• 제목/요약/키워드: Mandibular prosthesis

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고정성 하이브리드 수복 (Fixed hybrid prosthesis)

  • 현동근
    • 대한심미치과학회지
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    • 제27권1호
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    • pp.24-40
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    • 2018
  • 하악 구치부에 임플란트 식립이 불가능할 정도로 치조제의 수직적 흡수가 심한 무치악 환자들이 종종 있다. 이런 경우 하악 전방부에 임플란트를 식립하고 implant assisted overdenture를 할 수도 있지만 가철성 보철물이 갖는 근본적인 불편함을 해결할 수는 없다. 하지만 양측 이공 사이에 임플란트를 적절히 식립하고 fixed hybrid prosthesis를 제작해준다면 가철성 보철물이 갖는 불편함 없이 환자를 만족시킬 수 있을 것이다. 다만 fixed hybrid prosthesis가 갖는 단점 및 예상되는 합병증을 예방하도록 치료계획을 잘 설계해야 할 것이다. 필자의 임상경험을 토대로 이에 대해 자세히 설명하고자 한다.

상악 전치부 고정성 보철물 수복 시 임시 임플란트를 이용한 임시보철물의 유지력 증가 증례보고 (Reinforcing the retention of provisional restoration using provisional implant on maxillary anterior region: clinical case report)

  • 김창대;문홍석;정문규;이재훈
    • 대한치과보철학회지
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    • 제51권3호
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    • pp.221-225
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    • 2013
  • 임시 보철물의 적절한 관리는 보철의 성공에 있어서 중요한 요소이다. 상악 전치 결손부 임시 보철물은 장경간의 결손부가 존재하거나, 타원형의 악궁을 가진 환자에서 자주 탈락하게 된다. 이는 상악 전치부가 구치부에 비해서 수평적인 힘에 더 많이 노출되며, 부가적으로 전방 캔틸레버 효과가 임시 보철물의 유지를 저해하고, 상악 전치부 임시 보철물은 하악의 기능 운동시 적절한 전방 유도를 제공하여야 하기 때문이다. 또한 임시 보철물의 최대 감합위에서 교합접촉은 지점선의 반대편에 위치하게 되어 그 자체로 임시 보철물의 탈락을 야기한다. 본 증례에서는 임시 임플란트를 이용하여 상악 전치부 보철물에 대한 전술한 유해 작용을 피할 수 있었고, 발치 후 치유기간 동안 환자에게 편안함과 만족감을 부여하였으므로 이를 보고하는 바이다.

A TWO DIMENSIONAL STRESS ANALYSIS COMPARING FIXED PROSTHETIC APPROACHIES TO THE TILTED MOLAR ABUTMENT

  • YANG, H.S.;Thompson, V.P.
    • 대한치과보철학회지
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    • 제29권1호
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    • pp.1-11
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    • 1991
  • A two dimensional finite element method was used to analyze the changes in mechanical behavior of the supporting structures when a fixed prosthesis replaced a mandibular 1st molar. In the unrestored situation as the degree of bone resorption increased, there was a corresponding increase in stress in the periodontium. Tilting of the molar abutment induced the additional stress on the mesial side of the root. The presence of a fixed prosthesis markedly reduced the magnitude and distribution of stress in the periodontium. The mechanical advantage obtained by a fixed prosthesis was greater in the situation of a tilted 2nd molar with reduced bone support than with the higher bone levels.

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Restoration of Mandibular Edentulous Patient By Dental Implant: Case Report

  • Kwon, Ji-Yung;Kim, Yung-Soo
    • 대한치과보철학회지
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    • 제38권3호
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    • pp.360-365
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    • 2000
  • The completely edentulous patient has few treatment options in conventional dentistry. When implants are considered, treatment plans range from a 2-implant overdenture to a completely implant-supported prosthesis. Fixed prosthesis is often the preferred selection of the edentulous patient. fixed full-arch cert amo-metal restorations can be a predictable implant treatment modality for the edentulous patient. Implant-supported fixed prosthesis has several advantages: predictability, fixedness, retrievability, improved function, lower maintenance of prosthesis, long-term published success. Edentulous patients with a severely resorbed mandible often experience problems with their dentures. Treatment concepts involving two to four implants for the support of an overdenture have been proposed. There seems to be no need to insert more than two endosteal implants to support an overdenture, however, long-term prospective studies are needed to support this notion. Using short endosseous implants and an overdenture in the extremely resorbed mandible is a justified treatment option because of the relative simplicity and low morbidity of this treatment strategy. Implant-supported overdenture has several advantages: Cost, retrievability, hygiene access, profile and contour control, increased retention and stability, implant installed in a predicted region(ant. mandible).

