• 대한치과보철학회지
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• 제56권4호
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• pp.330-337
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• 2018

무치악 환자에게 임플란트 지지 고정성 보철수복 치료는 그 효용성이 검증되었으나, 복잡한 치료과정이 수반된다. 반면, 현대 치의학에서 디지털 기술력은 나날이 발전하여 현재 무치악 환자의 임플란트 수복치료까지 그 범위를 확장하였다. 본 증례에서는 66세 하악 무치악 환자의 임플란트 고정성 보철 수복에 대하여 진단부터 수술, 임시수복물 및 최종수복물의 디자인과 제작까지 디지털 시스템을 모든 단계에 이용하였다. 수술 전 진단단계에서 구강스캐너를 이용한 점막스캔과 환자의 안정적인 기존 총의치 교합을 토대로 임시수복물을 디자인하였다. 수술가이드를 이용하여 무절개 임플란트 식립 후에 사전제작한 임시수복물을 임플란트와 연결하여 즉시 임시수복물로써 사용하였다. 디지털 기술을 이용하여 안정적인 교합이 형성된 임시수복물의 수직고경과 중심위를 이전하여 최종수복물을 디자인 및 제작 하였다. 디지털 기술을 활용하여 환자의 수직고경과 교합을 보전하는 방법을 사용함으로써 무치악환자에서 복잡할 수 있는 임플란트 치료의 간단한 프로토콜을 정립하였기에 보고하는 바이다.

• 구강회복응용과학지
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• 제40권2호
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• pp.91-99
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• 2024

골격성 3급 무치악 환자의 경우 총의치 제작 시 잔존치조제 관계를 고려하여 교차교합을 형성해 줌으로써 의치의 안정을 얻을 수 있다. 골격성 3급 악간관계에서 전치부를 정상교합 관계로 형성하는 것은 전방 캔틸레버를 가중시켜 의치의 안정을 저하시킬 수 있다. 하지만, 환자들은 총의치를 사용할 때 기능적인 면 뿐 아니라 심미적인 면 또한 중요시한다. 전치부 인공치들이 어떻게 배열되느냐에 따라 총의치의 심미성이 좌우되어, 골격성 3급 악간관계를 갖는 무치악 환자에서 정상교합이나 절단교합을 활용한 총의치 제작 증례가 보고되고 있다. 본 증례에서는 3급 악간관계를 갖는 무치악 환자에게 상악 전치부에 중립대를 고려하여 전치부 절단교합을 형성하여 의치를 제작하였고, 우수한 심미적, 기능적 결과를 얻었다.

• 대한심미치과학회지
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• 제10권1호
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• pp.104-113
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• 2001

This article described a procedure for fabricating an esthetic gingival porcelain restoration as an implant-supported fixed prosthesis for edentulous maxilla. Alternative treatments for fully edentulous patients include an implant-supported overdenture or a fixed implant-supported prosthesis with bilateral distal cantilevers. But, from a functional and biomechanical point of view, the fixed implant-supported prosthesis with posterior cantilevers or implant-supported tissue-borne overdenture do not significantly improve masticatory effectiveness compared with a distributed implant restoration as a fixed implant-supported prosthesis. The fact that the prosthesis is supported by distributed implants over eight for edentulous maxilla in general, provides increased masticatory efficiency as a fixed restoration and similar gingival appearance with esthetic gingival porcelain. It is also detachable by dentist to allow easier after-care of soft tissue and the prosthesis.

• 대한치과의사협회지
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• 제40권9호통권400호
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• pp.709-715
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• 2002

Two patients with sufficient vertical bone height but insufficient bone width in the anterior mandibular edentulous area, less than 6mm in the buccolingual aspect, for implant placement were chosen for treatment with a ridge splitting procedure. The surgical technique involving greenstick fracture is described. This ridge splitting procedure could be simple placement of implants into ideal restorable positions in severely atrophic, knife-edged ridges and predictable for narrow edentulous alveolar ridge augmentation associated with implant placement. We experienced two cases to place implant with insufficient bone width in the anterior mandibular edentulous area for overdenture be ridge splitting technique. Thus, we will report two cases and review of the literature.

