• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.95-98
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• 2017

Due to hypodontia, poor oral hygiene, and significantly more prevalent periodontal disease, patients with Down syndrome show higher incidence of edentulism. Oral rehabilitation of such patients is imperative but challenging as high rates of prosthesis failure are reported due to malocclusion, high masticatory force, and parafunctional habits. As CAD/CAM(Computer-Aided Design and Computer Aided Manufacturing) is the recent trend in prosthodontics, this report discusses the application of CAD/CAM in a Down syndrome patient. A 25-year-old patient with Down syndrome was presented to the Department of Pediatric Dentistry, Yonsei University Dental Hospital for oral examination. 5 maxillary teeth were missing, 3 were fully impacted, and 4 had grade III mobility. The patient underwent general anesthesia for extraction of impacted and mobile teeth, implant surgery, and final impression for prosthesis. Afterwards, CAD/CAM was used to design and manufacture a 10-unit zirconia bridge. However the bridge was fractured after 18 months due to the patient's bruxism and high masticatory force. Final impression taking, bite registration, cast fabrication, cast scanning, and prosthesis designing were not needed as CAD/CAM data remained. Previous CAD/CAM design was used to remanufacture the zirconia bridge. Down syndrome patients have malocclusion, high masticatory force, and parafunctional habits which increase the possibility of prosthesis fracture. CAD/CAM is beneficial for Down syndrome patients as previous digital records can be utilized for prosthesis repair or remake. In detail, application of CAD/CAM in remanufacturing decreases patient's discomfort of impression taking, shortens and simplifies dental laboratory procedures, and reduces clinician's effort of taking detailed final impressions or accurate bite registration. In conclusion, oral rehabilitation using CAD/CAM provides not only satisfactory levels of comfort, stability, and esthetics, but also easier repair or remake compared to conventional prostheses.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.1
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• pp.66-73
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• 2015

Alveolar bone loss and deformation can be a risk factor in removable prosthetic restoration treatment for partially or fully edentulous patients. The use of implants to solve this problem could improve the support, retention and stability of removable restoration. Attachments used in implant overdenture are versatile. The attachment should be selected according to the patients' conditions. Milled bar has been chosen when readymade bar could not be used because of the narrow distance between implants or firm stability and support of supra-structure were needed. Milled bar design is able to provide cross arch stabilization and comfortability to patients. However, it needs skilled laboratory procedures. Recently, the fabrication of milled bar has become simple and its suitability has been improved through the development of CAD/CAM system. In a 67-year-old female Alzheimer's disease patient with 8 implant fixtures on the fully edentulous site of mandible, implant overdenture with using milled bar and magnet attachment was planned. As rapid treatment was required, CAD/CAM system was used to make a simple laboratory procedure instead of a traditional fabrication process. With this system, implant overdenture with milled bar can be fabricated esthetically and functionally.

• The korean journal of orthodontics
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• v.37 no.4
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• pp.272-282
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• 2007

The purposes of this study were to evaluate the nasolabial angle changes between closed lip position at centric occlusion and relaxed lip position at which the bite is open so that the lips do not touch and to elucidate the significance of the relaxed lip position for dentofacial diagnosis. Methods: The subjects consisted of 60 (35 Males, 25 Females) skeletal Class III malocclusion adult patients (mean age 23.3 years) with anterior crossbite. Results: In Class III malocclusion adult patients, there were significant differences in the nasolabial angle changes between closed lip position and relaxed lip position. Using the cluster analysis, the subjects were divided into three groups according to the pattern of nasolabial angle change: Group 1 (N = 27, 45%, $-8\;{\sim}\;1$), Group 2 (N = 30, 50%, $2^{\circ}\;{\sim}\;17$), and Group 3 (N = 3, 5%, over 18). Conclusion: The results showed that the pattern of the nasolabial angle change between closed lip position and relaxed lip position varies in skeletal Class III malocclusion patients. Thus, relaxed lip position should be taken into account when diagnostic records are obtained and analyzed to accurately to evaluate the facial soft tissues and predict facial esthetics after surgical-orthodontic treatment.

