• The korean journal of orthodontics
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• 제36권5호
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• pp.388-396
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• 2006

Treatment of skeletal Class III malocclusion with mini-implant anchorage is discussed in relation to vertical control of the maxillary posterior dentoalveolar region and horizontal control of mandibular anterior teeth. A midpalatal mini-implant provided anchorage for intruding the maxillary posterior teeth. Mandibular mini-Implant implants were used to bring about labioversion of mandibular anterior teeth. After mandibular setback surgery, improvement of the facial profile was obtained both horizontally and vertically, Total treatment time was 11 months. Stable occlusion was maintained after 18 months of retention, The effectiveness and efficacy of mini-implants for the treatment of skeletal Class III malocclusion are also discussed.

• The Journal of Korean Academy of Prosthodontics
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• 제36권1호
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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.

• Journal of Biomedical Engineering Research
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• 제21권6호
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• pp.599-606
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• 2000

고정체 나사산 형상이 식립된 고정체를 둘러싸고 있는 턱 뼈에서 발생된 응력분포에 미치는 영향과 효과적인 나사산 형상을 결정하기 위해서 다양한 치아 고정체 형상에 대해서 응력해석을 수행하였다. 나사산 골 한쪽 부위에 라운딩이 된 형상의 고정체에서 발생된 응력분포는 다른 나사산 형상의 고정체에서 발생된 응력분포보다 더 효과적으로 나타났다. 이 해석 결과를 근거로 최적의 고정체 치수를 결정하기 위해서 나사산 끝단의 폭, 나사산 높이, 그리고 가해지는 하중의 방향 등과 같은 설계 변수의 변화에 따른 응력해석이 수행되었다. 최대 응력 집중은 고정체 나사산의 첫단 부위에서 발생하였으며, 100 N의 15도 경사하중이 가해졌을 때 발생된 최대 등가응력은 동일 크기의 수식하중보다 2배 정도 더 높게 나타났다. 그리고 나사산 끝단의 폭과 나사산 높이 사이의 연관성에 관련된 해석결과에서 나사산 끝단의 폭과 나사산 높이 사이의 연관성 효과는 무시할 만큼 작다는 것을 알았다. 고정체의 나사산 피치에 대한 나사산 끝단의 폭의 비와 나사산 높이의 비가 각각 0.5와 0.46일 때 다른 고정체의 치수들보다 더 효과적인 응력분포가 나타났다

• The Journal of Korean Academy of Prosthodontics
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• 제50권2호
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• pp.119-127
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• 2012

Purpose: This study was performed to compare the stress distribution pattern of abutment-fixture connection area using 3-dimensional finite element model analysis when 5 different implant systems which have internal connection. Materials and methods: For the analysis, a finite element model of implant was designed to locate at first molar area. Stress distribution was observed when vertical load of 200 N was applied at several points on the occlusal surfaces of the implants, including center, points 1.5 mm, 3.0 mm away from center and oblique load of 200 N was applied $30^{\circ}$ inclined to the implant axis. The finite element model was analyzed by using of 3G. Author (PlassoTech, California, USA). Results: The DAS tech implant (internal step with no taper) showed more favorable stress distribution than other internally connected implants. AS compare to the situations when the loading was applied within the boundary of implants and an oblique loading was applied, it showed higher equivalent stress and equivalent elastic strain when the loading was applied beyond the boundary of implants. Regardless of loading condition, the abutments showed higher equivalent stress and equivalent elastic strain than the fixtures. Conclusion: When the occlusal contact is afforded, the distribution of stress varies depending on the design of connection area and the location of loading. More favorable stress distribution is expected when the contact load was applied within the diameter of fixtures and the DAS tech implant (internal step with no tapering) has more benefits than the other design of internally connected implants.

• The Journal of Korean Academy of Prosthodontics
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• 제46권4호
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• pp.359-371
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• 2008

Purpose: The purpose of this study was to investigate the stress distribution in mandibular implant overdentures with telescopic crowns compared to bar attachment. Material and methods: Three-dimensional finite element models consisting of the mandibular bone, 4 implants, and primary bar-splinted superstructure or secondary splinted superstructure with telescopic crowns were created. Vertical and oblique loads were directed onto the occlusal areas of the superstructures to simulate the maximal intercuspal contacts and working contacts such as group function occlusion. Maximum stress and stress distribution were analysed in mandibular bone, implant abutments, and superstructures. Results: 1. In comparison of von Mises stress on mandibular bone, telescopic overdenture had a little lower stress values in vertical load and working side load except oblique load. In the mandible, the telescopic overdenture distributed more uniform stress than the bar overdenture. 2. In comparison of von Mises stress on implant abutments, telescopic overdenture had much lower stress values in all load conditions. In implant abutments, the telescopic overdenture distributed stress similar to the bar overdenture. Stress was concentrated on the distal surfaces of the posterior implant abutments in both mandibular overdentures. 3. In comparison of von Mises stress on superstructures, the telescopic overdenture had much more stress values in all load conditions. However, the telescopic overdenture distributed more uniform stress on superstructure than the bar overdenture. In the bar overdenture, stress was concentrated on each cental area of bar structures and connected area between implant abutments and bar structures. Conclusion: In the results of this study, the telescopic overdenture had lower stress values than the bar overdenture in mandibular bone and implant abutments, but more stress values in superstructures. However, if optimal material was selected in making superstructures, the telescopic overdenture was compared to the bar overdenture in stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• 제51권3호
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• pp.183-189
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• 2013

