• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.290-297
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• 2008

STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. $4.1{\times}10$ mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 1-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 1-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 2-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 2-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N, it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2- 3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.382-394
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• 2022

The treatment of patients with severe periodontitis should be proceeded step-bystep through an accurate diagnosis of each patients' individual tooth and with a strategic treatment plan. Implant-supported fixed prosthetic restoration has the advantage of high patient satisfaction and stable vertical dimension compared to the removable partial denture. However, multiple teeth defect areas lacking hard tissue may be disadvantageous in aesthetic failure and longer treatment time. In addition, it takes a certain period of time to manufacture and install a conventional fixed prosthesis, and during this process, the provisional prosthesis must satisfy the mechanical, biological, and aesthetic requirements of teeth. The purpose of this article is to describe the fabrication of implant-supported fixed prosthesis through a step-by-step approach in a partially edentulous patient.

• The Journal of Advanced Prosthodontics
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• v.5 no.2
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• pp.209-217
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• 2013

This clinical report presents the reconstruction of a maxillary arch with a cement retained implant supported fixed prosthesis using a monolithic zirconia generated by CAD/CAM system on eight osseointegrated implants. The prosthesis was copy milled from an interim prosthesis minimizing occlusal adjustments on the definitive prosthesis at the time of delivery. Monolithic zirconia provides high esthetics and reduces the number of metal alloys used in the oral cavity.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.214-220
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• 2013

Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported- overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.221-225
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• 2013

Proper management of provisional prosthesis is key to success in prosthodontics. Provisional restoration on maxillary anterior missing area frequently come across a incident of falling off especially in patients with long span pontics and oval arch shape. This is because maxillary anterior teeth are more exposed to horizontal force than the posterior teeth and additional anterior cantilever effect will negatively affect to the retention of provisional prosthesis. Beside that maxillary anterior provisional prosthesis should provide proper incisal guidance during the mandibular functional movements. However occlusal contacts on the prosthesis in maximum intercuspal position are located on opposite side of fulcrum line of prosthesis which will cause removing force against the provisional prosthesis. This case report present that provisional implant prevent pre-described harmful effect on maxillary anterior fixed provisional prosthesis and provide comfort and satisfactory result during post-extraction healing period.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.51-57
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• 2013

Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial. In this study, the current status of implant occlusion was reviewed and discussed. Further randomized clinical research to investigate the correlation between implant occlusion, the implant success rate, and its risk factors is warranted to determine best clinical practices.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.1
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• pp.63-72
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• 2023

When oral restoration is performed with a full mouth implant-supported fixed restoration in an edentulous patient, it is very important to determine the shape and position of the definitive prosthesis in consideration of the anatomical state and the relationship with the antagonist, and the process of placing multiple implants in the planned direction and angle is very important. In this case, implants were ideally planned based on an upper prosthesis through a computer-guided surgical procedure for an edentulous maxillary patient who visited due to discomfort in the existing denture. Through this, we would like to report this because we obtained satisfactory functional and esthetic results for both the patient and the operator with the treatment of oral restoration by manufacturing a fixed prosthesis for maxillary and full jaw implants.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.131-139
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• 2024

In a edentulous patient, various methods can be employed for prosthetic treatment using implants, such as implant-supported fixed prostheses, overdentures, hybrid prostheses, and implant assisted removable partial denture. In this case, in a patient with moderate to severe chronic periodontitis requiring full arch extractions, implants were strategically placed using computer-guided surgery. In the maxilla, due to inadequate bone quality and quantity leading to insufficient initial stability, delayed loading was implemented, and interim prosthesis was used during the osseointegration period. In the mandible, stable initial stability was achieved, allowing for immediate loading to reduce patient discomfort. Primary stability is considered the most crucial factor for obtaining immediate loading, so a thorough clinical and radiological evaluation of the remaining alveolar bone quantity and quality must be conducted before surgery.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.8 no.1
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• pp.46-59
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• 1999

A fixed bridge is preferred as a prosthetic option supported by oral implants. However, it is very difficult to re tore edentulous maxilla with fixed prosthesis in cases with improper position and angulation of fixtures, abnormal jaw relation, and need for proper lip support. Six Br${\aa}$nemark implants were installed in edentulous maxilla opposing mandible with natural dentition. A removable hybrid prosthesis attached to a bar milled by 6 degrees was therefore designed to overcome such disadvantages of fixed prosthesis. Lateral stabilization of removable prosthesis was obtained by framework closely fitting the milled bar. Support for the prosthesis was ensured by three elevated areas on the bar. Two precision attachments(CEKA REVAX) provided appropriate direct and indirect retention without influencing support. A clinical and laboratory procedure was presented.

• The Journal of Advanced Prosthodontics
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• v.7 no.3
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• pp.264-270
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• 2015

This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene.