• The Journal of Advanced Prosthodontics
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• v.13 no.4
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• pp.216-225
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• 2021

PURPOSE. The aim of this study is to evaluate the effects of canine guidance occlusion and group function occlusion on the degree of stress to the bone, implants, abutments, and crowns using finite element analysis (FEA). MATERIALS AND METHODS. This study included the implant-prosthesis system of a three-unit bridge made of monolithic zirconia and hybrid abutments. Three-dimensional (3D) models of a bone-level implant system and a titanium base abutment were created using the original implant components. Two titanium implants, measuring 4 × 11 mm each, were selected. The loads were applied in two oblique directions of 15° and 30° under two occlusal movement conditions. In the canine guidance condition, loads (100 N) were applied to the canine crown only. In the group function condition, loads were applied to all three teeth. In this loading, a force of 100 N was applied to the canine, and 200-N forces were applied to each premolar. The stress distribution among all the components of the implant-bridge system was assessed using ANSYS SpaceClaim 2020 R2 software and finite element analysis. RESULTS. Maximum stress was found in the group function occlusion. The maximum stress increased with an increase in the angle of occlusal force. CONCLUSION. The canine guidance occlusion with monolithic zirconia crown materials is promising for implant-supported prostheses in the canine and premolar areas.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.24 no.2
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• pp.122-133
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• 2015

The requirements for the successful treatment of all-ceramic restorations are not so different from the ones of conventional restorations. "The provisional restoration followed by an adequate tooth reduction" and "the accurately fitting prostheses with corresponding to final impression" can be the examples of them. Nevertheless, the one which all-ceramic restorations are distinguished from conventional restorations is the additional procedure of so called "bonding". In addition to the application of resin cement between "inner surface of restoration and outer surface of abutment", bonding technology can be also applied to the treatment process of "Post and Core" in particular if the abutments are non-vital teeth. Core build-up for all-ceramic crown is conducted with fiber post and tooth colored composite by considering the properties of the restorations transmitting light. We know well that a vital abutment is easier than a non-vital one to get the targeted goals for clinical success in connection with esthetics and structure. The creation of "Post and Core" with bonding technique is a decisive factor for a long-term success if the abutment is non-vital tooth with dentinal collapse. I would like to share my clinical experience about "post & core build-up and all-ceramic restoration bonding" out of several success strategies of all-ceramic crown with this review article.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.82-90
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• 2024

It often happens that a removable partial denture needs to be repaired due to tissue changes in the remaining alveolar ridge, fracture of the denture, or fracture of the abutment tooth. There are several advantages to retrofitting a customized surveyed crown under the existing RPD. Retrofitting a crown to the RPD decreases the economic burden to the patient and avoids the need for several appointments to fabricate a new RPD. It is difficult for artificial teeth used to repair dentures due to fractured natural teeth to have a shape similar to that of natural teeth, and to repair aesthetic artificial teeth, it is necessary to manufacture customized artificial teeth similar to the shape of each patient's teeth. Recently, CAD/CAM technology has been used to fabricate customized prosthetics on existing RPD to achieve high retention and fitness accuracy, and by manufacturing customized artificial teeth, more aesthetic and harmonious artificial tooth repair is possible. This is a case in which a denture was repaired using a digital method to fabricate a customized prosthesis on an existing partial denture and customized artificial teeth that mirrored the adjacent dentition, saving time and cost, simplifying the process, and achieving aesthetically and functionally satisfactory results.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.364-370
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• 2015

Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.10-20
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• 2012

