• The Journal of Korean Academy of Prosthodontics
• /
• v.47 no.3
• /
• pp.328-334
• /
• 2009

Statement of problem: Pier abutments act as a Class I fulcrum lever system when the teeth are incorporated in a fixed partial denture with rigid connectors. Therefore non-rigid connector incorporated into the fixed partial denture might reduce the stresses created by the leverage. Purpose: The purpose of this study was to evaluate, by means of finite element method, the effects of non-rigid connectors and supporting alveolar bone level on stress distribution for fixed partial dentures with pier abutments. Material and methods: A 2-dimensional finite element model simulating a 5-unit metal ceramic fixed partial denture with a pier abutment with rigid or non-rigid designs, the connector was located at the distal region of the second premolar, was developed. In the model, the lower canine, second premolar, and second molar served as abutments. Four types of alveolar bone condition were employed. One was normal bone condition and others were supporting bone reduced 20% height at one abutment. Two different loading conditions, each 150 N on 1st premolar and 1st molar and 300N on 1st molar, were used. Results: Two types of FPD were displaced apically. The amount of displacement decreased in an almost linear slope away from the loaded point. Non-rigid design tended to cause the higher stresses in supporting bone of premolar and molar abutments and the lower stresses in that of canine than rigid design. Alveolar bone loss increased the stresses in supporting bone of corresponding abutment. Conclusion: Careful evaluation of the retentive capacity of retainers and the periodontal condition of abutments may be required for the prosthetic design of fixed partial denture with a pier abutment.

• Journal of Periodontal and Implant Science
• /
• v.33 no.1
• /
• pp.79-89
• /
• 2003

치주질환은 세균감염에 의해 치조골이 파괴되는 염증성질환으로서 치아상실의 주된 원인이다. Treponema denticola는 성인성 치주염의 병소에서 자주 발견되는 세균으로서 부착능 및 단백분해효소생성능과 같은 독성 인자가 밝혀져 치주조직 파괴에 있어서 중요성이 강조되어 왔다. 골개조는 조골세포의 골형성및 파골세포에 의한 골흡수의 균형에 의하여 유지되며 치주염시 야기되는 치조골파괴는 조골세포 및 파골세포 기능의 불균형에 의하여 야기되는 것으로 설명되고 있다. 골세포에 대한 영향으로서 T. denticola는 파골세포의 형성을 촉진시키는 것으로 보고되었으나 조골세포에 대한 영향은 아직 밝혀져 있지 않다. 따라서 본 연구에서는 T. denticola가 골형성에 미치는 영향을 알아보고자 마우스의 두개골세포로부터 조골세포를 분리한 후 T. denticola분쇄액으로 처리하여 본 세균이 조골세포의 alkaline phosphatase(ALPase) 활성, 석회화결절 형성 및 Prostaglandin $E_2\;(PGE_2)$ 생성에 미치는 영향을 평가하였다. ALPase활성은 p-nitrophenylphosphate분해능, 석회화결절형성은 Von Kossa 염색법, 그리고 PGE2의 농도는 효소면역측정법으로 측정하였다. T. denticola분쇄액 (2.5 ug/ml)은 마우스 두개골세포의 ALPase활성을 억제하였으며 석회화결절의 형성을 감소시켰다. 또한 동일한 농도의 균분쇄액은 마우스 두개골세포의 $PGE_2$ 생산을 증가시켰다. 균분쇄액과 prostaglandin의 합성억제제인 indomethacin으로 세포를 동시에 처리한 경우 T .denticola분쇄액에 의한 $PGE_2$의 생산은 감소되었으나, ALPase의 활성억제에는 변화가 없었다. 균분쇄액을 열처리하여 마우스 두개골세포에 처리하였을 때에도 ALPase의 활성이 억제되는 것에는 변함이 없었다. 이러한 결과는 T. denticola의 구성성분 중 열에 안정한 물질이 prostaglandin과 무관한 경로를 통해 조골세포의 분화를 억제함을 시사하며 이와 같은 T. denticola에 의한 골형성억제가 치주염시 야기되는 치조골 파괴에 관여할 수 있을 것으로 생각된다.

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.2
• /
• pp.161-168
• /
• 2020

Failure of fixed implant supported prosthesis is caused by biomechanical factors such as excessive occlusal stress and biological factors such as bacterial infections and inflammation. Implants with severe bone resorption that have worsened without being resolved due to implant complications should be removed and then new treatments should be planned, taking into account remaining teeth, remaining implants, and residual alveolar. The patient of this case removed some of fixed implant prosthesis of mandible. The condition of the remaining alveolar bone was reassessed for further implant replacement and a few implants were placed. Then implant assisted removable partial denture (IAPRD) treatment is performed using implant surveyed bridge as abutment. Through this treatment, the clinical results were satisfactory on aspect of masticatory function recovery and oral hygiene management.

