• Journal of Korean Dental Science
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• 제10권2호
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• pp.87-95
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• 2017

This case study was to report the possible increase in the denture retention and psychological relief using the implant-supported fixed prostheses in a completely edentulous patient. The implants were placed in the anterior portion of the mandible in a patient who had completely edentulous state following the extraction of residual abutment teeth, and consequently a distal extension removable partial denture was fabricated. The patient's adaptation and satisfaction to the new prosthesis was monitored and confirmed in terms of masticatory function and esthetics, by restoring the oral condition similar to initial status before the residual teeth extraction. After 6 months, radiographic examination confirmed that both the abutment teeth and the implants were stable and well maintained. Considering the relatively short clinical follow-up period, however, continuous long-term monitoring was required.

• 대한소아치과학회지
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• 제32권3호
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• pp.543-549
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• 2005

상악 견치는 가장 긴 치근을 가지며 저작기능과 함께 하악의 측방운동을 유도하고 심미적으로도 치열궁의 구각부위에 위치하여 교합관계의 조화와 대칭을 유지하는 등의 중요한 기능을 수행한다. 상악 견치는 발육기간이 가장 길며 형성되어 맹출하기까지 복잡한 경로를 갖기 때문에 다른 치아보다 매복의 빈도가 높다. 이러한 매복치를 치료하기 위해 임상의는 관찰을 하거나 외과적 노출과 교정적 견인, 자가치아이식, 발치 등 다양한 치료방법을 고려할 수 있다. 외과적 노출과 교정치료는 견치를 교합선상에 배치할 수 있기 때문에 가장 이상적인 접근으로 생각할 수 있다. 본 증례 보고는 구개측으로 매복된 상악 견치를 외과적 노출과 교정적 치아이동을 통해 기능적, 심미적으로 양호한 결과를 얻었다.

• 구강회복응용과학지
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• 제32권4호
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• pp.351-357
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• 2016

상악절제술 후 환자들의 재건 치료는 쉽지 않은 과정이다. 상악골 결손은 저작, 발음, 연하 장애를 초래하여 기능적인 회복이 필요하다. 폐쇄장치 제작의 목표는 결손부를 대체하여 구강기능을 회복하고 환자에게 편안함과 심미성을 제공하는 것이다. 본 증례에서는 임플란트를 이용한 인두 폐쇄장치 제작 후 획득한 저작력과 심미성 그리고 개선된 유지력을 보고하고자 한다.

• Restorative Dentistry and Endodontics
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• 제19권1호
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• pp.231-254
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• 1994

Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.21.1-21.6
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• 2020

Background: Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical site can cause severe fibrosis and atrophy of soft tissue in the head and neck region. Case presentation: Here, we report a case of severe soft tissue atrophy that appeared along with scar formation after mandibular reconstruction through the fibular free flap procedure. This led to normal occlusion collapse after it was established, and the midline of the mandible became severely deviated to the affected side that was replaced with the fibula free flap, leading to facial asymmetry. We corrected the malocclusion with a secondary operation: a sagittal split ramus osteotomy on the unaffected side and a sliding osteotomy on the previous fibula graft. After a healing time of 3 months, implants were placed on the fibula graft for additional occlusal stability. Conclusion: We report satisfactory results from the correction of malocclusion after fibula reconstruction using sliding fibula osteotomy and sagittal split ramus osteotomy. The midline of the mandible returned to its original position and the degree of facial asymmetry was reduced. The implants reduced difficulties that the patient experienced with masticatory function.

• 대한치과보철학회지
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• 제57권3호
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• pp.296-303
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• 2019

자연치아가 모두 상실되면, 저작이나 발음 등의 기능이 불가능할 뿐 아니라 심미성에 있어서도 노인성 안모를 가지게 되어 대단히 비심미적인 외모를 하게 된다. 총의치를 장착함으로써 저작기능도 회복되며, 총의치에 의한 구강 주위조직의 적절한 지지가 이루어짐으로써 심미성의 회복도 가능해진다. CAD/CAM을 이용한 의치는 저장된 데이터를 이용하여 언제든지 신속하게 의치의 재제작이 가능하고, 높은 강도와 밀도를 가지는 의치상이 장점이라고 할 수 있다. 본 증례에서는 최종의치 기공과정에서 악간관계채득 단계까지는 전통적 방식으로 진행한 후, 이후 최종의치 완성 전 기공과정을 전통적 방식과 CAD/CAM을 이용한 방식으로 나누어서 진행하였다. 이후 각각을 평가하여 환자가 만족하는 임상결과를 얻었기에 이를 보고하는 바이다.

