• Title/Summary/Keyword: 골 흡수

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THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF THE EFFECTS OF ALVEOLAR BONE LOSS ON STRESS DISTRIBUTION IN POST-RECONSTRUCTED TEETH (치조골 흡수가 포오스트로 인한 치근내 응력에 미치는 영향에 관한 삼차원 유한요소법 분석)

  • Lee, Ky-Young;Chang, Ik-Tae
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.4
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    • pp.674-696
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    • 1997
  • There're many cases that should be reconstructed with post and core when clinical crown is destructed. But this post and core restoration may cause damaging stress on the teeth. Previous finite element study was restricted to normal bone model relatively close to cemen-toenamel junction. Moreover, the test of a model with diminished bone support was rare. The purpose of this study is to test the effects of alveolar bone loss on the magnitude, stress distribution and displacement of post reconstructed teeth. In this study, it was assumed that the coronal portion of upper incisor was severely destructed. After conventional endodontic treatment, it was restored with post and core. The PFM restoration was made on it. This crown was cemented with ZPC. Alveolar bone was classified by 4 types of bone, such as normal, 2 mm, 4 mm, 6 mm bone, according to the bone loss. Meanwhile, the material of post are divided into 2 types of materials, such as gold, co-cr. Force was applied to two directions. One was fuctional maximum bite force (300 N) applied to the spot just lingual to the incisal edge with the angle of 45 degree to the long axis of the tooth, and the other one was horizontal force (300 N) applied to the labial surface. The results analyzed with three dimensional finite element method were as follows : 1. Stress was concentrated on the adjacent dentin of the post apex, one third portion of the post apex and the labial & lingual mid-portion of the root in all case. The stress of middle third of the root was apparently concentrated on the labial aspect. 2. The stress on adjacent dentin of the post apex and one third of the post apex increased as alveolar bone height moved apically. This increase was dramatic beyond 4 mm bone loss model. 3. The stress of the post apex was spreaded to the middle third of the post and greater than gold post in the case of metal post. 4. The displacement of the neck of post was the greatest in one of the post-cement interface and this increased as alveolar bone height moved apically. Besides the displacement of the metal post is slightly lower than one of the gold post.

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A comparison of bioresorbable membranes alone or in combination with platelet-derived growth factors and insulin-like growth factors on the periodontal healing of the dehiscence defects in dogs. (성견의 열개형 골 결손부에서 흡수성 차단막과 PDGF-BB 및 IGF-I의 혼합 사용시 치주조직의 치유에 미치는 영향)

  • Cho, Kyoo-Sung;Kim, Chang-Sung;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.27 no.1
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    • pp.217-234
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    • 1997
  • The purpose of present study is to compare the effect of treatment using $Guidor^{(R)}$ as a barrier membrane in conjunction with platelet-derived growth factor and insulin like growth factors on experimental dehiscence defects. Following the resection of premolar crowns, roots were submerged. After 12 weeks of healing period, experimental dehiscence defects of 4mm in height and 4mm in width were surgically created on the mid-facial aspect of the lower premolar roots in each of 4 adult dogs. After root planning and demineralization of the root surface with citric acid, the control groups received 4% methylcellulose gel only, the test group I received 4% methylcellulose gel and were covered by $Guidor^{(R)}$ and the test group II were treated with PDGF and IGF and 4% methylcellulose gel with $Guidor^{(R)}$ coverage. Histological and histomorphometric analysis following 8 weeks of healing revealed the following results. 1. The new bone formation showed no statistically significant difference in all groups with $0.59{\pm}0.82mm$($14.03{\pm}19.60%$) for control, $0.70{\pm}0.39mm$($16.30{\pm}9.01%$) for group I, $0.87{\pm}0.76mm$($18.74{\pm}16.03%$) for group II. 2. The new cementum formation showed no statistically significant difference in all groups with $0.54{\pm}0.48mm$($l6.38{\pm}14.57%$) for control, $0.95{\pm}0.38mm$($23.43{\pm}9.30%$) for group I, $1.01{\pm}0.75mm$($22.10{\pm}16.ll%$) for gorup II. 3. The root resorption showed statistically significant differences betweenthe control group and all test groups(p<0.05) with $2.11{\pm}0.53mm$($52.93{\pm}12.32%$) for control, $0.63{\pm}0.27mm$($15.32{\pm}7.05%$) for group I, $0.89{\pm}0.33mm$ ($19.26{\pm}7.11%$) for group II. On the bases of these results, there were no statistically difference between treatment using resorbable membrane and resorbable membrane in conjunction with PDGF and IGF in the dehiscence defects, where it was difficult to maintain space. The use of membrane seemed to be more effective in the inhibition of root resorption.

