Sungwoo Ju;Seoung-Jin Hong;Janghyun Paek;Kwantae Noh;Ahran Pae;Kung-Rock Kwon;Hyeong-Seob Kim
The Journal of Korean Academy of Prosthodontics
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v.61
no.4
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pp.316-327
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2023
In the case of fully edentulous patients with severe alveolar bone resorption, the consideration of 'All-on-X' implant-supported fixed prosthesis after placing four or more implants in the anterior maxilla is possible. Recent advancements in digital dentistry have enabled systematic and predictable treatment in all phases, including diagnosis, surgery, and prosthesis fabrication. By incorporating digital dentistry techniques such as digital complete denture, implant surgical guides, facial scanning into the conventional restoration process, it is possible to reduce the complexity of the prosthesis fabrication and effectively achieve the transition from provisional prosthesis to definitive prosthesis in terms of both aesthetics and function.
Ina Kim;Eunji Oh;Sang-Won Park;Hyun-Pil Lim;Kwi-dug Yun;Chan Park
Journal of Dental Rehabilitation and Applied Science
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v.40
no.2
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pp.82-90
/
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.
The objective of this study was to evaluate the changes that occurred over time in the distracted periodontal ligament space following the rapid retraction of a tooth by periodontal distraction after bone undermining surgery had been conducted in the dogs. The upper second premolars were extracted on the left and right side in 4 male beagle dogs. Immediately after extraction, the interseptal bone distal to the upper first premolar was thinned and undermined by grooving to decrease the bone resistance. Activating an individualized distraction appliance at the rate of 0.225mm twice a day, the upper first premolar was retracted rapidly toward the extraction socket. Periodontal distractions were performed for 5, 10, and 20 days, and 20-day-distraction cases were followed by maintenance periods of 0, 14, 28, and 56 days. After 20 days of rapid retraction, the average distal movement of the upper first premolar was 5.02mm, and the average mesial movement of the upper third premolars serving as an anchorage unit was 0.18 mm. On histological examination, the regeneration of bone occurred in a highly organized pattern. Distracted periodontal ligament space was filled with newly formed bone oriented in the direction of the distraction, and this was followed by extensive bone remodeling. This result was similar to those observed in other bones after distraction osteogenesis. In the periodontal ligament, the relationship between collagen fibers and cementum began to be restored 2 weeks after the distraction was completed, and showed almost normal features 8weeks after the completion of the periodontal distraction. However, on the alveolar side, the new bone formation was still in process and collagen fiber bundles and Sharpey's fibers were not present 8 weeks after the completion of the periodontal distraction. Reactions in the periodontal ligament of the anchorage tooth represented bone resorption on the compressed side and new bone deposition on the tension side as occurred in conventional orthodontic tooth movement. In conclusion, the results of this study showed that periodontal structures on the distracted side of the periodontal ligament were regenerated well histologically following rapid tooth movement.
The orthodontic osseointegrated titanium implant, a kind of intraoral skeletal anchorage can be an alternative to tooth-borne anchorage, in case that the conventional tooth-borne anchorage is not available or the anchorage is critical. This study was conducted to elucidate the effect of early loading on the osseointegration of the orthodontic titanium implant and the healing process of the impaired bone at the site of implant after removing it. In two adult beagle dogs24 osseointegrated titanium implants were inserted into the alveolar bone, with 12 implants placed in each dog. In dog1, 6 out of 12 implants were loaded with 200-300gm of force immediately after placing, and the remaining 6 implants were not loaded for 4weeks. In dog2, all 12 implants had healing period of 4weeks, and then were loaded with 200-300gm of force for another 4weeks. Following an observation period of 4 and 8 weeks, the animals were sacrificed. Then the implants and the surrounding bone of dog1 and dog2 were removed, respectively. Undecalcified sections along the long axis of implant were made and the degree of osseointegration was examined under the light microscope. The results were as follows. 1. In the histologic features of tissues around implants anchored in dog1, there was no difference between immediately loaded implants and unloaded implants. Immature woven bone was ingrowing into the thread spaces from the original compacta and in direct contact with the implant surface in part. 2. The premature loading just after 4weeks healing period did not halt the progress of the osseointegration between bone and implant surface. The woven bone around the implants was maturing into the lamellar bone which resembled the structure of the original compacta at the end of 8weeks observation period. 3. Most implants with the inflammed surrounding mucosa were lost or mobile. The mobile implants were encapsulated by fibrous connective tissue which separated the implant surface from the bone. 4. The impaired bone at the site of the implant failed to anchor was showing recovery without inflammatory reaction 2weeks after removing, with the immaure woven bone lined by active osteoblasts and osteoid. Based on the results of this study, the integration of this orthodontic implant seemed to be impaired by the inflammation of the tissue surrounding the Implant rather than by early loading on implant, and increased with time lapsed after placing the implant. The use of implant described in this report can be recommended as an orthodontic anchorage unit immediately after insertion under the careful control of orthodontic force applied and plaque.
