• The Journal of Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.189-194
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• 2019

It is necessary to set the correct occlusal plane and to distribute the occlusal force uniformly considering the state of the opposing dentition during the prosthetic of the single edentulous patient with severe alveolar bone resorption. Implant supported overdenture is superior to complete denture in terms of maintenance and stability, and limited implants are used in fully edentulous patients with high alveolar bone resorption. Telescopic attachments using a newly introduced material based on poly-aryl-ether-ketone (PAEK) have the advantages of typical telescopic copping, excellent abrasion resistance, and are lighter and more economical than conventional implant overdentures. In this case, we restored maxillary arch with a implant retained overdenture using the telescopic attachment made of Pekktonand the mandible was restored with fixed implant prosthesis. Through these procedures esthetic aspects and functional outcomes were satisfactorily achieved.

• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.12-17
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• 2013

The purpose of this review is to examine the performance of attachments used in implant-supported overdenture (IOD) in both clinical and in vitro settings and report the compiled findings, comparisons, and trends in the research literature. Articles published in PubMed on IOD attachment systems and performance were reviewed. Non-original articles were excluded. For each article included, the type of study, number of implants, number of attachment systems, and study outcome were recorded. Of the 283 articles found, 158 met the inclusion criteria. Ninety-four articles were clinical studies and 64 articles were in vitro studies. Studies on retention were the most common for in vitro studies, and four or more attachment systems were compared in most articles with significant differences in outcome. A clinical outcome of one attachment system was most common for clinical studies, while most studies had neutral outcomes overall. Ball attachment was the most commonly tested IOD attachment system. The trend in the literature showed that there is a large discrepancy between the study designs and outcomes between the clinical and the in vitro studies for IOD. Further clinical studies that can validate in vitro research should be encouraged to address this discrepancy between the two areas.

• The Journal of Advanced Prosthodontics
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• v.7 no.4
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• pp.329-337
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• 2015

PURPOSE. This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS. In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS. One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: $5.9{\pm}2.2years$), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION. Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.375-390
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• 2009

Statement of problem: Implant supported overdenture is accepted widely as a way to restore edentulous ridge providing better retention and support of dentures. Various types of attachment for overdenture have been developed. Purpose: The purpose of this study was to investigate the influence of attachment type in implant overdentures on the biomechanical stress distribution in the surrounding bone, prosthesis and interface between implant and bone. Material and methods: Finite element analysis method was used. Average CT image of mandibular body(Digital $Korea^{(R)}$, KISTI, Korea) was used to produce a mandibular model. Overdentures were placed instead of mandibular teeth and 2mm of mucosa was inserted between the overdenture and mandible. Two implants($USII^{(R)}$, Osstem, Korea) were placed at both cuspid area and 4 types of overdenture were fabricated ; ball and socket, Locator, magnet and bar type. Load was applied on the from second premolar to second molar tooth area. 6 times of finite element analyses were performed according to the direction of the force $90^{\circ}$, $45^{\circ}$, $0^{\circ}$ and unilateral or bilateral force applied. The stress at interface between implants and bone, and prosthesis and the bone around implants ware compared using von Mises stress. The results were explained with color coded graphs based on the equivalent stress to distinguish the force distribution pattern and the site of maximum stress concentration. Results: Unilateral loading showed that connection area between implant fixture and bar generated maximum stress in bar type overdentures. Bar type produced 100 Mpa which means the most among 4 types of attachments. Bilateral loading, however, showed that bar type was more stable than other implants(magnet, ball and socket). 26 Mpa of bar type was about a half of other types on overdenture under $90^{\circ}$ bilateral loading. Conclusions: In any directions of stress, bar type was proved to be the most vulnerable type in both implants and overdentures. Interface stress did not show any significant difference in stress distribution pattern.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.4
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• pp.251-276
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• 2002

The purpose of this study was to compare and analyze the stress distribution and displacement of the fully bone anchored bridge and implant-supported overdenture in edentulous mandible on certain conditions such as number of implants, different design of superstructure. Three dimensional analysis was used and nine kinds of models designed for this study. FEM models were created using commercial software[$Rhinoceros^{(R)}$ (Ver. 1.0 Robert McNeel & Associates, USA)], and analyze using commercial software [Cosmos/$Works^{TM}$(Ver. 4.0 Structural Research & Analysis Corp., US A)]. A vertical load and $45^{\circ}$ oblique load of 17kgf were applied at the left 1st. molar. The results were as follows : (1) In the group of OVD, the displacement was reduced as increasing the number of fixture under vertical loading but there was no specific difference in Von Mises stress. Under oblique loading, the displacement was same at the vertical loading but Von Mises stress was reduced in order of OVD-3, OVD-4, OVD-2. But, bending moment reduced according to increasing the number of fixture. (2) In the group of FBAB, under vertical and oblique loading, the magnitude of Von Mises stress and displacement reduced according to increasing the number of fixtures. FBAB-4 and FBAB-5 showed similar score and distribution, but FBAB-6 showed lower value relatively. (3) In cantilever design, the maximum displacement reduced under vertical loading but increased under oblique loading. However, von mises stresses on fixtures increased under vertical and oblique loading. (4) In comparing OVD-group with FBAB-group, FBAB showed low magnitude of displacement in respect of oblique loading. However OVD-group was more stable in respect of stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.123-130
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• 2024

