• Title/Summary/Keyword: Edentulous Patients

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THE TRANSMANDIBULAR IMPLANT SYSTEM (The Transmandibular Implant System)

  • Moon, Hong-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.3
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    • pp.435-444
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    • 1997
  • Many of the problems which are faced to the edentulous patients are related to a minimal amount of available mandibular bone volume and height. Most of the patients with mild atrophy of the mandible are treated using endosseous implant prosthodontics. TMI(Trans-mandibular Implant) can be used in case of severe mandibular atrophy, poor bone quality, atrophy of the mandible with exposed of inferior alveolar nerve, osteoporosis and the fracture of the atrophic mandible. Also it can eliminate the need for bone grafting and vestibuloplasty. The TMI is a rigid box frame structure which controls and distribute the masticatory force over the severely resorbed mandible. The box frame structure consist of a superstructure, baseplate, 4 transosseous posts, and 5 cortical screws. This is a case report that also describes about the transmandibular implant reconstruction system.

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MEASUREMENT OF MAXILLARY SINUS VOLUME FOR THE PLACEMENT OF GRAFT MATERIAL - A CASE CONTROL STUDY USING CT IMAGE (상악동 골이식술을 위한 이식재의 부피 측정 - CT를 이용한 환자 대조군 연구)

  • Kim, Hyung-Wook;Lee, Seul-Ki;Chung, Jae-An;Shin, Jin-Eob;Um, Yun-Sub;Kim, Ki-Young;Kim, Jong-Sik;Song, Yun-Jung;Hong, Soon-Min;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.511-517
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    • 2007
  • Purpose: The aim of this study is to determine whether a difference in the amount of bone graft material is needed between edentulous patients and dentulous patients and to calculate the amount of augmentation for a sinus lift procedure. Methods: 19 patients(20 sinuses) were included to measure maxillary sinus volume. Facial CT scanning was performed using MX 8000 IDT CT devices(Philips, USA). And it was used for IDLvm(The IDL Virtual Machine) 6.0, CT Volume Analyzer Ver 2.3 program to measure maxillary sinus volumes Results: At edentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.56{\pm}0.13cm^3$(5mm height), $2.35{\pm}0.57cm^3$(10mm height), $4.85{\pm}1.10cm^3$(15mm height). At dentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.41{\pm}0.18cm^3$(5mm height), $1.76{\pm}0.42cm^3$(10mm height), $3.80{\pm}0.84cm^3$ (15mm height). A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume.(p=0.027, p=0.018, p=0.044) Conclusions: A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume. Detailed preoperative knowledge of sinus lift augmentation volume is helpful in determining the appropriate amount of the bone graft material.

Patients satisfaction for implant supported overdenture with small diameter implant (작은 직경 임플란트를 이용한 임플란트 지지 피개의치에 대한 환자 만족도 조사)

  • Lee, Sang-Yeup;Choi, Dae-Gyun;Paek, Jang-Hyun;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.1
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    • pp.29-37
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    • 2011
  • Purpose: In cases when implant supported overdenture is made by using standard size implant, additional procedure such as bone surgery and bone grafting can be required. And it gives burden to doctor and patient in terms of cost. Therefore, it is necessary to find the implant therapy for the edentulous patients in making denture with accordable cost and simple procedure. Materials and methods: Edentulous patients with upper and lower dentures participated in this study. Before the operation, survey about patient's satisfaction to the existing dentures was carried out. Surgical procedures included four small diameter implants installation anterior area and immediate loading. One and three month after the procedure, the same survey about patient's satisfaction was carried out, and radiography was taken. Results: We are doing research to the nine patients. Survival rate is 97.2 percent. The comparison of patient's satisfaction before and after surgery is performed based on oral health impact profile 49. We analyze mainly with masticatory discomfort, retention, aesthetics, social problem, psychological discomfort problems. As a result, satisfaction level is increased at all factors. Retention is the most increased satisfactory factor followed by mastication difficulty, pronunciation, psychological discomfort, social discomfort, aesthetics in order. Marginal bone loss is 0.21 mm at 12 weeks after implant placement. Conclusion: This research reveals that the denture supported by mini dental implant increases patient's satisfaction. This study will be continued with more patients for a long time and we are scheduled for taking additional radiography to check whether peri-implant bone resorption occurs or not.

A CLINICAL STUDY ON THE SATISFACTION OF COMPLETE DENTURE PATIENTS (총의치 환자의 만족도에 대한 연구)

  • Kim, Hyung-Woo;Kim, Chang-Whe;Kim, Yung-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.3
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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).

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A prospective study of patient satisfaction after implant supported mandibular overdenture treatment in fully edentulous patients (완전 무치악 환자에서 하악 임플란트 지지 피개의치 사용 후의 환자만족도에 관한 전향적 연구)

  • Hong, Ju-Hee;Jung, Gyu-Un;Shin, Sang-Wan;Pang, Eun-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.1-8
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    • 2015
  • Purpose: The purpose of this prospective study was to compare the satisfaction levels of the patients worn implant supported mandibular overdentures and conventional complete dentures. Materials and methods: Full edentulous patients (n=40) who were planned to do implant supported mandibular overdentures, aged 51 to 82 years, were enrolled in this study. All subjects rated their satisfaction levels (mastication, pronunciation, esthetics, pain, and general satisfaction) of their original conventional dentures prior to treatment and their new overdentures 1 week and 12 weeks after the delivery on 10 cm visual analogue scales. Repeated-measures ANOVA was performed to compare the satisfaction level of each three period (P<.05). Results: The mean satisfaction levels of the implant supported overdentures after 1 week and 12 weeks of delivery were significantly higher than those of the conventional complete dentures in all scoring parameters (P<.05). After 12 weeks of overdenture delivery, the increase of the satisfaction levels in mastication, pronunciation, and pain and the decrease in esthetics and general satisfaction were observed in comparison with those after 1 week of delivery, however, no significant difference was found between the satisfaction levels of 1 week and 12 weeks after delivery. Conclusion: An implant supported overdenture might be one of the effective ways to give more satisfaction to patients who were not gratified with a conventional denture and eventually to improve their quality of life.

