• Title/Summary/Keyword: 보철적 합병증

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Factors affecting the survival of implants: a long-term retrospective study (임플란트의 생존에 영향을 미치는 요인에 대한 장기간의 후향적 연구)

  • Song, Susanna;Lee, Jae-Kwan;Um, Heung-Sik;Chang, Beom-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.1
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    • pp.10-19
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    • 2015
  • Purpose: The aim of the present study was to evaluate the long-term survival of implants retrospectively and determine the risk factors associated with implant failure. Materials and Methods: Of all implants that were placed at the Department of Periodontology of the Dental Hospital of Gangneung-Wonju National University from January 1998 to December 2012, 2265 implants that were followed up until June 2013 were included in this study. Data were collected from clinical and radiographic examinations from previous visits. The information gathered included gender, age, smoking status, implant diameter, implant length, surface of implant, location of implant within the dental arch, surgical techniques and existence of complications. Results: The survival rate before loading was 98.9%. The cumulative survival rate after 5 years of loading was 97.2%, and after 15 years of loading was 95.2%. In a simple logistic regression analysis, gender (P = 0.016), smoking status (P = 0.001), location of implant (P = 0.020) and existence of complications (P = 0.002) were statistically associated with implant failure and included in the multiple regression analysis. As a result of multiple logistic regression analysis, the variables statistically associated with implant failure (P < 0.05) were smoking status (P = 0.049) and existence of complications (P < 0.001). Conclusion: The cumulative survival rate of dental implants after 15 years of loading was 95.2% and that the variables statistically associated with implant failure were smoking status and existence of complications.

Implant restoration considering maintenance for a patient with excessive crown height space (과도한 치관높이 공간을 가진 환자에서 유지관리를 고려한 임플란트 수복증례)

  • Ma, Juri;Yang, Hong-So;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-Dug;Vang, Mong-Sook
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.2
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    • pp.107-112
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    • 2013
  • Complications increases when crown height space is excessive and one should be careful of choosing type of fixed prosthesis in case crown height space is over 12 mm. In this condition, tooth seems to be longer, therefore, it is needed to use gingival shade in aesthetically important area for fixed prosthesis. In this case, fixed prosthesis which has inappropriate maintenance and hygiene could hold food, plaque, calculus, thus increase incidence of inflammation and infection. Moreover, it could lead to chronic inflammation and infection and in that case surgical improvement could be necessary. In present case report, gingival inflammation and swelling developed around prosthesis after having made it considering articulation and aesthetic view in patient who had excessive crown height space. Finding out that design of prosthesis is a factor to make it hard to maintain oral hygiene, a temporary prosthesis which has enough interproximal space and proper emergence profile was fabricated. After two months of observation, significant abnormal symptoms are not found and oral reconstruction is performed using fixed prosthesis with zircornia infrastructure and porcelain build-up based on convenient self hygiene design. Through serial treatment, inappropriate soft tissue response is not observed and satisfactory result in functional aspect comes out.

Implant-supported prosthetic rehabilitation for the edentulous maxilla using the additive manufacturing technology: A case report (레이저 적층 제조 기술을 이용한 상악 무치악 환자의 임플란트 고정성 보철 수복 증례)

  • Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.173-178
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    • 2018
  • The direct metal laser sintering (DMLS) technique would be promising for the full-arch implant-supported restorations due to reduced cost and manufacturing time without potential human errors and casting defects. The aims of this case report were to describe the successful outcome of an implant-supported fixed dental prosthesis in the edentulous maxilla by using the DMLS technology and computer-aided design and computer-aided manufacturing (CAD/CAM) monolithic zirconia crowns, and to describe its clinical implications. A healthy 51-year-old Korean woman visited Seoul National University Dental Hospital and she was in need of a rehabilitation of her entire maxilla due to severe tooth mobility. In this case, all maxillary teeth were extracted and an implant-supported fixed dental prosthesis was fabricated that involved a cobalt-chromium (Co-Cr) framework with the DMLS technique and CAD/CAM monolithic zirconia crowns. Six months after delivery, no distinct mechanical and biological complications were detected and the prosthesis exhibited satisfactory esthetics and function. In this case report, with the DMLS system, the three-dimensional printed prosthesis was created without additional manual tooling and thus, reliable accuracy and passive fit were obtained.

