• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.330-337
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• 2018

In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.2
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• pp.107-112
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• 2001

The prosthodontic treatment of severely resorbed edentulous patients has been one of the frustrating areas due to extensive loss of tissues. The integrated neuromuscular balance among tongue, lip, and cheek is compromised. The retention, stability, and support are the three major factors to influence the clinical outcome. Fish described a denture as having three surface, with each surface playing an independent and important role in the over all fit, stability, and comfort of the denture. He recommended that the polished surface should be a series of inclines so that pressure from muscular activity will retain dentures. Within the denture space there is an area that has been termed the neutral zone. The neutral zone is that area in the mouth where, during function, the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. According to Jacobson and Krol, neuromuscular control interacts to provide retention and the relationship of polished surface of denture base to the surrounding muscular structure of orofacial capsule facilitates the stability and retention. This neutral zone concept has been demonstrated with various modification by a number of authors. The theory used to develop the denture base contours is based on the belief that the muscle should functionally mold not only the border but the entire polished surface. Lott and Walsh reported the clinical success on complete mandibular dentures with application of neutral zone concept. A number of studies demonstrated that denture stability and retention are more dependent on correct position of the teeth and correct contour of external surfaces of the denture in a severely resorbed alveolar ridge. This article presents a prosthodontic approach to treatment of a edentulous patient using neutral zone technique to improve the retention and stability of the prosthesis.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.4
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• pp.331-337
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• 2018

Prosthetic rehabilitation of an edentulous patient who has a maxillary defect is difficult to achieve for many clinicians. The maxillary defect causes leakage of air during pronunciation and compromises denture stability, support and retention by reducing denture-bearing area and breaking peripheral seal. In these patients, the sizes and shapes of defects are very important factors which attribute to prognosis of maxillary obturators. This case report shows the prosthetic rehabilitation of the patient who had maxillectomy on the right maxillary sinus because of squamous cell carcinoma. The patient had a stepwise treatment protocol which started with pre-operative dental examination and followed by surgical, interim and definitive obturation phase. In this case, an acceptable level of retention could be obtained due to well-defined static defects and the preserved premaxillae and the patient was satisfied with the result of the treatment in the aspect of function and esthetics.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.347-353
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• 2022

Traditional denture treatment is often performed in patients with the completely edentulous maxilla and the bilateral edentulous posterior mandible. However, with a long-term prognosis, a complication called 'combination syndrome' may occur in this oral environment. In this case, by applying an implant-assisted removable partial denture (IARPD), it is possible to preserve the alveolar bone and prevent combination syndrome. In this case, when additional implants are placed in the edentulous area, the stress applied to the abutment due to the movement of the removable denture can be reduced, so it is possible to design an esthetic clasp using resin rather than metal, and flexible denture base resin is used. As a treatment for maxillary complete denture and mandibular flexible IARPD, it showed an esthetic and functional long-term prognosis with minimal cost and surgery.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.3
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• pp.396-410
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• 1994

Ten subjects who were going to wear conventional complete dentures were selected for this study. Theree subjects were women and seven were men. The average age was 63.1 years(range : 44 to 76 years). With the Height tracer (extraoral tracing device) in place the subject was instructed to go through the entire range of mandibular movements. The extreme lateral pathway of the incisor point, the so-called Gothic arch, was thereby inscribed by the stylus on the tracing plate. The mandibular movements in this study were peformed voluntarily by the subject(self guided technique) and guided by the dentist(chin-point technique and bimanual technique). The Gothic arch tracings were analysed and the Gothic arch angles and eccentric movement distances were measured. The results were as follows : 1. The apex position of the Gothic arch tracings of mandibular movements in edentulous patients varied both anterioposteriorly and mediolaterally. 2. The Gothic arch tracing had some lateral deviation during protrusion. 3. The average Gothic arch tracing angle was $136.7{\pm}12.0^{\circ}$ by subjects self guided technique, $135.7{\pm}5.9^{\circ}$ by chin-point technique, $136.6{\pm}6.5^{\circ}$ by bimanual technique. But there were no statistical differences in the reliability among the three techniques. 4. The average mandibular eccentric movements were irregular and the mandibular eccentric movement distances varied with a wide range.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.4
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• pp.351-359
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• 2008

It is difficult to provide prosthodontic treatment to fully edentulous patients with severe alveolar bone resorption, because this makes patents hard to endure functional load, and to adapt to the dentures, which result in emotional stress to patients. Implant supported overdenture can be chosen to solve these problems. Among several types of them, the implant retained and tissue supported overdenture, is available to the patients of low masticatory force with the reduced cost. Attachments also can be used for increasing retention and esthetics in dentures. Especially, $Locator^{(R)}$ system needs a small vertical interarch space for restoration and is able to compensate the difference of angle between fixtures. In this study, we restored maxilla with conventional complete denture, and mandible with implant and tissue supported overdenture and $Locator^{(R)}$ system.

