• Title/Summary/Keyword: Mandibular surgery

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Full mouth rehabilitation in a patient with reduced vertical dimension due to numerous tooth loss and excessie worn dentition: A case report (다수의 치아 상실과 치아 마모로 인해 수직고경이 감소된 환자의 완전 구강 회복 증례)

  • Lee, Eun-Hyuk;Lim, Young-Jun;Kwon, Ho-Beom;Kim, Myung-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.456-466
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    • 2019
  • As digital dentistry technology is being developed, it is being used in various ways. This case covers how digital dentistry technology is being applied on the treatment of patients with loss of vertical dimension due to worn dentition and multiple loss of teeth. The loss of vertical dimension was carefully assessed and recovered, and implants were placed with surgical guides, designed considering the final restoration. The movement of the mandibular was measured with the electronic instrument for recording mandibular movement. Wax-up process was done with Naturgemäße Aufwachs-Technik (N.A.T.) and Natural functional reconstruction (N.F.R.). It was scanned, and the provisional restoration was fabricated using Computer-Aided-Design/Computer-Aided-Manufacturing (CAD/CAM) technology, and the adjustment process was done at the clinic to meet with the satisfaction both functionally and esthetically, and then, using double scanning and CAD/CAM technology, it was carried out as a final restoration. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

THE EFFECTS OF THE PLATELET-DERIVED GROWTH FACTOR-BB ON THE PERIODONTAL TISSUE REGENERATION OF THE FURCATION INVOLVEMENT OF DOGS (혈소판유래성장인자-BB가 성견 치근이개부병변의 조직재생에 미치는 효과)

  • Cho, Moo-Hyun;Park, Kwang-Beom;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.23 no.3
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    • pp.535-563
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    • 1993
  • New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

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A Study on the Postoperative Stability of Hard Tissue in Orthognathic Surgery Patients Depending on the Difference of Occlusal Plane (악교정 수술시 교합평면의 차이에 따른 술후 경조직의 안정성에 관한 연구)

  • Hwang, Chung-Ju;Lim, Seon-A;Moon, Jeong-Lyon
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.239-249
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    • 1999
  • In orthognathic surgery to obtain proper functional and esthetic form after skeletal discrepancy treatment, precise diagnosis and treatment plan are essential. Especially in two jaw surgeries that have serious upper and lower jaw problems, maxilla and mandible are arranged in three dimensions. Based on the maxillary rearrangement, mandibular sagittal and transverse positions are determined, and thus new occlusal plane is established. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane based on the architectural and structural craniofacial analysis of Delaires. The subjects of this study were 48 patients who underwent two jaw surgeries, and they were equally divided into two groups, A and B. A group was operated with ideal occlusal plane and B group was not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. ANS was lower than that of PNS for both A and B after the surgery. That is, maxilla and mandible are rotated in posterior and superior direction. 2. Significances were found between $T_2$ and $T_3$ for both A and B are HRP-Me at vortical measurements, articular angle(p<0.01), gonial angle(p<0.01), and Mn. plane angle(p<0.05) at angular measurement. Mn. plane angle is increased at HRP-Me is decreased for both A and B. 3. There is no significance in skeletal stability aster the surgery between group A and B. 4. Horizontal movements of B and Pog by surgery have statistically significant inverse correlations with horizontal relapse of B and Pog, and vertical relapse of PNS, as well as Mn. Plane angle, and gonial angle after the surgery.

