• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.209-222
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• 2011

Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.349-357
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• 2015

Edentulous patients with a severely resorbed mandible or maxilla often experience problems with conventional dentures, such as insufficient stability and retention, together with a decrease in chewing ability. Because of the good prognosis of dental implants, these patients can be successfully treated with implant-retained or implant-supported prosthesis. Ideally, a maximum number of implants of maximum length are placed in appropriate surgically prepared sites that are surrounded by a maximum amount of bone of favorable quality. The implants are favorably aligned faciolingually and mesiodistally to enhance optimal prosthodontic design. This article describes the clinical problems and complications encountered when treating a consecutive number of edentulous patients with osseointegrated implant-supported prostheses.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.78-83
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• 2009

In case of endodontic treatment and extensive restoration of severe dental caries, trauma, and developmental defect, esthetic restoration of primary incisors and permanent anterior teeth for children and adolescents period is delicate matter for pediatric dentists. Existing restorative methods for anterior teeth have retentive and esthetic limitations for badly damaged teeth, especially for the adolescent anterior teeth. Therefore, the preparative stage for setting the permanent prosthesis as well as the retention and esthetics have to be considered. In this case, esthetic restoration for badly destroyed anterior teeth was tried with fiber-reinforced post and the result was satisfactory.

• The Journal of Advanced Prosthodontics
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• v.8 no.5
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• pp.411-416
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• 2016

Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.717-730
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• 1998

The Finite Element Analysis has been used for stress analysis of prosthesis, orthodontic or orthopedic appliances and filling materials. The primary purpose of the present studying was to evaluate the effectiveness of needle post in promoting the retention and integrity of composite crown restored on the pulpotomized primary central incisor. Three finite element models-natural tooth (Sample I), composite crown with (Sample II) and without (Sample III) needle post-were constructed and the stress distribution within each model were analyzed and compared one another. The results can be summarized as follows: 1. In sample I, the stress was shown to have distributed uniformly throughout the whole tooth even to the alveolar bone. 2. In sample II, the transmission of stress from the crown to the root area was shown to be very poor and irregular. 3. In sample III, the needle post was proved to be very effective in distributing the stress well to the aveolar bone which might help in maintaining the stability of crown restoration.

• The Journal of the Korean dental association
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• v.54 no.7
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• pp.513-520
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• 2016

In crossed occlusion, displacement of removable partial denture is likely to occur during function due to different characteristics of abutment and supporting tissue. It increases discomfort to the patient. In addition, adverse effect on the residual ridge and abutment can induce an unfavorable prognosis of the denture. In this case, a small number of implants can be placed in strategic locations. Attachment can be added for additional support and retention of removable partial denture assisted by implants. This article describes the rehabilitation of a crossed occlusion patient using implant-assisted removable partial denture with Locator$^{(R)}$ attachment. After 24 months, the patient was satisfied with the aesthetic and function of the prosthesis that is maintained stable.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.2
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• pp.127-144
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• 2002

There is an increasing appreciation of the vital role that biomechanics play in the performance of oral implant. The aim of this article is to provide some basic principles that will allow a clinician to formulate a biomechanically valid treatment plan. However, at this point in the history of oral implantology, the clinician should realize that we do not know enough to provide absolute biomechanical rules that will guarantee success of all implants in all situations. To examine the biomechanical questions, one must begin with an analysis of the distribution of biting forcess to implants. Related topics, such as stress transfer to surrounding tissues and interrelationships between bone biology and mechanical loading are major subjects, deserving a separate discussion. Once rigid fixation, angulation, crestal bone level, contour, and gingival health are achieved, stress beyond physiologic limits is the primary cause of initial bone loss around implants. The restoring dentist has specific responsibilities to reduce overload to the bone-implant interface. These include proper diagnosis, leading to a treatment plan designed with adequate retention and form, and progressive loading to improve the amount and density of bone and further reduce the risk of stress beyond physiologic limits. The major remaining factor is the development of occlusal concept in harmony with the rest of the stomagnetic system.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.23 no.1
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• pp.34-40
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• 2014