Vitamin D is known to exert its action by activating DNA and RBA within target cells to produce proteins and enzymes that can be used in bone resorption process. Particularly, the active form of vitmain D, 1,25-dihydroxycholecalciferol $[1,25-(OH)_2D_3]$, is considered to be one of the most potent stimulators of osteoclatic acitivity in vitro. The purpose of this study was to evaluate the effect of 1,25-Dihydroxyvitamin $D_3$ on the avtivity of periodotal ligament cells and, the experimental tooth movement. Human periodontal ligament cells were collected from the first premolar tooth extracted for the orthodontic treatment, and were incubated in the environment of $37^{\circ}C$, 5% $CO_2$ and 95% humidity. Microtitration(MIT) assay was done at 10, 25, 50 and 100ng/ml of 1,25-Dihydroxyvitamin $D_3$. 21 Sprague-Daft rats were divided into a control gmup(3), and experimental groups(18) where 100g of force from helical spring was applied across the maxillary incisors 1,25-Dihydroxyvitamin $D_3$ was injected into periodontal ligament at the mesial or distal surface of maxillary incisors so that we can compare the control side and the experimental side. Expreimental groups were sac rifled at 12, 24, 36, 48, 72hours and 7 days after force application, respectively. And the obtained tissues were evaluated histologically. The observed results were as follows. 1. The activity of periodontal ligament cells in l0ng/ml or 25ng/ml of 1,25-Dihydroxyvitamin $D_3$ 1,25-Dihydroxyvitamin $D_3$ was not significantly different to the control at the cultivation of 1, 2 and 3 days. 2. The activity of periodontal ligament cells was significantly increased at 3 days in 50 ng/ml of 1,25-Dihydroxyvitamin $D_3$ and 2, 3 days in 100g/ml of 1,25-Dihydroxyvitamin $D_3$. 3. Up to 7 days after force application, there was no difference in osteoblastic activity, tearing of periodontal ligament and proliferation of capillary at tension side between 1,25-Dihydroxyvitamin $D_3$ injection side and the control side. 4. The osteoclastic activity and the resorption of alveolar bone was greater in 1,25-Dihydroxyvitamin $D_3$ injection side than the control side at 36 hours after force application.
Biodegradable barrier membrane has been demonstrated to have guided bone regeneration capacity on the animal study. The purpose of this study is to evaluate the effects of cultured calvarial cell inoculated on the biodegradable barrier membrane for the regeneration of the artificial bone defect. In this experiment 35 Sprague-Dawley male rats(mean BW 150gm) were used. 30 rats were divided into 3 groups. In group I, defects were covered periosteum without membrane. In group II, defects were repaired using biodegradable barrier membrane. In group III, the defects were repaired using biodegradable barrier membrane seeded with cultured calvarial cell. Every surgical procedure were performed under the general anesthesia by using with intravenous injection of Pentobarbital sodium(30mg/Kg). After anesthesia, 5 rats were sacrificed by decapitation to obtain the calvaria for bone cell culture. Calvarial cells were cultured with Dulbecco's Modified Essential Medium contained with 10% Fetal Bovine Serum under the conventional conditions. The number of cell inoculated on the membrane were $1{\times}10^6$ Cells/ml. The membrane were inserted on the artificial bone defect after 3 days of culture. A single 3-mm diameter full-thickness artificial calvarial defect was made in each animal by using with bone trephine drill. After the every surgical intervention of animal, all of the animals were sacrificed at 1, 2, 3 weeks after surgery by using of perfusion technique. For obtaining histological section, tissues were fixed in 2.5% Glutaraldehyde (0.1M cacodylate buffer, pH 7.2) and Karnovsky's fixative solution, and decalcified with 0.1M disodium ethylene diaminetetraacetate for 3 weeks. Tissue embeding was performed in paraffin and cut parallel to the surface of calvaria. Section in 7${\mu}m$ thickness of tissue was done and stained with Hematoxylin-Eosin. All the specimens were observed under the light microscopy. The following results were obtained. 1 . During the whole period of experiment, fibrous connective tissue was revealed at 1week after surgery which meant rapid soft tissue recovery. The healing rate of defected area into new bone formation of the test group was observed more rapid tendency than other two groups. 2 . The sequence of healing rate of bone defected area was as follows ; test group, positive control, negative control group. 3 . During the experiment, an osteoclastic cell around preexisted bone was not found. New bone formation was originated from the periphery of the remaing bone wall, and gradually extended into central portion of the bone defect. 4 . The biodegradable barrier membrane was observed favorable biocompatibility during this experimental period without any other noticeable foreign body reaction. And mineralization in the newly formed osteoid tissue revealed relatively more rapid than other group since early stage of the healing process. Conclusively, the cultured bone cell inoculated onto the biodegradable barrier membrane may have an important role of regeneration of artificial bone defects of alveolar bone. This study thus demonstrates a tissue-engineering the approach to the repair of bone defects, which may have clinical applications in clinical fields of the dentistry including periodontics.
