• The Journal of Korean Academy of Prosthodontics
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• 제62권3호
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• pp.215-223
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• 2024

The patient in this case presented with a desire to have new dentures due to discomfort with existing ones. At the initial visit, all of teeth were missing except for the mandibular left second molar. As the patient was 65 years old, treatment with dentures and implant-supported prostheses was possible under the national health insurance system, and the patient opted for the mandibular denture using implant. Temporary prostheses were initially provided for patient adaptation, and following successful adaptation period, the treatment progressed. A maxillary complete denture and a mandibular implant-supported denture using two implants in the canines were fabricated. The mandibular denture is a Kennedy Class II removable partial denture which consists of a six-unit porcelain fused to metal fixed dental prostheses supported by the implant in the canines on both sides and left second molar serving as the abutments. Despite severe bone resorption and insufficient abutment teeth, the patient expressed satisfaction with the treatment results. In cases with economic and anatomical constraints affecting the feasibility of complete denture, implant-supported overdenture, and implant-supported fixed dental prostheses, an implant-assisted removable partial denture using implant surveyed crowns proves to be a viable and effective alternative treatment option. Nevertheless, the current dearth of scientifically rigorous studies underscores the necessity for meticulous regular check-up and occlusal assessment.

• Journal of Dental Rehabilitation and Applied Science
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• 제17권4호
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• pp.283-305
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• 2001

The purpose of this study was to analyze the stress distribution of condylar regions and edentulous mandible with implant-supported cantilever prostheses on the certain conditions, such as amount of load, location of load, direction of load, fixation or non-fixation on the condylar regions. Three dimensional finite element analysis was used for this study. FEM model was created by using commercial software, ANSYS(Swanson, Inc., U.S.A.). Fixed model which was fixed on the condylar regions was modeled with 74323 elements and 15387 nodes and spring model which was sprung on the condylar regions was modeled with 75020 elements and 15887 nodes. Six Br${\aa}$nemark implants with 3.75 mm diameter and 13 mm length were incorporated in the models. The placement was 4.4 mm from the midline for the first implant; the other two in each quardrant were 6.5 mm apart. The stress distribution on each model through the designed mandible was evaluated under 500N vertical load, 250N horizontal load linguobuccally, buccal 20 degree 250N oblique load and buccal 45 degree 250N oblique load. The load points were at 0 mm, 10 mm, 20 mm along the cantilever prostheses from the center of the distal fixture. The results were as follows; 1. The stress distribution of condylar regions between two models showed conspicuous differences. Fixed model showed conspicuous stress concentration on the condylar regions than spring model under vertical load only. On the other hand, spring model showed conspicuous stress concentration on the condylar regions than fixed model under 250N horizontal load linguobuccally, buccal 20 degree 250N oblique load and buccal 45 degree 250N oblique load. 2. Fixed model showed stress concentration on the posterior and mesial side of working and balancing condylar necks but spring model showed stress concentration on the posterior and mesial side of working condylar neck and the posterior and lateral side of balancing condylar neck under vertical load. 3. Fixed model showed stress concentration on the posterior and lateral side of working condylar neck and the anterior and mesial side of balancing condylar neck but spring model showed stress concentration on the anterior sides of working and balancing condylar necks under horizontal load linguobuccally. 4. Fixed model showed stress concentration on the posterior side of working condylar neck and the posterior and lateral side of balancing condylar neck but spring model showed stress concentration on the anterior side of working condylar neck and the anterior and lateral side of balancing condylar neck under buccal 20 degree oblique load. 5. Fixed model showed stress concentration on the anterior and lateral side of working condylar neck and the posterior and mesial side of balancing condylar neck but spring model showed stress concentration on the anterior side of working condylar neck and the anterior and lateral side of balancing condylar neck under buccal 45 degree oblique load.. 6. The stress distribution of bone around implants between two models revealed difference slightly. In general, magnitude of Von Mises stress was the greatest at the bone around the most distal implant and the progressive decrease more and more mesially. Under vertical load, the stress values were similar between implant neck and superstructure vertically, besides the greatest on the distal side horizontally. 7. Under horizontal load linguobuccally, buccal 20 degree oblique load and buccal 45 degree oblique load, the stress values were the greatest on the implant neck vertically, and great on the labial and lingual sides horizontally. After all, it was considered that spring model was an indispensable condition for the comprehension of the stress distributions of condylar regions.

