• Title/Summary/Keyword: Alveolar resorption

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A conversion to implant assisted removable partial denture in failed fixed implant prosthesis of mandible: A case report (실패한 고정성 임플란트 보철물을 제거 후 임플란트 융합 가철성 국소의치로 전환 치료한 증례)

  • Jin, Seung-Lee;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo;Lee, Hyeon-Jong;Lee, So-Hyoun
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.2
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    • pp.161-168
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    • 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.

PERIODONTAL DISEASE CAUSED BY TRAUMA FROM OCCLUSION IN A CHILD (외상성 교합으로 인한 어린이의 치주질환)

  • Choi, Byung-Jai;Ko, Dong-Hyun;Kim, Seong-Oh;Lee, Jae-Ho;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.448-452
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    • 2004
  • Trauma from occlusion(TFO) is injury to the periodontal tissue as a result of occlusal forces. Mobility is a common clinical sign of occlusal trauma. In acute occlusal trauma, this may be accomanied by pain, tenderness to percussion, thermal sensitivity, and pathologic tooth migration. Chronic occlusal trauma may be marked by excessive wear and gingival recession. Radiographic finding include a widened periodontal ligament space, radiolucence and condensation of the alveolar bone and root resorption. TFO is related to the pathogenesis of periodontal disease. It can cause increased tooth mobility TFO itself does not initate or aggravate marginal gingivitis or initiate periodontal pockets. Active trauma can accelerate bone loss, pocket formation and gingival recession depending on the presence of local irritants and inflammation. Gingival recession associated with occlusal forces includes traumatic crescent, McCall's festoon and Stillman's cleft. TFO plays a minor role in the pathogenesis of early to moderate periodontitis. A 5-year-old male visited Yonsei University Pedodontics clinic with a chief complaint about gingival recession. Mobility, excessive wear, gingival recession were detected by clinical exam on the both mandibular deciduous ca nine. On the radiographic view, vertical alveolar bone loss was observed on both mandibular deciduous canine.

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THREE DIMENSIONAL FINITE ELEMENT STRESS ANALYSIS OF IMPLANT PROSTHESIS ACCORDING TO THE DIFFERENT FIXTURE LOCATIONS AND ANGULATIONS (임플랜트 지지 보철물에서 고정체의 식립위치와 각도에 따른 삼차원 유한요소법적 응력분석에 관한 연구)

  • Park Won-Hee;Lee Young-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.1
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    • pp.61-77
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    • 2005
  • Statement of problem. The implant prosthesis has been utilized in various clinical cases thanks to its increase in scientific effective application. The relevant implant therapy should have the high success rate in osseointegration, and the implant prosthesis should last for a long period of time without failure. Resorption of the peri-implant alveolar bone is the most frequent and serious problem in implant prosthesis. Excessive concentration of stress from the occlusal force and biopressure around the implant has been known to be the main cause of the bone destruction. Therefore, to decide the location and angulation of the implant is one of the major considering factors for the stress around the implant fixture to be dispersed in the limit of bio-capacity of load support for the successful and long-lasting clinical result. Yet, the detailed mechanism of this phenomenon is not well understood. To some extent, this is related to the paucity of basic science research. Purpose. The purpose of this study is to perform the stress analysis of the implant prosthesis in the partially edentulous mandible according to the different nature locations and angulations using three dimensional finite element method. Material and methods, Three 3.75mm standard implants were placed in the area of first and second bicuspids, and first molar in the mandible Thereafter, implant prostheses were fabricated using UCLA abutments. Five experimental groups were designed as follows : 1) straight placement of three implants, 2) 5$^{\circ}$ buccal and lingual angulation of straightly aligned three implants, 3) 10$^{\circ}$ buccal and lingual angulation of straightly aligned three implants. 4) lingual offset placement of three implants, and 5) buccal offset placement of three implants. Average occlusal force with a variation of perpendicular and 30$^{\circ}$ angulation was applied on the buccal cusp of each implant prosthesis, followed by the measurement of alteration and amount of stress on each configurational implant part and peri-implant bio-structures. The results of this study are extracted from the comparison between the distribution of Von mises stress and the maximum Von mises stress using three dimensional finite element stress analysis for each experimental group. Conclusion. The conclusions were as follows : 1. Providing angulations of the fixture did not help in stress dispersion in the restoration of partially edentulous mandible. 2. It is beneficial to place the fixture in a straight vertical direction, since bio-pressure in the peri-implant bone increases when the fixture is implanted in an angle. 3. It is important to select an appropriate prosthodontic material that prevents fractures, since the bio-pressure is concentrated on the prosthodontic structures when the fixture is implanted in an angle. 4. Offset placement of the fixtures is effective in stress dispersion in the restoration of partially edentulous mandible.

