• Title/Summary/Keyword: 연조직 심미성

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Implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition: A clinical report (하악 자연치열에 대합되는 상악 임플란트 전악 수복 증례)

  • Kim, In-Ju;Park, Jong-Hee;Park, Ju-Mi;Song, Kwang-Yeob;Ahn, Seung-Geun;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.51-57
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    • 2015
  • When an implant-supported maxillary full-arch fixed prosthesis is planned for patients with the horizontal and vertical bone resorption induced by periodontal disease, it is necessary to consider the masticatory function, esthetics and phonetics when placing implants. For this reason, thorough clinical and radiological diagnosis is necessary. Extensive bone and soft tissue grafting may be required as well. Since there is no clear guideline for proper number of implants, segment or splinting of substructure and method of retaining prosthesis, these should be considered during diagnostic process. This clinical report describes a patient who has experienced several tooth extractions and periodontal treatment due to severe periodontitis on maxilla and mandible. With bone and soft tissue graft before dental implant placement, the patient have satisfactory result in esthetic and functional aspect with the implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition.

Evaluation of nasolabial angle in adult patients with skeletal Class III malocclusion (성인 골격성 III급 부정교합 환자의 올바른 비순각 평가에 관한 연구)

  • Chang, Jun-Ho;Lee, Shin-Jae;Kim, Tae-Woo
    • 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.

ANALYSIS OF FACIAL SOFT-TISSUE CHANGES AFTER MANDIBULAR SAGITTAL SPLIT RAMUS OSTEOTOMY (하악 전돌증 환자의 하악지 시상 골절단술후 경조직 변화에 따른 안모 연조직 변화 분석)

  • Park, Hee-Dae;Kwon, Tae-Geon;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.87-108
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    • 1996
  • This study was intended to perform cephalometric analysis of the facial soft tissue profile after surgical correction of skeletal Class III malocclusion after SSRO in 29 patients (Males 12, females 17). Lateral cephalograms were taken in centric occlusion before and immediate, long term after surgeries. 1. Counter-clockwise rotation of mandible was observed after the surgery, average relapses of mandibular set back were 1.23-1.28mm. The net effects of the mandibular set-back after surgeries were 81.7-82.2%. Because these relapse tendencies may reduce the effects of the surgical outcomes, surgeon must consider these net before the surgical treatment planning. 2. The ratio of horizontal changes of hard tissue to soft tissue at lower lip, mentolabial sulcus, pogonion were 72.7-93.7%, 100.3%, 99.1-102.1% respectively. There were little changes at upper lip position anteroposteriorly. 3. The relationship of upper and lower lips were improved after surgery. Lower lip was posteriorly repostioned and upper lip was flattend and elongated in conjunction with deepening of inferior lobial sulcus. But profile of chin was still prominent after surgery. 4. Hard tissue horizontal changes and tissue vertical changes were significantly correlated with each other and there were reverse correlations with hard tissue vertical changes and soft tissue horizontal changes.

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A study on long-term soft tissue changes after superior repositioning of the maxilla (상악골의 수술적 상방이동에 대한 연조직의 장기적 변화에 관한 연구)

  • Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.29 no.5 s.76
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    • pp.627-635
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    • 1999
  • Soft tissue changes that occurred between presurgery to 5-years post-surgery in 49 orthognathic surgery patients whose maxillae were moved upward by Le Fort I osteotomy were examined by lateral cephalometric film. The objective of this paper was to document soft tissue changes at long-term follow-up after superior repositioning of the maxilla and to relate soft tissue and hard tissue changes in this group. The results were as follows. 1. On average, soft tissue landmarks in the nose and the upper lip were not changed statistically significantly except superior movement of superior labial sulcus and forward movement of pronasale between presurgery and 5 years postsurgery. 2. Upward and forward movement of the lower lip were found at 5 years postsurgery in comparison with presurgery and genioplasty added this effects. 3. Upper lip length and vertical dimension of upper vermilion didn't show any significant changes, but increase of lower lip length and decrease of vertical dimension of lower vermilion were statistically significant between presurgery and 5 years post-surgery. 4. The decrease of upper incisor exposure and interlabial distance from presurgery to 1 year were continued from 1 year to 5 years and the amount of the decrease was more than that of vertical movement of the maxilla by surgery. 5. Long term changes in soft tissue landmarks from 1 to 5 years postsurgery exceeded hard tissue changes, meaning soft tissue moved down more than skeletal changes.

