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.
Journal of Dental Rehabilitation and Applied Science
/
v.25
no.4
/
pp.349-360
/
2009
Purpose: As the esthetic demands of dental implant patients are increased, the demands of zirconia as implant abutment material are also increased. It has non-metalic color, good biocompatibility, high strength and high toughness. Even thought the advatage of zirconia abutment, there are a few studies about mechanical properties of zirconia abutment. This study evaluated the mecanical strength with compressive bending strength and endurance limit of implant-zirconia abutment assembly. Materials and Methods: Static and cyclic loading of implant-Zirconia abutment assembly were simulated under worst case condition according to ISO. Test groups were implants of external butt joint with straight regular diameter and angled regular diameter zirconia abutment, implant of external butt joint with narrow straight diameter zirconia abutment and implant of internal conical joint with straight narrow diameter zirconia abutment. All test group were evaluated the mecanical strength with compressive bending strength and endurance limit. After fatique testing, fracture surface were examined by SEM. Results: The compressive bending strengths exceed 927N. Regular diameter zirconia abutment were stronger than narrow diameter zirconia abutment(P<.05). The endurance limits ranged from 503N to 868N. Conclusion: Within the limitation of this study, zirconia implant abutment exceeded the estabilished values for maximum incisal biting forces reported in the literature.
Journal of the korean academy of Pediatric Dentistry
/
v.34
no.1
/
pp.53-61
/
2007
In case of missing tooth caused by dental caries or periodontal disease, it can be restored by various methods, and there has been much interest in implant and tooth transplantation. The success of tooth transplantation is going to be attained through the knowledge of growth, development and calcification of tooth. Tooth transplantation has been experimented in vivo and in vitro. Many animals such as rats, mice, cats and dogs are used for tooth transplantation experiment in vivo. In most experiments, tooth was transplanted into the extraoral site, but rare into the intraoral site In this study, to observe the capacity of formation and mineralization of tooth germ, first molar of a matured white rat was extracted and the cap stage tooth germ of a 13.5 Embryonic day embryo rat was transplanted into the extracted socket. The rats were killed 6 months later and the radiographical and histological results are as followings. 1. Tooth germ transplanted for 2 and 6 months are developing calcified tooth material such as dentin, cementum, pulp tissue, and epithelium around enamel space in the maxilla was seen. 2. The epithelium around enamel space was located beneath the oral epithelium and contained connective tissue and periodontal ligament. 3. Tooth formation was progressed as transplantation period but the size of newly formed tooth was small and the shape of tooth was incomplete.
Three dogs were admitted for repair of bone fracture. Case 1 (Maltese, 1.8 kg, intact female, 5-month-old) and case 2 (poodle, 3.0 kg, intact female, 6-month-old) had non-weight bearing lameness in the left pelvic limb, and case 3 (mixed, 3.3 kg, intact female, age unknown) had non-weight-bearing lameness in the left thoracic limb. On orthopedic examination, there was pain, crepitus, palpable instability and substantial soft tissue swelling on the affected side. No neurological deficits were identified. Radiographs revealed left proximal metaphyseal tibial and fibular fractures in cases 1 and 2, and left proximal metaphyseal radial and ulnar fractures in case 3. All cases had closed long-bone fractures with short juxta-articular fracture segments. Under fluoroscopic guidance, proper placement of the ring fixation elements was confirmed during surgery. Two or three rings were used to stabilize fractures with traditional circular external skeletal fixators (CESF). Postoperative radiographs showed acceptable alignment and apposition of the previously identified fracture. Time to radiographic union ranged from 5 to 14 weeks and there were no signs of implant failure or pin tract infection. Functional outcomes were excellent in all cases. CESF can be successfully used to reduce short juxta-articular fractures in which bone plates or external skeletal fixation cannot be applied.