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INTENTIONAL REPLANTATION OF CROWN-ROOT FRACTURED TOOTH WITH OPEN APEX (의도적 재식술을 이용한 치관-치근 파절된 미성숙영구치의 치험례)

  • Ryu, Jung-A;Lee, Jae-Ho;Choi, Byung-Jai;Son, Heung-Kyu;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.267-272
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    • 2004
  • This case report describes an uncommon treatment method for crown-root fractured incisor with immature root. A 7-year-old girl was referred for treatment of crown-root fractured maxillary central incisor. The fracture line extended to 1/2 of the total tooth length with incomplete root formation. The prognosis of crown-root fracture is usually poor and extraction is usually undertaken. But, in the mixed dentition, extraction of maxillary permanent incisor results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation and mastication. Conservative therapy in the permanent dentition comprises of few treatment modalities; supragingival restoration, gingivectomy, orthodontic extraction of apical fragment, surgical extrusion of apical fragment with or without rotational replantation. However, in this case, these indications are not applicable, so intentional replantation with adhesive resin system is the treatment of choice. The tooth was followed-up for 12 months. Currently, there are no symptoms. Since this modality adopts the respective advantages of both intentional replantation and adhesive treatment, it might be the treatment of choice in cases of vertical crown-root fracture.

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INTENTIONAL REPLANTATION OF THE CROWN-ROOT FRACTURED TOOTH: A CASE REPORT (치관-치근 파절된 치아의 의도적 재식술 치험례)

  • Kim, Soo-Kyoung;Ahn, Seung-Tae;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.381-386
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    • 2010
  • As the vertical fracture occurs at the various locations following the long axis of a root, treatment method of crown-root fractured anterior teeth is decided according to the depth. If the fracture line is close to the crown, gingivectomy, orthodontic - forced eruption or surgical extrusion of apical fragment could be done. If the line is over 1/3 length of the root, the prognosis is poor and extraction is usually undertaken. However, extraction of maxillary incisor at growing children causes many complications such as esthetic, phonetic problem and alveolar bone resorption. Therefore, preservation of tooth is the highest priority. Recently, intentional replantation with composite resin could be considered as alternative treatment of crown-root fractured anterior tooth. This report presents a patient in mixed dentition with deep vertical crown-root fracture of the maxillary permanent central incisors by trauma. Intentional replantation of the fractured teeth was performed using composite resin. After 2 years, specific clinical symptom has not been found and the patient was satisfied of esthetic result. This method suggests the new technique to preserve a tooth as an alternative to extraction, although it is technically sensitive and the reports of long-term prognosis is insufficient.

The Effects of Bone Morphogenetic Protein-4 and Resorbable Membrane on the Regeneration of Periodontal Tissues (골형태형성단백질과 흡수성차폐막이 치주조직 재생에 미치는 영향)

  • Lim, Sang-Cheol;Kwon, Young-Hyuk;Lee, Man-Sup;Partk, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.30 no.4
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    • pp.757-779
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    • 2000
  • The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membraneapplied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-andmembrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-andmembrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treat-

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Influence of platform switching on crestal bone resorption (치조정 골흡수에 대한 platform switching이 미치는 영향)

  • Kim, Do-Young;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.38 no.2
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    • pp.135-142
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    • 2008
  • Purpose: Numerous studies have shown that crestal bone resorption around the implant was related to the location of the implant abutment junction(IAJ). Recently it was hypothesized that platform switching termed the inward horizontal repositioning of the IAJ might limit bone resorption around the implants. The purpose of this clinical study was to evaluate the effect of platform switching on crestal bone resorption. Materials and Methods: The crestal bone loss of 65 external hex implants in 26 patients were radiographically measured at crown placement and follow-up examinations. 23 standard implants(non-platform switching group, NP) were connected with the matching abutments and 42 wide implants(platform switching group, PS) were connected with the 1 mm smaller diameter abutments. Results: There was significant difference of crestal bone loss between NP group and PS group. For implants in the NP group, mean crestal bone loss was $1.18{\pm}0.68\;mm$ at crown placement and $1.42{\pm}0.41\;mm$ at follow-up. The meal bone loss in PS group was $0.47{\pm}0.52\;mm$ at crown placement and $0.60{\pm}0.65\;mm$ at follow-up. When the crestal bone changes according to placement depths of implants were compared, subcrestal position of IAJ had a significantly less bone loss in PS group, but it was not in NP group. Conclusion: Within the limits of the present study, it was concluded that platform switching technique might decrease crestal bone loss around the implants. Additionally, when the IAJ of implant was placed 1 mm deeper in the alveolar bone, the effect of platform switching on bone loss was enhanced.

THREE-YEAR FOLLOW UP OF FERRIC SULFATE PULPOTOMY IN PRIMARY MOLARS (Ferric sulfate를 이용한 유치치수절단술의 3년 후 임상평가)

  • Yun, Youn-Hee;Jang, Ki-Taeg;Han, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.1
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    • pp.38-43
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    • 2002
  • The objective of this report is to assess clinically and radiographically the state of the primary molars pulpotomized with a 15.5% ferric sulfate solution. The subjects selected were healthy children treated at the pediatric dental clinic of the Seoul National University Hospital in Korea. Thirty teeth were pulpotomized with a ferric sulfate solution(FS). Another twenty-one teeth were pulpotomized with 20% dilute formocresol(FC). Clinical and radiographic data for the fifty-one primary molars were collected with a mean follow-up period of 34 months. The success rate for the FS group was 80.0%. The success rate for the FC group was 81.0%. The differences in the results between the two groups were analyzed statistically utilizing the chi square test. External root resorption was observed in four teeth of FS group and four of the FC group. Periapical bone destruction was observed in three of FS group and two of FC group. There were no significant statistical differences between the success rates for FS group and the FC group.

