• 대한치과마취과학회지
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• 제9권2호
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• pp.98-103
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• 2009

Background: Despite increasing popularity of dental implants, there is limited information on the pain experience associated with the surgical implant placement under general anesthesia. The aim of this study was to assess the characteristics of patient-reported pain and efficacy of patient controlled analgesia after implant surgery under general anesthesia. Methods: Total 39 patients who underwent implant surgery under general aensthesia were enrolled. In PCA group (n=30), patients received patient controlled analgesia (fentanyl 700 mg and ketorolac 150 mg) set to basal rate 1 ml/h, bolus 1 ml, and lockout interval 10 min. In control group (n=9), patients received ketorolac 30 mg intravenously when they feel painful. We evaluated pain intensity using VAS score at the end and after 12 hr of the operation and recorded the number of bolus injection as a surrogate of rescue therapy. We compared the VAS data, the frequency of complication between two groups. Results: The self reported pain was highest at 1 hous after surgery in both groups. However, the intensity was not severe (PCA group = 5.7, control group = 5.6), and decreased gradually thereafter. Total demand bolus number was less than 6 in nearly 65% patients. And there was no significant difference in the frequency of complications such as nausea, vomiting and dizziness between both groups. Conclusions: The Pain following the surgical placement of dental implants was generally mild and gradually decreased with time. There was no difference in complications between control group and PCA group.

• 대한치과보철학회지
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• 제57권2호
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• pp.171-175
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• 2019

치조제가 심하게 흡수된 하악의 정확한 해부학적 구조를 채득하는 것은 매우 어렵다. 이 경우 보다 정확한 인상을 채득하기 위하여 수정모형 제작법을 통한 기능 인상 채득이 추천된다. 이를 위해서는 양측에 2개의 임플란트 크라운을 이용하여 적절한 고정원을 얻을 필요가 있다. 이를 통해 임플란트 피개의치에서는 불가능하였던 수정모형 제작법을 시행할 수 있다. 본 증례에서는 하악의 치조제가 심하게 흡수된 80세 여환을 하악 양측 견치 부위의 임플란트 크라운을 지대치로 한 가철성 국소의치를 이용하여 수복하였다. 가철성 국소의치의 금속구조물을 이용하여 개인 트레이를 제작하고 수정모형 제작을 위한 이차 인상을 채득하였다. 환자는 앞선 2회의 피개의치 실패 후 제작된 최종 보철물에 만족하였다. 치료 초기에 행해진 피개의치 치료에서는 부정확한 인상법에 따른 부적절한 보철물로 인해 술자와 환자 모두 만족하지 못했지만, 2개의 임플란트를 적절한 고정원으로 이용함으로써 성공적인 수복이 가능하였다.

• 대한치과의사협회지
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• 제55권7호
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• pp.457-466
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• 2017

In the case of failed fixed implant prosthesis accompanied by abutment screw fracture, fractured screw fragment must be removed to use the existing implant fixtures. A 61-year-old male patient, who had a failed maxillary fixed implant prosthesis accompanied by three abutment screw fracture, hoped to reconstruct the maxillary implant prosthesis, while maintaining the existing implant fixtures. To use the existing implant fixtures, fractured screw fragments were removed. A maxillary implant overdenture using available existing implants was planned. Bar-attachment with Locator was used for implant splinting, denture stability, and retention. Final impression was taken after treatment of peri-implantitis. Jaw relation registration was taken to evaluate available interarch space for bar-attachment. After fabricating bar-attachment, centric relation was taken. Implant overdenture using bar-attachment with Locator was delivered after wax-denture evaluation. This case report showed that a satisfactory clinical result was achieved by implant overdenture using existing implant fixtures in a maxillary edentulous patient.

• Journal of Korean Dental Science
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• 제4권1호
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• pp.20-25
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• 2011

Purpose: To describe the newly developed Film image transfer system (FITS) for proper positioning of the orthodontic mini-implant in the narrow interdental space and considerations for better application. Materials and Methods: A patient who was planning to have orthodontic mini-implant treatment on the posterior maxilla was recruited to assess the feasibility of FITS. Dental radiographic film and bite record was taken. And then the film image was transferred on the photographic emulsion coated model using transfer light through film projector (enlarger). After exposing the photo emulsion coating on the model, the image was developed with a working solution for a paper developer and fixed. The surgical guide for the mini-implant was fabricated from the transported FITS data. Results: The completed surgical guide was easily placed intraorally, and allowed a simple and rapid placement of the mini-implant. The site of the implant placement was accurate as planned position. Conclusion: In the reported case, The FITS technique represents an effort to minimize risk to the patient and produce consistently good results based upon accurate information about the anatomy of the implant site.

• Journal of Periodontal and Implant Science
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• 제43권5호
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• pp.243-247
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• 2013

Purpose: The aim of this work is to evaluate a surgical technique for mobilization of mal posed dental implant in anterior area. Methods: A 38-year-old patient consulted our unit for esthetic dissatisfaction with the implant treatment of a central incisor. An implant was observed in 11 and 21, where 11 was 3 mm above the ideal limit, with excessive vestibular angulation. The choice was made to perform a segmental osteotomy and mobilize the bone block and the implant down and forward; a bone block extracted from the mandibular ramus was installed between the implant block and the bed to stabilize the segment. Results: After 4 months, a conventional fixed prosthesis was created and the esthetic result achieved was close to what the patient wanted, with no need for further surgery. The surgical condition was stabilized and maintained for the long-time and no complications how necrosis, infection or bone defects was present. Conclusions: It was concluded that the procedure is efficient, and the biological arguments in favor of the procedure are discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권5호
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• pp.331-336
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• 2013

