• Title/Summary/Keyword: Complete prosthesis

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Prosthetic resurfacing of engaging posterior capitellar defects in recurrent posterolateral rotatory instability of the elbow

  • Dani Rotman;Jorge Rojas Lievano;Shawn W. O'Driscoll
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.287-295
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    • 2023
  • Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI. Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic). Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation. Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.

Esthetic Full Zirconia Fixed Detachable Implant-Retained Restorations Manufactured from Monolithic Zirconia : Clinical Report (Monolithic zirconia framework으로 제작된 fixed detachable prostheses를 이용한 심미적인 임플란트 전악 수복 증례)

  • Hong, Jun-Tae;Choi, Yu-Sung;Han, Se-Jin;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.253-268
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    • 2012
  • Full-mouth reconstruction of a patient using dental implants is a challenge if there is vertical and horizontal bone resorption, since this includes the gingival area and restricts the position of the implants. however, hard- and soft-tissue grafting may allow the implants to be placed into the desired position. Although it is possible to regenerate lost tissues, an alternative is to use fixed detachable prostheses that restore the function and the esthetics of the gingiva and teeth. Various material combinations including metal/acrylic, metal/ceramic, and zirconia/ceramic have been used for constructing this type of restoration. Other problems include wear, separation or fracture of the resin teeth from the metal/acrylic prosthesis, chipping or fracture of porcelain from the metal/ceramic or zirconia/ceramic prosthesis, and fracture of the framework in some free-end prostheses. With virtually unbreakable, chip-proof, life-like nature, monolithic zirconia frameworks can prospectively replace other framework materials. This clinical report describes the restoration of a patient with complete fixed detachable maxillary and mandibular prostheses made of monolithic zirconia with dental implants. The occluding surfaces were made of monolithic zirconia, to decrease the risk of chipping or fracture. The prostheses were esthetically pleasing, and no clinical complications have been reported after two years.

All-on-4 implant restoration with full-digital system preserving existing occlusion: A case report (완전 디지털 시스템으로 기존 교합을 보전한 All-on-4 임플란트 수복증례)

  • Kim, Kyoung Hee;Jeong, Seung-Mi;Lee, Ye Chan;An, Xue Yin;Choi, Byung-Ho
    • 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.

The job analysis of dental technicians in Busan, Gyeongnam (부산, 경남지역 치과기공사의 직무분석)

  • Nah, Jung-Sook
    • Journal of Technologic Dentistry
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    • v.36 no.4
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    • pp.277-296
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    • 2014
  • Purpose: This study intends to set standard for organizing the curriculum of short-term dental technicians and the change of job environment, as well as the knowledge & training, by identifying the importance and actual job performance of dental technicians following job analysis in the university education of Dept. of Dental Laboratory Technology, and furthermore to foster junior executives to cope with modernization and globalization. Methods: The tools used in this study are based on the job analysis of research report suggested by National Health Personnel Licensing Examination Board(Lee Gyu-seon, 2011), and it consists of general characteristic 7 items. Every competence duty was measured through Likert 5 point gauging, and internal consistency through Cronbach's Alpha. The competence importance of entire questionnaire was .984 and its performance was .874, reflecting considerably high level, and in terms of each competence duty, high credibility was proved and high internal consistency was verified with competence importance ranging from the minimum .655 to the maximum .966 and its performance ranging from the minimum .677 to the maximum .993. Results: Competence importance and its performance in each duty on the job analysis of dental technicians were measured. In competence importance in each duty, the highest was "checking design order form"(average, 4.52), followed by "selling dental prosthesis"(average 4.49), "making removable orthodontic appliance"(average, 4.48), "open managing dental laboratory"(average, 4.46) in order. However, "making complete denture" was found the lowest(average, 4.23), with importance of all competence dutys was considerably high level. In the performance of its competence duty, "checking design order form"(average, 4.04) was found to be the most importance competence, followed by "making conservative restoration"(average, 4.00), "making porcelain"(average 3.98), "checking working cast"(average, 3.90) in order. However it was found out that "making fixed orthodontic appliance"(average, 3.12) was the lowest, and the importance of all competence dutys was quite high level. Conclusion: The duties of dental technicians consist of 13 kinds, in total, and it was found out that "checking design order form"(average, 4.52) was the most important in the competence importance and job performance. In particular, it was revealed that there was a great difference between the competence importance and its performance in the order of "selling dental prosthesis", "open managing dental laboratory", "making removable orthodontic appliance", "making CAD/CAM prosthesis", and then "making fixed orthodontic appliance".

