• Journal of Periodontal and Implant Science
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• 제50권2호
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• pp.97-105
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• 2020

Purpose: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions: NDIs in the anterior and posterior jaws functioned equally well in terms of periimplant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

• 구강회복응용과학지
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• 제30권1호
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• pp.71-80
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• 2014

골흡수가 심한 환자에서 임플란트를 이용한 전악 수복의 경우 치은과 치아의 외형을 심미적이면서도 기능적으로 회복하기 위해서는 보철물 제작에 있어 신중을 기해야 한다. 이러한 전악 수복 증례에서 CAD/CAM 시스템이 높은 정확성을 가지는 보철물 제작을 가능하게 함으로써 사용이 증가하고 있다. 최근에 임상에서 티타늄이나 지르코니아의 단점을 보완하면서 높은 생체적합성을 가지고 CAD/CAM 시스템으로 제작할 수 있는 팔라듐-은(Pd-Ag) 합금이 개발되어 사용되고 있다. 본 증례에서는 상악 전부 무치악 환자에서 임플란트를 식립하고 도재의 chipping이나 파절의 위험을 감소시키기 위해 Pd-Ag 합금을 이용해 제작된 임플란트 고정성 보철물로 수복한 환자에 대해 보고하고자 한다.

• The Journal of Advanced Prosthodontics
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• 제12권2호
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• pp.67-74
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• 2020

PURPOSE. This study evaluated the influence of prosthesis weight and number of implants on the bone tissue microstrain. MATERIALS AND METHODS. Fifteen (15) fixed full-arch implant-supported prosthesis designs were created using a modeling software with different numbers of implants (4, 6, or 8) and prosthesis weights (10, 15, 20, 40, or 60 g). Each solid was imported to the computer aided engineering software and tetrahedral elements formed the mesh. The material properties were assigned to each solid with isotropic and homogeneous behavior. The friction coefficient was set as 0.3 between all the metallic interfaces, 0.65 for the cortical bone-implant interface, and 0.77 for the cancellous bone-implant interface. The standard earth gravity was defined along the Z-axis and the bone was fixed. The resulting equivalent strain was assumed as failure criteria. RESULTS. The prosthesis weight was related to the bone strain. The more implants installed, the less the amount of strain generated in the bone. The most critical situation was the use of a 60 g prosthesis supported by 4 implants with the largest calculated magnitude of 39.9 mm/mm, thereby suggesting that there was no group able to induce bone remodeling simply due to the prosthesis weight. CONCLUSION. Heavier prostheses under the effect of gravity force are related to more strain being generated around the implants. Installing more implants to support the prosthesis enables attenuating the effects observed in the bone. The simulated prostheses were not able to generate harmful values of peri-implant bone strain.

• 대한치과보철학회지
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• 제57권2호
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• pp.176-181
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• 2019

편측 부분 무치악에서 소수의 치아로 지대치를 형성하여 가철성 국소의치 제작 시 환자의 불편함 및 지대치 손상 등으로 인해 만족도가 낮아질 수 있다. 최근 편측 부분 무치악에서 임플란트 고정성 보철물을 지대치로 사용하여 양측성 후방 연장 국소의치로 제작하는 방법이 보고되고 있다. 본 증례에서 임플란트 고정성 보철물을 사용하여 환자의 수직 악간관계를 보존하고 본인의 치아와 같은 형태를 부여하여 환자에게 심리적 안정감을 주며 향상된 저작 기능의 결과를 제공하였다. 또한 임플란트 고정성 보철물을 통하여 예후가 불량할 것으로 예상되는 편측성 후방 연장 국소의치를 역학적, 기능적으로 유리한 양측성 후방 연장 국소의치를 제작하였다. 국소의치의 지지, 유지, 안정 요소의 향상을 가져왔으며 환자에게 경제적 및 사용 시 만족감을 가져왔다.

• The Journal of Advanced Prosthodontics
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• 제15권4호
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• pp.171-178
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• 2023

