• Title/Summary/Keyword: Edentulous maxilla

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Case report: Full mouth rehabilitation for patient with heavy occlusal force and excessive abrasion (강한 교합력과 과도한 마모를 보이는 환자의 전악수복 증례)

  • Park, Ji-Hee;Vang, Mong-Sook;Yang, Hong-So;Park, Sang-Won;Yun, Kwi-Dug;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.2
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    • pp.119-124
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    • 2013
  • Many of the patients with extensive abrasion need comprehensive restorative treatment. The abrasion is usually caused by attrition, besides of it, there are many reasons for it. The plan of treatment should be started on assessment of the type of attrition and the etiologic analysis. Patient with well-developed masticatory muscle, alveolar process, and high occlusal force and also with little muscle length difference between the stable and the contracted state should be carefully assessed for the vertical dimensional loss and the restoration should be carefully designed. Decrease of tooth length can be compensated by the growth of the alveolar bone height; therefore, consistency of the occlusal vertical dimension is maintained. Accordingly, a careless increase of the vertical dimension can produce muscle fatigue, depressed tooth and pain, and fracture of the restoration. In this case, the patient with multiple tooth abrasion and clenching habit, the edentulous maxillary area is restored with amalgam inserted RPD, and the dentulous area of the maxilla and mandible are treated with fixed restoration accompanying with the increase of vertical dimension. Consequently, we are going to report about the satisfying result in both functional and esthetic aspects.

THE COMPARATIVE EVALUATION USING HATCH REAMER TECHNIQUE AND OSTEOTOME TECHNIQUE IN SINUS FLOOR ELEVATION (상악동저 거상술 시 Osteotome 술식과 Hatch Reamer 술식의 비교평가)

  • Cho, Seong-Woong;Kim, Sang-Jung;Lee, Dong-Keun;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.154-161
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    • 2010
  • Many edentulous posterior maxilla are found to be compromised by alveolar resorption and increased pneumatization of the sinus. One of the surgical procedures to overcome this anatomical limitation is sinus floor elevation with bone graft, which is reported as more appropriate and more successful procedure. Commonly, if the residual bone height is over 5mm, sinus floor elevation is operated through transcrestal approach using osteotome technique. But, it is possible for patients to feel discomfort during operation and dizziness after operation while malleting, sinus floor elevation, using osteotome technique. Some instruments and methods has been used to overcome these problems and use more easily. The aim of this study is to compare between the surgical procedure of sinus floor elevation using Hatch reamer technique and that of sinus floor elevation using osteotome technique. From 2004 Feb to 2007 Oct, we investigate patients (osteotome group: 72, Hatch reamer group: 70) who were given implant surgery with sinus floor elevation (osteotome group: 92, Hatch reamer group: 98). We analysed gender, age, residual bone height, amount of sinus floor elevation, used graft material, total success rate, failure rate by residual bone height and implant type and discomfort during operation, etc. The results obtained were as follows. 1. In the amount of sinus elevation was osteotome group was $3.85{\pm}1.02\;mm$ and Hatch reamer group was $3.93{\pm}1.38\;mm$. There was no statistically significant difference between the two groups (P > 0.05). 2. At the total success rate, osteotome group was 92.4% and Hatch reamer group was 94.9%. There was no statistically significant difference between the two groups (P > 0.05). 3. On the discomfort during the operation by using numerical rating scale, osteotome group was $2.87{\pm}0.83$ and Hatch reamer group was $1.12{\pm}0.64$. There was statistically significant difference between the two groups (P < 0.05). The Hatch reamer group clinical results was similar to osteotome group and we thought that Hatch reamer technique can overcome the faults of osteotome technique.

