The technology of precision attachments has developed at such a pace that from a very few T-shaped attachments and bar attachments from the years 1915 to 1935 since removable bridge utilizing a T-shaped intracoronal attachment was constructed by Dr. Herman E.S. Chayes in 1906. There are now more than 120 models of the most diversified designs, ready made or laboratory fashioned. In 1971, 126 attachments were listed and classified by Mensor in his E M Attachment Selector. This selector consists of five charts giving specifications as to type, vertical dimensions, application, type of resilience, size of movement, type of retention and type of material and alloy. Thus the E M Attachment Selector is a useful guide for dentists to choose the attachment for his patients. But dentists should apply the attachment in each patient's case according to an accurate diagnosis and treatment plan. This paper is a case report of removable partial dentures utilizing CSP, PD and Bar attachment on a patient who needed full mouth reconstruction. Patient has right first, second molar and left first molar on the upper arch and also left first molar, first premolar and right canine on the lower arch. (Fig. 5)All remaining teeth are relatively healthy in their supporting tissues. On upper arch, ring shape CSP attachment was designed on left first molar and modified ring shape CSP attachment was designed on right first and second molar as the direct retainer of the removable partial denture. Full palatal coverage was used as the major connector in this case. (Fig. 23) On lower arch, author first splinted with a fixed bridge between left first molar and second premolar and a splint bar between left second premolar and right canine. (Fig. 11) A lower removable partial denture in which was designed with an Aker clasp on the left first molar and a PD attachment on .the right canine was constructed. (Fig. 17) This denture could get additional support from anterior splint bar. After both removable partial dentures were delivered to the patient (Fig. 26), author evaluated function of the dentures and supporting structures of the abutment teeth by means of clinical and X-ray examinations for eighteen months. According to the examination data author came to the conclusion that the prognosis of this case was excellent.
Statements of problem: All ceramic fixed partial denture cores can be made by the slip casting method and the advanced alumina tape method. The fracture resistance of these core connector areas is relatively low. Purpose: The purpose of this study is to standardize the appropriate volumetric figure and location of the connectors in the alumina core fabricated in alumina tape to be used in fixed partial dentures by way of topology optimization. Material and method: A maxillary anterior three-unit bridge alumina core with teeth form and surrounding periodontal apparatus model was used to ultimately design the most structurally rigid form of the connector. Loadings from a $0^{\circ}$, $45^{\circ}$ and $60^{\circ}$ to the axis of each tooth were applied and analyzed with the 3-D finite element analysis method. Using the results from these experiments, the topology optimization was applied and the optimal reinforcement layout of connector was obtained and the detail shape in the fixed partial denture core was designed. Results: The modified prosthesis with the form of a bulk in the lower lingual surface of the connector in the event, reduced the stress concentration up to 20% in the 3-D FEA. Conclusion: The formation of a bulk in the lower lingual connector area of an alumina core for a fixed partial denture decreases the stress to a clinically favorable measure but does not harm the esthetic point of view. This result illustrates the possibility of clinical application of the modified form designed by the topology optimization method.
In this study, effects of incision of retrodiscal tissue and unilateral occlusal reduction on temporomandibular joint of rabbit were investigated. Twenty-seven adult New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study. Temporomandibular joint surgery was performed in left temporomandibular joint of 24 rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc. They were divided into two groups : twelve were left untreated after surgery, occlusal reduction was performed on left posterior teeth every 2 weeks in the other twelve rabbits, The remaining three served as the control group. The sample were sacrificed by 8, 12, and 16 weeks after surgery. Histologic examinations were performed after sacrificing them. The results were as follows : 1. Histologic findings which were manifested by flat articular fossa, broad articular surface, generalized recession of articular cartilage and sclerosis of subchondral bone were observed. These findings were similar to internal derangement. 2. In the rabbits untreated after surgery, thin cartilagenous layer and necrotic tissue were observed in 8 weeks group, calcifying cartilagenous layer was observed in 12 weeks group, and cartilagenous layer on anterior portion was observed in 16 weeks group. So, it showed gradual healing pattern into the normal tissue except displaced disc. 3. Occlusal trauma after surgery resulted in generalized recession of upper and lower articular surface. Necrosis and vertical split on condylar process of mandible were observed in 8 weeks group. Osteoclasts, exposure of subchondral bone due to erosion on upper and lower articular surface, and degenerative changes on retrodiscal tissue were observed in 16 weeks group. So, it showed continuous prowess pattern of osteoarthrosis.
