• 대한치과보철학회지
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• 제26권1호
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• pp.153-169
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• 1988

There is a little scientific documentation reporting the stress, distribution to the edentulous mandible by different concepts of occlusal scheme. So, this study was to investigate the hypothesis that the magnitude and distribution of the occlusal stresses, transmitted through a mandibular complete denture base to the edentulous mandible, would be influenced by the lingualized occlusion. This investigation was performed to analyze the stresses induced in a three-dimensional photoelastic edentulous mandible, when a load is applied to the denture arranged into lingualized occlusion in centric relation, lateral and protrusive functional position. The mounted denture on a Dentatus Type ARO articulator was loaded in a pure vertical direction with 15kgs on the center of articulator in each case and the stresses were frozen into epoxy edentulous model at $127^{\circ}C$ in the stress freezing furnace. The stress-frozen epoxy models were sliced with diamond disc saw into 4mm thick. The slices were examined with a circular polariscope. The results were as follows: 1. In centric relation, the stresses were low at anteriors, and gradually increase to the premolar, molar area and highest at the first molar and gradually decrease from the second molar and lowest at the retromolar pad region. The lingual side showed higher stresses than labiobuccal side. 2. In lateral functional position, the working side showed higher stresses than the balancing side. In working side, the lingual side showed higher stresses than the buccal side and in balancing side, the buccal side showed higher stresses than the lingual side. 3. In protrusive position, stress distribution was symmetrical on the posteriors and the stresses were concentrated at the labial side of the anteriors.

• 구강회복응용과학지
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• 제31권3호
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• pp.242-252
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• 2015

무치악 환자에서는 치아가 상실되면서 주위 치조골의 개조와 흡수가 일어나고, 이에 따라 총의치의 유지력 감소, 저작 효율의 저하와 통증으로 인해 의치 사용에 어려움을 겪게 된다. 이를 개선하기 위해 하악에 2 - 4개의 임플란트를 식립하고 어태치먼트에서 유지 또는 지지를 얻는 피개의치가 바람직한 치료 방법으로 고려되고 있다. 본 증례들은 하악 완전 무치악 환자들을 악간 관계, 골흡수 정도, 안모지지 등을 평가하여 하악에 2개의 임플란트 식립을 고려하고, 다양한 종류의 어태치먼트를 이용한 임플란트 피개의치 수복을 계획하여 치료하였다. 주기적인 경과 관찰 결과 심미적, 기능적으로 만족할만한 결과를 얻었기에 이를 보고하는 바이다.

• 구강회복응용과학지
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• 제16권3호
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• pp.187-196
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• 2000

This study was performed to offer convenience to determine the vertical dimension of occlusion of edentulous patients by investigating the interocclusal distances at physiologic rest position, at speaking of /m/ sound, and some korean short sounds, that is, /mem/ and /beb/ sounds, which were found in our previous study with dentulous subjects. Ten edentulous subjects - 6 men and 4 women - were selected for this study. The frequencies at speaking of /m/, /mem/, and /beb/ sounds were analyzed with Computerized speech lab($CSL^{TM}$, Model 4300B, Software version 5.X, Kay Elemetrics Co. U.S.A.). And the interocclusal distances at physiologic rest position and at speaking of /m/, /mem/, and /beb/ sounds were measured with K6 diagnostic system(Myo-tronics, Inc. U.S.A.). The results of this study were as follows ; 1. In the acoustic analysis by Computerized speech lab, frequencies of sounds of edentulous subjects with complete denture at speaking of /m/, /mem/, and /beb/ were similar to those of dentulous subjects. 2. In the linear correlation by Pearson's correlation coefficient, the interocclusal distance at physiologic rest position was most similar to those of speaking /mem/ sound, secondly /m/ sound, and thirdly /beb/ sound(p<0.05). In reliability by Cronbach's alpha, the results were reliable with alpha value 0.97. 3. It was found by Levene's test for equality of variance that the difference between men and women in the interocclusal distances at physiologic rest position and at speaking of /m/, /mem/, and /beb/ sounds was not statistically significant(p>0.05).

• 대한치과의사협회지
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• 제53권6호
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• pp.411-417
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• 2015

In an edentulous situation, the oral rehabilitation with complete denture is substantially different from treatment of natural teeth. The artificial teeth arrangement and occlusion are important factor for the stability of the denture. Bilateral balanced occlusion is that stability of the denture is attained when bilateral contacts exist throughout all excursion and static states of the denture during function and, artificial teeth are arrangement in neutral zone where the forces between the tongue and cheeks or lips are equal. This is how dentist make a favorable prognosis. Therefore, dentists are have to be a little more involved in the selection and arrangement of artificial teeth.

