• Title/Summary/Keyword: Edentulism

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Comparative evaluation of peri-implant stress distribution in implant protected occlusion and cuspally loaded occlusion on a 3 unit implant supported fixed partial denture: A 3D finite element analysis study

  • Acharya, Paramba Hitendrabhai;Patel, Vilas Valjibhai;Duseja, Sareen Subhash;Chauhan, Vishal Rajendrabhai
    • The Journal of Advanced Prosthodontics
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    • v.13 no.2
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    • pp.79-88
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    • 2021
  • Purpose. To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion. Materials and methods. A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points. Results. In Group 1 for vertical load, maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1. Conclusion. In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.

Comparison of treatments for maxillary full denture and mandibular implant-supported fixed prosthesis in completely edentulous patients: A case report (완전 무치악 환자에서 상악 총의치와 하악 임플란트 지지 고정성 보철 치료를 위한 치료법 비교: 증례 보고)

  • Jin-Won Han;Se-Wook Pyo;Jae-Seung Chang;Sunjai Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.73-81
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    • 2023
  • There are various approaches to treatment for patients with fully edentulous jaw. In maxilla, it is easy to obtain sufficient stability, support, and retention with the traditional full denture method. In mandible, however, there are difficulties caused by anatomical limitations. In this case, treatment with implants can be considered. If it is difficult to place implants in posterior area, a fixed complete denture can be considered, using 4 - 5 implants anterior to mental foramen. This approach has changed in many ways, such as surgical methods and materials used, over the years. This case report compares two approaches and their changes over time, especially in the cases of mandibular fixed prostheses using implants, paired with maxillary complete denture.

Fixed implant rehabilitation of maxillary edentulous patient using intraoral scanning digital workflow: a case report (상악 완전 무치악 환자에서 구강 스캐닝 디지털 워크플로우를 활용한 완전 고정성 임플란트 수복 증례)

  • Seung Min Park;YoungBum Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.38-46
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    • 2024
  • In order to treat edentulous patients with fixed implant prosthesis, the final prosthesis form should be predetermined based on the anatomic structures of the arch, the opposing dentition, and the occlusal plane. The design and occlusion of the interim prosthesis can provide useful information when fabricating the definitive prosthesis. In this case report, scan data of the edentulous region and the interim prosthesis were superimposed through an intraoral scanning digital workflow. In this way, the interim prosthesis information was incorporated into the design of the final prosthesis. Furthermore, the interim prosthesis data acquired through intraoral scanning was utilized to plan the positions and angles of the implants based on the final prosthesis design. Surgical guides were used to accurately place the implants in the planned three-dimensional positions. In this case report, satisfactory esthetic and functional clinical outcomes were achieved through application of digital techniques.

APPLICATION OF CAD/CAM FOR ORAL REHABILITATION IN A PATIENT WITH DOWN SYNDROME (CAD/CAM을 이용한 다운 증후군 환자의 구강 재건)

  • Chung, Hyunjin;Shim, Joon-Sung;Choi, Byung-Jai;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.95-98
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    • 2017
  • Due to hypodontia, poor oral hygiene, and significantly more prevalent periodontal disease, patients with Down syndrome show higher incidence of edentulism. Oral rehabilitation of such patients is imperative but challenging as high rates of prosthesis failure are reported due to malocclusion, high masticatory force, and parafunctional habits. As CAD/CAM(Computer-Aided Design and Computer Aided Manufacturing) is the recent trend in prosthodontics, this report discusses the application of CAD/CAM in a Down syndrome patient. A 25-year-old patient with Down syndrome was presented to the Department of Pediatric Dentistry, Yonsei University Dental Hospital for oral examination. 5 maxillary teeth were missing, 3 were fully impacted, and 4 had grade III mobility. The patient underwent general anesthesia for extraction of impacted and mobile teeth, implant surgery, and final impression for prosthesis. Afterwards, CAD/CAM was used to design and manufacture a 10-unit zirconia bridge. However the bridge was fractured after 18 months due to the patient's bruxism and high masticatory force. Final impression taking, bite registration, cast fabrication, cast scanning, and prosthesis designing were not needed as CAD/CAM data remained. Previous CAD/CAM design was used to remanufacture the zirconia bridge. Down syndrome patients have malocclusion, high masticatory force, and parafunctional habits which increase the possibility of prosthesis fracture. CAD/CAM is beneficial for Down syndrome patients as previous digital records can be utilized for prosthesis repair or remake. In detail, application of CAD/CAM in remanufacturing decreases patient's discomfort of impression taking, shortens and simplifies dental laboratory procedures, and reduces clinician's effort of taking detailed final impressions or accurate bite registration. In conclusion, oral rehabilitation using CAD/CAM provides not only satisfactory levels of comfort, stability, and esthetics, but also easier repair or remake compared to conventional prostheses.

