• Journal of Periodontal and Implant Science
• /
• v.47 no.5
• /
• pp.312-327
• /
• 2017

Purpose: This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods: An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14-24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results: All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean $0.07{\pm}0.48mm$), while the crestal bone level decreased significantly, from $2.34{\pm}0.93mm$ at baseline to $1.70{\pm}1.10mm$ at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions: Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.24 no.2
• /
• pp.122-133
• /
• 2015

The requirements for the successful treatment of all-ceramic restorations are not so different from the ones of conventional restorations. "The provisional restoration followed by an adequate tooth reduction" and "the accurately fitting prostheses with corresponding to final impression" can be the examples of them. Nevertheless, the one which all-ceramic restorations are distinguished from conventional restorations is the additional procedure of so called "bonding". In addition to the application of resin cement between "inner surface of restoration and outer surface of abutment", bonding technology can be also applied to the treatment process of "Post and Core" in particular if the abutments are non-vital teeth. Core build-up for all-ceramic crown is conducted with fiber post and tooth colored composite by considering the properties of the restorations transmitting light. We know well that a vital abutment is easier than a non-vital one to get the targeted goals for clinical success in connection with esthetics and structure. The creation of "Post and Core" with bonding technique is a decisive factor for a long-term success if the abutment is non-vital tooth with dentinal collapse. I would like to share my clinical experience about "post & core build-up and all-ceramic restoration bonding" out of several success strategies of all-ceramic crown with this review article.

• Journal of Technologic Dentistry
• /
• v.38 no.2
• /
• pp.63-68
• /
• 2016

Purpose: The purpose of this study was to assess the internal fitness of the PMMA 3-unit bridge that was fabricated with 5-axis milling machine and to verify the clinically allowable values. Methods: For fabrication of the crown bridge in this study, 25-27 abutment teeth were used. The prepare abutment teeth were scanned with a scanner and 3-unit bridge was designed by using design software. Upon the completion of the design, the 3-unit bridge was fabricated by using a PMMA block with 5-axis milling machine. The internal surface of the fabricated 3-unit bridge was scanned by using a scanner and the difference between the 3-unit bridge and the abutment teeth was assessed by merging them together. Results: $RMS{\pm}SD$ values for PRE group, MOL group, and BRI group were $51.2{\pm}18.2$, $44.8{\pm}10.0$, and $52.1{\pm}8.3{\mu}m$, respectively. The mean of the PRE group was bigger than that of the MOL and BRI group; however, statistically significant difference was not found (p>0.05). Conclusion: The PMMA 3-unit bridge that was fabricated with 5-axis milling machine presented stable internal values for each crown and overall internal values were within the range of clinically allowable values.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.31 no.2
• /
• pp.143-149
• /
• 2015

In esthetic treatments, it is important to consider the arrangement of teeth and the relation between the teeth and soft tissues. A precise diagnosis and establishing an appropriate treatment plan is essential in an esthetic treatment of anterior maxillary teeth. For a fixed prosthesis to meet esthetic expectations, It is crucial to achieve symmetry and adequate proportions of the gingival contour around the crowns. To achieve an esthetic improvement and creating a favorable environment for gingival healing of a physiologic gingival contour, gingivectomy, crown lengthening and forced eruption can be applied to the appropriate site. All ceramics or porcelain laminate veneer can be selected for esthetic improvement of teeth contour and shade. In this case report, malposition of the remaining teeth made it hard to get an esthetic appearance. Gingivectomy, crown lengthening and provisional restoration insertion were performed before the final prosthesis fabrication to reform the gingival form. This case presents satisfying result esthetically and functionally.