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Decoronation and implant restoration of ankylosed tooth resulted from anterior avulsion: A case report (전치부 탈구로 인한 유착치의 치관절제술 및 임플란트 수복 증례)

  • Hyeon Kim;Eunsu Lee;Woohyung Jang;Hyun-Pil Lim;Sangwon Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.26-32
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    • 2023
  • Dental trauma is common in active children and adolescents. Among them, in the case of ankylosis due to avulsion, diagnosis through clinical examination is important, and the treatment is important for esthetic prosthetic restoration after adulthood. This case is a case of esthetic prosthetic restoration of maxillary anterior teeth through decoronation and implant. After that, space was maintained for prosthetic restoration using a decoronated crown. After becoming an adult, precise implant placement and esthetic prosthetic restoration were possible using guide surgery. For soft tissue support, the temporary crown were replaced by changing the contours of the temporary crown, and the final esthetic prosthesis was fabricated by digital wax-up.

The laterally closed tunnel for the treatment of mandibular gingival recession in thin biotype patients: case report (얇은 치주 생체형 환자에서 교정 치료 후 발생한 하악 전치부 치은 퇴축에 대한 laterally closed tunnel procedure의 처치: 증례보고)

  • Kim, Hyun-Joo;Kwon, Eun-Young;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.253-259
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    • 2019
  • In this case report, gingival recession of the mandibular anterior teeth was treated with a laterally closed tunnel technique. Two patients had altered the inclination of mandibular anterior tooth during past orthodontic treatment and had periodontal thin biotype. The recipient site was formed by tunneling method, and the connective tissue graft obtained from the palatal side was placed in the tunnel, and the margins of flap were gathered at the center of the root and sutured. Despite the thin periodontal biotype, the root coverage was successfully obtained, keratinized gingiva was increased, and aesthetics were achieved by harmonizing with surrounding tissues in terms of shape and color.

Laterally positioned flap using subepithelial connective tissue graft for iatrogenic gingival recession treatment (상피하결합조직 이식을 동반한 측방변위 판막술을 통한 의원성 치은퇴축 치료 증례보고)

  • Lee, Sung-Jo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.4
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    • pp.330-337
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    • 2016
  • Gingival recession could occur after orthodontic or endodontic treatment. This could influence not only functional and aesthetic problem, but also patient's treatment satisfaction. There are a lot of techniques for preventing gingival recession, but laterally positioned flap with subepithelial connective tissue graft could get definite advantages such as increase of keratinized gingival width and harmonious color match between graft tissue and surrounding tissue. Clinician should select a right patient case and diagnosis with clinical and radiography exam. In a surgical procedure, getting enough amounts of subepithelial connective tissue and flap coverage should be taken into consideration. The clinical outcomes in this case report shows laterally positioned flap with subepithelial connective tissue graft could be a treatment with predictive outcome.

Prosthetic reconstruction of maxillary defect resulting from a traumatic fall in an elderly patient: A case report (낙상에 의해 상악 전치부에 외상을 입은 노인 환자에서 수술을 배제하고 고정성 보철물을 이용하여 수복한 증례)

  • Bae, Yoonjoo;Choi, Sunyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.75-80
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    • 2019
  • Fall is the most common cause of trauma in the elderly and a major reason of dental injury. Maxillary anterior region is the most vulnerable area to the traumatic fall. Loss of teeth and adjacent tissue in this area results in maxillofacial defects and inappropriate maxillomandibular relationship. Reconstruction of the loss requires comprehensive and careful planning to fulfill not only functional but also esthetic demand. Prosthetic approach can avoid surgically extensive intervention, reducing both treatment cost and time. This clinical report describes a 78-year-old woman with the loss of teeth and alveolar bone in maxillary anterior region due to a traumatic fall, rehabilitated with a metal-ceramic fixed dental prosthesis using gingival porcelain.

Full mouth rehabilitation of mandibular edentulous patient using implant hybrid prosthesis (하악 무치악 환자에서 임플란트 하이브리드 보철물을 이용한 전악 수복 증례)

  • Kim, Seong-Bin;Kim, Sung-Hoi;Park, Young-Bum;Moon, Hong-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.3
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    • pp.214-220
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    • 2013
  • Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported- overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

Conservative approach for anterior crown-root fractured teeth: forced eruption (상악 전치부 치관-치근 파절 증례에서의 보존적 접근법: 교정적 정출술)

  • Kim, Ji-Eun;Choi, Sung-Hyeon;Chang, Hoon-Sang;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.1
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    • pp.48-54
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    • 2020
  • In the case of crown-root fracture due to traumatic injury in anterior tooth and the fracture margin is located subgingivally, forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. Forced eruption is one of the easiest orthodontic approaches that can have an acceptable outcome and prognosis, and has a low incidence of relapse. However, using heavy forces or very fast movements can also cause tissue damage or ankylosis. The following case reports present forced eruption as treatment option of crown fracture in maxillary anterior teeth.