• Title/Summary/Keyword: 보철물 형태

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Aesthetic treatment of patient with facial asymmetry and severe gingival retraction (안면비대칭과 치은퇴축이 심한 환자의 심미치료)

  • Choi, Moon-Shik
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.25 no.1
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    • pp.50-63
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    • 2016
  • Successful treatment in the anterior esthetic prosthetic can be a balance between aesthetics in the facial, tooth, and periodontal tissue in the oral. In the case of facial symmetry of patients with normal occlusal plane, If you establish criteria of finding balance of aesthetics such as a several books and articles and manufacture a prostheses by the established-criteria, you can manufacture a harmonious and aesthetic prostheses without any trouble. However, in the case of patients with facial asymmetry, if you manufacture a tooth as patient's facial aesthetic symmetry by force even facial asymmetry case, you can't get a result not only aesthetic but also functional prostheses. Also, to produce the prosthetic of harmonious and aesthetic with periodontal tissue, and excellent self-cleansing function, you must apply to the form of the prosthetic changed dental environment.

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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Oral rehabilitation of a patient with severely worn dentition using monolithic zirconia (단일구조 지르코니아 보철물을 이용한 심한 마모 환자의 전악 수복 증례)

  • Park, Jun-Seo;Ryu, Jae-Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.273-279
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    • 2016
  • Severe tooth wear may lead to pathological changes of pulp, imbalance in occlusion as well as functional and esthetic problems. In this case, 34-year-old male came to the hospital because of generally worn dentition due to attrition and erosion. After evaluation, a full mouth restoration with elevation of the vertical dimension of occlusion was planned. After occlusion was stabilized by an occlusal stabilization appliance, centric relation position was recorded and subsequent provisional restorations were fabricated. After evaluation, a CAD-CAM (computer aided design-computer aided manufacturing) prosthetic restoration was carried out using monolithic zirconia. After 12 months of follow up observation, the patient was satisfied with function and esthetic appearance.

Convergence analysis of cusp variation symmetry of the mandibular second premolars using 3-dimensional virtual models - Focusing on college students in Jeollabuk-do (3차원 가상모형을 이용한 하악 제2소구치 교두 변이 대칭성에 대한 융복합적 분석 - 전북지역 일부 대학생을 중심으로)

  • Nam, Shin-Eun
    • Journal of Digital Convergence
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    • v.20 no.2
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    • pp.317-323
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    • 2022
  • This study aimed to qualitative analyze the cusp variation pattern of the mandibular second premolars using a three-dimensional virtual models, and to analyze the left-right bilateral symmetry with a quantitative analysis of the tooth surface area according to the cusp variation. 127 virtual mandibular second premolars were prepared and individual absolute/relative cusp area, total crown area and groove form were analyzed using RapidForm2004(INUS technology INC, Seoul, Korea). Independent t-test, Kruskal-Wallis test and chi-square were performed. As a result, the groove form showed high bilateral symmetry between the left and right sides. Based on the left side of groove form, the bilateral symmetry was 100.0% for the U pattern, and 73.7% for the H patterned, and 78.9% for the Y pattern(p<.001). The finding could be as a meaningful reference for manufacturing CAD/CAM dental prostheses, and it is expected that further studies will be conducted on more samples including the mandibular second premolar immediately after eruption.

Surface Modification by Laser Deposition and Femtosecond Laser for Biomedical Applications (레이저증착과 펨토레이저를 이용한 생체의료분야의 표면처리응용)

