• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.1
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• pp.81-92
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• 2014

It is so hard to obtain optimal anterior esthetics in the implant prosthesis. This is not only because of hard and soft tissue problem such as alveolar bone resorption and interdental papilla loss but also because of prosthetic limitation related to marginal exposure of metal abutment and metal ceramics and low transillumination. In this case, guided soft tissue healing is obtained using a long term provisional restoration with soft and hard tissue augmentation or immediate implantation. Then, this healed tissue is transferred to final master model using a customized impression coping and the implant is restored with a customized zirconia abutment and a all ceramics. This case presents satisfying result esthetically and functionally.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.405-414
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• 2021

Purpose. This study was conducted to evaluate clinical usefulness by evaluating the marginal bone resorption and survival rate of an implant with a taper straight type SLA surface domestically available on the market recently. Materials and methods. 40 implants satisfying the including criteria were observed for one year of 125 implants of 83 adult men and women who had KISPLANT^® implanted from August 2016 to December 2019 at the Department of Periodontology, Chonnam National University Dental Hospital. The marginal bone level was measured on periapical radiographs taken initially and 1 year later and we analyzed implant survival and success rates. A t-test was used for the analysis of the association between the marginal bone resorption and the severity of periodontitis, supportive periodontal therapy, the inserted site, the cause of extraction, immediate placement, and systemic disease. Results. After 1 year of loading, the mesial bone resorption was 0.74 ± 1.07 mm, and the distal bone resorption was 0.53 ± 1.04 mm. The marginal bone resorption of 2 mm or more occurred at 3 implants out of 40 implants after 1 year, so the success rate of implant was 92.5% and survival rate was 100%. There was a significant difference in mesial marginal bone resorption according to the inserted site and no significant differences were found between marginal bone resorption and the other factors. Conclusion. As a result of marginal bone resorption, success rate, and survival rate in this study, we found little marginal bone resorption and high survival and success rate. It can be concluded that they represent excellent clinical results.

• The Journal of the Korean dental association
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• v.55 no.10
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• pp.725-732
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• 2017

Thin labial plate will be resorbed after extraction. Immediate implantation cannot prevent soft and hard tissue loss. Bone graft can be necessary in the immediate implantation after anterior tooth extraction. Slowly-resorbed or non-resorbable bone graft material have many advantages in esthetic area because of maintenance of volume. The clinicians should select the adequate cases of immediate implantation according to the indication and contraindication.

• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.913-923
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• 2006

목적 : 최근 발치 후 즉시 임플란트 식립은 널리 사용되는 수술 방식이다. 이 연구의 목적은 임플란트 주위 골결손시 Ca-P으로 표면 처리된 이종골을 사용하여 골재생을 평가하기 위함이다. 재료와 방법 : 두 마리의 개 모델에서 하악 소구치와 제일 대구치를 발치하였다. 발치 6주 후 trephine bur를 이용하여 7.5 mm 지름과 5 mm 깊이를 가진 결손부를 형성하였다. 이 후 이 결손부의 중앙에 3.5 mm 지름과 15mm 길이의 fixture(GS II)를 식립하였다. 결과적으로 임플란트와 주변을 둘러싸고 있는 골 사이에는 2.0 mm정도의 gap이 만들어진다. 준비된 결손부 내로 자기골 또는 $Biocera^{(R)}$를 채웠다. 각각 4주, 8주 후 조직 절편을 제작하였다. 조직학적 평가를 위해 Block biopsy를 시행하였다. 결과 : 두 집단 모두 임상적으로 골이 완전히 채워졌다. 자가골이 이식된 부위(control)의 평균 골-임플란트 접촉(BIC)은 각각 4주째 $28.2{\pm}19%$였고, 8주째 $44.9{\pm}9%$였다. $Biocera^{(R)}$가 이식된 부위(test)의 평균 BIC는 각각 4주째 $34.6{\pm}27%$였고, 8주째 $27.6{\pm}23%$였다. 자가골이 이식된 부위(control)의 평균 골밀도는 각각 4주째 $32.7{\pm}25%$, 8주째 $37.4{\pm}17%$였다. 골-임플란트 접촉(BIC)과 골밀도의 평균 비율(%)은 비슷하였다. 조직학적으로 자가골과 이종골 이식 부위 모두 주변골과 잘 조화를 이루었고 유사한 치유 양상이 관찰되었다. 자가골과 이종골 이식 부위간 유의한 차이는 없었다.(P>0.05) 결론 : 임플란트 주위 2 mm의 골 결손부위에 자가골 또는 이종골로 채운 경우 유사한 결과를 얻었다. 이 결과 임플란트 fixture 주위의 골 결손부 해소를 위해 자가골을 대체할 수 있는 재료로 $Biocera^{(R)}$를 사용할 수 있음을 보여준다.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.4
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• pp.284-292
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• 2023

Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient's posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.4
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• pp.337-349
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• 2008

