• Journal of Dental Rehabilitation and Applied Science
• /
• v.33 no.4
• /
• pp.321-328
• /
• 2017

Treatment options for edentulous patients are complete denture and implant prosthesis. A two implant-retained overdenture can be considered the first treatment in the edentulous mandible, but there is no clear consensus of treatment for edentulous maxilla. Implant-retention/support overdenture shows better retention and stability than complete denture and is less expensive and more esthetic than implant-supported fixed prosthesis. CM $LOC^{(R)}$ $Pekkton^{(R)}$ attachment is a solitary type attachment and evaluated to have excellent abrasion resistance and retention with a female part made of poly-ether-ketone-ketone. Meanwhile, SR Ivocap system is injection molding method and discussed to show few changes in the vertical dimension of denture and have excellent fracture resistance. In this case, we restored maxillary arch with a four implant-retained overdenture using CM $LOC^{(R)}$ $Pekkton^{(R)}$ and SR Ivocap system, and mandibular arch with a removable partial denture. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

• Imaging Science in Dentistry
• /
• v.44 no.2
• /
• pp.121-128
• /
• 2014

Purpose: The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning. Materials and Methods: One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image data-sets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs. Results: All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels. Conclusion: Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.13.1-13.6
• /
• 2020

Background: The aim of this study was to evaluate the factors that may affect implant fixture fractures. Methods: Patients who experienced implant fixture removal at Seoul National University Bundang Hospital from 2007 to 2015 due to implant fixture fracture were included. Implant/crown ratio, time of implant fracture, clinical symptoms before implant fracture, treatment of fractured implants, and the success and survival rate of the replaced implants were evaluated retrospectively. Results: Thirteen implants were fractured in 12 patients. Patient mean age at the time of fracture was 59.3 years. Of the 13 implants, 7 implants were placed at our hospital, and 6 were placed at a local clinic. The mean crown/implant ratio was 0.83:1. The clinical symptoms before fracture were screw loosening in five implants, marginal bone loss in five implants, and the presence of peri-implant diseases in five implants. All the fractured implants were removed, and 12 out of the 13 sites were re-implanted. Parafunctions were observed in two patients: one with bruxism and one with attrition due to a strong chewing habit. Conclusions: Several clinical symptoms before the fracture of an implant can predict implant fixture failure. Therefore, if these clinical symptoms are observed, appropriate treatments can be taken before more serious complications result.

• Journal of Periodontal and Implant Science
• /
• v.32 no.3
• /
• pp.615-630
• /
• 2002

Various long-term studies have shown that titanium implants as abutments for different types of prostheses have become a predictable adjunct in the treatment of partially or fully edentulous patients. The continuous exposure of dental implants to the oral cavity with all its possible contaminants creates a problem. A lack of attachment, together with or caused by bacterial insult, may lead to peri-implantitis and eventual implant failure. Removal of plaque and calculus deposits from dental titanium implants with procedures and instruments originally made for cleaning natural teeth or roots may cause major alterations of the delicate titanium oxide layer. Therefore, the ultimate goal of a cleaning procedure should be to remove the contaminants and restore the elemental composition of the surface oxide without changing the surface topography and harming the surrounding tissues. Among many chemical and mechanical procedure, air-powder abrasive have been known to be most effective for cleaning and detoxification of implant surface. Most of published studies show that the dental laser may be useful in the treatment of pen-implantitis. $CO_2$ laser and Soft Diode laser were reported to kill bacteria of implant surface. The purpose of this study was to obtain clinical guide by application these laser to implant surface by means of Non-contact Surface profilometer and X-ray photoelectron spectroscopy(XPS) with respect to surface roughness and atomic composition. Experimental rough pure titanium cylinder models were fabricated. All of them was air-powder abraded for 1 minute and they were named control group. And then, the $CO_2$ laser treatment under dry, hydrogen peroxide and wet condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of the control models. The results were as follows: 1. Mean Surface roughness(Ra) of all experimental group was decreased than that of control group. But it wasn't statistically significant. 2. XPS analysis showed that in the all experimental group, titanium level were decreased, when compared with control group. 3. XPS analysis showed that the level of oxygen in the experimental group 1, 3($CO_2$ laser treatment under dry and wet condition) and 4(Soft Diode laser was used under toluidine blue O solution) were decreased, when compared with control group. 4. XPS analysis showed that the atomic composition of experimental group 2($CO_2$ laser treatment under hydrogen peroxide) was to be closest to that of control group than the other experimental group. From the result of this study, this may be concluded. Following air-powder abrasive treatment, the $CO_2$ laser in safe d-pulse mode and the Soft Diode laser used with photosensitizer would not change rough titanium surface roughness. Especially, $CO_2$ laser treatment under hydrogen peroxide gave the best results from elemental points of view, and can be used safely to treat peri-implantitis.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.37 no.4
• /
• pp.186-198
• /
• 2021

As the increased certainty of osseointegration, new parameters are now being used to assess implant success. Accordingly, patients' and clinicians' high demands and expectation for esthetics have expanded and implant-supported restorations show better esthetic outcomes. The pre-implant treatment planning process, the implant surgical steps and the post-surgery prosthetic process can affect all esthetic outcomes. Prevention of esthetic implant failures can be achieved by appropriate treatment at each stage, considering the 3 factors of alveolar bone, soft tissue, and implants. It is necessary to achieve the esthetic implant prostheses followings: minimal invasive surgery, bone augmentation, ideal 3-dimensional implant position, peri-implant soft tissue management, and provisional restorations to optimize peri-implant soft tissue architecture.

