• 구강회복응용과학지
• /
• 제24권1호
• /
• pp.91-104
• /
• 2008

최근에, 의치의 유지, 안정성, 지지를 개선시키기 위해 골유착 임플란트가 사용되고 있다. 여러 연구에서 하악에 두 개의 임플란트를 식립한 후 제작된 피개의치가 환자 보철에서 기능과 만족의 유의한 증가를 나타내고 있다. stud, magnet, 그리고 bar attachment를 포함하여 다양한 attachment 시스템을 사용해 임상적으로 예상 가능하고 효과적인 것이 증명되었다. 본 증례에서 2개의 임플란트를 이용한 피개의치가 무치하악의 치료를 위한 고려의 기본이 될 수 있다는 것을 나타낸다.

• 구강회복응용과학지
• /
• 제31권4호
• /
• pp.378-386
• /
• 2015

피개 의치는 의치의 안정과 유지력 증가라는 장점을 갖지만 지대치가 우식 또는 치주질환에 이환되기 쉬우며 의치의 두께가 얇아짐으로써 의치가 파절되기 쉽다는 단점도 갖고 있다. 자성 어태치먼트 피개 의치는 수직적 유지력은 크지만 수평적 유지력은 작으므로 지대치나 임플란트에 덜 위해한 힘을 가하며, 다른 기계적 유지장치에 비해 마모나 파손 등이 적다는 장점이 있다. 피개 의치에서 나타나는 의치의 파절은 의치상의 두께가 얇아져서 발생하기도 하지만, 연조직과 경조직, 임플란트와 자연치의 압하량 차이로 인해 발생하기도 한다. 이를 보상하기 위해 silicone ball이 자석 안에 삽입되어있는 자성 어태치먼트가 개발되었으며, 이를 이용해 피개 의치를 제작한 증례에서 우수한 결과가 나타나 보고하고자 한다.

• 대한치과보철학회지
• /
• 제59권4호
• /
• pp.442-450
• /
• 2021

컴퓨터 지원 설계 및 제조 기법(CAD-CAM)은 치과 영역에서 급속도로 발전해온 분야로, 다양한 보철 치료 영역에 적용되고 있다. 이 중 절삭형 방식(Subtractive Manufacturing)으로 분류되는 절삭가공 기법을 이용한 의치 제작은 상용화된 디지털 총의치 제작 방식 중 하나이며, 동시에 첨가형 방식(Additive Manufacturing)으로 분류되는 레이저 소결 혹은 용융 기법을 활용하여 피개의치를 위한 금속구조물을 보다 효율적으로 제작할 수 있게 되었다. 본 증례에서는, CAD-CAM을 통해 절삭형 방식으로 제작한 상악 총의치와 3D 금속 프린팅을 이용한 금속구조물과 절삭형 방식으로 제작된 인공치를 접목한 하악 임플란트 피개의치를 제작하였다. 이를 통해 기능적, 심미적으로 적절한 임상적 결과를 얻었으므로 이를 보고하는 바이다.

• 대한치과보철학회:학술대회논문집
• /
• 대한치과보철학회 2001년도 추계학술대회
• /
• pp.72-72
• /
• 2001

• The Journal of Advanced Prosthodontics
• /
• 제6권5호
• /
• pp.325-332
• /
• 2014

PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

• The Journal of Advanced Prosthodontics
• /
• 제4권4호
• /
• pp.197-203
• /
• 2012

PURPOSE. The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction. MATERIALS AND METHODS. A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems. RESULTS. Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems. CONCLUSION. The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system.

• The Journal of Advanced Prosthodontics
• /
• 제12권1호
• /
• pp.33-37
• /
• 2020

PURPOSE. The purpose of this study is to evaluate the effects of type of magnet attachment and implant angulation in two implant overdenture models. MATERIALS AND METHODS. Magnet attachments used in this study were flat and dome types (MGT5515, MGT5520D, Dentium Co., Seoul, Korea). Two implants with keepers were inserted in the resin blocks at a distance of 24 mm. For the first model, the implants were parallel to the vertical and perpendicular to the horizontal; for the second model, both were angulated 5 degrees to the mesial; for the third model, both were angulated 10 degrees toward the mesial. The retentive force was measured in both vertical and lateral directions. Statistical analyses were performed using SPSS software version 22.0 (α=.05). RESULTS. The flat type magnet attachment showed the highest lateral retentive force in the 20° divergent group (P<.05) and the dome type magnet attachment showed the highest lateral retentive force in the parallel group (P<.05). The vertical and lateral retentive force of the dome type magnet attachment was greater than that of the flat type magnet attachment in every direction (P<.05). CONCLUSION. Within the limitations of this study, the dome shape magnet attachment can resist vertical and lateral retentive force more superiorly than the flat type magnet attachment, regardless of angle, in the mandibular two implant model.