There are various methods for restoring the dentition of completely edentulous patients. Removable complete dentures have the advantage of being relatively economical, but they can be uncomfortable to wear. With the introduction of implant prosthodontics, various options such as implant-supported overdentures and hybrid prostheses have become available. If there is inadequate remaining ridge or limited financial resources, an overdenture supported by a few implants with additional attachments may be more suitable. In this case, due to severe peri-implantitis and other complications, the implants were removed. Subsequently, four implants (two on each side) were placed in the maxilla and a milled-bar with attachment was fabricated for each side of the maxilla.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.214-220
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• 2013

Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported- overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

• Journal of Technologic Dentistry
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• v.43 no.4
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• pp.202-209
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• 2021

By classifying temporary denture production for surgical guides, digital guide-based surgery, and final prosthesis production, the problems of each process were assessed in advance and the factors that could be improved were confirmed in this study. The manufacturing process of fusion dental prosthesis uses virtual programs and computed tomography images to manufacture devices using the latest technologies of computer-aided design/computer-aided manufacturing and three-dimensional printing, which enables implants to be placed in the desired location in advance. Moreover, implant placement is not dependent on the skill and condition of the dentist, and because it uses a computer system, it can always be performed at a constant and optimal position. This can reduce the remanufacturing rate compared with the general method, shorten the treatment period, and eliminate patient discomfort. Unlike the traditional method of using impression materials and plaster models, digital fusion dental prostheses would be evaluated as a technology for producing prosthesis through professional design technology and communication.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.1
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• pp.58-66
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• 2020

Implant-Assisted Removable Partial Dentures (IARPDs) treatment is being performed in a fully edentulous patient using implant surveyed prosthesis as an abutment. Implant-supported prosthesis as an abutment of IARPDs is classified into screw-retained and cement-retained type according to the retention type, and each has advantages and disadvantages. The EZ crown system (Samwon DMP, Yangsan, Korea) has a cylinder combined with abutment, and the nickel-titanium spring in this cylinder provides a constant force on the zirconia ball to obtain retention in EZ crown system. In this patient, the natural abutment teeth of the mandibular overdenture was hopeless. We planned implant assisted removable partial denture using anterior implant surveyed prosthesis considering functional and esthetical rehabilitation, cost and patient's needs. When fabricating IARPDs using implant as abutment, we could compensate for the shortcomings of existing implant-supported prosthesis retention type and made the design of removable partial denture easy due to using EZ crown system.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.1
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• pp.1-17
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• 1998

두개의 임플랜트로 지지되는 overdenture를 이용한 하악무치악환자의 치료법은 경제적이면서, 실용적인 치료로 인정을 받고 있다. 하지만 해부학적인 조건으로 임플랜트를 설측 혹은 후방에 식립해야 되는 경우에는 일반적인 bar설계는 bar가 구강저 상방을 지나게 되어 혀운동, 발음, 위생관리 등에 많은 문제점을 부여한다. 이에 대한 해결방법으로 전방부 치조제 상에 보철물의 회전을 허용하는 angular bar를 설계할 수 있다. 하지만 이 설계는 임플랜트에 불리한 moment를 유발한다. 그럼에도 불구하고 뛰어난 유지력과 지지능력, 경제적인 면 때문에 angular bar는 임상에서 많이 사용되고 있다. 이에 본 연구는 angular bar의 전방 cantilever양을 달리하여 임플랜트 및 주변조직에 미치는 영향을 삼차원 유한요소분석법을 통해서 알아보고자 하였다. 이공사이의 하악골을 단순화시킨 준하악골모형에 직경 3.75mm인 브로네마르크 임플랜트 2개를 길이가 13,15mm인 경우로 설정하여 제 1소구치 부위에 식립하였다. 두 임플랜트를 연결하는 bar는 전방부 cantilever양을 0-5mm, 1mm씩 하여 6가지 경우를 가정하고 제작하였다. 각각 bar 중앙부에 수직압 (90도) 35N, 경사압(120도) 70N, 수평압(0도) 10N을 가하였으며 이때 나타나는 응력 분산형태와 임플랜트의 골유착에 불리하게 작용하는 최대주응력(인장력)과 변위량을 살펴보았다. 연구결과 다음과 같은 결론을 얻었다. 1. Cantilever양이 증가할수록 주변피질골과 임플랜트로 응력이 집중되었으며 상부 보철물의 변위량도 커졌다. 2. Cantilever양에 대한 수평압의 영향은 크지 않았으며 임플랜트 길이가 긴 것이 변위량과 응력이 작았다. 3. 경사압에 대한 응력의 변화는 cantilever양의 증가에 따라 급격히 증가하는 양상을 띠었으며 임플랜트길이가 응력 및 변위의 양에 미치는 영향은 없었다. 4. 수직압에 대한 응력의 변화는 초기에는 완만한 증가를 보이다가 일정 시점 지난 후에는 증가율이 커지는 경향을 띠었다. 증가현상이 두드러지기 전에는 길이의 증가가 응력의 분산효과는 가져왔으나 이후에는 길이의 응력분산 효과는 없었다. 5. 응력분포양상은 cantilever양이 증가할수록 골조직을 통한 분산정도는 작아지고 특정부위의 피질골과 임플랜트, 상부보철물에 집중되는 경향을 보였다. 6. 임플랜트와 주변 골조직으로의 응력분산능력이 예후를 좌우한다는 점에서 angular bar는 적합치 못하며 부득이한 경우는 임플랜트 길이를 길게 하고 최대한 3mm이내로 cantilever양을 제한하는 것이 추천된다.