• 제목/요약/키워드: Implant Treatment

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미니 임플란트 고정원을 이용한 전위된 상악 견치-제1소구치의 교정치료 (Correction of a maxillary canine-first premolar transposition using mini-implant anchorage)

  • Oztoprak, Mehmet Oguz;Demircan, Cigdem;Arun, Tulin
    • 대한치과교정학회지
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    • 제41권5호
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    • pp.371-378
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    • 2011
  • Transposition is defined as a dental anomaly manifested by a positional interchange of 2 adjacent teeth within the same quadrant of the dental arch. Maxillary canine-first premolar [Mx4-3] transposition is the most frequent tooth transposition reported in the literature. In this case report, an orthodontic correction of a transposition of the maxillary left canine and first premolar with the help of palatally located mini-implant anchorage is described. Esthetic and occlusal evaluations suggested alignment of the transposed teeth to their correct anatomic positions in the dental arch. The clinical result at the end of the treatment was satisfactory. Alignment was obtained, and intercuspation was adequate. Nevertheless, the maxillary canine showed facial recession, probably because it was initially positioned buccally. Supporting tissue was examined after treatment and no alveolar bone damage was observed.

활동기준원가(Activity Based Cost)를 적용한 치과 임플란트 원가산정 (Dental implant cost estimation using the Activity-Based Costing approach)

  • 신호성;안은숙
    • 대한치과보철학회지
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    • 제51권4호
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    • pp.292-299
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    • 2013
  • 연구 목적: 의료환경의 변화에 따라 새로운 의료관리에 대한 필요성과 함께 의료기관의 원가관리에 대한 관심이 증가되었다. 본 연구는 치과의료기관에서 빈번하게 제공되는 치과 임플란트 서비스를 직원의 활동에 근거하여 자원 또는 원가를 배부하는 활동기준원가(Activity-Based Cost, ABC) 방법을 적용하여 원가를 산정하기 위해 시행되었다. 연구 대상 및 방법: 수도권 소재의 A 치과의료기관을 대상으로 치과 임플란트 원가산정을 실시하였다. 해당 기관의 총비용을 확인하기 위해 1사분기 세무회계자료를 사용하였고 기관 내에서 이루어지는 활동을 파악하기 위하여 활동분석표 작성을 요청하였다. 자료를 바탕으로 치과 임플란트에 해당하는 직접원가와 간접원가를 분리하고, 간접원가의 왜곡을 최소화하기 위해 원가동인(Cost driver)을 파악하여 활동별로 비용을 배분하는 활동기준원가 분석을 실시하였다. 결과:치과 임플란트 원가를 직접비와 간접비로 나누어 비교한 결과 각각 35.8%, 49.5%로 나타났다. 치과 임플란트 1개당 원가는 1,579천원 정도로 산정되었고, 임플란트 수술 및 시술 전 후 활동이 포함된 보철 시술 진료영역에 47만원(30%)이 소요되어 가장 많은 부분을 차지하였다. 연수 및 치과학 교육 등의 활동도 기타 진료에 비해 상대적으로 높은 비중을 나타내었다. 결론: 과학적인 치과 임플란트의 수가 산정을 위해서 치과 임플란트와 관련된 직접적인 진료 술식 이외에 시술 전 후 준비활동 등에 대한 고려가 충분히 이루어져야 한다. 임플란트 시술 전 후의 활동 및 교육, 연수활동 등은 간접비에 포함되는 부분이나 진료의 질을 담보하고 환자의 만족도를 향상시키기 위해 반드시 필요할 활동으로 이러한 활동들을 고려한 합리적 수가 산정이 필요하다.

임플란트와 레진 클래스프를 이용한 심미 가철성 국소의치 증례 (Esthetic removable partial denture with implants and resin clasp: Case report)

