• Title/Summary/Keyword: prosthetic treatment

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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.

Case report: Application of Implant Supported Removable Partial Denture due to Multiple Dental Implant Loss of the Fixed Implant Supported Prosthesis (다수의 임플란트발거로 임플란트 고정성 보철이 실패한 환자에서의 잔존 임플란트를 이용한 부분 가철성 국소의치 수복증례)

  • Kang, Jeong Kyung;Nam, Gi Hoon
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.23 no.1
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    • pp.34-40
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    • 2014
  • There are several treatment options for rehabilitation of partial edentulism including the use of conventional or implant-retained fixed prostheses. However, such prosthetic options cannot always be possible because of compromised general and oral health (i.e. loss of supporting tissues, medical reasons, extensive surgical protocol and osseointegration failure of dental implant) as well as the affordability of patients. In some cases, removable partial denture provides easier access for oral hygiene procedures and the ability to correct discrepancies in dental arch relationships than implant fixed prosthesis. Recently, Implant Supported Removable Partial Denture (ISRPD) where to place dental implant in strategic position has been suggested to improve the limitation and shortcomings of conventional RPD. ISPRD can overcome mechanical limition of conventional RPD by placing implant in a favorable position and can be cost-effective, prosthetic solution for partially edentulous patients who are not immediate candidates for extensive, fixed implant supported restorations. Incorporation of dental implants to improve the RPD support and retention and to enhance patient acceptance should be considered when treatment planning for RPD. In this case, 59 years old male patient who received dental treatment of implant fixed prosthesis on both side of the upper jaw and implant overdenture on lower jaw showed implant abutment screw fracture on #15i and osseointegration failure on multiple number of implants. After removing failed implants, we planned ISRPD using #15i,24i,25i,26i and #23 natural tooth for RPD abutment. We fabricated #23 surveyed crown,#24i=25i=26i surveyed bridge and #15i gold coping for support,retention and stability for RPD. Periodic follow up check for 2years has been performed since the ISRPD delivery to the patient. No sign of screw loosening, fracture or bone resorption around abutment implants were detected.

Dental implant cost estimation using the Activity-Based Costing approach (활동기준원가(Activity Based Cost)를 적용한 치과 임플란트 원가산정)

  • Shin, Ho-Sung;Ahn, Eun-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.292-299
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    • 2013
  • Purpose: There is a growing concern for the cost management of medical institutions. The purpose of this study was to estimate Activity-Based Costing (ABC) for dental implant cost. ABC refers to allocating resources or cost based on the activities of services. Materials and methods: A dental institution located in the metropolitan area was selected in this study. The tax accounting data of the institution were utilized to confirm total cost, and the institution was asked to make out clinical activities to figure out what activities were carried out. The direct cost and indirect cost for dental implant were separately estimated, and cost driver was analyzed to estimate the indirect cost accurately. Results: The rates of the direct and indirect cost respectively stood at 35.8 and 49.5 percent. The cost for a dental implant was found to be approximately 1,579 won, and the cost of prosthetic surgery and treatment that included implant surgery accounted for the largest portion of the cost, which was 470 thousand won (30%). And the weight of training and education on dentistry was relatively higher than that of the other kinds of treatment. Conclusion: In order to ensure accurate and scientific costing for dental implant, not only direct medical procedure but every pre- and post-procedure activity should fully be taken into account. Pre-activities, post-activities, education and training are included in the indirect cost, but all these activities are mandatory and associated with the quality of treatment and the satisfaction level of patients.