• 구강회복응용과학지
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• 제35권1호
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• pp.37-45
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• 2019

무치악 환자의 보철치료에서 총의치를 이용한 보철 치료 시 각화 점막을 통해 교합력을 분담하므로 저작력과 저작 능률이 떨어지고 특히 지지 점막 면적이 작은 하악의 경우 상악에 비해 통증 발생 등의 부작용이 더 많다. 치조골 흡수가 많은 환자일수록 이는 더 심화되나 하악 구치부 측의 하치조신경관의 존재 때문에 임플란트를 동반한 적극적 치료가 어려운 경우가 많다. 이에 본 증례에서는 상악에는 전통적인 총의치를 제작하고 하악은 치조골 높이가 충분한 전방부에만 임플란트를 식립하여 all-on-4 방법으로 치료한 환자에서 좋은 경과를 보여 보고하고자 한다.

• 구강생물연구
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• 제42권4호
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• pp.208-215
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• 2018

The purpose of this study was to identify the risk of dysphagia among patients that visited prosthodontics department, and evaluate the difference in risks arising from oral conditions and disease in order to preliminarily intervene the various influencing factors of dysphagia. A questionnaire was given to patients that were aged 65 years or older who visited the prosthodontics department between September to December 2017. The data was collected and analyzed using the t-test, $x^2-test$ and logistic regression analysis. The mean age of the patients was 75 years. Out of 300 patients, 206 patients (68.7%) had a risk of dysphagia. There were statistically significant differences between the -non-risk and risk groups, which included the number of natural teeth, total number of teeth including prosthesis, denture use, denture discomfort, number of tooth brushing, oral dryness, digestive system diseases, and musculoskeletal diseases. Among these, oral dryness was a risk factor while the total number of teeth, including natural teeth and prostheses, served as a protective factor. More than half of the elderly patients were at risk of dysphagia. Oral dryness is influenced by many factors and it should continuously be managed. Patients should fully recover their masticatory function by preserving the remaining teeth and compensating for the missing teeth. A dental practitioner should be fully aware of the risk of dysphagia in elderly patients and be able to intervene and offer proper patient health care in advance through treatment guidelines and education.

• 대한치과보철학회지
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• 제59권1호
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• pp.107-115
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• 2021

전체 치열에 걸쳐 과도한 병적 마모가 발생하는 경우 저작기능의 저하 및 악관절, 근신경계의 병리적인 문제가 발생할 수 있다. 본 증례는 71세 남성 환자로 상악 좌측 제 1 대구치 부위 임플란트 수복 공간의 부족 및 전치부 절단교합 및 전방, 측방유도의 상실 및 전치아에 걸친 심화된 파절과 마모가 관찰된 환자에서 수직고경 증가를 동반한 전악구강회복술을 계획하였다. 환자의 적절한 수직고경을 결정하기 위하여 안모, 심미, 기능 및 보철 수복 공간을 평가하였으며, 거상된 수직고경의 임시수복물을 제작하였고 약 4개월 간의 관찰기간을 거친 후 임상증상 및 불편감 없음을 확인한 후 CAD-CAM을 이용한 단일구조 지르코니아 전장관전악수복을 완료하였다. 이상과 같은 과정을 통해 수직고경 거상을 동반한 전악구강회복술을 시행하였으며, 만족스러운 심미 및 기능적 결과를 얻었기에 이를 보고하고자 한다.

• 치위생과학회지
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• 제21권1호
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• pp.8-18
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• 2021

The purpose of this study is to provide the general history of fostering dentists in Japan and introducing their new roles. This research was conducted based on the government policy report on dentists and the information published by each educational institution. Based on the collected data, the official websites were used to represent the latest statistics of the institutions. The number of dentists in Japan has increased. The government established the National Examination for Dentists to guarantee the quality of dentists. After the standards for developing questions for the national examination were established in 1985, the contents of the examination have been appropriately improved by revising the standards every four years. This improvement has required dental students to study a variety of subjects for six years at dental school. Since dentists in Japan are required to respond to various demands from the nation; the Model Core Curriculum for Dental Education was developed to teach medical ethics and abilities to ensure that dentists conduct themselves professionally. Recently, the roles of dentists have been changing in Japan. When providing dental services to older patients over the age of 65, dentists and other dental professions focus on maintaining oral functions, such as saliva secretion, bite force, tongue movement, and masticatory/swallowing functions. However, oral function-related services for children are different. In addition to providing essential dental services, dental practitioners also provide special treatment, such as oral muscle training, myofunctional therapy, health guidance, and space retainers to the child patients with developmental insufficiency in oral functions. Dentistry in Japan has undergone numerous changes over the years and has continued to offer high-quality dental health services. Thus, information gained from the Japanese experience may be helpful to dental professions in other developed countries for planning oral health measures.