• Title/Summary/Keyword: dental prosthetic treatment

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Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

  • de Almeida Cardoso, Mauricio;de Molon, Rafael Scaf;de Avila, Erica Dorigatti;Guedes, Fabio Pinto;Filho, Valter Antonio Ban Battilani;Filho, Leopoldino Capelozza;Correa, Marcio Aurelio;Filho, Hugo Nary
    • The korean journal of orthodontics
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    • v.46 no.1
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    • pp.42-54
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    • 2016
  • The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

Full mouth rehabilitation on the patient with maxillary anterior diastema and posterior bite collapse with orthodontic treatment (상악 전치부 치간 이개와 구치부 교합지지 상실을 가진 환자에서 교정치료를 동반한 완전 구강회복 증례)

  • Lee, Seon-Ki
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.1
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    • pp.60-68
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    • 2022
  • A patient with severe periodontitis has causative factors that cause pathological tooth movement, the occlusion is disintegrated, and the vicious cycle of worsening periodontitis is repeated. In particular, when pathological tooth movement occurs in the maxillary anterior region, the patient has an aesthetic sense of atrophy, and the quality of life was reduced. Therefore, when orthodontic treatment was added to patients with severe periodontitis, it promotes the formation of new bone, reduces periodontal cysts, and obtains clinical attachment, which leads to favorable results in prosthetic restoration, thereby enabling ideal occlusion, function and aesthetics. Periodontal treatment, orthodontic treatment, natural tooth restoration, and implant prosthesis were planned for patients with pathological tooth movement in the anterior region due to loss of occlusal support in the posterior region. As a result, an ideal restoration space was secured, a stable restoration of occlusal contact was formed, and the maxillary anterior teeth were aesthetically improved.

Case report: Application of Implant Supported Removable Partial Denture due to Multiple Dental Implant Loss of the Fixed Implant Supported Prosthesis (다수의 임플란트발거로 임플란트 고정성 보철이 실패한 환자에서의 잔존 임플란트를 이용한 부분 가철성 국소의치 수복증례)

  • Kang, Jeong Kyung;Nam, Gi Hoon
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.23 no.1
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    • pp.34-40
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    • 2014
  • There are several treatment options for rehabilitation of partial edentulism including the use of conventional or implant-retained fixed prostheses. However, such prosthetic options cannot always be possible because of compromised general and oral health (i.e. loss of supporting tissues, medical reasons, extensive surgical protocol and osseointegration failure of dental implant) as well as the affordability of patients. In some cases, removable partial denture provides easier access for oral hygiene procedures and the ability to correct discrepancies in dental arch relationships than implant fixed prosthesis. Recently, Implant Supported Removable Partial Denture (ISRPD) where to place dental implant in strategic position has been suggested to improve the limitation and shortcomings of conventional RPD. ISPRD can overcome mechanical limition of conventional RPD by placing implant in a favorable position and can be cost-effective, prosthetic solution for partially edentulous patients who are not immediate candidates for extensive, fixed implant supported restorations. Incorporation of dental implants to improve the RPD support and retention and to enhance patient acceptance should be considered when treatment planning for RPD. In this case, 59 years old male patient who received dental treatment of implant fixed prosthesis on both side of the upper jaw and implant overdenture on lower jaw showed implant abutment screw fracture on #15i and osseointegration failure on multiple number of implants. After removing failed implants, we planned ISRPD using #15i,24i,25i,26i and #23 natural tooth for RPD abutment. We fabricated #23 surveyed crown,#24i=25i=26i surveyed bridge and #15i gold coping for support,retention and stability for RPD. Periodic follow up check for 2years has been performed since the ISRPD delivery to the patient. No sign of screw loosening, fracture or bone resorption around abutment implants were detected.