Regeneration of emergence profile with soft tissue graft and wide computer aided design/computer aided mamufacturing abutments: a clinical report (연조직 이식술과 넓은 computer aided design/computer aided mamufacturing 지대주를 이용한 임플란트 고정성 보철물의 출현윤곽 재현)

  • Kim, Min-Kyung;Lee, Ji-Hun;Ahn, Seung-Geun;Kim, Kyung-A;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.364-370
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    • 2015
  • Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.

Oral health status of institutionalized elderly in Korea (노인장기요양시설 입소노인의 구강건강실태와 시사점)

  • Han, Dong-Hun;Kim, Nam-Hee;Ko, Seok-Min;Kwak, Jeong-Min;So, Jong-Seop;Lee, Seong-Keun;Lim, Soon-Ryun;Hwang, Ji-Young;Lee, Hye-Ju;Choi, Ho-Joon;Paek, Ji-Hyun;Kim, Yeon-Ju
    • The Journal of the Korean dental association
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    • v.53 no.10
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    • pp.688-695
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    • 2015
  • Purpose: The institutionalized elderly have placed the most vulnerable state, and the report about the oral health status of the institutionalized elderly was scarce. The aims of the current study were to investigate the oral health status of institutionalized elderly. Materials and methods: The survey of the oral health status was carried out on 487 institutionalized elderly from 4 longterm care facilities of Seoul metropolitan city, Gyunggi province, and Gangwon province in Korea. Results: The prevalence of dental caries, root caries, and dental calculus of the institutionalized elderly was 19.2%, 15.3%, and 23.7%, respectively. The percentage of edentulism among the institutionalized elderly was 26.2%. Those who had poor oral hygiene and tongue coating were 43.9% and 90.5%, respectively. The percentages wearing complete and removable partial denture on maxilla were 12.8% and 3.3%, respectively. The percentages wearing complete and removable partial denture on mandible were 7.8% and 5.6%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on maxilla were 29.7% and 27.2%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on mandible were 24.5% and 30.9%, respectively. Conclusion: The oral health stuatus of institutionalized elderly was poor. For the oral health promotion of elderly in longterm care facilities, it is essential to educate nurses and caregivers about the importance of the oral health and oral hygiene method.

A HISTOLOGIC STUDY OF THE OSSEOINTEGRATION PROCESS TO THE TITANIUM TOOTH ROOT IMPLANT (타이타늄 치근형 매식체에 대한 골유착 과정에 관한 조직학적 연구)

