• The Journal of Korean Academy of Prosthodontics
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• v.29 no.1
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• pp.233-248
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• 1991

The purpose of this study was to qunatatively analyze the stress patterns induced in the abutment, superstructure, supporting bone and to determine the deflection of abutment and superstructure by appling occlusal force to natural teeth supported fixed prostheses and implant-supported fixed prostheses. The analysis has been conducted by using the two dimensional finite element method. The implant and natural tooth-supported bridge has a first molar pontic supported by mandibular second bicuspid and implant posterior retainer, which were rigidly(Model A) or flexible(Model B). The natural teeth-supported bridge has a first molar pontic supported by mandibular second bicuspid and second molar, which were rigidly splinted together(Model C). 63.5kg(Load P1) of localized load on central fossa of first molar pontic and 24kg(Load P2) of distributed load on each occlusal surface were applied respectively. 1. The coronal portion of premolar pontic and posterior abutment in fixed partial denture deflected inferiorly in order of Model B, Model C and Model A under Load P1 and Load P2. 2. Mesial displacement of the coronal portion of premolar showed in Model A, Model B and Model C under Load P1, but mesial displacement of that in Model B and distal displacement of that in Model A and Model C showed under Load P2. 3. Mesial displacement of the coronal portion of the pontic and distal displacement of the coronal portion of posterior abutment showed in Model A, Model B and Model C under Load P1 and Load P2. Displacement in the case of Model B was greater than that of Model A and Model C. 4. In the case Model A under Load P1 and Load P2, high stress apically was concentrated in the mesiocervical portion of the posterior abutment than in the disto-cervical portion of the premolar. 5. In the case of Model B under Load P1 and Load P2 high stress was concentrated in the case of the premolar than in that of posterior abutment and high stress especially was concentrated in the connected portion of pontic and posterior abutment. 6. In the case of Model C under Load P1 and Load P2, high stress was concentrated in the distal area of the cornal portion of premolar and the mesial area of the coronal portion of posterior abutment, and stress pattern was anteroposterially symmetric around the pontic. 7. Load P1 and Load P2 compared, stress magnitude was different but stress pattern was similar in Model A, Model B and Model C. 8. Under Load P1 and P2, stress magnitude in the mesial distal portion and the portion of root apex of the posterior abutment was in order of Model B, Model A and Model C.

• The Journal of Korean Academy of Prosthodontics
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• v.19 no.1
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• pp.39-45
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• 1981

Distal-extension removable partial dentures have long been implicated in the increase in mobility and the destruction of the supporting structures of the primary abutment teeth. Various clasping systems have traditionally been used to retain distal extension removable partial dentures, and other designs have been proposed to minimize torquing forces on the abutment teeth. Most recent studies investigating the effects of removable partial dentures on abutment teeth have been performed in it laboratory setting. Results obtained from in vitro research have given dentists insight into removable partial denture design, but laboratory test model cannot be constructed that simulates actual functional or parafunctiona1 movements and forces. The purpose of this study was to clinically evaluate the degree of tooth mobility produced by two clasping systems (suprabulge type and infrabulge type) used for distal extension removable partial dentures. Akers clasp and R.P.I. system were selected for the evaluation, and four patients required a distal extension removable partial denture on the mandibular arch were selected for participation in the study. Two partial dentures were constructed in the same condition expect the design of clasp. All abutments in the study were mandibular first or second premolars. Measurements of mobility were made with a research tool designed by $M\"{u}hlemann$. This instrument, periodontometer, measures tooth mobility in the mouth by means of a dial gauge accurated to 0.01mm when the tooth is stressed with a force meter. Lingual and buccal deflection of abutment tooth was measured using buccal and lingual pressure. The amount of force applied was 500gm. Tooth mobility tests were made at four key stages; 1. Before insertion of the first removable partial denture, baseline mobility was establsihed. 2. After wearing of the first prosthesis, measurement was made at weekly intervals for 4 weeks. 3. The removable partial denture was then taken from the patient, and tooth mobility was measured again at weekly intervals until the patient's established baseline mobility had returned. 4. The second prosthesis of different clasp design was worn for a month and evaluated in the same manner as the first. The sequence of placement of clasping system was alternated between patients. The following results were obtained from this study; 1. The mobility of abutment tooth increased during the initial stage of wear and returned to baseline mobility after removal of removable partial dentures. 2. The mobility of abutment tooth showed no difference between Akers clasp and I-bar clasp during the 4-week test period. 3. All teeth tested showed greater mobility toward the buccal than the lingual direction.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.253-261
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• 2015

Chronic periodontitis involves subsequent loss of teeth, and if left untreated, can lead to adjacent teeth drifting and supraeruption of the rest dentition. Careful consideration has to be given when deciding extraction of remaining teeth in treatment of periodontally compromised dentitions. For tooth-supported fixed partial dentures or removable partial dentures, periodontally compromised teeth are extracted due to possible early failure from functional overload, but for implant restoration, the teeth could be used as supports for fixed partial dentures because implants can reduce overload on teeth. The remaining natural teeth can help clinicians restoring vertical dimension and normal occlusal plane in full mouth rehabilitation because it conserves patients' proprioceptive response. This clinical report describes treatment of a patient who has a few remaining teeth and supraeruption of the rest dentition from severe chronic periodontitis. Satisfactory clinical result was achieved with full mouth rehabilitation using a few teeth and implants.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.65-71
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• 2016

