형 보철 수복을 통한 임플란트 주위 합병증의 개선 증례)

  • Jieun Song;Woohyung Jang;Chan Park;Kwidug Yun;Hyun-Pil Lim;Sangwon Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.260-266
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    • 2023
  • The concept of 'Implant Supracrestal Complex (ISC)' was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant. Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the long-term stability of the implant.

Single-unit fixed restoration using the automated crown shaping artificial intelligence program (자동 치관 형성 인공지능 프로그램을 이용한 단일 고정성 보철물 수복 증례)

  • Eun-Bi Park;Young-Eun Cho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.3
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    • pp.169-178
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    • 2024
  • Recently, several attempts have been made to integrate AI into the field of dentistry. To overcome the limitations of traditional fixed prosthetic fabrication methods such as CAD-CAM (computer-aided design-computer-aided manufacturing), AI programs are being developed for automated crown fabrication, and various studies are underway to applicate in clinical situation. In these case studies, single-unit fixed prostheses were fabricated using an AI program (Dentbird Crown, Imagoworks Inc, Seoul, Korea) in both the anterior and posterior regions and the fabrication time and accuracy were compared with previously used CAD-CAM method. The first case is a 44-year-old woman who presented for re-fabrication of a zirconia prosthesis due to a prosthesis fracture on the lingual side of the upper right lateral incisor. The second case is a 53-year-old male patient who presented for a crown restoration on an upper left first molar following root canal treatment, where he received a final zirconia restoration. In both cases, the first prosthesis was designed manually using a CAD program, the second prosthesis was designed using AI alone, and the third prosthesis was designed using AI and then modified by CAD program, and the three designs were superimposed to compare suitability. When evaluated after temporary placement, the final prosthesis demonstrates adequate stability, retention and support, resulting in functional and esthetic satisfaction.

Rehabilitation with orthognathic surgery and orthodontic treatment in patient with severe occlusal disharmony: A case report (심한 교합 부조화를 보이는 환자에서 악교정수술 및 교정치료를 동반한 구강회복: 증례 보고)

  • Jung-Jin Lee;Kwang-Yeob Song;Seung-Geun Ahn;Ju-Mi Park;Jae-Min Seo
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.204-214
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    • 2023
  • The occlusal treatment including prosthetic treatment should be considered when the pathologic symptom was observed with the excessive discrepancy between the centric relation occlusion (CRO) and the maximum intercuspal position (MIP). Through careful diagnosis, the malocclusion and interarch relationship can be analyzed, and occlusal adjustment, restorative treatment, orthodontic therapy, or orthognathic surgery can be performed depending on the degree of disharmony. The patient in this case report complained the unstable occlusion and loss of masticatory function that had been occurring for several years. At the time of the visit, the patient showed severe occlusal disharmony, with only the upper right second molar contacting the lower jaw at the maximum intercuspal position. Based on the analysis of the occlusion, it was difficult to solve the problem with just occlusal adjustment or restorative treatment. In addition, the patient had the skeletal class II malocclusion between the upper and lower jaws. Therefore, for resolving the severe skeletal class II malocclusion, pre- and post-orthodontic treatment, bilateral sagittal split ramus osteotomy (BSSRO) was performed. After that, the occlusal adjustment was performed for stable occlusion, and the missing teeth area was restored with dental implants. During the follow-up period, a periodic follow-up visits and additional occlusal adjustments were performed to achieve a stable centric occlusion and harmonious anterior and lateral guidance. As a result, the final prosthodontic treatment was completed, and the patient's masticatory function was restored.

Clinical study on the comparison of gold and zirconia wear in an implant-supported fixed prosthesis (임플란트 지지 고정성 보철물에서 금과 지르코니아의 마모 비교에 대한 임상 연구)

  • Kim, Jee-Hwan;Yang, Seung-Won;Oh, NamSik
    • 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.

Effect of the Number and Location of Implants on the Stress Distribution in Three-unit Fixed Partial Denture: A Three-Dimensional Finite Element Analysis (임플란트 고정성 보철물에서 수와 식립위치 변화에 따른 골과 임플란트에서의 응력분포에 관한 3차원 유한요소법적 연구)

  • Lee, Woo-Hyun;Lim, Jong-Hwa;Cho, In-Ho
    • 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.

