• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.255-261
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• 2007

Preface: Dental implant is important method that may solve the mastication, occlusion, esthetic, temporomandibular joint, and psychologic problem in oral and maxillofacial surgery. It is ideal that all of the implant are well positioned by adequate technique. By the way it‘s not always possible because of some anatomic, physiologic factor. In this case, If the implant can be moved to adequate position, it may be possible more esthetically and implanted patients more satisfied, but the majority of Implantists and orthodontists have thought that it is not possible. However, Implant, in fact, can be moved. and thus we can overcome the limit of implantation more. The aim of the present study was to evaluate the possibility of implant movement after corticotomy. Case report: Patient missed the upper right first molar. and implantation was done after completion of socket healing. We wait six months for osseointegration. Then, corticotomy was done under local anesthesia and close coil was used for orthodontic force. After traction during 3 weeks, we find the change of implant position at horizontal plane. we can not see the degenerative change on adjacent structure and tracted implant. there is a clinical mobility on upper right second premolar that used for anchorage but it subside spontaneously at the timing of prosthetic restoration without additional treatment. Discussion: As we could have some knowledge with this experiment, we report the case of implant movement after corticotomy and suggest a method about more esthetic implant treatment with a review of literature.

• 한국정밀공학회지
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• 제23권2호
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• pp.154-163
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• 2006

Tooth morphology is the most important scientific aspect of dental medicine in regards to the treatment and study of teeth attrition relating to the absence of teeth due to dental caries or the occlusion of teeth due to external force. Most of the studies have focused on the external morphology in cutting teeth regardless of sex and age. However, the importance of internal morphology in the treatment of damaged teeth has been increased. Therefore, this study established the measurement criteria for the morphology of the mandibular first premolar which had never been presented, in order to investigate the external and internal morphologies of mandibular first premolars, and introduced a non-destructive method such as a microcomputed tomogrphy. Mandibular first premolars in superlative state were taken from molars of middle aged males and females and used as specimens for this study. Criteria relating to the internal and external morphology measurements were established to quantify the length of the teeth in identical state. Two dimensional image data for the selected mandibular first premolar were obtained by taking the image of each O.022mm section, which is perpendicular to the vertical direction using the microcomputed tomography. The Vworks program was applied to measure the length of each morphological part according to the set measurement criteria. These measured data were compared with the data presented by G. V. Black and the internal and external morphologies of the teeth of middle aged Koreans were also compared according to gender. In addition, the methodology for measurement of the mandibular first premolar was presented and according to this, the standardized mandibular first premolars of middle aged Korean males and females were made by using a rapid prototyping system.

• 대한치과보철학회지
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• 제55권1호
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• pp.79-87
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• 2017

전치부 개방 교합은 다양한 원인이 복합적으로 작용하고, 진단에 따라 효과적인 치료 계획과 적절한 유지 방법을 선택할 수 있다. 대부분의 경우 교정과 악교정 수술을 통해 안정적인 교합을 얻고, 기능과 심미를 회복한다. 하지만 전체 치열에서 심한 우식증이 있는 경우 광범위한 수복이 필요하게 되므로, 보철 수복을 통해서도 교합을 재형성할 수 있다. 본 증례는 심한 우식을 동반한 골격성 전치부 개방 교합 환자에서 안모 분석 및 진단 납형으로부터 가장 효과적인 치료로 전악 보철 수복을 선택하였다. 교합력을 균등하게 분산하고 심미적인 임시 수복물을 제작하였고, 악간 관계 평가, 혀 등 연조직의 적응, 입술과의 조화를 관찰하고 수정하였다. 충분한 기간 동안 사용한 임시 수복물을 CAD/CAM (Computer-aided design/computer-aided manufacturing)을 이용하여 단일구조 지르코니아 최종 보철물로 이행하였고, 치료 종결 후 3개월 간 주기적으로 관찰하였을 때 만족스러운 결과를 얻었다.

