• The Journal of the Korean dental association
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• v.54 no.7
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• pp.492-500
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• 2016

Crown fractures are a common type of dental injuries and very frequently occurred on maxillary anterior teeth, area of requiring a rapid aesthetic recovery. Crown fragment reattachment is a simple and conservative method to restore the fractured teeth. The technique promotes esthetic outcomes as utilizing natural contour, shade, surface texture of teeth and gives mechanical similarity in terms of wear-resistance. Also it gives emotional positive responses to patients and requires less of chair time and costs. This case report presents two cases of crown fragment reattachments on maxillrary anterior teeth, including one complicated crown fracture and one uncomplicated crown fracture. If the fragment is available in cases of crown fractures, reattachment of fragment can be regarded as a predictable alternative. However, it is all the time important that a close conversation informing the patients about the limitations and prognoses of this treatment option.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.284-291
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• 2013

Purpose: This study compared fracture strength and fracture modes between metal wire reinforcement and glass fiber reinforcement in repaired maxillary complete denture. Materials and methods: In this study, fracture was reproduced on center of maxillary complete dentures and the denture was repaired with auto-polymerizing resin. The experimental groups (n = 10) were subjected to the following condition: without reinforcing material (control group), reinforcing with metal wire (W group), reinforcing with glass fiber pre-impregnated with light-curing resin (SES MESH, INNO Dental Co., Yeoncheon, Korea, G group). The fracture strength and fracture modes of a maxillary complete denture were tested using Instron test machine (Instron Co., Canton, MA, USA) at a 5.0 mm/min crosshead speed. The flexure load was applied to center of denture with a 20 mm diameter ball attachment. When fracture occurred, the fracture mode was classified based on fracture lines. The Kruskal-wallis test and the Mann-whitney U test were performed to identify statistical differences at ${\alpha}=.05$. Results: W group showed the highest value of fracture strength, there was no significant difference (P>.05) between control group and G group. Control group and W group showed anteroposterior fracture mainly, group W showed adhesive fracture of denture base and reinforcing material. Conclusion: In limitation of this study, the glass fiber did not improve the fracture strength of repaired maxillary complete denture, and adhesive failure was occurred along the lines of glass fiber.

• The Journal of Advanced Prosthodontics
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• v.11 no.3
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• pp.187-192
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• 2019

PURPOSE. The purpose of this in vitro study was to investigate the fracture loads and modes of failure for the full range of natural teeth under simulated occlusal loading. MATERIALS AND METHODS. One hundred and forty natural teeth were taken from mandibles and maxillas of patients. There were 14 groups of teeth with 10 teeth in each group (5 males and 5 females). Each specimen was embedded in resin and mounted on a positioning jig, with the long axis of the tooth at an inclined angle of 30 degrees. A universal testing machine was used to measure the compression load at which fracture of the tooth specimen occurred; loads were applied on the incisal edge and/or functional cusp. RESULTS. The mean fracture load for the mandibular first premolar was the highest (2002 N) of all the types of teeth, while the mean fracture load for the maxillary first premolar was the lowest (525 N). Mean fracture loads for the mandibular and maxillary incisors, and the first and second maxillary premolars, had significantly lower values compared to the other types of teeth. The mean fracture load for the teeth from males was significantly greater than that for the teeth from females. There was an inverse relationship between age and mean fracture load, in which older teeth had lower fracture loads compared to younger teeth. CONCLUSION. The mean fracture loads for natural teeth were significantly different, with dependence on tooth position and the sex and age of the individual.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.111-114
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• 2013

The anterior maxillary sinus walls are the most frequently injured sites in midfacial fractures. The maxillary sinus is a difficult surgical site for reduction and fixation due to its narrow surgical field, and has a chance of developing sinusitis when sufficient treatment is not given. In this study, the methods developed by the authors for managing such are introduced. Two small openings were made on both sides of the fracture line, then a suture knot was tied instead of wiring for reduction and fixation. Then an absorbable mesh was applied on top of the fracture site, with a suture knot for additional fixation. This method was applied on an actual patient, and it was a convenient method despite the narrow surgical field that was provided. The authors believe that using suture knots to fixate fractured segments and absorbable mesh is relatively convenient and economically efficient when it comes to the reduction and fixation of the maxillary sinus wall fracture with several fragments.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.89-92
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• 2022

Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

• The Journal of Advanced Prosthodontics
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• v.9 no.1
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• pp.22-30
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• 2017