  • Choe, Han-Cheol
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2015.05a
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    • pp.24-24
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    • 2015
  • 최근 생체재료의 개발이 눈부시게 발전되고 생체적합성이 우수한 표면을 요구함에 따라 생체재료의 표면처리에 대한 연구가 활발히 진행되고 있다. Laser Deposition법은 항공기 부품제조 분야에 주로 사용되고 있으며 최근에 오하이오 주립대 타이타늄합금연구센터를 중심으로 표면처리에 관한 연구가 주로 이루어졌다. 특히 이를 이용하여 치과재료의 표면처리에 응용을 시도하였다. 치과에서 응용될 수 있는 경우는 주로 임플란트는 부분 또는 완전 무치악 환자의 보철수복에 사용되는 보철물의 제작등에 사용될 수 있으며 이중에서도 특히 생체용 임플란트의 표면처리응용으로 임플란트와 조직간의 접합성을 개선하는 표면처리법으로 연구되었다. 임플란트의 성공과 실패는 물성적인 측면에서 임플란트의 형태, 표면거칠기 및 표면처리방법, 초기하중 등에 의하여 좌우되며 임플란트 재료에 작용하는 응력차폐는 생체적합성을 좌우하는 큰 요인이 되고 있다. 이를 위하여 저 탄성계수합금을 설계하지만 하중을 버티는 강도가 낮아지는 단점이 있어 레이저증착법을 이용하여 임플란트재료인 Ti6Al4V합금에 탄성계수가 낮은 Ta, Nb등을 코팅하는 방법을 통하여 이를 해결하고자하는 시도가 이루어지고 있다. 이 방법은 최근의 3D 프린팅의 원리가 되고 있다. 따라서 발표에서는 Laser Deposition방법을 이용하여 치의학분야에서 응용되고 있는 예를 강연하고 응용 가능 분야에 대하여 토론 하고자한다. 또한 펨토레이저를 이용하여 생체합금의 표면처리는 생체활성화를 더욱 증진시키며 이를 위하여 많은 연구 수행되고 있다. 본 발표에서는 매식용 합금 표면에 펨토레이저를 이용하여 텍스춰링하여 세포가 잘 성장 할 수 있는 크기의 조절함으로써 기존의 표면처리와는 다른 효과를 얻을 수 있는 장점을 알아본다. 펨토레이저를 이용하면 여러 가지 형태의 텍스춰링이 가능하며 원형, 사각형등등 자유자제로 형태의 묘사가 가능하고 깊이 또한 쉽게 조절할 수 있는 장점이 있다. 지금까지는 표면 개질에 사용되는 레이저는 주로 Nd:YAG 레이저의 파장을 반으로 줄인 녹색레이저 (${\lambda}=532nm$)를 사용하거나, 자외선파장영역의 레이저를 사용하는 경우가 일반적으로 가장 보편화되었다. 이를 이용하여 제조된 Ti합금에 펨토 초(10-15 second) 펄스폭 대역을 갖는 레이저를 이용하여 나노크기의 미세 요철을 표면에 형성한 후, 나노튜브를 형성하여 그 표면특성의 변화를 알아보고 펨토레이저가 의료분야에 적용되고 있는 예를 살펴보고자 한다.

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A Study on the Shear Bond Strength of Veneering Ceramics to the Lithium Disilicate (IPS e.max CAD) Core (Lithium Disilicate (IPS e.max CAD) 코어와 전장 도재 사이의 전단결합강도에 관한 연구)

  • Kim, Ki-Baek;Kim, Jae-Hong
    • Journal of dental hygiene science
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    • v.13 no.3
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    • pp.290-295
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    • 2013
  • The purpose of this study was to investigate the shear bond strength between various commercial all-ceramic system core and veneering ceramics, and evaluate the clinical stability by comparing the conventional metal ceramic system. The test samples were divided into three groups: Ni-Cr alloy (metal bond), yttria-stabilized, tetragonal zirconia polycrystal (Y-TZP) (zirconia bond), lithium disilicate (lithium disilicate bond). The veneering porcelain recommended by the manufacturer for each type of material was fired to the core. After firing, the specimens were subjected to shear force in a universal testing machine. Load was applied at a crosshead speed of 0.50 mm/min until failure. Average shear strengths (mega pascal) were analyzed with a one-way analysis of variance and the Tukey test (${\alpha}$=0.05). The mean shear bond strength${\pm}$SD in MPa was $44.79{\pm}2.31$ in the Ni-Cr alloy group, $28.32{\pm}4.41$ in the Y-TZP group, $15.91{\pm}1.39$ in the Lithium disilicate group. The ANOVA showed a significant difference among groups (p<0.05). None of the all-ceramic system core and veneering ceramics could attain the high bond strength values of the metal ceramic combination.

Regeneration of emergence profile with soft tissue graft and wide computer aided design/computer aided mamufacturing abutments: a clinical report (연조직 이식술과 넓은 computer aided design/computer aided mamufacturing 지대주를 이용한 임플란트 고정성 보철물의 출현윤곽 재현)

  • Kim, Min-Kyung;Lee, Ji-Hun;Ahn, Seung-Geun;Kim, Kyung-A;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.364-370
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    • 2015
  • Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.

