• The Journal of Advanced Prosthodontics
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• 제8권5호
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• pp.345-353
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• 2016

PURPOSE. The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients. MATERIALS AND METHODS. Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) for 23 implant-supported single restorations. The satisfactions of the patients on the esthetic outcome of the treatment have been evaluated according to the visual analog scale (VAS). RESULTS. The mean total PES/WES was $12.26{\pm}4.76$. The mean PES was $6.45{\pm}2.78$ and mean WES was $5.80{\pm}2.82$. There was a statistically significant difference among the different specialties for WES (P<.01) and Total PES/WES (P<.01). Prosthodontists were found to have assigned poorer ratings among the other specialties, while oral surgeons gave the higher ratings than periodontists, orthodontists, and prosthodontists. CONCLUSION. Prosthodontists seemed to be stricter when assessing aesthetic outcome among other specialties. Moreover, a clear correlation existed between dentists' and patients' esthetic perception, thereby providing rationales for involving patients in the treatment plan to achieve higher levels of patient satisfaction.

• 대한치과의사협회지
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• 제58권2호
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• pp.83-92
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• 2020

In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.

• Journal of Periodontal and Implant Science
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• 제41권5호
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• pp.248-252
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• 2011

Purpose: The anterior region is a challenge for most clinicians to achieve optimal esthetics with dental implants. The provisional crown is a key factor in the success of obtaining pink esthetics around restorations with single implants, by soft tissue and inter-proximal papilla shaping. Provisional abutments bring additional costs and make the treatment more expensive. Since one of the aims of the clinician is to reduce costs and find more economic ways to raise patient satisfaction, this paper describes a practical method for chair-side fabrication of non-occlusal loaded provisional crowns used by the authors for several years successfully. Methods: Twenty two patients (9 males, 13 females; mean age, 36,72 years) with one missing anterior tooth were treated by using the presented method. Metal definitive abutments instead of provisional abutments were used and provisional crowns were fabricated on the definitive abutments for all of the patients. The marginal fit was finished on a laboratory analogue and temporarily cemented to the abutments. The marginal adaptation of the crowns was evaluated radiographically. Results: The patients were all satisfied with the final appearance and no complications occurred until the implants were loaded with permanent restorations. Conclusions: The use of the definitive abutments for provisional crowns instead of provisional abutments reduces the costs and the same results can be obtained.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.825-838
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• 2007

Endosseous implants are used in the treatment of various types of tooth loss, and numerous long-term studies have demonstrated the excellent reliability of this method of treatment. However, the increase of implant failure are associated with inadequate quality and/or height of bone. At the end of the 1980s, Wide(>3.75mm) implants were initially used for managing these difficult bone situations. The recommended indications for its use included poor bone quality, inadequate bone height. immediate placement in fresh extraction sockets, and immediate replacement of failed implants. At the 2000s, wider implants(6.0mm and 6.5mm) were used in a few studies. Although good clinical outcomes have been reported in recent years, there is still a controversy on this topic. Therefore, the purpose of this study was to estimate the survival rate of wide implants($6.0{\sim}8.0mm$) in molar regions, evaluating the clinical outcome. In this study, 1135 RBM surfaced wide implants($Rescue^{TM}$, MEGAZEN Co., Korea/595 maxillary, 540 mandibular) were placed in 650 patients(403 male, 247 female/age mean: $51.2{\pm}11.1$ years, range 20 to 83 years). Of the total, 68.3% were used to treat fully or partially edentulous situations, including single-tooth losses and 31.7% were placed immediately after teeth extraction or removal of failed implants, of which all were in the molar regions. Implant diameter and length ranged from 6.0 to 8.0mm and from 5.0 to 10.0mm respectively. The implants were followed for up to 42 months (mean: $14.6{\pm}9.5$ months). Of 1135 placed implants, 58 implants were lost. Among them, 53 implants were lost within 12 months after implant placement. The survival rate was 93.6% in the maxilla and 96.3% in the mandible, yielding an overall survival rate of 94.9%, for up to 42 months. As the result of Cox regression model, prosthetic type, sinus graft, and patient gender have an statistical significance on the implant survival rate in this study. This study suggests that the use of wide implants($6.0{\sim}8.0mm$) would provide a predictable treatment alternative in posterior areas.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.41-45
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• 2009

Background: Reduced bone height is one of the major problems faced in restoring tooth loss with implants. By the use of short implants, it is possible to reduce complicated and invasive treatment such as bone graft, allowing more simple surgery. But short implants are generally considered to have lower success rates than that of standard implants. Purpose: To assess the results of short Straumann implants by a retrospective study of short Straumann implants with TPS(titanium plasma-sprayed) and SLA(sandblasted, large grit, acid etched) surfaces. Materials and methods: 173 implants in 106 patients who received short Straumann implant surgery(${\le}8\;mm$) in the department of oral and maxillofacial surgery, Kyunghee Dental Hospital, from February 1996 to October 2006 were selected and studied. All of the implants were followed up after prosthetic rehabilitation. The average follow-up period was 34 months with 119 months as the longest follow up period. The average follow-up period after prosthetic rehabilitation was 31 months. 64 females(60.4%) and 42 males(39.6%) participated in the research with the age range of 19 to 85(mean age 47). 20 patients(18.9%) were under 40, 85 patients(80.2%) were over 40 and under 70, and only one patient(0.9%) was over 70 years old. Results: 27 implants(15.6%) had TPS surface while 146 implants(84.4%) had SLA surface. 9 implants(5.2%) were 3.3, 108 implans(62.4%) were 4.1mm and 56 implants(32.4%) were 4.8mm in diameter. 167 implants(96.5%) were 8mm and 6 implants(3.5%) were 6mm in length. There were 24 implants(13.9%) on the maxillas and 149 implants(68.8%) on the mandibles. 119 implants(68.8%) were rehabilitated with FPD(fixed partial denture), 47 implants(27.2%) with single crowns and 4 implants(2.3%) with overdentures. Among the fixed partial dentures, 30 of them were splinted with short implants only. After over an year of follow-up period, 139 implants(96.5%) out of 144 implants showed marginal bone loss of less than 1mm. 3 out of 173 implants failed showing 98.27% survival rate. Conclusions: The use of short Straumann implants(${\le}8mm$) can be a simple and reliable treatment method in minimal residual bone height.

