• Title/Summary/Keyword: 치아상실

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Fabrication of fixed prosthesis by employing functionally generated path technique and dual scan technique in a tardive dyskinesia patient: a case report (지연성 운동이상증 환자에서 functionally generated path 술식과 이중스캔법을 이용한 고정성 보철물 제작: 증례 보고)

  • Shilpa;Du-Hyeong Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.227-233
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    • 2023
  • Tardive dyskinesia is an involuntary neurological movement disorder caused by long-term use of dopamine receptor-blocking drugs leading to dental implications like uncontrolled gnashing and grinding of teeth which in turn imperil the oral rehabilitation procedures as the excessive load increases the risk of prosthesis fracture. A 40-year male with a medical history of tardive dyskinesia visited the hospital to receive oral rehabilitation for missing maxillary anterior teeth. After the oral examination, tooth preparation was done on teeth 13, 15, and 23. After that silicon impression was made and the gypsum cast was digitalized using a desktop scanner and an interim prosthesis was fabricated by milling a resin block. During the try-in, the occlusal one-third of the interim prosthesis was trimmed, and an auto-polymerizing acrylic resin was applied on the occlusal surfaces and inserted in the patient's mouth. Then, the functionally generated path (FGP) of occluding surfaces of opposing arches was traced on the resin surface. When the resin was hardened, the modified interim prosthesis was removed and digitized using an intraoral scanner. The scan image was used in designing the occlusal morphology of definitive prosthesis by modifying the design of the interim prosthesis using the dual scan method. Lastly, a monolithic zirconia prosthesis was fabricated by milling a zirconia block. The definitive prosthesis was delivered reflecting the patient's occlusal scheme. This case report shows that the FGP technique with the dual scan method can help in fabricating fixed prosthesis with harmonious occlusion in a tardive dyskinesia patient.

Treatment with upper complete denture and lower implant-fixed restorations on an elderly patient presenting fully edentulous maxilla and bilateral posterior edentulous mandible: a case report (상악 완전무치악 및 하악 양측 구치부 결손 고령환자에 대한 상악 가철성, 하악 고정성 보철치료: 증례보고)

  • Joseph Junesirk Choi;Richard Leesungbok;Suk-Won Lee;Phyo Ei Ei Htay;Jeong-yun Park;Jin-Young Chon
    • 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.

Implant-assisted removable partial denture restoration in small number of residual teeth in mandible: A case report (하악 소수 잔존치 환자에서 임플란트 보조 국소의치 수복 증례)

  • Jong-Ha Park;Jee-Hwan Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.3
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    • pp.215-223
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    • 2024
  • The patient in this case presented with a desire to have new dentures due to discomfort with existing ones. At the initial visit, all of teeth were missing except for the mandibular left second molar. As the patient was 65 years old, treatment with dentures and implant-supported prostheses was possible under the national health insurance system, and the patient opted for the mandibular denture using implant. Temporary prostheses were initially provided for patient adaptation, and following successful adaptation period, the treatment progressed. A maxillary complete denture and a mandibular implant-supported denture using two implants in the canines were fabricated. The mandibular denture is a Kennedy Class II removable partial denture which consists of a six-unit porcelain fused to metal fixed dental prostheses supported by the implant in the canines on both sides and left second molar serving as the abutments. Despite severe bone resorption and insufficient abutment teeth, the patient expressed satisfaction with the treatment results. In cases with economic and anatomical constraints affecting the feasibility of complete denture, implant-supported overdenture, and implant-supported fixed dental prostheses, an implant-assisted removable partial denture using implant surveyed crowns proves to be a viable and effective alternative treatment option. Nevertheless, the current dearth of scientifically rigorous studies underscores the necessity for meticulous regular check-up and occlusal assessment.

