• Title/Summary/Keyword: 보철물 유지관리

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Full mouth rehabilitation with implant fixed prostheses using POP bow system and 3D printing gothic arch tracer in a patient with unilateral facial nerve palsy (편측성 안면 신경마비 환자에서 3D printing gothic arch tracer와 POP bow system을 이용한 전악 임플란트 고정성 보철 수복)

  • Seong-Yun Jeong;Chang-Mo Jeong;Mi-Jung Yoon;Jung-Bo Huh;So-Hyoun Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.3
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    • pp.201-214
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    • 2024
  • In patients with unstable mandibular movements who are accompanied by involuntary facial muscle movements and asymmetrical changes in the facial features, many difficulties exist in determining the vertical dimension of occlusion, recording centric relation, and transferring information about the occlusal plane. In this case, for a patient with unilateral facial nerve palsy who was edentulous for a long period of time, a CAD-CAM provisional prosthesis was fabricated using a 3D printing customized gothic arch tracer and a prefabricated occlusal plane recorder, the POP bow system, to achieve a stable interarch relationship. Afterwards, a full mouth implant fixed prosthesis was fabricated by delivering an appropriate vertical dimension of occlusion, a reproducible centric relation, and a correct three-dimensional occlusal plane, and continuous maintenance was performed to restore functional and aesthetic oral health to the patient.

Effect of milling and sintering process on integrity of zirconia prosthesis: a literature review (밀링과 소결과정이 지르코니아 보철물의 완성도에 미치는 영향에 관한 문헌고찰)

  • Lee, Kiun;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.3
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    • pp.127-137
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    • 2022
  • Zirconia is fabricated through various processes. Each element in fabricating process can affect the physical properties of the definitive prosthesis. In particular, both the milling process and the sintering process can affect the final integrity of the zirconia prosthesis. Most of the milling machines adopt the ultra-precision 5-axis machining method, and the results vary depending on which milling method was used and how the milling equipment was managed. Milling blocks are selected according to cutting efficiency and aesthetic reproducibility. The sintering method can affect the grain growth and optical properties, and an accurate evaluation can be made only with additional research on the recent speed sintering procedure. Not only the sintering temperature but also the temperature holding time can affect the quality of definitive prosthesis.

Prosthetic treatment for patient with anterior overbite and partial edentulism using maxillary hybrid telescopic double crown RPD and mandibular fixed prostheses: A 11-yr follow-up (전치부 과개교합을 가진 상하악 부분 무치악 환자에서의 상악 하이브리드 텔레스코픽 이중관 국소의치와 하악 고정성 보철물을 이용한 치료의 11년 경과관찰 증례)

  • Choi, Hyunsuk;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.415-421
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    • 2021
  • The biomechanical prognosis of conventional removable partial denture is questionable in case of patient with few remaining teeth or periodontally compromised teeth. In this case, hybrid telescopic double crown RPD may be a successful treatment alternative. Hybrid telescopic double crown RPD has following advantages over conventional RPD: secondary splinting effect between abutments, more vertical stress direction and more convenient in repairing the denture after extraction of abutment tooth. In this clinical case, patient had deep overbite in anteriors and partially edentulous. The maxilla was restored with hybrid telescopic double crown RPD and the mandible was restored with implants and fixed prostheses. Long-term follow-up and supportive periodontal treatment were performed, and satisfactory results were achieved in terms of function and aesthetics.

Prosthetic rehabilitation by obturator considering the biomechanics in partially edentulous patient after maxillectomy (상악골 절제술을 받은 부분 무치악 환자에서 생역학을 고려해 제작한 구개 폐색장치를 이용한 보철 수복 증례)

  • Lee, Kang-Shin;Park, Ju-Mi;Ahn, Seung-Geun;Seo, Jae-Min;Park, Yeon-Hee;Lee, Jung-Jin
    • 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.