PURPOSE. The purpose of this study was to determine the effect of the connector configuration on the fracture load in conventional and translucent zirconia of three-unit fixed dental prostheses (FDPs). MATERIALS AND METHODS. Six different three-unit FDPs were prepared (n = 6) from three types of zirconia (3Y-TZP (Katana ML^®), 4Y-TZP (Katana STML^®), and 5Y-TZP (Katana UTML^®)) in combination with two connector configurations (4 × 2.25, 3 × 3 mm). The CoCr master models were scanned, and the FDPs were designed and fabricated using CAD-CAM. The FDPs were cemented on the metal model and then loaded with a UTM at a crosshead speed of 1 mm/min until failure. Two-way ANOVA and Tukey's test were used for statistical analysis (α = .05). RESULTS. Fracture loads of 3Y-TZP (2740.6 ± 469.2 and 2718.7 ± 339.0 N for size 4 × 2.25 mm and 3 × 3 mm, respectively) were significantly higher than those of 4Y-TZP (1868.3 ± 281.6 and 1663.6 ± 372.7 N, respectively) and 5Y-TZP (1588.0 ± 255.0 and 1559.1 ± 110.0 N, respectively) (P < .05). No significant difference was found between fracture loads of 4Y-TZP and 5Y-TZP (P > .05). The connector configuration within 9 mm² was found to have no effect on the fracture loads on all three types of zirconia (P > .05). CONCLUSION. Fracture loads of three-unit FDPs were affected by the type of zirconia. The fracture loads of conventional zirconia were higher than those of translucent zirconia. However, it was not affected by the connector configuration when the connector had a cross-sectional area of 9 mm².

• 대한치과보철학회지
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• 제62권2호
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• pp.131-139
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• 2024

무치악 환자에서 임플란트를 이용한 보철치료는 임플란트 고정성 보철, 임플란트 융합 국소 의치, 하이브리드 보철물, 임플란트 유지 및 지지 피개의치 등의 다양한 방법이 있다. 본 증례에서는 중등도 이상의 만성 치주염에 이환 되어 전악 발치가 필요한 환자에서 computer guided surgery를 이용하여 계획된 위치에 임플란트를 식립하였다. 상악은 불량한 골질로 초기고정력이 충분하지 않아 지연 부하를 시행하였고 골 유착 기간 동안 임시 의치를 사용하였다. 하악은 안정적인 초기 고정을 얻어 즉시 부하를 이용하여 환자의 불편감을 감소시켰다. 임플란트 일차 안정은 즉시 부하를 얻기 위해 가장 중요한 요소로 여겨지기 때문에 수술 전 반드시 임상적, 방사선학적 평가를 통해 잔존 치조골 양 및 골질을 파악해야 한다.

• 대한치과보철학회지
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• 제62권3호
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• pp.243-252
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• 2024

상하악 완전 무치악 환자에서 임플란트 지지 고정성 최종 보철물을 제작할 때 환자의 수직 고경, 악간관계, 구강내에 식립된 임플란트와 임플란트에 연결된 지대주, 그리고 잇몸 형태에 관한 정확한 정보의 체득이 중요하다. 본 증례에서는 임시 보철물을 통해서 이러한 정보들을 채득하여 최종 보철물을 제작하였다. 임시 보철물을 구강 밖에서 스캔하여 스캔의 효율성을 높였고, 스캔 때 임시 보철물의 양측 후방 부위를 연결하는 스캔지그를 사용하여 스캔의 정밀도를 향상시켰다. 본 증례에서는 이와 같은 디지털 기술을 활용하여 심미적, 기능적으로 만족할 만한 임상적 결과를 얻었기에 이를 보고하는 바이다.

• 대한치과보철학회지
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• 제38권3호
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• pp.375-381
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• 2000

The conventional approach for replacing missing maxillary lateral incisors dictates the placement of either a conventional porcelain-fused-to-metal (PFM)bridge, resin-bonded fixed partial denture, or single implant prosthesis. However, several appearance-related disadvantages have been reported in the use of a prosthesis which incorporates a metal substructure. To address these limitations, metal -free restorative alternatives have been recently developed to expand the clinical options when fabrication of these prostheses is indicated. This clinical report describes the treatment of patients with a missing maxillary lateral incisor where the dentition was non-invasively restored with resin-bonded fixed partial denture(RBFPD) using In-Ceram and Targis-Vectris system.

• Journal of Korean Dental Science
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• 제15권1호
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• pp.84-91
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• 2022

An all-on-4 restoration allows edentulous patients to use a fixed prosthesis with a minimum number of implants. These implant-supported fixed complete dentures have traditionally been fabricated as screw-retained or cement-retained prostheses. However, it is difficult to passively fit the long-span full-arch prosthesis using the screw-retained type restoration, and predictable retrievability is not obtained with the cement-retained type. This case report describes a prosthesis fabricated using a combination of the two retention types. The screwmentable method allows the implant-supported fixed complete denture to achieve a passive fit at the connection with retrievability. In addition, a framework with an optimized size was designed by using digital dental technology.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.105-114
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• 2023

The axial contour and proximal contact of the prosthesis affect periodontal health, food impaction, and patient satisfaction. This narrative review provides a summary of articles regarding the axial contour and proximal contact of a fixed dental prosthesis on periodontal health and physiologic function. By acquiring a comprehensive understanding of the axial contour and proximal contact of teeth and prostheses, as well as their functional significance, the virtual design of fixed dental prosthesis can be optimized to maintain periodontal health and promote physiologic function effectively.