• Journal of Dental Rehabilitation and Applied Science
• /
• v.35 no.3
• /
• pp.191-198
• /
• 2019

This case report presents a closed hollow bulb obturator made by 3D printing for a maxillectomy patient. Final impression was taken according to the instructions and impression trays provided by the Magic $denture^{TM}$ system. Vertical dimension, facial appearance, and retention had been checked with the try-in denture. The try-in denture was corrected and adjusted to fulfill the demand of the patients, then these were reflected to the final design of the denture. The defect area was designed as a closed hollow bulb shape to reduce the weight and to provide uniform thickness of the denture. The patient satisfied with the esthetics and function of the denture.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.3
• /
• pp.158-167
• /
• 2023

As digital technology has advanced in the field of dentistry, the use of computer-aided design/computer-aided manufacturing (CAD/CAM) has brought changes to the stages of dental treatment. The use of CAD/CAM technology in dental restoration offers clinical efficiency and convenience by reducing production time and appointment intervals, while also simplifying the fabrication process to reduce errors. In this case, digital replication and printing of temporary teeth were used to aid a patient with complex medical histories and physical disabilities. The final impression obtained with silicone impression material included information on the vertical dimension, centric relation, and the angle and length of the anterior teeth, which shortened the production time and appointment intervals and increased patient satisfaction. The final restoration was fabricated using milling and monolithic disc techniques, demonstrating appropriate stability, retention, and support, resulting in functional and aesthetic satisfaction.

• Archives of Craniofacial Surgery
• /
• v.9 no.2
• /
• pp.105-109
• /
• 2008

Temporomandibular joint(TMJ) and dental occlusion are important in functional aspect as well as in cosmetic aspect for craniofacial surgery such as orthognathic and traumatic surgery. During these operations, appropriate maxillomandibular fixation(MMF) is especially necessary to conserve or reconstruct, dynamic TMJ and functional occlusion. Arch bar is one of the most popular method to gain proper MMF. Seventeen patients including 5 patients with mandibular fracture, 12 patients with orthognathic surgery(6 patients had relatively normal occlusion, however 6 patients had facial anomalies such as hemifacial microsomia with irregular occlusal plane.) were joined in this study. Arch bar was contoured on the dental cast, which was prepared for model surgery, prior to apply it on the facial anomaly patient. On using pre-contoured arch bar, patients felt better during the procedure and surgeons saved time. Moreover, well-contoured arch bar promises precise transmission of force on the bone, which implies surgeons do not need to worry about the occlusion while fixing bony structures. Authors suggest how to apply arch bar to satisfy basic theories about dental row and occlusion based on the experience. In addition, it is proposed to contour arch bar on the dental impression prior to apply it on the patient who has irregular and complex occlusal plane.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.2
• /
• pp.202-210
• /
• 2022

Recently with the advance in digital dentistry, the fabrication of dentures using computer-aided design and computer-aided manufacturing (CAD-CAM) is on the rise. The denture designed through a CAD software can be produced in a 3-dimensional manufacturing process. This process includes a subtractive processing method such as milling and an additive processing method such as 3D printing and in which it can be applied efficiently in more complex structures. In this case, complete dentures were fabricated using Stereolithography (SLA)-based 3D printing to shorten the production time and interval of visits in patient with physical disabilities due to cerebral infarction. For definitive impression, the existing interim denture was digitally replicated and used as an individual tray. The definitive impression obtained with polyvinyl siloxane impression material was including information about the inclination and length of the maxillary anterior teeth, vertical dimension, and centric relation. In addition, facial scan data with interim denture was obtained so that it can be used as a reference in determination of the occlusal plane and in arrangement of artificial teeth during laboratory work. Artificial teeth were arranged through a CAD program, and a gingival festooning was performed. The definitive dentures were printed by SLA-based 3D printer using a FDA-approved liquid photocurable resin. The denture showed adequate retention, support, and stability, and results were satisfied functionally and aesthetically.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.33 no.6
• /
• pp.525-528
• /
• 2011