• 구강회복응용과학지
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• 제28권1호
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• pp.27-36
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• 2012

임플란트를 이용한 치료가 대중화됨에 따라 다양한 문제가 보고되고 있는데, 이 중에서도 나사풀림현상과 관련된 토크 조절기의 사용에 있어 제조회사에서 권장하는 적절한 토크값과 실제 적용되는 조임력에는 차이가 있음이 여러 연구결과를 통해 보고되고 있다. 본 연구에서는 제품마다 사용기간이 다른 토크 조절기를 이용하여 각각에 따른 정확도를 비교, 분석하고자 하였다. 오차율은 제조회사별로 차이가 있었지만 모든 제품에서 사용기간이 증가할수록 기준값에 대한 오차율은 증가하였다. 그리고 반복 조임 횟수 증가에 따른 측정값의 변화를 살펴보면 반복 조임 초기에는 기준값에 근접한 값을 나타내었지만 기준값에 대한 변화의 폭은 크게 나타났고, 반복 조임 횟수가 증가할수록 기준값에 대한 오차율은 증가하였지만 변화의 폭은 줄어드는 것으로 관찰되었다.

• 대한치과보철학회지
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• 제50권4호
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• pp.330-335
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• 2012

Shortened dental arch(SDA) 개념은 여러 현실적인 이유로 적절한 대안이 없을 경우 제 2 소구치까지만 수복이 이루어져도 안정적인 교합과 저작력을 얻을 수 있다는 것으로 자연치와 임플란트를 이용한 수복시 공히 적용되는 개념이다. 본 증례는 2급 지적장애로 인해 치료시 협조를 구할 수 없으며 우식으로 인해 다수의 치아가 상실된 환자로 대구치 부위의 심한 골흡수와 상악동의 함기화 및 상악동염으로 인해 제 2 대구치까지의 수복이 용이하지 않아 가급적 위험요인을 줄이면서 최소한의 전신마취로 치료를 종결하기 위해 SDA 개념을 적용, 제 2 소구치까지만 수복이 이루어졌다. 치료 결과 심미적, 기능적으로 만족할 만한 향상이 이루어졌고 추가적인 저작력의 요구는 없었으며 주기적인 재내원으로 구강위생이 강화되었다.

• 구강회복응용과학지
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• 제18권4호
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• pp.301-311
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• 2002

The purpose of this study was to compare the distributing pattern of stress on the finite element models with the different vertical bone level of implant fixture. The two kinds of finite element models were designed according to vertical bone level around fixture ($4.0mm{\times}11.5mm$). The cemented crowns for mandibular first and second molars were made. Three- dimensional finite element model was created with the components of the implant and surrounding bone. Vertical loads were applied with force of 200N distributed within 0.5mm radius circle from the center of central fossa and distance 2mm and 4 mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the supporting bone, fixtures, abutment screws, and crown. The results were as following : (1) In vertical loading at the center circle of central fossa on model 1 and 2, the difference from vertical bone in implant placement did not affect the stress pattern on all components of implant except for crown. (2) With offset distance incerasing and the bone level of implant decreasing, the concentration of stress occured in the buccal side of long crown, around the buccal crestal bone, and on the fixture- abutment interface. As a conclusion, the research showed a tendency to increase the stress on the supporting bone, fixture and screw under the offset loads when the vertical level of bone around fixture was different. Since the same vertical bone bed has more benefits than the different bone bed around fixtures, it is important to prepare a same vertical level of bone bed for the success of implants under occlusal loads.

• 구강회복응용과학지
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• 제29권4호
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• pp.426-433
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• 2013

완전 무치악 환자를 총의치로 수복할 때 특히 하악의 경우 유지, 지지 면적이 상악보다 좁아 의치의 탈락, 불량한 지지 및 안정성, 통증을 유발하여 의치의 사용이 불편할 수 있다. 이런 환자에서 임플란트를 이용한 보철수복은 심미성, 안정성, 저작력을 향상시킬 수 있다. 반면 상악 완전무치악은 구개를 이용할 수 있으므로 총의치로 수복하였을 때 많은 환자들이 잘 적응하여 사용하고 있다. 이에 상하악 완전 무치악 환자의 치료 옵션으로 하악은 임플란트로 지지를 받는 고정성 보철물 또는 임플란트 오버덴쳐로 수복하고 상악은 연조직에 의해 지지를 받는 전통적인 총의치로 수복하는 전악 보철수복이 제시되었다. 이 때 상악 총의치에 대합하는 하악 임플란트 고정성 보철이 상악 잔존치조제의 골흡수에 어떠한 영향을 미치는지에 대한 문헌고찰과 함께 증례를 보고하고자 한다.