• 대한치과보철학회지
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• 제52권3호
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• pp.239-245
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• 2014

총의치 보철은 잔존 자연치가 완전히 소실된 환자를 위한 상, 하악의 상실된 관련 구조물과 자연치의 수복을 포함한다. 보철치료의 궁극적인 목적중에 심미적 그리고 기능적인 회복이 포함된다. 최근에는 고령의 환자들에도 심미적인 요구가 크게 증가되고 있기에 총의치 보철치료에 있어서도 이점을 간과해서는 안 된다. 총의치 보철치료에서도 자연 치아와 유사하게 보이기 위해 치아 마모 정도 및 배열, 치경부 치은의 퇴축, 착색, 치은의 색조 개선 등을 표현하려는 다양한 시도들이 이루어져 왔다. 본 61세 여환은 5년 전 개인치과에서 제작한 의치가 부러지고 잘 맞지 않는다는 주소로 본원 보철과 내원하였고 상악 총의치 및 하악의 임플란트 피개의치를 제작하기로 계획하였다. 환자는 기본적인 저작기능의 회복을 고려하고 있었지만, 그보다는 자연스럽고 심미적인 총의치 제작에 최우선 순위를 두고 있었다. 심미적이며 자연스러운 형태를 표현하기 위하여 Aesthetic Color Set Easy system$^{(R)}$ (Candulor dental GmbH, Wangen, Germany)을 활용하여 치은의 다양한 색조를 재현한 총의치를 제작하였다. 보철물 시적이 완료되었고 총의치의 기능적인 면이 회복되었을 뿐만 아니라 환자의 심미적인 요구까지 충족시킬 수 있었다. 적절한 심미적 재료의 선택과 더불어 개개인에 적합한 특성을 잘 표현할 수 있다면 환자와 치과의사 모두에게 만족감을 주는 총의치 보철치료가 가능할 것이라고 생각된다.

• 대한치과보철학회지
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• 제57권2호
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• pp.195-202
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• 2019

치과보철과에는 장기간 총의치를 사용해 온 고령 환자 중에서 발치 후 시간의 경과와 함께 심하게 치조골이 위축된 상태로 환자들이 종종 내원하게 된다. 통상 하악 총의치는 하악 협붕 부위의 1차 지지를 기반으로 한 개구인상법에 의해 제작하는 것이 일반적이다. 하악 총의치의 유지력 및 안정성을 확보하기 위해서는 진단에서부터 의치 주위 조직의 기능 및 의치상의 경계, 교합평면, 악궁의 대합관계, 인공치아의 배열, 저작습관, 그리고 환자에 대한 교육과 장착 후 주의 사항 등을 충분히 고려해두어야 한다. 그러나 치조골 위축이 심하게 발생된 무치악 환자에서 개구인상법을 이용하여 제작한 하악 총의치는 간혹 실제 저작과정에서 유지와 안정에 한계를 보이는 경우가 있기 때문에, 이에 대한 대안으로 폐구인상법을 이용한 총의치 제작 방법을 선호하는 임상가들에 의해 개구인상법과 폐구인상법을 비롯한 다양한 인상채득 방법을 비교한 연구가 보고되기도 하였다. 본 증례에서는 폐구인상법을 토대로 한 기능인상으로 하악 총의치를 제작하여 동일한 환자에서 개구인상법으로 제작한 의치보다 나은 유지력과 안정성을 확인했고, 심하게 치조골이 위축된 상태의 구강조건에서 개구인상법으로 제작한 의치와 폐구인상법으로 제작한 의치의 임상적 결과를 비교한 내용에 대해 보고하고자 한다.

• The Journal of Advanced Prosthodontics
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• 제13권6호
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• pp.361-372
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• 2021

PURPOSE. To improve the clinical effects of complete denture use and simplify its clinical application, a digital complete denture restoration workflow (Functional Suitable Digital Complete Denture System, FSD) was proposed and preliminary clinical evaluation was done. MATERIALS AND METHODS. Forty edentulous patients were enrolled, of which half were treated by a prosthodontic chief physician, and the others were treated by a postgraduate student. Based on the primary impression and jaw relation obtained at the first visit, diagnostic denture was designed and printed to create a definitive impression, jaw relation, and esthetic confirmation at the second visit. A redesigned complete denture was printed as a mold to fabricate final denture that was delivered at the third visit. To evaluate accuracy of impression made by diagnostic denture, the final denture was used as a tray to make impression, and 3D comparison was used to analyze their difference. To evaluate the clinical effect of FSD, visual analogue scores (VAS) were determined by both dentists and patients. RESULTS. Two visits were reduced before denture delivery. The RMS values of 3D comparison between the impression made via diagnostic dentures and the final dentures were 0.165 ± 0.033 mm in the upper jaw and 0.139 ± 0.031 mm in the lower jaw. VAS ratings were between 8.5 and 9.6 in the chief physician group, while 7.7 and 9.5 in the student group; there was no statistical difference between the two groups. CONCLUSION. FSD can simplify the complete denture restoration process and reduce the number of visits. The accuracy of impressions made by diagnostic dentures was acceptable in clinic. The VASs of both dentists and patients were satisfied.