A deep circumflex iliac artery (DCIA) flap is usually used for reconstruction in oral and maxillo-facial surgery department since introduced by O'Brien in 1975. Various flap designs are possible for osteomusculocutaneous, musculocutaneous, musculosseous and vascularized bone types. Iliac crest shape is similar to contour of mandible. Moreover, though a fibular flap has only 15~20 mm of cutting plane width, a DCIA flap contains much more bone amount, making this a similar reconstruction compare with normal mandible. A 68 year-old male with squamous cell carcinoma on the anterior floor of the mouth had an impression with T2N0Mx and the treatment procedure was DCIA reconstruction after wide resection and marginal mandibulectomy, with both supraomohyoid neck dissection. We present an experience of DCIA flap for reconstruction with a literature review.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.10 no.1
• /
• pp.13-19
• /
• 2010

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

• Archives of Plastic Surgery
• /
• v.38 no.6
• /
• pp.851-860
• /
• 2011

Purpose: Reduction by simply assembling bones is recognized as treatment for a zygoma fracture. However, in patients who originally had a protruding zygoma, the fractured parts look like malarplasty after the edema subsides, giving a soft impression which patients notice. Thus, we created symmetry through simultaneous contralateral malar reduction in a unilateral zygoma fracture. Methods: In this study, the patients who had surgery between July, 2008 and December, 2009 with admission were object. In 76 patients with a zygoma fracture, the patients with bilateral zygoma fractures were excluded. Among 48 patients who had a reduction only after a unilateral zygoma fracture, the patients hoping for a reduction of their rough protruding zygoma were analyzed with front cephalometry. The study progressed on 22 patients who had simultaneous contralateral malar reduction in a unilateral zygoma fracture with consent. After fixing the fracture, we did a straight zygoma osteotomy through a 1.5 cm intraoral incision. After that, we created symmetry with a special ruler and fixed the broken zygomatic arch with a screw and plate. We evaluated the facial index and satisfaction with a statistical analysis before and after the surgery. Results: In 22 patients, there was no reoperation except for 1 patient who had a zygoma fracture. None of the patients were treated for infection or hematoma. Two patients complained of paresthesia after the malar reduction operation, but this subsided in 4 months. Most of them were satisfied with the malar reduction, especially the women, and we obtained a better mid facial contour with decreased facial width ($p$ <0.05). Conclusion: Existing zygoma fracture surgery focuses on anatomical reduction. However, we need to have a cosmetic viewpoint in fractures as interests of face contour arise. Thus, contralateral malar reduction got a 4.7 (range 0~5) from patients who had malar reduction surgery in our hospital. Although adjusting to all zygoma fractures has limitations, it can be a new method in zygoma fractures when there are limited indications of protruding zygoma and careful attention is given to patients' high demands.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.34 no.3
• /
• pp.218-224
• /
• 2018

Macroglossia is an obstacle in regard to general prosthodontic restoration. Not only is it difficult to obtain support and stability from dentures manufactured from normal protocol, obtaining efficacy from basic mastication is also difficult. In such cases, realizing harmony between the occlusion and surrounding muscle structures may be important with regard to manufacture of stable full dentures, and it is necessary to form the appropriate polished surface for this case. The neutral zone is defined as the potential area resulting from the neuromuscular function that results in equilibrium between the outward force exerted by the tongue and the inward force exerted by the lips and cheeks. The artificial teeth of the full denture lies in this area, and if the polished zone follows the anatomic form of the dynamic muscles, the movement of the muscles simply acts as an element of stabilizing the dentures improving the esthetics through facial support.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.1
• /
• pp.117-127
• /
• 1991

When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.38 no.1
• /
• pp.34-41
• /
• 2022

Recently, digital technology and computer-aided design/computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of dentures. The denture manufacturing method with CAD/CAM technology simplifies the treatment and laboratory process to reduce the occurrence of errors and provides clinical efficiency and convenience. In this case, complete dentures were fabricated using stereolithography (SLA)-based 3D printing in patient with mandibular deviation. Recording base were produced in a digital model obtained with an intraoral scanner, and after recording a jaw relation in the occlusal rim, a definitive impression was obtained with polyvinyl siloxane impression material. In addition, facial scan data with occlusal rim was obtained so that it can be used as a reference in determination of the occlusal plane and in arrangement of artificial teeth during laboratory work. Artificial teeth were arranged through a CAD program, and a gingival festooning was performed. The definitive dentures were printed by SLA-based 3D printer using a Food and Drug Administration (FDA)-approved liquid photocurable resin. The denture showed adequate retention, support and stability, and results were satisfied functionally and aesthetically.