Changes in periodontal tissue and denture around the implants in the mandibular milled-bar implant overdenture: A 12-year follow-up (하악 Milled Bar 임플란트 피개의치에서 12년 간의 임플란트 주변 치주조직 및 의치의 변화)

  • Choi, Hyun-Suk;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.55-62
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    • 2021
  • The mandible has a smaller support area than the maxilla, and in particular, in patients with generalized alveolar bone resorption, the stability of the denture and the masticatory efficiency are significantly low in the case of conventional complete denture, due to the movement of the tongue and mandible. In these patients, implant overdenture is evaluated as a highly predictable treatment method with high retention and stability, and excellent pronunciation and masticatory force. In this clinical case, patient had an edentulous maxilla and generalized alveolar bone resorption in mandible. Therefore, complete denture was placed in the maxilla and implant overdenture using milled bar attachment on 4 implants was placed in the mandible. During the 12-year follow-up period, changes in periodontal tissue and denture around the implants were periodically managed and observed.

Full mouth prosthetic rehabilitation based on systemic analysis, diagnosis and treatment plan: a case report (체계적 분석, 진단, 치료 계획을 통한 전악 보철 재건 증례)

  • Kwon, Sooyeon;Paek, Janghyun;Pae, Ahran;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.332-338
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    • 2013
  • Data collection including checking the problem list and analyzing the etiology cannot be overemphasized in full mouth rehabilitation cases. It is well reported that favorable prognosis of prosthodontic treatment depends on accurate diagnosis. Seventy seven year old female patient presented with chief complaints of chewing pain on maxillary and mandibular left premolars and unesthetic existing prosthesis. Clinical evaluation, radiographic examination and cast analysis were performed to gather comprehensive data and problem lists. Treatment planning was based on collected data and related articles. Abutment evaluation, prognosis depending on various types of prosthesis, and maintenance were considered as well. Occlusal vertical dimension was increased to solve esthetic dissatisfaction and insufficient interocclusal space. Patient adaptation was verified with provisional restorations followed by diagnostic wax up. Function, esthetics and occlusal stability were verified during 8 week follow-up period. Prosthodontic reconstruction based on systemic analysis, diagnosis, and treatment plan led to satisfactory result after delivery of definitive prosthesis.

Comparison of Expectation and Satisfaction of Implant Patients in Pre-post Implant Therapy (임플란트 시술환자 시술 전·후의 기대와 만족도 비교)

  • Han, Ji-Hyoung;Kim, Ki-Eun
    • Journal of dental hygiene science
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    • v.11 no.2
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    • pp.121-127
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    • 2011
  • This study was conducted to improve patients satisfaction by comparing patients expectation prior to the implant therapy to patient satisfaction after the implant therapy. The data of 158 patients with dental implant in Seoul, Gyeonggi-Do and Cheonan city was obtained. The results are as follows : 1. 40.5% of patients placed one implant and 36.1 % of patients answered that the average cost for each implant is from 1,500,000 to 2,000,000won. 23.4% of them answered they decided to have implant because no tooth preparation is required. 2. Overall, the expectation level for implant therapy in general properties, women showed higher level of expectation than men. Especially, 'Implant has a longer life than other denture' showed significant difference between women(4.29) and men(3.87). Expectation by age, 'Implant has similar color and shape' was found the highest in age 20(4.38). Satisfaction by general properties, 'No tooth preparation required' was found the highest in age 20(4.57) and was statistically significant(p<.002). 3. Comparing patients' expectation prior to implant therapy to satisfaction afterward, 'Implant prevents jawbone resorption and keeps facial appearance' showed 3.7 of expectation but satisfaction was found increased to 3.87(p=.020). No tooth preparation required' was found 3.95 in expectation prior to implant therapy but after therapy it was found 4.23 in satisfaction (p<.001). 4. Overall satisfaction in implant therapy was found 4.25, recommendation to other patients was found 4.18 and repurchase was found 4.17.

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.

