Purpose: The aim of this prospective pilot study was to compare alveolar ridge preservation (ARP) procedures with open-healing approach using a single-layer and a double-layer coverage with collagen membranes using radiographic and clinical analyses. Methods: Eleven molars from 9 healthy patients requiring extraction of the maxillary or mandibular posterior teeth were included and allocated into 2 groups. After tooth extraction, deproteinized bovine bone mineral mixed with 10% collagen was grafted into the socket and covered either with a double-layer of resorbable non-cross-linked collagen membranes (DL group, n=6) or with a single-layer (SL group, n=5). Primary closure was not obtained. Cone-beam computed tomography images were taken immediately after the ARP procedure and after a healing period of 4 months before implant placement. Radiographic measurements were made of the width and height changes of the alveolar ridge. Results: All sites healed without any complications, and dental implants were placed at all operated sites with acceptable initial stability. The measurements showed that the reductions in width at the level 1 mm apical from the alveolar crest (including the bone graft) were $-1.7{\pm}0.5mm$ in the SL group and $-1.8{\pm}0.4mm$ in the DL group, and the horizontal changes in the other areas were also similar in the DL and SL groups. The reductions in height were also comparable between groups. Conclusions: Within the limitations of this study, single-layer and double-layer coverage with collagen membranes after ARP failed to show substantial differences in the preservation of horizontal or vertical dimensions or in clinical healing. Thus, both approaches seem to be suitable for open-healing ridge preservation procedures.
Kim, Mi-Ni;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
Journal of the korean academy of Pediatric Dentistry
/
v.36
no.1
/
pp.119-125
/
2009
Fusion and gemination are irregularities in tooth development. It is often difficult to differentiate between gemination and fusion and it is common to refer to these anomalies as 'double teeth'. The deciduous teeth are most commonly involved, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, funtional and periodontal problems can result. Double teeth present great difficulties in management and required a multidisciplinary approach. The central groove on the labial and palatal surfaces of a double tooth is extremely prone to caries, therefore early 'fissure sealing' is essential. In permanent dentition, surgical separation of fused teeth may be possible with subsequent orthodontic alignment and restorative treatment as needed to reshape the crown. Reshaping or reduction of a double tooth with a single canal may be attempted by modifying the appearance of the labial groove and the use of composite tints but is often impossible and extraction may be the only alternative. Orthodontic treatment and prosthetic replacement is then required. Implants may be an option for adolescents. The present study describes three clinical cases of double teeth in the position of the maxillary permanent incisors. The first case demonstrates an example of multidisciplinary care including surgical intraoral hemisection, root canal therapy, restorative and orthodontic treatment. The second and third cases describe the external and internal morphology of the two fused teeth by means of three dimensional dental computer tomography.
The success of dental implant therapy relies mainly upon the presence and maintenance of bone adjacent to implant. An 1-year prospective study was performed, upon the patients who were diagnosed as having chronic adult periodontitis, and had been treated with dental implant. The purpose of this study was to measure the radiographic bone level changes proximal to Astra Tech Single Tooth Implants (ATST, Astra Tech AB, $M{\"{o}}lndal$, Sweden) with microthread and Astra Tech TiOblast Implant (ATTB) without microthread supporting fixed partial prosthesis. Measurements were used to determine mean marginal bone loss during the first year of loading, 17 subjects with its partial prosthesis supported by 37 implants were followed up for an 1-year period. The marginal bone loss of implants was positively correlated with the retention factor, microthread($Microthread^{TM}$) in crestal area of ATST. The results were as follows. 1. The mean marginal bone loss of ATST was 0.226${\pm}$0.395mm, while ATTB was 0.440${\pm}$0.360mm. There was a statistically significant difference between ATST and ATTB (p<0.05). 2. The mean bone loss of the upper jaw fixtures was 0.269${\pm}$0.265mm for ATST and 0.529${\pm}$0.417mm for ATTB . There was a statistically significant difference between ATST and ATTB (p<0.05). In the lower jaw the corresponding figures were 0.167${\pm}$0.231mm and 0.313${\pm}$0.214mm, respectively. There was no significant difference between ATST and ATTB (p>0.05). 3. The mean bone loss of ATST was lower than that of ATTB at all sites according to bone quality. There was a statistically significant difference between ATST and ATTB at bone quality type III(p <0.05). In conclusion, the mean bone loss of ATST was smaller than that of ATTB . Therefore, the retention factor of crestal area, microthread ($Microthread^{TM}$) was effective to maintenance of marginal bone level around fixture.
