• The Journal of Korean Academy of Prosthodontics
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• v.39 no.3
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• pp.306-312
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• 2001

Achieving an aesthetic implant-supported restoration in the single tooth missing case can be challenging when the implant site is in e anterior region. The objective of this report is to focus on presurgical evaluation of implant site and systematic development of related prosthetic modalities. An accurate diagnostic evaluation, a systematically developed pesurgical plan, and knowledge and clinical skill of the various related therapeutic modalities are indispensible. Collection of patient's information, appropriate abutment selection, soft tissue contour, implant axis, and occlusion need to be discussed for aesthetic clinical outcome. For aesthetic restoration, such as surgical guide stent for precise implant positioning customized provisional restoration for development of optimal periimplant soft tissue contours, and fabrication customized abutment (mesiostructure) for veriable emergence profile, are recommended.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.25 no.1
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• pp.35-49
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• 2016

With the increasing demand for aesthetic implant dentistry, the importance of implant restoration is emphasized not only in the functional aspect but also in the aesthetic aspect. The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. The soft tissue aesthetics are dependent upon the condition of the supporting hard tissue because the osseous structure provides a framework for the development of a healthy and aesthetic soft tissue interface. Therefore, the augmentation of hard tissue is a first step and especially, optimal 3-dimensional position of implant is the most important factor in aesthetic implant restoration. The management of soft tissue is a second step, and the final step is a restoration of harmonic prosthesis using provisional restoration with proper emergence profile. This clinical report describes the procedure of bone augmentation in labial dehiscence defect, Vascularized Interpositional Periosteal-Connective Tissue (VIP-CT) flap for aesthetic anterior soft tissue, and the importance of provisional restoration and impression taking stage with customized impression coping.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.1
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• pp.33-39
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• 2021

When maxillary anterior tooth is extracted due to alveolar bone loss, the augmentation of alveolar ridge is very important for esthetic implant restoration. Because alveolar bone loss increases after extraction, the ridge preservation performed right after tooth extraction is meaningful for esthetic implant restoration. However, no achievement of primary closure during ridge preservation can negatively affect bone regeneration. To overcome this problem, we can use granulation tissue in the extraction socket for primary closure. This case report confirmed that primary closure using granulation tissue resulted in not only ridge preservation but also ridge augmentation by providing an environment more advantageous of bone regeneration than the open wound.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.16 no.2
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• pp.7-18
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• 2007

There is now an increased demand for harmony between the peri-implant gingiva and adjacent dentition. In the event of a pending loss of a single tooth in the aesthetic zone with healthy periodontium, expectation for optimal gingival and prosthodontic aesthetics are often very high. Unfortunately, bone resorption is common following the removal of an anterior tooth, compromising the gingival tissue levels for the eventual implant restoration. Also, improper implant placement and inadequate osseous-gingival support potentially deleterious aesthetic result. The creation of an esthetic implant restoration with gingival architecture that harmonizes with the adjacent dentitionis formidable challenge. The predictability of the peri-implant esthetic outcome may ultimately be determined by the patient's own presenting anatomy rather than the clinician's ability to manage state-of-the-art procedures. To more accurately predict the peri-implant esthetic outcome before removing a failing tooth, a considering of diagnostic keys is essential. This presentation addresses the useful diagnostic keys that affect the predictability of peri-implant gingival aesthetics and the overcoming of the risk factors in anterior single-tooth replacement; it also describes a surgical and prosthodontic technique in achieving a long term successful esthetic outcome. Proper diagnosis and understanding of the biological and periodontal variables of failing dentition and their response to surgical and prosthodontic procedures are the essence of predictability. Using a smart protocol that alters the periodontium toward less risk and more favorable assessment of the diagnostic keys before implant placement will provide the most predictable esthetic outcome. Simple diagnostic keys suggested this presentation are useful method to evaluate the overcoming of the risk factors in anterior single implant restoration.

• The Journal of the Korean dental association
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• v.53 no.6
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• pp.418-426
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• 2015

The appropriate occlusion is one of the most important factors for the long-term success of implant and its restorations. The purpose of this review is to investigate and define occlusal considerations to reduce failure of implant prostheses. The physiological movement of implants is markedly lower than that of natural teeth and they also lack in occlusal sensitivity. Proper occlusal pattern may be assigned to compensate for the biological disadvantages and occlusal contacts must be formed where the cantilever effect is minimized. Moreover, the long-term success of implants after osseointegration can be assured by reducing early occlusal loading to avoid implant overloading and selecting appropriate occlusion material. Occlusal overload was brought by the number and location of occlusal contacts, which are under the clinician's control. The concept of implant occlusion is based on the concepts derived from traditional prosthetics. Moreover, there are few evidence on the concept or design of implant occlusion. Several occlusal design was recommended for implant prosthesis. Mutually protected occlusion, group function occlusion and bilateral balance occlusion was recommended for the specific types of implant restorations. This article reviews proper design of occlusion for implant restoration and offers occlusion strategy clinically.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.659-662
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• 2006