  • 김수민;전영찬;정창모;윤미정;허중보
    • 대한치과보철학회지
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    • 제53권1호
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    • pp.58-65
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    • 2015
  • 완전 무치악 환자의 수복 시 총의치나 임플란트 지지 피개의치와 더불어 임플란트를 지대치로 이용하는 국소의치가 치료 방법의 하나로 고려될 수 있다. 적은 수의 임플란트를 전략적으로 중요한 위치에 식립한 후 가철성 국소의치로 수복할 경우, 임플란트를 통해 안정을 얻고 부가적으로 유지 및 지지를 확보할 수 있을 뿐만 아니라 광범위한 임플란트 식립을 통한 고정성 보철물에 비해 환자의 수술 부담을 줄여줄 수 있으며, 치료비용 절감 효과도 기대할 수 있다. 본 증례는 오랫동안 국소의치를 사용해 온 환자에서 치아 상실 후 잔존 치조골의 상태 및 환자의 요구를 고려하여 임플란트 지지 국소의치를 제작한 증례로서 전치부에 식립한 임플란트는 고정성 보철물로 수복하고 구치부의 짧은 임플란트는 지지 기능만 부여하였다. 또한 의치상과 클래스프를 열가소성 아크릴 레진으로 제작함으로써 기능적, 심미적으로 만족스러운 치료 결과를 얻었기에 이를 보고하는 바이다.

Clinical outcome of conservative treatment of injured inferior alveolar nerve during dental implant placement

  • Kim, Yoon-Tae;Pang, Kang-Mi;Jung, Hun-Jong;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권3호
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    • pp.127-133
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    • 2013
  • Objectives: Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. Materials and Methods: Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2007 at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, were retrospectively investigated. The objective tests and subjective evaluations were performed to evaluate the degree of damage and duration of sensory disturbance recovery. Tests were performed on the day of the first visit and every two months afterward. Patient's initial symptoms, proximity of the implant to the IAN, time interval between implant surgery and the first visit to our clinic, and treatment after implant surgery were analyzed to determine whether these factors affected the final outcomes. Results: Among the 64 patients, 23 had a chief complaint of sensory disturbance and others with dysesthesia. The mean time until first visit to our hospital after the injury was 10.9 months.One year after nerve injury, the sensation was improved in 9 patients, whereas not improved in 38 patients, even 4 patients experienced deterioration. Better prognosis was observed in the group of patients with early visits and with implants placed or managed not too close to the IAN. Conclusion: Nearly 70% of patients with IAN injury during implant placement showed no improvement in sensation or dysesthesia with the conservative management. Earlier decision for active treatment needs to be considered because of possibility of deterioration of symptoms and unsatisfactory recovery.

Sandblasted, Large-grit and Acid-etched Implant에 대한 후향적 임상 연구 (Retrospective Study of Sandblasted, Large-grit and Acid-etched Implant)

  • 조지호;김수관;문성용;오지수;박진주;정종원;윤대웅;양성수;정미애
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권4호
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    • pp.352-358
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    • 2011
  • Purpose: This study evaluated the prognosis and survival rate of SLA (Sandblasted, Large-grit and Acid-etched) implants and it also evaluated the prosthodontic complications and the associated factors. Methods: Twenty seven patients (14 men and 13 women, mean age: 54.9) who visited Chosun University Hospital Implant Center with the chief desire for placement of an implant in an edentulous area from March, 2008 to December 2008 and who received placement of a SLA implant ($Implantium^{(R)}$, Dentium Co., Korea) were selected for this study. Results: The average follow-up period was 15 months and the study was based on the treatment records, radiographs and clinical examinations. A total of 69 implant cases were retrospectively assessed for the width and length of the implant, the primary and secondary stability, the combined surgery, the employed bone graft material and barrier membrane, the status of the opposing tooth, implant failure and the prosthetic complications. During the follow-up period (average: 15 months), the accumulative survival rate of the 69 implants in 27 patients was 100%. Complications such as infection, sinusitis and fixture exposure after surgery were seen for 5 implants in 4 patients. Complications such as screw loosening, contact loosening and peri-implant gingivitis after prosthodontic treatment occurred in 7 cases (10.14%). Conclusion: This study reports placement of SLA implants may cause various complications, yet the final accumulative survival rate was 100%. The SLA implant ($Implantium^{(R)}$) has an excellent clinical survival rate and outcome.