Implant assisted removable partial denture (IARPD) has been practiced in various forms for a long time, and among them, implant surveyed crown RPD is gaining predictability as well as being considered as a treatment option for patients with anatomical and financial disadvantages. The position of implant could be divided as posterior placement or anterior placement according to the purpose of the treatment and should be planned in consider to the alveolar ridge of patient, anticipated prognosis of remaining teeth, and opposing dentition. This case report describes a treatment for mandibular Kennedy class I partial edentulous patient with two implant-supported surveyed crown and implant assisted removable partial denture. Given the difficulty of posterior placement in this patient and the prognosis of the residual teeth, the plan was to place two implants in close proximity to the residual teeth, which were placed in the planned position, angle, and depth using guided surgery. The process of fabricating the fixed prosthesis was carried out in parallel with the maxillary edentulous tooth arrangement process to increase predictability, and when fabricating the localized tooth, the implant was designed in a form that allows the patient to perform functional movements by preventing excessive loading as the last supporting tooth, and was fabricated through a secondary impression process. Each treatment procedure was proceeded as planned, with aesthetically and functionally satisfactory results for both patient and operator.
This study was aimed to analyze the stress distribution of implant and supporting tissue in single tooth implant restoration using Branemark $system^{(R)}$(Nobel Biocare, Gothenberg, Sweden) and Bicon system(Bicon Dental Implants, Boston, MA). Two dimensional finite element analysis model was made at mandibular first premolar area As a crown materials porcelain, ceromer, ADA type III gold alloy were used. Tests have been performed at 25Kgf vertical load on central fossa of crown portion and at 10Kgf load with $45^{\circ}$ lateral direction on cusp inclination. The displacement and stresses of implant and supporting structures were analyzed to investigate the influence of the crown material and the type of implant systems by finite element analysis. The results were obtained as follows : 1. The type of crown material influenced the stress distribution of superstructure, but did not influence that of the supporting alveolar bone. 2. The stress distribution of ceromer and type III gold alloy and porcelain is similar. 3. Stress under lateral load was about twice higher than that of vertical load in all occlusal restorative materials. 4. In Bicon system, stress concentration is similar in supporting bone area but CerOne system generated about 1.5times eater stress more in superstructure material. 5. In Branemark models, if severe occlusal overload is loaded in superstvucture. gold screw or abutment will be fractured or loosened to buffer the occlusal overload but in Bicon models such buffering effect is not expected, so in Bicon model, load can be concentrated in alveolar bone area.
This study is an analysis of types of patients and distribution of implant site and survival rate of $Xive^{(R)}$ implant. The following results on patient type, implant distribution and survival rate were compiled from 324 implant cases of 140 patients treated at the periodontal dept. of Yonsei University Hospital and G dental clinic between February 2003 and April 2006. 1. There are no dissimilarities between men and women, with patients in their 30, 40, 50s accounting for 80% of patients and accounted for 82% of implant treatments; the largest share of patients and implant treatments. 2. Mn, posterior area. accounted for 57% of implant treatments followed by Mx. posterior area(29%), Mx, anterior area(8%) and Mn, anterior area(6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 96% and fully edentulous patient accounted for the remaining 4%. 4. The major cause of tooth loss is periodontal disease, followed by dental canes, trauma and congenital missing. 5, The distribution of bone quality for maxillae was 54,2% for type III, followed by 30.8% for type II, 15% for type IV and 0% for type I. As for mandible, the distribution was 63% for type II, followed by 34% for type III, 2,5% for type I and 0,5% for type IV. 6. The distribution of bone quantity for maxillae was 55% for type C, followed by 35% for type B, 8% for type D and 2% for type A. As for mandible, the distribution was 60% for type B, followed by 32% for type C, 7% for type A and 0% for type D. 7. The majority of implants were those of 9.5-13 mm in length(95%) and regular diameter in width(82%). 8. The total survival rate was 98%. The survival rate was 97% in the maxillae region and 99% in the mandible region. 9. The survival rate in type I was 83%, in type II was 99%, in type III was 97% and in type IV was 100%. As for the bone quantity, the survival rate in type A and D(100%) was most, followed by type B(99%) and type C(96%). The results showed that $Xive^{(R)}$ implant could be used satisfactorily compare for the other implant system. But we most to approach carefully in certain extreme condition especially with poor bone quality and quantity.
