• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.519-526
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• 2000

Osteoporosis has recently been recognized as a major health problem in the elderly population. The disorder is manifested as a loss of bone mass accompanied by structural alteration of bone and increased incidence of fracture. Mandible also may be affected. So, I evaluated panoramic views of 66 postmenopausal women for finding the possibility of useful diagnostic mandibular parmeters of osteoporosis. To know the correlationship between skeleton and mandible, the average of the bone mineral density of lumbar from 2nd to 4th by the dual energy X-ray absorptiometry(DEXA, LUNAR DPZ. USA), and age and mandibular parameters, that is, the number of residual teeth, alveolar ridge resorption ratio, panoramic mandibular index (PMI), mandibular cortical width (MCW), angular cortical thickness (ACT), ramus cortical thickness (RCT), morphology of mandibular inferior cortical (MIC) were compared. And I divided the all tested women to the osteoporotic group and non-osteoporotic group by the use of T-score -2.0, which was derived from skeletal bone mineral density (BMD). To find the correlationship of the each group with mandibular parameters, t-test and discriminant analysis were done. The results of the t-test were that all parameters were highly related with 2 groups (p<0.05). Especially ACT, MIC, age have had even higher correlationship than others (p<0.001). The results of the discriminant analysis by the use of these ACT, MIC and age were that the discriminant function was Z = -2.973+(-1.447)$\times$(ACT)+1.131$\times$(MIC score)+(0.052)$\times$(age), the cutting score was 0.257 and the classification accuracy was 84.8%. Therefore I suggest that the consideration of the angular cortical thickness (ACT), the age of patient and the morphology of mandibular inferior cortical(MIC) may help find the osteoporosis.

• The Journal of Advanced Prosthodontics
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• 제13권1호
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• pp.55-64
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• 2021

PURPOSE. To investigate the biomechanical effect of marginal bone resorption (MBR) on the mandibular mini implant (MI)-retained overdenture (MI-OD) on the edentulous model. MATERIALS AND METHODS. The experimental mandibular edentulous model was modified from a commercial model with 2 mm thick artificial soft tissue under denture base. Two MIs (Φ2.6 mm × 10 mm) were bilaterally placed between the lateral incisor and the canine area and attached with magnetic attachments. Three groups were set up as follows: 1) alveolar bone around the MI without MBR (normal group), 2) with MBR to 1/2 the length of the implant (resorption group), and 3) complete denture (CD) without MI (CD group). Strain around the MI, pressure near the first molar area, and displacement of denture were simultaneously measured, loading up to 50 N under bilateral/unilateral loading. Statistical analysis was performed using independent-samples t test and one-way ANOVA (α=.05). RESULTS. The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure in CD was higher than in MI-ODs (P<.05), while there was no statistical difference between the normal and resorption group (P>.05). Similarly, the CD demonstrated a greater displacement of the denture base than did the MI-ODs during bilateral and unilateral loadings (P<.05). CONCLUSION. The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure on posterior alveolar ridge and denture displacement of MI-ODs significantly decreased compared to CDs, even when MBR occurs. Bilateral balanced occlusion was recommended for MI-ODs, especially when MBR occurred.

• The Journal of Advanced Prosthodontics
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• 제6권5호
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• pp.361-371
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• 2014

PURPOSE. In case of large horizontal discrepancy of alveolar ridge due to severe resorption, cantilevered crown is usually an unavoidable treatment modality. The purpose of this study was to evaluate the clinical criteria for the placement of the aforementioned implant crown. MATERIALS AND METHODS. The mandible model with 2 mm thick cortical bone and cancellous bone was fabricated from CT cross-section image. An external connection type implant was installed and cantilevered crowns with increasing offset of 3, 4, 5, 6, and 7 mm were connected. Vertical load and $30^{\circ}$ oblique load of 300 N was applied and stress around bone and implant component was analyzed. A total of 14 cases were modeled and finite element analysis was performed using COSMOS Works (Solid works Inc, USA). RESULTS. As for the location of the vertical load, the maximum stress generated on the lingual side of the implant became larger according to the increase of offset distance. When the oblique load was applied at $30^{\circ}$, the maximum stress was generated on the buccal side and its magnitude gradually decreased as the distance of the offset load increased to 5 mm. After that point, the magnitude of implant component's stress increased gradually. CONCLUSION. The results of this study suggest that for the patient with atrophied alveolar ridge following the loss of molar teeth, von-Mises stress on implant components was the lowest under the $30^{\circ}$ oblique load at the 5 mm offset point. Further studies for the various crown height and numbers of occusal points are needed to generalize the conclusion of present study.

