Kim, Jongsung;Kim, Gimin;Lee, Jaesik;Kim, Hyunjung;Nam, Soonhyeun
Journal of the korean academy of Pediatric Dentistry
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v.49
no.1
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pp.104-112
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2022
The purpose of this study is to analyze the fracture resistance of reattached tooth according to the resin materials and tooth preparation type under physiological conditions. Uncomplicated crown fracture in the oblique direction was reproduced on the extracted 64 anterior teeth. Depending on the composite resin material, reattachment was performed using a flowable resin and a packable resin. Depending on retentive forms, reattachment was performed using simple reattachment, 1.0 mm × 1.0 mm labial chamfer bevel, 1.0 mm × 1.0 mm lingual chamfer bevel and 1.0 mm × 1.0 mm circumferential bevel. A load was applied to the palatal surface of the tooth using a universal testing machine at an angle of 125 degree, which is the interincisal angle of normal children. Under the masticatory pressure condition, fracture resistance of lingual chamfer groups was 28.28 ± 7.41 MPa and 27.54 ± 4.45 MPa, which was significantly higher than those of simple reattachment groups, 17.21 ± 5.87 MPa and 20.10 ± 6.00 MPa, in both flowable and packable resin groups. When considering the lingual force similar to masticatory pressure, the fragment retention was significantly improved when the lingual chamfer was formed compared to the simple reattachment. Clinicians may consider the design of the lingual chamfer in order to improve fracture resistance to masticatory pressure during fragment reattachment.
Sung-Hoon Lee;Seong-Kyun Kim;Seong-Joo Heo;Jai-Young Koak;Ji-Man Park
The Journal of Korean Academy of Prosthodontics
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v.61
no.4
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pp.367-378
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2023
With the recent development of computer-aided design-computer-aided manufacturing technology and 3D printing technology, and the introduction of various digital techniques, the accuracy and efficiency of top-down definitive prosthetic restoration are increasing. In this clinical case, stable occlusion support was obtained through the placement of a total of 9 maxillary and mandibular posterior implants in patient with anterior-posterior crossed occlusion. The edentulous area of the maxillary anterior teeth, which showed a tendency of high resorption of the residual alveolar bone, was restored with a Kennedy Class IV implant assisted removable partial denture to restore soft tissue esthetics. Computed tomography guided surgery was used to place implants in the planned position, double scan technique was used to reflect the stabilized occlusion in the interim restoration stage to the definitive prostheses, and metal 3D printing was used to manufacture the coping and framework. This clinical case reports that efficient and predictable top-down full mouth rehabilitation was achieved using various digital technologies and techniques.
Statement of problem: Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complications of fixed prostheses were found in the mouth of patients. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. Purpose: The purpose of this study was to evaluate the clinical status of fixed prostheses. Material and methods: In order to assess the clinical status of fixed prostheses, a total of 161 individuals(aged 17-85, 99 women and 62 men with 1596 unit of fixed prostheses, and 1169 abutments) who first visited the Department of Prosthodontics, Pusan National University Hospital, between April to September, in 2007 were examined. Results and conclusion: The results of this study were as follows: 1. Length of service of fixed prostheses was $8.6{\pm}0.6$ years(mean), 10.0 years(median). 2. Location of fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in posterior region and in mandible where the failure rate was high in combination(P<.05). 3. Longevity of fixed prostheses made of metal was longest(mean: $13.0{\pm}9.3$, median: 14.0), gold, precious ceramic, non-precious ceramic trailing behind(P<.05). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in Single-unit and the failure rate was high in over 3-unit(P<.05). 5. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in natural dentition(P<.05). 6. Defective margin(28.2%), dental caries(23.0%), periodontal disease(19.3%), periapical disease(16.9%) were frequent complications. In 30.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.
Journal of Dental Rehabilitation and Applied Science
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v.28
no.4
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pp.359-370
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2012
The endodontically treated tooth is generally restored with post and core, owing to the brittle and the loss of large amount of tooth structure. The purpose of this study was to evaluate the clinical status of fixed prostheses to improve the quality of dental care. In order to assess the clinical status of fixed prostheses, a total of 101 individuals (aged 30-89, 66 women and 35 men loaded with 125 fixed prostheses) who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between January 1990 to December 2005 were examined. The results of this study were as follows: 1. Length of service of fixed prostheses was $9.7{\pm}3.4$ years (mean), 11.1 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 3. Location of fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in anterio-posterior combination region (median:9.2 years). 4. Longevity of fixed prostheses made of base metal ceramic(median:12.0 years) and noble metal ceramic (median:11.3 years) is long (P<.05). 5. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 7. Dental caries, periapical disease, tooth fracture were frequent complications. In 51.9% of the cases, abutment state after removing fixed prostheses was needed to be extracted.
