• 구강회복응용과학지
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• 제17권2호
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• pp.107-112
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• 2001

The prosthodontic treatment of severely resorbed edentulous patients has been one of the frustrating areas due to extensive loss of tissues. The integrated neuromuscular balance among tongue, lip, and cheek is compromised. The retention, stability, and support are the three major factors to influence the clinical outcome. Fish described a denture as having three surface, with each surface playing an independent and important role in the over all fit, stability, and comfort of the denture. He recommended that the polished surface should be a series of inclines so that pressure from muscular activity will retain dentures. Within the denture space there is an area that has been termed the neutral zone. The neutral zone is that area in the mouth where, during function, the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. According to Jacobson and Krol, neuromuscular control interacts to provide retention and the relationship of polished surface of denture base to the surrounding muscular structure of orofacial capsule facilitates the stability and retention. This neutral zone concept has been demonstrated with various modification by a number of authors. The theory used to develop the denture base contours is based on the belief that the muscle should functionally mold not only the border but the entire polished surface. Lott and Walsh reported the clinical success on complete mandibular dentures with application of neutral zone concept. A number of studies demonstrated that denture stability and retention are more dependent on correct position of the teeth and correct contour of external surfaces of the denture in a severely resorbed alveolar ridge. This article presents a prosthodontic approach to treatment of a edentulous patient using neutral zone technique to improve the retention and stability of the prosthesis.

• 대한치과보철학회지
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• 제54권4호
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• pp.445-450
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• 2016

Piezography는 발음을 이용하여 채득된 보철 공간을 의미하며, 의치의 인공치와 연마면의 위치를 결정하는 참고점으로 사용하게 된다. 본 증례 대상은 67세 여성환자로, 새 의치 제작을 주소로 내원하였다. 기존 의치에서 2급 악간관계와 불량한 유지력을 확인할 수 있었으며, 안정적인 의치를 위해 piezography와 설측교합을 이용하기로 하였다. 통상적인 방법으로 인상 채득 후 주모형 상에서 상하악 기초상과 왁스 교합제를 제작하였고, 별도로 piezography를 위하여 하악에 추가적인 기초상을 하나 더 제작하였다. 이 추가 기초상에 실리콘 인상재를 적용 한 뒤 '시', '소', '메', '테', '데', '무' 여섯개의 발음으로 piezography를 채득하였다. 하악 인공치를 이 보철공간에 맞추어 배열한 뒤, 형태를 수정하여 설측 교합을 부여하였다. 그 결과, 환자는 새로운 의치에 기능적, 심미적으로 만족하였다.

• 대한치과보철학회지
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• 제57권3호
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• pp.238-244
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• 2019

연성 이장재는 점탄성적 특수성으로 인하여 인상 채득 후 바로 치과용 경석고를 주입할 시, 기능 인상에 사용할 수 있다. 본 증례는 78세의 남성으로 새로운 의치를 제작하고 싶다는 주소로 내원하였다. 하악 치조제의 심한 흡수로 인하여, 폐구법을 통한 기능 인상을 채득하기로 계획하였다. 먼저, 상, 하악 임시 의치의 제작을 시행하고, 연성 이장재를 내면에 도포하여 압박된 상, 하악 무치악 치조제의 치유를 유도하였다. 이후, 회복된 상, 하악 치조제에 맞게 내면이 변형된 상, 하악 임시 의치를 이용하여 폐구법을 통한 기능 인상을 채득하였으며, 상악 임시 의치의 치아 배열을 참고하여 최종 의치를 제작하였다. 이상과 같이 완전 무치악 환자에서 임시 의치를 이용하여 기능 인상을 채득하여 만족스러운 유지와 기능을 회복할 수 있었기에 본 증례를 보고하고자 한다.

• The Journal of Advanced Prosthodontics
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• 제3권4호
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• pp.236-239
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• 2011

Maxillary labial and buccal frena are considered as normal anatomic structures in the oral cavity. However, they may exist intraorally as a thick broad fibrous attachment and/or become located near the crest of the residual ridge, thus interfering with proper denture border extension resulting in inferior denture stability, retention and overall patient satisfaction. This case report highlights the importance of clinical examination and treatment planning which may mandate preprosthetic surgery prior to fabrication of a new conventional complete denture. Adequate patient satisfaction with conventional complete dentures can be significantly increased after frenectomy.

• 대한치과보철학회지
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• 제29권2호
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• pp.49-57
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• 1991

The magnets were widely used to increase the retention of overdentures. The purpose of this study was to compare the break load between overdentures and edentulous models. For this study, Model former(U-402) was used for model fabrication and four different magnets were used for evaluation of break load. The artificial saliva was used between overdenture and model. Breakaway loads were tested with an Instron 1122 at a speed of 2mm/min. The results were as follows. 1. The retentivee forces complete dentures with artificial saliva were than the retentive forces of complete detures without artificial saliva. 2. Magnetic overdenture with artificial saliva showed best retentive force, magnetic overdenture without artificial saliva showed the next retentive force, and the complete denture without artificial saliva showed the worst retention. 3. As the magnetic sizes increased, the retentive forces of magnetics were increased. 4. The retentive force of nipple shape magnet is greater than the retentive force of flate shape magnet in the same size.

