• The korean journal of orthodontics
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• v.52 no.6
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• pp.451-460
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• 2022

Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia. This case report presents a 7-year-old male patient who was diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class II malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during the treatment to expand the arch width. After 30 months of phase II treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.

• The korean journal of orthodontics
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• v.24 no.1 s.44
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• pp.95-104
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• 1994

There are orthodontic closure, surgincal closure, prosthetic solution in the treatment of diastema. The orthodontic closure has been widely used owing to its conservative nature, but retention after treatment has been difficult and problematic. So, authors observed relapse and retention after the orthodontic closure of 3 diastema cases. The results might be summarized as follows : The space that had been approximated between central incisors, was reopened by the use of retention appliance which did not join two central incisors together though fixed prothesis. By the frenectomy, circumferential supracrestal fibrotomy and lingual bonded retainer which joined two central incisors together after the orthodontic closure of diastema, were good results obtained. The frenectomy, fibrotomy, and the fixed retention appliance which joined two central incisors together must be needed after the orthodontic closure of diastema.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.1
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• pp.233-248
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• 1991

The purpose of this study was to qunatatively analyze the stress patterns induced in the abutment, superstructure, supporting bone and to determine the deflection of abutment and superstructure by appling occlusal force to natural teeth supported fixed prostheses and implant-supported fixed prostheses. The analysis has been conducted by using the two dimensional finite element method. The implant and natural tooth-supported bridge has a first molar pontic supported by mandibular second bicuspid and implant posterior retainer, which were rigidly(Model A) or flexible(Model B). The natural teeth-supported bridge has a first molar pontic supported by mandibular second bicuspid and second molar, which were rigidly splinted together(Model C). 63.5kg(Load P1) of localized load on central fossa of first molar pontic and 24kg(Load P2) of distributed load on each occlusal surface were applied respectively. 1. The coronal portion of premolar pontic and posterior abutment in fixed partial denture deflected inferiorly in order of Model B, Model C and Model A under Load P1 and Load P2. 2. Mesial displacement of the coronal portion of premolar showed in Model A, Model B and Model C under Load P1, but mesial displacement of that in Model B and distal displacement of that in Model A and Model C showed under Load P2. 3. Mesial displacement of the coronal portion of the pontic and distal displacement of the coronal portion of posterior abutment showed in Model A, Model B and Model C under Load P1 and Load P2. Displacement in the case of Model B was greater than that of Model A and Model C. 4. In the case Model A under Load P1 and Load P2, high stress apically was concentrated in the mesiocervical portion of the posterior abutment than in the disto-cervical portion of the premolar. 5. In the case of Model B under Load P1 and Load P2 high stress was concentrated in the case of the premolar than in that of posterior abutment and high stress especially was concentrated in the connected portion of pontic and posterior abutment. 6. In the case of Model C under Load P1 and Load P2, high stress was concentrated in the distal area of the cornal portion of premolar and the mesial area of the coronal portion of posterior abutment, and stress pattern was anteroposterially symmetric around the pontic. 7. Load P1 and Load P2 compared, stress magnitude was different but stress pattern was similar in Model A, Model B and Model C. 8. Under Load P1 and P2, stress magnitude in the mesial distal portion and the portion of root apex of the posterior abutment was in order of Model B, Model A and Model C.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.3
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• pp.145-154
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• 2001

In the past, many dentist were interested mainly in the mechanical aspects such as tooth preparation and retainer types for making dental restoration. But, these days, the concept of restorative treatment emphasizes the importarce of gnatic system and masticatory muscles in addition to oral cavity. So, the current considerations for the fixed prosthodontic treatment include the stabilization of temporomandibular joint and neuromuscualr system and the relationship of periodontal ligament and occlusion. To achieve the above objectives, occlusal splint has been used as one of the mouth preparations for restorative treatment. The objectives of occlusal splint are as follows; 1. To use as preliminary application for periodontal-occlusal treatment 2. To provide proper vertical dimension 3. To control abnormal habits and parafunction 4. To treat the temporomandibular disease and myofascial pain 5. To establish the new therapeutic position In some cases, the patients had improper vertical dimension and occlusal interferences caused by prostheses reconstucted using centric relation recorded without considering the health of TMJ and manticatory muscle. And these prosthesis act as primary source that cause pathologic phenomenon in periodontal ligament, muscles and TMJ. Physiologically, in order to make the treatment occlusion guided by proper centric relation method, the method should be guided after the use of occlusal splint for some period. The main objective of prosthetic treatment is to maintain the function and health of stomatognathic system. So, one of the most important things that have to be performed by clinicians is a clinical ability to do the correct diagnosis and treatment planning based on the stomatognatic function and occlusion.