Purpose: The purpose of this study was to investigate the stress distribution in mandibular implant-supported overdentures and tooth-supported overdentures with telescopic crowns. Materials and methods: The assumption of this study was that there were 2, 3, 4 natural teeth and implants which are located in the second premolar and canine regions in various distributed conditions. The mandible, teeth (or implants and abutments), and connectors are modeled, and analyzed with the commercial software, ANSYS Version 10.1. Stress distribution was evaluated under 150 N vertical load bilaterally on 3 experimental conditions - between canine areas, canine and $2^{nd}$ premolars, 10 mm posterior to $2^{nd}$ premolars. Results: Overall, the case of the implant group showed more stress than the case of the teeth group in stress distribution to bone. In stress distribution to superstructures of tooth and implants, there was no significant difference between TH group and IM group and the highest stress appeared in TH-IV and IM-IV. The stress caused from bar was much higher than those of implant and tooth. TH group showed less stress than IM group in stress distribution to abutment teeth and implant. Conclusion: The results shows that it is crucial to make sure that distance between impact loading point and abutment tooth does not get too far apart, and if it does, it is at best to set abutment tooth on premolar tooth region. It will be necessary to conduct more experiments on effects on implants, natural teeth and bone, in order to apply these results to a clinical treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.479-489
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• 2008

Statement of the problem: Under anatomical limitations on maxillary posterior region, a poor crown-to root ratio acting on dental implants can result in undesirable stress in surrounding bone, which in turn can cause bone defects and eventual failure of implants. Purpose: The purpose is to compare stress distribution due to different crown-root ratio and effect of splinting between natural teeth and implants in maxillary molar area under different loads. Material and methods: Analysis of stress arising supporting bone of the natural teeth and the implant was made with 3-dimensional finite element method. The model simulated naturel teeth was made with 2nd premolar and 1st molar in the maxillary molar region (Model T). The model simulated implants placed on same positions with two parallel implants of Straumann Dental Implant cemented abutment (Model I). Each model was designed in different crown-root ratio (0.7:1, 1:1, 1.25:1) and set cement type gold crown to make it non-splinted or splinted. After that, 300 N force was loaded to each model in five ways (Load 1: middle of occlusal table, Load 2: middle of buccal cusp, Load 3: middle of lingual cusp, Load 4: horizontal load to buccal cusp of anterior abutment only, Load 5: horizontal load to middle of buccal cusp of each abutment), and stress distribution was analyzed. Results and conclusion: On all occasions, stress was concentrated at the cervical region of the implant. Under load 1, 2 and 3, stress was not increased even when crown-root ratio increases, but under load 4 and 5, when crown-root ratio increases, stress also increased. There was difference in stress values between natural teeth and implants when crown-root ratio gradually increases; In case of natural teeth, splinting decreased stress under vertical and horizontal loads. In case of implants, splinting decreased stress under vertical loads 1,2 and 3, but increased maximal stress under loads 2 and 3. Under horizontal loads, splinting decreased stress, however the effect of splinting decreased under load 5 than load 4. Furthermore, the stress was increased, when crown-root ratio is 1.25:1. Clinical implications: This limited finite element study suggests that the stress on supporting bone may be increased under non-axial loads and poor crown-root ratio. Under poor crown-root ratio, excessive stress was generated at the cervical region of the implant, and decreased splinting effect for stress distribution, which can be related to clinical failure.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.208-217
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• 2018

The maxillary anterior teeth play an important role in esthetics. The esthetic of maxillary anterior teeth is closely related to tooth morphology and also harmony with gingiva. Precise diagnosis and treatment plan are essential to satisfy patient's demand, and sometimes surrounding soft tissue management is involved to achieve the goal. Gingivectomy can be considered as one method to make esthetic restoration possible. As well as esthetics, function has to be considered in maxillary anterior teeth restoration. Definitive cast of abutment and diagnostic cast waxed up labially were superimposed with model scanner, so can provide former comfortable occlusion. This case report demonstrates functional and esthetic improvements of two patients through gingivectomy and the data of superimposed image of casts.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.140-145
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• 2024