• The Journal of Korean Academy of Prosthodontics
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• v.30 no.2
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• pp.286-318
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• 1992

The objective of preventive dentistry is the maintenance of a healthy dentition for the life of a patient. Unfortunately, if an individual has not received the benefit of a comprehensive program of preventive dentistry and has finally reached the edentulous state, as a consequence, he receives a set of complete denture. Dentures are mechanical devices and subject to the principles of mechanics. In some cases, the general health and nutritional status of the patient are felt to be the causative factors. But, the most important thing in residual ridge resorption is felt to be caused by the unequal distribution of functional forces. This study was to analyze mandibular stresses of complete denture occlusion by three dimensional finite element method. The results were as follows ; 1. As deformation and stress distribution of the complete denture of the mandible were concentrated on the upper lingual side of the mandible, alveolar ridge resorption of the mandible occurred from lingual side to labio-buccal side. 2. Analyzing by three dimensional F. E. M., the mandible is a very effective form for tolerating stress and deformation biomechanically. 3. According to the concentration of stress distibution in the upper buccal side of the lower posteriors, buccal shelf area must be a primary stress bearing area in the lower complete denture. 4. Lower complete denture moved horizontally to the balancing side under lateral occlusal force. 5. Bilateral balanced occlusion should be constructed in the complete denture for denture stability, especially in the protrusive movement. 6. Physical property of the denture base material was as important for stress distribution in the denture base as or even more than that in the mandible. 7. Impression technique is very important because of most of stress was concentrated between them due to close contact of the mandible and the denture base.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.4
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• pp.500-509
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• 2000

In general, the three major oral functions of edentulous patients-mastication, phonation, esthetics-can be rehabilitated by the complete dentures, and both the resin based complete denture and the metal based complete denture are commonly used by many clinicians today. For the sake of many advantages such as the excellent thermal conductivity, low volumetric change, high strength, low risk of fracture and the better patient's adaptation, the metal based complete dentures are indicated to the several cases. But, there are common failures of these type of dentures mainly by the fracture or the debonding between the resin structures and the metal frameworks which is caused by the discrepancies of the flexural strength and the coefficient of thermal expansion. This is aggravated by the water contamination of the interface when exposed to the oral environment and results in the failure of complete denture treatment. So, the purpose of this study is to compare the bond strength and the fracture patterns of the gold alloy based and the Co-Cr alloy based complete dentures using the PMMA resins and the 4-META adhesive resins. The results of this study were as follows. 1. Both to the PMMA resin and the 4-META resin, the flexural bond strength of gold alloy is lower than that of Co-Cr alloy(P<0.05) 2. To the Co-Cr alloy, the bond strength of the 4-META resin is significantly higher than that of PMMA resin(P<0.05). 3. The flexural strength of the group with the mechanical retention form is significantly higher than that of the group without retention form(P<0.05). 4. Comparing with the other groups, the fracture patterns of the group 3 are quite different from the group 1,2,5.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.49-57
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• 1991

The magnets were widely used to increase the retention of overdentures. The purpose of this study was to compare the break load between overdentures and edentulous models. For this study, Model former(U-402) was used for model fabrication and four different magnets were used for evaluation of break load. The artificial saliva was used between overdenture and model. Breakaway loads were tested with an Instron 1122 at a speed of 2mm/min. The results were as follows. 1. The retentivee forces complete dentures with artificial saliva were than the retentive forces of complete detures without artificial saliva. 2. Magnetic overdenture with artificial saliva showed best retentive force, magnetic overdenture without artificial saliva showed the next retentive force, and the complete denture without artificial saliva showed the worst retention. 3. As the magnetic sizes increased, the retentive forces of magnetics were increased. 4. The retentive force of nipple shape magnet is greater than the retentive force of flate shape magnet in the same size.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.2
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• pp.113-123
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• 2001

The success of complete denture prosthesis is to satisfy three basic requirements for the edentulous patient : maximum comfort, efficiency, and esthetic appearance. This can be achieved only if the dentures are both stable and retentive. When the residual alveolar ridge has resorbed significantly, stability and retention are more dependent on the correct position of the teeth and external surfaces of the denture. The stability and retention of the denture can be improved by locating the denture in the neutral zone and reproducing exact mandibular border movement for balanced occlusion. The neutral zone philosophy is based upon the concept that there exists a specific area where the musculature function will not unseat the denture in the mouth. In here, forces generated by the tongue are neutralized by the forces generated by the lips and cheeks. One of the simplest methods for recording border movements in three dimensions is to make stereographic record of condylar movement. Stereographs are made in the mouth during mandibular movement with intraoral clutches and central bearing point, and used in dictating the condylar movement on the articulator later by generating the condylar paths in doughy acrylic resin. Its procedure is simpler and more convenient than that of Pantograph. In this clinical report, we introduce the concept of neutral zone and stereograph in complete denture fabrication.