THE INFLUENCE OF THE DIE HARDENER ON GYPSUM DIE (석고 다이에 대한 다이 강화제의 영향)

  • Kim, Young-Rim;Park, Ju-Mi;Song, Kwang-Yeob
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.4
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    • pp.546-554
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    • 2007
  • Statement of problem: Die materials require abrasion resistance, dimensional stability with time, and high surface wettability for adequate material properties. Wear of gypsum materials is a significant problem in the fabrication of accurately fitting cast prosthetic devices. So It has been recommended that the use of die hardener before carving or burnishing of the wax pattern. Purpose: The purpose of this study was to compare the abrasion resistance and surface microhardness(Knoop) with 3 commonly used gypsum die materials(MG Crystal Rock, Super plumstone, GC $FUJIROCK^{(R)}$ EP) with and without the application of 2 die hardeners. Material and methods: Three die materials were evaluated for abrasion resistance and surface microhardness after application of 2 die hardeners(Die hardener and Stone die & plaster hardener). Thirty specimens of each gypsum material were fabricated using an impression of resin die(Pattern resin; GC Corporation, Japan) with 1-mm high ridges, sloped 90 degrees. Gypsum materials were mixed according to manufacturer's recommendations and allowed to set 24 hours before coating. Specimens were arbitrary assigned to 1 of 3 treatment subgroups (n=10/subgroup): no treatment(control), coated with Die hardener, and coated with Stone die & plaster hardener. Abrasion resistance(measured by weight loss) was evaluated using device in 50g mass perpendicular to the ridges. Knoop hardness was determined by loading each specimen face 5 times for 15 seconds with a force of 50g. A scanning electron microscope was used to evaluate the surface of specimens in each treatment subgroup. Conclusions: The obtained results were as follows: 1. 3 types of die stone evaluated in this study did not show significant differences in surface hardness and abrasive resistance(P<.05). 2. In the abrasive resistance test, there were no significant differences between GC $FUJIROCK^{(R)}$ EP and MG Crystal Rock with or without 2 die hardener(P<.05). 3. Super plumstone treated with Stone die & plaster hardener showed increased wear loss(P<.05) 4. Die hardener coatings used in this study decreased the surface hardness of the gypsum material(P<.05).

Case report of a newly designed narrow-diameter implant with trapezoid-shape for deficient alveolar bone (좁은 치조골에서 사다리꼴형 디자인으로 개발된 단폭경임플란트의 증례 보고)

  • Lee, Sa Ya;Goh, Mi-Seon;Ko, Seok-Yeong;Yun, Jeong-Ho
    • The Journal of the Korean dental association
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    • v.56 no.5
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    • pp.263-276
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    • 2018
  • Long-term survival and prognosis of narrow-diameter implants have been reported to be adequate to consider them a safe method for treating a deficient alveolar ridge. The objective of this study was to perform case report of narrow-diameter implants with a trapezoid-shape in anterior teeth alveolar bone. A 50-year-old male patient presented with discomfort due to mobility of all of the maxillary teeth and mandibular incisors. Due to destruction of alveolar bone, four anterior mandibular teeth were extracted. Soft tissue healing was allowed for approximately 3 months after the extraction, and a new design of implant placement was planned for the mandibular incisor area, followed by clinical and radiological evaluation. Implant placement was determined using an R2GATE surgical stent. The stability of the implants was assessed by ISQ measurements at the first and second implant surgery and after prosthetic placement. At 1 and 3 months and 1 year after implantation of the prosthesis, clinical and radiological examinations were performed. Another 50-year-old male patient presented with discomfort due to mobility of the mandibular central incisors. For the same reason as in the first patient, implant placement was carried out in the same way after extraction. ISQ measurements and clinical and radiological examinations were performed as in the previous case. In these two clinical cases, 12 months of follow-up revealed that the implant remained stable without inflammation or additional bone loss, and there was no discomfort to the patient. In conclusion, computer-guided implant surgery was used to place an implant in an optimal position considering the upper prosthesis. A new design of a narrow-diameter implant with a trapezoid-shape into anterior mandibular alveolar bone is a less invasive treatment method and is based on the contour of the deficient alveolar ridge. Through all of these procedures, we were able to reduce the number of traumas during surgery, reduce the operation time and total treatment period, and provide patients with more comfortable treatment.