Removable partial denture wearers are exposed to the risks that remaining teeth get damaged by caries, attritions, erosion, and fracture. In the case of damaged abutment tooth which should fit to Removable partial denture (RPD), the fabrication of surveyed crown is followed by the making of RPD. However, making new denture takes a long time, and needs several processes and costs. Also, patients should get used to new denture. If other abutment teeth and edentulous ridges provide the existing denture with support, retention, and stability, use of existing denture is considered clinically acceptable. In this situation, fabricating retrofit crowns to an existing removable partial denture makes patient use existing denture, cuts costs, and reduces discomfort. In this case, severely worn teeth were restored using monolithic zirconia crown which fit to an existing removable partial denture by CAD-CAM. Moreover, support, retention, and stability of the denture were improved, and both doctor and patient were satisfied with the result.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.1
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• pp.81-87
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• 2019

Patients with Down's syndrome have several dental complications such as small teeth caused by underdevelopment of dentin and enamel, periodontitis, agenesis of teeth, prolonged retention of primary teeth and malocclusion due to narrow palate. Removable denture with maxillary double crowns would be a good treatment option to solve the problems of the patient with Down's syndrome. Double crowns compensate the insufficient support and retention of denture and easily solve the cross bite problem. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 26-year-old female patient with Down's syndrome and dental phobia had small number of teeth with enamel hypoplasia, prolonged retention of primary teeth and dental cross bite. Prosthetic treatment was done using removable denture with double crowns in the maxilla. In the mandible, teeth preparation was done on enamel margin without anesthesia. Anterior laminate and posterior complete zirconia crown restorations were performed. As a result, the cross bite was effectively corrected by denture with double crowns. Pronunciation and appearance were also improved without extraction of teeth and dental anesthesia.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.6
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• pp.753-759
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• 2007

Statement of problem. In distal extension removable partial denture, the preservation of health of abutment teeth is very important, but abutment teeth are subjected to unfavorable stress under unilateral loading specially. Purpose. The purpose of this study was to investigate the biomechanical effects of mandibular removable partial dentures with various prosthetic designs under unilateral loading, using strain gauge analysis. Material and methods. Artificial teeth of both canines were anchored bilaterally in a mandibular edentulous model made of resin. Bilateral distal extension removable partial dentures with splinted and unsplinted abutments were fabricated. Group 1: Clasp-retained mandibular removable partial denture with unsplinted abutments Group 2: Clasp-retained mandibular removable partial denture with splinted abutments by 6-unit bridge. Group 3: Bar-retained mandibular removable partial denture Strain gauges were bonded on the labial plate of the mandibular resin model, approximately 2 mm dose to the abutments. Two unilateral vertical experimental loadings (30N and 100N) were applied subsequently via miniature load cell that were placed at mandibular left first molar region. Strain measurements were performed and simultaneously monitored from a computer connected to data acquisition system. For within-group evaluations, t-test was used to compare the strain values and for between-group comparisons, a one-way analysis of variance (ANOVA) was used and Tukey test was used as post hoc comparisons. Results. The strain values of group 1 and 2 were tensile under loadings. In contrast, strain values of group 3 were compressive in nature. Strain values increased as the applied load in increased from 30N to 100N (p<.05) except for right side in group 1. Under 30N loading, in left side, group 1 showed higher strain values than groups 2 and 3 in absolute quantity (p<.05). And group 2 showed higher strain values than group 1 (p<.05). In right side, group 1 and 2 showed higher strain values than group 3 in absolute quantity (p<.05). Under 100N loading in left side, group 1 showed higher strain values than groups 2 and 3 in absolute quantity (p<.05). And group 2 showed higher strain values than group 1 (p<.05). In right side, group 1 and 2 showed higher strain values than group 3 in absolute quantity (p<.05). Under 30N loading, group 2 and 3 showed higher strain values in right side than in left side. Under 100N loading, right side strain values were higher than left side ones for all groups. Conclusion. Splinting of two isolated abutments by bridge reduced the peri-abutment strain in comparison with unsplinted abutments under unilateral loading. Bar-retained removable partial denture showed the lowest strain of three groups, and compressive nature.