Biomechanical evaluation of dental implants with different surfaces: Removal torque and resonance frequency analysis in rabbits

  • Koh, Jung-Woo;Yang, Jae-Ho;Han, Jung-Suk;Lee, Jai-Bong;Kim, Sung-Hun
    • The Journal of Advanced Prosthodontics
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    • 제1권2호
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    • pp.107-112
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    • 2009
  • STATEMENT OF PROBLEM. Macroscopic and especially microscopic properties of implant surfaces play a major role in the osseous healing of dental implants. Dental implants with modified surfaces have shown stronger osseointegration than implants which are only turned (machined). Advanced surface modification techniques such as anodic oxidation and Ca-P application have been developed to achieve faster and stronger bonding between the host bone and the implant. PURPOSE. The purpose of this study was to investigate the effect of surface treatment of titanium dental implant on implant stability after insertion using the rabbit tibia model. MATERIAL AND METHODS. Three test groups were prepared: sandblasted, large-grit and acid-etched (SLA) implants, anodic oxidized implants, and anodized implants with Ca-P immersion. The turned implants served as control. Twenty rabbits received 80 implants in the tibia. Resonance frequencies were measured at the time of implant insertion, 2 weeks and 4 weeks of healing. Removal torque values (RTV) were measured 2 and 4 weeks after insertion. RESULTS. The implant stability quotient (ISQ) values of implants for resonance frequency analysis (RFA) increased significantly (P <. 05) during 2 weeks of healing period although there were no significant differences among the test and control groups (P >. 05). The test and control implants also showed significantly higher ISQ values during 4 weeks of healing period (P < .05). No significant differences, however, were found among all the groups. All the groups showed no significant differences in ISQ values between 2 and 4 weeks after implant insertion (P >. 05). The SLA, anodized and Ca-P immersed implants showed higher RTVs at 2 and 4 weeks of healing than the machined one (P < .05). However, there was no significant difference among the experimental groups. CONCLUSION. The surface-modified implants appear to provide superior implant stability to the turned one. Under the limitation of this study, however, we suggest that neither anodic oxidation nor Ca-P immersion techniques have any advantage over the conventional SLA technique with respect to implant stability.

성견 하악골에 식립한 다양한 임플란트 표면에서의 골 치유 양상에 관한 연구 (The Study of Bone Healing Response According to the Various Surfaces of the Implant in the Mandible of the Mature Dog)

  • 임현필;김용학;방몽숙;양홍서;박상원;최홍란
    • 구강회복응용과학지
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    • 제25권2호
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    • pp.125-137
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    • 2009
  • 성공적인 임플란트 시술을 위해 최근에는 다양하게 표면 처리된 임플란트가 소개되고 있으며, 이러한 표면 처리가 임플란트 표면에서 세포 반응에 영향을 준다는 많은 보고가 있다. 본 연구는 성견 하악골에 현재 사용 중이거나 개발 중인 다양하게 표면 처리된 8종류의 임플란트를 식립하여 조직학적 및 조직계측학적 분석을 함으로써 임플란트 표면 처리 방법이 골 치유에 어떤 영향을 주는지 비교 평가하고 임플란트 식립 후 시기에 따른 골내 치유 양상을 알아보고자 하였다. 8가지의 서로 다르게 표면 처리된 임플란트를 이용하여 총 72개의 임플란트를 9마리의 성견 하악골에 식립하였고, 2주, 4주, 8주에 각각 3마리씩 희생하였다. 골편을 절단 및 처리하여 시편을 제작한 후 조직학적 분석을 하였으며, 조직계측학적 분석으로 bone to implant contact(BIC)를 측정 비교하였다. 조직학적 분석 결과 전반적으로 골 형성이 좋은 상태로 2주의 실험군에서도 임플란트의 인접부위에서 상당량의 골 형성을 볼 수 있었다. 4주의 실험군에서는 골 형성이 전반적으로 관찰되었으나, 신생골은 기저골과 구분되었고, 8주 실험군에서는 신생골이 성숙되어 기저골과 잘 연결되어 있었다. 8가지 서로 다른 임플란트에서 표면에 따른 차이는 보이지 않았다. 조직계측학적 분석 결과 2주군에서 4주군과 8주군에 비해 BIC가 유의할만하게 낮게 나타났으며 4주군과 8주군 사이에는 유의성 있는 차이를 보이지 않았다, 또한 표면 처리에 따른 차이도 보이지 않았다.

Film Image Transfer System (FITS): An Efficient Method for Proper Positioning of Orthodontic Mini-implants

  • Go, Taek-Su;Kim, Seong-Hun;Nelson, Gerald
    • 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.