There are several treatment options for rehabilitation of partial edentulism including the use of conventional or implant-retained fixed prostheses. However, such prosthetic options cannot always be possible because of compromised general and oral health (i.e. loss of supporting tissues, medical reasons, extensive surgical protocol and osseointegration failure of dental implant) as well as the affordability of patients. In some cases, removable partial denture provides easier access for oral hygiene procedures and the ability to correct discrepancies in dental arch relationships than implant fixed prosthesis. Recently, Implant Supported Removable Partial Denture (ISRPD) where to place dental implant in strategic position has been suggested to improve the limitation and shortcomings of conventional RPD. ISPRD can overcome mechanical limition of conventional RPD by placing implant in a favorable position and can be cost-effective, prosthetic solution for partially edentulous patients who are not immediate candidates for extensive, fixed implant supported restorations. Incorporation of dental implants to improve the RPD support and retention and to enhance patient acceptance should be considered when treatment planning for RPD. In this case, 59 years old male patient who received dental treatment of implant fixed prosthesis on both side of the upper jaw and implant overdenture on lower jaw showed implant abutment screw fracture on #15i and osseointegration failure on multiple number of implants. After removing failed implants, we planned ISRPD using #15i,24i,25i,26i and #23 natural tooth for RPD abutment. We fabricated #23 surveyed crown,#24i=25i=26i surveyed bridge and #15i gold coping for support,retention and stability for RPD. Periodic follow up check for 2years has been performed since the ISRPD delivery to the patient. No sign of screw loosening, fracture or bone resorption around abutment implants were detected.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.365-375
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• 2009

Statement of problems: Stress analysis on implant components of the combined screw- and cement-retained implant prosthesis has not investigated yet. Purpose: The purpose of this study was to assess the load distribution characteristics of implant prostheses with the different prosthodontic retention types, such as cement-type, screw-type and combined type by using 3-dimensional finite element analysis. Material and methods: A 3-dimensional finite element model was created in which two SS II implants (Osstem Co. Ltd.) were placed in the areas of the first premolar and the first molar in the mandible, and three-unit fixed partial dentures with four different retention types were fabricated on the two SS II implants. Model 1 was a cement-retained implant restoration made on two cement-retained type abutments (Comocta abutment; Osstem Co. Ltd.), and Model 2 was a screw-retained implant restoration made on the screw-retained type abutments (Octa abutment; Osstem Co. Ltd.). Model 3 was a combined type implant restoration made on the cement-retained type abutment (Comocta abutment) for the first molar and the screw-retained type abutment (Octa abutment) for the first premolar. Lastly, Model 4 was a combined type implant restoration made on the screw-retained type abutment (Octa abutment) for the first molar and the cement-retained type abutment (Comocta abutment) for the first premolar. Average masticatory force was applied on the central fossa in a vertical direction, and on the buccal cusp in a vertical and oblique direction for each model. Von-Mises stress patterns on alveolar bone, implant body, abutment, abutment screw, and prosthetic screw around implant prostheses were evaluated through 3-dimensional finite element analysis. Results: Model 2 showed the lowest von Mises stress. In all models, the von Mises stress distribution of cortical bone, cancellous bone and implant body showed the similar pattern. Regardless of loading conditions and type of abutment system, the stress of bone was concentrated on the cortical bone. The von-Mises stress on abutment, abutment screw, and prosthetic screw showed the lower values for the screw-retained type abutment than for the cement-retained type abutment regardless of the model type. There was little reciprocal effect of the abutment system between the molar and the premolar position. For all models, buccal cusp oblique loading caused the largest stress, followed by buccal cusp vertical loading and center vertical loading. Conclusion: Within the limitation of the FEA study, the combined type implant prosthesis did not demonstrate more stress around implant components than the cement type implant prosthesis. Under the assumption of ideal passive fit, the screw-type implant prosthesis showed the east stress around implant components.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.323-329
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• 2018

Traditional options for posterior edentulous treatment include removable partial dentures and implant fixed prostheses. Recently, the concept of implant assisted removable partial denture, in which two treatments are fused, has been introduced in consideration of systemic health and patient's needs, costs, residual alveolar bone status and so on. Implant assisted removable partial denture has the advantage of increasing the retention and stability of the denture and improving its esthetics in cases of large bone defects or biomechanical disadvantages. In addition, it is possible to strategically place the implants in a site where the alveolar bone is relatively sufficient, thereby overcome the limit of the conventional removable partial denture design as well as reducing the burden on a wide range of implant surgery. Cost reduction is also expected. In this case, the patient was treated by placing the implant in both premolar sites of the mandible and fabricating the distal extension removable partial denture with the implant fixed prosthesis as an abutment. After delivering the definitive prosthesis, the patient showed satisfaction with the masticatory function and esthetics. and has been regularly followed-up for more than one year. The following 20-months follow-up case report describes the design of an implant-assisted-removable partial denture (IARPD) in which two cementretained implant crowns used to provide support and stability.