DMFT Index, Periodontal Index and Oral Hygiene Status in Diabetic Patients (당뇨병 환자에서 우식경험영구치지수, 치주질환지수 및 구강위생 상태)

  • Lee, Kyung-Dong;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.62-71
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    • 2005
  • Background: This study examined the oral health condition of diabetic patients and evaluated the oral health behavior through a questionnaires survey. In addition, this study provide primary informations for developing a dental health program for diabetic patients. Materials and Methods: There were fifty patients with diabetes mellitus or glucose tolerance (controlled by a community health center at Dalsung-Gun in Daegu City and fifty nondiabetic age, gender and location matched control subjects. Data were collected by a direct oral examination and by questionnaires from 100 subjects in July, 2004. Results: The DMFT (Decay, Missing, Filling Teeth) mean values in diabetics were significantly higher than that in non-diabetics (p<0.05). The decay teeth index and Filling teeth index was similar in the two groups, but the mean Missing teeth index was significantly higher in the diabetics than in non-diabetics. The PI (Periodontal Index) mean values were significantly higher in the diabetics than in the non-diabetics (p<0.01). There was a significant difference between the diabetics and non diabetics aged in their 50s and 60s, but there was no difference with those aged in their 70s. The oral hygiene status was similar in the two groups. The average number of remaining teeth was significantly lower in the diabetics ($16.1{\pm}10.35$) than in the non-diabetics ($20.04{\pm}8.70$) (p<0.05). Conclusion: In the diabetic patients, the M component of the DMFT index was found to be higher than the controls. Diabetics lose their teeth mainly due to periodontal disease, which is supported by the increased PI mean values.

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Retrospective study on survival, success rate and complication of implant-supported fixed prosthesis according to the materials in the posterior area (구치부 임플란트 지지 고정성 보철물의 재료에 따른 생존율, 성공률 및 합병증에 대한 후향적 연구)

  • Chae, Hyun-Seok;Wang, Yuan-Kun;Lee, Jung-Jin;Song, Kwang-Yeob;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.342-349
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    • 2019
  • Purpose: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. Materials and methods: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The KaplanMeier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. Results: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. Conclusion: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications.

Oral Health Status of Some Patients with Chronic Mental Illness in Korea (일부 만성 정신질환자의 구강건강 상태)

  • Seo, Hye-Yeon;Jeon, Hyun-Sun;Park, Su-Kyung;Park, Ki-Chang;Chung, Won-Gyun;Mun, So-Jung
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.493-500
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    • 2013
  • The study aims to determine the status of oral health of mental illness patients and establish the preliminary data. The examinations and questionnaire survey were done 92 psychiatric patients to measure sociodemographic characteristics, decayed, missing and filled teeth (DMFT) index, patient hygiene performance (PHP) index, community periodontal index of treatment need (CPITN). Result of the missing teeth index in the state of oral health was higher in the hospital group (6.42) while the filled teeth index was higher in the center group (4.78). In the DMFT index, mental illness patients were higher than the national sample. The oral health status of medical aid recipients was poorer as the subjects were older and less educated (p<0.05). The PHP index was 3.41, close to the bad oral hygiene state. The hospital group (81.7%) required higher need for periodontal treatment. The periodontal health state was much poorer especially when the subject was in the age of 40's and 60's, received less education, and had no family (p<0.05). $CPITN_3$ was higher in the hospital group (13.3%) than the national sample (5.7%). The mental illness patients were socially vulnerable, therefore oral health care program should be needed and age, education level, health insurance type, presence of family and other factors needs to be considered in this approach.

Comparison of Bite Forces between Pre- and Post-Treatment in Patients with Temporomandibular Disorders (측두하악장애 환자의 치료 전후 교합력 비교)

  • Lee, Sang-Il;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.211-218
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    • 2007
  • The purpose of this study was to compare the maximum bite forces between pre- and post-treatment related to specific diagnostic groups of TMD including masticatory muscle disorder (MMD), disc derangement (DD), joint inflammation (JI) and osteoarthritis (OA). Bite force between pre- and post-treatment was compared in 36 patients with unilateral TMD, successfully-managed in the Department of Oral Medicine, Dankook University Dental Hospital, for this study. The ratio of men to women was 7:29 and their mean age of $28.1{\pm}13.7$ years. The patients were categorized, through clinical and radiographic examination, into aforementioned 4 groups; MMD (N=18), DD (N=6), JI (N=5) and OA (N=7). The maximum bite force measurements were done at the antagonizing canines and 1st molars using a bite force recorder. Paired t-test, ANOVA, Multiple Comparison t-tests were used for statistical analysis. The results of this study showed that the maximum bite force before treatment increased after TMD treatment, which was noticeable at the canines (p=0.001 and p=0.000 for the affected and unaffected sides, respectively). In comparison related to the diagnostic groups of TMD, patients with osteoarthritis of TMJ exhibited the lowest strength while those with inflammatory disorder of TMJ had the highest strength on the affected sides. Increase of bite force after treatment was also found in each group. Significant difference between pre- and post-treatment was found at canines on the affected sides in MMD (p=0.045) and DD groups (p=0.009) while on the unaffected sides in OA group (p=0.003). Conclusively, the reduced bite force due to TMD could be recovered by conservative TMD treatment and that the difference of bite forces between pre- and post-treatment was noticeable at the canines.