• 대한치과보철학회지
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• 제36권2호
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• pp.293-301
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• 1998

The purpose of this study was to investigate the effects of load on root that was applied to edentulous area in three simulated situation, in each case the guiding planes of abutment were right vertical, 95 degrees, or 100 degrees to residual ridge. The 2-dimensional finite element method was used and the finite element model was prepared as fellows. Right mandibular 1st and 2nd molar was lost and the 2nd premolar with distal rest was used as primary abutment which had three different degrees of guiding plane. Then 150N of compressive force was applied to central fossae of the 1st and 2nd molars and von Mises stress and displacement was measured. The results were as follows; 1. Irrespective of slopes of guiding planes, the stress was concentrated on mesial side of root apex and distal side of coronal portion of root, in particular on junction with distal alveolar bone. As slopes of guiding planes were increased. stress on root and compact bone surrounding abutment was increased but no considerable effect was seen on compact bone of residual ridge. 2. Distal side of coronal portion of root limited by periodontal ligament was displaced distally and mesial side of apical portion was mesially. With slope of guiding plane increasing, the pattern of displacement was similar with one another but the quantity was increased. 3. Both abutment & alveolar bone were displaced downward and root of abutment, especially distal side of coronal portion, was displaced severely. As the guiding plane was tiffed more mesially over $90^{\circ}$, the degree of displacement was also increased.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.414-417
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• 1999

The congenital epulis of newborn is a rare benign tumor that occurs on the gingiva of the anterior alveolar ridge of the jaws, also known as a congenital granular cell tumor. Females are affected 8 - 10 times more often than males. The typical location is the alveolar ridge of the maxilla near the canine but the mandibular region can also be involved. The lesion may be sessile or pedunculated with red or normal color. The size of tumor varies from several millimeters to a few centimeters in diameter. Surgical excision is generally indicated and no recurrences have been noticed. Spontaneous regression is rare. It is histologically similar to the granular cell tumor, although pseudoepitheliomatous hyperplasia does not occur in the former lesion. Thus sheets of large, closely packed cells showing fine, granular, eosinophilic cytoplasm comprise the tumor mass. This is a case report of congenital epulis in the fetus. The lesion was detected in ultrasonogram, its size is 3cm in diameter. The infant showed nursing disturbance and respiratory obstruction after birth, so the tumor was surgically excised under local anesthesia.

• 대한치과보철학회지
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• 제30권2호
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• pp.286-318
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• 1992

The objective of preventive dentistry is the maintenance of a healthy dentition for the life of a patient. Unfortunately, if an individual has not received the benefit of a comprehensive program of preventive dentistry and has finally reached the edentulous state, as a consequence, he receives a set of complete denture. Dentures are mechanical devices and subject to the principles of mechanics. In some cases, the general health and nutritional status of the patient are felt to be the causative factors. But, the most important thing in residual ridge resorption is felt to be caused by the unequal distribution of functional forces. This study was to analyze mandibular stresses of complete denture occlusion by three dimensional finite element method. The results were as follows ; 1. As deformation and stress distribution of the complete denture of the mandible were concentrated on the upper lingual side of the mandible, alveolar ridge resorption of the mandible occurred from lingual side to labio-buccal side. 2. Analyzing by three dimensional F. E. M., the mandible is a very effective form for tolerating stress and deformation biomechanically. 3. According to the concentration of stress distibution in the upper buccal side of the lower posteriors, buccal shelf area must be a primary stress bearing area in the lower complete denture. 4. Lower complete denture moved horizontally to the balancing side under lateral occlusal force. 5. Bilateral balanced occlusion should be constructed in the complete denture for denture stability, especially in the protrusive movement. 6. Physical property of the denture base material was as important for stress distribution in the denture base as or even more than that in the mandible. 7. Impression technique is very important because of most of stress was concentrated between them due to close contact of the mandible and the denture base.