Gradual occlusal attrition is a normal process of aging. However, severe attrition causes pathogenic pulp, occlusal disharmony, functional disorder and esthetic problems. Alteration of vertical dimension should be considered for space regaining for tooth restoration, esthetic improvement or correction of occlusal relationship. Vertical dimension should be determined within the range of minimal invasive process satisfying patient's esthetic requirements and operator's functional goal. And patient's adaptation to newly determined vertical dimension should be assessed simultaneously. Deep overbite is not a simple problem of overbite, instead it is an usually complicated problem with anterior-posterior occlusal relationship. Considering these facts, appropriate restoration of edentulous part as well as improvement of anterior-posterior relationship should be performed to solve this fundamental problems. In this study, a 67 year-old male patient with many worn teeth and loss of posterior teeth was treated with removable partial denture at edentulous mandibular area to increase vertical dimension and fixed prostheses at dentulous maxillary and mandibular area. With these treatments, we attained a satisfactory result in functional and esthetic aspects as a report case.

• The Journal of the Korean dental association
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• v.49 no.2
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• pp.77-84
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• 2011

The benefits of implant supported overdenture are readily apparent for the fully edentulous patients and have been well documented, however, there is deficiency of the studies regarding the combination of implants with removable partial dentures for partially edentulous patients. The purpose of this article is to review the literature concerning implants with removable partial dentures and evaluate the evidence for this clinical approach. Through many clinical case reports and studies we have searched from a broad variety of journals, we present the six considerations needed to contemplate respecting implants with removable partial denture in partially edentulous patients. First, the connection between abutment tooth and removable partial denture has to be rigid and the link between implant and removable partial denture should be hinged. Second, a mesial rest acts better in the point of force distribution for distal extension removable partial denture and splinting between implants is also a favorable choice. Third, T bar has an advantage for implants which are used as abutments in distal extension removable partial denture. Forth, as we all known functional impression is better way to reproduce movement for distal extension removable partial denture. Fifth, indirect retainer and guiding plane on the proximal surfaces of terminal abutment teeth are important in preventing denture base lifting. Sixth, implants in conjunction with removable partial denture is superior in the esthetic and phonetic as well as cost-effective point of view. We also suggest that which place we should install implants for force distribution and which diameter and length of implants should be used. in this review article, we recommend to locate the implant near of the abutment tooth for esthetics or near of first molar position for good stress distribution. The diameter and length of implant also influence to stress distribution. When we compare to conservative partial denture, patients go for removable partial denture using implants due to convenience, better support and retention according to several studies. But it is true that we need to study more on this subject and collect long term follow up cases before we discuss on it. So it is enough to bring this subject into the surface of prosthetic treatment by this article.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.1
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• pp.29-39
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• 2006

Statements of problem: Zirconia core is used for posterior fixed partial dentures because it's good mechanical properties. Stress is concentrated on connectors in fixed partial dentures, so the proper design of connector areas is needed for adequate mechanical long-term properties of any prosthesis. The area of connector is critical, but tooth size and surrounding soft tissue limit the connector design. Purpose: The purpose of this study is to compare fracture strengths between different connector designs of zirconia core for posterior fixed partial dentures manufactured with CAD/CAM system and determining the optimal connector design satisfying strength and hygiene. Material and method: The following four groups of 40 posterior fixed partial denture specimens(each group 10) were fabricated as followed; group 1 vertical height of connector is 3mm (control group, all groups have the same condition); group 2, lingual vertical 1mm reinforcement on connector; group 3, lingual vertical 2mm reinforcing on connector and group 4, lingual vertical 3mm reinforcing on connector. Specimens were subjected to compressive loading on the central fossa of pontic by instron. SEM was used to identify the initial crack and characterize the fracture mode. Results: The results were as follows: 1. The mean fracture load of the non-lingual reinforcing group was 1212N and the lingual vertical 1mm reinforcing group was 1510N, the lingual vertical 2mm reinforcing group was 1882N, the lingual vertical 3mm reinforcing group was 1980N. 2. The reinforcing groups were statistically significant compared to non-reinforcing groups(P<0.001). 3. There were 2, 3mm reinforcing groups that were statistically significant compared to 1mm reinforcing groups(P<0.001), and the 3mm reinforcing group was not statistically significant compared to 2mm reinforcing groups(P>0.05) 4. Fractures were initiated in gingival embrasures of connectors and processed to the loading site. Conclusion: In this study, lingual reinforcement of connector for improved strength of zirconia based fixed partial denture is nessasary. And long-term study for clinical application is required

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.4
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• pp.526-552
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• 1994

