• 제목/요약/키워드: prosthetic rehabilitation

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심한 치아 마모 및 파절 환자의 수직고경거상을 동반한 전악 수복 증례 (Full mouth rehabilitation on the patient with severe tooth wear and tooth fracture using reestabilishment of occlusal vertical dimension)

  • 이호선;주세진;진수윤;강동완;이경제
    • 구강회복응용과학지
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    • 제32권3호
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    • pp.224-231
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    • 2016
  • 과도한 치아의 마모는 치아의 병적 변화, 교합 불균형, 기능 및 심미적 문제를 일으키며 악관절과 근육의 문제를 일으킬 수 있는 수직고경의 감소를 야기할 수도 있다. 수직고경의 감소가 발생한 경우, 전악보철수복을 통해 수직고경을 회복시켜 주기 위해서는 정확한 진단이 중요하다. 본 증례는 59세 남성으로 전반적인 치아의 마모와 파절로 인한 수직고경의 감소 및 비심미성을 해결하기 위해 전악 지르코니아 보철 수복을 시행하였다. 생리적 안정위, 견치간 거리 등을 분석하여 수직고경을 3 mm 거상하기로 하였고 전악 왁스업 후 임시치관을 제작하여 6개월동안 사용한 뒤 이를 이용하여 지르코니아 최종 보철을 완성하였다. 1년 6개월 경과 관찰하여 만족스러운 결과를 얻었기에 보고하는 바이다.

Fiber-reinforced composite resin을 이용한 전치부 결손 수복 (REHABILITATION OF MISSING ANTERIOR TOOTH USING FIBER-REINFORCED COMPOSITE RESIN)

  • 박헌정;김종수;김용기
    • 대한소아치과학회지
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    • 제26권1호
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    • pp.62-68
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    • 1999
  • One of the many dilemmas that the clinical restorative dentist must face is treating young adolescent patient who prematurely loses his permanent teeth. Temporary prosthetic replacement can be achieved with removable denture, orthodontic band-wire fixed denture, adhesion bridge, composite resin splint with reinforcing material until the patients go through growth and development. But, all of these have limitations. Advances in restorative materials and reinforcement materials have made possible new techniques which are as much esthetic, conservative and more economic and stronger than adhesion brides. Two cases are being presented where gas-plasma treated, woven polyethylene fabric to reinforce composite resin was used to fabricate a temporary prosthetic restoration to replace a missing maxillary central incisor. This relatively noninvasive and basically reversible procedure allows the patient to decide the final restoration as he or she goes thorough maturation of the hard and soft tissues.

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디지털 치의학 시대의 교합 (Occlusion and articulation in digital dentistry: A review)

  • 이재현
    • 대한치과의사협회지
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    • 제58권8호
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    • pp.505-512
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    • 2020
  • With the fourth industrial revolution, digitization is accelerating in all healthcare areas. In the field of dentistry, active discussions on digital dental technologies are ongoing, with increasing interest from clinicians daily. Thus far, accuracy and efficiency have primarily been emphasized in digital dentistry, and interest in occlusion has been relatively low. This is because digital dentistry has been predominantly used to restore small numbers of teeth rather than extensive prosthetic reconstruction. However, in the future, most dental treatments will undergo a digital transformation that will require the application of digital technology to more extensive prosthetic rehabilitation, for which discussion of occlusion is essential. In extensive prosthetic reconstruction, occlusion and articulation involve determining the position of the dental arch in relation to the reference plane of the skull or the long axis of the face and the position of the transverse horizontal axis. It also includes determining an occlusal surface with a shape that allows the mandible to move in an eccentric path and masticate most efficiently without any occlusal interference. To better understand how digitization will impact dentistry, this review article summarizes and discusses occlusion and articulation using digital dental technologies. This discussion is divided into several aspects, including facial scan, virtual articulation, augmented reality, and virtual reality.