Relationship between usage of removable denture and depression in Korean adults with loss of multiple teeth: A cross-sectional study using the seventh Korea National Health and Nutrition Examination Survey (다수 치아를 상실한 한국 성인에서 가철성 의치의 장착 여부와 우울증의 연관성: 국민건강영양조사 제 7기 자료를 활용한 단면 연구)

  • Shim, Jaeseung;Lee, Younghoo;Hong, Seoung-Jin;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock;Paek, Janghyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.1-10
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    • 2021
  • Purpose: The purpose of this study is to evaluate the relationship between removable denture and depression. This study aims to investigate the relationship between depression and each group by dividing them into a group that were using removable dentures and a group that needed removable dentures but were not using removable dentures. Materials and methods: This study was conducted using raw data from the 7th Korea National Health and Nutrition Examination Survey (KNHNES). By using variables related to the state of the prosthesis and the need for prosthesis among oral examination data, the oral examination data were classified into two groups; group using removable denture and group in need of removable dentures. In addition, the variables of depression were classified into normal (0-4), mild depression (5-9), moderate depression (10-19), and severe depression (20-27) using the values of PHQ-9. For statistical analysis, logistic regression analysis was performed using SAS 9.4. Results: In the group in need of removable dentures, the risk of severe depression was statistically and significantly higher than the group using removable dentures. Conclusion: In patient who have lost multiple teeth, rehabilitation of the missing area with removable dental prosthesis is expected to decrease the occurrence of severe depression.

Assessment of swallowing and masticatory performance in obturator wearers: a clinical study

  • Vero, Nungotso;Mishra, Niraj;Singh, Balendra Pratap;Singh, Kamleshwar;Jurel, Sunit Kumar;Kumar, Vijay
    • The Journal of Advanced Prosthodontics
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    • v.7 no.1
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    • pp.8-14
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    • 2015
  • PURPOSE. To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS. Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS. Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION. Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.

Overdentures of the patient with Parkinson's disease: A case report (파킨슨 병을 가진 환자의 상악 마그네틱 피개의치 및 하악 임플란트 피개의치 수복 증례)

  • Min, Byung-Kwee;Shin, Eun-Jung;Vang, Mong-Sook;Yang, Hong-So;Park, Sang-Won;Yun, Kwi-Dug;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.4
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    • pp.352-358
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    • 2015
  • The retention of complete dentures in patients with Parkinson's disease is often poor due to their constant dislodgement by involuntary movements of the tongue and lips. Furthermore, insertion of the overdenture is expected to be difficult due to their limited voluntary movements. This case is about the bimaxillary overdenture restoration where its retention and stability are improved, using magnetic attachment of remained roots of maxilla and two implant $Locator^{(R)}$ attachments of mandible in patients with Parkinson's disease. This report describes the fabrication of this functionally improved prosthesis.

Implantation of a permanent pacemaker through the coronary sinus in a patient who underwent mechanical valve replacement for infective endocarditis with a complete atrioventricular block (완전방실차단을 동반한 감염성 심내막염 환자에서 판막치환술 후 관정맥동을 통해 좌심실을 조율하는 심박조율기 시술)

  • Jo, Kwan Hoon;Kim, Inho;Ann, Soe Hee;Oh, Yong Seog
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.113-116
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    • 2014
  • A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

Complete mouth rehabilitation with fixed implant-supported prosthesis using temporary denture and dental CAD-CAM (완전 무치악 환자에서 임시 의치와 치과용 CAD-CAM을 활용한 전악 고정성 임플란트 회복 증례)

  • Jeon, Sol;Yoon, Hyung-In;Lee, Jae-Hyun;Yeo, In-Sung Luke;Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.100-109
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    • 2022
  • Installation of dental implants at optimal angles and positions is critical in long-term stable implant-supported restorations. Surgery and prosthodontic procedures should be performed accurately as the treatment is planned. In this clinical case, Computer aided design and manufacturing technology was used not only to establish a precise surgical plan, but also to fabricate both provisional and definitive fixed prostheses. A surgical guide was designed to install the implants at proper positions for the definitive prostheses. The patient's esthetic information, which was necessary for the new provisional and definitive fixed prostheses, was obtained from the existing temporary dentures. Finally, the complete mouth fixed implant-supported rehabilitation using monolithic zirconia provided the patient with functionally and esthetically satisfactory prostheses.

Cervical Esophageal Cancer (경부식도암)

  • 노영수;김진환
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.30-38
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    • 2003
  • Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50% to 70% of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20% to 30% range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

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