• The Journal of the Korean dental association
• /
• v.50 no.7
• /
• pp.384-393
• /
• 2012

Successful treatment of a badly broken down tooth with pulpal disease depends not only on good endodontic therapy, but also on good prosthetic reconstruction of the tooth after endodontic therapy is completed. The ideal treatment of endodontically treated teeth has been widely and controversially discussed. Endocrown is a restorative option for endodontically treated teeth. Endocrown design incorporates the core and short post into the crown as a single restoration. The preparation of endocrown consists of a circular equigingival butt-joint margin and central retention cavity of the entire pulp chamber instead of employing intraradicular posts. This design significantly increases the surface area of the preparation available for cementation. It is particularly useful in young patient teeth for long-term provisional restoration and in teeth with short clinical crowns. This technique represents a promising and conservative method for the treatment of endodontically treated teeth that require long-term protection and stability. Endocrown can be considered as a feasible alternative to full crowns or composite overlays for the restoration of non vital teeth.

• The Journal of Korean Academy of Prosthodontics
• /
• v.50 no.4
• /
• pp.324-329
• /
• 2012

Excessive tooth wear causes loss of tooth structure, disharmony of occlusal plane, functional and esthetic problems. Although the decrease of occlusal vertical dimension may be compensated by growth of alveolar bone, if the length of tooth is not enough for the retention of restoration, minimum increase of occlusal vertical dimension is required without discomfort of the patient. In this case, 33-year-old woman drinks more than 1 liter of soft drinks a day and has bruxism in night time, visited in Seoul National University Dental Hospital with chief complaint of generalized tooth wear and related esthetic and functional problems. It was considered as a loss of occlusal vertical dimension based on the accelerated tooth wear caused by erosion and bruxism and facial appearance, phonetic, esthetic, functional evaluations. It was planned to raise occlusal vertical dimension by provisional restoration two times for patient's adaptation, 3 mm and 2 mm each, total 5 mm. Confirming no discomfort and clinical symptom during total 16 weeks after restoration with provisional fixed restoration, it was restored with porcelain fused to gold crown and bridge. Because the patient was young woman, anterior teeth were restored with collarless porcelain fused to gold crown. This case presents that satisfactory esthetic and functional result by full mouth rehabilitation with increase of occlusal vertical dimension.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.16 no.2
• /
• pp.149-159
• /
• 2000

Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.2
• /
• pp.175-186
• /
• 2022

A crossed occlusion resulting from the presence of posterior teeth in one arch but no opposing teeth in the opposite arch results in collapse of the vertical dimension. In this case, the patient has a class III malocclusion with crossed occlusion and anterior crossbite. In order to evaluate the proper vertical dimension, provisional denture was used to stabilize the vertical occlusal dimension for 3 months. After, provisional fixed restoration was used for the stabilizing occlusal relationship and aesthetic improvement for lip support. Definitive prosthesis in implants in the mandible and abutments in the maxillary were using Porcelain-fused-to-metal crown (PFM) crown and the maxillary unilateral edentulous area was treated with removable partial dentures. Through this, proper support of the posterior region and normal anterior occlusal relationship were formed, and the patient was able to obtain aesthetically and functionally satisfactory treatment results.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.267-275
• /
• 2023

To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors. Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.

• The Journal of Korean Academy of Prosthodontics
• /
• v.49 no.1
• /
• pp.80-86
• /
• 2011

When a tooth adjacent to implant has coronal damages caused by severe dental caries or fracture, the clinical crown lengthening by forced eruption makes it possible to get esthetic restoration due to the prevention of alveolar crestal bone resorption and loss of interdental papilla. A 54-years-old male patient wanted prosthetic treatment because his anterior 3 unit bridges had fallen out. A right maxillary central incisor showed mild dental caries but a right maxillary canine lost most clinical crowns. Forced eruption combined with a gingival fiberotomy of a right maxillary canine was performed for 1 month after the dental implant had been simultaneously placed with bone grafts on a right maxillary lateral incisor. About 5 months after implant placement, 2nd surgical operation was performed. The provisional restorations were adjusted to make esthetic gingival contour for 8 weeks. The porcelain fused gold restorations were fabricated and set. The patient was satisfied with the final restorations in esthetic and functional aspect.