Lee, Kye Young;Jee, Young Koo;Choi, Young Hi;Myong, Na Hye;Kim, Keun Youl
Tuberculosis and Respiratory Diseases
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v.43
no.4
/
pp.613-622
/
1996
Constrictive bronchiolitis, one of small airway diseases, is very rare and occupies one of the two arms of bronchiolitis obliterans together with proliferative bronchiolitis. Proliferative bronchiolitis, presenting the prototype with bronchiolitis obliterans with organizing pneumonia(BOOP), can be easily taken into diagnostic consideration in terms of relatively rapid clinical course and radiologic presentation as if atypical pneumonia with interstitial and alveolar infiltrations. Meanwhile constrictive bronchiolitis is not only very Tare but also easily overlooked as chronic obstructive pulmonary diseases such as emphysema, because it usually shows normal chest radiographic finding and obstructive pattern in pulmonary function test. In the aspects of the response to treatment, proliferative bronchiolitis showed dramatic response to the corticosteroid while constrictive bronchiolitis is intractable, which is easily explained on the basis of the pathologic characteristics of cicartrical replacement of bronchiolar walls. The bronchiolitis, both proliferative and constrictive, can be associated with diverse conditions such as inhalational injury, postinfectious process, drug of chemical induced reactions, connective tissue diseases, and organ trasplantation. And there is idiopathic type which has no associated condition. There is one explanation that both types of bronchiolitis lie on the same disease spectrum because the different disease pattern can be evoked from the same etiology. In contrast, another explanation is suggested that both types of bronchiolitis are one of nonspecific tissue reaction rather than a disease specific histologic finding because the various types of causes can provoke the same histologic findings. These dilemma remains for further investigation. With literature investigation, the authors report a case of constrictive bronchiolitis proven by open lung biopsy in 47 year old female who was diagnosed as non-Hodgkin's lymphoma and simultaneously had relatively rapid progression of airflow obstruction and showed negative radiographic finding without the rise factors for the development of chronic obstructive lung disease. We consider it as idiopathic because we could not find any relationship between constrictive bronchiolitis and non-Hodgkin's lymphoma on the literature search and it requires further investigation.
Purpose: The changed expressions of $TGF-{\beta}1$, as a key cytokine in the fibrotic process, due to melatonin with potent antioxidative effects, were investigated in the irradiated lung using fibrosis-sensitive C57BL/6 mice. Materials and Methods: Female C57BL/6 mice were divided into control irradiation-only, and melatonin (300 mg/kg i.p. 1 hr before irradiation) pretreatment groups. The thoraces of the mice were irradiated with a single dose of 12 Gy. The mRNA expressions of $TGF-{\beta}1$ in the lung tissue 2 and 4 weeks after irradiation were quantified using semiquantitive RT-PCR, and the cellular origin and expression levels of $TGF-{\beta}1$ protein were identified using immunohistochemical staining. Results: The relative mRNA expression levels in the irradiation-only and melatonin pretreatment groups 2 and 4 weeks after irradiation were 1.92- and 1.80-fold (p=0.064) and 2.38- and 1.94-fold (p=0.004) Increased, respectively compared to those in the control group. increased expressions of $TGF-{\beta}1$ protein were prominently detected in regions of histopathologicai radiation injury, with alveolar macrophages and septal epithelial cells serving as important sources of $TGF-{\beta}1$ expression. At 2 and 4 weeks after irradiation, the expression levels of protein were $15.8\%\;vs.\;16.9\%$ (p=0.565) and $36.1\%\;vs.\;25.7\%$ (p=0.009), respectively. Conclusion: The mRNA and protein expressions of $TGF-{\beta}1$ in the lung tissue following thoracic irradiation with 12 Gy were significantly decreased by melatonin pretreatment at 4 weeks. These results indicate that melatonin may have a possible application as an antifibrotic agent in radiation-induced lung injury.
