• The Journal of Advanced Prosthodontics
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• v.10 no.2
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• pp.138-146
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• 2018

PURPOSE. The purpose of this study was to analyze the effects of the splinted implant prosthesis in a reconstructed mandible using three-dimensional finite element analysis. MATERIALS AND METHODS. Three-dimensional finite element models were generated from a patient's computed tomography data. The patient had undergone partial resection of the mandible that covered the area from the left canine to the right condyle. The mandible was reconstructed using a fibula bone graft and dental implants. The left mandibular premolars and molars remained intact. Three types of models were created. The implant-supported prosthesis was splinted and segmented into two or three pieces. Each of these models was further subcategorized into two situations to compare the stress distribution around normal teeth and implants. Oblique loading of 300 N was applied on both sides of the mandible unilaterally. The maximum von Mises stress and displacement of the models were analyzed. RESULTS. The stress distribution of the natural mandible was more uniform than that of the reconstructed fibula. When the loading was applied to the implant prosthesis of reconstructed fibula, stress was concentrated at the cortical bone around the neck of the implants. The three-piece prosthesis model showed less uniform stress distribution compared to the others. Displacement of the components was positively correlated with the distance from areas of muscle attachment. The three-piece prosthesis model showed the greatest displacement. CONCLUSION. The splinted implant prosthesis showed a more favorable stress distribution and less displacement than the separated models in the reconstructed mandible.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.152-159
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• 2016

Implant fixed prosthesis for the complete edentulous maxilla provides significant benefits in the aspects of functions and esthetics compared with the conventional denture. Implant supported fixed prosthesis are totally supported by implant, and thus stabilizes the prosthesis to the maximum degree as possible. Also, the improved retention and stability of fixed prosthesis enhance patients' psychological and psychosocial health. This clinical presentation describes a maxillary full arch implant-supported fixed prosthesis in complete maxillary edentulous patient who showed vertical and horizontal alveolar bone resorption in the anterior ridge. To rehabilitate the esthetics and proper lip support, the zirconia framework was fabricated and the pink porcelain was veneered to reproduce the natural gingival tissue. After 9 months of follow up, the restorations were maintained without complications and the patient was satisfied with the restoration both functionally and esthetically.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.84-89
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• 2015

We report the eventually successful treatment of a huge bone defect and peri-implantitis following reconstruction of a previously failed intra-mobile cylinder implant system (IMZ) implant site using distraction osteogenesis (DO). In the anterior mandible, two IMZ implants failed and surgical debridement was performed in accordance to the patient's needs. Thereafter, mobility and suppuration were decreased and the patient visited the dental clinic on a regular basis for oral health maintenance. However, the inflammation did not resolve, and the bone destruction around the implants progressed for 4 years. Finally, the implants failed and a severe bone defect remained after implant removal. To reconstruct the bone defects, we attempted bone graft procedures. Titanium mesh was unsuccessfully used to obtain bone volume regeneration. However, DO subsequently was used to obtain sufficient bone volume for implant placement. The new implants were then installed, followed by prosthetic procedures. In conclusion, progression of peri-implantitis could not be arrested despite surgical intervention and repeated maintenance care for 3 years. Reconstruction of the peri-implantitis site was complicated due to its horizontal and vertical bone defects. Lesions caused by implant failure require an aggressive regenerative strategy, such as DO. DO was successful in reconstruction of a peri-implantitis site that was complicated due to horizontal and vertical bone defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.67-70
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• 2009

Purpose: This study presents the use of mini implants for fixed restoration and implant supported overdenture to enable the practitioner to overcome the anatomic obstacles of ridge width and narrow interdental space. Patients and methods: This study consisted of 9 patients who required single implants for one or two teeth replacement and 1 patient who required implant supported overdenture after mandiblectomy, iliac bone graft due to ghost cell tumor. The ages ranged from 29 to 70 years (mean 51). All patients were in good health. Clinical and radiographs were taken pretreatment, postoperatively, during rehabilitation, and at follow ups. Results: Total implant survival rate was 94.7%. One implant was removed due to its mobility as a result of bad bone quality (Type IV) and patient's carelessness (Heavy smoker). All patients except one reported complete satisfaction regarding to function, aesthetics, and phonetics. Radiographic follow up every 3months postoperatively showed success in achieving function and maintaining marginal bone level. Conclusion: Clinician can overcome both severe ridge deficiency and small interdental space with mini implant.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.1
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• pp.42-48
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• 2019

In the case of a patient with a small number of unilateral remaining teeth in the mandible, a restoration with conventional removable partial denture cannot provide sufficient retention and resistance. A harmful stress from the poor stability of denture on remaining teeth occurs due to alveolar bone resorption in edentulous area. Although implant fixed prosthesis can provide multiple benefits over conventional removable partial denture, there are limitations come from anatomic structures and costs. In this case, an implant-assisted removable partial denture (IARPD) with a couple of implants placed in strategic positions can be a treatment modality. The objective of this article is to present a case report of two patients showed satisfactory clinical outcomes during three-year follow-up period describing the fabrication and advantages of removable partial denture assisted by teeth and implants (IARPD) for a patient with a small number of unilateral remaining teeth in mandible using Locator as an implant attachment.