Evaluation of clinical status of removable partial dentures (가철성 국소의치의 임상적 상태에 대한 평가)

  • Yang, Dong-Seok;Cho, Uk;Jeong, Chang-Mo;Jeon, Young-Chan;Yun, Mi-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.320-327
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    • 2009
  • Statement of Problem: Although many efforts have been continually made to estimate long term prognosis of removable partial dentures, the complication of removable partial dentures was still found because of inaccurate fabrication procedure and improper maintenance care. Purpose: The purpose of this study was to evaluate the clinical status of removable partial dentures. Material and methods: A total of 112 individuals with 153 removable partial dentures (35 - 87 years, 64 women and 48 men) were examined by intra-oral examination, diagnostic cast and radiographic examination. Results and conclusion: The results of this study were as follows: 1. Length of service of removable partial dentures was $5.3{\pm}4.3$ years (mean), 4.0 years (median). 2. A total of 45 removable partial dentures were considered failures. The loss of 18 abutments of 369 was founded. 3. Type of arch, Kennedy classification and type of opposite dentition were found to have no influence on longevity and success rate of removable partial dentures (P > .05). 4. Most common major connector was the palatal plate in maxilla and the number of lingual bar and linguoplate designed in mandible were similar. 5. The circumferential type retainer was the most commonly used retainer. 6. Sixty-three percent of the class I and II removable partial dentures incorporated indirect retention into the design. 7. Approximately 81% of the removable partial dentures had at least one defect. Excessive wear of posterior teeth (27.9%), lack of integrity (23.2%), lack of stability (22.6%) were frequent defects of removable partial dentures.

Re-establishment of occlusal plane in a patient with a failed implant prosthesis (실패한 임플란트 보철수복물을 가진 환자의 교합평면 재설정)

  • Kang, Hyeon-Goo;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.141-153
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    • 2018
  • A non-physiological occlusal plane caused by continuous tooth loss, occlusal wear, and failure of a prosthesis may result in an unattractive appearance and functional problems, such as reduced masticatory efficiency and occlusal interference. Therefore, when undertaking prosthetic treatment for edentulous patients or patients with a collapsed occlusal plane, it is important to establish an occlusal plane that is compatible with masticatory function. The patient in this case report had undergone restoration of a completely edentulous maxilla using an implant-supported fixed prosthesis. On follow-up examination in the following 6 years, mechanical complications were observed in the existing implant prosthesis, including porcelain chipping, occlusal wear, and screw loosening. Moreover, due to occlusal wear and supraeruption of the opposing anterior teeth, as well as loss of some posterior teeth, the occlusal plane had collapsed. Following diagnosis, the patient underwent full mouth rehabilitation, involving additional implant installation in edentulous sites, recreation of the existing prosthesis, and prosthetic restoration of all remaining teeth.

The incidence of the abutment screw loosening and its affecting factors in posterior implant restorations (구치부 임플란트 고정성 수복물에서의 지대주 나사 풀림 현상과 이에 영향을 미치는 요인)

  • Hong, Su-Jung;Bae, Jung-Yoon;Kim, Hyun-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.3
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    • pp.212-217
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    • 2018
  • Purpose: This study was to assess clinically the incidence of abutment screw loosening of posterior implant-supported fixed prosthesis and its affecting factors. Materials and methods: 391 implant-supported crowns restored from January 2013 to January 2016 were included in this study. All restorations were fabricated with either a single crowns or a splinted crown, and cemented with temporary cement. The incidence of abutment screw loosening is investigated and gender, restoration position, opposing teeth, restoration type, abutment connection type were assessed as possible factors affecting abutment screw loosening. Results: During the observation period (2 - 5 years), abutment screw loosening was found in 29 restorations (7.4%). It took 3 to 48 months (means 19.5 months) to loose the screw, and three of these implants were fractured. Among the factors considered, there were statistically significant differences at abutment screw loosening rate between molar group (9.4%) and premolar group (2.6%) (P<.019). According to the type of opposing teeth, there were statistically significant differences between nature teeth (74.7%) and implant (25.0%), removable denture (3%) (P<.019). The other possible factors did not have a significant effect on loosening of the abutment. Conclusion: The incidence of abutment screw loosening in posterior restoration was 7.4%. Abutment screw loosening were more likely to occur in molars group than premolar group, and according to the opposing teeth, there were the greatest frequency in nature teeth than implant and removal denture. There was a statistically significant difference.

