• Title/Summary/Keyword: Anterior implant

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Robotic-assisted Total Hip Arthroplasty and Spinopelvic Parameters: A Review

  • Steven J. Rice;Anthony D'Abarno;Hue H. Luu
    • Hip & pelvis
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    • v.36 no.2
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    • pp.87-100
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    • 2024
  • Total hip arthroplasty (THA) is an effective treatment for osteoarthritis, and the popularity of the direct anterior approach has increased due to more rapid recovery and increased stability. Instability, commonly caused by component malposition, remains a significant concern. The dynamic relationship between the pelvis and lumbar spine, deemed spinopelvic motion, is considered an important factor in stability. Various parameters are used in evaluating spinopelvic motion. Understanding spinopelvic motion is critical, and executing a precise plan for positioning the implant can be difficult with manual instrumentation. Robotic and/or navigation systems have been developed in the effort to enhance THA outcomes and for implementing spinopelvic parameters. These systems can be classified into three categories: X-ray/fluoroscopy-based, imageless, and computed tomography (CT)-based. Each system has advantages and limitations. When using CT-based systems, preoperative CT scans are used to assist with preoperative planning and intraoperative execution, providing feedback on implant position and restoration of hip biomechanics within a functional safe zone developed according to each patient's specific spinopelvic parameters. Several studies have demonstrated the accuracy and reproducibility of robotic systems with regard to implant positioning and leg length discrepancy. Some studies have reported better radiographic and clinical outcomes with use of robotic-assisted THA. However, clinical outcomes comparable to those for manual THA have also been reported. Robotic systems offer advantages in terms of accuracy, precision, and potentially reduced rates of dislocation. Additional research, including conduct of randomized controlled trials, will be required in order to evaluate the long-term outcomes and cost-effectiveness of robotic-assisted THA.

Effect of attachments and palatal coverage of maxillary implant overdenture on stress distribution: a finite element analysis (상악 임플란트 피개의치에서 유지장치 종류와 구개 피개 유무에 따른 응력분포에 대한 유한요소분석)

  • Park, Jong-Hee;Wang, Yuan-Kun;Lee, Jeong-Jin;Park, Yeon-Hee;Seo, Jae-Min;Kim, Kyoung-A
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.2
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    • pp.70-79
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect of attachments and palatal coverage on stress distribution in maxillary implant overdenture using finite element analysis. Materials and Methods: Four maxillary overdenture 3-D models with four implants placed in the anterior region were fabricated with computer-aided design. 1) Ball-F: Non-splinted ball attachment and full palatal coverage, 2) Ball-P: Non-splinted ball attachment and U-shaped partial palatal coverage, 3) Bar-F: Splinted milled bar attachment and full palatal coverage, 4) Bar-P: Splinted milled bar attachment and U-shaped partial palatal coverage. Stress distribution analysis was performed with ANSYS workbench 14. 100 N vertical load was applied at the right first molar unilaterally and maximum stress was calculated at the implant, peri-implant bone and mucosa. Results: The use of the ball attachment showed lower maximum stress on implant and peri-implant bone than the use of the milled bar attachment. But it showed contrary tendency in the mucosa. Regardless of attachment, full palatal coverage showed lower maximum stress on implant, peri-implant bone and mucosa. Conclusion: Within the limitation of this study, ball attachment improved stress distribution on implant and peri-implant bone rather than milled bar attachment in maxillary implant overdenture. Also, full palatal coverage is more favorable in stress distribution.

En-masse retraction with a preformed nickel-titanium and stainless steel archwire assembly and temporary skeletal anchorage devices without posterior bonding

  • Jee, Jeong-Hyun;Ahn, Hyo-Won;Seo, Kyung-Won;Kim, Seong-Hun;Kook, Yoon-Ah;Chung, Kyu-Rhim;Nelson, Gerald
    • The korean journal of orthodontics
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    • v.44 no.5
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    • pp.236-245
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    • 2014
  • Objective: To evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction. Methods: Thirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with preadjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed. Results: Both groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group. Conclusions: Preformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency.