THE ROOT RESORPTION AND THE PERIODONTAL TISSUE CHANGE AFTER ORTHODONTIC TOOTH MOVEMENT OF THE VITAL AND ENDODONTICALLY TREATED TOOTH IN THE DOG (실활치의 교정적 치아이동시 치근 및 치주조직의 변화에 관한 실험적 연구)

  • Shim, Won Seop;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.20 no.3 s.32
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    • pp.447-462
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    • 1990
  • The objective of this experiment is to observe structural differences in the othodontic movement of vital (control group) and devitalized (experimental group) teeth in the mongrel dogs. The 5 utilized dogs in this experiment were approximately 1 year of age and their average weight was about 12 Kg. Endodontic therapy was performed on the 2nd premolars in upper & lower jaws of each animal under the general anesthesia by intravascular injection of 25mg/kg of pentobarbital sodium. The canals of the teeth were obturated by using gutta percha in conjunction with root canal sealer (AH26 Densply). One of the roots in the 2nd premolars was hemisected to make an extraction space for the devitalized teeth to be moved. The edgewise technique was employed for the movement of the teeth. Orthodontic models and intraoral roentgenograms were taken before and after orthodontic tooth movement. The open coil springs (.010 x .040) were used at interbraket space in order to provide equal forces (75gm) between the teeth in each arch wire. After 13 weeks of active orthodontic tooth movement, dogs were sacrified and the experimental results w ere examined through the intraoral radiography, microscopic examination and scanning electromicroscopic examination at the root sulfate. From the results of the study, the following conclusions may be drawn: The root resolution and cemental deposition were observed within the pressure and tension site in both group. 2. The root resorbed lacunae were observed in the cementum and/or into the dentin in both group. 3. The prominent osteoblastic activities were observed on the alveolar margin in the tension site in both group. 4. A few of blood vessels were observed in the pressure site, but also lots of blood vessels were observed in the tension site especially in the periphery of the alveolar bone in both group. 5. In the pressure site, resorbed lacunae were formed with deep and narrow cavity in the control group; the shallow and wide cavity in the experimental group. 6. In the pressure site, the repaired cementum or cementoid tissue was lined on cementum in the experimental group, but not in the control group. 7. There was no significant difference between external root resolution of endodontically and vital teeth when both were subjected to orthodontic forces.

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THREE-DIMENSIONAL ANALYSIS OF THE NORMAL DENTITION AND EDENTULOUS MAXILLA OF KOREANS (한국인의 상악 유치악 치열 및 무치악 치조제에 관한 삼차원적 연구)