• Journal of Periodontal and Implant Science
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• 제46권4호
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• pp.234-243
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• 2016

Purpose: Immediate loading of dental implants has been proved to be feasible in partially edentulous jaws. The purpose of this retrospective investigation was to assess the feasibility of immediately loading dental implants in fully edentulous jaws. Methods: A total of 24 patients aged between 53 and 89 years received a total of 154 implants in their edentulous maxillae or mandibles. Among the implants, 45 were set in fresh extracted sockets and 109 in consolidated alveolar bones. The implants were provisionally managed with chair-side made provisional resin bridges and exposed to immediate loading. Implants were followed up for 1-8 years, including radiographic imaging. Marginal bone levels were evaluated based on radiographic imaging. Results: A total of 148 out of the 154 implants survived over the follow-up period of 1 to 8 years, giving a survival rate of 96%. The time or region of the implantation, the pre-implant augmentation, and the length and diameter of the implants had no statistically significant influence on the survival or the success rate. The marginal bone level remained stable with only minimal loss of 0.3 mm after 60 months of loading. Conclusions: Within the limitations of this study, immediate loading is feasible for dental implants in edentulous jaws.

• Imaging Science in Dentistry
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• 제51권3호
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• pp.243-250
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• 2021

Purpose: The objective of this study was to evaluate the amount of height available for a maxillary sinus augmentation procedure without blocking the ostium and jeopardizing the drainage of the ostiomeatal complex using cone-beam computed tomography (CBCT) imaging. Materials and Methods: A total of 200 sinonasal complexes comprising 100 dentate and 100 edentulous scans were retrospectively assessed using CBCT. Invivo 5.0, a CBCT reconstruction program, was used for image evaluation. The coronal section demonstrating the ostiomeatal complex was selected as a reference view to perform measurements of the sinus. The measurements were done by 2 evaluators in separate sessions. Comparative analyses of measurements were performed between dentate and edentulous patients and between male and female patients. Results: The safe height to which the sinus can be elevated without compromising the integrity of the ostiomeatal complex was calculated for each sinus. In the presence of significant mucosal thickening, the height available for augmentation was calculated by subtracting the height of mucosal thickening from the sinus floor to the location of the ostium. In this study, the available height was approximately 27.05 mm for dentate and 23.40 mm for edentulous patients. The inter-operator reliability was excellent for all the parameters evaluated. Conclusion: This retrospective study with a limited number of patients from a single university-based site shows that CBCT is valuable in evaluating the location and patency of the ostium for planning sinus augmentation procedures for dental implant placement.

• The Journal of Advanced Prosthodontics
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• 제4권4호
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• pp.254-258
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• 2012

Implant-supported overdenture is a reliable treatment option for the patients with edentulous mandible when they have difficulty in using complete dentures. Several options have been used for implant-supported overdenture attachments. Among these, bar attachment system has greater retention and better maintainability than others. SFI-Bar$^{(R)}$ is prefabricated and can be adjustable at chairside. Therefore, laboratory procedures such as soldering and welding are unnecessary, which leads to fewer errors and lower costs. A 67-year-old female patient presented, complaining of mobility of lower anterior teeth with old denture. She had been wearing complete denture in the maxilla and removable partial denture in the mandible with severe bone loss. After extracting the teeth, two implants were placed in front of mental foramen, and SFI-Bar$^{(R)}$ was connected. A tube bar was seated to two adapters through large ball joints and fixation screws, connecting each implant. The length of the tube bar was adjusted according to inter-implant distance. Then, a female part was attached to the bar beneath the new denture. This clinical report describes two-implant-supported overdenture using the SFI-Bar$^{(R)}$ system in a mandibular edentulous patient.

