• Title/Summary/Keyword: Mandibular Fractures

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Fracture resistance of implant- supported monolithic crowns cemented to zirconia hybrid-abutments: zirconia-based crowns vs. lithium disilicate crowns

  • Elshiyab, Shareen H;Nawafleh, Noor;Ochsner, Andreas;George, Roy
    • The Journal of Advanced Prosthodontics
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    • v.10 no.1
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    • pp.65-72
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    • 2018
  • PURPOSE. The aim of this in vitro study was to investigate the fracture resistance under chewing simulation of implant-supported posterior restorations (crowns cemented to hybrid-abutments) made of different all-ceramic materials. MATERIALS AND METHODS. Monolithic zirconia (MZr) and monolithic lithium disilicate (MLD) crowns for mandibular first molar were fabricated using computer-aided design/computer-aided manufacturing technology and then cemented to zirconia hybrid-abutments (Ti-based). Each group was divided into two subgroups (n=10): (A) control group, crowns were subjected to single load to fracture; (B) test group, crowns underwent chewing simulation using multiple loads for 1.2 million cycles at 1.2 Hz with simultaneous thermocycling between $5^{\circ}C$ and $55^{\circ}C$. Data was statistically analyzed with one-way ANOVA and a Post-Hoc test. RESULTS. All tested crowns survived chewing simulation resulting in 100% survival rate. However, wear facets were observed on all the crowns at the occlusal contact point. Fracture load of monolithic lithium disilicate crowns was statistically significantly lower than that of monolithic zirconia crowns. Also, fracture load was significantly reduced in both of the all-ceramic materials after exposure to chewing simulation and thermocycling. Crowns of all test groups exhibited cohesive fracture within the monolithic crown structure only, and no abutment fractures or screw loosening were observed. CONCLUSION. When supported by implants, monolithic zirconia restorations cemented to hybrid abutments withstand masticatory forces. Also, fatigue loading accompanied by simultaneous thermocycling significantly reduces the strength of both of the all-ceramic materials. Moreover, further research is needed to define potentials, limits, and long-term serviceability of the materials and hybrid abutments.

Mandibular implant-natural tooth retained overdenture using magnetic attachment with stress breaker (하악에서 완압형 자성 어태치먼트를 부착한 임플란트-자연치 피개 의치: 10년 증례보고)

  • Park, Eun-Chul;Lee, Su-Yeon;Kim, Hee-Jung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.378-386
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    • 2015
  • Overdenture has the advantage of improving the stability and retention of the denture but the abutment may be easily affected by caries or periodontal disease and the thin denture can be easily broken. The magnetic attachment overdenture has a high vertical retention but a low horizontal retention, thus, exerting a less disruptive force to the abutment or implant and shows less abrasion or damage compared to other mechanical retainers. Denture fractures in overdenture is caused by the thin denture base as the attachment is inserted, but it may also be caused by the difference in detrusion between soft tissue and hard tissue, and between an implant and a natural tooth. To compensate this shortcoming, a magnetic attachment with a silicone ball inserted in the magnet was developed as we report a successful case using this specific type of magnetic attachment overdenture.

FUNCTIONAL TREATMENT OF PEDIATRIC CONDYLAR FRACTURES : A CASE REPORT (Activator를 이용한 소아의 하악과두골절의 치험례)

  • Lee, Jung-Ha;Park, Heon-Dong;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.477-482
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    • 2003
  • The pediatric condylar fracture occurs very frequently in the mandible, but this injury is occasionally ignored due to difficulty of diagnosis and no cooperation of patient. The adequate initial diagnosis and active treatment must be performed because delayed and improper treatment lead to possible severe complication such as TMJ ankylosis and reta rdation of mandibular development. Most pediatric condylar fracture is mainly performed by the conservative or functional treatment, but it may be required open reduction according to cases. In this study, activator is applied for functional treatment of pediatric condylar fracture and fair recovery of jaw function is acquired.

