• Journal of Oral Medicine and Pain
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• v.33 no.3
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• pp.279-294
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• 2008

This study aimed to make an analysis of the occlusion in the state of muscle fatigue produced by excessive mouth opening and clenching during the dental treatment to control the dental pain and to evaluate the sensory nerve in the muscle pain state. Most of the reasons why patients visit the dental office result in pain-either conceivably the dental origin pain or the non-dental origin pain. The dental offices have many therapeutic actions to produce the masticatory muscle fatigue for the treatment. Dental treatment with long minutes of mouth opening can cause some headaches, masticatory muscle pain and mouth opening difficulties. Patients with mastication problems who visits a dental office to alleviate pain run against another unexpected pain with other aspects. This study uses T-scan II system(Tekscan Co., USA) for the evaluation on the occlusal pattern in the experimental muscle fatigue after clenching, opening the mouth excessively and chewing gum. The occlusal contact pattern is analyzed by the contact timing, namely first, intercuspal, maximum and end point of contact. This inspection was performed at frequencies of 2000Hz, 250 Hz and 5 Hz before and after each experimental muscle pain was produced to 24 subjects who had normal occlusion without the orthodontic treatment or a wide range of the prosthesis by using $neurometer^{\circledR}$ CPT/C(Neurotron, Inc. Baltimore, Maryland, USA). The measuring sites were mandibular nerve experimental muscle fatigue respectively. This study could obtain the following results after the assessment of occlusion and sensory nerve of the experimental muscle fatigue. 1. There were the fastest expression after the excessive mouth opening in muscle fatigue and after tooth clenching in muscle pain. In the visual analog scale that records the subjective level, there was the highest scale after the clenching in the muscle fatigue in jumping off the point of pain. 2. Tooth contact time, contact force, relative contact force on the point of the first contact had no difference, and there were decreases in the contact force after the excessive mouth opening on intercuspal position point, after the excessive mouth opening and the gum chewing on the point of the maximum, and in the contact time after all the experimental muscle fatigue state on the point of the end contact. 3. There was no statistic significance in the current perception threshold before and after the experimental muscle fatigue. 4. There was no significant difference in the contact number, the maximal contact number on the point of the first contact, and the contact number after the mouth opening and gum chewing on the point of the intercuspal position and the contact number after the experimental muscle fatigue on the maximum point, and showed significant decreases. In conclusion, it was found that the occlusal pattern can cause the changes on the case of the clinical muscle weakness by intra-external oral events. It was important that the sedulous attention to details is required during dental treatment in case of excessive mouth opening, mastication and clenching.

• Journal of Oral Medicine and Pain
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• v.32 no.3
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• pp.283-292
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• 2007

In several treatment modalities for snoring and obstructive sleep apnea (OSA), oral appliances mainly including mandibular advancement appliance (MAA) and tongue retaining device (TRD) are recognized as a non-invasive, reversible alternative with favorable results. Tongue bulb is a major component of TRD which prevents the tongue from approaching the posterior wall of the pharynx and can be combined with MAA. Determination of tongue bulb size for the patient is important for therapeutic effect, but frequently needs time-consuming work. For effective fabrication and standardization of tongue bulbs, this study aimed to categorize tongue bulb size for healthy young men and to examine its relation with maximum retention force and with physical parameters including tongue-related variables. 36 non-snoring, asymptomatic young men with normal occlusion were voluntarily participated in this study (mean age: $24.47{\pm}2.58$ years). Experimental procedures consisted of prefabrication of tongue bulb set (20 types with a width of 27-36mm and thickness of 8 and 10 mm), determination of tongue bulb size and the maximum retention force for each subject, and measurement of physical parameters including body mass index (BMI), neck circumference and width, thickness and length of tongue. This study showed that there was significant difference of retention force among the bulb size-related groups both in upright and supine position (p<0.05) and that retention force increased with bulb size. Correlation of tongue bulb size with physical parameters was not clearly verified and there was no significant difference in retention force between upright and supine positions. Based on our results, it can be suggested that retention force relates with tongue bulb size, ultimately with tongue volume. A further study needs to be performed in the patients with snoring and OSA.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.169-181
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• 2008

The aim of this study was to compare the retention and stability of implant overdenture according to the shape and the number of magnetic attachment. The experimental groups were designed for the number of implants(1, 2, 4) and shape of magnetic attachments(flat, cushion, dome type) resulting in 9 subgroups. 45 attachments were tested attached to $Br{\aa}nemark$ system implants which were planted on a mandibular model. Each attachment was composed of the magnet assembly embedded in a overdenture sample and the abutment keeper screwed into the implants. Dislodging tensile forces were applied to the overdenture samples using an Instron(cross-head speed 50.80mm/min) in 3 directions simulating function: vertical, oblique, and anterior-posterior. The loading was repeated 10 times in each direction for 45 samples. The values of maximum dislodging force of each subgroup were processed statistically using SPSS V. 12.0 at the 0.05 level of significance. The results of this study were as follows: 1. Flat type magnetic overdenture was the most retentive when subjected to vertically directed forces and dome type was the lest retentive when subjected to obliquely directed forces(p<0.05). 2. In case of planting one implant, flat type had a higher vertically retentive force than anterior-posteriorly retentive force. In case of planting two implants, flat type and dome type had a higher vertically retentive force and in case of planting four implants, flat type and cushion type had a higher vertically retentive force than anterior-posteriorly retentive force(p<0.05). 3. The incremental number of dental implant, without regards to the three types of magnetic attachment shapes, showed higher retention of overdenture(p<0.05). From the results, if a patient need much more retention of implant overdenture, flat type magnetic overdenture would be a good treatment. In case of the bruxism where excessive lateral forces are already present, dome type could be expected to produce better results. In case of planting one implant, flat type is more stable than the other shape of magnet and in case of two implant, flat type and dome type are more stable and in case of four implants, flat type and cushion type are more stable. Planting more than two implants and using flat type magnetic attachment would provide better retention and stability of implant overdenture