A STUDY OF THE RELATIONSHIP BETWEEN TOOTH MOBILITY AND BITE FORCE ACCORDING TO THE PERIODONTAL DISEASE SEVERITY (치주질환 심도에 따른 치아동요도와 교합력의 상관관계에 관한 연구)

  • Choi, Joug-Woo;Lee, Man-Sup;Kwon, Young-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.23 no.2
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    • pp.331-344
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    • 1993
  • The purpose of this study was to investigate the change of tooth mobility and bite force according to periodontal disease severity. Tooth mobility and biting force due to change of viscoelastic property of periodontium were influenced by inflammation of periodontal tissue. 30 patients participated in this study, the periodontal disease severity is evaluated with SBI and attachment loss. SBI and attachment loss were examined by periodontal probe. Tooth mobility was tested two times to each tooth using periotest (Siemens Co, Germany) and bite force was evaluated with MPM-3000 (Nihon Kohden Co, Japan). Statistical analysis was applied to correlation ($r^2$) and regression analysis. The obtained results were as follows : 1. As the attachment loss increased, tooth mobility increased with significance, and they had highly positive correlation ($r^2=0.68$) on entire dentition. 2. As the SBI increased, tooth mobility increased with significance, and they had positive correlation ($r^2=0.37$) on entire dentition. 3. As the attachment loss increased, bite force decreased with significance, and they had highly negative correlation ($r^2=0.42$) on maxillary anterior dentition but low negative correlation ($r^2=0.20$) on the other portion of dentition. 4. As the SBI increased, bite force decreased with significance, and they had highly negative correlation ($r^2=0.31$) on maxillary anterior dentition but low negative correlation ($r^2=0.16$) on the other portion of dentition. 5. As tooth mobility increased, bite force decreased with significance, and they had highly negative correlation ($r^2=0.32$) on maxillary anterior dentition but low negative correlation ($r^2=0.16$) on the other portion of dentition.

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Phonosurgery after Laser Cordectomy (레이저 성문절제술 후의 음성수술)

  • So, Yoon-Kyung;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.11-15
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    • 2008
  • Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

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The Srudy on the Relationship between blood Cyclosporin A level and Gingival Overgrowth in rats (Cyclosporin A 혈중농도와 백서 치은증식과의 관계)

  • Chung, Chan-Gill;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.71-86
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    • 1998
  • The purpose of this study was to evaluate clinically and histopathologically the effects to the periodontal tissue in rats after Cyclosporin A (CsA) administration and to determine whether there is a relationship between dosage of CsA or blood CsA level and the seventy of gingival overgrowth in rats. Twenty 6-week-old Sprauge-Dawley Fats were randomized into 4groups. The control group received olive oil only and the test group received daily CsA in olive oil via gastric feeding for 6weeks at a 3,10, and 30mg/kg. Rats were weighed to evaluate the systemic effect of drug and stone models were made from alginate impressions of upper and lover anterior region at 2 week interval. On completion of offal CsA administration, blood were collected and blood CsA levels were quantitated by TDxFLx analyzer. Rats were sacrificed an6 their upper and lower jaws were removed together with the surrounding gingiva and soft tissue for light microscopic examination. The results were as follows : 1. The weight gain of GsA-treated rats was much less than of the control group and central incisors were gradually displaced and separated in the test groups. 2. The extensive fibrovascular proliferation and scattered inflammatoy infiltrates in an edematous stroma were observed in enlarged gingiva of CsA-treated rats. 3. The increase in buccolingual, mesiodistal dimension of the anterior teeth and vertical height of the interdental papilla showed dose-dependent manner in CsA-treated rats. 4. Significant positive correlation exists between blood CsA level and the severity of gingival overgrowth in anterior teeth. This result indicates that the severity of gingival enlargement in CsA treated rats is correlated with dosage of CsA administration and blood CsA level.

