• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.412-424
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• 2004

Statement of problem: Several prosthetic options are available for the restoration of multiple adjacent implants. A passively fitting prosthesis has been considered a prerequisite for the success and maintenance of osseointegration. Passivity is a particular concern with multiple implants because of documented inaccuracies in the casting and soldering process. One way to avoid this problem is to restore the implants individually, however, the restorations of individual adjacent impants requires careful adjustment of interproximal contacts. Purpose: The purpose of this study was to compare the stress distribution pattern and amount surrounding Bicon implants with individual crowns and splinted restorations. Material and method: A photoelastic model of a human partially edentulous left mandible with 3 Bicon implants($4{\times}11mm$) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 abutments ($4{\times}0.65mm,\;0^{\circ}$, 2.0 mm post, Bicon Inc., Boston, USA) After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal ($8{\mu}m$ shim stock drags without tearing), medium($40{\mu}m)$), and heavy($80{\mu}m$). Splinted 3-unit fixed partial dentures were fabricated and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions(7.5, 15, 30 lb) were analyzed with a circular polaricope. Results: 1. Stresses were distributed around the entire body of fin in Bicon implants. 2. Splinted restorations were useful for distribution of stress around implants especially with higher loads. 3. By increasing the contact tightness between the individually restored three implants, the stress increased in the coronal portion of implants. Conclusions: Ideal adjustment of the contact tightness was important to reduce the stresses around individually restored Bicon implants.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.2
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• pp.217-229
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• 1990

The Applegate-Kennedy classification, the drawing of removable partial denture design using color coding, the selective tissue placement impression method in case of Class I and Class II removable partial dentures, the design of the swing lock attachment of an alternative approach to conventional removable partial denture, the design of the intracoronal or extracoronal attachment, and the removable partial denture design using a rotational path were presented. The following conclusions from the above things were presented : 1. The swing lock attachment removable partial denture can be effective to an alternative approach when the design of conventional removable partial denture is improper with markedly mobile remaining teeth or missing key abutments. 2. Intracoronal or extracoronal attachments must be selected care-fully considering the conditions of the abutment teeth and alveolar ridge whether more occlusal loads to the abutment teeth or to the alveolar ridge are distributed. 3. It must be almost prerequisite that a functional impression is taken in case of Class I and class II removable partial dentures and in case of tooth-borne removable partial dentures, a removable partial denture using rotational path is strong, hygienic, esthetic, and can be accomplished successfully in the clinical aspect when it is properly designed and fabricated through the complete understanding of an indication and a principle. 4. All necessary informations must be achieved with carefully investigated surveying procedure according to each clinical case by Applegate-Kennedy classification which can be helpful and useful in the clinical application and it is important that dentists themselves must be in the habit of drawing a reasonable partial denture design using a color coding in the paper sheet.

• The Journal of the Korean dental association
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• v.55 no.12
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• pp.842-849
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• 2017

The term, 'crossed occlusion' implies clinical situation in which the residual teeth in one arch have no contact with those in the antagonistic arch, resulting in the collapse of occlusal vertical dimension. The treatment goal of this pathologic condition is restoration of the collapsed vertical dimension and stabilization of abnormal mandibular position. Previously, konus removable prostheses or tooth supported overdentures were suggested to solve crossed occlusion. Nowadays, dental implants have been used for definitive support to solve this problem. In this case report, a 65 years old female patient had a crossed occlusion, in which the maxillary posterior residual teeth and mandibular anterior residual teeth cross. Interim removable and fixed dental prostheses were used to confirm the proper vertical and horizontal jaw relation. After that, the mandibular posterior edentulous region was restored with implant-supported fixed dental prostheses. Computer tomography guided implant surgery was performed according to the concept of the restoration-driven implant placement. The maxillary anterior edentulous region was restored with Kennedy class IV removable prosthesis, considering the patient's economic status. The patient's jaw position and prostheses have been well maintained at the follow-up after 6 months of definitive restoration. The antero-posterior crossed occlusion problems appeared to be effectively solved with the combination of removable in one arch and implant-supported fixed prostheses in the other.

