• The Journal of Korean Academy of Prosthodontics
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• v.60 no.2
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• pp.168-174
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• 2022

In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.3
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• pp.222-228
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• 2011

Purpose: The purposes of this study were to evaluate the stress distributions and the displacements of obturator for edentulous maxillectomy patients and to compare them with those of complete denture using three-dimensional finite element analysis. Materials and methods: Based on the CT image of edentulous patient, three-dimensional finite element model of edentulous maxillae was constructed. Three-dimensional finite element model of edentulous maxillae with palatal defect was also fabricated. On each model, complete denture and obturator prosthesis were created. Vertical static force of 200 N was applied on the left maxillary premolar and molar region. The von Mises stress values and the displacements of models were analyzed using three-dimensional finite element analysis. Results: Maximum von Mises stress values were recorded in the cortical bones of both models. The von Mises stress value in the complete denture model was 2.73 MPa and 2.69 MPa in the obturator model. High von Mises stress values were also observed on the tissue surface of prosthesis. The maximum value of the displacement in the obturator was higher than that of complete denture. Conclusion: The obturator showed a worse result in terms of stress distribution and displacement than complete denture. In the prosthodontic rehabilitation of edentulous maxillectomy patient accurate impression procedure based on patients'anatomy and application of prosthodontic principle should be considered.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.354-359
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• 2018

In a single implant restoration of maxillary anterior teeth, it is difficult to accomplish an aesthetic restoration of the implant prosthesis in the case of gingival recession and bone defect problems. To maintain aesthetic stability in the long term, it is important to place the implant in the ideal position as well as the recovery of the soft tissue and harmony with the prosthesis. Not only ideal implant position but also the harmony with surrounding soft tissues are important to fabricate aesthetic implant prosthesis for these cases. for these cases, a 47- years -old male with lowered level of osseous crest and gingival recession on maxillary anterior tooth was treated with guided bone regeneration and gingival recontouring.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.319-324
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• 2017

Patients with maxillectomy defects predisposed to not only difficulty in deglutition, mastication, speech but also psychological depression from impaired facial esthetics that affect life quality. Obturator prostheses play a important role in restoring the lost form, function and the quality of life for patients with maxillectomy defects. This clinical report presents the simplified approach to predict the degree of adequate facial support by Artificial palate which reflected from a maxillary interim obturator during the stabilization period after maxillectomy.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.238-247
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• 2021

Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.15-26
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• 2006

흡수성 차페막을 이용한 조직 유도 재생술시 차폐막의 견고성으로 미루어 보아 재생을 위한 공간의 유지가 어려울 수 있다. 조직 유도 재생술과 함께 골이식술을 시행함으로써 공간 확보와 함께 적절한 혈병의 유지를 도모할 수 있고 이식된 골은 선생골 형성을 위한 핵으로 작용할 수도 있다. 최근에 사람의 치아회분말과 연석고를 혼합한 골이식재가 여러 연구를 통해 좋은 골이식재로 평가되었다. 본 연구에서는 성견 하악 소구치 2급 치근이개부위에 외과적으로 형성하여 흡수성 차폐막과 치아회분말-연석고 혼합 이식재를 이용한 조직유도재생 술을 시행하여 치주 조직 재생의 양상을 조직학적으로 관찰하고자 한다. 생후 12개월에서 16개윌 된 체중 15 Kg 내외의 성견 4마리를 이용하였다. 실험 재료로 생체흡수성 차폐막 (Biogide(R), Swiss) 를 사용하였고, 골이식재로 치아회분말-연석고를 혼합매식 하였다. 양측 상악 소구치 부위에 변연 치조골하방에 4 mm ${\times}$ 4 mm ${\times}$ 4 mm, (깊이 ${\times}$ 근원심 ${\times}$ 협설폭경) 깊이로 골내낭을 형성하였다. 형성된 골내낭의 기저부위 치근 표면에 1/4 round bur로 notch를 형성하여 참고점으로 하였다. 무작위로 선택된 한 쪽의 결손부를 대조군으로 오직 생체 흡수성 차폐막을 사용하였고, 실험군으로 치아회분말-연석고와 생체 흡수성 차폐막을 결손부로부터 2 mm 이상 덮을 수 있도록 다듬어 결손부 위에 위치시킨 후 협측 판막을 덮고 봉합하였다. 4주 후 2마리 ,8주 후 2마리를 희생시키고 통상의 방법으로 고정, 탈회, 포매의 과정을 거쳐 광학 현미경으로 검경하였다. 그 결과, 1. 4주 대조군에서 Bio-gide(R)는 완전한 흡수를 보였고, 치근이개부내에는 큰 공간이 존재하였다. 2. 4주 실험군에서 역시 Bio-gide(R)는 완전한 흡수를 보였고, 골 결손부내에 더 많은 신생골 관찰되었다. 그러나 아직까진 기존골과 신생골간에 명확한 차이가 있어서 쉽게 구분할 수 있었다. 또한 골이식재 주변으로 파골세포가 다수 관찰되며 이로 미루어 보아 활발한 골흡수가 일어남을 알 수 있었다. 3. 8주 대조군에서 결손부내에서는 기존골에 인접하여 신생골 형성이 부분적으로 일어났으나 연조직 침입이 관찰되었다. 4. 8주 실험군은 신생골이 기존골과 매우 유사한 형태로 관찰되었고, 신생골 형성 부위에 신생 혈관 증식이 관찰되었다. 또한 골내낭 기저부위에서는 백악질과, 치주인대가 재생됨이 관찰되었다. 이상의 결과에서 치아회분말-연석고 혼합매식은 골재생을 위한 골전도성이 있는 재료로 사료되며, 이를 이용히여 치주조직재생술시 흡수성 차폐막과 병행하여 사용한다면 더 많은 골재생이 있을 것으로 기대된다.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.291-298
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• 2017