Evaluation of sleep quality and stress response in patients requiring dental prosthetic treatment (치과보철치료를 요하는 환자에서의 수면질과 스트레스 반응 평가)

  • Jeon, Hye-Mi;Jung, Kyoung-Hwa;Choi, Na-Rae;Song, Jae-Min;Lee, So-Hyoun;Kim, So-Yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.181-189
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    • 2021
  • Purpose: The purpose of this study is to investigate the stress response and sleep state of the new patients who visit the hospital for prosthodontic treatment due to tooth loss to make reference to further treatment direction. Materials and methods: Examinations, consultations, and surveys were conducted on 236 patients (94 males, 142 females, and 24-86 years old), who newly registered at the department of prosthodontics at Pusan national university hospital, for 2 years from 2018. The number of remaining teeth, edentulous arch, possibility of mastication, and future prosthetic treatment directions were recorded. The visual analogue scale (VAS), stress response inventory (SRI) and Insomnia severity index (ISI) were used as tools to measure patient's subjective discomfort, stress response, and sleep status. Results: Among the entire prosthodontic patient group, the average value of 'fatigue' was significantly higher among the 7 items of SRI, and the value of 'aggression' was significantly lower (P<.001). There are a significant difference between the edentulous and full dentition in the oral discomfort value measured by VAS (P=.004). In cases where less than 20 teeth remain, mastication is impossible, and patients who are planning treatment with removable prostheses, VAS value and 'depression' and 'fatigue' values in SRI were higher than those in the reverse case (P<.05). The patients showed severe level in VAS value have high value of 'tension', 'somatization', 'depression', 'fatigue'and 'frustration'in SRI than non-serious patients (P<.05). Clinical insomnia occurred in 11.4% of all patients, and women had significantly lower sleep quality than men (P=.044). Patients with insomnia showed significantly higher scores on the VAS value and all 7 SRI items than those of normal sleepers (P<.05). Conclusion: The new prosthetics had high 'fatigue' value among the 7 items of SRI. The oral condition, number of residual teeth and mastication function and clinical insomnia affected oral discomfort and the stress response.

Comparison of Dental Outcomes after General Anesthesia According to the Follow-up Pattern in Special Health Care Needs Patients (장애인 환자의 전신마취 하 치과 치료 후 정기검진 패턴에 따른 치과치료 결과 비교)

  • Kim, Jihyun;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.145-150
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    • 2016
  • Special Health Care Needs (SHCN) patients need regular follow-up because of high incidence and severity of oral disease. The aim of this study was to evaluate the dental treatment outcomes of SHCN patients according to follow-up patterns. SHCN patients who were treated under general anesthesia (GA) at Kyung Hee University Dental Hospital from 2006 to 2014 were included in this study. The final samples comprised of 53 patients that were divided into regular (33 patients) and irregular (20 patients) follow-up groups according to their follow-up patterns. The type of dental treatment after GA during the follow-up periods were compared. In the irregular group, aggressive treatment including endodontic, prosthetic treatment, and extraction were predominant, compared with the regular group (p < 0.05). In addition, all patients who had dental treatment under GA in follow-up periods were in the irregular group (p < 0.05). In conclusion, the results of this study provide the importance of regular follow-ups with SHCN patients and emphasize responsibilities of dentists for educating patients and their guardians.

Retreatment of implant overdenture using Milled Bar and Attachment in a patient using a unilateral prosthetic arm: A case report (편측 의수 사용 환자에서 Milled Bar와 Attachment를 이용한 임플란트 피개의치 재수복 증례)

  • Park, So-Hyung;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo;Lee, So-Hyoun
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.187-194
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    • 2022
  • The use of implants could improve the support, retention, and stability of removable prosthetic restoration for fully edentulous patients with severe alveolar bone resorption. When the prosthesis is manufactured without accurate diagnosis and evaluation, this may lead to unfavorable treatment result. The patient in this case had the treatment of implant overdentures at a private dental clinic, but visited the hospital for retreatment due to soft tissue pain and decreasing retention of existing dentures. The vertical dimension was raised compared to the existing dentures, and overdentures were manufactured using milled bars and additional attachments. The clinical results were satisfactory in the aspect of improved oral hygiene maintenance, function and esthetics.

Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

  • Kim, Sang-Yun;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.27.1-27.8
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    • 2018
  • Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

Reconstruction of anterior guidance using duplication technique of CAD/CAM: a case report (CAD/CAM의 복제 기법을 이용한 전방 유도의 재현 증례)

  • Bae, Ji-Cheol;Kim, Won-Hee;Jeon, Yong-Chan;Jeong, Chang-Mo;Yoon, Mi-Jung;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.2
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    • pp.121-127
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    • 2014
  • Comprehensive prosthetic treatment requires considerations from various points of view. The anterior guidance is important factor in prosthodontic treatment of anterior teeth. Lingual surface contour of anterior restoration is so critical that a small mistake of laboratory or clinical process can cause discomfort of patient and disharmony of entire dentition. There are no guidelines for lingual surface contour that fit all patients. Therefore the lingual surface of provisional restoration is most accurately described as a customized one. The dentist transfers the exact information of anterior guidance that has made through long term provisional restoration to the technician. This case introduce that the duplication technique of CAD/CAM system to reproduce the anterior guidance of provisional restoration. This method can improve satisfaction of both patient and dentist.

IMPLANTS IN PSYCHIATRIC PATIENTS (정신장애 환자의 임프란트 치료)

  • Moon, Sung-Yong;Kim, Su-Gwan
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.1
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    • pp.1-5
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    • 2007
  • Patients of mental disorder have more missing teeth than general population because of the difficulty of oral hygiene management. In addition, especially Down syndrome patients etc., congenital dental problems develop more frequently. Therefore, prosthetic rehabilitation treatments for missing teeth in mental disorder patients are required more urgently. In other words, a removable partial denture may be very difficult for such patients to wear and manage. So in this review article we reviewed implant therapeutic modes for mental disorder patients based on previous reports. It should be understood that implant treatments are not impossible for mental disorder patients, and if implants could be a good method that could provide them good quality care, so implant should be included in treatment plans before surgery. Before surgery it should be evaluated that patients ability to manage themselves their ability to manage themselves should be evaluated and also should be evaluated whether general anesthesia or sedative treatment is required for the treatment, and whether their cooperation is good enough.

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Flexual strength of resins for provisional fixed prostheses (임시 고정성 보철물 제작용 레진의 굽힘강도)

  • Choi, Myoung-Ah;Ahn, Seung-Geun;Cho, Kuk-Hyeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.3
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    • pp.221-227
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    • 2000
  • Provisional fixed partial dentures(FPDs) are an important part of many prosthodontic treatment procedures. These provisional fixed prostheses must fulfill biologic, mechanical, and esthetic requirements to be considered successful. Consideration of all these factors and requirements are important because provisional resin restorations may be worn over a long period to assess the results of periodontal and endodontics therapies, and also during the restorative phase of implant reconstructive procedures. This in vitro study examined flexual strength of four resins commonly used for fixed provisional prostheses. The effects of polymerization conditions were also evaluated. The four resins tested were : Caulk Temporary bridge resin(L.D. Caulk Co. Dentsply International Millford), Jet(Lang Dental Mfg. Co. Chicago. ILL. U.S.A), Alike (Coe Laboratories. Inc. Chicago. ILL. U.S.A) and Tokuso Curefast (Coe Laboratories. Inc. Chicago. ILL. U.S.A) The test specimens were 65mm long, 14mm wide, and 3.5mm thickness. 10 specimens of four resins were cured for 15 minutes at atmospheric pressure and 10 specimens of four resins were cured at an additional pressure of approximately 20 psi. A total of 80 specimens were prepared. The flexual strength was determined by three-point bending test. Data were analysed with the Paired samples T-test and Tukey student-range test Within the limitations imposed in this study, the following conclusions can be drawn : 1. Under the condition of bench curing, Caulk Temporary bridge resin showed the highest flexual strength. In decreasing order, the flexual strength of the other materials was as follows : Jet, Tokuso Curefast, Alike, and Caulk Temporary bridge resin demonstrated significantly higher strength than other resins. 2. Under the condition of pressure curing, Jet showed the highest flexual strength. In decreasing order, the flexual strength of the other materials was as follows : Caulk Temporary bridge resin, Tokuso Curefast, and Alike. There were all statistically significant differences among four resins 3. There was a statistically significant difference between bench- and pressure-cured specimens in all four materials.

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