• The Journal of Korean Academy of Prosthodontics
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• 제39권2호
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• pp.157-170
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• 2001

The bond strength is the most important factor in establishing long-term success of resin-retained fixed prostheses. So, various surface treatment methods have been introduced to improve the bond strength of metal surface and bonding resin till now This study was performed to compare the effect of silicoating with that of metal primer and analyze the correlation between treatment time of sandblasting and the bond strength, so that meant to find more effective surface treatment method that could enhance the bond strength of resin-retained fixed prostheses. The surfaces of all specimens made of $Verabond^{(R)}$ alloys were air abraded with $250{\mu}m\;Al_2O_3$ according to treatment time of sandblasting and they were subdivided to be treated with only sandblasting(S group), silicoating following sandblasting(SS group) and metal primer application after sandblasting(SM group). Then pairs of metal specimens (${\phi}10mm{\times}h\;2mm,\;{\phi}6{\times}h\;2mm$) were bonded with Super bond $C&B^{(R)}$. The specimens were stored in $38^{\circ}C$ water for 48 hours and shear bond strength was measured using the universal testing machine. The results were as follows, 1. In the comparison of shear bond strength according to treatment time of sandblasting, bond strength was increased in the order of 0', 15', 30', 45', 60' group. 0' group had significantly lower value than any other, while 0', 15' group were significantly different with 30', 45', 60' group(p<0.05). 2. In the comparison of shear bond strength according surface treatment methods, bond strength was increased in the order of S group. SS group and SM group. S group was significantly different with SS group and SM group(p<0.05). 3. Observing the mode of bond failure. 0', 15' group showed only adhesive failure, and 30', 45', 60' group did mostly adhesive & cohesive failure in S group. In SS group and SM group, all other groups except 0', 15' group showed mostly cohesive failure. From the above results, it is considered that sandblasting should be treated for more than 30 seconds, and metal primer be more effective and available clinically than silicoater system which is complicate, technique-sensitive and time-consuming method, when nonprecious metal surface is planning be treated with in order enhance the bond strength of resin-retained fixed prostheses.

• The Journal of Korean Academy of Prosthodontics
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• 제38권5호
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• pp.724-743
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• 2000

One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• 제54권3호
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• pp.239-245
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• 2016

Purpose: The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition. Materials and Methods: A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed. Results: The average of 3.4 implant-supported prostheses were used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification. Conclusion: All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPD for long-term result.

• The Journal of Korean Academy of Prosthodontics
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• 제55권2호
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• pp.180-186
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• 2017

Implant supported prostheses have improved the quality of lives of totally edentulous patients. However, there are some limitations on the number of implants related to the residual bone level or the economic concern and so on. In this situation, applying fixed detachable prosthesis with bilateral cantilevers can be considered. This clinical report describes implant supported prosthetic rehabilitation of a patient with severe bone resorption. The patient was satisfied and felt comfortable with upper complete denture and lower fixed detachable prosthesis.

• The Journal of Korean Academy of Prosthodontics
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• 제55권2호
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• pp.218-224
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• 2017

The implant-supported fixed dental prosthesis in irradiated maxilla needs meticulous treatment planning due to low bone healing capacity. All-on-4 concept implantation can reduce the number of implants to be placed avoiding bone grafting procedure. Conventionally, prefabricated angled abutments for tilted implants have been used. However, in this case, it was replaced with computer-aided design and computer-aided manufacturing (CAD/CAM) abutment. This case report described all-on-4 concept implantation and fabrication of CAD/CAM zirconia fixed dental prostheses using CAD/CAM titanium abutments.

