• Title/Summary/Keyword: Provisional prosthesis

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Full mouth rehabilitation of the patient with severely worn dentition and limited vertical dimension (심한 치아 마모와 수복공간 부족을 보이는 환자에서의 완전 구강회복 증례)

  • Yang, Min-Seong;Kim, Seong-Kyun;Heo, Seong-Joo;Koak, Jai-Young;Park, Ji-Man;Yi, Yu-Seung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.91-99
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    • 2022
  • Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient's adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.

Maxillary tuberosity connective tissue graft for restoration of gingival depression in the anterior implant region (전치부 임플란트 영역 치은 함몰 회복을 위한 결체조직 이식술에서 상악결절 수여부의 선택)

  • Lee, Dong-Woon;Jung, Gwang-Young;Bang, Joo-Hyuk;Lee, Keun-Woo
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.102-111
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    • 2021
  • Implant placement in the anterior region is performed in several stages, and harmonization of both hard and soft tissues is essential. In addition, adequate esthetic and functional evaluations are necessary in the process of transitioning from the provisional to the final prosthesis to attain patient satisfaction. Although gingiva can be molded in the anterior region, depression in the occlusal view can yield good results through the augmentation procedure. However, the harvesting of connective tissue from the palate is not suitable for various reasons, such as postoperative discomfort and intraoperative bleeding. Compared to the palatal area, the harvesting of connective tissue from the maxillary tuberosity can easily result in relatively thick tissue and quick healing of the donor site, thus proving to be a good modality for graft procedures. The purpose of this report is to examine the relevant evidence from previous studies and evaluate the process of soft tissue augmentation through a case presentation.

Three-dimensional finite element analysis according to the insertion depth of an immediately loaded implant in the anterior maxilla (상악 전치부 즉시하중 임플란트의 식립 깊이에 따른 삼차원 유한요소 분석)

  • Park, Cheol-Woo;Kim, Sung-Hun;Yeo, In-Sung;Yoon, Hyung-In;Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.105-113
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    • 2018
  • Purpose: The purpose of this study was to investigate the effects of the insertion depth of an immediately loaded implant on the stress distribution of the surrounding bone and the micromovement of the implant using the three-dimensional finite element analysis. Materials and methods: A total of five bone models were constructed such that the implant platform was positioned at the levels of 0.00 mm, 0.25 mm, 0.50 mm, 0.75 mm, and 1.00 mm depth from the crest of the cortical bone. A frictional coefficient of 0.3 and the insertion torque of 35 Ncm were simulated on the interface between the implant and surrounding bone. A static load of 178 N was applied to the provisional prosthesis with a vertical load in the axial direction and an oblique load at $30^{\circ}$ with respect to the central axis of the implant, then a finite element analysis was performed. Results: The implant insertion depth significantly affected the stress distribution on the surrounding bone. The largest micromovement value of the implant was $39.34{\mu}m$. The oblique load contributed significantly to the stress distribution and micromovement in comparison to the vertical load. Conclusion: Increasing the implant insertion depth was advantageous in dispersing the concentrated stress in the cortical bone and did not significantly affect the micromovement associated with early osseointegration failure.

Full mouth rehabilitation using orthodontic treatment and implants in patient with collapsed occlusion: A case report (붕괴된 교합을 가진 환자에서 교정치료와 임플란트를 이용한 전악 수복: 증례보고)

  • Ahn, Ayoung;Koak, Jai-Young;Heo, Seong-Joo;Kim, Seong-Kyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.439-447
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    • 2019
  • The distance between the natural teeth and the implants is an important factor in preserving the periodontal tissues and esthetics. And abnormal positional displacement and tilting of the teeth during restorative procedure may require intentional root canal treatment and may affect masticatory function. This report is to present a successful full mouth rehabilitation of a patient with uneven dentition and collapsed occlusion using orthodontic and implant treatment. The patient had no symptoms or discomfort of temporomandibular joint disorder such as pain or sound. The orthodontic treatment was continued until implant provisional prosthesis delivery. And the vertical height of occlusion was elevated 2mm on anterior basis for anterior teeth protection and esthetics. After the orthodontic treatment, the implant abutments and natural teeth were finally restored with porcelain-fused-to-metal crowns and bridges. Satisfactory function and esthetic outcomes are observed after 6months of follow up.

Esthetic considerations for anterior implant-supported prostheses: focus on surgical and prosthetic treatment (전치부 임플란트의 연조직 심미성을 달성하기 위한 외과적, 보철적 고려사항)

  • Park, Yeon-Hee;Ahn, Seung-Geun;Kim, Kyoung-A;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.186-198
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    • 2021
  • As the increased certainty of osseointegration, new parameters are now being used to assess implant success. Accordingly, patients' and clinicians' high demands and expectation for esthetics have expanded and implant-supported restorations show better esthetic outcomes. The pre-implant treatment planning process, the implant surgical steps and the post-surgery prosthetic process can affect all esthetic outcomes. Prevention of esthetic implant failures can be achieved by appropriate treatment at each stage, considering the 3 factors of alveolar bone, soft tissue, and implants. It is necessary to achieve the esthetic implant prostheses followings: minimal invasive surgery, bone augmentation, ideal 3-dimensional implant position, peri-implant soft tissue management, and provisional restorations to optimize peri-implant soft tissue architecture.

From TMJ to 3D Digital Smile Design with Virtual Patient Dataset for diagnosis and treatment planning (가상환자 데이터세트를 기반으로 악관절과 심미를 고려한 진단 및 치료계획 수립)

  • Lee, Soo Young;Kang, Dong Huy;Lee, Doyun;Kim, Heechul
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.71-90
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    • 2021
  • The virtual patient dataset is a collection of diagnostic data from various sources acquired from a single patient into a coordinate system of three-dimensional visualization. Virtual patient dataset makes it possible to establish a treatment plan, simulate various treatment procedures, and create a treatment planning delivery device. Clinicians can design and simulate a patient's smile on the virtual patient dataset and select the optimal result from the diagnostic process. The selected treatment plan can be delivered identically to the patient using manufacturing techniques such as 3D printing, milling, and injection molding. The delivery of this treatment plan can be linked to the final prosthesis through mockup confirmation through provisional restoration fabrication and delivery in the patient's mouth. In this way, if the diagnostic data superimposition and processing accuracy during the manufacturing process are guaranteed, 3D digital smile design simulated in 3D visualization can be accurately delivered to the real patient. As a clinical application method of the virtual patient dataset, we suggest a decision-making method that can exclude occlusal adjustment treatment from the treatment plan through the digital occlusal pressure analysis. A comparative analysis of whole-body scans before and after temporomandibular joint treatment was suggested for adolescent idiopathic scoliosis patients with temporomandibular joint disease. Occlusal plane and smile aesthetic analysis based on the virtual patient dataset was presented when treating patients with complete dentures.

Full mouth rehabilitation for a patient with vertical dimension loss using digital diagnostic analysis: A clinical report (수직고경이 감소된 환자의 디지털 진단 분석을 이용한 완전 구강 회복 증례)

  • Choi, Yeawon;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Kim, Hyeong-Seob;Kwon, Kung-Rock;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.487-496
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    • 2021
  • Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.