The extent and direction of movement of removable partial dentures during function are influenced by the nature of the supporting structures and and the design of the prosthesis. Since forces are transmitted to the abutment teeth through occlusal rests, guide planes and direct retainers during functional movements, proper design based on the avaialble research data will maintain the health of abutment teeth and their supporting structures. The purpose of this in vitro study is evaluating stress distribution clinically around the abutment teeth prepared following 4-type clasping systems for unilateral free-end removable partial dentures. Three-Dimensional Photoelastic Stress Analysis method was used because it shows a visual display of stresses of the simulated abutment teeth and residual ridges and reveals stress concentration that can be read at any given points in terms of direction and magnitude. For this study, the author fabricated 4 mandibular photoelastic epoxy models missing left 1st and End molar. Epoxy models were duplicated and 4 unilateral removable partial dentures were construe- ted in accordance with 4-type direct retainers. Unilateral free-end removable partial dentures were positioned on their own models. 6kg force was loaded on the every removable partial dentures of the epoxy model on the central fossa of mandibular left 1st molar vertically by the loading device. After the stress was frozen in a stress freezing furnace, 6 specimens of 6-mm thickness were made from every epoxy model and examined with the circular polariscope. The results were as follows : 1. Generally I-bar clasp revealed the most favorable stress distribution around the abutment teeth. 2. At the end portion of the free-end ridge, Back action clasp showed the highest stress concentration at the bucco-lingual and top portions of the residual alveolar ridge. 3. At the distal area of the abutment teeth, Akers clasp and Roach clasp showed higher stress concentration bucco-lingually and apically than the others. 4. To the abutment tooth, I-bar clasp showed the least stress distribution bucco-lingually but the others showed irregular stress distribution. 5. At the mesial area of the abutment teeth, the order of effective stress distribution was I-bar clasp, Back-action clasp, Akers clasp and Roach clasp. There was big difference of stress distribution between them. 6. At the right 2nd premolar and 1st molar, the stress concentration of Akers clasp was a little high but that of I-bar clasp was low.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.281-293
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• 2021

Patients who went through maxillectomy can have severely impaired swallowing, mastication, and pronunciation functions because of palatal defects. Leakage occurs through the nasal cavity while eating, chewing becomes difficult due to the loss of teeth and alveolar ridges, and oral and nasal passages are not separated, leading to hyper-nasal sound, and significantly reducing the quality of life. To prosthetically reconstruct the defect, the weight of the obturator should be reduced as much as possible to minimize dropout because of gravity, and the bulb of the obturator should be properly extended into the defect to get additional retention and stability. In this case of a partially edentulous patient who underwent additional maxillary resection because of tumor recurrence, a metal framework was designed by applying the basic design principles of removable partial dentures. An obturator with improved retention, stability, and support was fabricated through functional impressions. The patient was satisfied with the improved facial expression, mastication, swallowing, and pronunciation, and showed stable occlusion and oral hygiene management during the follow-up period.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.1
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• pp.63-70
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• 2022

Teeth wear with loss of posterior support often leads to symptoms such as irregular occlusal plane and excessive wear of anterior teeth. In such environment, establishing proper posterior support and harmonious anterior guidance and occlusal plane is recommended. In this case, the patient had excessively worn dentition with loss of posterior support, while denying surgical treatment due to her(his) history of osteoporosis, ibandronate injection, and risk of medication-related osteonecrosis of the jaw (MRONJ). To recover the vertical space needed for prosthetic restoration, full mouth rehabilitation with vertical dimension increase of remaining teeth was decided. Missing teeth in the posterior area were restored with mandibular removable partial denture. The treatment plan was determined through careful diagnosis, and every step of procedures including tooth preparation, provisional phase with the increased vertical dimension, and definitive prosthetic phase were carried out accordingly. Once the treatment was completed, the patient was satisfied functionally and esthetically. Periodic examination of oral hygiene, occlusal stability was conducted.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.113-124
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• 2023

Purpose. The purpose of this study is to help increase the success rate by analyzing the types and characteristics of implant prosthesis and the survival rate. Materials and methods. Among implants placed between 2011 and 2020 at Sanbon Dental Hospital, College of Dentistry, Wonkwang University, a case restored by a prosthetic surgeon was investigated for the characteristics and correlation of failure. The causes of failure were classified as failure of osseointegration, peri-implantitis, fixture fracture, abutment fracture, screw fracture, screw loosening, prosthesis fracture, and loss of prosthesis retention. Prosthetic method, cantilever presence, placement location, etc. were analyzed for their correlation with implant failure. Results analysis was derived through Chi-square test and Kaplan-Meier survival analysis using SPSS ver 25.0 (IBM, Chicago, IL, USA). Results. A total of 2587 implants were placed, of which 1141 implants were restored with Single Crown and 1446 implants with Fixed Partial Denture, and the cumulative survival rate was 88.1%. The success rate of SC was 86.2% (984) and the success rate of FPD was 89.6% (1295), showing statistically significant differences, among which factors that had significant differences were abutment fracture, screw fracture, and screw loosening (P < .05). Conclusion. As a result of the 10-year follow-up, more failures occurred due to biomechanical factors than biological factors. Further studies on the success of implants will be needed in the future.