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Cannula-typed Silicone Voice Prosthesis(소망$\circledR$)의 개발 (Development of Cannula-typed Silicone Voice Prosthesis(So-Mang$\circledR$))

  • 최홍식;정은주;전희선;문인석;김영호;김광문
    • 대한후두음성언어의학회지
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    • 제12권2호
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    • pp.152-157
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    • 2001
  • Background : Electrolarynx, Esophageal voice, and Silicone voice prosthesis with tracheoesophageal(T-E) fistula have been used as vocal rehabilitating methods for the post-laryngectomized patients. Prosthetic rehabilitation of voice after total laryngectomy has gained wide acceptance and has become a common practice in many clinics since the pioneering works of Singer and Blom In 1979. Since the introduction of tracheo-esophageal puncture and application of Blom Singer$\circledR$ voice prosthesis in 1980, several reliable voice prostheses have been developed and are successfully being used. Objectives : Even though quality of voice produced by Silicone voice prosthesis with T-E fistula is superior to other modalities, it still has some disadvantages. We devised a new cannulatyped silicone voice prosthesis. Methods : 1) Devising a new prototype of cannula-typed silicone voice prosthesis. 2) Application of the prototype using canine animal model(laryngectormized dog) and fitting trial on human patient whose previously inserted Silicone voice prosthesis is not functioning due to presumed fungal infection. Discussion : Final form of prototype was made after several times of major and minor modifications. Insertion of the newly developed Cannula-typed Silicone voice prosthesis on canine animal model and human trial were done without any difficulty. There were no serious leakage of saliva or food during swallowing. Conclusion : The newly developed Cannula-typed Silicone voice prosthesis(So-Mang$\circledR$) and the modified replacement method will further improve the results of post-laryngectomized prosthetic voice rehabilitation. Long-term animal study and human trial are planned in the near future.

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상지 및 하지절단 환자의 의지보행훈련 증례연구 (A Case Study of Prosthetic Ambulation Training for Upper and Both Lower Extremity Amputated Patient)

  • 홍도선;박창주
    • 대한물리치료과학회지
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    • 제7권1호
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    • pp.367-375
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    • 2000
  • The purpose of this study is to announce the present condition, walking training, and adaptable training of a limb amputated patient. The study is a successful report of the limb amputated patient through the medical treatment of the physical therapy. A cause of the limb amputated patient, a truck driver, was that the patient was hit by a train when the driver alight from the truck. Then, the driver was surgical operated on left AK (Above Knee) amputation and left AE (Above Elbow) amputation by orthopedics at the Young Dong Severance Hospital on Dec.7, 1996. Two weeks after the operation (Dec., 22, 1996), the patient was trained at the Yonsei Medical Center Physical Therapy Hospital for the walking and temper adjust training. It was possible to do a flat surface walking and a slope surface walking without helping due to the patients optimistic personal character and motivation. However, the patient struggled to a dull surface walking and his weak endurance. the patient has several problems when the patient wears artificial legs and hands, fears on fall down, and mentally worries on noise when he walks. It is necessary to approach for this problems by many fields of the helpers, such as Rehabilitation medical doctor, physical therapist, occupational therpist, artificial limbs makers, psychologists, and etc. Therefore, in order for recovering from the amputated parts function after the surgical operation, more approved reports have to be for the amputated patients due to increasing traffic accidents, industrial disaster, cancer, diabetes, obstacles of the peripheral nervous system, and etc.

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하악의 전돌 및 비대칭을 가진 환자에서 보철적 전악 구강회복 증례 (Prosthetic full mouth rehabilitation of patient with mandibular prognathism and asymmetry: a case report)