  • Kim Hyeong-Seop;Shin Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.2
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    • pp.191-203
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    • 2005
  • Statement of problem. In Korea, the preliminary impression trays for dental and edentulous maxillae are manufactured on the base of the statistical value of Westerners. There had been less study on the dental and edentulous arches of Koreans. Purpose. The purpose of this study was to evaluate an average dental cast, preliminary impression trays, three-dimensional relation of dental and edentulous maxilla of Koreans Material and methods. The subjects for this study were 173 dental casts of maxilla (dental: 52, edentulous : 146) with ages $18\{\sim}60$ years old. Each of the master casts was measured 69 measuring points on the dental cast or maxilla, and 46 measuring points on the edentulous cast of maxilla with three-dimensional digital measuring machine. Each measuring points were analysed and were overlapped, that three dimensional dental graphic manufactured by CAD/CAM system. Results. 1. A standard of distribution to alveolar bone were width between left and right buccal border lines of the standard 3/4 line. The mean value of dental and edentulous casts were 67.27mm, 63.49mm respectively. 2. Morphological classification of dental casts were divided into three groups or V-shape, O-shape, U-shape, that proportion of distribution were 17%, 16%, 67%, respectively. Dimensional classification of the dental casts were divided into five groups of less than 63mm, 63 up to 65mm, 65 up to 67mm. 67 up to 69mm, more than 69mm, respectively. 3. Morphological classification of edentulous casts were divided into three groups or V-shape, O-shape, U-shape, that proportion of distribution were 18%, 17%, 65%, respectively Dimensional classification of the edentulous casts were divided into five groups of less than 57mm, 57 up to 61mm, 61 up to 65mm, 65 up to 69mm, more than 69mm, respectively. 4. Mean dental and edentulous cast of maxilla were overlapped, the proportion of bone resorption to alveolar bone is higher than that of palatal bone, its difference were higher anterior 2/4 area than posterior 3/4 area. Conclusion. It obtains information of preliminary impression trays for dental and edentulous maxilla of Koreans.

Quality and Morphology on cortico-cancellous bone in Korean mandibular symphysis area (한국인 하악 유합부에서의 피질골-해면골의 밀도 및 형태)

  • Min, Cheon-Ki;Park, Hyun-Do;Kim, Chang-sung;Jung, Han-Sung;Cho, Kyoo-Sung;Kim, Hee-Jin;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.31 no.3
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    • pp.581-595
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    • 2001
  • In performing implant procedures in the anterior portion of the maxilla, many difficulties exist because of anatomical reasons, such as the proximity of the nasal floor, lateral extension of the incisive canal, and labial concavity. On the other hand, in the posterior region of the maxilla, there is often insufficient recipient bone between the maxillary sinus and alveolar ridge due to alveolar ridge resorption and pneumatization of the maxillary sinus. In order to perform implants in such regions, ridge augmentation procedures such as onlay bone graft, guided bone regeneration, and maxillary sinus grafting are performed. In studies of Caucasians, use of autograft from mandibular symphysis has been reported to be highly successful in maxillary sinus grafting. However, in a clinical study of Koreans, autograft of mandibular symphysis has been reported to have significantly low success rate. It has been hypothesized that this is because of insufficient cancellous bone due to thick cortical bone. In order to test this hypothesis, bone quality and morphology of Koreans can be compared with those of Caucasians. In this study, the bone density and morphology of the cortical bone and cancellous bone in the mandibular symphysis of 35 Korean cadavers were evaluated. The following results were obtained: 1. In terms of bone density, type I, type II, and type III consisted of 1.4%(3/213), 72.3%(154/213), and 26.3%(56/213) of the cross-sectioned specimens, respectively. In general, the bone density tended to change from type II to type III, as cross-sectioned specimens were evaluated from the midline to the canine. Type IV wasn't observed in this study. 2. The distance between the root apex and the lower border of the cancellous bone was 18.34mm-20.59mm. Considering that the bone has to be cut 5mm below the root apex during the procedure, autografts with about 15mm of vertical thickness can be obtained. 3. The thickness of cortical bone on the labial side increased from the root apex to the lower border of the mandible. The average values ranged from 1.43mm to 2.36mm. 4. The labio-lingual thickness of cancellous bone ranged from 3.43mm to 6.51mm. The thickness tended to increase from the apex to the lower border of the mandible and decrease around the lower border of cancellous bone. From the above results, the anatomic factors of the mandibular symphysis (bone density, thickness, quantity and length of the cortical bone and cancellous bone) didn't show any difference from Caucasians, and it cannot be viewed as the cause of failure in autografts in the maxillary sinus for implants.