• 구강회복응용과학지
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• 제19권3호
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• pp.247-256
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• 2003

The patient had bruxism and epilepsy tendency. Inadequate or unstable posterior support was identified due to severe anterior attrition and decreased occlusal vertical dimension. Prematurities of posterior occlusal and wear facets increased the function of anterior teeth, resulting in severe wear. Wear facets displayed sharply defined peripheries, which are matched on articulated diagnostic casts. Also the patient showed C III malocclusion tendency, and lost some facial contour with drooping corners on the mouth. In this case, the alteration of OVD (Occlusal Vertical Dimention) may provide a biologically compatible adjunct to the treatment such as dentofacial esthetics, improved visual proportion in facial heightand mechanical solutions to the force-management of the masticatory system. The patient requires extensive restorative treatment to regain appropriate function, esthetics and comfort. According to the report by Farhad Fays, the average vertical distance from the maxillary to the mandibular mucolabial reflection in the region of the central incisors is approximately 34mm. However, the vertical distance of this patient was found to be 32mm, which was necessary to add gauge 20-sheets to apply vertical dimension. A removable occlusal overlay splint, which restores OVD to the estimated optimalposition, is the general first trial. The patient was observed periodically for 6 weeks, while appropriate adjustments were made vertical dimension to function. When patient felt comfortable with the splint, the teeth were prepared, and provisional restorations are placed for 3 months. The provisional restoration was fabricated by a diagnostic wax-up. When the patient felt comfortable with the provisional restoration, the final restoration mimics OVD, function, and esthetics that have been developed in the treatment restorations. Restoration of the extremely worn dentition presents a substantial challenge to thedentists. Therefore, careful evaluation of the etiology, history, and factors associated with occlusal vertical dimension should be preceded prior to the appropriate treatment planning.

• 구강회복응용과학지
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• 제16권2호
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• pp.123-132
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• 2000

The field of maxillofacial prosthetics is concerned with the prosthetic reconstruction of missing head and neck tissue. Currently, facial prostheses are usually applied in cases of defects caused by the surgical removal of tumors or congenital defects. While silicone has been most widely used for the reconstruction of missing maxillofacial defects, it does not have ideal physical properties. Therefore, bonding a thin polyurethane sheet to silicone prostheses was recommended. In this case skin adhesives were used for the retention of maxillofacial prostheses. But retention of devices has always been problematic. The contributions of implants can be made to solve these problems. Implants have reduced the need for adhesive use, simplifying cleaning procedures and thus extending the life of the prostheses. For implant-retained prostheses, retentive matrix is necessary to hold attachments and/or magnets. The retentive matrix is usually fabricated with autopolymerizing acrylic resin or visible light- polymerized resin. The purpose of this study was to compare the adhesion-in-peel force of silicone adhesive to autopolymerizing acrylic resin and polyurethane sheet with two different surface textures : pumice polish only or retention groove, and three surface primers : Dow corning 1205 primer or Dow corning S-2260 primer or FactorII A-304 primer, and two polymerization methods : room temperature or dry heat oven. The t-peel bond strength of specimens was determined as described in ASTM Standard D1876-72. The results were statistically analyzed using the ANOVA test, multiple range test and t-test The results were as follows. 1. The t-peel bond strength of A-304 primer was the highest and statistically higher than that of S-2260(p<0.05). 2. The t-peel bond strength of specimens with retention groove was statistically higher than that of specimens polished with pumice(p<0.05). 3. The t-peel bond strength of specimens polymerized in dry heat oven was statistically higher than that of specimens in room temperature(p<0.01).

• 구강회복응용과학지
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• 제35권1호
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• pp.37-45
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• 2019

무치악 환자의 보철치료에서 총의치를 이용한 보철 치료 시 각화 점막을 통해 교합력을 분담하므로 저작력과 저작 능률이 떨어지고 특히 지지 점막 면적이 작은 하악의 경우 상악에 비해 통증 발생 등의 부작용이 더 많다. 치조골 흡수가 많은 환자일수록 이는 더 심화되나 하악 구치부 측의 하치조신경관의 존재 때문에 임플란트를 동반한 적극적 치료가 어려운 경우가 많다. 이에 본 증례에서는 상악에는 전통적인 총의치를 제작하고 하악은 치조골 높이가 충분한 전방부에만 임플란트를 식립하여 all-on-4 방법으로 치료한 환자에서 좋은 경과를 보여 보고하고자 한다.