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A Literature Study of The Osteomalacia (골연화증(骨軟化症)에 대(對)한 동서의학적(東西醫學的) 문헌고찰(文獻考察))

  • Park, Jong-Hyuck;Hwang, Young-Geun;Jeong, Ji-Gheon
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.1
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    • pp.159-169
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    • 1999
  • Osteomalacia is syndrome of diverse etiology. characterized pathophysiologically by a failure of normal mineralization of bone and epiphyseal cartilage. This study was performed to investigate causes of disease, pathogenic mechanisms, symptoms, therapies and precriptions through the successive medical literatures. recent chinese medical literatures and chinese medical journals. It is similar to atrophic debility of bones, bone leaning, bone exhaustion, rheumatism involving the bone, osteodynia and cold and heat of bone etc. of oriental medicine. The most principal cause of this is deficiency of kidney. similar to hypophosphatemia caused by increased renal clearance and deficiency of vitamin D, and the rest are senility, deficiency of spleen, deficiency of qi and deficiency of blood. There are nourishing the kidney and spleen, nourishing the qi and blood, warming and passing the muscle and mac, passing an articulation an invigorating the muscle and bone, in principal therapy. And in medical herbs are rehmanniae radix preparat, corni fructus, discoreae rhizoma, cuscutae semen, tigridis os, juglandis semen, hominis placenta, drynariae rhizoma, eucommiae cortex, cynomorii herba, cervi cornus colla, cervi pantotrichum cornu, moutan cortex, polygoni multiflori radix, angelicae gigantis radix, achyranthis bidentatae radix, cibotii rhizoma, hirudo, eupolyphaga, spatholobi caulis, salviae miltiorrhizae radix, draconis resina, curcumae longae rhizoma. In care there are a sun-bath, exercise, high protein diet and taking vitamin D. And they reduce smoking, coffee, drinking etc.

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Modified resin-bonded fixed partial dentures utilizing tooth undercuts: a clinical case study (서로 다른 삽입로를 이용한 최소 삭제 접착성 고정성 보철물의 임상 연구)

  • Doh, Re-Mee;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.2
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    • pp.106-113
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    • 2011
  • The object of this clinical study was to evaluate the short-term outcome of modified resin-bonded fixed partial dentures which utilizes the original tooth undercuts and different path of insertion of components. Materials and methods: 71 units of modified RBFPDs that were used in 21 patients at the Department of Prosthodontics, College of Dentistry, Yonsei University were evaluated. The follow-up period was up to 25 months, the mean being 7 months. Survival rate, mobility, percussion, probing depth, bleeding on probing, plaque index was recorded and radiographs were taken to monitor alveolar bone loss. Results & Conclusion: Within the limits of this short term retrospective study, it was concluded that: 1. No mechanical failure such as debonding or fracture of the framework was found during the follow-up period. 2. The periodontal apparatus was stable and no clinical change was observed after prosthetic treatment. 3. No significant marginal bone loss was found in the radiographic evaluation.

The Gingival Tissue Levels of Bone Resorptive Mediators in Human Chronic Periodontitis with Type 2 Diabetes Mellitus (2형 당뇨병환자의 만성 치주염 치은조직에서 골흡수 인자의 발현 양상 비교)

  • Kim, Mi-Jung;Ryu, Sang-Ho;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.37 no.4
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    • pp.743-753
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    • 2007
  • Purpose: The purposes of this study were to compare and quantify the expression of MMP-3, $PGE_2$ and IL-6 in the gingival tissues of patients with $type_2$ diabetes mellitus and healthy adults with chronic periodontitis. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1(n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2(n=8) is inflamed gingiva from patients with chronic periodontitis. Group 3(n=8) is inflamed gingiva from patients with chronic periodontitis associated with type 2 DM. Tissue samples were prepared and analyzed by Westernblotting. The quantification of MMP-3, $PGE_2$ and IL-6 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: 1. The expression levels of MMP-3 were shown highest in group 3 compared to group 1 and 2, and It showed increasing tendency in group 2 and 3. 2. The expressions of $PGE_2$ and IL-6 were shown increasing tendency in group 2 and 3, and It was highest in group 3. 3. As expressions of MMP-3 were increased, $PGE_2$ and IL-6 expressions showed increasing tendency in group 3 than group1 and 2, although there were no proportional relationship. Conclusion: This study demonstrated that the expression levels of MMP-3, $PGE_2$ and IL-6 will be inflammatory markers of periodonta linflamed tissue and DM. It can be assumed that MMP-3 affect to expressions of $PGE_2$ and IL-6 in progression of periodontal inflammation with alveolar bone resorption to type 2 DM.