• The Journal of Korean Academy of Prosthodontics
• /
• v.38 no.3
• /
• pp.321-327
• /
• 2000

Statement of Problem. As a standard means of diagnostics, an orthopantomogram(OPT) permits to measure the vertical and mesiodistal dimension of available bone at the desired implant site with the help of suitable radioopaque references. Based on the clinical investigation of the dentition and the edentulous sites, information upon the width of the implant site can be obtained and documented in the dental scheme. Both findings permit together systematic primary planning for endosteal implants. Purpose of Study. Contents of the present article are the representation of a semiquantitative classification of available bone with the aim to simplify the primary phase of a systematic implant planning. Results. Thus the ASCIi- system permits a clear protocol of bone findings for the implant case with all information available during the primary appointment for treatment planning as a basis of further diagnostic and therapeutic measures. Conclusion. With the ASCIi system, important parameters such as alveolar height and sub-crestal alveolar width can be documented systematically, easily and time saving in the dental scheme as a basis for exact treatment planning.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.40 no.3
• /
• pp.130-134
• /
• 2014

Objectives: The goal of this study was to estimate the overall satisfaction level of dental implant patients and further evaluate factors influencing satisfaction. Materials and Methods: Self-administered questionnaires were mailed to patients who received dental implant therapy at Seoul National University Bundang Hospital (Seongnam, Korea) from October 2003 to April 2005. The main portion of the questionnaire was shared to evaluate the level of satisfaction with implant therapy. The questionnaires contained evaluations of influencing factors, which were classified as pain-related, service-related, and complication-related. Results: The responses from 93 patients (41 males, 52 females) with a total of 325 implants were included in the analysis, and the mean score for overall satisfaction level with implant therapy was 8.26. Female patients showed higher visual analogue scale (VAS) scores for both pain during (P=0.000) and after implant surgery (P=0.016). Male patients showed more 'negative' values for the reasonability of treatment cost (P=0.008) and the adequacy of the treatment period (P=0.022). Conclusion: The subjective satisfaction of patients was influenced by various factors, especially complication-related factors.

• The Korean Society of Law and Medicine
• /
• v.17 no.1
• /
• pp.281-297
• /
• 2016

In order to make a treatment plan and outcome prediction, it is important to evaluate accurately and objectively osseous tissues of the implant area. The evaluation of osseous tissues is the most objective method for the decision of production time of upper structure of alveolar bone. However, the evaluation of osseous tissues contains contradiction because it is made by subjective opinions of dental surgeons. Many dentists also point out the problem of subjective evaluation of osseous tissues. Therefore, it is necessary to create accurate and objective standards. Previously, the evaluation of bone density depends on dentist's subjective sensation during drilling procedure of implant. However, the HU(Hounsfield unit) figure of CT(computed tomography) scan allows of objective and precise categorization of bone density now. Misch and Kircos divided the bone density levels from D1 to D5 with subjective separation of bone density. Their method also depended on not objective and quantification data but subjective separation by sensation. Thus, we need the evaluation of implant area through comparative analysis of more objective and quantification data. Implant treatment comprises the highest frequency of medical disputes of dental clinic. If we bring objective checkup and reasonable treatment method in the implant treatment, we can deduce more reasonable results, and the failure late of implant treatment also can decrease. The ultimate objective of this study is the minimization of dental disputes between dental patients and dentists by creating new legal standards on the basis of objective and quantification data.

• Journal of Korean society of Dental Hygiene
• /
• v.2 no.1
• /
• pp.85-95
• /
• 2002

The purpose of this study was to examine dental hygienists' knowledge of implant operation, which is recently emerging as one of the important medical services in the dental treatment sector. It's ultimately intended to serve as a basis for the preparation of more effective, appropriate implant-education programs for dental hygienists and to help them, who take a crucial part in implant operation, provide better dental services to patients who are in need of implant operation. The subjects in this study were 368 selected dental hygienists who were working in the dental institutions in the region of Taegu. The results of this study were as below: 1. The largest number of the dental hygienists investigated, 34.1%, were at age 25 to 27. The second most common age was 24 and under, and the third most common age group was 28 to 30. For educational level, most of them, 91.0%, were junior-college graduates, and 9.0% were being in or graduated from four-year-course university. Concerning career, 52.7%, the greatest percentage, had worked for one to three years, and 41.3% had a four-year or higher career. 812%, most of them, were working in dental clinics, and 18.3% were serving in dental hospital or general hospital. 2. Many of the dental institutions were providing implant operation services, as the dental institutions where 64.9% of the subjects were working conducted implant operation. In relation to the necessity of implant operation, the dominant opinion, 73.0%, was thai it's needed to make oral slate healthier. So there was a strong tendency to ad mit implant as one of the necessary treatments in the dental treatment sector. 3. Their collective mean implant knowledge got $57.02{\pm}14.11$. And the collective average of 21 items was $2.7153{\pm}0.6720$ on the basis of 5 points, which was below the average(3 points of Likert scale). This meant that the dental hygienists didn't have a good knowledge or understanding of implant. When it's taken into account what role should be performed by dental hygienists, their implant knowledge should be increased. 4. As a result of examining the effect of the general characteristics on their implant knowledge, the educational level(t=-3.481, P=0.001) and the type of dental institution where they were working(F=16.476, P=0.001) made a significant difference. 5. Their implant knowledge was significantly different according to whether or not the dental institution they were serving conducted implant operation (t=7.199, P=0.001). And, whether or not they agreed to the necessity of implant operation also generated a significant difference to their implant knowledge(F=8.610, P=0.000).

• Archives of Plastic Surgery
• /
• v.37 no.1
• /
• pp.26-30
• /
• 2010

Purpose: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. Methods: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$ and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$. Results: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. Conclusion: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.