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.

Prospective Clinical Trial of Survival Rate for Two Different Implant Surfaces Using the Osstem(R) SS II Non-submerged Implant System in Partially Edentulous Patients

  • Kim, Su-Gwan;Lim, Chae-Su;Oh, Min-Seok;Park, Jin-Sung;Kim, Seo-Yoon;Seol, Ka-Young
    • Journal of Korean Dental Science
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    • v.2 no.2
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    • pp.35-41
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    • 2009
  • Objective : This study sought to investigate the clinical survival rate of two implants with different surfaces: resorbable blasting media (RBM)-treated and calcium metaphosphate (CMP)-coated implant. Study design : SSII non-submerged implants (Osstem, Seoul, Korea) were placed in a total of 48 patients with mean age of 38.8. At least 31 patients in the experimental group had a CMP-coated implant, and 1 patient in the control group received a, RBM surface implant. The evaluation period was between April 2006 and December 2007. Radiographs, periotest, clinical periodontal examination, and prosthetic adjustment and occlusion were used. Results : The survival rate of the experimental and control groups after 1 year was 97.2% and 100%, respectively. The Wald confidence interval reported for the experimental group was not inferior to the control group. Conclusion : No significant differences were found between the RBM and CMP groups. The observed data suggest that CMP-coated methods can provide favorable clinical results for the functioning and healing of dental implants.

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Long-term results of new deproteinized bovine bone material in a maxillary sinus graft procedure

  • Shin, Seung-Yun;Hwang, You-Jeong;Kim, Jung-Hoon;Seol, Yang-Jo
    • Journal of Periodontal and Implant Science
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    • v.44 no.5
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    • pp.259-264
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    • 2014
  • Purpose: The aim of this case report is to present the longitudinal results of sinus grafting using a new demineralized bovine bone material (DBBM) in human cases. Methods: A patient with a resorbed maxilla was treated by maxillary sinus grafting using a new deproteinized bovine bone material. After a healing period of 6.5 months, three implants were placed and restored. The patient was periodically recalled and followed up for 5 years after restoration. Results: Twelve partially edentulous patients (average age, 55.7 years) were followed up. All patients had insufficient residual height in their maxillary posterior area and underwent maxillary sinus graft surgery to increase the height of their maxilla. In all, 27 fixtures were placed in the augmented bone area. On average, 8.6 months later, implants were loaded using provisional or final restorations. The observation period ranged from 27 to 75 months (average, 43.3 months), and the patients did not show any severe resorption of the graft material or any infection during this time. Conclusions: Our results show that the new DBBM is useful for a maxillary sinus graft procedure. Good healing responses as well as reliable results were obtained for an average follow-up period of 43.3 months.

Technique for fabricating a mandibular suction denture with a plastic implant tray (임플란트용 플라스틱 트레이를 이용하여 하악 흡착의치를 제작하는 방법)

  • Lee, Ju-Hyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.36-42
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    • 2021
  • Even though implant overdentures are preferentially recommended to mandibular edentulous patients, many patients may select conventional complete dentures due to cost and general condition. Proper retention and stability of conventional complete dentures in patients with severe alveolar bone resorption is difficult to achieve. To overcome the limitations, mandibular suction dentures with the closed mouth impression technique have been used. However, the previous technique requires the Frame cut back tray, the Centric tray, and the Gnathometer M. This article introduces a technique for fabricating a mandibular suction denture with common dental materials.

Fibula Free Flap for Mandibular Reconstruction using Simulation Surgery in Bisphosphonate related Osteonecrosis of the Jaw

  • Kim, Hong-Joon;Hwang, Jong-Hyun;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • v.2 no.1
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    • pp.1-6
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    • 2015
  • Purpose Bisphophonate-related osteonecrosis of the jaw (BRONJ) is an emerging problem. Extensive osteonecrosis of the jaw needs free flap reconstruction. Free fibular flap is the most useful flap for maxilla-mandibular hard and soft tissue reconstruction. The advantages of fibular free flap are simultaneous soft and hard tissue reconstruction and placing implant in reconstructed mandible and maxilla. In this study, four consecutive BRONJ patients who underwent fibula free flap reconstruction using simulation surgery were reviewed. Materials and Methods Four BRONJ patients who underwent free fibula reconstruction between May 2006 and September 2014 were included in this study. Male to female ratio was 1:3 and average age was 67.3 years old (62-70). All patients need mandibular bone reconstruction. Three patients suffered from osteoporosis and one male patient had multiple myeloma. Postoperative flap survival, functional reconstruction, esthetic results, food taking were evaluated. Results Three osseous flaps and one osteocutaneous flap were used. All the fibular flaps were survived and patients were recovered without complications. Oro-cutaneous fistula was resolved after operation. All patients were satisfied with the esthetic results. Patients reported improved solid food intake after operation with partial denture. One fully edentulous patient had semi-fluid diet after operation. Conclusion Treatment of the BRONJ is difficult due to lack of standard protocol. Fibular free flap using simulation surgery is the workhorse flap for mandibular hard and soft tissue reconstruction, especially in stage III BRONJ patient. In this study, functional and esthetic results were successful in all patients. Normal diet was possible with partial dentures.