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.378-386
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• 2015

Overdenture has the advantage of improving the stability and retention of the denture but the abutment may be easily affected by caries or periodontal disease and the thin denture can be easily broken. The magnetic attachment overdenture has a high vertical retention but a low horizontal retention, thus, exerting a less disruptive force to the abutment or implant and shows less abrasion or damage compared to other mechanical retainers. Denture fractures in overdenture is caused by the thin denture base as the attachment is inserted, but it may also be caused by the difference in detrusion between soft tissue and hard tissue, and between an implant and a natural tooth. To compensate this shortcoming, a magnetic attachment with a silicone ball inserted in the magnet was developed as we report a successful case using this specific type of magnetic attachment overdenture.

• Journal of Periodontal and Implant Science
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• v.46 no.2
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• pp.96-106
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• 2016

Purpose: Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. Methods: Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects' skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. Results: In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. Conclusions: The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.71-81
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• 2004

The purpose of this study was to compare the distributing pattern of stress on the finite element models of two units implant prosthesis with one angulated placement of two implant fixtures. The two unit implant crowns simulated to mandibular first and second molars were made. The two kinds of finite element models were designed according to angulation of fixture ($4.0mm{\times}11.5mm$) : Model 1($15^{\circ}$ buccally angulated placement of one fixture on second molar area), Model 2($15^{\circ}$ lingually angulated placement of one fixture on second molar area). Axial loads of 200N were applied to the center of central fossa and to distance of 2mm and 4mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the fixtures, and buccolingual section of implants. The results were as follows: 1. Under axial loading at the central fossa, the stress was distributed along the straight fixture except apical portion, while on buccally or lingually angulated placement, the highest stresses were concentrated in the neck portion on the opposite side of the angulated fixture. 2. With offset distance increasing, the stresses were concentrated greater in buccal neck of lingually angulated fixture than in lingual neck of buccally angulated fixture. From the above results, in designing of the occlusal scheme for implant prosthesis with the angulated fixture, occlusal contacts should be placed to distribute stress axially in maximum intercuspation and to avoid offset force during eccentric movements.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.284-290
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• 2017

For individuals with cleft lip and palate, the removable partial dentures (RPDs) have been an important treatment option. Some modifications from conventional prosthetic treatment may be necessary to achieve satisfactory functional and esthetic results in cleft patients. In case of cleft palate patient with periodontally compromised and only posterior few remaining teeth, removable partial prosthesis connected to telescopic crown can be the alternative treatment option. When connected to the RPD, telescopic crowns increase the prosthetic stability and retention, optimize favorable force transmission to the long dental axis, and improve esthetics. And the cross arch stabilization of double crown denture helps to stabilize both divided maxillary ridges in CLP patient. This case present one adult CLP patient using an RPD connected with hybrid telescopic crowns with friction pins to improve not only retention and stability but also aesthetics.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.55-62
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• 2017

Overdenture using dental implants could improve the problems of conventional complete denture function which are pain during mastication, insufficient retention and stability. Locator attachment used widely for implant-retained overdenture has advantages that it needs the smallest vertical space and also its nylon male cap allows personalized retention for each case. However its retention force decreases rapidly with function rather than the bar and ball attachment. So, implant fixture should be positioned as parallel as possible.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.33-38
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• 2010

Maxillectomy is a treatment option for maxillary cancer, which leaves the patient with a palatal defect. It may cause problems with facial deformation, swallowing, mastication, and speech. These functional problems and changes in appearance may result in psychological problems. To control these deficits after maxillectomy, surgical reconstruction or prosthodontic treatment can be chosen as a treatment option. Obturator prosthesis has been used as a preferred method of rehabilitation for most maxillectomy patients. This case is a patient who was classified Aramany classification II hemi-maxillectomy patient with residual teeth from #11-25, whose teeth had substantial labioversion and clinically lengthened from alveolar bone involution, thus making it hard to select proper framework design and resist to the rotational dislodging force of the obturator. Therefore we selected swing-lock attachment design to remain pre-existing crown and bridges and obtain retention and stability of obturator. The swing-lock RPD is economical than the conventional RPD because we can remain pre-existing crown and bridges. And residual teeth which have mobility and poor prognosis can be successfully retained through properly designed swing-lock RPD as it is functioning as a removable splint on the teeth.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.3
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• pp.299-310
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• 2008

In this study, the regression analysis method was tested for the estimation of peak stress at stress concentration area in the cervical bone. Submerge type EZ plus implant (Megagen. Daegu, Korea), 4.1 mm in cervical diameter and 9.6 mm in endosseous length, were axisymmetrically modelled together with surrounding alveolar bone of which the width was 10 mm. Vertical force of 100 N was applied to a head of crown above 8.5 mm from the outer surface of the cortical bone. Four different mesh models were composed of differently sized elements in vicinity of sharp corners, and they include 6 stress monitoring points that are located in the same geometrical points regardless of the differences in the meshes. Primary consideration was given to the stresses in the cortical bone surrounding the implant neck. The results showed that virtually all the stresses were concentrated in the cortical bone regardless of mesh designs. The peak stresses were successfully calculated by a regression analysis in a stable manner, as far as the mesh is designed to represent the acute gradient of stresses near the sharp corner.