• 구강회복응용과학지
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• 제17권2호
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• pp.113-123
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• 2001

The success of complete denture prosthesis is to satisfy three basic requirements for the edentulous patient : maximum comfort, efficiency, and esthetic appearance. This can be achieved only if the dentures are both stable and retentive. When the residual alveolar ridge has resorbed significantly, stability and retention are more dependent on the correct position of the teeth and external surfaces of the denture. The stability and retention of the denture can be improved by locating the denture in the neutral zone and reproducing exact mandibular border movement for balanced occlusion. The neutral zone philosophy is based upon the concept that there exists a specific area where the musculature function will not unseat the denture in the mouth. In here, forces generated by the tongue are neutralized by the forces generated by the lips and cheeks. One of the simplest methods for recording border movements in three dimensions is to make stereographic record of condylar movement. Stereographs are made in the mouth during mandibular movement with intraoral clutches and central bearing point, and used in dictating the condylar movement on the articulator later by generating the condylar paths in doughy acrylic resin. Its procedure is simpler and more convenient than that of Pantograph. In this clinical report, we introduce the concept of neutral zone and stereograph in complete denture fabrication.

• 대한치과보철학회지
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• 제57권4호
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• pp.389-396
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• 2019

심하게 흡수된 치조제에서 의치의 유지력을 얻기 어려운 경우, 의치가 불안정하게 되어 의치 사용이 어렵다. 흡착 의치는 의치상 변연부를 가동 점막으로 봉쇄하여 폐구 시에 의치상 내면에 생기는 음압 형성을 통해 더 높은 유지와 안정을 목표로 한다. 본 증례에서는 4명의 환자들이 의치가 헐겁다는 주소로 내원하였다. 의치의 유지력에 대한 높은 요구도를 반영하여 흡착 의치의 개념을 이용하여 유지와 안정을 얻고자 하였다. 무치악 환자들에서 흡착의치를 이용한 보철 수복 시 고려할 사항들에 대하여 비교 분석하여 보고하고자 한다.

• The Journal of Advanced Prosthodontics
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• 제4권2호
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• pp.97-102
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• 2012

Study was conducted to determine and assess the effect of different type of denture adhesives on the incisal bite force of complete denture wearers until the dislodgement of upper denture, using pressure transducer. MATERIALS AND METHODS. 30 patients out of 100 were included in the study. Based on the Kapur's method of scoring denture retention and stability, these patients were divided into 3 groups-Group A - Clinically good dentures; Group B - Clinically fair dentures; and Group C - Clinically poor dentures. A custom made occlusal force meter was constructed based on the load cell type of pressure transducers. Different adhesives (powder, paste and adhesive strips) were used in the study. Complete denture wearers were asked to bite on the load cell and the readings of incisal bite force were recorded. The readings of incisal bite force were subjected to statistical analysis using Repeated measures ANOVA followed by post-hoc bonferroni test. RESULTS. The result suggests that denture adhesives improved the incisal bite force of complete denture wearers significantly The incisal bite force (in kg) in Group A without using adhesives, with powder adhesive, with paste adhesive and with adhesive strips was found to be 2.48 (${\pm}0.16$), 3.43 (${\pm}0.11$), 6.01 (${\pm}0.11$), 3.22 (${\pm}0.09$) respectively. The incisal bite force (in kg) in Group B without using adhesives, with powder adhesive, with paste adhesive and with adhesive strips was found to be 1.87 (${\pm}0.18$), 3.35 (${\pm}0.14$), 5.34 (${\pm}0.18$), 3.21 (${\pm}0.12$) respectively. The incisal bite force (in kg) in Group C without using adhesives, with powder adhesive, with paste adhesive and with adhesive strips was found to be 1.00 (${\pm}0.17$), 3.07 (${\pm}0.14$), 4.37 (${\pm}0.26$), 2.99 (${\pm}0.14$) respectively. CONCLUSION. Within the limitations of the study, it was concluded that the use of denture adhesive was found to be significantly effective in improving the incisal bite force of complete dentures until the dislodgement of upper denture. Fittydent paste adhesive was found to be more effective than the powder and strips adhesives. The improvement in incisal bite force was found to be higher in Group C in comparison to that of Group A and Group B.

• 대한치과의사협회지
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• 제55권1호
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• pp.82-89
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• 2017

Proponents of bilaterally balanced occlusion believe that this occlusal concept is important for denture retention and stability. However, the critical appraisal of the literature reveals no scientific evidence to support the bilaterally balanced occlusion as the ideal occlusal concept for conventional complete dentures. Current evidence suggests that the occlusal concept has little influence on clinical outcomes or patient satisfaction. Additional randomized controlled clinical trials should be developed taking into account the influence of mucosal resiliency, alveolar ridge anatomy, and parafunctional activities on occlusal concept choice. In this paper, various types of complete denture occlusion (bilaterally balanced occlusion, lingualized occlusion, canine-guided occlusion) will be reviewed and compared.

• 대한치과보철학회지
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• 제53권3호
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• pp.250-255
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• 2015

심한 잔존치조제의 흡수와 의치지지조직의 손상을 동반한 총의치 난증례는 정확한 진단과 체계적인 치료계획 수립을 통해 보철물의 유지, 안정, 지지를 증진시켜야 한다. Provisional restoration은 총의치의 안정성을 다각도로 평가하고 환자와 치과의사의 피드백을 가능하게 하는 유용한 도구로서 사용될 수 있다. 본 증례에서는 진단용의치를 통해 인상면, 연마면, 교합면을 평가하여 의치의 안정성을 증대시키고 환자의 심미적 요구를 반영하여 최종의치로 이행하였으며 임상적으로 기능과 심미적인 측면에 있어서 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.