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Influence of dental services on satisfaction of old prosthetic patients (노인구강보철환자에게 미치는 치과 의료서비스 요인)

  • Kim, Soon-Duck
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.1
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    • pp.15-30
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    • 2007
  • The main objective of this study is to investigate the improvement of the quality of dental health based on the dental service satisfaction factors of the old dental prosthesis patients of more than 60 years of age who use the dental institutes including dental hospital, clinic, and public health center and to identify the interest in the dental prosthesis as changing paint. Across the country through a questionnaire survey of a question and answer type conducted by the trained dental hygienists or dentist's. Major results of the empirical analysis are as follows. 1. looking at variation of the variables of socio-demographic features of the respondents, the group of female, age distribution of 60-65, average monthly income of 0.5-1 million Won, and schooling background of college showed significant difference. And the prosthesis treatment in terms of the purpose of isiting a dental institute, and the dental clinic in terms of the type of visiting dental institute showed a remarkably significant difference. 2. looking at variation of variables of the general features of the respondents, a prosthesis satisfaction service in terms of age showed significant difference: a prosthesis satisfaction service, dental staffs' service and dental facilities' service in terms of average monthly income showed significant difference: the entire conditions except for the dental facilities' service in terms of schooling and general features showed significant difference: and in terms of the purpose of visiting dental institute, it showed no significant difference. In terms of a visiting dental institute, the prosthesis satisfaction service, dental facilities, overall level of satisfaction, result of treatment, word of mouth and revisit showed significant difference. 3. looking at variation of the variables of post-installation prosthesis satisfaction of the respondents, the prosthesis satisfaction service, dentist's dental service, staffs' service, dental facilities' service and revisit in terms of the prosthesis type: and the prosthesis satisfaction service, word of mouth, revisit and overall level of satisfaction from the perspective of serious concern showed significant difference. The prosthesis satisfaction service and dentist's service in terms of the solving the economic burden: and the entire variables in terms of dissatisfaction elements showed a similar level of significant difference 4. in regard to the satisfaction of dental service and the change of the recognition of prosthesis patients, it was revealed that the level of dental prosthesis satisfaction of the respondents was closely related to the dentist's service, staffs' service, and dental facilities' service. Finally, looking at the influence of the dental service on the treatment result, satisfaction, word of mouth, revisit and the overall satisfaction level, it was revealed that they had a great impact on the prosthesis satisfaction service.

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Retrospective Study of Wide-Diameter Implants in Maxillary & Mandibular Molar regions (상하악 대구치 부위에서 넓은 직경 임플란트의 생존율에 대한 후향적 연구)

  • Park, Kyung-Ah;Jeong, Cheol-Woong;Ryoo, Gyeong-Ho;Park, Kwang-Bum;Kim, Young-Joon
    • Journal of Periodontal and Implant Science
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    • v.37 no.4
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    • pp.825-838
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    • 2007
  • Endosseous implants are used in the treatment of various types of tooth loss, and numerous long-term studies have demonstrated the excellent reliability of this method of treatment. However, the increase of implant failure are associated with inadequate quality and/or height of bone. At the end of the 1980s, Wide(>3.75mm) implants were initially used for managing these difficult bone situations. The recommended indications for its use included poor bone quality, inadequate bone height. immediate placement in fresh extraction sockets, and immediate replacement of failed implants. At the 2000s, wider implants(6.0mm and 6.5mm) were used in a few studies. Although good clinical outcomes have been reported in recent years, there is still a controversy on this topic. Therefore, the purpose of this study was to estimate the survival rate of wide implants($6.0{\sim}8.0mm$) in molar regions, evaluating the clinical outcome. In this study, 1135 RBM surfaced wide implants($Rescue^{TM}$, MEGAZEN Co., Korea/595 maxillary, 540 mandibular) were placed in 650 patients(403 male, 247 female/age mean: $51.2{\pm}11.1$ years, range 20 to 83 years). Of the total, 68.3% were used to treat fully or partially edentulous situations, including single-tooth losses and 31.7% were placed immediately after teeth extraction or removal of failed implants, of which all were in the molar regions. Implant diameter and length ranged from 6.0 to 8.0mm and from 5.0 to 10.0mm respectively. The implants were followed for up to 42 months (mean: $14.6{\pm}9.5$ months). Of 1135 placed implants, 58 implants were lost. Among them, 53 implants were lost within 12 months after implant placement. The survival rate was 93.6% in the maxilla and 96.3% in the mandible, yielding an overall survival rate of 94.9%, for up to 42 months. As the result of Cox regression model, prosthetic type, sinus graft, and patient gender have an statistical significance on the implant survival rate in this study. This study suggests that the use of wide implants($6.0{\sim}8.0mm$) would provide a predictable treatment alternative in posterior areas.