MORPHOMETRICS OF ALVEOLAR PROCESS AND ANATOMICAL STRUCTURES AROUND INFERIOR MAXILLARY SINUS FOR MAXILLARY IMPLANTATION (임플랜트 시술을 위한 치조돌기와 상악동 주변 구조물의 형태계측적 연구)

  • Park, Ju-Jin;Lee, Young-Soo;Paik, Doo-Jin;Park, Won-Hee;Yoo, Dong-Yeob
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.2
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    • pp.228-239
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    • 2007
  • Statement of problem: Following tooth loss, the edentulous alveolar process of maxilla is affected by irreversible reabsorption process, with progressive sinus pneumatization leads to leaving inadquate bone height for placement of endosseous implants. Grafting the floor of maxillary sinus by sinus lifting surgery and augmentation of autologous bone or alternative bone material is a method of attaining sufficient bone height for maxillary implants placement and has proven to be a highty successful. Purpose: This study was undertaken to clarify the morphometric characteristics of inferior maxillary sinus and alveolar process for installation of implants. Material and method: Nineteen skulls (37 sinuses, 10M / 9F) obtained from the collection of the department of anatomy and cell biology of Hanyang medical school were studied. The mean age of the deceased was 69.9 years (range 44 to 88 years). The distance between alveolar border and inferior sinus margin at each tooth, the height of alveolar process and the thickness of cortical bone of the outer and inner table of alveolar process and the inferior wall of maxillary sinus were measured. Results and Conclusion: 1. The septum of inferior maxillary sinus were observe 28 sides (76.%) and located at the third molar (52.6%) and the second molar (26.3%). The deepest points of inferior border of maxillary sinus were located the first or second molar. The distance between alveolar margin and the deepest point of inferior maxillary sinus is $9.7{\pm}4.9mm$. 2. The length of the outer table of alveolar process were $4.9\sim28.2mm$ and the shortest point was between the first and the second molors. The thickness of them were $0.9\sim3.2mm$. The length of the inner table of alveolar process were $7.4\sim25.8mm$ and the shortest point was between the first and the second molars. The thickness of the were $0.9\sim4.6mm$. The results of this study are useful anatomical data for installing of maxillary implants.

EFFECT OF ANCHORAGE SYSTEMS AND PALATAL COVERAGE OF DENTURE BASE ON LOAD TRANSFER WITH MAXILLARY IMPLANT-SUPPORTING OVERDENTURES : A THREE-DIMENSIONAL PHOTOELASTIC STRESS ANALYSIS (상악 임플란트 overdenture에서 anchorage system과 의치상 구개피개가 하중전달에 미치는 영향)

  • Je, Hong-Ji;Jeon, Young-Chan;Jeong, Chang-Mo;Lim, Jang-Seop;Hwang, Jai-Sug
    • The Journal of Korean Academy of Prosthodontics
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    • v.42 no.4
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    • pp.397-411
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    • 2004
  • Purpose: The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-supported overdenture. Material and methods: Maxillary implant -supported overdentures in which 4 implants were placed in the anterior region of edentulous maxilla were fabricated, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional photoelastic stress analysis. Two photoelastic overdenture models were fabricated in each anchorage system to compare with the palatal coverage extent of denture base, as a result we got eight models : Hader bar using clips(type 1), cantilevered Hader bar using clips(type 2), Hader bar using clip and ERA attachments(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4). Result: 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. In every experimental models with or without palatal coverage of denture base, maximum fringe orders on the distal ipsilateral implant supporting bone in an ascending order is as follows; type 3, type 1, type 4, and type 2. 3. Each implants showed compressive stresses in all experimental models with palatal coverage of denture base, but in the case of those without palatal coverage of denture base, tensile stresses were observed in the distal contralateral implant supporting bone. 4. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant supporting bone on loaded side. 5. The type of anchorage system affected in load transfer more than palatal coverage extent of the denture base. Conclusion: To the results mentioned above, in the case of patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant, and poor bone quality, selecting a resilient type attachment or minimizing the distal cantilevered bar is considered to be an appropriate method to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

The success rate of Mg-incorporated oxidized implants in partially edentulous patients: a prospective clinical study (부분 무치악 환자에서 마그네슘 이온주입 임플란트의 성공률에 대한 전향적 임상연구)