Influence of the Food Intake Ability and the Number of Remaining Teeth on Oral Health Related Quality of Life in Some Elderly People (일부 노인의 저작강도별 음식섭취능력과 잔존치아수가 구강건강관련 삶의 질에 미치는 영향)

  • Kim, Da-Hye;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.16 no.1
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    • pp.53-61
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    • 2016
  • Eating supports to gain energy and nutrition and improves quality of life. Ageing affects the food intake ability due to loss of natural teeth and the progressive muscle degeneration. Our objective was to investigate how the food intake ability (FIA) and the remaining teeth could influence on oral health related quality of life in the elderly. This study was performed with 503 elderly subjects living in Daejeon, Korea. The questionnaire with the FIA with 30 Korean food and Oral Health Impact Profile 14 (OHIP-14) and oral examination were surveyed. The five groups according to cluster analysis of FIA had the different numbers of remaining teeth and functional posterior teeth with opposing teeth or prosthesis significantly: group 1, $21.78{\pm}8.27$ and $2.80{\pm}2.63$; group 2, $16.75{\pm}7.87$ and $2.16{\pm}2.44$; group 3, $14.68{\pm}9.77$ and $1.73{\pm}2.30$; group 4, $9.93{\pm}8.13$ and $0.78{\pm}1.68$; group 5, $10.18{\pm}8.37$ and $0.51{\pm}1.22$. The more foods the subjects could masticate, the better oral health related quality of life they had. The medium FIA, soft FIA and the number of remaining teeth could explain 46% of OHIP-14, but hard FIA could not in the multiple regression model. We suggested to develop the oral health program for the elderly to be able to eat the food with medium physical property at least be helpful to improve oral health related quality of life.

Evaluation of clinical status of fixed prosthesis (고정성 보철물의 임상적 상태에 대한 평가)

  • Yun, Mi-Jung;Jeon, Young-Chan;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.99-107
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    • 2009
  • 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.

EFFECT OF THE NUCLEAR FACTOR I-C ON THE FORMATION OF HERTWIG'S EPITHELIAL ROOT SHEATH DURING ROOT DEVELOPMENT (Nuclear factor I-C가 치근발생 과정에서 Hertwig's 상피초 형성에 미치는 영향)

  • Shin, In-Cheol;Park, Joo-Cheol;Jeong, Moon-Jin;Oh, Hyun-Ju;Park, Sun-Hwa;Lee, Chang-Seop;Kim, Heung-Joong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.576-583
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    • 2005
  • Tooth formation is a complex developmental process that is mediated through a series of reciprocal epithelial-mesenchymal interactions. Several signal pathways and transcription factors have been implicated in regulating molar crown development, but relatively little is known about the regulation of root development. It was reported that NFI-C knockout mice showed abnormal root formation with normal crown. The aims of this study are to elucidate how the NFI-C regulate the determine of root shape and odontoblasts differentiation. We carried out immunohistochemistry using cytokeratin to investigate the role of Hertwig's epithelial root sheath and DSPP mRNA in-situ hybridization to conform the nature of root dentin during root development in NFI-C knockout mice. Cytokeratin reacted with all the HERS cells and the continuity of cytokeratin positive cells between the HERS cells and enamel epithelium was lost in the cervical region both wild and K/O types. After root dentin deposition cytokeratin positive-HERS cells showed irregularity and loss of polarity in the cervical region in K/O type. DSPP mRNA was strongly expressed in odontoblasts of crown and root dentin in wild type mice, whereas expression of DSPP mRNA was restricted in odontoblast of crown dentin in the K/O type. During root formation in NFI-C knockout mice, HERS normally grow out of the crown but fail to induce odontoblast differentiation in root portion. These results suggest that NFI-C may play important roles in odontoblast differentiation during root dentin formation.

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