• Title/Summary/Keyword: edentulous

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THE MANAGEMENT OF A COMPLEX IMPLANT CASE USING CAD-CAM TECHNOLOGY: A CLINICAL REPORT

  • Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.6
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    • pp.634-638
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    • 2008
  • PURPOSE: The application of computer-aided technology to implant dentistry has created new opportunities for treatment planning, surgery and prosthodontic treatment, but the correct selection and combination of available methods may be challenging in times. Hence, the purpose of this case report is to present a combination of several computer-aided tools as approaches to manage complicated implant case. MATERIAL AND METHODS: A 47 year-old female patient with severe dental anxiety, high expectations, financial restrictions and poor compliance presented for a fixed rehabilitation. A CT scan with a radiographic template obtained with software (SimPlant, Materialize, Leuven, Belgium) was used for treatment planning. The surgical plan was created and converted into a stereolithographic model of the maxilla with bone-supported surgical templates (SurgiGuide, Materialise, Leuven, Belgium), that allowed for the precise placement of 7 implants in a severely resorbed edentulous maxilla. After successful osseointegration, an accurate scan model served as the basis for the fabrication of a one-piece milled titanium framework using the Procera (Nobel Biocare, Gothenburg, Sweden) technology. The final rehabilitation of the edentulous maxilla was rendered in the form of a screw-retained maxillary metal-reinforced resin-based complete prosthesis. RESULTS: Despite challenging circumstances, 7 implants could be placed without bone augmentation in a severely resorbed maxilla using the SimPlant software for pre-implant analysis and the SurgiGuide-system as the surgical template. The patient was successfully restored with a fixed full arch restoration, utilizing the Procera system for the fabrication of a milled titanium framework.

Comparative analysis of immediate functional loading and conventional loading about implant survival rate in the completely edentulous: Retrospective study (완전 무치악에서 즉시 부하시와 표준 부하시 임플란트 생존율에 대한 비교 분석: 후향적 연구)

  • Seo, Hyun-Soo;Park, Jun-Woo;Hong, Soon-Min;Lee, Seok-Ryun
    • The Journal of the Korean dental association
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    • v.52 no.12
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    • pp.771-782
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    • 2014
  • Introduction: This study researched the clinical application of immediate functional loading technique about implant survival rate in the completely edentulous and suggested our protocol about surgical & prosthetic procedure. Materials and methods: 32 consecutive patients participated in this study. A total of 242 implants were inserted. In test group, 144 implants were inserted in 19 patients with immediate functional loading with occlusal contact. In control group, 98 implants were inserted in 13 patients and conventional loading was done after 4~6 months. Result: In the immediately loaded implants group, overall cumulative survival rate was 98.6%.

Comparative analysis of case series for the prosthetic rehabilitation of edentulous patients using suction denture (완전 무치악 환자들을 위한 보철 수복 시 흡착 의치를 이용한 비교 분석 증례)

  • Kim, Ye-Ji;Song, Young-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.389-396
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    • 2019
  • In patients with severely resorbed alveolar bone, it is difficult to gain retention in denture. Lack of retention makes denture unstable and lead to trouble in using denture. Suction denture seals the entire denture border with movable mucosa and this sealing mechanism forms negative pressure beneath the denture and produce higher retention and stability to denture. In this case, 4 edentulous patients visited for lack of retention with dentures. Considering their high expectation with retention, suction denture concept was used to fabricate retentive and stable denture. The purpose of this case report is to compare and analyze the considerations of suction denture restorations in edentulous patients.