Lee Yu-Mi;Lee Eun-Jung;Yeom Dong-Sun;Kim Do-Soon;Yee Sung-Tae;Kim Byung-Il;Cho Hyun-Wook
Journal of Life Science
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v.16
no.2
s.75
/
pp.302-309
/
2006
To evaluate the biocompatibility of untreated and anodized titanium specimens, the specimens were implanted in the subcutaneous tissue of the abdominal region of female mice for two weeks. The reaction of connective tissue to specimens was histologically studied. The implants were encapsulated by fibrous connective. tissue consisting of fibroblast, fibrocyte and other cellss including neutroophil, macrophage and giant multinucleated cell. some newly formed blood vessels were located in the fibrous capsule surrounding the implant. Giant multinucleated cells were observed at the fibrous capsule adjacent to the implant. Kind of cell types and the thickness of fibrous capsules were examined quantitatively. Most of cell types located in the fibrous capsule were fibroblast and fibrocyte. The average thickness of fibrous capsules for the anodized specimens was much thinner than that of the untreated titanium specimen. Biocompatibility of titanium specimens were also studied by using cell culture method. The number of MG-63 cells was significantly increased on the anodized titanium specimens in vitro experiment. Our observations suggest that anodized titanium specimens are more effective for the improvement of biocompatibility in vivo and in vitro.
Purpose: The purpose of this study is to assess the effectiveness of beta-tricalciumphosphate (${\beta}$-TCP) as a bone graft material on new bone formation and regeneration of mandible bone defect around dental implants. Methods: Both mandibular sites of ten rabbits were exposed. The experimental subjects were divided into two groups. Rabbits in the control group (right site of the mandible) had dental implants around cortical bone defects, without treatment, while, in the experimental group (left site of the mandible), ${\beta}$-TCP was grafted into the bone defect around the implant. Rabbits were sacrificed after one, two, three, four, and eight weeks, and histomorphometric evaluation and analysis of the bone implant contact rate were performed using an optical microscope. Results: Bone formation rates in the experimental group were greater than those in the control group from one to eight weeks, and percentages of implant surface contacted to bone were greater in the experimental group than in the control group from three weeks after implantation. Conclusion: These results suggest that the bone formation activity around dental implants was increased by osteoconduction activity of ${\beta}$-TCP.
Song, Young Woo;Yoon, So-Ra;Cha, Jae-Kook;Lee, Jung-Seok;Choi, Seong-Ho;Jung, Ui-Won
The Journal of the Korean dental association
/
v.55
no.10
/
pp.676-687
/
2017
Objectives : The aim of this study was to evaluate the effects of a composite of bone substitute and collagen barrier membrane (bone patch) for local ridge augmentation at peri-implant dehiscence defects on the clinical efficacy and positional stability in dogs. Materials and methods : Implant placement and ridge augmentation procedure were performed at surgically created peri-implant dehiscence defects in canine mandible (n=6). Four treatment modalities were randomly applied: i) bone patch group, ii) Guided bone regeneration (GBR) without pin fixation group (bone graft and collagen membrane), iii) GBR with pin fixation group, and iv) negative control group. After 12 weeks, clinical, micro-CT and histological analyses were performed. Results : Histologic analysis showed that bone patch group had similar results to GBR group and GBR with fixation group in terms of new bone formation. Micro-CT analysis revealed similar results to histologic analysis in terms of total volume maintenance. Operating time was shorter in bone patch group compared to GBR group and GBR with fixation groups. Conclusions : GBR using bone patch could simplify the ridge augmentation procedure with reduced operating time and equivalent biological performance compared to the conventional procedure.
Pulsed Nd : YAG laser has been used to treat various soft tissue lesions. However, there have been warnings of using laser to treat peri-implantitis because the laser can alter the surface of implant and can rise its temperature so that it might be harmful to implant itself and its surrounding tissue. However, the study in vivo has not been done yet. The purpose of this study was to evaluate the biocompatibility to the pulsed Nd:YAG lased dental implant. 16 HA coated implants and 16 titanium plasma sprayed implants were used. They were divided 4 groups as unlased control, 0.3 watt, 1.0 watt and 2.0 watt lased groups after lasing. And they were implanted in the peritonial walls of 12 rabbits. The rabbits were sacrificed 6 weeks after implantation and the LM and EM specimems were made. 1. In the unlased implant group, both HA coated and titanium plasma sprayed implants were surrounded by fibroblasts and collagen fibers. No macrophages and inflammatory cells were seen. 2. In HA coated implants 0.3 watt, 1.0 watt lased group had a little inflammation, but in 2.0 watt lased group had scattered macrophages, a significantly larger number of chronic imflammatory cells were seen. 3. In titanium plasma sprayed implant 0.3 watt, 1.0 watt lased group had a little inflammation, but in 2.0 watt group had severe inflammation as in the conditions of HA coated group. 4. The inflammatory reaction of both lased HA coated and titanium plasma sprayed implant groups increased as the increase of the power of the laser.