For the determination of instantaneous centre of rotation in the mandibular movement, the habitual opening path was recorded on the sagittal tracing plate by a Gnathorecorder attached on the lower anterior teeth which was designed for this study. The opening path was demonstrated mathematically and the instantaneous centre of rotation in the opening path were calculated and plotted by computer programs, and then a computer graphic movement of the mandible was obtained according to the opening path. The hinge path of posterior border movement was graphied by the Gnathorecorder as well and demonstated mathematically. This hinge path was compared with the same obtained by Visitrainer to prove a reliability of the Gnathorecorder. The results obtained from this study were as follows. 1. The habitual opening path and hinge path obtained from the Gnathorecorder movement were expressed mathematically as follows: $y=0.11x^2-0.66x+3.09$ (equation of opening path), $y=0.04x^2+0.21x+3.71$ (equation of hinge path), and a kinematic hinge axis was not shown in the equation of kings path. 2. The early habitual opening movement of the mandible demonstrated almost a straight opening path or an arc motion with the larger radius and it's centre of rotation moved parallelly in the more rear and lower position than a kinematic hinge axis. 3. Instantaneous centre of rotation occured along with the translation of the condyle, and mandible was rotated around an axis in the close to the maximum opening and then moved toward the forward and upward position. 4. There were some similarities between the articular eminence and the movement pattern of a special point which was the kinematic hinge axis.
Journal of the korean academy of Pediatric Dentistry
/
v.25
no.1
/
pp.134-143
/
1998
Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.
Kim, Ji-Hee;Choi, Byung-Jai;Kim, Seong-Oh;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
Journal of the korean academy of Pediatric Dentistry
/
v.35
no.3
/
pp.532-538
/
2008
Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence or decrease in activity of hypoxanthine guanine phosphoribosyl transferase(HPRT), an enzyme involved in purine metabolism. This enzyme deficiency gives rise to nephropathy symptoms, such as hyperuricosuria and hyperuricemia by excessive uric acid production and neuropathy symptoms, such as mental retardation, choreoathetosis and self mutilation behavior. Patients with Lesch-Nyhan syndrome have tendency to bite their lip, tongue and finger. In severe cases, partial or even total amputation of tongue or finger occur. Self-inflicted bites are often complicated by secondary infection to the injured site as well as pain. Furthermore tissue loss by biting results in esthetic problems. The dental management of self mutilation includes treatment with appliances such as soft mouth guard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a case of a 13 year-old boy with Lesch-Nyhan syndrome, who severely injured himself on his tongue. At first, conservative treatment using soft mouth guard was considered, but it could not prevent trauma on his tongue. Therefore, extraction of the lower anterior and posterior teeth was carried out.
The purpose of this study was to evaluate the shear bond strength of three light-cured glass ionomer cements to blood contaminated bovine dentin. The materials used in this study were Fuji II LC, Dyract and Variglass VLC. The dentin conditioners were 10% polyacrylic acid, 10% maleic acid and 10% phosphoric acid. 180 lower anterior bovine teeth were selected in this study. The teeth were embedded in acrylic resin and were grounded with 320 to 600 grit silicon carbide paper to create a flat dentin surface. The teeth were divided into SIX groups. The experimental procedures in six groups were as follows; Group l(GF) : Samples bonded to dentin surface with Fuji II LC after 10% polyacrylic acid treatment. Group 2(BGF) : Samples bonded to dentin surface with Fuji II LC after 10% polyacrylic acid treatment and blood contamination. Group 3(MD) : Samples bonded to dentin surface with Dyract after 10% maleic acid treatment. Group 4(BMD) : Samples bonded to dentin surface with Dyract after 10% maleic acid treatment and blood contamination. Group 5(PV) : Samples bonded to dentin surface with Variglass VLC after 10% phosphoric acid treatment. Group 6(BPV) : Samples bonded-to dentin surface with Variglass VLC after 10% phosphoric acid treatment and blood contamination. Group 1,3 and 5 were classified into the control groups, while group 2,4 and 6 were classified into the experimental groups. Each group contained 30 samples. After 24 hours water storage at $37^{\circ}C$, all smples were subjected to a shear load to fracture at a cross head speed of 1.0 mm/min with Instron universal testing machine(No. 4467). Debonded surfaces were observed under Scanning Electron Microscope(Hitachi S-2300) at 20kvp. The data were evaluated statistically at the 95% confidence level with Student's t-test. The following results obtained; 1. Shear bond strengths were higher in the control groups(1,3,5 group) than in the experimental groups(2,4,6 group). 2. The shear bond strength of group 5(PV) was the highest in the control groups, and the group 5 was significantly higher than the group l(GF) on the shear bond strength. 3. The group 4(BMD) was the highest on the shear bond strength, and the group 2(BGF) was the lowest in the experimental groups. The group 4(BMD) and 6(BPV) showed a significant difference with the group 2 on the shear bond strength. 4. All the groups showed an adhesive-cohesive failure. except the group 2(BGF) showing adhesive failure.