  • 임재영;이화정;김종은
    • 대한치과보철학회지
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    • 제62권1호
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    • pp.28-37
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    • 2024
  • 심한 하악 전돌증이 있는 환자의 경우 교정치료나 악교정수술을 활용하여 치료를 시도할 수 있으나, 장기간의 교정치료 및 수술의 침습적인 거부감이 있는 환자에서 보철적으로만 개선해야 하는 상황이 존재할 수 있다. 골격성 III급 부정교합 환자는 전방유도가 없으며, 수직적인 저작 양식을 보여주기 때문에 이러한 측면을 고려하여 치료하는 것이 중요하다. 또한, 전치부의 반대교합을 개선하기 위한 방법으로 교합수직고경을 거상하는 술식을 선택하기 쉬운데, 이는 종종 불리한 결과를 야기할 수 있으므로 신중한 진단 및 치료계획의 수립이 필요하다. 본 증례에서는 하악 전돌 및 비대칭을 가진 환자에서 단계적인 치료과정을 통하여 기존의 교합수직고경을 그대로 유지하며 임플란트 및 자연치를 이용한 최종 고정성 보철 수복을 진행하였다. 이에 기능적이고 심미적으로 적절한 결과를 보여, 환자의 진단 및 치료 과정에 대해 보고하고자 한다.

적합도에 따른 ITI 임플란트 지지 고정성 국소의치의 삼차원 유한요소 분석 (Three Dimensional Finite Element Analysis on ITI Implant Supported Fixed Partial Dentures with Various Fitting Accuracy)

  • 최민호;이일권;김유리;조혜원
    • 구강회복응용과학지
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    • 제22권1호
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    • pp.75-87
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    • 2006
  • The purpose of this study was to investigate the effects of prostheses misfit, cantilever on the stress distribution in the implant components and surrounding bone using three dimensional finite element analysis. Two standard 3-dimensional finite element models were constructed: (1) 3 ITI implant supported, 3-unit fixed partial denture and (2) 3 ITI implant supported, 3-unit fixed partial denture with a distal cantilever. variations of the standard finite element models were made by placing a $100{\mu}m$ or $200{\mu}m$ gap between the fixture, the abutment and the crown on the second premolar and first molar. Total 14 models were constructed. In each model, 244 N of vertical load and 244 N of $30^{\circ}$ oblique load were placed on the distal marginal ridge of the distal molar. von Mises stresses were recorded and compared in the crowns, abutments, crestal compact bones, and trabecular bones. The results were obtained as follows: 1. In the ITI implant system, cement-retained prostheses showed comparatively low stress distributions on all the implant components and fixtures regardless of the misfit sizes under vertical loading. The stresses were increased twice under oblique loading especially in the prostheses with cantilever, but neither showed the effects of misfit size. 2. Under the oblique loading and posterior cantilever, the stresses were highly increased in the crestal bones around ITI implants, but effects of misfit were not shown. Although higher stresses were shown on the apical portion of trabecular bones, the effects by misfit were little and the stresses were increased by the posterior cantilever. 3. When the cement loss happened in the ITI implant supported FPD with misfit, the stresses were increased in the implant componets and supporting structures.

Locator attachment를 이용한 하악 임플란트 유지 피개의치의 후향적 평가 (Retrospective Evaluation of Implant Retained Overdentures Using Two Implants and Locator Attachments in the Edentulous Mandibles)

  • 이주형;손동석;이청희
    • 구강회복응용과학지
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    • 제29권2호
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    • pp.153-162
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    • 2013
  • 이번 연구는 2개의 임플란트 식립 후 로케이터를 이용한 하악 임플란트 유지 피개의치를 한 20명의 환자를 대상으로 임플란트 생존율, 변연골 흡수량, 보철적 합병증을 알아보았다. 진료 기록부를 조사하고 방사선 사진을 계측하여 후향적 임상연구를 하였으며, 임플란트는 95%의 누적 생존율을 보였고, 평균 94주 후 방사선 사진에서 임플란트는 평균 1.21 mm($SD{\pm}0.20mm$)의 골소실을 보였다. 보철적 합병증으로는 피개의치 파절, 의치상 이장 또는 개상, 메일의 탈락 또는 유지력 감소로 인한 메일 교체 등이 있었다. 그러나 의치상 이장 및 개상, 메일 인써트의 간단한 교체로 인해 장기적으로 임플란트 및 임플란트 유지 피개의치가 환자에게 유지되고 있었다. Locator를 이용한 하악 임플란트 유지 피개의치는 최소침습적인 수술, 간단한 보철 과정 및 수리 과정의 장점으로 인해 장기적으로 안정적인 치료법으로 사료된다.