Maxillary sinus membrane elevation and bone graft have been performed routinely in alveolar bone with insufficient residual bone height. There are a number of causes for development of maxillary sinusitis after these procedures. When maxillary sinusitis is caused by sinus membrane elevation, bone graft, and implant placement, various treatment such as medication, incision and drainage (I&D), implant removal, and the Caldwell-Luc procedure can be considered. Removal of an implant or the Caldwell-Luc procedure can be harmful if inflammation is not present in the oral cavity and survival of grafted bone and implant osseointegration can be expected despite the presence of maxillary sinusitis. In this case, functional endoscopic sinus surgery, which was often used in the otorhinolaryngology department, was performed without removal of the implant for a patient with maxillary sinusitis after one month following implant placement. Thus, we report on this case with a review of the literature.

• 한국치위생학회지
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• 제13권2호
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• pp.221-230
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• 2013

Objectives : This study is to confirm the influencing factors on patients satisfaction and intention to revisit the implant service clinic by structural equation model. Methods : We surveyed 250 implant patients visiting 6 dental clnics(hospitals) in Busan, Changwon, Gimhae city and questionnaire was for four weeks in July 2012, a total 209 patients filled out the questionnaires within July and the complete data were analyzed. we were used structural equation model for analysis to confirm influencing factors on implant patients' satisfaction and intention to revisits. Results : This study finds that factors influencing on implant patients' satisfaction and intention to revisit are reasonable medical fee, medical skill treatment of dentist, dental hygienist and other support staff, administrative procedure, and there existed between influencing factors and the patient's treatment satisfaction as well as intention to revisit. In order to satisfy the implant patients, dentist and hygienists should try to provide high quality of treatment and dental services. Conclusions : The results of this study provide managerially important messages to the managers of dental clinics in order to develope management strategies for new customers.

• 대한치과보철학회지
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• 제59권4호
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• pp.497-507
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• 2021

무치악 환자에서 잔존 치조골을 최대의 효율로 활용해 임플란트 고정성 보철물을 수복하는 치료법 중 하나로 All-on-6 개념을 사용할 수 있으나, 치료과정에서 복잡함과 번거로움이 동반된다. 나날이 발전해 온 디지털 시스템을 활용한다면 무치악 환자의 임플란트 식립부터 보철물 제작 및 수복까지 높은 효용성으로 활용할 수 있다. 본 증례에서는 76세 상악 무치악 환자의 일체형 나사 유지형 고정성 임플란트 보철 수복(1-piece design, screw retained implant fixed prosthesis)에 대해 진단부터 임플란트 식립 그리고 보철물 제작까지 전 과정에서 디지털 시스템을 활용하였다. 술전 진단에서 구강직접스캔(Direct intraoral scan)을 통해 환자의 정보를 데이터화 하였으며 이를 토대로 임플란트 식립 수술 가이드와 식립직후 장착할 즉시 임시보철물을 디자인 하였다. 최적의 잔존 치조골 위치에 식립된 6개의 임플란트 위치정보에 따라 정밀하게 제작된 즉시 임시보철물을 수복하여 술 후 사용 가능하도록 하여 환자의 불편감을 최소화하였다. 디지털 시스템을 활용하여 환자의 요구사항, 안정된 수직고경과 교합, 심미성을 고려하여 제작한 새로운 임시보철물을 거쳐 최종보철물을 디자인하고 제작하였다. 디지털 시스템을 활용하여 무치악 환자의 효율적이고 정확한 임플란트 식립부터 보철물 제작까지 전 과정에 있어서 복잡한 임플란트 치료과정을 단순화하여 환자의 불편감을 최소화시키고 기능적이고 심미적인 결과를 얻어 보고하는 바이다.

• 한국CDE학회논문집
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• 제16권3호
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• pp.216-226
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• 2011

Surgeon dentists usually rely on their experiential judgments from patients' oral plaster casts and medical images to determine the positional and directional information of implant fixtures and to perform drilling tasks during dental implant surgical operations. This approach, however, may cause some errors and deteriorate the quality of dental implants. Computer-aided methods have been introduced as supportive tools to alleviate the shortcomings of the conventional approach. In this paper, we present an approach of 3D dental implant simulation which can provide the realistic and immersive experience of dental implant information. The dental implant information is primarily composed of several kinds of 3D mesh models obtained as follows. Firstly, we construct 3D mesh models of jawbones, teeth and nerve curves from the patient's dental images using software $Mimics^{TM}$. Secondly, we construct 3D mesh models of gingival regions from the patient's oral impression using a reverse engineering technique. Thirdly, we select suitable types of implant fixtures from fixture database and determine the positions and directions of the fixtures by using the 3D mesh models and the dental images with software $Simplant^{TM}$. Fourthly, from the geometric and/or directional information of the jawbones, the gingival regions, the teeth and the fixtures, we construct the 3D models of surgical guide stents which are crucial to perform the drilling operations with ease and accuracy. In the application phase, the dental implant information is combined with the tangible interface device to accomplish 3D dental implant simulation. The user can see and touch the 3D models related with dental implant surgery. Furthermore, the user can experience drilling paths to make holes where fixtures are implanted. A preliminary user study shows that the presented approach can be used to provide dental students with good educational contents. With future work, we expect that it can be utilized for clinical studies of dental implant surgery.

• The Journal of Advanced Prosthodontics
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• 제6권4호
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• pp.245-252
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• 2014

PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.