Purpose: The aim of this study was to evaluate clinical outcomes of implant supported fixed-hybrid prostheses (FHP) in the fully edentulous arches. Materials and methods: Patients in this retrospective study were restored with fixed-hybrid prostheses supported by 4 to 6 implants and functioned more than 1 year of loading. Outcome measures were marginal bone change of implant related with sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients, tilting of posterior implant by Mann- Whitney U test and cantilever length of superstructure by regression analysis, and complication rates. Significance level was set P<.05. Results: A total number of 84 implants (16 restorations) placed in 16 patients were observed for 28 months and mean marginal bone loss was $0.53{\pm}0.39mm$. There were no differences of marginal bone loss according to sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients (P>.05), and cantilever length was not significantly related with a marginal bone loss of implant next to cantilever (P>.05). Complication was shown in 11 patients and veneer fracture and dislodging of artificial teeth were most prevalent. Conclusion: Within the limitations of this study, although marginal bone loss of FHP was very little, complication rates were high. Irrespective of tilting of most posterior implants, marginal bone loss of most posterior implants next to cantilever was less than those of the other implants positioned anteriorly. Cantilever length (<17 mm) did not affect a marginal bone loss of most posterior implants.

• The korean journal of orthodontics
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• 제40권4호
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• pp.250-259
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• 2010

Objective: Intraoral noncompliance upper molar distalization techniques have gained in popularity and have subsequently found to be successful in Class II correction. The aim of the present study was to introduce a screw supported intraoral distalization appliance and investigate its efficiency. Methods: Twenty-one subjects (11 females, 10 males; average age of 14.9 years) with Angle Class II malocclusion participated in this study. Two screws were inserted behind the incisive foramen and immediately loaded to distalize the upper first molars. An intraoral screw supported distalization appliance was used to distalize the upper molars in order to achieve a Class I molar relationship. Skeletal and dental changes were evaluated using cephalometric and three-dimensional (3D) model analysis. Results: Upper molars were distalized 3.95 mm on average and a Class I molar relationship was achieved without any anchorage loss. The upper molars were tipped only $1.49^{\circ}$ and the upper right and left molars were rotated only $0.54^{\circ}$ and $0.74^{\circ}$ respectively which were statistically non-significant (p > 0.05). Conclusions: The newly designed screw supported noncompliance distalization appliance was found to be an effective device for achieving bodily molar distalization without any anchorage loss.

• Journal of Dental Rehabilitation and Applied Science
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• 제28권2호
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• pp.179-190
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• 2012

The installation of an implant in the distal extension area to assist a partial dentrue (IARPD) was used carefully in clinical situations. The purpose of this review on the IARPD is describing the concept, clinical results and guidelines of IARPD. For the review, a literature search was performed using the PubMed. The data from the literature suggest that the placement of the implants could improve function and patient satisfaction. In addition, IARPD reduced the residual ridge resorption. Longer and wider implant should be placed. Less than $15^{\circ}$ angulation may be not harmful. To prevent the loosening of the abutment, modified abutment or resilient attachment should be used. However, the connection method between the clasp retention and IARPD should be considered for long time success. Moreover, longitudinal clinical studies are required for evaluation of IARPD.

• The Journal of Korean Academy of Prosthodontics
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• 제57권4호
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• pp.439-447
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• 2019

The distance between the natural teeth and the implants is an important factor in preserving the periodontal tissues and esthetics. And abnormal positional displacement and tilting of the teeth during restorative procedure may require intentional root canal treatment and may affect masticatory function. This report is to present a successful full mouth rehabilitation of a patient with uneven dentition and collapsed occlusion using orthodontic and implant treatment. The patient had no symptoms or discomfort of temporomandibular joint disorder such as pain or sound. The orthodontic treatment was continued until implant provisional prosthesis delivery. And the vertical height of occlusion was elevated 2mm on anterior basis for anterior teeth protection and esthetics. After the orthodontic treatment, the implant abutments and natural teeth were finally restored with porcelain-fused-to-metal crowns and bridges. Satisfactory function and esthetic outcomes are observed after 6months of follow up.

• Journal of Dental Rehabilitation and Applied Science
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• 제35권1호
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• pp.37-45
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• 2019

In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.