• Journal of Dental Rehabilitation and Applied Science
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• 제33권4호
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• pp.252-259
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• 2017

Purpose: The purpose of this study was to compare and analyze the wear of a prosthesis for 6 months after restoration with implant-supported fixed dental prosthesis made of either zirconia or gold. Materials and Methods: This study was conducted on patients requiring implant-supported fixed dental prostheses on first or second molar from January, 2015 to January, 2016. A total of 47 prostheses and antagonists were examined. Occlusal surface was recorded by impression of each prosthesis and antagonist 1 week and 6 months after prosthesis delivery. The digital files were created by impression scan. Occlusal shapes of 1 week and 6 months were compared and wear of prostheses and antagonists was analyzed. The Mann-Whitney test was used to analyzed the result data underwent normality test using SPSS (Version 23.0, IBM Corporation) Results: Mann-Whitney test revealed that there was no statistically significant difference in the median amount of mean vertical wear for 6 months in zirconia ($50.84{\mu}m$) and gold ($42.84{\mu}m$) prostheses (P > 0.05). When the opposing teeth were natural, the median amount of mean vertical wear of zirconia and gold prostheses was $47.72{\mu}m$ and $41.97{\mu}m$, respectively, and the median amount of mean vertical wear of enamel was $47.26{\mu}m$ and $44.59{\mu}m$, respectively. Statistical analysis showed no significant difference (P > 0.05). Conclusion: Despite the short study period and the small number of experimental groups, zirconia and gold showed no significant difference in wear during the first 6 months. Opposing natural enamel also showed no significant difference in the wear.

• Journal of Korean Dental Science
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• 제12권1호
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• pp.13-19
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• 2019

Purpose: The aim of this study was to compare the flexural strength of provisional fixed dental prostheses which was three-dimensional (3D) printed by several build directions. Materials and Methods: A metal jig with two abutment teeth and pontic space in the middle was fabricated. This jig was scanned with a desktop scanner and provisional restoration was designed on dental computer-aided design program. On the preprocessing software, the build angles of the restorations were arranged at $0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ and support was added and resultant structure was sliced to a thickness of $100{\mu}m$. Processed restorations were printed with digital light processing type 3D printer using poly methyl meta acrylate-based resin. After washing and post-curing, compressive loading was applied at a speed of 1 mm/min on a metal jig fixed to a universal testing machine. The maximum pressure at which fracture occurred was measured. For the statistical analysis, build direction was set as the independent variable and fracture strength as the dependent variable. One-way analysis of variance and Tukey's post hoc analysis was conducted to compare fracture strength among groups (${\alpha}=0.05$). Result: The mean flexural strength of provisional restoration 3D printed with the build direction of $0^{\circ}$ was $1,053{\pm}168N$; it was $1,183{\pm}188N$ at $30^{\circ}$, $1,178{\pm}81N$ at $45^{\circ}$, $1,166{\pm}133N$ at $60^{\circ}$, and $949{\pm}170N$ at $90^{\circ}$. The group with a build direction of $90^{\circ}$ showed significantly lower flexural strength than other groups (P<0.05). The flexural strength was significantly higher when the build direction was $30^{\circ}$ than when it was $90^{\circ}$ (P<0.01). Conclusion: Among the build directions $0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ set for 3D printing of fixed dental prosthesis, an orientation of $30^{\circ}$ is recommended as an effective build direction for 3D printing.

• The Journal of Advanced Prosthodontics
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• 제9권3호
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• pp.232-237
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• 2017

Dentists often place post and core buildups on endodontically treated abutments for crown and bridge restorations. This article analyzes the bio-mechanical purposes, advantages and disadvantages of placing a core or a post and core in an endodontically treated tooth and reviews literature on post and core biomechanics. The author assesses the scientific rationale of the claim that the main purpose of a post is to retain a core, or the claim that posts weaken teeth. More likely, the main function of a post is to help prevent the abutment, on which a crown is cemented, from fracturing such that the abutment separates from the tooth root, at a fracture plane that is located approximately and theoretically at the level of the crown (or ferrule) margin. A post essentially improves the ferrule effect that is provided by the partial fixed denture prosthesis. This paper also explores the difference between bio-mechanical failures of crowns caused by lack of retention or excess taper, versus failures due to a sub-optimal ferrule effect in crown and bridge prostheses.