  • Ahn, Chang Young;Kim, Yung Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.28 no.2
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    • pp.1-28
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    • 1990
  • The severe atrophic edentulism with poor neuromuscular control militates against successful conventional denture therapy. To such situation, a prescribing of dental implant treatment has been considered with some probability. Implant materials used as a trial for dental implants includes metals, plastic polymers and ceramics. The purpose of this study was to observe histologic response in osseointegration process at titanium implant-tissue interface based on biocompatibility at specific period of sequential natures which were divided into a half month, one, month, two months, three months and immediate as a base line. In this study, unilateral lower left premolar and molar teeth were extraced in three dogs. After allowing to heal for 6 months, three kinds of osseointegrated implant, $Br{\aa}nemark$, Corevent and kimplant(a prototype of SNU implant study)were inserted in each dog respectively according to the above sequence from front to back. The specimens were taken from those dogs at the same time since implant were inserted quite reverse order of the specified periods, and decalcified and processed for histologic examination for the light microscopy and the electron microscopy. The microscopic histologic findings at the interface between titanium implants and tissue were interpretated as follows : A. Light microscopic findings : a. Immediate : Implant were surrounded by compact bone and spongy bone. Microcrak was observed in the superficial bone tissue. Osteocytes were disappeared and bone lacunae were observed as a vacant space in some parts. In the contacting with the spongy bone, bone trabeculae and bone marrow were in contact with the implant. b. A half Month : Osteoblasts exist as a monolayer in th inner bone trabeculae and do bone additiocn. Osteoblasts&inflammatory cells were observed in some parts. c. One Month : The presence of osteoclasts decreased. Osteoblasts did active bone fromation, and bone marrow was in contact with the implant in the many places. d. Two Months : Bone formation was advanced in comparison with the b and c. The presence of osteoclsts was not observed. e. Three Months : The superficial bone tissue contacted with the implants was entirely composed by the compact bone. B. Electron microscopic findings : a. A half month and one month group : In the parts of the active bone formation, osteoblasts with the well developed endoplasmic reticulum and Golgi apparatus were arranged in the monolayer. In the parts of the bone resorption, ruffled border was well developed and many osteoclasts with the well-developed golgi apparatus, mitochondria, vacuole, vesicle and lysosome were existed. b. Three months group : No osteoblasts were observed in the superficial bone tissue. Bone matrix with collaen fiber was observed. c. No significant dirrerence in the histologic findings was observed in $Br{\aa}nemark$, Core-vent and kimplant.

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Implant prosthesis for fully edentulous patients using intra-oral scanning and abutment merging technique: A case report (무치악 환자에서 구강 스캔과 지대주 중첩을 이용한 임플란트 보철수복 증례)

  • Hwang, Chan-Hyeon;Jeong, Seung-Mi;Kim, Yong-Jun;Kim, Kyeong-Hee;Fang, Jeong-Whan;Kim, Dae-Hwan;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.61-70
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    • 2017
  • In this case, the impression surface of the existing denture was scanned and was inverted three-dimensionally to express the residual ridge form. Implant planning was performed on the superimposed data of the CT with the scanned image of the denture with radiopaque markers attached. At the day of surgery, customized abutments fabricated in accordance with the form of the gingival margin were linked with fixtures and temporary restorations were set. In the process of fabricating the final prosthesis after the osseointegration of implant fixture, the intraoral scan images at abutment level were merged with images of the abutments scanned and stored before implant surgery. By fabricating the final prosthesis with the abutments obtained by merging can increase the marginal fitness of the final prosthesis and simplify the clinical process.

Implant Supported Fixed Restoration for Maxillary Edentulism using CAD/CAM Guided Implant Surgery (NobelGuide$^{TM}$) and Immediate Loading (상악 완전 무치악 환자의 CAD/CAM 을 이용한 임플란트 식립(NobelGuide$^{TM}$) 및 즉시하중 후 고정성 보철수복 증례)

  • Huh, Yoon-Hyuk;Yi, Yang-Jin;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.423-439
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    • 2012
  • This case report described a technique utilizing a computer-aided design (CAD)/computer-aided machining (CAM) - guided surgical implant placement and prefabricated temporary fixed prosthesis for an immediately loaded restoration. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla received 8 implants in maxilla using CAD/CAM surgical templates. Prefabricated provisional maxillary implant supported fixed prosthesis were connected immediately after implant installation. Provisional prosthesis was evaluated for aesthetics, function during 6 months. Definitive implant supported fixed porcelain fused metal bridges were fabricated.

Complication and management of implant-assisted removable partial denture with distal extension: a clinical report (양측성 후방연장 임플란트 보조 국소의치의 합병증과 관리: 증례보고)

  • Choi, Jung-Yun;Lee, Jung-Jin;Song, Kwang-Yeob;Park, Ju-Mi;Kim, Kyoung-A;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.4
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    • pp.338-344
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    • 2016
  • Implant supported removable partial denture (ISRPD) using the implants enables favorable rehabilitation by complementing biomechanical limitations of the conventional removable partial denture (RPD). However, continuous recall check is necessary for evaluation of the mechanical and biological complications to ensure good long-term prognosis of ISRPD. This clinical report describes the complication and management in patient of Kennedy class I edentulism with ISRPD using healing abutment. The wear and fracture of healing abutment occurred at 36 months after delivery. So, healing abutment was replaced by connecting $Locator^{(R)}$ abutment for altering into the implant retained partial overdenture.