• 대한치과보철학회지
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• 제31권3호
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• pp.351-384
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• 1993

Complete denture occlusion must be developed to function efficiently and with the least amount of trauma to the supporting tissues. For the preservation of supporting tissues, it is imperative to reduce to a minimum the functional stress induced by dentures. The magnitude of the horizontal component of functional stress contributed by various occlusal teeth forms has not been studied. This study was aimed to investigate the influence of different occlusal teeth forms on the mode of distribution of the stresses in the mandibular tissue, and the displacement of lower dentures during the variant functional movement of mandible for this study three dimensional finite element analysis was used. FEM models were created using commercial software Super Sap for IBM 32 bit computer. The model was composed of 3380 brick elements and 4346 nodes. The results were as follows. 1. The magnitude of stress was similar between two models in centric occlusion, in the case of anatomic model, the stress was concentrated on the buccal side of alveolar ridge beneath the bicuspids. 2. During the protrusive movement, the increasing of stress from the posterior to anterior part of mandible was seen in the case of anatomic model. 3. During the lateral movement, the stress of anatomic model was greater than that of nonanatomic model. 4. The stress of anatomic model was concentrated on the anterior region of residual ridge during the lateral movement. 5. In the case of anatomic model the anterior part of denture was displaced severely at the centric and lateral position, but the denture of nonanatomic model was displaced minutely at the protrusive and lateral position.

• 대한치과기공학회지
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• 제34권4호
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• pp.473-482
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• 2012

Purpose: The purpose of this study was to investigate the stress distribution of the surrounding tissues according to 3 proximal plate types of the RPI clasp. Methods: The removeable partial denture which mandibular right and left second premolars and mandibular molars were lost was attached to a three dimensional photo elastic epoxy resin model. Then 120N of vertical load was applied. After 3-dimensional photoelastic stress analysis was used to record the isochromatic fringe patterns. Results: Kratochvil type guiding plane exhibited little uniform stress distribution on load center and alveolar ridge, but higher stress concentration on buccal surface of second premolar. Krol type guiding plane exhibited the stress concentration on the front of load center and relatively higher stress concentration on buccal surface of first premolar. However, this type had no effect on canine. Researcher type guiding plane showed the stress concentration on second premolar and molar, but the little stress distribution on first premolar. Conclusion: In all types, excessive stress concentration was appeared and three types were not significant different.

• 구강회복응용과학지
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• 제17권2호
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• pp.113-123
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• 2001

The success of complete denture prosthesis is to satisfy three basic requirements for the edentulous patient : maximum comfort, efficiency, and esthetic appearance. This can be achieved only if the dentures are both stable and retentive. When the residual alveolar ridge has resorbed significantly, stability and retention are more dependent on the correct position of the teeth and external surfaces of the denture. The stability and retention of the denture can be improved by locating the denture in the neutral zone and reproducing exact mandibular border movement for balanced occlusion. The neutral zone philosophy is based upon the concept that there exists a specific area where the musculature function will not unseat the denture in the mouth. In here, forces generated by the tongue are neutralized by the forces generated by the lips and cheeks. One of the simplest methods for recording border movements in three dimensions is to make stereographic record of condylar movement. Stereographs are made in the mouth during mandibular movement with intraoral clutches and central bearing point, and used in dictating the condylar movement on the articulator later by generating the condylar paths in doughy acrylic resin. Its procedure is simpler and more convenient than that of Pantograph. In this clinical report, we introduce the concept of neutral zone and stereograph in complete denture fabrication.

• 대한치과보철학회지
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• 제61권1호
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• pp.18-25
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• 2023

본 증례는 65세 남환으로, 10년 전 편도암으로 하악골이단술을 시행한 환자에서 중립대를 활용한 상하악 총의치 수복 증례이다. 본 환자는 무치악 기간이 짧아 치초제의 흡수가 거의 없으며, 혀의 운동기능에도 이상이 없었지만, 수술 이후의 변화로 인해 하악의 후구치 삼각융기가 상악의 구상절흔보다 안쪽에 위치해 있으며 하악의 구치부 치조제는 상대적으로 설측으로 돌아간 구조를 보였다. 만약 통상적으로 해부학적 지표를 참고하여 치아를 배열한다면, 혀의 기능 공간을 침범하게 되며, 이는 의치의 안정성을 저하시킬 것이다. 이런 경우 중립대 개념을 적용한 의치의 제작은 좋은 참고점이 될 수 있을 것이다. 연성 이장재를 사용하여 중립대를 인기하였으며, 이를 인덱스로 제작하여 치아배열을 시행하였다. 중립대의 가장 큰 장점은 의치의 안정을 얻는 것에 있다. 본 환자의 경우 하악 좌측 구치부가 혀 공간을 침범하지 않도록 구치 치아의 설측배열 한계를 얻기 위해 중립대 기법을 적용하였다. 특히, 치조제의 흡수로 의치의 안정성을 얻기 어려운 난증례 환자의 경우 이러한 방법을 사용한다면 의치의 안정성 면에서 더욱 좋은 결과를 얻을 수 있을 것이라 보기에 본 증례를 보고하는 바이다.