• 구강회복응용과학지
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• 제29권4호
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• pp.399-406
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• 2013

자연치아와 연결한 임플란트 수복물에서 종종 자연치아의 압하가 보고되곤 하지만 임플란트에 둘러싸인 자연치아의 압하에 대한 보고는 매우 드물다. 56세의 여성을 하악 우측 제1소구치는 임플란트로, 제 2소구치 치근은 포스트 수복 후 지르코니아로 각각 수복했다. 제 1대구치와 제 2대구치는 이미 임플란트로 수복되어 있었다. 기능 4개월 후 제 2소구치의 압하로 인한 대합치와의 간격이 분명히 관찰되었으나 불편감을 비롯한 이상증상은 없었다. 예후에 대한 자세한 설명 후 별다른 조치 없이 경과 관찰을 시작하였다. 3개월 후 치근단 방사선 사진상에서 원위치로의 치아 회복 시작이 관찰되었으며 다시 11개월이 경과한 후 치아의 추가 정출로 교합의 완전한 회복이 이루어졌다. 압하를 인지한지 2년 3개월째 관찰 중이다. 임플란트에 둘러싸인 자연치가 압하되고 저절로 회복되는 과정의 관찰을 통해 압하가 생기는 원인과 저절로 회복된 기전을 추정할 수 있었다.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.207-214
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• 2008

Purpose: The aim of augmentation of the alveolar ridge is to restore absorbed alveolar ridges for future implant site or esthetic prosthodontic restoration. The present clinical report describes the anterior maxillary augmentation cases using a soft tissue rotated palatal flap, and considers various problems of before and after surgery. Method: First & second patients were treated by vascularized interpositional periosteal-connective tissue(VIP-CT) flap for horizontal soft tissue augmentation. Especially second patient was progressed with bone grafting at the same time. Third patient was treated by the same flap with bone graft and implant placement in single tooth missing premaxillary area. Result: The obtained horizontal augmentation width measured $0.5{\sim}2.7\;mm$. Conclusion: This technique constitutes a viable approach for augmentation the anterior sector of alveolar ridge with the placement of dental implants. But it needs correct diagnosis preparation and careful surgery skill.

• The Journal of Advanced Prosthodontics
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• 제7권2호
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• pp.160-165
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• 2015

PURPOSE. In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS. Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous$^{(R)}$; Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at $30^{\circ}$ in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS. Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION. Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

• 대한치과보철학회지
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• 제51권4호
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• pp.252-260
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• 2013

연구 목적: 치과 임플란트가 소개된 이후로 단일 치아 상실에 따른 임플란트 수복에 관한 성공적인 연구 결과들이 보고되고 임상적으로도 널리 사용되고 있다. 구강내의 다양한 부위에 따른 연구들이 있어 왔으나, 교합력이 강한 구치부 특히 하악 구치부에서 단일 임플란트에 관한 연구가 필요할 것이다. 본 연구는 하악의 제1대구치와 제2대 구치 부위에 식립된 단일 임플란트의 생존율에 관해 연구, 분석하였다. 연구 대상 및 방법: 2002년부터 2009년까지 대구광역시 소재의 7개 치과의원에서, 하악 제1, 2대구치에 단일 임플란트 치료를 받은 환자 284명에게 식립된 308개의 임플란트를 대상으로 하였다. 하악 제1대구치에 168개의 임플란트가 식립되었고, 하악 제2대구치에 140개의 임플란트가 식립되었다. 이들 임플란트는 식립위치, 환자의 성별, 연령, 임플란트의 직경 및 길이에 따라 분석하였다. 결과:하악 제1대구치에서는 4개의 임플란트가, 하악 제2대구치에서는 10개의 임플란트가 실패하였다. 하악 제1대구치에서는 97.6%, 하악 제2대구치에서는 92.9%의 성공률을 나타내었다. 환자의 연령, 성별, 식립방법, 임플란트의 직경 등에 따른 차이는 관찰할 수 없었다. 결론: 하악 제1대구치 단일 임플란트의 생존율은 하악 제2대구치 단일 임플란트의 생존율보다 높게 나타났다. 이는 하악 제2대구치 부위의 골질이 좋지 않고, 하악의 해부학적인 구조로 인해 하악 제2대구치 부위에 과도한 교합력이 가해질 우려가 있기 때문이라 생각된다.

• The Journal of Advanced Prosthodontics
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• 제1권3호
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• pp.140-144
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• 2009

STATEMENT OF PROBLEM. Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE. This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS. Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS. The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION. To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.