• 제목/요약/키워드: Dental technique

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IMPLANT INSTALLATION USING VERTICAL DISTRACTION OSTEOGENESIS AT A SEVERELY ATROPHIED EDENTULOUS MANDIBLE (심하게 위축된 하악골의 완전 무치악 환자에서의 수직 골신장술을 이용한 임플란트 치료)

  • Yeom, Hak-Ryol;Jeon, Seung-Ho;Kim, Yoon-Tae;Paeng, Jun-Young;Ahn, Kang-Min;Myung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.154-165
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    • 2006
  • Objectives : It is difficult to place implants at a severely atrophied edentulous mandible because of vertical and horizontal alveolar defect. The autogenous and allogenic bone graft and guided bone regeneration are useful, but there are some limitations such as the resorption and infection of the grafted bone, and insufficiency of soft tissue. Distraction osteogenesis has recently evolved a challenging technique to overcome major draws of conventional augmentation procedures, we, therefore, report the four applications of implant placement after vertical alveolar distraction osteogenesis. Patients and Methods : Four patients(all female, mean age: $60{\pm}6$ years) with severe alveolar ridge deficiencies at their anterior mandible were treated with vertical alveolar distraction osteogenesis by intraoral device(Track 1.5, 15 mm model, KLS Martin, Tuttlingen, Germany) and placement of implants (Branemark MK III, TiUnite). After the latency periods of 5, 7, 8 days, distraction rhythm and rate were $0.5\;mm{\times}2\;times/day$ in the case of good bone quality, and $0.25\;mm{\times}3\;times/day$ in the case of poor bone quality. After consolidation periods of mean fifteen weeks, five implants for each patients were placed at the interforaminal area. Results : On average, a vertical gain of $11.38{\pm}1.38\;mm$ was obtained by distraction. And all distraction zone showed complete ossification by panoramic radiography. There were no postoperative complications other than numbness of lower lip in one case. Total twenty implants in four patients were placed and their outcomes were satisfactory. Conclusion : It is a useful method to place five implants after vertical distraction osteogenesis of the severely atrophied mandible for the implant-supported fixed prosthesis.

FUNCTIONAL RECONSTRUCTION OF DENTO-PALATAL AND MAXILLARY DEFECT USING STAGED OPERATION OF PREFABRICATED SCAPULAR FREE FLAP AND DENTAL IMPLANTS (분층피부와 분말골로 이식 전 처리된 유리견갑골근피판과 임플란트 보철을 이용한 경구개와 상악골의 기능적 재건)

  • Lee, Jong-Ho;Kim, Myung-Jin;Park, Jong-Chul;Kim, Yung-Soo;Ahn, Kang-Min;Paeng, Jun-Young;Kim, Sung-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pill-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.301-307
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    • 2004
  • The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

Translucency and Color Stability of Various Core Ceramics for All-Ceramic Restoration (전부도재수복물을 위한 수종의 코어 세라믹의 반투명도 및 색 안정성)

  • Oh, Sang-Chun;Lee, Hae-Hyoung;Shin, Mee-Ran;Park, Kwang-Su
    • Journal of Dental Rehabilitation and Applied Science
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    • v.23 no.2
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    • pp.157-170
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    • 2007
  • Purpose: This investigation was designed to determine the translucency and color stability of various core ceramics for all-ceramic restoration using the CIE $L^*a^*b^*$ system. Material and Methods: IPS e.max Press ceramic(Ivoclar-Vivadent, Liechtenstein), $LAVA^{TM}$ All Ceramic(3M-Espe, Germany), Cercon Smart Ceramic(Dentsply, Germany), and Z-match Ceramic(DentAim, Korea) were used for this study. For the specimens of zirconia oxide ceramics, the as-sintered cylindrical blanks($11.0{\times}25.0mm$) were machined into the shape of a disk(0.4, 0.8, 1.5 mm in thickness, 10 mm in diameters) with a diamond grind machine. The IPS e.max Press specimens ($0.8{\times}10mm$) were fabricated using the "lost wax" technique. CIE $L^*a^*b^*$ coordinates and light transmission were recorded for each specimen with a spectrophotometer(CM-2600d, Minolta, Japan). Color differences were calculated using the equation, ${\Delta}E^*ab=[({\Delta}L^*)2+({\Delta}a^*)2+({\Delta}b^*)2]1/2$. Results: The results were obtained as follows: 1. The most translucent group was IPS e.max Press ceramic that is a glass-ceramic, and $Lava^{TM}$ and Z-match ceramic were more translucent than Cercon Smart ceramic in zirconia ceramic group. 2. In the all groups, there was no significant translucent change after 6 times heat-treatments required to make a final restoration. 3. Colored zirconia was showed more yellowish and dark than uncolored zirconia. 4. After heat-pressing, IPS e.max Press ceramic was showed high ${\Delta}E^*ab$ value(4.1 of eM1, 6.8 of eM2) that means to be more whiter than before heat-pressing. However, there was no color change after additive heat treatments for final restoration. 5. In the colored zirconia groups, there was no significant color change after some heat-treatments required to make a final restoration.

