• Title/Summary/Keyword: Severe alveolar bone resorption

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TWO CASES OF TRAUMATIC OCCLUSION (외상성 교합의 2예)

  • Kang, Hong-Koo;Lee, Jae-Shin
    • The Journal of the Korean dental association
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    • v.19 no.3 s.142
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    • pp.275-278
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    • 1981
  • Traumatic occlusion is a morbid condition that is caused by repeated occlusal stresses exerted on the periodontium that exceed the physiologic limits of tissue tolerance and contribute to the breakdown of the supporting tissue of the teeth. In reviewing these cases, the authors obtained the following results. 1. Roentgenographic examination revealed the typical signs of traumatic occlusion: severe resorption of roots, destruction of alveolar bone. 2. The major factor of traumatic occlusion is abnormal occlusal force. 3. The rsorptions of roots and periodontal changes which are caused by traumatic occlusion depend on the individual variation of the physical potential. 4. The pathologic features of traumatism are basically different from those of inflammation.

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IMPLANT INSTALLATION USING VERTICAL DISTRACTION OSTEOGENESIS AT A SEVERELY ATROPHIED EDENTULOUS MANDIBLE (심하게 위축된 하악골의 완전 무치악 환자에서의 수직 골신장술을 이용한 임플란트 치료)

  • Yeom, Hak-Ryol;Jeon, Seung-Ho;Kim, Yoon-Tae;Paeng, Jun-Young;Ahn, Kang-Min;Myung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.154-165
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    • 2006
  • Objectives : It is difficult to place implants at a severely atrophied edentulous mandible because of vertical and horizontal alveolar defect. The autogenous and allogenic bone graft and guided bone regeneration are useful, but there are some limitations such as the resorption and infection of the grafted bone, and insufficiency of soft tissue. Distraction osteogenesis has recently evolved a challenging technique to overcome major draws of conventional augmentation procedures, we, therefore, report the four applications of implant placement after vertical alveolar distraction osteogenesis. Patients and Methods : Four patients(all female, mean age: $60{\pm}6$ years) with severe alveolar ridge deficiencies at their anterior mandible were treated with vertical alveolar distraction osteogenesis by intraoral device(Track 1.5, 15 mm model, KLS Martin, Tuttlingen, Germany) and placement of implants (Branemark MK III, TiUnite). After the latency periods of 5, 7, 8 days, distraction rhythm and rate were $0.5\;mm{\times}2\;times/day$ in the case of good bone quality, and $0.25\;mm{\times}3\;times/day$ in the case of poor bone quality. After consolidation periods of mean fifteen weeks, five implants for each patients were placed at the interforaminal area. Results : On average, a vertical gain of $11.38{\pm}1.38\;mm$ was obtained by distraction. And all distraction zone showed complete ossification by panoramic radiography. There were no postoperative complications other than numbness of lower lip in one case. Total twenty implants in four patients were placed and their outcomes were satisfactory. Conclusion : It is a useful method to place five implants after vertical distraction osteogenesis of the severely atrophied mandible for the implant-supported fixed prosthesis.

Full mouth rehabilitation of a patient using monolithic zirconia and dental CAD/CAM system: a case report (단일구조 수복용 지르코니아와 Dental CAD/CAM System을 이용한 전악 임플란트 고정성 보철 수복 증례)

  • Lee, Sang-Hoon;Yoon, Hyung-In;Yeo, In-Sung;Han, Jung-Suk;Kim, Sung-Hun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.3
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    • pp.196-207
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    • 2018
  • An accurate implant placement with ideal location is significant for long-term success of the implant. An exact evaluation of nearby anatomic structures such as quality of residual bone, an inferior alveolar bone and a maxillary sinus is required. For a prosthetic-driven treatment, planned surgery, precise prosthesis and communication with the patient are significant requisites especially for full-mouth rehabilitation. In this case, the patient with severe alveolar bone resorption had a CT guided surgery supported by CT data and the data from scanning diagnostic wax-up. Afterward, edentulous area was restored by full mouth implant-supported prosthesis by using monolithic zirconia and CAD/CAM technique. This paper reports the outcome of the procedure which was remarkable both esthetically and functionally.