Despite an improved bone reactions of Mg-incorporated implants in the animals, little yet has been carried out by the experimental investigations in functional loading conditions. This study investigated the clinical and histologic parameters of osseointegrated Mg-incorporated implants in delayed loading conditions. A total of 36 solid screw implants (diameter 3.75 mm, length 10mm) were placed in the mandibles of 6 beagle dogs. Test groups included 18 Mg-incorporated implants. Turned titanium Implants served as control. Gold crowns were inserted 3 months. Radiographic assessments and stabilitytests were performed at the time of fixture installation, $2^{nd}$ stage surgery, 1 and 3 months after loading. Histological observations and morphometrical measurements were also performed. Of 36 implants, 32 displayed no discernible mobility, corresponding to successful clinical function. There was no statistically significant difference between test implants and controls in marginal bone levels (p=0.413) and RFA values. The mean BIC % in the Mg-implants was $54.4{\pm}20.2%$. The mean BIC % in the turned implant was $48.9{\pm}8.0%$. These differences between the Mg-implant and control implant were not statistically significant (P=0.264). In the limitation of this study, bone-to-implant contact (BIC) and bone area of Mg-incorporated oxidized implant were similar to machine-turned implant. The stability analysis showed no significantly different ISQ values and marginal bone loss between two groups. Considering time-dependent bone responses of Mg-implant, it seems that Mg-implants enhanced bone responses in early loading conditions and osseointegrated similarly to cp Ti implants in delayed loading conditions. However, further investigations are necessary to obtain long-term bone response of the Mg-implant in human.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.32 no.1
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• pp.16-22
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• 2023

Esthetic factors are very important in the success of maxillary anterior implant restoration. However, achieving esthetic results is difficult, especially in cases where periodontitis has resulted in severe alveolar bone loss. In the case of maxillary anterior teeth, the alveolar ridge resorption that begins immediately after tooth extraction interferes with the esthetic implant restoration. Therefore immediate implant placement can be performed to minimize the alveolar ridge resorption. However, in severe bone loss cases, immediate implant placement could result in esthetic failure, and this result might cause irreparable problems. We can also perform alveolar ridge preservation and then place implants later. On JCP published in 2019, there is the consensus of European academy of periodontology on the extraction socket management and the timing of implant placement. This consensus states that alveolar ridge preservation should be considered when there is severe labial bone loss in an esthetically important area such as maxillary anterior region. On performing the alveolar ridge preservation, we cannot obtain the primary wound closure, so secondary wound healing is induced with open membrane technique or soft tissue grafting should be performed for primary wound closure. However, the secondary wound healing can have a negative impact on bone regeneration, and soft tissue grafting such as FGG or CT graft can be burdensome for both patients and dentists. On the other hand, by using the granulation tissue in the extraction socket, primary closure can be achieved without soft tissue grafting. Also some studies have shown that granulation tissue in periodontal defects contains stem cells that may help in tissue regeneration. Based on this, implant restorations were performed on maxillary anterior teeth with severe alveolar bone loss by alveolar ridge preservation using granulation tissue. In spite of the severe bone defect of the extraction socket, relatively esthetic results could be obtained in implant restorations.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.3
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• pp.245-253
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• 2019

Orthognathic surgery of skeletal Class III malocclusion improves oral function and facial appearance. The greater amount of skeletal discrepancy, the greater amount of teeth movement required for decompensation, and this often causes pathological changes in periodontal tissue especially in lower anterior dentition. We made a Top-Down treatment plan with personalized analysis using Face Hunter, Plane System and ARCUS Digma II, in order to resolve severe mobility and cross-bite of lower anterior teeth for 49-year-old female patient who had undergone orthognathic surgery 20 years ago due to skeletal Class III malocclusion and mandibular prognathism. Lower anterior teeth were extracted and alveoloplasty was done. After healing of the wound, immediate loading was conducted immediately after implant placement. Final restorations were fabricated Zirconia using CAD/CAM, and inserted intraorally screw-retained type. During 6-month follow-up, no abnormal episodes of restorations were observed, and obtained satisfactorily both of functional and esthetic outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.301-311
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• 2009

Statement of problem: Flapless implant surgery using a soft tissue punch device requires a circumferential excision of the mucosa at the implant site. To date, Although there have been several reports on clinical outcomes of flapless implant surgeries, there are no published reports that address the appropriate size of the soft tissue punch for peri-implant tissue healing. Purpose: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effect of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model. Material and methods: Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a three month healing period, three fixtures (diameter, 4.0 mm) were placed on each side of the mandible using 3 mm, 4 mm, or 5 mm soft tissue punches. During subsequent healing periods, the peri-implant mucosa was evaluated using clinical, radiological, and histometric parameters, which included Gingival Index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues. Results: The results showed significant differences (P <0.05) between the 3 mm, 4 mm and 5 mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss during healing periods after implant placement. When the mucosa was punched with a 3 mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter $\geq$ 4 mm. Conclusion: Within the limit of this study, the size of the soft tissue punch plays an important role in achieving optimal healing. Our findings support the use of tissue punch that 1 mm smaller than implant itself to obtain better peri-implant tissue healing around flapless implants.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.79-87
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• 2021

The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient's visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an 'A.I. abutment matching algorithm' the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner's advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.