• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.189-196
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• 1992

Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.301-307
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• 2004

The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.3
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• pp.198-203
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• 2012

Excessive occlusal wear results in unacceptable damage to the occluding surfaces, and can cause pulpal injury, occlusal disharmony, impaired function, and aesthetic deformity. Patients with severely worn dentition need to be classified as several categories relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. When treating patients classified as those who have excessive wear without loss of occlusal vertical dimension but with limited space, we could consider treating them at an increased vertical dimension of occlusion. Treatments at an increased vertical dimension of occlusion may provide stability, given that the amount of its increase was minimal, and a perfected occlusion was achieved after enough stabilization period. A 50-year-old male visited the department of Prosthodontics in Yonsei University Dental Hospital with the chief complaint of worn teeth on lower anterior area. Reconstruction at an increased vertical dimension of occlusion was planned. After the compatibility of the new vertical dimension of occlusion had been confirmed under interim fixed restorations, definitive fixed restorations composed of full-contour monolithic zirconia prostheses were placed. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition at an increased vertical dimension of occlusion with an improvement in esthetics and function.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.3
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• pp.231-238
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• 2001

This study was performed to evaluate soft tissue cephalometric norms for Korean adults which can be implemented in surgical orthodontic treatment planning using selected horizontal reference plane especially for Koreans (Male: $SN-7.5^{\circ}$, Female: $SN-9.0^{\circ}$) and a simplified analytical method. 70 males and 70 females consisting of freshmen of Yonsei University from 1996 to 1997 and students from the Dental College of Yonsei University were chosen according to clinical examination and cephalometric analysis. The samples had normal profiles, normal anteroposterior skeletal relationship(ANB angle of $0^{\circ}\;to\;4^{\circ}$ and Wits appraisal of -4.0mm to 0mm), and Class I molar and canine relationship. They had no missing or supernumerary teeth and had no experience of orthodontic or prosthetic treatment. After the selection of 15 soft tissue landmarks and the construction of horizontal and vertical reference lines, 25 measurements were taken. These consisted of vertical and horizontal linear measurements and angular measurements. The results were as follows. 1. Mean and standard deviation of the measurements were calculated in males and females. 2. Vertical measurements were comparably bigger in males than females whereas anterior facial height ratio(sN-Sn/Sn-sMe) and lower anterior facial height ratio(Sn-Stms/Stmi-sMe) showed no significant difference between sexes. 3. Most of the horizontal measurements in relation to the vertical reference line(G-perpendicular) showed no significant difference between sexes. 4. Nasofacial angle, columellar angle, nasolabial angle and facial contour angle showed no significant difference between sexes. 5. The upper and lower lip were positioned about $-1.0{\pm}2.0mm$ and $+1.0{\pm}2.0mm$ in relation to the Ricketts' esthetic line in both sexes. In this study, soft tissue cephalometric norms of Korean adults for orthognathic surgery were obtained.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.5
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• pp.463-476
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• 2001

Since the treatment of edentulous patients with osseointegrated implant was first introduced more than 30 years ago, implant therapy has become one of the most important dental treatment modalities today. Based on the previous experience and knowledge, $Br{\aa}nemark\;Novum^{(R)}$ protocol was introduced with the concept of simplifying surgical and prosthetic technique and reducing healing time recently. This protocol recommends the installation of three 5mm wide diameter futures in anterior mandible and the prefabricated titanium bars for superstructure fabrication. This study was designed to analyze the stress distribution at fixture and superstructure area according to changes of fixture number, diameter and superstructure materials. Four 3-dimensional finite element models were fabricated. Model 1 - 5 standard fixtures (13mm long and 3.75mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 2- 3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 3-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and resin Model 4-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and porcelain A 150N occlusal force was applied on the 1st molar of each model in 3 directions - vertical($90^{\circ}$), horizontal($0^{\circ}$) and oblique($120^{\circ}$). After analyzing the stresses and displacements, following results were obtained. 1. There were no significant difference in stress distribution among experimental models. 2. Model 2, 3, 4 showed less amount of compressive stress than that of model 1. However, tensile stress was similar. 3. Veneer material with a high modulus of elasticity demonstrated less stress accumulation in the superstructure. Within the limites of this study, $Br{\aa}nemark\;Novum^{(R)}$ protocol demonstrated comparable biomechanical properties to conventional protocol.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.198-205
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• 1991