Inadequate keratinized mucosa around dental implants can lead to more plaque accumulation, tissue inflammation, marginal recession and attachment loss. We evaluated the effects of free gingival and extracellular matrix membrane grafts performed to increase the insufficient width of keratinized tissue around dental implants in the posterior mandible. A 47-year-old female patient presented with discomfort due to swelling of the lower right second premolar area. Due to severe destruction of alveolar bone, the tooth was extracted. After 3 months, a guided bone regeneration (GBR) procedure was performed and then a dental implant was placed 6 months later. During the second-stage implant surgery, free gingival grafting was performed to increase the width of the keratinized tissue. After 12 months, a clinical evaluation was performed. A 64-year-old female patient had a missing tooth area of bilateral lower molar region with narrow zone of keratinized gingiva and horizontal alveolar bone loss. Simultaneous implant placement and GBR were performed. Five months after the first-stage implant surgery, a gingival augmentation procedure was performed with an extracellular matrix membrane graft to improve the width of the keratinized tissue in the second-stage implant surgery. After 12 months, a clinical evaluation was performed. In these two clinical cases, 12 months of follow-up, revealed that the increased width of the keratinized tissue and the deepened oral vestibule was well maintained. A patient showed a good oral hygiene status. In conclusion, increased width of keratinized tissue around dental implants could improve oral hygiene and could have positive effects on the long-term stability and survival rate of dental implants. When planning a keratinized tissue augmentation procedure, clinicians should consider patient-reported outcomes.
Purpose: Platelet derived growth factor(PDGF)-BB and bone morphogenetic protein(BMP)-2 are well-known representative growth factors. The purposes of this study were to investigate the effect of rhPDGFBB and rhBMP-2 on osseointegration of titanium implants at periimplant bone defects grafted with hydroxyapatite and to evaluate the feasibility of imaging bone structures around screw-type titanium implant with micro-CT. Materials and Methods: The first molar and all premolars in the mandible region of four beagle dogs were extracted. Following a healing period of 4 months, three $8{\times}8{\times}6mm$-sized bony defects were formed and screw-type titanium implants were placed with hydroxyapatite(HA) block and growth factors; Control group, PDGF group and BMP group. Two months post-implantation, the mandible was harvested. Bone volume(BV), bone-to-implant contact(BIC) and bone mineral density(BMD) were analyzed with micro-CT and histology. Results: According to micro-CT analysis, BV and BMD measures of PDGF and BMP group were significantly higher than control group(BV; PDGF group: $p{\fallingdotseq}0.011$, BMP group: $p{\fallingdotseq}0.006$/BMD; PDGF group: $p{\fallingdotseq}0.020$, BMP group: $p{\fallingdotseq}0.011$) and BIC measures of BMP group were significantly higher than PDGF group($p{\fallingdotseq}0.015$). In histologic evaluation, BIC measures of BMP group was significantly higher than PDGF group($p{\fallingdotseq}0.048$). The values of BV in histologic sections were higher than in micro-CT images and the values of BIC in micro-CT images were higher than in histologic sections. Conclusion: The findings of this experimental study indicates that the use of rhPDGF-BB and rhBMP-2 can increase new bone formation in a large bony defect around titanium implant, and rhBMP-2 is more effective than rhPDGF-BB. Micro-CT can be considered useful for assessment as a rapid and nondestructive method for 3-dimensional measurement of bone healing around implants. Further study is necessary, however, to remove metal artifacts around titanium implant and to standardize the method.
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