• 구강회복응용과학지
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• 제28권4호
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• pp.397-406
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• 2012

치아가 상실되면 주위 치조골의 개조와 흡수가 일어나면서 위축성 무치악을 초래하게 되고, 치은부착은 점차적으로 감소된다. 이에 따라 총의치의 지지력 감소, 저작 효율의 저하와 통증으로 인해 무치악 환자들은 의치 사용의 어려움을 경험한다. 이를 개선하기 위해 하악에 2개의 임플란트를 식립하고 어태치먼트를 장착하는 피개의치의 형태가 유지력 측면에서 바람직한 치료 방법으로 우선적으로 고려되고 있다. 본 증례는 오래된 상, 하악 무치악을 가진 환자로 하악에 2개의 임플란트를 식립하고, 상악은 총의치, 하악은 Locator$^{(R)}$ attachment를 이용한 임플란트 피개의치로 제작하였다. 본 증례에서 기능적, 심미적으로 만족스러운 결과를 얻었기에 수복 과정과 결과에 대하여 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.31.1-31.7
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• 2016

Background: The objective of this retrospective study was to show results from platform-switched narrow-diameter implants in the posterior edentulous region, which we followed up for more than 1 year after functional loading. Methods: Ninety-eight narrow implants were inserted into 66 patients. After healing, fixed implant-supported prostheses were delivered to the patients, and Periotest and radiographic examinations were performed. After the first year of loading, the implant outcome was again evaluated clinically and radiographically using the Periotest analysis. Crestal bone loss and Periotest values (PTVs) were used to evaluate the effect of surgery, prosthesis, implant, and a host-related factor. A general linear model was used to statistically detect variables statistically associated with crestal bone loss and Periotest value. Results: We followed up on the implants over 1 to 4 years after loading; their survival rate was 100 %, and pronounced differences from PTVs were noted among jaw location, bone quality, and loading period. No difference was detected in bone loss among the variables studied. Bone loss after functional loading was $0.14{\pm}0.39mm$. The stability value from the Periotest was $-3.29{\pm}0.50$. Conclusions: Within the limitations of this study, judicious use of platform-switched narrow implants with a conical connection must be considered an alternative for wide-diameter implants to restore a posterior edentulous region.

• 구강회복응용과학지
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• 제16권3호
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• pp.187-196
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• 2000

This study was performed to offer convenience to determine the vertical dimension of occlusion of edentulous patients by investigating the interocclusal distances at physiologic rest position, at speaking of /m/ sound, and some korean short sounds, that is, /mem/ and /beb/ sounds, which were found in our previous study with dentulous subjects. Ten edentulous subjects - 6 men and 4 women - were selected for this study. The frequencies at speaking of /m/, /mem/, and /beb/ sounds were analyzed with Computerized speech lab($CSL^{TM}$, Model 4300B, Software version 5.X, Kay Elemetrics Co. U.S.A.). And the interocclusal distances at physiologic rest position and at speaking of /m/, /mem/, and /beb/ sounds were measured with K6 diagnostic system(Myo-tronics, Inc. U.S.A.). The results of this study were as follows ; 1. In the acoustic analysis by Computerized speech lab, frequencies of sounds of edentulous subjects with complete denture at speaking of /m/, /mem/, and /beb/ were similar to those of dentulous subjects. 2. In the linear correlation by Pearson's correlation coefficient, the interocclusal distance at physiologic rest position was most similar to those of speaking /mem/ sound, secondly /m/ sound, and thirdly /beb/ sound(p<0.05). In reliability by Cronbach's alpha, the results were reliable with alpha value 0.97. 3. It was found by Levene's test for equality of variance that the difference between men and women in the interocclusal distances at physiologic rest position and at speaking of /m/, /mem/, and /beb/ sounds was not statistically significant(p>0.05).