• The korean journal of orthodontics
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• v.35 no.4 s.111
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• pp.302-311
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• 2005

This study was performed to compare the fatigue limit of stainless steel wires and Fiber-reinforced composites (FRC) under conditions of permitting physiologic tooth movement. and to evaluate the clinical value of FRCs which was used to reinforce the anchorage unit. The stainless steel wire groups were divided into round and rectangular wire groups. The FRC groups were divided into uni-directional and woven groups, with resin coating and without resin coating in the Proximal area After the number of cycles to failure of each of the 6 groups were measured within the $5{\times}10^5\;cycle$ fatigue limit simulating the orthodontic treatment period. the fatigue limit of each group was compared with each other The findings of this study were as follows. In stainless steel wires, the fatigue limit of rectangular wires were higher than that of round wires. But there was no statistically significant difference (p>0.05). In FRCs with resin coating and without resin coating in the interproximal area, the fatigue limit of uni-directional type was higher than that of the woven type (p<0.05). In uni-directional and woven type FRCs, the fatigue limit of FRC with resin coating in the interproximal area was higher thar that of FRC without resin coating (P<0.05) As the FRCs and stainless steel wires did not fracture until the $5{\times}10^5\;cycle$ fatigue limit which clinically is useful. it is sufficient to use FRC and stainless steel wire for reinforcing anchorage. When esthetics is important and the attachment of additional devices are necessary. it seems sufficient to use FRC as anchorage reinforcement.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.3
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• pp.554-563
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• 1999

For the purpose of elucidating the polymerization modes of dual-cure restorative materials and comparing them with single-cure restorative materials, a study was performed on the light-cured composite resin, dual-cure composite resin, dual-cure glass ionomer cement and chemical-cure glass ionomer cement. By measuring the microhardness of each material at 0mm, 1mm and 3mm depth during initial 24 hours with predetermined interval, the state of polymerization and degree of conversion was indirectly evaluated for each material, and obtained results are as follows : 1. All of four materials tested showed significant increase in microhardness after 24hrs compared with just after curing starts. 2. In all materials except Ketac-fil, there showed a significant difference in microhardness between each depth at each time interval. 3. In the test of lap time till final curing for each material, the polymerization process was revealed to last longer in the dual-cure type materials than in single-cure type materials at 3mm depth. Based on the results above, it was demonstrated with materials of dual-cure mode that the degree of conversion increases by successive curing reactions even in the deeper layers where sufficient curing light is impermeable.

• The korean journal of orthodontics
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• v.28 no.5 s.70
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• pp.741-750
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• 1998

This study was designed to evaluate the Personality characteristics of orthognathic surgery patients preoperatively and postoperatively through the MMPI. Comparison was made between the personality characteritics of preoperative and postoperative groups. Motivation for undergoing orthognathic surgery and postoperative satisfaction were examined through the questionnaire. Subjects used in this study consisted of 50 patients under presurgical orthodontic treatment and 22 patients who had received orthognathic surgery. From this study, the results were followings. 1. In preoperative patients group, all T-scores were within the normal range except for K-scale. The T-score of K-scale is 57.7, this showed that these patients underwent some or less stress. 2. In postoperative patients group, all T-scores were within the normal range. 3. Only in K-scale, there was statistically significant increase after surgery (p<0.05). 4. In male patients group, all T-scores were within the normal range except for that of preoperative K-scale. Postoperatively, there were statistically significant increase in K and Hs scales(p<0.05) 5. In female patients group, all T-scores were within the normal range. 6. Motivation for undergoing orthognathic surgery could be divided into 4 categories. esthetic goal($28.2\%$), functional goal($32.1\%$), TMJ problem($9.0\%$), and psychosocial reason($30.7\%$). 7. The degree of postoperative satisfaction was quite high($85.7\%$). $14.3\%$ of all patients were very satisfied, $71.4\%$ were satisfied, $9.5\%$ were neither satisfied or dissatisfied, and $4.8\%$ were very dissatisfied.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.5
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• pp.582-595
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• 2003