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Cone-beam computed tomography-based diagnosis and treatment simulation for a patient with a protrusive profile and a gummy smile

  • Uesugi, Shunsuke;Imamura, Toshihiro;Kokai, Satoshi;Ono, Takashi
    • The korean journal of orthodontics
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    • v.48 no.3
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    • pp.189-199
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    • 2018
  • For patients with bimaxillary protrusion, significant retraction and intrusion of the anterior teeth are sometimes essential to improve the facial profile. However, severe root resorption of the maxillary incisors occasionally occurs after treatment because of various factors. For instance, it has been reported that approximation or invasion of the incisive canal by the anterior tooth roots during retraction may cause apical root damage. Thus, determination of the position of the maxillary incisors is key for orthodontic diagnosis and treatment planning in such cases. Cone-beam computed tomography (CBCT) may be useful for simulating the post-treatment position of the maxillary incisors and surrounding structures in order to ensure safe teeth movement. Here, we present a case of Class II malocclusion with bimaxillary protrusion, wherein apical root damage due to treatment was minimized by pretreatment evaluation of the anatomical structures and simulation of the maxillary central incisor movement using CBCT. Considerable retraction and intrusion of the maxillary incisors, which resulted in a significant improvement in the facial profile and smile, were achieved without severe root resorption. Our findings suggest that CBCT-based diagnosis and treatment simulation may facilitate safe and dynamic orthodontic tooth movement, particularly in patients requiring maximum anterior tooth retraction.

A Relationship between Interdental Papilla Existence and the Distance from Contact Point to Interdental Alveolar Crest in the Maxillary Anterior Dentition of Korean adults (한국인 상악 전치부에서 치간유두 존재와 치아접촉점과 치간골 거리와의 관계)

  • Jeong, Dong-Keun;Park, Jung-Mi;Chang, Moon-Taek;Kim, Hyung-Seop;Kim, Hyun-Chul
    • Journal of Periodontal and Implant Science
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    • v.31 no.3
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    • pp.633-640
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    • 2001
  • As the public becomes concerned with looking younger and healthy, aesthetic considerations will become more relevant to dental treatment planning. The purpose of this study was to evaluate the relationship between interdental papilla existence and the distance from contact point to interdental alveolar crest in the maxillary anterior dentition of korean. Fifty-nine Korean adult consist of adults. 34 males and 25 females participated in the study. Papilla Index(PI) was recorded. The distance between contact point and interdental alveolar crest was measured by sounding with Williams probe. Measurement were carried out in 257 maxillary anterior interproximal area. The results showed that mean PI was 1.95 and mean distance between contact point and interdental alveolar crest was 5.07mm. The correlation between the papilla index and distance was negative and statistically significant(r=-0.819; p=0.000). A high negative correlation existed between PI and distance from contact point to alveolar crest. When the distance between contact point and alveolar crest was 4mm, the papilla got lost on a half of all cases. When the distance was 5mm, the papilla was present almost 11%. When the distance was 6mm, the papilla was present 4%. When the distance was 7mm or more, the papilla was lost in all cases.

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Clinical evaluation of the removable partial dentures with implant fixed prostheses (임플란트 고정성 보철물을 이용한 가철성 국소의치의 합병증에 관한 임상적 평가)

  • Kang, Soo-Hyun;Kim, Seong-Kyun;Heo, Seong-Joo;Koak, Jai-Young;Lee, Joo-Hee;Park, Ji-Man
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.239-245
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    • 2016
  • Purpose: The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition. Materials and Methods: A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed. Results: The average of 3.4 implant-supported prostheses were used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification. Conclusion: All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPD for long-term result.

ANTERIOR ESTHETIC IMPROVEMENT THROUGH ORTHODONTIC EXTRUSIVE REMODELING AND SINGLE-UNIT IMPLANTATION IN A FRACTURED UPPER LATERAL INCISOR WITH ALVEOLAR BONE LOSS: A CASE REPORT (치은연하 파절로 치조골 소실을 동반한 상악측절치에서 orthodontic extrusive remodeling후 임플란트 식립을 통한 심미수복: 증례보고)

  • Hwang, Soo-Youn;Shon, Won-Jun;Han, Young-Chul;Bae, Kwang-Shik;Back, Seung-Ho;Lee, Woo-Cheol;Kum, Kee-Yeon
    • Restorative Dentistry and Endodontics
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    • v.33 no.1
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    • pp.39-44
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    • 2008
  • The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured maxillary lateral incisor associated with alveolar bone loss, which was achieved by forced orthodontic extrusion before implant placement. Through these procedures we could reconstruct esthetics and function in a hopeless tooth diagnosed with subgingival root fracture by trauma.