Although the purpose of orthodontic treatment is to increase the function and aesthetics of the jaws as well as to increase stability, there are side effects from the treatment itself such as root resorption and alveolar bone resorption. Such resoiption of the apical root is unpredictable and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effects of different oral habits, especially that ef nail biting, and their correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration. The possibility of root resorption and alveolar bone loss during orthodontic treatment can also be considered. Also, any legal problems that might occur may be pondered as well. Among the male md female patients of the ages 10~15, 63 were chosen as the test group with known nail biting habits at time of examination and within the same age range those without nail biting habits as the control group. The test group was composed of 30 males and 33 females. The control group had 31 males and 32 females. The result from this study were as follows : 1. Of the 63 patients of both the test and control groups, the male-to-female-ratio was 1:1, and had no statistically significant difference in male and female root resorption. 2. In comparing crown length of the test and control groups, no significant difference existed, but in root length, maxillary and mandibular right and left central incisors and mandibular right lateral incisors had a smaller value. (p<0.001) 3. Average crown-to-root ratio of the test group on the periapical view show a noticeably high value for the maxillary and mandibular right and left central incisors and mandibular right and left lateral incisors. (p<0.01) 4. In comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, mesial surfaces of the maxillary and mandibular right and left central incisors and distal surface of maxillary right central incisor of the test group showed greater loss of crestal bone than the control. (p<0.05)
The purpose of this study was to evaluate the differences of soft tissue profile changes between the growing patients and the adult who had passed the growth peak, in orthodontic treatment with four premolar extractions. The results which was taken by correlating the soft tissue changes with hard tissue changes, lip thickness, molar relationship and arch length discrepancy in both groups was like the followings. 1. Significant hard tissue changes were decrease of VIs, VIi, UlPP, LlMP, HIi and increase of HPog'in adults and decrease of VIs, VIi and increase of VA, VPog'and all the vertical measurements in adolescents. 2. Significant soft tissue changes were decrease of VLs, VLi, and VILS in adults and increase of VSn, VSLS, VLs, VPog' and almost all vertical measurements in adolescents, and ${\Delta}LsE,\;{\Denta}LiE$ in adults and ${\Delta}LsE,\;{\Denta}LiE,\;{\Delta}LiSP\;and\;{\Delta}Mang$ was also significant 3. Correlation coefficient between ${\Delta}VIs\;and\;{\Delta}VLs$ was the greatest in adults and the next was ${\Delta}Ii/{\Delta}Li,\;{\Delta}Ii/{\Delta}ILS,\;{\Delta}ID/{\Delta}Li\;and\;{\Delta}ID/{\Delta}ILS$. In contrast all the vertical and horizontal measurements of hard and soft tissue in adolescents showed statistically significant corerrlation. 4. There were differences in correlation between soft tissue changes and incisor inclination and retraction at both groups, but the lower lip, nasolabial angle and mentolabial angle were commonly less influenced by the hard tissue changes in both groups. 5. The thinner the upper lip was, the more the ${\Delta}LsSP$ was in both groups, and the thinner the lower lip was, the more the ${\Delta}LiE\;and\;{\Denta}LiSP$ was in adolescents. 6. Molar relationship didn't influence the soft tissue profile changes. 7. Arch length discrepancy didn't influence the soft tissue profile changes.
Kim, Jae-Do;Park, Pil-Jae;Kwon, Young-Ho;Jang, Jae-Ho;Lee, Young-Gu
The Journal of the Korean bone and joint tumor society
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v.11
no.1
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pp.71-81
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2005
Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.