We obtained successful functional and esthetic results by grafting of iliac marrow-cancellous bone in 2 cases of alveolar-palatal cleft patients. Bone graft of alveolar-palatal clefts provide bony support to adjacent teeth of cleft area, prevented from relapse of orthodontic arch expansion, closure of oroantral fistula and improvement of speech problem. 1. In one case, extraction of upper right central incisor that was little bone support, alignment of rotated teeth and expansion of collapsed arch segment were done with pre-ortodontic treatment. The other case, Bone grafting was done after removal of prosthesis with no preorthodontic treatment. 2. After mucoperiosteal incision in cleft area. The mucosal flap of labial area, palate and nose were separation and the raised nasal mucosa was sutured for closure of oroantral fistula. Then, the iliac marrow-cancellous bones were grafted to cleft site. 3. After 6 months of operation, we had seen the new bone deposition to cleft site in dental radiography and prosthetic treatments of missing teeth were done.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.274-287
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• 2000

The use of dental implants has increased tremendously in recent years and is expected to increase even more in the future. The successful outcome of any implant procedure is surely dependent on interrelationship of the various components of an equation that includes biocompatibility of implant material, macroscopic and microscopic nature of the implant surface, the status of implant bed, surgical technique, undisturbed healing phase and subsequent prosthetic design and long-term loading phase. The purpose of this study was to clarify the effects of adrenalectomy on the osseointegration of pure titanium implants. Seventy rats, 11 weeks of age, were divided into two groups : an adrenalectomized group and a control group. Titanium screw implant(diameter, 2.0mm; length, 3.5mm) was placed into left tibia of 70 rats, 35 in control group and 35 in the experimental group. The rats were sacrificed at different time interval (1, 2, 3, 4, 6, 8, and 12 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with fibronectin and CD44 antibody. The results obtained from this study were as follows: 1. Histopathogically, findings, newly formed bone was seen at 3 weeks control group and became lamellar bone at 12 weeks. At 6 weeks, lipocytes were observed in bone marrow space. Thickness of regenerated trabecular bone increased till 6 weeks after then, that decreased gradually. 2. By histomorphometric analysis, marrow bone density and contact ratio of marrow bone to implant decreased significantly from 8 to 12 weeks in experimental group compared to control group and also total bone to implant contact ratio decreased significantly from 4 to 12 weeks in experimental group compared to control group. 3. Fibronectin immunoreactivity was very strong at 3 and 4 weeks control group. And after that reduced gradually. But it was continuously strong from 1 to 12 weeks experimental group. 4. CD44 immunoreactivity was very strong in the newly formed osteoblasts at 3 and 4 weeks control group. But it reacted minimally later. However, it reacted continuously strong from 3 to 12 weeks experimental group. From these results, bone to implant contact ratio decreased gradually from 4 weeks in adrenalectomized group compared to control group. CD44 and fibronectin immunoreactivities were strong at all times in adrenalectomized rats. Therefore, it could be stated that immature bone remained continuously for a long time and not readily proceeded into mature status.

• The Journal of Korean Academy of Prosthodontics
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• v.18 no.1
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• pp.7-13
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• 1980