  • Choi, Su-Jung;Yoo, Jung-Ho;Lee, Ku-Bok;Kim, Jin-Wook
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.176-183
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    • 2012
  • Purpose: This study examined the clinical success rate of Mg titanate implants (M Implant system, Shinhung, Korea), which employ a Mg coating method, by evaluating the marginal bone loss and implant stability using radiographs and Osstell$^{(R)}$, over a 1 year. Materials and methods: The locations of the implants placement were divided into 4 areas; the maxillary and mandibular premolars and molars. In the maxilla, 8 and 9 implants were inserted in the premolar and molar areas, respectively. In the mandible, 11 and 51 implants were inserted in the premolar and molar areas. Marginal bone loss and ISQ of all implants (79) were measured after insertion, mounting the prosthetic appliance, and 1, 3, 6, and 12 months after loading. The marginal bone loss was measured from the radiograph using XCP bite, which was customized, and the implant stability measured using Osstell$^{(R)}$. Fisher's exact test (${\alpha}$=.05) was used to compare the success rates of each region. Results: The mean marginal bone loss for the upper and lower jaws were 1.537 mm and 1.172 mm. The mobility showed a non-significant reduction or increase according with time. The success rates were accounted for 94.12% and 98.39% in the upper and lower jaws; the premolars and molars were accounted for 100% and 96.67%. The two cases of early failure resulted from failure of primary stability during implant insertion. The late failures were not observed for 1 year after adding a loading to the implants. Conclusion: The Mg titanate implant showed good primary stability and good clinical results in both healing and function.

Implant assisted removable partial denture using a few remaining maxillary teeth and locator bar system: A case report (소수 잔존치를 가진 상악에 Bar와 Locator®를 이용한 임플란트 융합 국소의치 치료 증례)

  • Kim, Seong-Jung;Bae, Eun-Bin;Jeon, Young-Chan;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Huh, Jung-Bo
    • The Journal of the Korean dental association
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    • v.55 no.8
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    • pp.528-536
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    • 2017
  • Treatment with removable partial denture is effective for partially edentulous patients who are unable to obtain sufficient retention and stability for functional and esthetic restoration. There are several cases reporting the improvement of retention and stability of the partial denture using a small number of implants. However, there are limited studies on the implant-assisted removable partial denture using a small number of remaining teeth and the bar locator system. The bar locator system has an advantage in that it could compensate the angle of insertion of removable prosthesis on implant with inconsistent placement angle due to anatomical constraints compared to when using the locator only. This case report describes the patient with $Parkinson^{\circ}$Øs disease who was treated with the Locator bar system using two previously placed implants and two remaining teeth on maxilla. No additional implants could be placed because of the medical and economic condition of the patients, and the angle of one of two implants could not be matched with the direction of the removable partial denture insertion. Considering the angle of the implants, the patient was treated with implant-assisted RPD using the Locator bar system and had satisfactory results in the aspect of esthetics, masticatory function, and oral hygiene maintenance.

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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.

A study of various factors related to satisfaction of complete denture wearers (총의치 장착자의 의치 만족도와 관련된 요인에 관한 연구)

  • Byun, Jin-Soo;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.2
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    • pp.109-116
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    • 2016
  • Purpose: The aim of this study was to evaluate correlations between denture satisfaction and various factors related to patients' and wearing dentures. Materials and Methods: Total 43 edentulous patients were recalled and they were wearing complete dentures fabricated more than one year ago. For patients' subjective assessment, the questionnaire based on the various literatures was developed and applied to patients for data acquisition. In addition, correlations were evaluated between subjective assessment and denture satisfaction score. For statistical analysis, Spearman correlation coefficient, multiple regression analysis, Mann-whitney U test and Kruskal-Wallis test were used to found out what the most considerable factors to denture satisfaction score (P < 0.05). Results: Denture satisfaction score of maxilla was higher than mandible (P < 0.05). In functional aspects, maxillary denture were received a favorable evaluation. Especially fit and pain causing were highly correlated to satisfaction. Gender, age, using period, visiting times after manufacturing denture were unrelated to satisfaction. But previous experience was related to denture satisfaction. Conclusion: Denture satisfaction was determined by a combination of various factors related to patients.