Correlation between The Parents' Character of Orthodontic Patients and Patients Cooperation (치과 교정 환자 부모의 인성(SCL-90-R)과 환자 협조도의 상관관계)

  • Kim, Jong-Oh;Chung, Dong-Hwa;Lee, Jin-Woo;Cha, Kyung-Suk
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.4
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    • pp.415-422
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    • 2011
  • The study on correlation between the parents' character of orthodontic patients and patients cooperation. Although dentists have excellent skill and technique, patients' cooperation is always demanded. Patients' poor cooperation results in poor treatment result. Cooperation between psycho-social state of parents and patient's cooperation was studied. The parent's psychosocial state is evaluated with scl-90-r. The cooperation is measured by appointment time compliance, appliance taking rate, breakage of appliance, and fee paying. Parents' psychosocial contents are somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic-anxiety, paranoid ideation, psychoticism, and additional item. Statistics was done by SPSS WINDOW version 12.0 program. The result showed no correlation between patients' cooperation and their parents' psychosocial state. There is no correlation between father's psychosocial state and patients' cooperation except psychoticism. There is no correlation between mother's psychosocial state and patients' cooperation. However, there was correlation among cooperation variables: appointment time compliance, appliance taking rate, breakage of appliance, cost paying. Appliance taking rate and cost paying showed positive correlation. Our findings suggest that patients' cooperation does not followed their parents' pychosocial state. Other combined factors should be considered like pychosocial state of patient and doctor-patient relationship.

COMPARISON OF TRAMADOL/ACETAMINOPHEN AND CODEINE/ACETAMINOPHEN/IBUPROFEN IN ONSET OF ANALGESIA AND ANALGESIC EFFICACY FOR POSTOPERATIVE ACUTE PAIN (수술후 급성 동통에 대한 Tramadol/Acetaminophen과 Codeine/Acetaminophen/Ibuprofen의 효과 발현시점과 진통효과의 비교)

  • Jung, Young-Soo;Kim, Dong-Kee;Kim, Moon-Key;Kim, Hyung-Jun;Cha, In-Ho;Han, Moo-Young;Lee, Eui-Wung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.143-149
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    • 2004
  • Background: Some clinical trials have reported that a new analgesic combination of tramadol and acetaminophen provides good efficacy in various pain models. For the more clinical uses of this agent, comparisons about the onset of analgesia and analgesic efficacy in the acute state of pain with the other drugs known as strong analgesics were needed. Purpose: The goal of this study was to compare the times to onset of analgesia and the other analgesic efficacy of 75 mg tramadol/650 mg acetaminophen and 20 mg codeine/500 mg acetaminophen/400 mg ibuprofen in the treatment of acute pain after oral surgery. Patients and Methods: Using a randomized, single-dose, parallel-group, single-center, and active-controlled test design, this clinical study compared the times to onset of analgesia using a two-stopwatch technique and the other analgesic efficacy of the single-dose tramadol/acetaminophen and codeine/acetaminophen/ibuprofen. These were assessed in 128 healthy subjects with pain from oral surgical procedures involving extraction of one or more impacted third molars requiring bone removal. From the time of pain development, the times to onset of perceptible and meaningful pain relief, pain intensity, pain relief, an overall assessment, and adverse events of the study medications were recorded for 6 hours. Results: The demographic distribution and baseline pain data in the two groups were statistically similar. The median times to onset of perceptible pain relief were 21.0 and 24.4 minutes in the tramadol/acetaminophen and codeine/acetaminophen/ibuprofen groups respectively and those to onset of meaningful pain relief were 56.4 and 57.3 minutes, which were statistically similar. The other efficacy variables such as mean total pain relief (TOTPAR) and the sum of pain intensity differences (SPID) were also similar in the early period after pain development and drug dosing. The safety of tramadol/acetaminophen was well tolerated and very comparable to that of codeine/acetaminophen/ibuprofen. Conclusions: In this acute dental pain model, the onset of analgesia and analgesic efficacy of tramadol/acetaminophen was comparable to that of codeine/acetaminophen/ibuprofen. These results showed that tramadol/acetaminophen was recommendable for fast and effective treatment in the management of postoperative acute pain.