• 대한치과보철학회지
• /
• 제59권1호
• /
• pp.55-62
• /
• 2021

하악은 상악보다 지지 면적이 적고, 특히 전반적인 치조골 흡수가 진행된 환자에서는 혀와 하악골의 움직임으로 인해 통상적인 총의치의 경우 의치의 안정성과 저작 효율이 현저히 낮다. 이러한 환자에 있어 소수의 임플란트를 이용한 임플란트 피개의치는 유지력과 안정성이 높고 발음이나 저작력 면에서도 우수한 예지성 있는 치료방법으로 평가되고 있다. 본 증례에서는 상악의 무치악, 하악의 전반적인 치조골 흡수를 보이는 환자에 있어 상악에는 총의치, 하악에는 4개의 임플란트를 식립하여 milled bar를 이용한 임플란트 피개의치를 제작하였다. 이후 12년 동안 임플란트 주변의 치주조직의 변화를 지속적으로 관리 및 관찰하였고, 변화 사항 및 보철물의 정기적인 관리에 대해서 보고하고자 한다.

• 대한치과보철학회지
• /
• 제34권1호
• /
• pp.31-69
• /
• 1996

The purpose of this investigation was to analyze stress distribution in implant supporting tissue according to different types of attachments such as combination bar attachment, Hader bar attachment, O-Ring attachment and Dal-Ro attachment that are used in mandibular overdenture by using two osseointegrated implants, to study the influence that POM IMC used in bar type attachment has in implant supporting tissue and compare the preceding analyses to find out an effective stress distribution method. Three dimensional photoelastic method was used to obtain the following results. (A) Analysis of stress distribution according to attachment type 1. Under vertical load condition, compressive stress was seen at implant supporting area of working side on all the photoelastic models but in Hader bar attachment tensional stress was seen at distal upper area of implant supporting area. Relatively Hader bar and O-Ring attachment showed even stress distribution pattern. 2. Under vertical load condition, compressive stress at implant apex area and tensional stress at implant lateral supporting area were seen at nonworking side of all models. 3. Under $25^{\circ}$ lateral load condition, general compressive stress was seen at working side implant supporting area in most of the models, especially at distal upper supporting area higher compressive stress concentration was seen in combination bar attachment and tensional stress concentration, in Hader bar attachment. 4. Under $25^{\circ}$ lateral load condition, compressive stress at implant apex area and tensional stress at implant lateral supporting area were seen at nonworking side of all models, except O-Ring model which showed compressive stress only. (B) Influence of POM IMC to stress distribution in bar type attachment 5. Under vertical load condition, better stress distribution pattern was seen at working side of combination bar and Hader bar attachment model using POM IMC. 6. Under vertical load condition, stress value was increased at nonworking side of combination bar attachment model using POM IMC and tendency of increasing compression was seen at nonworking side of Hader bar attachment model using POM IMC. 7. Under $25^{\circ}$ lateral load condition, better stress distribution pattern was seen at working side of combination bar attachment model using POM IMC but tendency of increasing stress was seen on working side of Hader bar attachment model using POM IMC. 8. Under $25^{\circ}$ lateral load condition, stress reduction was seen at nonworking side of combination bar attachment model using POM IMC but tendency of increasing stress was seen at nonworking side of Hader bar attachment model using POM IMC.

• 대한치과의사협회지
• /
• 제40권9호통권400호
• /
• pp.709-715
• /
• 2002

Two patients with sufficient vertical bone height but insufficient bone width in the anterior mandibular edentulous area, less than 6mm in the buccolingual aspect, for implant placement were chosen for treatment with a ridge splitting procedure. The surgical technique involving greenstick fracture is described. This ridge splitting procedure could be simple placement of implants into ideal restorable positions in severely atrophic, knife-edged ridges and predictable for narrow edentulous alveolar ridge augmentation associated with implant placement. We experienced two cases to place implant with insufficient bone width in the anterior mandibular edentulous area for overdenture be ridge splitting technique. Thus, we will report two cases and review of the literature.