• The korean journal of orthodontics
• /
• v.25 no.4
• /
• pp.403-414
• /
• 1995

The purpose of this study was to investigate the histologic changes in mandibular periodontium during overbite closure for openbite treatment by continuous arch wires and anterior vertical elastics. Two female monkey(Macaca nemestrina) with permanent dentition were used. Posterior bite block was fixed to each of their maxillae, which made the animal temporary anterior openbite as well as stabilized the whole maxillary anchorage. In each mandible, all the teeth except the second molars which had been extracted, were prepared for cast crowns. 018 inch Standard brackets were welded on these crowns. After cementation, two types of the $016{\times}022$ inch continuous arch wires, the plain ideal arch to the control animal and the MEAW(multiloop edgewise archwire) to the other experimental one were inserted. Then anterior vertical elastics were applied for two weeks. The overbite depth changes in the monkeys and histologic examinations of the mandibular periodontiums suggested the following conclusions. 1. During two weeks of the experimental period, the overbite increased + 0.3 mm in the control and + 1.3 mm in the experimental one. 2. In both the control and the experimental animal, histologic examinations showed that incisors, canines and first premolars were subject to extrusive force and the rest of posteriors were subject to intrusive one. 3. In periodontiums of the extruded incisors of the experimental one, reorientation of the periodontal fiber structures reflected the direction of force and the alveolar bone surfaces including apical and crestal areas which had been subject to tension, were the front of new bone formation. 4. In periodontiums of the extruded incisors of the experimental one, neither excessive hyalinization nor gross root resorption was observed. 5. Alveolar bone remodeling of anteriors and posteriors was more remarkable in the experimental one than the control.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.2
• /
• pp.246-251
• /
• 2010

Impactions can occur because of malpositioning of the tooth bud or obstruction in the path of eruption. However, the exact mechanism is still unknown. The impaction of mandibular first molar is rare with prevalence rates of 0.01~0.25%, but it is important to deimpact the tooth as soon as possible to avoid complications such as dental caries, root resorption, and periodontal problems on the adjacent teeth. Several biomechanical strategies have been proposed for uprighting mesially tipped mandibular first molars. However, most of these have had problems with movement of the anchorage unit because of the reciprocal force. The recent development of skeletal anchorage system(SAS) allows direct application of precise force systems to the target tooth or segment, producing efficient tooth movement in a short time. In this case, an impacted mandibular left first molar with dilacerated roots was treated with a miniplate, which provided skeletal anchorage to upright the tooth. The miniplate was installed in the mandibular ramus, and 10 months after the application of orthodontic force, the impacted tooth was exposed in the oral cavity and uprighted. At this point, the mandibular left first molar was included in the orthodontic appliance with fixed mechanotherapy, the tooth could achieve a normal occlusion. Therefore, the use of SAS simplified the orthodontic procedures and reduced the orthodontic treatment period, and had few side effects.

• The korean journal of orthodontics
• /
• v.27 no.4 s.63
• /
• pp.559-568
• /
• 1997

For orthodontic tooth movement, optimal orthodontic force should be maintained without periodontal breakdown and alveolar bone should be remodeled physiologically Therefore, To obtain proper occlusion through tooth movement within alveolar bone, we should know the biomechanics of teeth and supporting 4issues. The present study was performed to observe histologic changes of periodontal tissue immediately after application of orthodontic force and during the retention period in growing young adult dogs. In this study, experimental group contained between mandibular left canine and 1st molar and control group contained contralateral teeth of same animal. The .018'x.022' stainless steel closed coil spring(Dentaurum Co.) was ligated on the experimental teeth at initial 200gm-force from mandibular canine to 1st molar The animals(4 to 6 months aged young adult dogs) were sacrificed on 0, 14, 28 days after the finish of appliance activation, and then tissue samples were divided into hematoxylin-eosin(HE) staining section, ground section, alkaline phosphatase(ALP) staining section, and tartrate-resistant acid phosphatase(TRAP) staining section. Thereafter, the preparations were examined under light microscopy The following results were obtained: 1. Immediately after the finish of appliance activation, the periodontal space was increased in tension side, but decreased in pressure side compared to that of control. The hyalinized zone was also observed in the periodontium. 2. After the 14-day retention, peridontal space was decreased in tension side and slightly increased in pressure side compared to that of immediately after the finish of appliance activation. The hyalinized zone was repaired and a few osteoblasts showing slightly new bone formation were seen. Osteoblasts were scarcely observed along the alveolar bone. 3. Aftter the 28-day retention, the periodontal fibers are normally repaired. A lot of TRAP(+) osteoclasts md increased alveolar bone resorption were observed in pressure side, and AP(+) osteoblast and increased new bone formation were observed in tension side.