• The korean journal of orthodontics
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• v.43 no.4
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• pp.186-192
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• 2013

Objective: To analyze the fatigue resistance, debonding force, and failure type of fiber-reinforced composite, polyethylene ribbon-reinforced, and braided stainless steel wire lingual retainers in vitro. Methods: Roots of human mandibular central incisors were covered with silicone, mimicking the periodontal ligament, and embedded in polymethylmethacrylate. The specimens (N = 50), with two teeth each, were randomly divided into five groups (n = 10/group) according to the retainer materials: (1) Interlig (E-glass), (2) everStick Ortho (E-glass), (3) DentaPreg Splint (S2-glass), (4) Ribbond (polyethylene), and (5) Quad Cat wire (stainless steel). After the recommended adhesive procedures, the retainers were bonded to the teeth by using flowable composite resin (Tetric Flow). The teeth were subjected to 10,00,000 cyclic loads (8 Hz, 3 - 100 N, $45^{\circ}$ angle, under $37{\pm}3^{\circ}C$ water) at their incisoproximal contact, and debonding forces were measured with a universal testing machine (1 mm/min crosshead speed). Failure sites were examined under a stereomicroscope (${\times}40$ magnification). Data were analyzed by one-way analysis of variance. Results: All the specimens survived the cyclic loading. Their mean debonding forces were not significantly different (p > 0.05). The DentaPreg Splint group (80%) showed the highest incidence of complete adhesive debonding, followed by the Interlig group (60%). The everStick Ortho group (80%) presented predominantly partial adhesive debonding. The Quad Cat wire group (50%) presented overlying composite detachment. Conclusions: Cyclic loading did not cause debonding. The retainers presented similar debonding forces but different failure types. Braided stainless steel wire retainers presented the most repairable failure type.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.2
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• pp.271-300
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• 1993

The purpose of this study was to analyze the stress distribution at supporting bone according to the types of connection modality between implant and tooth in the superstrcture. This investigation evaluated the stress patterns in a photoelastic model produced by three different types of dental implants such as Branemark, Steri-Oss, IMZ and resin tooth using the techniques of quasi three dimensional photoelasticity. The teeth-supported bridge had a first molar pontic supported by second premolar and second molar as a control group. The implant and toothsupported bridge had a first molar pontic supported by second premolar and implant posterior retainer as an experimental group. Prostheses were mechanically connected to an adjacent second premolar by the rigid of nonrigid connection, Nonrigid connection used an attachment placed between the tooth-supported and fixture-supported component. The female(keyway) of attachment was placed on the distal end of the retainer supported by the tooth ; the male(Key) of attachment connected to the osseointegrated bridge was engaged into the keyway. All prostheses were casted in the same nonprecious alloy and were cemented and screwed on their respective abutments and implants. 16㎏ of vertical loads on central fossae of second premolar, first molar pontic, implant of second molar were applied respectively and 6.5㎏ of inclined load on middle buccal surface of first molar pontic was applied. The results were as follows : 1. Under the vertical load on the central fossa of first mloar pontic, the stress developed at the apex of tooth of implat was more uniformly distributed in the case of nonrigid connection than in the case of rigid connection. 2. Under the vertical load on the central fossa of first molar pontic, the stress developed around the cervical area of tooth of implant was larger in the case of rigid connection than in the case of nonrigid connection because the bending moment was more occured in the case of rigid connection than in the case of nonrigid connection. 3. Stress was more restricted to the loaded side of nonrigid connection than to that of rigid connection 4. Under the inclined load. The set screw loosening of implant was more easily occured in the case of nonrigid connection than in the case of rigid connection due to torque moment. 5. In the case of Branemark implant, the stress concentration in second premolar was larger and the stress developed around the cervical area of implant was lower than any other cases under the vertical load, because Branemark implant with the flexible gold screw was showed in incline toward second premolar by a bending moment. 6. The stress developed around the apex of tooth or implant was more uniformly distributed in the case of Steri-Oss implant with stiff screw than in the case of Branemark implant under the vertical load. But, the stress developed around the cervical area of the Steri-Oss implant was larger than that of any other implants because bending moment was occured by vertical migration of second premolar. 7. The stress distribution in the case of IMZ implant was similar to the case of natural teeth under small vertical load. But, the residual stress around the implant was showed to occurdue to deformation of IMC and sinking of screw under larger vertical load.