Three dimensional finite element analysis of the stress distribution around the mandibular posterior implant during non-working movement according to the amount of cantilever

  • Park, Ji-Man;Kim, Hyun-Joo;Park, Eun-Jin;Kim, Myung-Rae;Kim, Sun-Jong
    • The Journal of Advanced Prosthodontics
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    • v.6 no.5
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    • pp.361-371
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    • 2014
  • PURPOSE. In case of large horizontal discrepancy of alveolar ridge due to severe resorption, cantilevered crown is usually an unavoidable treatment modality. The purpose of this study was to evaluate the clinical criteria for the placement of the aforementioned implant crown. MATERIALS AND METHODS. The mandible model with 2 mm thick cortical bone and cancellous bone was fabricated from CT cross-section image. An external connection type implant was installed and cantilevered crowns with increasing offset of 3, 4, 5, 6, and 7 mm were connected. Vertical load and $30^{\circ}$ oblique load of 300 N was applied and stress around bone and implant component was analyzed. A total of 14 cases were modeled and finite element analysis was performed using COSMOS Works (Solid works Inc, USA). RESULTS. As for the location of the vertical load, the maximum stress generated on the lingual side of the implant became larger according to the increase of offset distance. When the oblique load was applied at $30^{\circ}$, the maximum stress was generated on the buccal side and its magnitude gradually decreased as the distance of the offset load increased to 5 mm. After that point, the magnitude of implant component's stress increased gradually. CONCLUSION. The results of this study suggest that for the patient with atrophied alveolar ridge following the loss of molar teeth, von-Mises stress on implant components was the lowest under the $30^{\circ}$ oblique load at the 5 mm offset point. Further studies for the various crown height and numbers of occusal points are needed to generalize the conclusion of present study.

Full mouth rehabilitation of the patient with crossed occlusion using implant fixed prosthesis: A case report (엇갈린 교합 환자에서 임플란트 고정성 보철물을 이용한 수복증례)

  • Jung, Byung-Suk;Jeon, Young-Chan;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.338-346
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    • 2018
  • Crossed occlusion can be treated either by overdenture and telescopic denture or by placing an implant at the edentulous area to reestablish the support on the occlusion. If alveolar bony support is sufficient and an the environment where an implant is inserted is favorable to restoring the masticatory and aesthetic function of a patient, the implant-supported fixed prosthesis can provide more definitive occlusal support and more aid for other oral functions. In this case report, a patient with a severe residual alveolar bone resorption following the extraction of teeth and who had a crossed occlusion was treated with sinus bone graft and alveolar bone augmentation in order to place the implants at prosthetically position. The definitive restoration was made to reflect the patient's occlusal and aesthetic function using the CAD/CAM double scanning method. Finally, the treatment had the masticatory and aesthetic function adequately restored, which is reported here.

THE STUDY ON THE PERIODONTAL VASCULAR CHANGES OF RAT INCISORS FOLLOWING EXPERIMENTAL TOOTH MOVEMENT (실험적 치아이동시 백서 상악절치 치근막의 혈관 변화에 대한 연구)

  • Hyun, Seong-Wook;Suhr, CheonsG-Hoon
    • The korean journal of orthodontics
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    • v.18 no.2
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    • pp.311-327
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    • 1988
  • Vascular changes in the periodontal ligament of the rat incisors following application of experimental orthodontic forces were examined by the India ink perfusion method. 57 rats were used for this experiment. The rats were divided into experimental group (54 rats) and control group (3 rats). 54 experimental rats were divided into group I (27 rats) and group II (27 rats). The right and left upper incisors of group. I and group II rats were separated distally with forces of 20gm, 70gm respectively. The vascular changes of periodontal ligament were observed histologically by means of light microscope after 1, 2 and 3 days of tooth movement and 1,3,5,8,14, and 21 days after removal of orthodontic force. The results were as follows; 1. After one day of tooth movement, occlusion of blood vessels, hyalinization of periodontal ligament and resorption of alveolar bone adjacent to the alveolar crest on pressure side were observed. Above the tissue changes on the pressure side of group II were more severe than those of group I. Especially, septal bone of group II was separated after 2 days of tooth movement. 2. In tension zones, periodontal space was widened and periodontal fibers were orientated in the direction of puil. The blood vessels of periodontal ligament were distended. New bone deposition was seen along the inner surface of the alveolus after 2 days of tooth movement. 3. After 3 days of tooth movement, deposition of new bone was seen along the periosteal surface of alveolar bone on pressure side, progressing with increasing after removal of orthodontic force. Remodelling of the new bone was occurred 5 days after removal of orthodontic force. 4. 3 days after removal of orthodontic force, invasion of blood vessels into the marginal periodontal ligament on pressure side was observed clearly and the vessels below the epithelial attachment were increased. 5. After removal of orthodontic force, hyalinized structures disappeared concomittantly with an invasion of blood vessels from the neighboring periodontal ligament. 14 days after removal of orthodontic force, the vessels in the periodontal ligament of group I were finished the vascular rearrangement. 21 days after removal of orthodontic force, the vessels in the periodontal ligament of group II were finished the vascular rearrangement.