• The Journal of Advanced Prosthodontics
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• v.14 no.2
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• pp.108-121
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• 2022

PURPOSE. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of implants in IC-RPDs. MATERIALS AND METHODS. Seventy implants were placed and used as surveyed crowns in 30 RPDs. The survival rates and MBL around implants based on multiple variables, e.g., position, sex, age, opposing dentitions, splinting, type of used retainer, and first year bone loss, were analyzed. Patient reported outcome measures (PROMs) regarding functional/esthetic improvement after IC-RPD treatment, and complications were also inspected. RESULTS. The 100% implant survival rates were observed, and 60 of those implants showed MBL levels less than 1.5 mm. No significant differences in MBL of implants were observed between implant positions (maxilla vs. mandible; P = .341) and type of used retainers (P = .630). The implant MBL of greater than 0.5 mm at 1 year showed significantly higher MBL after that (P < .001). Splinted implant surveyed crowns showed lower MBL in the maxilla (splinted vs. non-splinted; P = .037). There were significant esthetic/functional improvements observed after treatment, but there were no significant differences in esthetic results based on implant position (maxilla vs. mandible). Implants in mandible showed significantly greater improvement in function than implants in the maxilla (P = .002). Prosthetic complication of IC-RPD was not observed frequently. However, 2 abutment teeth among 60 were failed. The bone loss of abutment teeth was lower than MBL of implants in IC-RPDs (P = .001). CONCLUSION. Class I RPD connected to residual teeth and strategically positioned implants as surveyed crowns can be a viable treatment modality.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.339-346
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• 2022

Compared with traditional full dentures, mandibular implant overdentures have the advantage in that good support and retention can be obtained even with two implants. When manufacturing a mandibular implant overdenture using two implants, it is important to place the implant in the correct position. The long-term prognosis of overdenture is good when two implants are placed in the direction vertical to the occlusal plane and parallel to each other at the canine position. However, it is difficult to place two implants in the correct position in edentulous patients, and if you use surgical guides in these cases, you can get help in placing the implants in a prosthetically advantageous position. This case, a 57-year-old male patient, came to our hospital with all upper and lower teeth removed due to periodontal disease. Therefore, the maxilla was restored with a traditional full denture and the mandible was restored with an implant overdenture using two implants, which resulted in satisfactory functional and esthetic results.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.1
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• pp.151-162
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• 1993

The author installed $3.75mm\times10mm$ $Br{\aa}nrmark$ osseointegrated implants and $3.5mm\times8mm$ I.T.I. hollow screw implants(Benefit) as a free standing abutment to replace lower left and right molars of 44-year-old female patient. Form the foregoing procedure, the author obtained the following results. 1. Free-standing $Br{\aa}nrmark$ and I.T.I. Hollow screw implants(Benefit) could be used to replace molars effectively without reduction of adjacent natural teeth, 2. Rotation of occlusal gold screw of $Br{\aa}nrmark$ implants was observed under occlusal force. 3. Adjustment of height of I.T.I. abutments was necessary in the mandibular second molar because of the limited occlusal clearance. 4. Form the oral examination, patient comments, panoramic and periapical radiographs, there were no pain, gingival imflammation and mobility, but slight reduction of alveolar bone level was shown around both implant systems. 5. Patient comments were comfortable on both systems. but the patient complained about economic problem of $Br{\aa}nrmark$ system and long treatment treatment time of both systems.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.241-248
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• 2011

Purpose: The aim of this study was to present the clinical results of maxillary sinus augmentation implants and to evaluate the effects of various factors on the implant survival rate. Methods: In a total of 112 patients, 293 implants after sinus augmentation were performed. The total survival rate and the influence of the following factors on implant survival were evaluated; patient characteristics (sex, age, smoking, general disease), graft material, implant surface, implant installation stage, site of implant placement, length and width of implant, closure method for osseous window, residual alveolar bone height. Results: 1. Age ranged from 16 to 70 yr, with a mean of 45.7 yr. 2. Cumulative survival rate for the 293 implants with the maxillary sinus augmentation procedure was 94.9%. 3. Simultaneous implant installation was performed in 122 patients and delayed implant installation was performed in 117 implants. The average healing period after sinus elevation was 7.3 months for delayed implant installation and this procedure had a significantly higher survival rate. 4. There were no significant differences in sex, age, smoking, general disease, site of implant placement, length and width of implant, residual alveolar bone height and the survival rate. 5. RBM (Resorbable Blasting Media) implant surface and allograft groups had significantly lower survival rates. Conclusion: These data suggest that maxillary sinus augmentation may give more predictable results for autogenous bone grafts and delayed implant placement.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.23 no.1
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• pp.34-40
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• 2014

There are several treatment options for rehabilitation of partial edentulism including the use of conventional or implant-retained fixed prostheses. However, such prosthetic options cannot always be possible because of compromised general and oral health (i.e. loss of supporting tissues, medical reasons, extensive surgical protocol and osseointegration failure of dental implant) as well as the affordability of patients. In some cases, removable partial denture provides easier access for oral hygiene procedures and the ability to correct discrepancies in dental arch relationships than implant fixed prosthesis. Recently, Implant Supported Removable Partial Denture (ISRPD) where to place dental implant in strategic position has been suggested to improve the limitation and shortcomings of conventional RPD. ISPRD can overcome mechanical limition of conventional RPD by placing implant in a favorable position and can be cost-effective, prosthetic solution for partially edentulous patients who are not immediate candidates for extensive, fixed implant supported restorations. Incorporation of dental implants to improve the RPD support and retention and to enhance patient acceptance should be considered when treatment planning for RPD. In this case, 59 years old male patient who received dental treatment of implant fixed prosthesis on both side of the upper jaw and implant overdenture on lower jaw showed implant abutment screw fracture on #15i and osseointegration failure on multiple number of implants. After removing failed implants, we planned ISRPD using #15i,24i,25i,26i and #23 natural tooth for RPD abutment. We fabricated #23 surveyed crown,#24i=25i=26i surveyed bridge and #15i gold coping for support,retention and stability for RPD. Periodic follow up check for 2years has been performed since the ISRPD delivery to the patient. No sign of screw loosening, fracture or bone resorption around abutment implants were detected.