• The Journal of Korean Academy of Prosthodontics
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• v.19 no.1
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• pp.7-16
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• 1981

The technology of precision attachments has developed at such a pace that from a very few T-shaped attachments and bar attachments from the years 1915 to 1935 since removable bridge utilizing a T-shaped intracoronal attachment was constructed by Dr. Herman E.S. Chayes in 1906. There are now more than 120 models of the most diversified designs, ready made or laboratory fashioned. In 1971, 126 attachments were listed and classified by Mensor in his E M Attachment Selector. This selector consists of five charts giving specifications as to type, vertical dimensions, application, type of resilience, size of movement, type of retention and type of material and alloy. Thus the E M Attachment Selector is a useful guide for dentists to choose the attachment for his patients. But dentists should apply the attachment in each patient's case according to an accurate diagnosis and treatment plan. This paper is a case report of removable partial dentures utilizing CSP, PD and Bar attachment on a patient who needed full mouth reconstruction. Patient has right first, second molar and left first molar on the upper arch and also left first molar, first premolar and right canine on the lower arch. (Fig. 5)All remaining teeth are relatively healthy in their supporting tissues. On upper arch, ring shape CSP attachment was designed on left first molar and modified ring shape CSP attachment was designed on right first and second molar as the direct retainer of the removable partial denture. Full palatal coverage was used as the major connector in this case. (Fig. 23) On lower arch, author first splinted with a fixed bridge between left first molar and second premolar and a splint bar between left second premolar and right canine. (Fig. 11) A lower removable partial denture in which was designed with an Aker clasp on the left first molar and a PD attachment on .the right canine was constructed. (Fig. 17) This denture could get additional support from anterior splint bar. After both removable partial dentures were delivered to the patient (Fig. 26), author evaluated function of the dentures and supporting structures of the abutment teeth by means of clinical and X-ray examinations for eighteen months. According to the examination data author came to the conclusion that the prognosis of this case was excellent.

• Journal of Dental Rehabilitation and Applied Science
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• v.16 no.2
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• pp.149-159
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• 2000

Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.583-594
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• 2000

Dislodgement of a crown or extension bridge and the loosening of a retainer of a bridge is a serious clinical problem in fixed restoration. Generally these problems are considered to be associated with deformation of the restoration. During biting, the restoration is subjected to complex forces and deforms considerably within the limit of its elasticity. Deformation of the restoration under the occlusal force induces excessive stress in the cement film, which then leads to the cement fracture. Such a fracture may eventually cause loss of the restoration. Because most of the past retention tests for full veneer crown were done without fatigue loading, they were not exactly simulating intraoral environment. And the purpose of this study was to evaluate the effect of cyclic cantilever loading on the retentive strength of full veneer crowns depending on different type of cements and taper of prepared abutment. Steel dies with $8^{\circ}\;or\;16^{\circ}$ convergence angle were fabricated through milling and crowns with the same method. These dies and crowns were divided into 8 groups. Group 1 : $16^{\circ}$ taper die, cementation with zinc phosphate cement, without loading Group 2 : $16^{\circ}$ taper die, cementation with zinc phosphate cement, with loading Group 3 : $8^{\circ}$ taper die, cementation with zinc phosphate cement, without loading Group 4 : $8^{\circ}$ taper die, cementation with zinc phosphate cement, with loading Group 5 : $16^{\circ}$ taper die, cementation with Panavia 21, without loading Group 6 : $16^{\circ}$ taper die, cementation with Panavia 21, with loading Group 7 : $8^{\circ}$ taper die, cementation with Panavia 21 without loading Group 8 : $8^{\circ}$ taper die, cementation with Panavia 21, with loading After checking the fit of die and crown, the luting surface of dies and inner surface of crowns were air-abraded for 10 seconds. The crowns were cemented to the dies, with cements mixed according to the manufacturer's recommendations. A static load of 5kg was then applied for 10 minutes with static loading device. Twenty-four hours later, group 1, 3, 5, 7 were only thermocycled, group 2, 4, 6, 8 were subjected to cyclic loading after thermocycling. Retentive tests were performed on the Instron machine. From the finding of this study, the following conclusions were obtained 1. Panavia 21 showed significantly higher retentive strength than zinc phosphate cement for all groups (p<0.05). 2. There was a significant difference in the retentive strength between $8^{\circ}\;and\;16^{\circ}$ taper for zinc phosphate cement(p<0.05), but no significant difference for Panavia 21 (p>0.05). 3. Cyclic loading significantly decreased the retentive strength for all groups(p<0.05). 4. For zinc phosphate cement, there was 35% reduction of the retentive strength after loading in the $16^{\circ}$ taper die, 25% in the $8^{\circ}$ taper die, and for Panavia 21, 21% in the $16^{\circ}$ taper die, 18% in the $8^{\circ}$ taper die.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.209-222
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• 2011

Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.