PURPOSE. The aim of this study was to investigate the effect of reinforcing materials on the fracture resistances of glass fiber mesh- and Cr-Co metal mesh-reinforced maxillary complete dentures under fatigue loading. MATERIALS AND METHODS. Glass fiber mesh- and Cr-Co mesh-reinforced maxillary complete dentures were fabricated using silicone molds and acrylic resin. A control group was prepared with no reinforcement (n = 15 per group). After fatigue loading was applied using a chewing simulator, fracture resistance was measured by a universal testing machine. The fracture patterns were analyzed and the fractured surfaces were observed by scanning electron microscopy. RESULTS. After cyclic loading, none of the dentures showed cracks or fractures. During fracture resistance testing, all unreinforced dentures experienced complete fracture. The mesh-reinforced dentures primarily showed posterior framework fracture. Deformation of the all-metal framework caused the metal mesh-reinforced denture to exhibit the highest fracture resistance, followed by the glass fiber mesh-reinforced denture (P<.05) and the control group (P<.05). The glass fiber mesh-reinforced denture primarily maintained its original shape with unbroken fibers. River line pattern of the control group, dimples and interdendritic fractures of the metal mesh group, and radial fracture lines of the glass fiber group were observed on the fractured surfaces. CONCLUSION. The glass fiber mesh-reinforced denture exhibits a fracture resistance higher than that of the unreinforced denture, but lower than that of the metal mesh-reinforced denture because of the deformation of the metal mesh. The glass fiber mesh-reinforced denture maintains its shape even after fracture, indicating the possibility of easier repair.

• The Journal of Advanced Prosthodontics
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• v.10 no.2
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• pp.155-162
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• 2018

PURPOSE. The aim of this study was to compare the fracture of implant component behavior of external and internal type of implants to suggest directions for successful implant treatment. MATERIALS AND METHODS. Data were collected from the clinical records of all patients who received WARANTEC implants at Seoul National University Dental Hospital from February 2002 to January 2014 for 12 years. Total number of implants was 1,289 and an average of 3.2 implants was installed per patient. Information about abutment connection type, implant locations, platform sizes was collected with presence of implant component fractures and their managements. SPSS statistics software (version 24.0, IBM) was used for the statistical analysis. RESULTS. Overall fracture was significantly more frequent in internal type. The most frequently fractured component was abutment in internal type implants, and screw fracture occurred most frequently in external type. Analyzing by fractured components, screw fracture was the most frequent in the maxillary anterior region and the most abutment fracture occurred in the maxillary posterior region and screw fractures occurred more frequently in NP (narrow platform) and abutment fractures occurred more frequently in RP (regular platform). CONCLUSION. In external type, screw fracture occurred most frequently, especially in the maxillary anterior region, and in internal type, abutment fracture occurred frequently in the posterior region. placement of an external type implant rather than an internal type is recommended for the posterior region where abutment fractures frequently occur.

• Archives of Craniofacial Surgery
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• v.24 no.3
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• pp.117-123
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• 2023

Background: Midfacial fractures frequently involve the maxillary sinus, leading to maxillary sinus pathology. We aimed to examine the incidence and contributing factors of maxillary sinus pathology in patients who underwent open reduction and internal fixation (ORIF) for midfacial fractures. Methods: A retrospective analysis was conducted on patients who underwent ORIF for midfacial fractures at our department over the past 10 years. The incidence of maxillary sinus pathology was identified clinically and/or by computed tomography findings. Factors that significantly influenced the groups with and without maxillary sinus pathology were examined. Results: The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was found to be 11.27%, with sinusitis being the most common pathology. Maxillary sinus pathology was significantly associated with the presence of a blowout fracture involving both the medial and the inferior orbital walls. Factors such as sex, age, diabetes mellitus, hypertension, smoking, inflammatory disease, follow-up period, use of absorbable plates, and use of titanium plates did not have a significant impact on the development of maxillary sinus pathology. Conclusion: The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was relatively low, and in most cases, it resolved without the need for specific treatment. Consequently, there may not be a significant need for concern regarding postoperative maxillary sinus pathology.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.370-375
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• 2019

Background: Some parts of a maxillary fracture-for example, the medial and posterior walls-may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. Methods: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. Results: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). Conclusion: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.

• Journal of Trauma and Injury
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• v.25 no.1
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• pp.32-35
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• 2012

Traumatic pseudoaneurysms in the head and neck region are very rare. Particularyly, pseudoaneurysms of the internal maxillary artery are known to be very rare. The authors report a 20-year old male who was diagnosed as having a pseudoaneurysm of the internal maxillary artery. The cause was assumed to be a mandible ramus fracture. When he visited our emergency room, we did not consider a pseudoaneurysm because of his other life-threatening conditions. Fortunately, he re-visited our hosipital before the aneurysm ruptured. He was diagnosed with angiography and was treated by using embolization with glue. The rupture of the pseudoaneurysm could have caused a life-threatening hemorrhage.