Statement of problem : Most posts are metallic, but in response to the need for a post that possesses optical properties compatible with an all-ceramic crown. an esthetic post has been developed. Although there have been many studies about the esthetic post materials, 3-dimensional finite element studies about the stress distribution of them are in rare. Purpose : The purpose of this study is to investigate comparatively the distribution of stresses of the restored, endodontically treated maxillary incisors with the esthetic post materials and the displacement on the cement layer on simulated occlusal loading by using a 3-dimensional finite element analysis model. Material and method : Four 3-dimensional finite element models were constructed in a view of a maxillary central incisor, a post, a core, and the supporting tissues to investigate the stresses in various esthetic posts and cores and the displacement on the cement layer (Model 1 ; Cast gold post and core, Model 2 ; Glass fiber post with composite core, Model 3 ; Zirconia post with composite core. Model 4 ; Zirconia post with ceramic core). Force of 300N was applied to the incisal edge and the cingulum (centric stop point) with the angle of 135-degree to the long axis of the tooth. Results : 1. The stresses and displacement on the incisal edge were higher than on the cingulum 2. The stresses in dentin were the highest in Model 2 (Glass fiber post with composite core), and the second was Model 3, the third Model 1, and the lowest Model 4. 3. The stresses in post and core were the highest in Model 4 (Zirconia post with ceramic core), and the second was Model 1, the third Model 3, and the lowest Model 2. 4. The displacement on the cement layer was the highest in Model 2 (Glass fiber post with composite core), and the second was Model 3, the third Model 1, and the lowest Model 4. Conclusion : When a functional maximum bite force was applied, the distribution of stresses or the esthetic post and core materials and the displacement on the cement layer were a little different. It seems that restoring extensively damaged incisors with esthetic post and core materials would be decided according to the remaining tooth structure.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.5
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• pp.640-655
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• 2003

Statement of problem : The beauty has a little different meaning according to a time, culture, and nation. Purpose : This study was undertaken to determine the Korean perception of the altered upper anterior dental esthetics including the lack of symmetry, the midline deviation, the gingival exposure, the inclination of incisal plane, the type of incisal plane, and the type of gingival line. Material and Method : 670 subjects were participated in this survey. A questionnaire accompanied by 12 sets of computer-manipulated images using 3D MAX 4.2 software was used to record the ranking of the geometric preference related to the anterior esthetic discrepancies in three or four degrees of alteration. The statistical significance of the differences between the groups was determined by a one-way ANOVA and a t-test. Results : The results obtained were as follows: 1) The Korean perception of the anterior dental esthetics according to the subjects' occupation, sex, and age was most affected by occupation. 2) The masked image emphasizing the dentition and lips appeared stranger than the non-masked image at the same alteration. 3) The lack of symmetry, which was expressed as a unilateral discoloration of the tooth, showed incongruity in any teeth of the anterior dentition. The incongruity was more severe as the degree occurred closer to the midline. 4) The deviation of midline was showed more severe strangeness as the degree of deviation increased. However, more than half of the subjects did not perceive a deviation of 5mm. 5) During smiling, the exposure of the upper gingiva showed more severe incongruity as the degree of gingival exposure increased. 77% of the subjects perceived strangeness at the gingival exposure of 4.5mm. 6) The inclination of the incisal plane appeared stranger as the degree of inclination increased. 62% of subjects perceived strangeness at the $7.5^{\circ}$ inclination of the incisal plane. 7) The type of incisal plane showed increasing strangeness in the order of convex/downward, straight/horizontal, and concave/upward. 80% of subjects perceived strangeness at concave/upward. 8) The type of gingival line was showed increasing incongruity in the order of the same, a little above, and a little under the zenith of the lateral incisor to the line joining the zenith of the central incisor and the canine. However, less than half the subjects did not perceive strangeness at any alteration of the gingival line. Conclusion : The Korean perception of the upper anterior dental esthetics was different to the westerner's perception in the some respects.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.375-383
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• 2018

Clinicians are faced with many difficulties when planning prosthodontic restorations with implants in a complete edentulous patient. When planning fixed implant prosthetics, it is often necessary to have additional surgery due to highly reduced alveolar bone, as well as high treatment costs and long-term treatment durations can be required. In addition, lack of interocclusal space can be a problem when planning implant supported overdentures. In this study, we planned to place a small number of implants on the anterior maxilla and used them as the abutments for distal-extension removable partial dentures on the posterior side in a maxillary fully edentulous patient. This would reduce the possibility of additional invasive operations such as alveolar bone graft, shorten the treatment time, and be relatively easy for elderly patients to burden. In this case, the patient was provided with a distal-extension removable partial denture and anterior implant fixed prostheses, which was similar to the previous one, and showed good adaptation, and chewing efficiency and esthetics was recovered.