Success and survival rate of the implant with crestal sinus lift using S-reamer and gel-type graft material: A retrospective study by more 5-years follow check up (S-reamer와 겔 형태의 이식재를 이용한 치조정 접근법을 통한 상악동 거상술 임플란트의 성공률과 생존율: 5년 이상 추적 관찰을 통한 후향적 연구)

  • Kim, Jong Jin;Cho, Sung Am
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.1
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    • pp.23-29
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    • 2020
  • Purpose: The purpose of this retrospective study was to evaluate the method using the S-reamer and gel-type graft material by the success rate and survival rate. Materials and methods: Implantation period was from 2008 to 2014, Follow check up year is 2019. There were 59 patients and 117 implants. All implants were placed in the posterior maxilla with the sinus lift. The patients population consisted of 34 men and 25 women, ranging from 19 to 75 years. The residual bone heights were from 1 mm to 6 mm. Sinus was perforated with S-reamer without membrane tearing and gel type bone graft material was used for membrane lifting and filling the space. all implants were placed simultaneously. Panoramic X-ray was taken. After 5 - 6 months healing period, final prostheses were restored. After more 5-years implant surgery, Panoramic X-ray was obtained and X-ray analysis and clinical examination were performed. Success criteria was referred to a Buser's success critera. All implants were classified to success implant, survival implant, failed implant. A success implant was satisfying success criteria, a survival implant was a implant that was acute infection with suppuration and bone loss, a failed implant was a implant that was mobile, removed. Results: Five implants were removed, and 4 implants had infected with bone loss. Survival rate was 95.7% and success rate was 92.3%. Conclusion: This retrospective study presented that this method with S-reamer and gel-type graft material was a successful treatment without membrane tear in the condition of 1-6 mm residual bone height.

Flexural strength of various kinds of the resin bridges fabricated with 3D printing (3D 프린팅으로 제작된 여러 종류의 레진브릿지의 굴곡강도에 대한 연구)

  • Park, Sang-Mo;Kim, Seong-Kyun;Park, Ji-Man;Kim, Jang-Hyun;Jeon, Yoon-Tae;Koak, Jai-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.4
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    • pp.260-268
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    • 2017
  • Purpose: Manufacturing with AM (Additive manufacturing) technique has many advantages; but, due to insufficient study in the area, it is not being widely used in the general clinic. In this study, differences of flexural strength among various materials of 3 unit fixed dental prosthesis were analyzed. Materials and Methods: A metal jig for specimens that had a 3-unit-fixed dental prosthesis figure were fabricated. The jigs were made appropriately to the specifications of the specimens. Three different kinds of materials of specimens which were NC (mathacrylic esther based), DP-1 (Bisphenol A epoxy acrylate type oligomer based), and DT-1 (urethane acrylate based) were printed with DLP machine. Five specimens for each kind of material were printed with an angle of $30^{\circ}$ from the horizontal surface. The specimens were placed on the jig and the flexural strength was measured and recorded using Universal testing machine. The recorded data was analyzed in SPSS using One-way ANOVA and Tukey HSD to determine the significance of the differences of flexural strength among the groups. Results: The flexural strengths of each group were the followings: NC, $1119{\pm}305$ N; DP-1, $619{\pm}150$ N; DT-1, $413{\pm}65N$. Using One-way ANOVA and Tukey Honestly Significant Difference test, significant difference was found between NC and the other groups (P < 0.05), but there was no significant difference between DP-1 and DT-1 (P > 0.05). Conclusion: Higher flexural strength was shown in 3-unit-fixed dental prosthesis that were 3D printed using a DLP machine with NC material.

Implant assisted removable partial denture using bilateral single implant-supported surveyed crown: a case report (양측성 단일 임플란트 지지 서베이드 크라운을 이용한 하악 임플 란트 보조 국소의치 수복 증례)

  • Seojune Choi;Hong Seok Moon;Jaeyoung Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.146-156
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    • 2024
  • Implant assisted removable partial denture (IARPD) has been practiced in various forms for a long time, and among them, implant surveyed crown RPD is gaining predictability as well as being considered as a treatment option for patients with anatomical and financial disadvantages. The position of implant could be divided as posterior placement or anterior placement according to the purpose of the treatment and should be planned in consider to the alveolar ridge of patient, anticipated prognosis of remaining teeth, and opposing dentition. This case report describes a treatment for mandibular Kennedy class I partial edentulous patient with two implant-supported surveyed crown and implant assisted removable partial denture. Given the difficulty of posterior placement in this patient and the prognosis of the residual teeth, the plan was to place two implants in close proximity to the residual teeth, which were placed in the planned position, angle, and depth using guided surgery. The process of fabricating the fixed prosthesis was carried out in parallel with the maxillary edentulous tooth arrangement process to increase predictability, and when fabricating the localized tooth, the implant was designed in a form that allows the patient to perform functional movements by preventing excessive loading as the last supporting tooth, and was fabricated through a secondary impression process. Each treatment procedure was proceeded as planned, with aesthetically and functionally satisfactory results for both patient and operator.