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A STUDY ON THE POSTOPERATIVE STABILITY OF OCCLUSAL PLANE IN ORTHOGNATHIC SURGERY PATIENTS DEFENDING ON THE DIFFERENCE OF OCCLUSAL PLANE (악교정 수술시 교합평면의 차이에 따른 술후 안정성에 관한 연구)

  • Hwang, Chung-Ju;Lim, Seon-A
    • The korean journal of orthodontics
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    • v.28 no.2 s.67
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    • pp.237-253
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    • 1998
  • Surgical-orthodontic treatment is performed for the skeletal Class III patients with no remaining growth and too big a skeletal discrepancy (or camouflage treatment, and two jaw surgery is needed in order to have maximum effect in such patients. In two jaw surgery cases, surgical alteration of the occlusal plane is necessary to establish optimal function, esthetics and postoperative sability, therefore the establishment of the occlusal plane is essential in diagnosis and treatment. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane bsaed on the architectural and structural craniofacial analysis of Delaires. Thus, the subjects of this study were 48 patients who underwent two jaw surgery, and divided in two groups. Each group were composed of 24patients, A group were operated with ideal occlusal plane and B group were not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. There was no significance in occlusal plane angulation between $T_2\;and\;T_3$. Average long term follow-up changes of occlusal Plane angle were $0.24^{\circ}{\pm}2.43$, with FH plane and $0.15{\circ}{\pm}2.16{\circ}$ with SN plane in all 48 patients. These results demonstrated that the occlusal plane after two jaw surgery in skeletal Class III malocclusion was stable. 2. There was no significance in postoperative stability of occlusal plane between A and B group. 3. There was no significance in postoperative stability of occlusal plane depending on surgeon and operative method within each group. 4. The postoperative changes of occlusal plane were correlated to the postoperative changes of jaw rather than tooth position. 5. There was no correlation between the postoperative changes of occlusal plane and maxillary impaction and mandibular setback with surgery.

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A study of facial soft tissue of Korean adults with normal occlusion using a three-dimensional laser scanner (3차원 레이저 스캐너를 이용한 한국 성인 정상교합자의 안면 연조직에 대한 연구)

  • Baik, Hyoung-Seon;Jeon, Jai-Min;Lee, Hwa-Jin
    • The korean journal of orthodontics
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    • v.36 no.1 s.114
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    • pp.14-29
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    • 2006
  • Developments in computer technology have made possible the 3-dimensional (3-D) evaluation of hard and soft tissues in orthodontic diagnosis, treatment planning and post-treatment results. In this study, Korean adults with normal occlusion (male 30, female 30) were scanned by a 3-D laser scanner, then 3-D facial images formed by the Rapidform 2004 program (Inus Technology Inc., Seoul, Korea.). Reference planes in the facial soft tissue 3-D images were established and a 3-D coordinate system (X axis-left/right, Y axis-superior/inferior, Z axis-anterior/posterior) was established by using the soft tissue nasion as the zero point. Twenty-nine measurement points were established on the 3-D image and 43 linear measurements, 8 angular measurements, 29 linear distance ratios were obtained. The results are as follows; there were significant differences between males and females in the nasofrontal angle $(male:\;142^{\circ},\;female:\;147^{\circ})$ and transverse nasal prominence $(male:\;112^{\circ},\;female:\;116^{\circ})$ (p<0.05). The transverse upper lip prominence was $107^{\circ}$ in males, $106^{\circ}$ in females and the transverse mandibular prominence was $76^{\circ}$ in both males and females. Li-Me' was 0.4 times the length of Go-Me'(mandibular body length) and the mouth height was also 0.4 times the width of the mouth width. The linear distance ratio from the coronal reference plane of FT, Zy, Pn, ULPm, Li, Me' was -1/-1/1/0.5/0.5/-0.6 respectively. The 3-D facial model of Korean adults with normal occlusion were be constructed using coordinate values and linear measurement values. These data may be used as a reference in 3-D diagnosis and treatment planning for malocclusion and dentofacial deformity patients and applied for 3-D analysis of facial soft tissue changes before and after orthodontic treatment and orthognathic surgery.