A retrospective study on survival rates of dental implants in elderly patients (노인 환자에서 임플란트의 생존율에 대한 후향적 연구)

  • Shin, Hee-Jong;Yu, Sang-Joun;Kim, Byung-Ock
    • The Journal of the Korean dental association
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    • v.53 no.5
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    • pp.326-347
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    • 2015
  • 목적: 노인 환자에서 식립된 임플란트의 생존율을 조사하고 다양한 요인에 따라 생존율에 미치는 영향을 후향적으로 평가하고자 하였다. 재료 및 방법: 2001년 1월부터 2007년 12월까지 조선대학교 치과병원 치주과에 내원한 65세 이상 노인 환자 56명에게 식립된 138개의 임플란트를 대상으로 하였다.(남자 38명, 여자 18명, 평균 연령$69.38{\pm}3.91$세) 임플란트 생존율은 환자 성별 및 연령, 전신질환 유무, 치아 상실 원인, 식립 위치, 임플란트 직경 및 길이, 골질, 골이식 여부, 상부 보철물 유형에 따라 조사되었다. Kaplan-Meier survival analysis을 통해 각 요인에 따른 누적 생존율을 조사하였고, chi-square test를 통해 누적 생존율과 각각의 요인 간의 통계학적 유의성을 평가하였다. 결과: 보철물 시적 후 5 ~ 140개월 간 추적 관찰을 시행하였다. 65세 이상 노인 환자 56명에게 식립된 총 138개의 임플란트 중 추적 관찰 기간 동안 5개의 임플란트가 실패하였다. 그 중 63개의 임플란트는 환자가 정기적인 내원 약속에 응하지 않아 도중에 조사대상에서 제외되었으며, 결과적으로 5년간 누적 생존율은 94.9%였다. 임플란트 생존율에 영향을 미치는 다양한 요인 중 골질 (P=0.037) 및 상부 보철물 유형 (P=0.015) 간에 누적 생존율이 통계적으로 유의한 차이가 있었다. 그외 연령, 성별, 전신질환 유무, 치아상실 원인, 식립 위치, 임플란트 직경 및 길이, 골이식 유무 관련 요인과 누적 생존율 사이에는 통계적으로 유의한 차이가 없었다. 결론: 여러 한계가 있었지만 노인 환자의 무치악 부위에 있어 임플란트는 장기간에 걸쳐 예지성 있고 받아들여질 만한 치료이면서 적은 합병증과 실패율을 가진다.

Flexible IARPD considering the prevention of combination syndrome: a case report (Combination syndrome 예방을 고려한 flexible IARPD 증례)

  • Kim, So-yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.347-353
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    • 2022
  • Traditional denture treatment is often performed in patients with the completely edentulous maxilla and the bilateral edentulous posterior mandible. However, with a long-term prognosis, a complication called 'combination syndrome' may occur in this oral environment. In this case, by applying an implant-assisted removable partial denture (IARPD), it is possible to preserve the alveolar bone and prevent combination syndrome. In this case, when additional implants are placed in the edentulous area, the stress applied to the abutment due to the movement of the removable denture can be reduced, so it is possible to design an esthetic clasp using resin rather than metal, and flexible denture base resin is used. As a treatment for maxillary complete denture and mandibular flexible IARPD, it showed an esthetic and functional long-term prognosis with minimal cost and surgery.

Prevention and management of foreign body ingestion and aspiration during the dental treatment (치과 치료에서 발생하는 이물질의 삼킴과 흡인의 예방과 대처)

  • Jeon, Han-Sol;Lee, Jin-Han
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.2
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    • pp.63-71
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    • 2018
  • Prosthetic restorations through implants were popularized, and they became routine treatments. Small accessories used in the implant prosthodontic procedure are more likely to slip or fall off the dentist's hands. If the dental appliance or material passes into the upper gastrointestinal tract, there is a high possibility of excretion to the outside of the body without complications, but serious complications may occur depending on the type of foreign body. If the foreign body is passed to the airway, it is an emergency situation, and if it is not done properly, it can be fatal. The purpose of this review report is to investigate the process of foreign body ingestion or aspiration during dental treatment, and the method of prevention and treatment.

Fixed hybrid prosthesis (고정성 하이브리드 수복)

  • Hyun, Dong Geun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.27 no.1
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    • pp.24-40
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    • 2018
  • Often there are edentulous patients with severe vertical resorption of the alveolar ridge so that implant placement in the mandibular posterior is impossible. In this case, implants can be placed in the anterior portion of the mandible and the patient can be treated with an implant assisted overdenture, but the inherent discomfort of the removable prosthesis can not be overcome. However, if implants are appropriately placed between the mental foramen of both sides and a fixed hybrid prosthesis is fabricated to the patient, the patient will be satisfied without the inconvenience of the removable prosthesis. However, the treatment plan should be well designed to prevent disadvantages and expected complications of fixed hybrid prosthesis. Based on my clinical experience, I will explain treatment plan and protocol in detail.