The purpose of this study was to evaluate the removable partial denture prescriptions including surveyed crowns and design of component parts sent to the laboratory technician. A total of 351 casess with prescription forms and master cast in maxillary and mandibular semi-edentulous situations collected from dental laboratory by random sampling were selected for this study. The evaluation and study observed here involved the classification of edentulous situations, status of abutment splinting, form of rest seats and guiding plane of surveyed crows, location of maxillary major connectors and tripodig marks on the master casts. Removable partial denture prescriptions contained (1) general request (upper and lower cast framework), (2) types of metal, (3) location of retainer(retention, lingual bracing, rest area, guiding plane surface), (4) location and type of major connector, (5) relief area and amount, (6) and other specific instructions. The following informations based on the classified groups such as Group I was those cases sent with no real prescriptions. They say 'make a partial.' No prescriptions, no thought beforehand, Group II was those cases sent with a minimal prescriptions. They say 'make a partial with clasps on May be some preparations, usually inadequate. Group III was those cases sent with a moderately good prescription. Adequate but could be much better. No tripoding but it tell what clasps go where. Still not good prescriptions. Group IV was good cases, tripoded with adequate prescriptions and a prescription which exactly describes what is expected from the laboratory. The analyzed results were as follows: 1. The normal form of rest seats and guiding plane of surveyed crowns in Class. I and Class. II edentulous situations on the maxillary cast were observed 31.9% and 27.89%, respectively. The abutment teeth and retainer without occlusal rests of Class. I and Class. II were showed 11.58% and 8.86%, respectively. In mandibular cases, the normal form of rest seats and guiding plane of surveyed crowns showed 27.54% and 8.82% in Class. I and Class. II situation. The abutment teeth and retainer without rest seats were showed 15.19%, respectively. 2. The splinted surveyed crowns of Class. I and Class. II maxillary edentulous situations in distal extension cases were showed 34.51% and 28.85%, but 28.52% and 10.29%, respectively. 3. The location and type of maxillary major connector delineated on the master cast were 66 cases (44.89%). 4. The results of 351 cases were classified as Group I 146(41.59%), Group II 115 (32.76%), Group III 57 (16.23%), and Group IV 33 (9.48%). 5. The delineation of abutment tooth for clasping were 176 cases (50.14%) among total of 351 cases. 6. The delineation of height of contour line were showed 45 cases (12.8%) in Group II, 14 cases (3.98%) in Group III and 33 cases (9.40%) in Group IV with total 92 cases (26.21%). 7. In surveying procedure, the delineation of tripoding marks and reference line were showed 17 cases (4.84%).

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.14-20
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• 2016

Purpose: The aim of this study was to know whether there is significant difference of peri-implant bone density according to the state of antagonist region. Materials and methods: 51 patients who had implant operation in Daejeon Dental Hospital of Wonkwang University participated in this study and total of 51 implants were analyzed. Implants were classified depending on opposing antagonist region, gender, age and location of jaw. The opposing antagonist region was divided into four groups; natural tooth, implant, pontic and edentulous region. Fractal analysis was performed using two periapical radiographs; one after implant placement and the other after 10 weeks following prosthetic restoration. The analysis was done by Image J. The data was statistically analyzed using one-way ANOVA and Tukey multiple comparison test. Results: The mean value of fractal difference was $0.009{\pm}0.048$ with opposing natural tooth, $0.026{\pm}0.080$ with opposing implant, $0.025{\pm}0.068$ with opposing pontic and $0.093{\pm}0.171$ with opposing edentulous area. There was a statistically significant difference in fractal value between opposing implant and opposing edentulous state. And there was no statistically significant difference according to age, gender and location of jaw. Conclusion: There was no statistically significant difference between 3 groups except opposing edentulous region and there was a statistically significant difference between opposing implant and edentulous region. And there was no statistically significant difference according to age, gender and location of jaw.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.385-395
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• 2012

This clinical report presents the case using overlay dentures to treat a patient with cleft lip and palate and malocclusion. This patient requires vigorous treatment such as orthodontic treatment and combined orthodontic/oral surgery procedures. Overlay denture can be used as an alternative treatment option. Intraoral and radiographic examinations were done. The vertical dimension of occlusion was evaluated for proper prosthetic procedures and the surveying in the diagnostic cast was done. Considering the tissue and teeth undercut, the alterations of teeth shape were done. Final preparation and impression was performed. After the evaluation of vertical dimension and occlusion with wax-denture, the dentures were polymerized. Clinical remounting and occlusal adjustment were done on the articulator. Overlay dentures were delivered and the patient was recalled for relining. The overlay dentures satisfied patient's esthetic and functional requirements and provided a stable occlusion. Overlay dentures in this case were a reversible and relatively inexpensive treatment for this patient, however the potential possibilities of caries and periodontal disease as a result of poor oral hygiene should be prevented with periodic recall.