A finite element analysis of implant-supported overdenture on the effect of anterior cantilever (임플랜트 bar overdenture에서 bar의 cantilever양이 임플랜트에 미치는 영향에 관한 삼차원 유한요소분석적 연구)

  • Jung, Tae-Wook;Kim, Young-Soo;Kim, Chang-Whe;Ling, Booi-Cie
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.1
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    • pp.1-17
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    • 1998
  • 두개의 임플랜트로 지지되는 overdenture를 이용한 하악무치악환자의 치료법은 경제적이면서, 실용적인 치료로 인정을 받고 있다. 하지만 해부학적인 조건으로 임플랜트를 설측 혹은 후방에 식립해야 되는 경우에는 일반적인 bar설계는 bar가 구강저 상방을 지나게 되어 혀운동, 발음, 위생관리 등에 많은 문제점을 부여한다. 이에 대한 해결방법으로 전방부 치조제 상에 보철물의 회전을 허용하는 angular bar를 설계할 수 있다. 하지만 이 설계는 임플랜트에 불리한 moment를 유발한다. 그럼에도 불구하고 뛰어난 유지력과 지지능력, 경제적인 면 때문에 angular bar는 임상에서 많이 사용되고 있다. 이에 본 연구는 angular bar의 전방 cantilever양을 달리하여 임플랜트 및 주변조직에 미치는 영향을 삼차원 유한요소분석법을 통해서 알아보고자 하였다. 이공사이의 하악골을 단순화시킨 준하악골모형에 직경 3.75mm인 브로네마르크 임플랜트 2개를 길이가 13,15mm인 경우로 설정하여 제 1소구치 부위에 식립하였다. 두 임플랜트를 연결하는 bar는 전방부 cantilever양을 0-5mm, 1mm씩 하여 6가지 경우를 가정하고 제작하였다. 각각 bar 중앙부에 수직압 (90도) 35N, 경사압(120도) 70N, 수평압(0도) 10N을 가하였으며 이때 나타나는 응력 분산형태와 임플랜트의 골유착에 불리하게 작용하는 최대주응력(인장력)과 변위량을 살펴보았다. 연구결과 다음과 같은 결론을 얻었다. 1. Cantilever양이 증가할수록 주변피질골과 임플랜트로 응력이 집중되었으며 상부 보철물의 변위량도 커졌다. 2. Cantilever양에 대한 수평압의 영향은 크지 않았으며 임플랜트 길이가 긴 것이 변위량과 응력이 작았다. 3. 경사압에 대한 응력의 변화는 cantilever양의 증가에 따라 급격히 증가하는 양상을 띠었으며 임플랜트길이가 응력 및 변위의 양에 미치는 영향은 없었다. 4. 수직압에 대한 응력의 변화는 초기에는 완만한 증가를 보이다가 일정 시점 지난 후에는 증가율이 커지는 경향을 띠었다. 증가현상이 두드러지기 전에는 길이의 증가가 응력의 분산효과는 가져왔으나 이후에는 길이의 응력분산 효과는 없었다. 5. 응력분포양상은 cantilever양이 증가할수록 골조직을 통한 분산정도는 작아지고 특정부위의 피질골과 임플랜트, 상부보철물에 집중되는 경향을 보였다. 6. 임플랜트와 주변 골조직으로의 응력분산능력이 예후를 좌우한다는 점에서 angular bar는 적합치 못하며 부득이한 경우는 임플랜트 길이를 길게 하고 최대한 3mm이내로 cantilever양을 제한하는 것이 추천된다.

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Full mouth rehabilitation of edentulous patient with intellectual disability using implants and monolithic zirconia (1급 지적장애 환자에서 임플란트와 단일 구조 지르코니아를 이용한 완전구강회복 증례)

  • Jeong, Ki-Won;Kim, Sung-Hun;Han, Jung-Suk;Yeo, In-Sung;Yoon, Hyung-In
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.156-163
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    • 2017
  • People with class I intellectual disability need lifelong assistance and protection from their surroundings due to impaired adaptive functioning. They have poor oral health and show higher prevalence of dental caries, periapical inflammation and tooth loss that require proper prosthetic restoration. Because removable prostheses for intellectually disabled patients often lack stability, retention, and maintenance, fixed prostheses are essential and the only available option is dental implants. In this case, a 45 year-old male patient with class I intellectual disability had poor oral hygiene with most of his teeth missing and visited the clinic to recover his masticatory function. Due to such systemic conditions, the definitive restoration of choice was the implant-supported fixed dental prosthesis made of biocompatible and highly strong monolithic zirconia. In consequence of the treatment process, the patient was able to improve his oral environment aesthetically and functionally.