The Immunohistochemical Expression of Collagens and the Morphogenesis in the Developing Mandible of Human Embryos and Fetuses (배자와 태아에서 하악골의 형태발생 및 교원질 발현에 관한 면역조직화학적 연구)

  • Kook, Yoon-Ah;Kim, Sang-Cheol;Kim, Eun-Cheol;Kim, Oh-Hwan;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.26 no.2 s.55
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    • pp.187-196
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    • 1996
  • Underlying malocclusions and dentofacial deformities are often related to variations in the craniofacial development. Type I and type II collagens are considered the major collagens of bone and cartilage respectively. Monitoring the patterns of those protein expressions during development will Provide a basis for the understanding of normal and abnormal growths. This study was undertaken to investigate the morphogenetic changes and the expression patterns of type I and II collagen proteins involved in the developing mandible of human embryos and fetuses. 50 embryos and fetuses were studied with Hematoxylin and Eosin, Alcian, blue-PAS, Masson Trichrome, md Immunohistochemical stains. The results were as follows : 1. A 13.5 mm embryo showed the stomatodeum with dental lamina, maxillary and mandibular processes. Meckel's cartilage appeared in the mandibular arch of a 20.5 mm embryo. New bone formation was bilaterally initiated at the outer side of middle portion of Meckel's cartilage of 22-38 mm embryos. 2. Meckel'cartilage was resorbed at the 15th week fetus. The endochondral ossification was observed where there was direct replacement of cartilage by bone. Meckel'cartilage disappeared and membraneous ossification were observed at the 25th week. 3. Before the appearance of Meckel's cartilage, the expression of type I collagen was moderate at the odontogenic epithelium of maxillary & mandibular process, but mild for the expression of type II collagen. 4. During the appearance of Meckel's cartilage and new bone formation, the immunoactivity of type II collagen was more expressed than type I collagen at the Meckel's cartilage and new bone. 5. During intrarmembranous bone formation, the expression of type II collagen was rare in the bony trabeculae. There was a switch for the expression of collagens from type II to type I during the appearance of Meckel's cartilage.

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RECONSTRUCTION OF INTRAORAL DEFECT USING RADIAL FOREARM FREE FLAP: A CASE REPORT (유리전완피부피판을 이용한 구강내 결손의 재건례)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Kwon, Yong-Dae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.246-249
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    • 1998
  • With the recent progress of microsurgical techniques, radial forearm free flap has an established place in oral reconstruction. Providing thin, soft and pliable skin with a large and constant vascular pedicle, this flap is optimal for intraoral reconstruction. One of the disadvantages of the flap is donor site morbidity, therefore various methods can be used to reduce it. A male complained of palatal and retromolar area mass with ulceration, which was diagnosed as squamous cell carcinoma. He also complained of discomfort and mouth opening limitation, attributed to the location and characteristics of the mass. Because of mouth opening limitation, mandibular swing approach was performed to allow for the surgical approach to the mass. After the surgical excison of the lesion, the intraoral defect was successfully reconstructed with radial forearm free flap.

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A resonance frequency analysis of sandblasted and acid-etched implants with different diameters: a prospective clinical study during the initial healing period

  • Kim, Hyun-Joo;Kim, Yeun-Kang;Joo, Ji-Young;Lee, Ju-Youn
    • Journal of Periodontal and Implant Science
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    • v.47 no.2
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    • pp.106-115
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    • 2017
  • Purpose: The possibility of immediate or early loading has become popular in implant dentistry. A prerequisite for the immediate or early loading of an implant prosthesis is the achievement of initial stability in the implant. Moreover, in response to clinicians' interest in verifying clinical stability to determine the optimal time point for functional loading, a non-invasive method to assess implant stability has been developed on the basis of resonance frequency analysis (RFA). The primary objective of this study was to monitor the stability of sandblasted, large-grit, and acid-etched (SLA) implants with different diameters during the early phases of healing by RFA. The secondary objective was to evaluate how the initial stability of implants varied depending on different surface modifications and other contributing factors. Methods: Thirty-five implants (25 SLA implants and 10 resorbable blasting media [RBM] implants) placed in 20 subjects were included. To measure implant stability, RFA was performed at baseline and at 1, 2, 3, 4, 6, and 10 weeks after surgery. Results: The longitudinal changes in the implant stability quotient (ISQ) values were similar for the SLA implants with different diameters and for the RBM implants. During the initial healing period, the ISQ decreased after installation and reached its lowest values at 1 week and 2 weeks, respectively. The mean ISQ values in the SLA implants were significantly higher in ${\varnothing}5.0mm$ implants than in ${\varnothing}4.0mm$ implants. Men showed a higher ISQ than women. Mandibular sites showed a higher ISQ than maxillary sites. Conclusions: All implants used in this study are suitable for immediate or early loading under appropriate indications. A wider diameter and SLA surface treatment of implants could improve the stability, if the implant is fixed with at least 30 Ncm of insertion torque.