After cardiac surgery, it has been recognized that various complications were associated with injured humoral and cellular immunity by cardiopulmonary bypass(CPB). Especially, in postoperative pulmonary dysfunction, transpulmonary leukostasis followed complement activation and inflammatory responses are major pathogen. Some studies have showed that pretreated-corticosteroids before CPB protected postoperative pulmonary dysfunction. Corticosteroids may inhibit complement and leukocyte activation. On based previous studies, present investigator determined changes of leukocyte counts and transpulmonary leukostasis during cardiac surgery and postoperative periods. For the evaluation of postoperative pulmonary function and edema, $PaO_2$ and chest X-ray were compared between pre-CPB and post-CPB. Fever and other parameters were also observed postoperatively. The aim of this study was to define for the prophylactic effects of corticosteroid(Solu-Medrol: 30mg/kg) on all the researched parameters. This study was prospectively designed with randomized-blind fashion for 50 patients undergoing cardiac surgery. According to the purpose of study, all patients were divided into placebo and steroid group. : Placebo group was 25 patients received normal saline(not corticosteroid), and steroid group was 25patients received corticosteroid(Solu-Medrol: 30mg/kg) before initiation of CPB. The results of study were summarized as follows. 1. Total peripheral leukocyte counts decreased significantly at 5 minutes of CPB in all patients(P<0.01), and began to increase progressively at later periods of CPB with neutrophilia. The significant rise remained at postoperative 7th day(P<0.05). 2. During partial CPB, transpulmonary leukostasis occurred in placebo group(P<0.001), whereas it was prevented in steroid group. 3. In both groups, peripheral lymphocyte counts were stable during CPB, but began to reduce at time of intensive care unit(ICU) and the lymphocytopenia remained until postoperative 3rd day. The lymphocyte counts recovered on postoperative 7th day. 4. In both groups, peripheral counts of monocyte were relatively stable in the early peroid of CPB, and increased gradually in the later periods of CPB. This significant monocytosis remained throughout postoperlative periods(P<0.05). 5. The mean value of postoperative $paO)_2$ was lower than that of pre-CPB in placebo group(P=0.01) but didn't significant in steroid group(P=0.90). In the incidence of pulmonary edema signs and fever, placebo group was higher than steroid group(P=0.001, p=0.01, respectively). However mechanical respiratory supporting and care periods at intensive care unit were not significant difference between two groups(P>.0.05).With the above results, the investigator concluded that leukocyte activation and pulmonary sequestration were caused by cardiac surgery with CPB and demonstrated that high dose corticosteroid will provide prophylactic effect for pulmonary leukostasis and higher neutrophilia. These effects may ameliorate postoperative pulmonary dysfunction and contribute to postoperative less morbidity. However, further study should be performed because postoperative lymphocytopenia continued for 3 days in both groups, which may suspected damage or suppression of cell-mediated immunity with used corticosteroid.
Cause of skeletal Class III malocclusion in growing patients can be classified into maxillary deficiency, mandibular overgrowth, and combination of the two. Use of Protraction Head Gear(P.H.G.) has been recommended for treatment of growing Class III malocclusion patients, for it results in forward & downward movement of maxilla and backward & downward rotation of mandible. Numerous animal experiments were performed and clinical study data have been reported ; nevertheless, studies on soft tissue profile change and comparison of treatment effects among the patients who had undergone treatment are considered to be somewhat insufficient. The author selected 93 patients, who had been diagnosed as skeletal Class III malocclusion with maxillary deficiency and then treated with P.H.G. ; the sample group was divided according to sex, treatment beginning age, palatal suture opening(intraoral appliance), and facial growth pattern. For each group, changing patterns of hard and soft tissue profile observed, and comparision with 20 normal group(Angle's Class I) patients of statistical significance in amount of growth and treatment of hard and soft tissue was done. The following results were obtained. 1. Skeletal, dental, and soft tissue measurements indicated that more growth changes was induced in the sample group that used P.H.G. compared to the growth amount of normal group. 2. No statistical significance was observed in the amounts of maxillary forward movement and mandibular backward & downward rotation depending on treatment beginning age in both sex group. 3. R.P.E. showed more significant maxillary forward movement and less protrusion of upper incisor than La-Li. 4. There was no statistical significance in the amount of maxillary forward movement depending on facial growth pattern. On the other hand, measurements indicating mandibular downward & backward rotation indicated greater change in counterclockwise growth pattern group than the clockwise. 5. Changes in upper and lower lip thicknesses showed a close relationship with positional changes in underlying bone tissue and upper and lower teeth, and upper lip height and nasolabial angle increased and mentolabial angle decreased.
Successful results of treatments using double crown prostheses for the partially edentulous patients who have a few remaining teeth have been reported in several journals. A double crown removable partial denture can be an alternative treatment for the patients with a poor periodontal condition of remaining teeth. Since a double crown removable partial denture can be applied without the risk of surgical operation to the medically compromised patients with a poor periodontal condition which is inadequate for dental implants, it has psychological and economical advantages. In this case, there were sufficient remaining teeth to be restored with fixed prostheses in maxilla, while there were a few remaining teeth with a very poor periodontal condition so that it was almost impossible to restore with a clasp removable partial denture using these remaining teeth in mandible. In addition, the patient had the medical history of surgical operation due to osteomyelitis in the mandibular anterior areas a year ago, thus difficult to conduct an implant placement. The main objective of this report is to introduce our case because a double crown partial denture using a few mandibular remaining teeth showed satisfactory results in functional and esthetical aspects during more than two years follow-up period in this unfavorable condition.
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