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A Retrospective Clinical Study of Survival Rate for a Single Implant in Posterior Teeth (구치부 단일 임플란트의 생존율에 대한 후향적 연구)

  • Han, Sung-Il;Lee, Jae-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.3
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    • pp.186-199
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    • 2012
  • Purpose: Single implants, of which screw loosening has been observed frequently, presents problems such as fixtures fractures, marginal bone loss, and inflammation of the soft tissue around the implant. However, the single implant is more conservative, cost effective, and predictable compared to the 3 unit bridge with respect to the long-term outcome. This study evaluated the survival rate as well as future methods aimed at increasing the survival rate in single implants in posterior teeth. Methods: Among the implants placed in the Dankook University Dental Hospital department of Oral & Maxillofacial surgery from January 2001 to June 2008, 599 implants placed in the maxillar and mandibular posterior were evaluated retrospectively. Survival rates were investigated according to implant location, cause of tooth loss, gender, age, general disease, fixture diameter and length, surface texture, implant type and shape, presence of bone graft, surgery stage, surgeons, bone quality and opposite teeth. Results: Out of 599 single implants in posterior teeth, 580 implants survived and the survival rate was 96.8%. The difference in survival rate was statistically significant according to the implant location. The survival rate was low (84.2%) in implants exhibiting a wide diameter (${\geq}5.1mm$) and the surface treated by the acid etching group demonstrated a significantly lower survival rate (91.1%). One stage surgical procedure, which implemented a relatively better bone quality survival rate (100%), was higher than the two stage surgical procedure (96.1%). The survival rate of type IV bone quality (75%) was significantly lower than the other bone quality. Conclusion: Single posterior teeth implant treatments should use an improved surface finishing fixture as well as careful and safe procedures when performing implant surgery in the maxilla premolar and molar regions since bone quality is poor.

A CLINICAL STUDY ON PULMONARY FUNCTION AFTER INTERMAXILLARY FIXATION (악간고정이 호흡기능에 미치는 영향에 대한 임상적 연구)

  • Kim, Chul-Hwan;Kim, Mi-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.361-366
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    • 1999
  • Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.

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Osteocutaneous flaps for head and neck reconstruction: A focused evaluation of donor site morbidity and patient reported outcome measures in different reconstruction options

  • Kearns, Marie;Ermogenous, Panagiotis;Myers, Simon;Ghanem, Ali Mahmoud
    • Archives of Plastic Surgery
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    • v.45 no.6
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    • pp.495-503
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    • 2018
  • With significant improvements in success rates for free flap reconstruction of the head and neck, attention has turned to donor site morbidity associated with osteocutaneous free flaps. In this review, we address the morbidity associated with harvest of the four most commonly used osteocutaneous flaps; the free fibula flap, the scapula flap, the iliac crest flap and the radial forearm flap. A comprehensive literature search was performed to identify articles relevant to donor site morbidity for these flaps. We assessed morbidity in terms of incidence of delayed healing, chronic pain, aesthetic outcomes, site specific complications and patient satisfaction/quality of life. Weighted means were calculated when sufficient studies were available for review. The radial forearm and free fibula flaps are associated with high rates of delayed healing of approximately 20% compared to the scapular (<10%) and iliac flaps (5%). The radial forearm flap has higher rates of chronic pain (16.7%) and dissatisfaction with scar appearance (33%). For the majority of these patients harvest of one of these four osteocutaneous does not limit daily function at long-term follow-up. The scapular osteocutaneous flap is associated with the lowest relative morbidity and should be strongly considered when the recipient defect allows. The radial forearm is associated with higher morbidity in terms of scarring, fractures, chronic pain and wrist function and should not be considered as first choice when other flap options are available.

Low-shrinking composites. Are they reliable for bonding orthodontic retainers?

  • Uysal, Tancan;Sakin, Caglar;AI-Qunaian, Talal
    • The korean journal of orthodontics
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    • v.41 no.1
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    • pp.51-58
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    • 2011
  • Objective: To evaluate the shear bond strength (SBS), fracture mode, wire pull out (WPO) resistance and microleakage between low-shrinking and conventional composites used as a lingual retainer adhesive. Methods: A total of 120 human mandibular incisor teeth, extracted for periodontal reasons, were collected. Sixty of them were separated into two groups. To determine the SBS, either Transbond-LR (3M-Unitek) or Silorane (3M-Espe) was applied to the lingual surface of the teeth by packing the material into standard cylindrical plastic matrices (Ultradent) to simulate the lingual retainer bonding area. To test WPO resistance, 20 samples were prepared for each composite where the wire was embedded in the composite materialand cured. Then tensile stress was applied until failure of the composite occurred. The remaining 60 teeth were divided into two groups and multi-stranded 0.0215-inch diameter wire was bonded with the same composites. Microleakage was evaluated by the dye penetration method. Statistical analyses were performed by Wilcoxon, Pearson chi-square, and Mann-Whitney-U tests at p < 0.05 level. Results: The SBS and WPO results were not statistically significant between the two groups. Significant differences were found between the groups in terms of fracture mode (p < 0.001). Greater percentages of the fractures showed mix type failure (85%) for Silorane and adhesive (60%) for Transbond-LR. Microleakage values were lower in low-shrinking composite than the control and this difference was found to be statistically significant (p < 0.001). Conclusions: Low-shrinking composite produced sufficient SBS, WPO and microleakage values on the etched enamel surfaces, when used as a lingual retainer composite.