A literature review on implant abutment and soft tissue response (임플란트 지대주와 임플란트 주위 연조직의 반응에 관한 고찰)

  • Lee, Young-Hoon;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.4
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    • pp.263-273
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    • 2016
  • In the implant prosthetic procedure, the soft tissue reaction was varied with the material and surface treatment of the abutment. It may be the cause of the peri-implantitis, and hence it can affect the long-term prognosis of the implant prosthesis. Titania and zirconia abutment presented superior biocompatibility and stable soft tissue reaction, while gold alloy abutment showed unfavorable reaction sometimes. A soft tissue reaction can be differed by the surface characteristics even in the same material type. Because rougher surface induces a bacterial attachment, the part contacting a soft tissue should have smooth surface. Additional surface treatment can enhance the cellular response without increasing bacterial attachment. Repeated removal and insertion of the abutment and the shape of the abutment may affect the soft tissue reaction, also. Ultrasonic cleaning and argon plasma cleaning are effective way to clean the retained micro-dust on the customized abutment.

All-on-6 implant fixed prosthesis restoration with full-digital system on edentulous patient: A case report (무치악 환자에서 완전 디지털 시스템을 활용한 All-on-6 임플란트 고정성 보철물 수복 증례)

  • Lee, SeungJin;Jeong, Seung-Mi;Chung, Chae-Heon;Fang, YiQin;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.497-507
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    • 2021
  • All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient's inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient's requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

Creation of the dental virtual patients with dynamic occlusion and its application in esthetic dentistry (심미치의학 영역에서 동적 교합을 나타내는 가상 환자의 형성을 통한 전치부 보철 수복 증례)

  • An, Se-Jun;Shin, Soo-Yeon;Choi, Yu-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.222-230
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    • 2022
  • Digital technology is gradually expanding its field and has a great influence on various fields of dentistry. Recently in digital dentistry, the importance of superimposing various 3-dimensional (3D) image data is emerging, in order to utilize gathered data effectively for diagnosis and prosthesis fabrication. Integrating data from facial scans, intraoral scans, and mandibular movement recordings can create a virtual patient. A virtual patient is formed by integrating digital 3D diagnostic data such as intraoral and extraoral soft tissues, residual dentition, and dynamic occlusion, and the results of prosthetic treatment can be evaluated virtually. The patients in this case report were a 37-year-old female whose chief complaint is that the appearance of the existing prosthesis was distorted and a 55-year-old female patient whose anterior prosthesis needed to be refabricated after the endodontic treatment. 3D facial scans were obtained from each patient, and the patient's mandibular movements were recorded using ARCUS Digma 2 (KaVo Dental GmbH, Biberach an der Riss, Germany). The collected data were integrated on computer-aided design (CAD) software (Exocad dental CAD; exocad GmbH, Darmstadt, Germany) and transferred to a virtual articulator to create a digital virtual patient. The temporary fixed prostheses were designed, restored, and evaluated, and it was reflected into the final restorations. With the aid of the virtual dental patient, accuracy and predictability could be increased throughout treatment, simplifying the occlusal adjustment and clinical evaluation with improved esthetic outcomes.