Journal of the korean academy of Pediatric Dentistry
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v.34
no.2
/
pp.315-321
/
2007
Removable appliance has many utilities in pediatric dentistry in the fields of space maintainance or occlusal guidance. In contrast to maxilla, many problems have occurred with mandible in using removable appliance such as deteriorated retention, inconvenience and patient's unwillingness to wear. It is probably due to adapting several retentive clasps at buccal side of the tooth, where there is actually little or no undercut especially in young children having the erupting teeth Moreover, acrylic base plate of conventional removable appliance is located at lingual parts, which leads to the conflict with alveolar crest undercut and sublingual soft tissues. Moreover, young children frequently do not follow the dentist's direction to elevate tongue properly during the impression taking process. Throughout this study, the position of clasps and acrylic baseplate was changed opposite to the traditional Hawley acrylic appliance in order to make a buccal acrylic appliance with buccal base plate and lingual clasp into primary dentition and early mixed dentition. This study was performed for the purpose of evaluating the buccal acrylic appliance in regards of patient compliance, retention and efficiency compared with traditional lingual acrylic appliance along with its merits and demerits. Buccal and lingual acrylic appliance were applied to 5 cases respectively which required space maintaining and tooth movement, and drew a comparison in relevance to patients' compliance, combination with the tongue's function and clinical effectiveness. According to this study, in every case buccal appliance was proved superior to lingual appliance in terms of retention and patients' compliance. Moreover, buccal appliance has shown to be similar to lingual appliance with respect to clinical effectiveness. Throughout this study, it was thought that, if removable appliance is to be applied to mandible, several drawbacks related to conventional lingual appliance shall be resolved. Conclusively, the buccal acrylic appliance is thought to be a good alternative in designing a mandibular appliance in young children and recommended to clinical applications.
Woo, Duck Soo;Seol, Won Jong;Kyung, Sun Young;Lim, Young Hee;An, Chang Hyeok;Park, Jeong Woong;Jeong, Sung Hwan;Lee, Jae Woong
Tuberculosis and Respiratory Diseases
/
v.55
no.5
/
pp.478-487
/
2003
Background : There have been several studies showing that the angiotensin II and angiotensin converting enzyme(ACE) contributes to the apoptosis of alveolar epithelial cells in idiopathic interstitial pneumonia and the activation of fibroblasts during the process of pulmonary fibrosis. These results suggest that the pulmonary fibrosis can be inhibited by the angiotensin II receptor antagonist(AGIIRA). This study was performed to identify the therapeutic effect of AGIIRA in idiopathic pulmonary fibrosis(IPF). Method : Thirteen patients with IPF, who were diagnosed with an open lung biopsy(6 patients) and furfilling the ATS criteria(7 patients) between March 1999 and October 2001 at the Gachon medical center, were enrolled in this study. Of these patients, eight patients were treated with a regimen including AGIIRA(AT group), and five were treated without AGIIRA(NT group). The pulmonary function tests and dyspnea(ATS scale) were measured at diagnosis and 1 year after treatment. All the data was collected to analyze the therapeutic effect of AGIIRA on the patients with IPF. Results : The AT group contained 8 patients(M:F=4:4) and the NT group contained 5 patients(M:F=3:2). There was no significant difference in the serum angiotensin II level between the two groups($202.5{\pm}58.5$ vs $163.7{\pm}47.3pg/ml$, p>0.05). The AT group showed an upward trend in TLC(+3%), FVC(+4%), FEV1(+3%) and DLco(+2%) compared to the NT group(TLC(-14%), FVC(-3%), FEV1(-4%) except for DLco(+5%)). The dyspnea score in the AT group improved significantly but not in the NT group. Conclusion : These results suggest that the angiotensin II receptor antagonist may have an effect on stabilizing IPF.
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