Rotational tolerances of a titanium abutment in the as-received condition and after screw tightening in a conical implant connection

  • Prisco, Rosario;Troiano, Giuseppe;Laino, Luigi;Zhurakivska, Khrystyna
    • The Journal of Advanced Prosthodontics
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    • 제13권6호
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    • pp.343-350
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    • 2021
  • PURPOSE. The success of an implant-prosthetic rehabilitation is influenced by good implant health and an excellent implant-prosthetic coupling. The stability of implant-prosthetic connection is influenced by the rotational tolerance between anti-rotational features on the implant and those on the prosthetic component. The aim of this study is to investigate the rotational tolerance of a conical connection implant system and its titanium abutment counterpart, in various conditions. MATERIAL AND METHODS. 10 preparable titanium abutments, having zero-degree angulation (MegaGen, Daegu, Korea) with an internal 5-degree conical connection, and 10 implants (MegaGen, Daegu, Korea) were used. Rotational tolerance between the connection of implant and titanium abutments was measured through the use of a tridimensional optics measuring system (Quick Scope QS250Z, Mitutoyo, Kawasaki, Japan) in the as-received condition (Time 0), after securing with a titanium screw tightening at 35 Ncm (Time 1), after tightening 4 times at 35 Ncm (Time 2), after tightening one more time at 45 Ncm (Time 3), and after tightening another 4 times at 45 Ncm (Time 4). RESULTS. The group "Time 0" had the lowest values of rotational freedom (0.22 ± 0.76 degrees), followed by the group Time 1 (0.46 ± 0.83 degrees), the group Time 2 (1.01 ± 0.20 degrees), the group Time 3 (1.30 ± 0.85 degrees), and the group Time 4 (1.49 ± 0.17 degrees). CONCLUSION. The rotational tolerance of a conical connection is low in the "as received" condition but increases with repetitive tightening and with application of a torque greater than 35 Ncm.

집중재활프로그램이 하지 절단 환자의 신체활동 및 의지 착용감에 미치는 영향 -후향적 연구- (Effect of an Intensive Rehabilitation Program on Physical Activity and Wearing Satisfaction in Traumatic Lower Limb Amputees -A Retrospective Study-)

  • 김진홍;홍예지;김유리;이강표
    • PNF and Movement
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    • 제18권3호
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    • pp.453-463
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    • 2020
  • Purpose: This study aimed to investigate the effect of an intensively rehabilitation program on the gait, balance, functional performance, and wearing satisfaction of patients with traumatic lower extremity amputations caused by industrial accidents. Methods: In this study, the anonymized electronic medical records of individuals who participated in the intensive rehabilitation program (among those who were admitted to the hospital belonging to the Labor Welfare Corporation) due to an industrial accident from August 2018 to September 2019 were collected. As a result, the records of 12 subjects meeting the screening criteria were analyzed. Results: According to the time of application to the intensive rehabilitation program, the 10 Meter Walk Test (10MWT) (p < 0.01), Berg Balance Scale (BBS) (p < 0.01), Timed Up and Go Test (TUG) (p = 0.01), the L Test of Functional Mobility (L-test) (p < 0.01), Prosthetic Limb Users Survey of Mobility (Plus-M) (p < 0.01), and Houghton Score Question (HSQ) (p < 0.01) values significantly improved with time. Conclusion: This study confirmed the positive effect of an intensive rehabilitation program on the gait, balance, functional performance, and wearing satisfaction of patients with traumatic lower extremity amputations caused by industrial accidents. However, this study was limited by the absence of a control group, and, thus, it highlights the need for more extensive research with a large sample.