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Implant-retained overdentures with pre-fabricated bar attachment system in edentulous patients (무치악 환자에서 기성 조립식 bar를 이용한 임플란트 피개의치 증례)

  • So, Na-Young;Hong, Young-Gi;Ha, Seung-Ryong
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.41-48
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    • 2016
  • Edentulous patients with severe alveolar bone resorption have trouble with using traditional complete denture. In order to overcome these problems, implant-retained overdenture was developed. SFI-bar$^{(R)}$ system can save time and cost compared to other existing bar systems which need complicated laboratory procedures because it can be adjusted directly in a patient's mouth. A 55-year-old male, who had experienced a fractured lower old implant-retained overdenture, wanted a durable and painless denture. The fractured Locator$^{(R)}$ attachments were removed and edentulous mandible was restored with SFI-bar$^{(R)}$. A 77-year-old female with a medical history of the Parkinson's disease and severely absorbed alveolar bone of mandible, wanted to wear a retentive mandibular denture without pain. After placing two implants in front of mental foramen, two adaptors were connected to two implants and a tube bar was connected to the adaptors. A female part fitted to the bar was attached to the new denture. These clinical reports describe two-implant-retained overdenture using the SFI-bar$^{(R)}$ system in mandibular edentulous patients. Since the patients were satisfied esthetically and functionally during 2 years' observation, we would like to report cases.

THE ERUPTION GUIDANCE OF AN IMPACTED DILACERATED MAXILLARY CENTRAL INCISOR (변위 매복된 상악 중절치의 맹출유도)

  • Kang, Keun-Young;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.550-556
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    • 2005
  • Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone by any causes. Any tooth in the dental arch can be impacted, but the teeth frequently involved in a descending order are the mandibular and maxillary third molars, the maxillary canines, the mandibular and maxillary second premolars, and the maxillary central incisors. In these teeth, impaction of maxillary incisor occurs in about 0.1-0.5% and major causes are trauma, supernumerary teeth and periapical inflammation of primary maxillary incisor. Delayed eruption of a maxillary central incisor results in midline shift, the space's being occupied by an adjacent tooth and different levels of alveolar height. Treatment options are observation, surgical intervention, surgical exposure and orthodontic traction, transplantation and extraction. These cases were about the patients with delayed eruption of maxillary central incisor. We surgically exposed impacted tooth and guided it into normal position by the orthodontic traction. At the completion of traction, the maxillary central incisor was positoned fairly within the arch and complications such as root resorption were not observed.

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A Study on the changes of periodontal tissue after orthodontic tooth movement in young adult dogs (유성견에서 교정적 치아이동에 따른 치주조직 변화에 관한 연구)

  • Kang, Nam-Yong;Yoon, Young-John;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.559-568
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    • 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.

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A RADIOGRAPHIC STUDY OF MESIODENSES OCCURRED IN THE MAXILLARY CENTRAL INCISOR REGION (상악중절치부위에 발생된 정중과잉치의 X선학적 연구)

  • Kim Young Il;Hwang Eui Hwan;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.2
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    • pp.367-375
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    • 1991
  • The clinical and radiographic features of 1,171 mesiodenses were studied with periapical radiograms and/or pantomograms in 942 persons visited the Department of Oral Radiology, School of Dentistry, Kyung Hee University during January 1980 to December 1989. The obrained results were as follows; 1. The incidence of mesiodens was higher in males (75.4%) than in females (24.6%). 2. In number of mesiodenses per individual, a single mesiodens was found to be 75.9%, 2-mesiodenses to be 23.8%, and 3-mesiodenses to be 0.2%. 3. In mesiodenses according to erupted and impacted status, the erupted mesiodens was found to be 16.5%, the impacted mesiodens in the interdental alveolar bone to be 66.6%, and in the region below root apex to be 16.9%. 4. In impacted mesiodenses according to direction of tooth crown, the inverted impaction was found to be 68.8%, the vertical impaction to be 15.1%, and the angulated impaction to be 16.1%. Among the impacted mesiodenses, a palatally located impaction was 87.5%, a middle 4.9%, and a labially 7.6%. 5. In mesiodenses according to shape of the tooth crown, a incisor-like type was found to be 1.6%, a canine-like type to be 6.8%, a conical type to be 79.2%, and a tuberculated type to e 12.4%. 6. In effect of mesiodens on adjacent tooth, non-specific influences were found to be 73.4%, crowding to be 0.3%, diastema to be 11.8%, rotation to be 5.7%, delayed eruption to be 3.8%, root resorption to be 2.6%, and dentigerous cyst to be 2.4%.

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