• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.14-20
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• 2016

Purpose: The aim of this study was to know whether there is significant difference of peri-implant bone density according to the state of antagonist region. Materials and methods: 51 patients who had implant operation in Daejeon Dental Hospital of Wonkwang University participated in this study and total of 51 implants were analyzed. Implants were classified depending on opposing antagonist region, gender, age and location of jaw. The opposing antagonist region was divided into four groups; natural tooth, implant, pontic and edentulous region. Fractal analysis was performed using two periapical radiographs; one after implant placement and the other after 10 weeks following prosthetic restoration. The analysis was done by Image J. The data was statistically analyzed using one-way ANOVA and Tukey multiple comparison test. Results: The mean value of fractal difference was $0.009{\pm}0.048$ with opposing natural tooth, $0.026{\pm}0.080$ with opposing implant, $0.025{\pm}0.068$ with opposing pontic and $0.093{\pm}0.171$ with opposing edentulous area. There was a statistically significant difference in fractal value between opposing implant and opposing edentulous state. And there was no statistically significant difference according to age, gender and location of jaw. Conclusion: There was no statistically significant difference between 3 groups except opposing edentulous region and there was a statistically significant difference between opposing implant and edentulous region. And there was no statistically significant difference according to age, gender and location of jaw.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.497-507
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• 2021

All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient's inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient's requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.367-371
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• 2009

Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 5-year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Materials and methods: One hundred and thirteen cases of 96 patients who visited our center from Aug 2004 to July 2009 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent augmentation sinus surgery with outfracture osteotomy technique. Feasibility of the outfracture osteotomy technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery of this new kind. Total fixture number available in follow-up period was 179, in which the lost 10 patients were excluded out of 96 patients. Results: Five-year cumulative survival rate was 97.2% with 5 failures of total 179 fixtures. The average follow-up period was 29 and a half months, with the minimum and maximum follow-up periods of 4 months 21 days and 59 months 14 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate of 97.2% (174 out of 179 fixtures), which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.8-12
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• 2014

Purpose: The aim of this retrospective chart review was to evaluate the four-year survival rate of a titanium implant system. Methods: A total of 352 sand-blasted, thermally acid-etched titanium implants were inserted into 181 partially or completely edentulous patients. Their cumulative survival rate was evaluated retrospectively. Associated factors, such as the implant distribution and treatment type were included in the evaluation. Results: The implants were equally distributed between the maxilla (52.3%) and the mandible (47.7%). 48 implants (13.6%) were placed in the anterior region and 304 implants (86.4%) in the posterior region. The majority of the implants were inserted into bone of type II and III quality (89.8%) and volume (quantity B and C, 87.2%). Most of the implants (70.7%) were restored as single crowns; 28.7% supported a bridge construction and 0.6% a full denture. Only one implant failed, resulting in a four-year cumulative survival rate of 99.7%. Conclusions: The implant system showed an excellent four-year survival rate. It proved to be a safe and predictable means for restoration of the dentition in partially or completely edentulous patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.94-99
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• 2013

Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 8.5 year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Methods: One hundred and seventy-six cases of 145 patients who visited our center from August 2004 to February 2013 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent sinus graft with outfracture osteotomy sinus graft technique. Feasibility of the outfracture osteotomy sinus graft technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery. Total fixture number available in follow-up period was 320, in which the lost 15 patients were excluded out of 160 patients. Results: Eight point five year cumulative survival rate was 95.6% with 14 failures of total 320 fixtures. The average follow-up period was 28 months 16 days with the minimum and maximum follow-up periods of 4 months 5 days and 94 months 10 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate, which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.4
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• pp.494-505
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• 1999

In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using 'patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other people's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessive-compulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptoms Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.426-433
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• 2013

When restoring edentulous patients with lower complete denture, the smaller supportive and retentive area of mandible can lead to poor support and stability, denture dislodgement and pain resulting discomfort. In this situation, implant prosthesis can improve esthetics, stability and occlusal force. Whereas, patients with a upper complete denture can adjust more easier because of palate. Therefore, it is suggested to rehabilitate fully edentulous patients with lower implant-supported, upper complete denture as one of the treatment options. So, we are going to report the case and literature review about how the lower implant prosthesis opposing to upper complete denture affects the bone resorption of maxillary residual ridge.

• Journal of Korean Dental Science
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• v.2 no.1
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• pp.4-10
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• 2009

Though implant treatment is considered as a common treatment option for edentulous patients, there have been few studies on the temporomandibular disorder (TMD) related with implant treatment. The purposes of this study were to evaluate the relevance of TMD to the implant patients and to evaluate the risk factors of TMD in relation with implant treatment. For the evaluation of various risk factors of TMD in relation with implant therapy, clinical evaluation focused on patient factors and implant factors. From a group of 694 patients, 25 patients (3.6 %) were included in this study. The majority of the patients were included in the asymptomatic 'adaptive' group. Parafunction was detected in 11 patients, 8 patients were male. Four patients having parafunction showed complications such as implant failure or fracture of the suprastructure. From the results, it is possible that TMJ related symptoms are developed or aggravated after implant therapy, which requires relatively more chair time; so TMJ examination should be included in the pre-operative evaluation for dental implant patients. Also, it is important to treat patients after they sign an informed consent that includes a detailed explanation on the possibility of TMD during treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.1
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• pp.66-73
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• 2015

Alveolar bone loss and deformation can be a risk factor in removable prosthetic restoration treatment for partially or fully edentulous patients. The use of implants to solve this problem could improve the support, retention and stability of removable restoration. Attachments used in implant overdenture are versatile. The attachment should be selected according to the patients' conditions. Milled bar has been chosen when readymade bar could not be used because of the narrow distance between implants or firm stability and support of supra-structure were needed. Milled bar design is able to provide cross arch stabilization and comfortability to patients. However, it needs skilled laboratory procedures. Recently, the fabrication of milled bar has become simple and its suitability has been improved through the development of CAD/CAM system. In a 67-year-old female Alzheimer's disease patient with 8 implant fixtures on the fully edentulous site of mandible, implant overdenture with using milled bar and magnet attachment was planned. As rapid treatment was required, CAD/CAM system was used to make a simple laboratory procedure instead of a traditional fabrication process. With this system, implant overdenture with milled bar can be fabricated esthetically and functionally.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.405-413
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• 2011

It was proposed that technologies derived from CAD-CAM and computed tomography may be useful for flapless implant treatment procedures. The aims of this study were to validate the reliability of this concept in a prospective 12-month clinical study. Twelve patients with fully edentulous areas in their mandibles were included in this study. A total of 71 implants were inserted in interforaminal regions by use of a CAD/CAM drill template($NobelGuide^{TM}$), specially designed for flapless implant surgery. To assess the degree of pain and discomfort, the patients were examined at 2 days and 1 week after surgery. Patient satisfaction and implant functionality were further evaluated at follow-up intervals of 1, 3, 6, and 12 months postoperatively. One implant failed early in 1 patient. All of the other implants were in a good functional state throughout the study. The mean marginal bone loss after 1 year of follow-up was 0.3 mm (SD, 0.1) at center, 0.5 mm (SD, 0.1) at canine and 0.7 mm (SD, 0.2) at distal fixtures, respectively. Statistically, there was not significant differences among each sites(P>.05)The mean ISQ change after 1 year of follow-up was -1.05 (SD, 2.76) at center, -0.85 (SD, 2.59) at canine and -1.27 (SD, 2.18) at distal fixtures, respectively. This prospective pilot study showed that the use of CAD/CAM technology and flapless implant surgery may be considered reliable for fully edentulous mandible of patients.