Purpose: Alloplastic implants, such as methylmethacrylate, Teflon, silicone, Supramid are commonly used to cover the floor defect and to prevent reherniation of the displaced orbital tissue in orbital floor fracture. Silicone implant has been used for reconstruction of orbital wall defects because of pliability, advantage of carving and chemically inert nature. However, silicone implant also has complications including infection, extrusion, pain, dystopia and tissue reaction. Cyst formation around the silicone implant is a very rare complication. According to many reports, cysts around alloplastic implant in an orbital area are mostly hemorrhagic cysts consisted of blood breakdown product with fibrous capsule cell in histologic examination. Methods: The authors report atypical case and successful treatment of intraorbital hemorrhagic cyst around silicone implant of a 37-year-old male patient. Results: Preoperative symptoms of diplopia, exophthalmos, proptosis, vertical dystopia and ectropion of lower eyelid were resolved after surgical removal of implants with surrounding capsule. Conclusion: Clinical suspicion of plastic surgeon is important in diagnosis of intraorbital cyst of patients who have history of silicone implantation and computed tomography is the standard tool of diagnosis. During the operation, caution must be taken on delivering the whole capsule of intraorbital cyst along with silicone implant to prevent recurrence of the cyst.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.755-760
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• 2009

Purpose: Breast surgeons usually insert tissue expander or implant beneath the subpectoral - subglandular dual plane in breast reconstruction. But sometimes it happens unsatisfactory lower pole fullness, asymmetric inframammary fold and breast shape because there is implant migration due to the pectoralis major muscle contraction and gravity. To solve all the problem like these, we introduce implant breast reconstruction using AlloDerm$^{(R)}$(LifeCell Corp., Branchburg, N.J.) sling. Methods: The AlloDerm$^{(R)}$ sling was used in 13 patients and 18 breasts for implant breast reconstruction. After mastectomy, costal and lower sternal insertion of pectoralis major muscle was detached. Rehydrated AlloDerm$^{(R)}$ was sutured to the chest wall and serratus anterior fascia at the level of inframammary fold downward and to lower border of the pectoralis major muscle upward like crescent shape with tension free technique after implant insertion into the subpectoral - subAlloDerm dual pocket. Results: We make satisfactory lower pole fullness, symmetric inframammary fold and breast shape. In conclusion, patients obtain relatively natural breast shape. There was no complication except one case of capsular contracture and one case of breast cellulitis. Conclusion: Implant breast reconstruction using AlloDerm$^{(R)}$ sling makes easy to get natural breast shape through satisfactory lower pole fullness, symmetric inframammary fold and implant positioning.

• The Journal of Advanced Prosthodontics
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• v.8 no.6
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• pp.494-503
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• 2016

PURPOSE. The aim of this study was to compare the efficacies of two-implant splinting (2-IS) and single-implant restoration (1-IR) in the first and second molar regions over a mean functional loading period (FLP) of 40 months, and to propose the appropriate clinical considerations for the splinting technique. MATERIALS AND METHODS. The following clinical factors were examined in the 1-IR and 2-IS groups based on the total hospital records of the patients: sex, mean age, implant location, FLP, bone grafting, clinical crown-implant ratio, crown height space, and horizontal distance. The mechanical complications [i.e., screw loosening (SL), screw fracture, crown fracture, and repeated SL] and biological complications [i.e., peri-implant mucositis (PM) and peri-implantitis (PI)] were also evaluated for each patient. In analysis of two groups, the chi-square test and Student's t-test were used to identify the relationship between clinical factors and complication rates. The optimal cutoff value for the FLP based on complications was evaluated using receiver operating characteristics analysis. RESULTS. In total, 234 patients with 408 implants that had been placed during 2005 - 2014 were investigated. The incident rates of SL (P<.001), PM (P=.002), and PI (P=.046) differed significantly between the 1-IR and 2-IS groups. The FLP was the only meaningful clinical factor for mechanical and biological complication rates in 2-IS. CONCLUSION. The mechanical complication rates were lower for 2-IS than for 1-IR, while the biological complication rates were higher for 2-IS. FLP of 39.80 and 46.57 months were the reference follow-up periods for preventing biological and mechanical complications, respectively.

• The Journal of the Korean dental association
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• v.53 no.5
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• pp.307-317
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• 2015

Although the long-term success of osseointegrated endosseous implants for the support of fixed dental prostheses has been reported, the increasingly widespread use of implant-supported prostheses has led to problems associated with their structural integrity. The most common biomechanical complications observed in dental implant treatment are fracture and screw loosening. The nature of loosening or fracture of dental implant components is complex, since it involves fatigue, fitness, and varied chewing patterns and loads. To assess the service life of the components of the prosthetic system, a knowledge of the loads transmitted through the system is necessary. Design of the final restoration and occlusion in relation to the geometry of a prosthetic restoration has a great influence on the mechanical loading of the implant. It is proposed that control of force in oral cavity may play a larger role in failures than previously believed. Based on theoretic consideration and clinical experiences with dental implant, this article gives simple guidelines for controlling these loads.

• Journal of Korean Dental Science
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• v.15 no.1
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• pp.84-91
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• 2022

An all-on-4 restoration allows edentulous patients to use a fixed prosthesis with a minimum number of implants. These implant-supported fixed complete dentures have traditionally been fabricated as screw-retained or cement-retained prostheses. However, it is difficult to passively fit the long-span full-arch prosthesis using the screw-retained type restoration, and predictable retrievability is not obtained with the cement-retained type. This case report describes a prosthesis fabricated using a combination of the two retention types. The screwmentable method allows the implant-supported fixed complete denture to achieve a passive fit at the connection with retrievability. In addition, a framework with an optimized size was designed by using digital dental technology.