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Prosthetic Treatment Strategies for Improving Denture Retention in Pediatric Patients with Hypohidrotic Ectodermal Dysplasia: a Report of Two Cases (저한성 외배엽 이형성증을 가진 소아 환자에서 의치 유지력 향상을 위한 보철 치료 전략: 두 가지 증례 보고)

  • Hongju Jeon;Seonmi Kim;Namki Choi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.4
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    • pp.483-494
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    • 2023
  • This report presents two cases concerning strategies for improving denture retention in pediatric patients with oligodontia caused by hypohidrotic ectodermal dysplasia (HED). Both patients presented with multiple missing teeth, conical canines, alveolar bone atrophy, and a skeletal Class III tendency. In the first case, a modified form of conical-crown-retained denture was used to cover the canines. This approach was carried out without tooth extraction or coping. In the second case of severe alveolar bone resorption and a distally tilted lower left canine, the tooth was restored with a hybrid ceramic crown. It was subsequently converted into a clasp-retained removable partial denture, utilizing a suction mechanism. Both patients are currently receiving regular check-ups for the maintenance of their prosthetic appliances and the evaluation of their growth patterns. This study presents innovative prosthetic treatment methods for pediatric patients with HED who have inadequate denture retention.

Prosthetic restoration of a partially edentulous patient using double crowns: a clinical report (이중관을 이용한 부분 무치악 환자의 수복 증례)

  • Park, Minseo;Kim, Hyeong-Seob;Kwon, Kung-Rock;Woo, Yi-Hyung;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.21-27
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    • 2016
  • In removable dental prostheses, it is important to minimize impairment of residual tissue caused by wearing dentures. There are two factors that harm residual tissue. The first is functional load bearing of remaining teeth and alveolar ridges and the second is the effect of poor oral hygiene. Double crown retained removable dental prostheses provide rigid support, and it may reduce impairment caused by load bearing of alveolar ridges. Also, dental plaque and oral deposits, which are attached to outer crowns and dentures, can be easily managed extra-orally. In addition, it is beneficial to the health of the marginal gingiva because inner crowns have easy access for oral hygiene. In this case, double crown retained removable dental prostheses were used for the partially edentulous patient with severe residual alveolar bone resorption and poor oral hygiene, and the result was clinically satisfactory in terms of functional, esthetical, and oral hygiene aspects.

Treatment Protocol for Cleft Lip and/or Palate Children in Kyushu University Hospital

  • Suzuki, Akira
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.2
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    • pp.69-82
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    • 2012
  • Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

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Immunohistochemical localization of several protein changes in periodontal ligament during tooth eruption and interdental separation of rats (흰쥐의 치아 맹출과 치간 이개 과정에서 수종의 치주인대 단백질 발현의 변화에 관한 면역 조직화학적 연구)

  • Lim, Sung-Hoon;Park, Hyung-Soo;Yoon, Young-Jooh;Kim, Kwang-Won;Kim, Heung-Joong;Jeong, Moon-Jin;Park, Joo-Cheol
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.71-81
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    • 2004
  • In this study, we attempt to investigate the mechanisms by which PDL cells regulate osteoclast formation and also tc know whether PDL retained their characteristic phenotype during tooth eruption and interdental separation. Rats were prepared at developmental days 21 (pre-root formation), 27(toot development), 34(advanced root formation/eruption) and at later times(adult rats). To induce severe resorption state of alveolar bone and tooth root, interdental separation with brass wire was performed between the lower first and second molars for 2 weeks in adult rats. Rat mandibles were demineralized and embedded in paraffin, and horizontal and frontal section were prepared for immuno-histochemical analysis using PDL-specific protein 22 (PDLs22), receptor activator of NFKB ligand (RANKL) and osteoprotegerin (OPG) antibodies. 1. Root formation and eruption stage of tooth development. 1) PDLs22 immunolocalization was observed in tooth follicle/PDL cells and osteoblasts throught out the root formation and eruption stages of tooth development. 2) RANKL expression became stronger at eruption stage than root formation stage of tooth development. 3) Strong expression of OPG was detected in follice/PDL cells of toot formation stage but it was decreased with tooth eruption. 2. Interdental separation between lower first and second molar 1) Comparared to normal animal, multinucleated osteoclasts and odontoclasts were markedly induced in the alveolar bone and tooth root with PDL remodeling in hematoxylin-eosin section. 2) PDLs22 expression was decreased with interdental separation. 3) RANKL expression was Increased with interdental separation in PDL fibroblasts, osteoblasts, odontoclasts and it lacunae, resorting dentin, cementum and bone matrix. 4) OPG expression was slightly decreased in the PDL cells adjacent to the alveolar bone and root surface with interdental separation. These results suggested that during tooth eruption and tooth movement, RANKL and OPG in the periodontal tissues are important determinants regulating balanced alveolar bone and tooth root resorption. And it is also suggested that PDL cells retained their characteristic phenotype during tooth eruption and interdental separation except for the short period of PDL remodeling.