THE CLINICAL STUDY OF MAXILLARY SINUS SEPTA USED IN PANORAMA, CT (Panorama, CT를 이용한 상악동내 중격의 임상적 연구)

  • Jung, Jin-Won;Song, Kyoung-Ho;Lee, Seul-Ki;Kim, Jwa-Young;Yang, Byoung-Eun;Kim, Sung-Gon;Song, Sang-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.319-324
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    • 2008
  • Purpose: The aim of this study was to examine the incidence, location and morphology of antral septa using radiographic exam.(Panorama, CT) in the dentate/non-atrophic and edentulous/atrophic maxillary segments. Material & methods: 232 sinuses were subdivided into two groups(group1 : 175 sinuses were classified as complete & partial dentate maxillary segments, group2 : 57 sinuses were classified as complete edentulous maxillary segments) and were investigated for the incidence, location and morphology of maxillary sinus septa. Results: A total of 80 septa were observed in 232 maxillary sinuses, which corresponded to 30.65% of the sinuses(71 of 232). 67.5% of the total septa was observed in the complete & partial dentate groups, but 32.5% of the total septa was observed in the complete edentulous group. Upon analysis of the anatomical location of the septa, it was seen that 14 septa(17.5%) were located in the P1 area, 15 septa(18.7%) were located in the P2 area, 19 septa(23.8%) were located in the M1 area and 32 septa(40%) were located in the M2 area & dista area of M2. we found 45 septa in the apical lesion of teeth, Group 1. However the remaining 9 septa were found in the edentulous area. Conclusion: CT is a better method than panoramic radiography for detecting the presence of the maxillary sinus septa. Maxillary sinus septa are more commonly detected in complete edentulous maxillary segments than in complete & partial dentate maxillary segments. Also maxillary sinus septa are more commonly detected posteriorly than anteriorly.

All-on-4 implant restoration with full-digital system preserving existing occlusion: A case report (완전 디지털 시스템으로 기존 교합을 보전한 All-on-4 임플란트 수복증례)

  • Kim, Kyoung Hee;Jeong, Seung-Mi;Lee, Ye Chan;An, Xue Yin;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.330-337
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    • 2018
  • In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.

Fractal analysis of peri-implant bone density surrounding implant with different state of antagonist (대합 조건에 따른 임플란트 주변 골밀도 변화에 대한 프랙탈 구조 분석)

  • Kim, Ju-Hee;Lee, Jae-In
    • 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.

All-on-6 implant fixed prosthesis restoration with full-digital system on edentulous patient: A case report (무치악 환자에서 완전 디지털 시스템을 활용한 All-on-6 임플란트 고정성 보철물 수복 증례)

  • Lee, SeungJin;Jeong, Seung-Mi;Chung, Chae-Heon;Fang, YiQin;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.497-507
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    • 2021
  • All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient's inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient's requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

Rational treatment planning for implant treatment of the edentulous patients (완전무치악환자의 전악 임플란트 치료 계획 수립을 위한 체계적인 접근법)

  • Jeong-In Bae
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.2
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    • pp.54-68
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    • 2023
  • Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.

Complete denture fabrication of a skeletal class III edentulous patient considering anterior neutral zone: a case report (골격성 III급 무치악 환자에서 전치부 중립대를 고려한 총의치 제작 증례)

  • Su-Hun Kim;Hyung-Jun Kim;Sang-Won Park;Hyun-Pil Lim;Chan Park;Woo-hyung Jang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.2
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    • pp.91-99
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    • 2024
  • In the case of skeletal class III edentulous patients, the stability of dentures can be achieved by using a crossbite by considering the residual ridge relationship when fabricating complete dentures. Forming the anterior teeth in a normal occlusal relationship in a skeletal class III ridge relationship may reduce the stability of the denture by increasing the anterior cantilever. However, when patients use complete dentures, not only functional aspects but also aesthetic aspects are important. The aesthetics of complete dentures depends on how the anterior artificial teeth are arranged, and cases of complete denture fabrication using normal occlusion or edge-to-edge bite in edentulous patients with skeletal class III ridge relationships have been reported. In this case, complete dentures were fabricated for an edentulous patient with a skeletal class III edentulous patients by forming anterior edge-to-edge bite considering neutral zone in maxillary anterior teeth, and good aesthetic and functional results were obtained.