• 구강회복응용과학지
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• 제18권3호
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• pp.197-204
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• 2002

Polymers are the dominant material for fabrication of denture bases. However, resin base can't fufill the patients' satisfactions completely and solve the pronunciation problem and prevent the denture fracture. In spite of many advantages, metal denture bases do not widespread in clinical practice. The main reasons are the difficulties in fabrication and additional time and cost, inability to rebase such prostheses. The use of the metal base can be one of options in complete denture treatments. This study helps, through reveiwing previous reports and literature about the metal base, metal base to be useful in the clinical application by recommend the materials, indications and advantage/disadvantage of the metal base and introduce variable designs. The clinical application of the metal base have many advantages, but the dentists have to select cases carefully and apply designs according to patient's various conditions. In conclusion, the use of the metal base can't alternate treatment of inadequate conventional complete denture. Adequate complete denture is very important for the treatment of the metal base complete denture.

• 대한치과보철학회지
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• 제61권4호
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• pp.344-355
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• 2023

총의치 제작 과정 중 정확한 최종인상을 얻기 위해서는 정확한 예비인상 채득이 선행되어야 한다. 본 증례에서는 비정형적인 악궁 형태를 가진 환자에서 기성 트레이 및 구강 스캐너로 채득하여 제작한 예비모형과 개인트레이를 비교하였다. 58세 남자 환자로 상, 하악 총의치 제작을 위해 본원 구강악안면외과에서 의뢰되었다. 상하악궁 모두 좁고 긴 형태로 비정형적인 형태를 보였다. 기성 트레이를 이용하여 채득한 예비모형은 구강 스캐너를 이용한 예비 모형에 비해 상악의 경우, 협측의 변연이 과연장되었고, 후방 구개 폐쇄 부위에서는 압박되어 있었다. 또한 하악에서도 과연장되었으나, 상악에 비하여 그 양이 많지 않았다. 그리고 구강 스캐너에 의해 채득된 예비모형은 기성 트레이로 채득된 예비 모형에 비해 저연장되었으나, 해부학적 지표는 충분히 인기되었다. 기성 트레이에 의해 제작된 개인 트레이는 IOS에 의해 제작된 개인 트레이에 비하여 구강 내 시적 시, 개인 트레이의 조정량이 많았고 진료 시간이 증가하였다. 본 증례를 통해 비정형적인 악궁을 가진 환자에게 3D 구강 스캐너로 인상을 채득하는 것이 대안이 될 수 있음을 보고하는 바이다.

• 대한치과보철학회지
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• 제33권3호
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• pp.440-452
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• 1995

A success of complete denture prosthesis can be determined by the satisfaction degree of the dentist and the patient. There are many factors influencing on the satisfaction of the complete denture patients. The purpose of this study is to analyze the correlation between the masticatory satisfaction and clinical evaluation, and the speech satisfaction and clinical evaluation in complete denture patients. 79 patients(total 119 complete dentures) were examined in this study who were treated in Seoul National University Dental Hospital. Through clinical evaluation, 2 examiners evaluated sex, age, edentulous period, the years of having used present complete denture, the number of the previous dentures, the state of the opposite arch, retention, stability, support, occlusion, vertical dimension of the complete denture and the condition of the residual alveolar ridge. Through questionnaires concerned with mastication and speech, examiners evaluate the satisfaction degree of the patients. This study led to the conclusion that : 1. The satisfaction degree of the mastication was lower in older patients(p<0.001) and in patients whose present complete denture period was shorter(p<0.05). The satisfaction degree of the mastication in male was higher than in female patients(p<0.01). 2. The satisfaction degree of the mastication was high when the retention of the complete denture was good(p<0.05), and when the condition of the residual alveolar ridge was good(p<0.05). 3. The satisfacion degree of the speech was high when the retention of the complete denture was good(p<0.01). 4. The satisfaction degree of the mastication was higher in patients with upper and lower complete denture than in patients with single complete denture whose oppsite arch was unilateral partial denture(p<0.05).