• The Journal of Korean Academy of Prosthodontics
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• v.25 no.1
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• pp.17-40
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• 1987

The purpose of this study was to clarify the effect of clasp design on abutment tooth adjacent to a distal extension base under the influence by the location of functional loading. The RPI clasp, the Akers clasp and the combination clasp were selected for evaluation. Tests were performed at 10Kg, 20Kg, 30Kg loads on the buccal, central, lingual, mesial and distal positions of loading platform of each mandibular distal extension partial denture. The laser reflexion method was used for three dimensional measurement of abutment movement, which is possible to measure precisely without contact. The movement in the mesiodistal(X), buccolingual(Y), and occlusoapical(Z) directions and the rotational movement(R) were measured, and in addition, the total movement (SV) as expressed by the three dimensional summation vector independent of direction was calculated. The data were analyzed using Student t-test, p<.05. The following results were obtained from this study; 1. Clasp design did not generally affect the direction of abutment tooth movement except the movement in an undesirable occlusal direction in case of the Akers clasp and the combination clasp. 2. The greater the load on the prosthesis, the greater was the abutment tooth movement, and the direction of abutment tooth movement was affected by positional loading. 3. Each prosthesis was dislodged from the test base under the small amount of load in the distal load position, and the buccal loading showed the greatest abutment tooth movement under the maximum load. 4. RPI clasp was evaluated as the most favorable design.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.1
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• pp.43-61
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• 1990

The laser reflexion method is a new technique which permits precise contactless measurement and observation of tooth mobility as well as tooth movement. The purposes of this study were to clarify the reliability of the laser reflexion method in clinical application and to measure the abutment tooth movement according to clasp design. This study was designed to determine 1) How much a bending movement of the impression plate stand affects the position of the reflexion pattern and how precise the patient bites into plate 2) Which clasp design causes greater movement of the abutment tooth. Under medium and maximum bite forces, tests were performed on central loading position which was 13mm distal to terminal abutment tooth of distal extension removable partial denture. The movement in the mesiodistal and buccolingual directions was measured. The Duncan's New Multiple-Range test was used to compare the means for the four castings under each direction-load combination; and the paired sample t-test was for medium and maximum bite forces. From this experiment, the following results were obtained. 1. The Roach clasp, the combination clasp, the RPI clasp, and the Akers clasp did not significantly differ in their effects on buccolingual movement of the abutment tooth. 2. The direction of abutment tooth movement was not significantly altered by clasp design and all abutment tooth movements were oriented distobuccally. 3. Under medium bite force, the Akers clasp caused greater distal movement of the abutment tooth than did the combination clasp and the RPI clasp. Under maximum bite force, the Akers clasp caused greater distal movement of the abutment tooth than did the RPI clasp. 4. The testing apparatus and procedures used in this study(laser reflexion method) proved to be reliable in clinical application.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.177-194
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• 1991

The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from a distal extension removable partial dentures with three kinds of mandibular major connectors, that is, lingual bar, linguoplate, and swing-lock attachment. A photoelastic model was made of the epoxy resin(PC-1) and hardener(PCH-1) and coated with plastic cement-1 (PC-1) at the lingual surface of the epoxy model and set with three kinds of chrome-cobalt removable partial dentures. A bilateral vertical load of 15kg to the middle portion of the metal bar crossing both the first molars of the right and the left, and a unilateral vertical load of 12.5kg to the right first molar were applied with the use of specially designed loading device and the reflective circular polariscope was used to analyze the photoelastic model under each condition. The following results were obtained : 1. When the bilateral vertical load was applied, the magnitude and distribution of the stress concentration of the edentulous area and the terminal abutment or adjacent teeth was in the order of lingual bar, linguoplate, swing-lock attachment. 2. When the unilateral vertical load was applied, the magnitude and distribution of the stress concentration of the edentulous area and the terminal abutment or adjacent teeth was in the order of lingual bar, linguoplate, swing-lock attachment. 3. When the unilateral vertical load was applied, the magnitude and distribution of the stress concentration of the termial abutment or adjacent teeth on the non-loaded side showed the least stress distribution in case of swing-lock attachment. 4. When the bilateral vertical load and the unilateral vertical load were applied the swing-lock attachment showed the mildest uniform stress distribution on the edentulous area and the alveolar bone around the abutment teeth.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.4
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• pp.807-823
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• 1995