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한국 노인의 구강보건지수와 치과보철물 필요도가 구강건강관련 삶의 질에 미치는 영향 (The Effect of Oral Health Index and Dental Prosthesis Needs on Oral Health Related Quality of Life in Korean Elderly)

  • 이희성;김한곤
    • 한국산학기술학회논문지
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    • 제17권1호
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    • pp.72-78
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    • 2016
  • 이 연구는 한국 노인의 구강건강상태와 치과보철물 필요도가 구강건강관련 삶의 질에 미치는 요인을 경험적으로 규명함으로써 향후 노인대상의 구강건강사업에 필요한 기초자료를 제공하고자 한다. 이 연구자료는 2010년 1월부터 12월까지 질병관리본부에서 시행한 '국민건강영양조사 제5기 1차 및 2차년도를 활용 구강검사까지 완료한 65세 이상 노인 2,389명 중 검사가 미흡한 노인 116명을 제외한 2,273명을 최종 연구대상으로 하였다. 수집된 자료는 SPSS 22.0 프로그램을 이용하여 전산통계 처리하였으며, 분석방법은 빈도분석, 다중회귀분석, 구조방정식 모형을 이용하였다. 주관적 구강건강상태에 영향을 미치는 요인은 나이가 적을수록, ST지수가 높을수록, FS-T 지수가 높을수록, T-Health 지수가 높을수록, 상악 크라운 요구도가 낮을수록, 상 하악 의치 요구도가 낮을수록 주관적 구강건강상태가 높은 것으로 나타났다. 씹기문제에 영향을 미치는 요인은 소득수준이 높을수록, T-Health 지수가 높을수록, 상악 크라운 요구도가 낮을수록, 상 하악 의치 요구도가 낮을수록 씹기 문제가 불편하지 않는 것으로 나타났다. 말하기 문제에 영향을 미치는 요인은 ST지수가 높을수록, T-Health 지수가 높을수록, 상악 임플란트 요구도가 낮을수록, 상악 의치 요구도가 낮을수록 말하기 문제가 불편하지 않는 것으로 나타났다. 이상의 결과를 토대로 구강건강상태와 치과보철물 필요도는 구강건강관련 삶의 질에 상당한 영향을 미치고 있음을 알 수 있었고, 향후 노인의 구강건강 관련 삶을 증진시키기 위해서는 노인을 위한 구강건강증진사업과 치과보철 사업이 필요가 요구된다.

교합력의 방향에 따른 소형견 치과보철물의 압축파절강도 비교 (Comparison of compressive fracture strength of small dog dental prosthesis along the direction of bite force)

  • 박유진;최성민
    • 대한치과기공학회지
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    • 제42권2호
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    • pp.129-137
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    • 2020
  • Purpose: The aim of this study is to observe the compressive fracture strength of the crown according to the direction of the occlusal force of the mandibular canine and carnassial of the small dog. Methods: The abutment models of mandibular canine and carnassial were prepared, specimens of zirconia, PMMA and Ni-Cr alloy were produced. The experimental jig was fabricated with Co-Cr alloy and buried in acrylic resin after make tilt to specified angle. The specimen was attached to a jig and loaded using a universal testing machine until the specimen fractured. Results: The compressive fracture strengths of CXZ and CXP specimens were found to be 999.21 ± 31.15 N on average and 731.42 ± 59.13 N on average. And CZZ and CZP specimens were 730.48 ± 70.14 N on average and 377.65 ± 11.87 N on average. CXN and CZN specimens were not fractured. In addition, MZZ and MZP specimens were 746.46 ± 50.75 N and 258.64 ± 31.86 N on average. The MZN specimens were not fractured. Conclusion: Zirconia has compressive fracture strength that can be applied to small dog's canine and Carnassial prosthetics, while PMMA has inadequate strength to small dog's carnassial prosthesis.

심미치의학 영역에서 동적 교합을 나타내는 가상 환자의 형성을 통한 전치부 보철 수복 증례 (Creation of the dental virtual patients with dynamic occlusion and its application in esthetic dentistry)

  • 안세준;신수연;최유성
    • 대한치과보철학회지
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    • 제60권2호
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    • pp.222-230
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    • 2022
  • 디지털 기술은 점차 그 영역을 넓혀 치의학의 여러 분야에 큰 영향을 미치고 있다. 최근 디지털 치의학에서는 다양한 삼차원적(3D) 이미지 데이터를 하나로 중첩시켜 진단 및 보철물 제작에 활용하는 것의 중요성이 대두되고 있다. 안면 스캔, 구내 스캔, 하악 운동 기록(mandibular movement recording) 등의 데이터를 통합하면 가상 환자 모델을 구성할 수 있다. 가상 환자(Virtual patient)란 구내 및 구외 연조직, 잔존 치열, 동적 교합 등 디지털 3D 진단 데이터를 통합하여 형성되며 이를 통해 보철 치료의 결과 등을 가상으로 시뮬레이션을 시행할 수 있다. 본 증례에서의 환자는 37세 여성 및 55세 여성 환자로 각각 기존 보철물의 외형이 틀어진 것 같다는 주소와 근관치료 후 전치부 보철물의 재제작을 주소로 내원하였다. 각 환자에서 3D 안면 스캔을 채득하였으며, ARCUS Digma 2 (KaVo Dental GmbH, Biberach an der Riss, Germany)를 통해 환자의 하악 운동을 기록하였다. 수집한 데이터를 computer-aided design (CAD) 소프트웨어(Exocad dental CAD; exocad GmbH, Darmstadt, Germany) 상에서 하나로 통합하여 가상 교합기에 옮겨 디지털 가상 환자를 형성하였다. 이를 통해 임시 고정성 보철물을 디자인하고 수복하여 평가하였으며, 최종수복물로 옮겨 심미적, 기능적으로 만족할 만한 결과를 보였기에 이를 보고하고자 한다.