RESORBABLE PLATES FOR THE FIXATION OF MANDIBULAR FRACTURES: CASE REPORTS AND REVIEW OF THE LITERATURE (하악골 골절 치료시 생체 흡수성 고정판 사용: 증례 보고 및 문헌고찰)

  • You, Jae-Seek;Kim, Su-Gwan;Kim, Hak-Kyun;Moon, Seong-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.2
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    • pp.182-190
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    • 2008
  • Fracture of mandible is the most frequent fracture among many types of maxillofacial fracture, and reduction of mandible fracture is performed using various methods of treatment to maintain bonding strength of fractured bone. Among these treatment of bone fracture, a semirigid fixation method which can reduce the period of intermaxillary fixation using metal mini plate under general or local anesthesia is spotlighted these days. The metal mini plate used during this semirigid fixation procedure is Titanium which is bio-inactive one and was used widely, but because the side effect of fracture reduction using titanium have been demonstrated recently, fracture reduction using biodegradable plate become to attract people's attention. The purpose of this study was to report the clinical case and review of the literature with the reduction of mandible fracture using biodegradable plate.

Treatment of large sized cystic lesion of the jaws with specific appliance for decompression:cases report (악골 내 거대 낭종성 병소의 감압술을 위해 고안된 장치를 이용한 치험례: 증례보고)

  • Jang, Chang-Su;Kim, Ju-Won;Yang, Seung-Bin;Yim, Jin-Hyuk;Kim, Jwa-Young;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.2
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    • pp.133-136
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    • 2011
  • Cystic lesions on the jaws with expansion can invade the adjacent anatomical structure, infiltrate and expand the jaws, cause facial deformity, etc. There is great potential for pathologic fractures after cyst enucleation, and damage to the major structures like the nerve, artery. For these reasons, marsupialization and decompression are commonly used to reduce the cystic size. In 1947, Thomas first mentioned decompression that reduces the osmotic pressure in a cyst by making a hole in the cyst and insert a drain. In our cases, a large sized cystic lesion was treated with a specific device made from an orthodontic band and spinal needle. This device is easy and effective for applications and self irrigation.

Influence of modification in core building procedure on fracture strength and failure patterns of premolars restored with fiber post and composite core

  • Kim, Young-Hoi;Lee, Jong-Hyuk
    • The Journal of Advanced Prosthodontics
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    • v.4 no.1
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    • pp.37-42
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    • 2012
  • PURPOSE. The influence of the modified process in the fiber-reinforced post and resin core foundation treatment on the fracture resistance and failure pattern of premolar was tested in this study. MATERIALS AND METHODS. Thirty-six human mandibular premolars were divided into 4 groups (n = 9). In group DCT, the quartz fibre post (D.T. Light-post) was cemented with resin cement (DUO-LINK) and a core foundation was formed with composite resin (LIGHT-CORE). In group DMO and DMT, resin cement (DUO-LINK) was used for post (D.T. Lightpost) cementation and core foundation; in group DMO, these procedures were performed simultaneously in one step, while DMT group was accomplished in separated two steps. In group LCT, the glass fiber post (LuxaPost) cementation and core foundation was accomplished with composite resin (LuxaCore-Dual) in separated procedures. Tooth were prepared with 2 mm ferrule and restored with nickel-chromium crowns. A static loading test was carried out and loads were applied to the buccal surface of the buccal cusp at a 45 degree inclination to the long axis of the tooth until failure occurred. The data were analyzed with MANOVA (${\alpha}$= .05). The failure pattern was observed and classified as either favorable (allowing repair) or unfavorable (not allowing repair). RESULTS. The mean fracture strength was highest in group DCT followed in descending order by groups DMO, DMT, and LCT. However, there were no significant differences in fracture strength between the groups. A higher prevalence of favorable fractures was detected in group DMT but there were no significant differences between the groups. CONCLUSION. The change of post or core foundation method does not appear to influence the fracture strength and failure patterns.