Implant treatment, which was first attempted in fully edentulous patients, is now widely used in partially edentulous, and a single tooth missing patients. Moreover, implant treatment has become an essential treatment modality in modern dentistry. The material of fabricating implant prostheses has also become more diverse than before, one of which is the use of high-performance polymers. The frequency of using high-performance polymers, which have been used in the medical field, is also increased in the dental field compared to the past. In the first case, a PEKK abutment and a PFG crown (cement-screw-retaining type) were fabricated in the lower left second premolar, and in the second case, a PEKK abutment and a monolithic zirconia crown (cement-screw-retaining type) were fabricated in the missing upper left first molar, and in the third case two PEKK abutments and a splinted PFM crowns (cement-screw-retaining type) were fabricated and connected to the upper right first and second molar implants. Through these procedures the patients obtained esthetically and functionally satisfactory results after 4 years of follow-up.
Purpose: The purpose of this study was to evaluate the 3 dimensional accuracy of impression taking on the newly developed healing abutment and impression coping combined system comparing conventional pick-up type impression. Materials and methods: For 10 patients who had a single missing tooth on molar area, dental implants (SuperLine; Dentium, Seoul, Korea) were placed and healing abutment (MyHealing; Raphabio Co., Seoul, Korea) abutments were connected. After 3 months, transfer type impression with MyHealing and pick-up type impression with impression coping were performed twice in the same patients, and master models were fabricated. Customized prosthetic abutments (Myplant; Raphabio Co., Seoul, Korea) were milled and connected to the master casts. Through a dental scanner (Scanner S600; Zirkonzahn, South Tyrol, Italy), the master casts were converted into virtual casts. The length and angulation differences between casts were measured using 3 dimentional analysis program (Geomagic Qualify 12; Geomagic, Morrisville, NC, USA). Statistical significance was calculated using Kruskal Wallis test and Mann-Whitney U test (${\alpha}$=.05). Results: The length differences between the two systems were 0.032 mm in sagittal plane, and 0.029 in coronal plane, and 0.023 mm in horizontal plane. The angulation differences were $0.755^{\circ}$ in sagittal plane, and $1.275^{\circ}$ in coronal plane, and $0.420^{\circ}$ in horizontal plane. Conclusion: The accuracy of newly developed healing abutment system is similar to that of conventional pick-up impression. The new system can reduces chair time by not using separate impression coping.
Purpose: The purpose of this study is to compare the accuracy of digital scans of implants according to different shapes of scanbodies, and to compare the accuracy of library merging according to different oral exposure height. Materials and methods: A master model with a single tooth edentulous site was prepared. For the first experiment, three types of intraoral scanbodies were prepared, divided into three groups, and the following experiments were conducted for each group: An internal hex implant was placed. The master model with the scanbody connected was scanned with a model scanner, and a master reference file (control group) was created. 10 files (experimental group) were created by performing 10 consecutive scans with an intraoral scanner. After superimposing the control and experimental groups, the following values were calculated: 1) Distance deviation of a designated point on the scanbody 2) Angle deviation of the major axis of the scanbody. For the second experiment, the scanbody scan data were prepared in 6 different heights. Library files were merged with each of the scan data. The distance and angular deviation were calculated using the 7 mm scan data as control group. Results: In the first experiment, there were no significant differences between A and B (P=.278), B and C (P=.568), and C and A (P=.711) in the distance deviations. There were no significant differences between A and B (P=.568), B and C (P=.546), and C and A (P=.112) in the angular deviations. Also, the scanbody showed significantly higher library merging accuracy in the groups with high oral exposure height (P<.5). Conclusion: There were no significant differences in scan accuracy according to the different shapes of scanbodies, and the accuracy of library merging increased according to exposure height of the scanbody in the oral cavity.
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