The purpose of this study is to determine if a relationship exists among osteoporosis, alveolar bone density and periodontal disease in postmenopausal osteoporotic women and postmenopausal healthy women. Twenty-two women were evaluated for this study. They were attending the postmenopausal clinic, Seoul National University Hospital and generally healthy except osteoporosis. They had experienced menopause not less than one year when we began to examine them. Bone densities of lumbar area(L2-L4) was determined by DEXA(LUNAR-expert Co,. U.S.A). We diagnosed osteoporosis when T-score was below -2.5 and healthy state when T-score was over -1. Osteoporotic(10 female), not hormone-treated group and healthy control group(12 female) were asked for their age, menopausal age, menopausal period and the number of remaining teeth and examined clinically for plaque index(PI), gingival index(GI), clinical attachment loss(CAL) on their 6 Ramfjord index teeth. Intraoral radiographs were taken in maxillary anterior zone. All films were equally exposed and developed. Each films was digitized and analysed using image processing software, Scion image. Alveolar bone regions of interest were selected and Intensity of each pixel was quantized in the array ranging from 0(white) to 255(black). The two groups were comparable with respect age, menopausal age, menopausal period and number of remaining teeth. The osteoporotic women had significantly lower alveolar bone density than controls in maxilla. But no significant difference was found with respect clinical attachment loss, plaque index and gingival index. Supported by the Ministry of Public Health and Welfare, Korea (HMP-00-CH-10-0009).
Journal of the korean academy of Pediatric Dentistry
/
v.46
no.1
/
pp.29-37
/
2019
The purpose of this study was to investigate the characteristics of intrusion in primary dentition and to evaluate factors influencing complications of primary and permanent dentition during long-term follow-up period. 61 patients (84 teeth) were selected in this study. Medical records of 61 patients were reviewed and age, gender, cause of injury, site of injury, severity of traumatic injury, other injuries associated with trauma, treatment method, and complications of primary and permanent dentition were examined. Collected data were statistically evaluated using Chi-square test and Fisher's exact test. Intrusion in primary anterior teeth was predominant in boys over girls and fall was the most common cause of trauma. It was most common at home and occurred most in the primary maxillary central incisors. Severity had an effect on the incidence of sequelae in permanent successors (p = 0.014). The incidence of complications was significantly lower in patients with soft tissue injuries than in patients with other periodontal injuries (p = 0.000).
Journal of the korean academy of Pediatric Dentistry
/
v.28
no.4
/
pp.694-699
/
2001
The prognosis for class III patients in growing child can be made in mixed dentition and the severity of the symptom is often amenable to early intervention. Class III malocclusion can be classified as functional class lit and skeletal origin. Skeletal Class III malocclusion is usually characterized by overdeveloped mandible, underdeveloped maxilla, but the cause of pseudo class III is most dentoalveolar or functional shift of mandible. The primary goal of early intervention of malocclusion is to supply an environment that is conducive to the development of favorable occlusal relationships and avoiding of worsening of the problems. Inverted labial bow appliance is introduced as an appliance to combine the advantage of active plate and activator. It is undemanding with this appliance to initiate not only dentoalveolar expansion of upper dentition but also to orient the functional retrusion of mandible. With simple design the compliance for patients such as mouth breathing problem can be improved. For successful use of this appliance it is utmost important to make accurate and early diagnosis between pseudo- and skeletal class III malocclusion. This article will demonstrate the use of an Inverted labial bow appliance for early treatment of a functional Class III malocclusion. After 4 month treatment, anterior crossbite was treated and the results were achieved mainly dentoalveolar change of upper and lower anterior teeth.
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