The purpose of this study was to analyze the stress distribution and the displacement happened to the abutment, the prosthesis, and the surrounding structure according to the location of the nonrigid connector, that is, the keyway in the distal of canine and the mesial of the implant in the three unit fixed partial denture. Two-dimensional finite element model ws constructed and analyzed for the stress distribution and the displacement using software ABAQUS(Ver 5.2 Hibbitt, Karisson & Sorenson, Inc., 1992). After finishing the finite element model, the distribution load of 15kg was applied simultaneously to the all cusp tips of the prosthesis and the concentration load of 10㎏ was applied respectively at the each cusp tip of the prosthesis. The following results were obtained : 1. The amount of displacement of the implant was greater in case of the non-rigid connection than the rigid connection, and the more favorable displacement was shown in case of the IKb than the IKa. 2. Without regard to the connection method, the stress represented at the surrounding bone was similar, and the more favorabel stress distribution was shown in case of IKb. 3. The maximum stress was concentrated at the fastening screw and the neck of implant in all experimental groups, and their stress magnitudes were in the order of IKb, IR, and IKa.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.1
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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.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.2
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• pp.218-231
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• 2005

Statement of problem. In the partially edentulous patients, removable partial dentures have been working as a important treatment modality. Clasps, a kind of direct retainers, received some amount of stresses during the insertion and removal of partial denture on the abutment tooth. Purpose. The study is to investigate stresses of the different clasps. Material and methods. In order to investigate the degree of stresses, maxillary partial edentulism (Kennedy Class II modification I) was assumed and removable partial dentures were designed on it with three kinds of metallic materials; cobalt-chromium alloy, type IV gold alloy and commercially pure (c.p.) titanium. Aker's clasp was applied on the left second molar. RPA (mesial rest-proximal plate-Aker's) clasp was on the left first premolar and wrought wire clasp was on the right first premolar. Three dimensional, non-linear, dynamic finite element analysis method was run to solve this process. Results. 1. Cobalt-chromium alloy had the highest von Mises stress value and c.p. titanium had the lowest one irrespective of the types of clasps. 2. In the Aker's clasps, stress on the retentive tips was shown shortly after the appearance of stresses of the middle and minor connector areas. These time lag was much shorter in the RPA clasps than in the Aker's clasp. 3. In general. retentive tips of wrought wire clasps had much less amount of stress than other clasps. Conclusion. The amount of stress was the highest in the RPA clasp and the lowest in the wrought wire clasp, in general.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.262-272
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• 2015

Loss of molar support and abnormal jaw relationship lead to occlusal disharmony and cause pathologic signs. Full mouth rehabilitations with reestablishment of occlusal schemes are needed. In this case, the 75 year-old female patient showed posterior bite collapse, irregular occlusal plane and Class II jaw relationship. By observing her profile and interocclusal distance, she was diagnosed as loss of occlusal vertical dimension. Treatment plan is to restore maxillay class I removable partial denture and mandibular fixed prosthesis and to establish vertical dimension and harmonious occlusal plane. Occlusal vertical dimension of 19 mm, which is obtained by 7.5 mm increase between maxillary right lateral incisor and mandibular canine, was established using temporary prosthesis via diagnostic wax-up. Patient adaptation with newly formed vertical dimension was verified during 8 week follow-up period. Within the information of interim prostheses, final restoration was constructed and delivered. The patient showed sound occlusal scheme and esthetic profile.