• Title/Summary/Keyword: Labial bone

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Aesthetic implant restoration with alveolar bone graft and digital method on maxillary central incisor: a case report (치조골이식과 디지털 방법을 활용한 상악 중절치 임플란트 심미 수복 증례)

  • Jang, Han-Sol;Pyo, Se-Wook;Kim, Sunjai;Chang, Jae-Seung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.168-174
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    • 2022
  • In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.

Cases of screw-retained implant prosthesis in the anterior maxilla through multidisciplinary approach, including orthodontic teeth alignment (교정적 치아 재배열을 포함한 다학제적 접근(multidisciplinary approach)을 통한 상악 전치부의 나사 유지형 임플란트 보철 수복 증례)

  • Kim, Hyo-Seon;Lee, Won-Sup;Lee, Su-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.244-250
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    • 2020
  • The labio-palatal location of the implant in the maxillary anterior region is one of the important factors affecting the aesthetics of the implant prosthesis. However, the thin labial bone of maxilla could be absorbed in significant amounts after extraction of the teeth, which makes the implant be placed on the palatal side rather than the ideal location. In fact, in the cases of maxillary central incisor loss, UCLA was used for prosthetic restoration of palatally placed implant. In addition, with multidisciplinary treatment, GBR (Guided Bone Regeneration) was performed for compensating the absorbed alveolar bone and adjacent anterior tooth were aligned. Definitive restoration was performed after confirming aesthetic recovery of the gingiva with sufficient provisional restoration period. There were satisfactory results of functional and esthetic recovery of tooth loss through implant prosthesis.

Morphological difference of symphysis according to various skeletal types using cone-beam computed tomography (안면골격 유형에 따른 하악 전치 치조골의 형태 차이: Cone-beam CT를 이용한 정량적 평가)

  • Kwon, Hyun-Jin;Chun, Youn-Sic;Kim, Min-Ji
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.215-222
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    • 2014
  • Purpose: The aim of this study was to investigate differences between the morphology of the mandibular symphysis and four facial skeletal types. Materials and Methods: 40 cone-beam computed tomographies were selected and classified in to 4 groups according to their vertical and anterior-posterior skeletal patterns. The bone volume ($mm^3$) of the symphysis, the cross sectional area corresponding to the 4 mandibular incisors' axis: the cross sectional area of total bone ($mm^2$), the area of the cancellous bone ($mm^2$) and the thickness (mm) of labial and lingual alveolar bone at 2 mm, 3 mm under the cemento-enamel junction (CEJ) were measured. General linear model (GLM), Kruskal-Wallis test and Tukey honestly significant difference (HSD) test were subsequently used for statistical analysis. Results: The lingual cortical bone thickness of the lateral incisors at 2, 3 mm under CEJ was greater in the Class I low angle group than the other 3 groups (P < 0.05). There were no statistically significant differences in the volume of the mandibular incisor bony support, cross-sectional area of total bone and cancellous bone at the mandibular incisor' axis. Conclusion: Patients in Class I, low angle group have a thicker lingual mandibular symphysis than Class I, high angle patients.

THE TREATMENT OF CLASS III MALOCCLUSION USING FR-III (FR-III를 이용한 3급 부정교합 환자의 치험례)

  • Kwak, Ah-Ram;Park, Jae-Hong;Choi, Sung-Chul;Kim, Kwang-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.345-350
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    • 2008
  • In children with Class III malocclusion, it is important to identify whether the etiology is functional, dental, skeletal. FR-III developed by Rolf Frankel in 1970, has been used during deciduous, mixed, and early permanent dentition to correct class III malocclusion characterized by maxillary skeletal retrusion. According Frankel, the vestibular shields and upper labial pads act to counteract the forces of the surrounding musculature that restrict forward maxillary development and cause a retrusion in maxillary tooth position. This can achieve favorable developments with the basal bone, teeth and alveolar bone. We report FR-III that can be applicated in cases of early mixed dentition with mild maxillary deficiency and deepbite before the eruption of permanent maxillary incisor.