Cell study on the Magnesium ion implanted surface with PSII (PSII를 이용한 마그네슘 이온 주입 임플란트에 대한 MC3T3-E1 골모양 세포 반응 연구)

  • Shin, Hyeong-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra;Lee, Hee-Su;Cha, Min-Sang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.361-374
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    • 2009
  • For successful osteogenesis around the implants, interaction between implant surface and surrounding tissue is important. Biomechanical bonding and biochemical bonding are considered to influence the response of adherent cells. But the focus has shifted surface chemistry. The purpose of this study is to evaluate the MC3T3-E1 osteoblast like cell responses of magnesium (Mg) ion implanted titanium surface produced using a plasma source ion implantation method. Commercially pure titanium disc was used as substrates. The discs were prepared to produce four different surface, A: Machine turned surface, B: Mg implanted surface, C: sandblasted surface, D: sandblasted and Mg implanted surface. MC3T3 El osteoblastic like cells were cultured on the disc specimens. Cell adhesion, proliferation, differentiation, and synthesis of extracellular matrix were evaluated. The cell adhesion morphology was evaluated by SEM. RT PCR assay was used for assessment of cell adhesion, proliferation and differentiation. ALP activity was measured for cell differentiation. The results of this study were as follows: 1. SEM showed that cell on Mg ion groups was more proliferative than that of non Mg ion groups. On the machine turned surface, cell showed some degree of contact guidance in aligning with the machining grooves. 2. In RT PCR analysis, osteonectin and c-fos mRNA were more expressed on sandblasted and Mg ion implanted group. 3. ALP activity was not significantly different among all groups. Within the limitations of this study, the following conclusions were drawn: It might indicate Mg ion implanted titanium surface induce better bone response than non Mg ion groups.

Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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Three-Dimensional Finite Element Analysis of Internal Connection Implant System (Gsii$^{(R)}$) According to Three Different Abutments and Prosthetic Design (국산 내부연결형 임플란트시스템(GS II$^{(R)}$)에서 지대주 연결방식에 따른 응력분석에 관한 연구)

  • Jang, Mi-Ra;Kwak, Ju-Hee;Kim, Myung-Rae;Park, Eun-Jin;Park, Ji-Marn;Kim, Sun-Jong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.2
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    • pp.179-195
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    • 2010
  • In the internal connection system, the loading transfer mechanism within the inner surface of the implant and also the stress distribution occuring to the mandible can be changed according to the abutment form. Therefore it is thought to be imperative to study the difference of the stress distribution occuring at the mandible according to the abutment form. The purpose of this study was to assess the loading distributing characteristics of three different abutments for GS II$^{(R)}$ implant fixture(Osstem, Korea) under vertical and inclined loading using finite element analysis. Three finite element models were designed according to three abutments; 2-piece Transfer$^{TM}$ abutment made of pure titanium(GST), 2-piece GoldCast$^{TM}$ abutment made of gold alloy(GSG), 3-piece Convertible$^{TM}$ abutment with external connection(GSC). This study simulated loads of 100N in a vertical direction on the central pit(load 1), on the buccal cusp tip(load 2) and $30^{\circ}$ inward inclined direction on the central pit(load 3), and on the buccal cusp tip(load 4). The following results were obtained. 1. Without regard to the loading condition, greater stress was concentrated at the cortical bone contacting the upper part of the implant fixture and lower stress was taken at the cancellous bone. 2. When off-axis loading was applied, high stress concentration observed in cervical area. 3. GSG showed even stress distribution in crown, abutment and fixture. GST showed high stress concentration in fixture and abutment screw. GSC showed high stress concentration in fixture and abutment. 4. Maximum von Mises stress in the surrounding bone had no difference among three abutment type. In GS II$^{(R)}$ conical implant system, different stress distribution pattern was showed according to the abutment type and the stress-induced pattern at the supporting bone according to the abutment type had no difference among them.