RADIOGRAPHIC EVALUATION OF THE PROXIMAL BONE LEVEL BETWEEN TWO IMPLANTS : A 3-YEAR COMPARATIVE STUDY BETWEEN BR$BR{\AA}$NEMARK AND ITI IMPLANTS IN THE MANDIBULAR POSTERIOR REGION (하악 구치부에 식립된 Br${\aa}$nemark 임프란트와 ITI 임프란트에서 임프란트간 치조정간골의 높이변화에 대한 방사선학적 비교)

  • Yi, Sang-Hwa;Cha, In-Ho;Shim, June-Sung;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.42 no.4
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    • pp.458-470
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    • 2004
  • Statement of problem: Br${\aa}$nemark or ITI are two currently most widely used implant systems but with contrasting design, surgical and restoration methods. Purpose: The purpose of this study was to compare changes and its statistical significance in bone height and shape which may rise due to the differences between two implant systems. Also to analyse the effect of inter-implant distance on annual bone height changes. Material & Method: Those patients who were treated with two or more of either Br${\aa}$nemark or ITI implants at posterior mandibular area at Yonsei University Dental Hospital, Implant Clinic were selected. At annual examination appointments, standardised radiographs using parallel technique were taken. Marginal bone and inter-implant crestal bone changes were measured and following results were obtained. Results: 1) When ITI and Br${\aa}$nemark system were compared, both annual marginal and inter-implant crestal bone height changes in ITI system in the first two years were smaller than Br${\aa}$nemark and they were statistically significant. On the third year, however, there was no statistical difference between two implant systems on their annual bone level changes (p>0.05). 2) The Marginal and inter-implant crestal bone changes were compared when inter-implant distance was less than 4mm. Statistically significant bone level changes were noted on the first year only for ITI implants but in the first and second year for Br${\aa}$nemark implants (p>0.05). 3) When comparing angulation changes between marginal bone and implant fixture, ITI system had smaller angulation changes but the annual changes were not statistically significant (p>0.05). Conclusion: Within the limitation of this study, it could be concluded that Br${\aa}$nemark implant systems had more changes in marginal and inter-implant crestal bone level in the first and second year after loading with statistical significance. Further studies are recommended to see the effects of these bone loss during the first and second year after loading on the long term prognosis of Br${\aa}$nemark Implants.

Double Processing Obturator for the Hemi-maxillectomy Treated Patient (Hemi-Maxillectomy 환자에서 이중온성법을 이용한 폐색장치의 제작)

  • Hong, Jun-won;Song, Kwang-yeob;Park, Mi-hee;Jeong, Soo-yang;Kim, Kyoung-il;Ahn, Seung-geun;Park, Ju-mi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.329-336
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    • 2009
  • In the case of congenital malformation, acquired trauma, or maxillectomy by neoplasm, the defect in maxilla is combined with nasal cavity, maxillary sinus and oral cavity. This results in abnormal function in pronunciation, mastication, and swallowing. In this situation, the purposes of prosthodontics are also applied. The purposes of obturator for acquired maxillary deficiency patients are restoring pronunciation, mastication, and swallowing, and make patients comfortable and esthetic satisfaction. Reducing weight of the obturator makes edentulous ridge heathy and functional. It also improves patients' comfort. Hollow obturator also reduces unnecessary stress because improves physiologic function, as it weights less than 6.55-33.06% compare to usual one. This case presents the double-processing method for maxillary obturator in the patient treated hemi-maxillectomy due to malignancy neoplasm. We report this case because the patient acquired functional and esthetic satisfaction from double-processing obturator.

The Accuracy of Master Cast for Implant Prosthesis According to the Types of Impression Tray and Splinting Methods of Impression Copings (인상용 트레이의 종류와 인상용 코핑의 연결고정이 임플랜트 주모형의 정확성에 미치는 영향)

  • Lee, Jee-Hyuk;Choi, Yu-Sung;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.4
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    • pp.433-445
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    • 2010
  • The aim of this study was to evaluate the fixation effect by connecting impression copings and to compare the three types of impression trays which were used in open tray impression technique. Experimental groups used 3 types of impression trays which are custom tray, plastic metal combination tray and polycarbonate stock tray. These three groups were subdivided into splinted and non-splinted impression copings group. The total number of experimental groups was six. 10 specimens were made for each group. We used 1-screw test, observing the specimen on which only one side abutment of reference framework was fixated with 20 Ncm. The gap between implant analogue and abutment of the other side was observed by stereo microscope. It was measured at 6 points in each specimen. Measuring value was selected when same result was revealed 3 times. Recorded data were statistically analyzed. Whether impression copings were splinted or not, there was no significant difference among custom tray group, plastic metal combination tray group, and polycarbonate stock tray group. Significant statistical difference in vertical fit discrepancy was found between splinted and non-splinted impression copings group with custom tray, plastic metal combination tray and polycarbonate stock tray (p<0.05).

The Study on Marginal discrepancy of Manufactured Coping Crown according to Production method and materials by using CAD/CAM System (CAD/CAM System을 활용하여 제작된 Coping Crown의 제작방식 및 재료에 따른 변연 적합도에 관한 연구)

  • Lee, Hee-Sung;Shin, Seong-Hun;Song, Joon-Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.448-453
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    • 2017
  • The purpose of this study was to compare the marginal discrepancy of coping crowns according to manufacturing method and materials by using the CAD/CAM system to compare the optimum manufacturing method and materials. The coping crowns were fabricated by using manufacturing methods and materials, and marginal fit was measured using the replica technique. For comparative analysis of manufacturing methods and materials, analysis of variance was performed. One-way ANOVA was performed to compare and analyze different mean values. For the milling method of the alloy, 114.6 was obtained for the MM group, 111.4 for the MS group, 67.2 for the MSC group, and 50.9 for the MSS group, respectively, using the milling/sintering method. In the milling/sintering method of ceramic, 35.6 and 36.3, respectively, were obtained for the SLME group and SLMR group, respectively. However,there was a significant difference according to the material. The milling/sintering method of the ceramic material gave the lowest value, and it was verified by the optimal method. However, marginal discrepancy of coping crowns fabricated using the CAD/CAM system is applicable to the clinic since it corresponds to acceptable numerical values in clinical practice.

Adhesion between heat-pressed lithium disilicate veneer and zirconia framework: Shear bond strength evaluation (열가압 리튬 디실리케이트 전장도재와 지르코니아 하부구조의 전단결합강도 평가)

  • Kim, Jae-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.335-341
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    • 2020
  • This study examined the shear bond strength between the zirconia core and pressed lithium disilicate veneering ceramics. The Schmitz-Schulmeyer test method was used to investigate the core-veneer shear bond strength of industrially manufactured zirconia core ceramic (Zirtooth, HASS, Gangneung, Korea) and pressed veneer ceramic (IPS e.max Zirpress, Vita PM9, GC Initial IQ, HASS Rosetta SM) (N=40). Data were statistically analyzed using one-way ANOVA and Tukey's test (a=0.05). The fractured surfaces of the specimens were examined to determine the failure pattern using a digital microscope. The mean ± SD shear bond strength in MPa were 16.69±3.11, 14.21±3.63, 11.17±2.92, and 27.90±5.71 for IPS e.max Zirpress, VITA PM9, GC Initial IQ, and HASS Rosetta SM, respectively. The average shear bond strength was largest for HASS Rosetta SM, followed by IPS e.max Zirpress, Vita PM9, and GC Initial IQ(p<0.05). The digital microscopy examination of the fracture surface showed adhesive and cohesive failure in pressed lithium disilicate veneering ceramics. The use of lithium disilicate veneer ceramic produced a significantly higher shear bond strength.