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A CASE OF PALATALLY IMPACTED INCISOR TREATED BY ONLAY TECHNIQUE WITH SURGICAL EXPOSURE (Onlay technique에 의한 매복중절치의 교정적 치험예)

  • Kim, Kwang-Hyun;Choie, Mok-Kyun;Bae, Chang
    • The korean journal of orthodontics
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    • v.4 no.1
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    • pp.57-61
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    • 1974
  • The patient, a girl of 19 years in good health, had a class I malocclusion. The maxillary left centra1 incisors and both lateral incisors had already erupted. But the space for the right central incisor was partially closed by the mesial drifting of the neighboring teeth. The caused a shift in the midline and a cross-bite relation on the incisors. X-ray examination revealed the presence of the right central incisor in the alveolar bone and odontoma just above the crown of the right central incisor. After enough space for the impacted incisor was created in the dental arch with a open-coil spring the rectangular incision was made. Removing the odontoma uncovered the flat surface of the labial aspect of the incisor. During the tooth had erupted of its own accord, any unnecessary force had been imposed on the tooth. When it was decided that the tooth should be brought out by the mechanical device, the gold cast onlay with hook was used and run a light elastic between this hook and the main arch wire. Finally the tooth was brought down to the arch level. The result was excellent. Fortunately the esthetic problem and any detrimental effects on the psychological make-up could be avoided.

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STRESS DISTRIBUTION OF ENDODONTICALLY TREATED TOOTH ACCORDING TO THE POST -THREE-DIMENSIONAL FINITE ELEMENT STUDY- (포스트가 치근내 응력분산에 미치는 영향에 관한 삼차원 유한요소법적 연구)

  • Lee, Sun-Hyung;Choi, Soo-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.34 no.4
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    • pp.780-790
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    • 1996
  • The endodontically treated tooth is generally restored with post and core, owing to the brittleness and the loss of large amount of tooth structure. Although there have been lots of studies about the endodontically treated teeth, the three-dimensional quantitative studies about the stress distribution of them are in rare cases. In this study, it was assumed that the coronal portion of the upper incisor had extensively damaged. After the root canal therapy it was post cored, and restored with PFG crown. The three-dimensional model, in which the root was supported with a normal alveolar bone, was constructed. Force was applied to the centric stop point with the angle of 135 degrees to the long axis of the tooth. Force was assumed to be 250N as functional maximum bite force of upper central incisors. The results analyzed with three-dimensional finite element method were as follows : 1. Stress was concentrated on the middle portion of the labial side dentin and the apical portion of the dentin. 2. Stress in the post was more concentrated on the post apex. 3. The displacement of the post at the post-cement interface was almost symmetrical la-bio-lingually. 4. It assumed that restoring extensively damaged tooth with a post-core and PFG crown is an adequate method of restoration.

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Surgical endodontic management of infected lateral canals of maxillary incisors

  • Jang, Ji-Hyun;Lee, Jung-Min;Yi, Jin-Kyu;Choi, Sung-Baik;Park, Sang-Hyuk
    • Restorative Dentistry and Endodontics
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    • v.40 no.1
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    • pp.79-84
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    • 2015
  • This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.

A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS ON THE LOCATION OF CENTER OF RESISTANCE DURING INTRUSION OF UPPER ANTERIOR TEETH (상악 전치 intrusion시 저항중심의 위치에 관한 3차원 유한요소법적 연구)