3차원 유한요소분석에 의한 소형견의 견치와 열육치의 교합력 방향 분석 (Analysis of the direction of the canine and carnassial of small dog by 3D FEM)

  • 박유진;최성민
    • 대한치과기공학회지
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    • 제42권2호
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    • pp.139-145
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    • 2020
  • Purpose: This study is for the prosthesis of dog. Observed the occlusal relation between the small dog canine and carnassial teeth. The direction of the bite force was analyzed by 3D FEM(finite element method). Methods: The mandibular canine and carnassial of dog were tested. The skull of dog was contact point confirmed by dental CAD. The skull of dog was scaned using CT and a 3D model was created. The 3D model was analyzed ABAQUS. Closing movement has been 100N, 200N, 300N, 500N, 1000N, 1500N. The Direction of bite force was confirmed. Results: As occlusal force increased, the direction of bite force appeared to (-y), (-x,-y,-z), (-x,-y), (-x,-y,+z), (-x,-y,+ z), (+x,-y) in mandibular left canine. And the direction was seen at (+x, -y), (+x,-y,-z), (+x,-y), (-x,-y,+z), (-x,-y,+z), (+x,-y). When the occlusal load is 100 N, 200 N, 300 N, 500 N, the direction of the mandibular carnassial appears as (-x, -y, -z), and when the occlusal load is 1000 N, 1500 N, the direction appears as (-x,-y). Conclusion: The mandibular canine showed irregularities in the coordinates of the direction of the bite force, and the mandibular carnassial showed regularity in the coordinates of the direction of the bite force.

단순교합기에 의한 하악운동의 오차에 대한 실험적 연구 (An Experimental study on the gap of movement by the hinge articulator)

  • 문희경
    • 대한치과기공학회지
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    • 제25권1호
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    • pp.111-118
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    • 2003
  • I measured the movement range on the hinge articulator and the movement range in an oral. And then I studied to analyze the gap. I got wax records by the movement on the hinge articulator, the movement in an oral and the movement on the hand articulating. I measured the distance of the cusp tips that are close to the mesial direction and the distal direction, the buccal direction and the lingual direction then I compared gaps. As I saw results on data, I knew that the hinge articulator represented the range of mandibular movement restrictively. I could find the decisive contradiction that the sliding movement finished on the hinge articulator although it did not finish in an oral. If the sliding movement does not reappear exactly, it brings a fatal failure to the dental prosthesis. In addition it is impossible that the hinge articulator restores the movement in an oral because the lateral condyle inclination and the horizontal condyle inclination are fixed previously. Therefore dental prosthesisses were made by the hinge articulator, they will interfere with a mastication. I have obtained the following results; 1. The distance of sliding movement on the hinge articulator showed shorter than the distance of sliding movement in oral. This means the increase of cusp inclination of the dental prosthesis that was made on the hinge articulator. Therefore, when the lateral movement occurs in oral, there is a possibility to become the premature as the increase of cusp inclination. 2. The results that were impressed records in oral and impressed records on the hand articulating have many congruities. I think that the simple crown etc. that were made by the hand articulating method except the long span bridge and the free end case that can not measure the vertical dimension exactly can represent similarly the mandibular movement. 3. If we want to represent the mandibular movement similarly, we have to use the articulator that can adjust the horizontal condyle inclination and the lateral condyle inclination at least.

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Comparative evaluation of peri-implant stress distribution in implant protected occlusion and cuspally loaded occlusion on a 3 unit implant supported fixed partial denture: A 3D finite element analysis study

  • Acharya, Paramba Hitendrabhai;Patel, Vilas Valjibhai;Duseja, Sareen Subhash;Chauhan, Vishal Rajendrabhai
    • The Journal of Advanced Prosthodontics
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    • 제13권2호
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    • pp.79-88
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    • 2021
  • Purpose. To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion. Materials and methods. A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points. Results. In Group 1 for vertical load, maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1. Conclusion. In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.