It is challenging to produce esthetic implant restoration in the narrow anterior maxilla region where insufficient volume of alveolar bone could limit the angle and position of implant fixture, if preceding bone augmentation is not considered. Ideal angle and position of implant fixture placement should be established to reproduce harmonious emergence profile with marginal gingiva of implant prosthesis, bone augmentation considered to be preceded before implant placement occasionally. In this case, preceding bone augmentation has been operated before esthetic implant prosthesis in narrow anterior maxilla region. Preceded excessive bone augmentation in buccal area allowed proper angulation of implantation, which compensates unfavorable implant position. Provisional restorations were corrected during sufficient period to make harmonious level of marginal gingiva and interdental papilla. The definite restoration was fabricated using zirconia core based glass ceramic. Functionally and esthetically satisfactory results were obtained.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.28 no.2
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• pp.74-85
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• 2019

The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. A newer technique, VIP-CT (Vacularized Interpositional Periosteal Connective Tissue) graft has been introduced as an alternative to these technique which allows the clinicians perform large volume soft tissue augmentation in esthetic sites with a single procedure. The advantages of the VIP-CT graft technique are that it allows the reconstruction of large soft tissue deficiency, with little constriction postoperatively. Furthermore, it facilitates improved hard tissue augmentation due to the additional blood supply and improved bone healing by mesenchymal cells. Moreover, this technique reduces patient discomfort and treatment time. This clinical report describes the procedure of bone augmentation during immediate implantation in facial dehiscence defect, especially Vascularized Interpositional Periosteal Connective Tissue(VIP-CT) graft for aesthetic anterior soft tissue.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.403-408
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• 2005

Ankylosis is defined as a fusion of cementum or dentine with alveolar bone. Due to the loss of the periodontal ligament on the ankylotic area, the tooth is incapable of continued eruption and hence is unable to follow the normal vertical development of the neighboring teeth and alveolar process. A 6-year-old female was referred to the Dept. of Pediatric Dentistry for ankylosis of primary molars and congenital missing of permanent premolars on both jaws. She had neither specific past medical history nor trauma and infection history in oral and maxillofacial region. Radiographic finding is that the maxillary primary molars were the early onset of ankylosis and had fast root resorption rate. However the mandibular primary molars were ankylosed later and being resorbed slower than maxillary primary molars. The object of treating this case is to maintain the proper alveolar bone growth and retention of deciduous molars. The point of managing this case is as follows: Proper treatment (observation, restoration, or extraction) should be established after thorough consideration of the time of onset, the root resorption rate, progression of infraocclusion and the development of alveolar bone support. We should consider the timing of extraction of the ankylosed teeth without problem of neighbouring alveolar bone growth and tilting of adjacent teeth in the view of growth spurt. Early diagnosis is important to avoid many of the complications with infraoccluded primary molars.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.1
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• pp.80-86
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• 2011

When a tooth adjacent to implant has coronal damages caused by severe dental caries or fracture, the clinical crown lengthening by forced eruption makes it possible to get esthetic restoration due to the prevention of alveolar crestal bone resorption and loss of interdental papilla. A 54-years-old male patient wanted prosthetic treatment because his anterior 3 unit bridges had fallen out. A right maxillary central incisor showed mild dental caries but a right maxillary canine lost most clinical crowns. Forced eruption combined with a gingival fiberotomy of a right maxillary canine was performed for 1 month after the dental implant had been simultaneously placed with bone grafts on a right maxillary lateral incisor. About 5 months after implant placement, 2nd surgical operation was performed. The provisional restorations were adjusted to make esthetic gingival contour for 8 weeks. The porcelain fused gold restorations were fabricated and set. The patient was satisfied with the final restorations in esthetic and functional aspect.