• The korean journal of orthodontics
• /
• v.29 no.1 s.72
• /
• pp.95-106
• /
• 1999

This study was performed to examine the effect of bisphosphonate, an inhibitor of bone resorption, on the formation of osteoclast and bone resorption during experimental tooth movement. Whether bisphosphonate has a cytotoxicity in high dose was also examined. Eighty-seven male Sprague-Dawley rats, weighing 260-350g, were classified into normal (no appliance + $0.9\%$ NaCl), control (appliance + $0.9\%$ NaCl) and four bisphosphonate-treated (appliance + 0.8, 4, 20 or 100mg/kg) groups. The maxillary left first molar was moved mesially with the tipping movement using 50-70g of force. Bisphosphonate(etidronate disodium) was injected intraperitoneally with a dose of 0.8, 4, 20, or 100 mg/kg simultaneously with the application or the orthodontic force. They were killed at day 1, 3, or 7 after the application or the orthodontic force. The activities of serum acid phosphatase and lactate dehydrogenase (LDH) were assayed, and osteoclasts and the degree of bone resorption were examined histologically. The results obtained were as follows: 1. Acid phosphatase activities were significantly higher in the appliance groups, both control and bisphosphonate-treated (4, 20, and 100 mg/kg) groups, at days 1 and 3 than these in normal. At day 1, bisphosphonate-treated(4, 20mg/kg) groups showed even higher acid phosphatase than control. However, at day 7, no significant difference was noted between the control and bisphosphonate-treated groups. 2. LDH activities in the 4, 20mg/kg bisphosphonate-treated groups were increased during the experimental Periods examined, but there were no significant differences in the 0.8, 100mg/kg bisphosphonate-treated groups. 3. There was no bone resolution at day 1, but severe bone resorption was observed at days 3 and 7 in the control. Bone resorption was reduced by bisphosphonate-treatment at day 3. Bone resolution observed at day 7 was similar between the control and bisphosphonate-treated groups. 4. Few osteoclasts were observed at the alveolar bone in the control and bisphosphonate-treated groups at day 1. At day 3, numerous osteoclasts were shown in the control, the degree of which was reduced in bisphosphonate-treated groups. These results suggest that the inhibition of the osteoclast formation was not the mechanism of bone resorption by the bisphosphonate-treatment during experimenal tooth movement. There was no distinct cytotoxicity with a high dose of bisphosphonate. And the drug should be administrated repeatedly to maintain the inhibitory effect of bone resolution.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.33 no.1
• /
• pp.66-72
• /
• 2011

A severely vertical resorbed ridge is a significant challenge in implant dentistry. To solve this problem, several augmentation techniques, such as guided bone regeneration (GBR), onlay bone grafts, distraction osteogenesis, and ridge splitting techniques, have been proposed and used for several years. Among these methods, vertical ridge augmentation using guided bone regeneration aims to build space and guide osteoblasts to this space to promote osteogenesis. The aim of guided bone regeneration is to maintain and stabilize the space and block the proliferation of adjacent soft tissue. In our hospital, we encountered a case of a woman in her forties with an atrophied mandible, who underwent implant surgery in the right mandible. Titanium reinforced Gore-Tex (TRG) was used to augment the mandible and titanium mesh was used in the left mandible. Favorable results were obtained. This report compares the two methods and reviews the relevant literature.

• The Journal of Korean Academy of Prosthodontics
• /
• v.30 no.4
• /
• pp.541-564
• /
• 1992

The purpose of this experiment was to study the effect of implantation of the dense hydroxyapatite (HA) granules$(Apaceram^{(R)})$ in the fresh extraction sockets on the residual ridge resorption in normal and induced diabetic rabbits. Sixty-four white rabbits, weighing 3.0kg, were utilized in this study and they were divided into four group : group 1-sixteen normal rabbits without filling HA granules, group 2-sixteen normal rabbits with filling HA granules, group 3-sixteen diabetic rabbits without filling HA granules, group 4-sixteen diabetic rabbits with filling HA granules. HA granules were filled immediately after extraction in the extraction sockets of the mandibular left 1st, 2nd, and 3rd molar in group 2 and 4, and no HA granules were filled in group 1 and 3. The calculation of residual ridge resoption was done at 4th week, 8th week, 12th week, and 16th week after surgery, and histologic examination was performed to study healing process at 2nd week, 4th week, 8th week, and 16th week after surgery. The results were as follows : 1. The amount of residual ridge resorption was largest in group 3, and smallest in group 2 in every interval. There was no statistically significant difference between group 1 and 4. 2. In all groups, the amount of residual ridge resorption was high until 4th week after surgery, but the rate of residual ridge resolution slowly decreased after 4th week 3. There was more active healing process in group 1 and 2 than in group 2 and 4. 4. According to filling of HA granules, there was no difference in the amount of new bone formation, but direct contact could be observed between newly formed bone and HA granules in group 2 and 4. 5. Group 1 and 3 showed marked bone resorption and adipose marrow from 8th-16th week after surgery, but group 2 and 4 did not show maeked bone resolution, and showed fibrous tissue and a little adipose tissue among trabeculae from 8th week.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.33 no.1
• /
• pp.19-24
• /
• 2017

Recently, flexible denture is widely used with some advantages such as esthetics, flexibility and biocompatibility. However, there is an opposite opinion about stability because of the movement of denture by the material's flexibility. As the denture moves to tissue surface during mastication, it irritates the supporting tissue. It can lead to trauma and rapid resorption of residual ridges if this irritation lasts for a long time. In this case, the patient has used flexible denture with insufficient stability, retention and support for several years and thus continuous irritation of the supporting tissue resulted in palate bone exposure. The patient discomfort and palate bone exposure underwent improvements by the new denture with stability and retention. A careful case selection for flexible denture, regular checkup and proper treatment are necessary to prevent the side effects.