  • Park, Chun-Keun;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.259-272
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    • 1997
  • This study was performed to locate the anteroposterior position of the center of resistance of upper anterior teeth when intrusive forces are acted on them by applying segmented arch mechanics. Three-dimensional finite element model of upper six anterior teeth, periodontal ligament and alveolar bone was constructed The locations of the center of resistance were compared according to the three variables, which are number of teeth contained in anterior segment, axial inclination of anterior teeth, and degree of alveolar bone loss. The following conclusions were drawn from this study; 1. When the axial inclination and alveolar bone height were normal, the locations of center of resistance of anterior segment according to the number of teeth contained were as follows; 1). In 2 teeth segment, the center of resistance was located in the distal area of lateral incisor bracket 2) In 4 teeth segment, the center of resistance was located in the distal 2/3 of the distance between the brackets of lateral incisor and canine. 3) In 6 teeth segment, the center of resistance was located in 3mm distal of canine bracket, which is interproxirnal area. between canine and 1st premolar. 4) As the number of teeth contained in anterior segment increased, the center of resistance shifted to the distal side. 2. As the labial inclination of incisors increased, the center of resistance shifted to the distal side. 3. As the alveolar bone loss increased, the center of resistance shifted to the distal side.

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A study on sagittal root position of maxillary anterior teeth in Korean (한국인에서 상악 전치의 시상 치근 위치에 대한 연구)

  • Kong, Hyun-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.2
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    • pp.88-94
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    • 2020
  • Purpose: The purpose of this study was to analyze the sagittal root position of maxillary anterior teeth and report the frequency of each classification in Korean for immediate implant placement. Materials and Methods: A retrospective review of cone-beam computed tomography (cone-beam CT) images was conducted on 120 patients (60 male and 60 female) who fulfilled the inclusion criteria. After reorientation of the axis, cone-beam CT images were evaluated and the relationship of the sagittal root position (SRP) of the maxillary anterior teeth to its associated osseous housing was recorded. Class I, II, and III were classified respectively when the root was positioned on the labial, central, and palatal aspect of the alveolar bone. Class IV was the position that at least two thirds of the root is engaging both the labial and palatal cortical plates. Then, the angulation of the root axis and the alveolar bone axis was measured. Descriptive statistics and Kruskal-Wallis test were used to compare the angulation according to the root position and SRP class. Results: The frequency distribution of sagittal root position of maxillary anterior teeth indicated that 81.1%, 10.3%, 1.9%, and 6.7% were classified as Class I, II, III, and IV, respectively. The sagittal angulation at approximately 77.5% of central incisor, lateral incisor, and canine was < 20 degrees, but the angle at more than 42.7% of canine was ≥ 20 degrees. Within the class, the angulation was statistically significantly greater in Class I (16.19) compared to Class II (8.72) and Class III (9.93), and smaller in Class IV (3.79). Conclusion: Within the limitation of this study, a majority of the maxillary anterior roots were positioned close to the buccal cortical plate. However, some roots have very thin alveolar bone and sagittal angulation larger than 30 degrees. Therefore, cone-beam CT analyses of the sagittal root position and the sagittal angulation are recommended for the selection of the appropriate dental implant treatment approach.

ERUPTING GUIDANCE OF IMPACTED MAXILLARY PERMANENT INCISOR WITH APICALLY REPOSITIONED FLAP (근단 변위 판막술을 이용한 상악 영구 절치의 맹출 유도)

  • Im, Ye-Jin;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.512-518
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    • 2010
  • The impaction of the maxillary permanent incisor is a common clinical problem and is mostly found at the "labial to the alveolar process." Surgical exposure and orthodontic treatment with fixed orthodontic appliances can be considered if normal eruption of the labillay impacted tooth is not expected. Surgical exposure of the impacted tooth, that is usually under the attached gingiva or is surrounded by alveolar bone through gingivectomy and removal of alveolar bone, may give a rise to complications such as diminution in the width of the attached gingiva, inflammation of the gingiva, and the loss of marginal alveolar bone. Therefore, closed eruption technique, which includes surgical exposure and orthodontic treatment with fixed orthodontic appliances followed by repositioning of surgical flap, is preferred. However, apically repositioned flap of the impacted tooth, which is beneath the movable submucosal area or is above the alveolar crestal area, can prevent unwanted exposures and facilitate successful tooth eruption. In this report, we described esthetic results of three patients with unerupted maxillary permanent incisor who were performed with an apically positioned flap without the loss of attached gingiva.