COMPARATIVE STUDIES OF RETENTIVE FORCES IN MAXILLARY OVERDENTURE BAR ATTACHMENTS (상악 임플랜트 Overdenture에서 Bar Attachment 설계에 따른 유지력 변화에 관한 연구)

  • Son Cha-Young;Jeong Chang-Mo;Jeon Young-Chan;Lim Jang-Seop;Jeong Hee-Chan
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.5
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    • pp.650-661
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    • 2005
  • Statement of problem: It could be hypothesised that attachments, which provide more retention against vortical and horizontal dislodgement, will be associated with more favorable parameters of oral function. Purpose: This study was to provide data of initial retentive force and retention loss of different bar attachment systems recommended for use with maxillary implant overdentures. Material and method: 4 implants were placed in the anterior region of edentulous maxilla, five different systems of bar attachment were fabricated as follows: cantilevered Hader bar using clips (Type 1), Hader bar using clips without cantilever (Type 2), Hader bar using clip and ERA attachment orange male (Type 3), Hader bar using clip and ERA attachment white male (Type 4), and Bar using magnets (Type 5). Each samples were placed in the universal testing machine for determination of retentive forces(at initial and after every 200 cycles up to 1,000 cycles). Results and Conclusion 1. Attachment type 1 showed the biggest initial retentive force followed by type 3, type 2, type 4, and lastly type 5(P<0.001). 2. After 1,000 cycles of repeated removals of attachments, significant loss of retentive forces was taken place except for attachment type 5. 3. After 1,000 cycles of repeated removals, the loss of retentive force between type 1 and type 2, which used Hader bar and clip attachments. was greater in type 1 that had wider clip formation. And between type 3 and type 4, which used ERA attachments, the loss of retentive force was greater in type 4 that had white male attached (P<0.001). 4. After 1.000 cycles of repeated removals, attachment type 3 showed the biggest retentive force followed by type 2, type 4, type 1 and lastly type. 5. There was no significant difference between attachment type 3 and 4, and type 4 and 1(P<0.001).

A Radiographic study of Fibro-osseous lesions of the jaw bones (악골 섬유성 골병소의 방사선학적 연구)

  • Kwon Kyung-Yun;Choi Karp-Shik
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.27-36
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    • 1998
  • The purpose of this study was to obtain information on the clinical and radiographic features of the fibro-osseous lesions in the jaws. For this study, the author examined and analysed the clinical records and radiographs of 71 cases of 68 patients in fibrous dysplasia, 35 cases of ossifying fibroma and 30 cases of 16 patients of periapical cemental dysplasia diagnosed by clinical and radiographic or histopathological examinations. The obtained results were as followings: L Fibrous dysplasia occurred most frequently in the 2nd decade (30.0%), ossifying fibroma in the 3rd-4th decades, periapical cemental dysplasia in the 4th decade, and all of three lesions showed slight predilection in females. In most cases, chief complaints were painless facial swelling in fibrous dysplasia and ossifying fibroma, and periapical cemental dysplasia was found accidentally in radiographs. 2. Fibrous dysplasia was occurred more frequently in maxilla, ossifying fibroma in mandible and both lesions in premolar-molar area. Periapical cemental dysplasia was occurred most frequently in the mandibular anterior area. The size of fibrous dysplasia was larger than that of ossifying fibroma, and the shape of ossifying fibroma was more round and elliptical than fibrous dysplasia whose was fusiform. 3. Fibrous dysplasia was shown homogeneous radiopaque shadow of 57.6% and ossifying fibroma & periapical cemental dysplasia were shown mixed appearance of radiolucency and radiopacity shadows at 74.2%, 60.0%, respectively. 4. Fibrous dysplasia was entirely shown poorly defined at 87.7%, but ossifying fibroma & periapical cemental dysplasia were shown well outlined at 60.0%, 70.0%, respectively. 5. Cortical thinning and expansion were observed in fibrous dysplasia and ossifying fibroma, and severe in ossifying fibroma than fibrous dysplasia, and those signs were not seen in periapical cemental dysplasia. Loss of lamina dura was dominant in fibrous dysplasia and root resorption was dominant in ossifying fibroma. Displacement of mandibular canal and the degree of the increase of vertical dimension were alike in both lesions. Displacement of maxillary sinus or nasal cavity, thinning & expansion of the maxillary sinus were dominant in fibrous dysplasia. 6. Polyostotic fibrous dysplasia was occurred at 5.9%, Multiple periapical cemental dysplasia at 43.7%. Occurrence rate in the edentulous area of fibrous dysplasia and ossifying fibroma were 7.0%, 8.6%, respectively.

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