The Prevalence of Enamel Projection on Molar Teeth Extracted from Dental Patients (치과 환자로부터 발거된 치아에서의 법랑돌기의 발현빈도)

  • Bae, Sung-Suk;Ku, Young
    • Journal of dental hygiene science
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    • v.7 no.4
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    • pp.207-211
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    • 2007
  • Many studies reported that the presence of cervical enamel projection (CEP) in cemento-enamel junction(CEJ) is greatly related to periodontal disease. The aim of this study was to investigate the prevalence of enamel projections in buccal, mesial, distal and lingual(palatal) surface of maxillary and mandibular first and second molars on extracted teeth. Among 660 teeth extracted due to the periodontal disease and dental caries in Seoul National University Dental Hospital was examined, 530 teeth which has distinct CEJ were examined with 8 times x electronic magnifier by one examiner. The prevalence of CEP for maxillary teeth (45.49%) was higher than that of mandible (39.62%). The first molar (45.22%) had more CEP than second (39.89%). Furthermore, buccal surface had highest incidence of CEP than other surfaces. The results of this study imply that the clinicians should take good care of the prevalence of CEP when scaling or root planning, plaque control instruction and periodontal surgery.

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Two-year survival analysis of twisted wire fixed retainer versus spiral wire and fiber-reinforced composite retainers: a preliminary explorative single-blind randomized clinical trial

  • Sobouti, Farhad;Rakhshan, Vahid;Saravi, Mahdi Gholamrezaei;Zamanian, Ali;Shariati, Mahsa
    • The korean journal of orthodontics
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    • v.46 no.2
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    • pp.104-110
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    • 2016
  • Objective: Traditional retainers (both metal and fiber-reinforced composite [FRC]) have limitations, and a retainer made from more flexible ligature wires might be advantageous. We aimed to compare an experimental design with two traditional retainers. Methods: In this prospective preliminary clinical trial, 150 post-treatment patients were enrolled and randomly divided into three groups of 50 patients each to receive mandibular canine-to-canine retainers made of FRC, flexible spiral wire (FSW), and twisted wire (TW). The patients were monitored monthly. The time at which the first signs of breakage/debonding were detected was recorded. The success rates of the retainers were compared using chi-squared, Kaplan-Meier, and Cox proportional-hazard regression analyses (${\alpha}=0.05$). Results: In total, 42 patients in the FRC group, 41 in the FSW group, and 45 in the TW group completed the study. The 2-year failure rates were 35.7% in the FRC group, 26.8% in the FSW group, and 17.8% in the TW group. These rates differed insignificantly (chi-squared p = 0.167). According to the Kaplan-Meier analysis, failure occurred at 19.95 months in the FRC group, 21.37 months in the FSW group, and 22.36 months in the TW group. The differences between the survival rates in the three groups were not significant (Cox regression p = 0.146). Conclusions: Although the failure rate of the experimental retainer was two times lower than that of the FRC retainer, the difference was not statistically significant. The experimental TW retainer was successful, and larger studies are warranted to verify these results.