• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권1호
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• pp.52-59
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• 2006

Purpose: The purpose of this study was to evaluate the influence of apical-coronal implant position on the stress distribution after occlusal and oblique loading. Materials and Methods: The cortical and cancellous bone was assumed to be isotropic, homogeneous, and linearly elastic. The implant was apposed to cortical bone in the crestal region and to cancellous bone for the remainder of the implant-bone interface. The cancellous core was surrounded by 2-mm-thick cortical bone. An axial load of 200 N was assumed and a 200-N oblique load was applied at a buccal inclination of 30 degrees to the center of the pontic and buccal cusps. The 3-D geometry modeled in Iron CAD was interfaced with ANSYS. Results: When only the stress in the bone was compared, the minimal principal stress at load Points A and B, with a axial load applied at 90 degrees or an oblique load applied at 30 degrees, for model 5. The von Mises stress in the screw of model 5 was minimal at Points A and B, for 90- and 30-degree loads. When the von Mises stress of the abutment screw was compared at Points A and B, and a 30-degree oblique load, the maximum principal stress was seen with model 2, while the minimum principal stress was with model 5. In the case of implant, the model that received maximum von Mises stress was model 1 with the load Point A and Point B, axial load applied in 90-degree, and oblique load applied in 30-degree. Discussion and Conclusions: These results suggests that implantation should be done at the supracrestal level only when necessary, since it results in higher stress than when implantation is done at or below the alveolar bone level. Within the limited this study, we recommend the use of supracrestal apical-coronal positioning in the case of clinical indications.

• 대한치과의사협회지
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• 제58권2호
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• pp.83-92
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• 2020

In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.

• 대한치과보철학회지
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• 제46권2호
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• pp.193-200
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• 2008

임플랜트 고정체의 표면처리 기술의 발달에 기인하여 골유착의 성공률이 좋아지고 있으며 임플랜트를 이용하는 보철물의 형태와 임상 술 식도 다양하게 발전되고 있다. 상악의 임플랜트 피개의치는 아직 표준화된 치료법에 대한 의견이 분분하다. 본 연구는 상악 무치악의 치료를 위하여 해부학적인 요소와 생역학적인 요소를 고려하여 양측 견치부 또는 소구치부위에 2개의 임플랜트를 식립할 때의 응력분포를 삼차원 유한요소분석을 이용하여 관찰하고자 하여 다음과 같은 결론을 얻었다. 1. 임플랜트를 양측 견치 부위에 식립한 모형에서 부하가 가해지는 우측의 임플랜트의 원심면에 최대 응력이 집중되었다. 2. 임플랜트를 양측 제2소구치 부위에 식립한 모형에서 임플랜트 주위의 응력 분포는 부하지점의 거리와 상관없이 고르게 나타났다. 3. 치조골에 발생하는 응력 분포의 관찰 결과, 임플랜트가 양측 제2소구치 부위에 식립된 모형이 양측 견치부위에 식립된 모형보다 고르게 나타났다. 이상의 결과로 볼 때, 상악 피개의치를 위한 임플랜트 식립 위치는 견치 부위에서보다 제2소구치 부위가 구강점막, 주위 골과 임플랜트에 전달되는 응력의 분포에 유리한 것으로 사료된다.

• 대한치과보철학회지
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• 제31권3호
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• pp.394-410
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• 1993

This study was accomplished for appreciation of the mandibular moments according to antero- posterior movement of pivot placed on the lower natural dentition. For this study, 20 subjects(male, $21\sim30$ yrs., average age 24) in the category of normal occlusion were selected, and the intraoral Vitallium clutches were cast and fabricated for each subjects. A 2-dimension PSD(Position Sensitive Detector, Hamamatsu Photonics Co., Japan) was attached to maxillary clutch in a mode of three dimensional control and LED (Light Emit Diode, Hamamatsu Photonics Co., Japan) was set up on mandibular clutch. Both clutches were set into oral cavity of each subjects and adjusted. Then the subjects were allowed to intercuspated with maximal bite force while the pivoting ball in the mid-line moving from anterior toward posterior position. The displacement scales were recorded by CCD camera(Sony, CCD-TR-705) and VCR, The conclusions were as follows : 1. When the subject was allowed to bite the metal pivoting ball in the midline of lower dentition with maximal bite force voluntarily while moving from lower central incisor to canine, 1st premolar, End premolar, 1st molar and 2nd molar. The lever actions on the pivot were revealed in all subjects. The equilibrium of moment were revealed on the pivots of 1st premolar(14 subjects), End premolar(4 subjects), and canine(2 subjects) areas. 2. The changes of loading on the TMJ according to antero-posterior positional changes of metal pivoting ball were able to recognize as follow. Compression on the TMJ was increased when the pivot moves anteriorly from the equilibrium point, and tension on the TMJ was increased when posteriorly. 3. 13 subjects were recognized their habitual chewing sides(Rights, Left8), and 7 subjects were not. During maximal biting, mandible was displaced toward their habitual chewing sides on the metal pivoting ball in the frontal plane. 4. In cephalometric analysis, the average genial angle of 20 subjects was $116.75^{\circ}$ and the average mandibular body length was 79.77mm. The equilibrium points of mandibular moment were positioned more posteriorly in the subjects having larger Genial angle than in the smaller(p<0.05). Relationships among the angle between FH plane and occlusal plane, the angle between occlusal plane and mandibular plane , and mandibular body length were not significant(p>0.05).

• The Journal of Advanced Prosthodontics
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• 제11권3호
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• pp.187-192
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• 2019

PURPOSE. The purpose of this in vitro study was to investigate the fracture loads and modes of failure for the full range of natural teeth under simulated occlusal loading. MATERIALS AND METHODS. One hundred and forty natural teeth were taken from mandibles and maxillas of patients. There were 14 groups of teeth with 10 teeth in each group (5 males and 5 females). Each specimen was embedded in resin and mounted on a positioning jig, with the long axis of the tooth at an inclined angle of 30 degrees. A universal testing machine was used to measure the compression load at which fracture of the tooth specimen occurred; loads were applied on the incisal edge and/or functional cusp. RESULTS. The mean fracture load for the mandibular first premolar was the highest (2002 N) of all the types of teeth, while the mean fracture load for the maxillary first premolar was the lowest (525 N). Mean fracture loads for the mandibular and maxillary incisors, and the first and second maxillary premolars, had significantly lower values compared to the other types of teeth. The mean fracture load for the teeth from males was significantly greater than that for the teeth from females. There was an inverse relationship between age and mean fracture load, in which older teeth had lower fracture loads compared to younger teeth. CONCLUSION. The mean fracture loads for natural teeth were significantly different, with dependence on tooth position and the sex and age of the individual.

• 구강회복응용과학지
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• 제17권4호
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• pp.245-256
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• 2001

The purpose of this study is to analyze the mechanical stress and displacement on the jaws during the simulated bilateral clenching task on the three-dimensional finite element model of the dentated skull with unilateral molar loss. For this study, the computed tomography(G.E.8800 Quick, USA) was used to scan the total length of human skull in the frontal plane at 2.0mm intervals. The fully assembled finite element model consists of the articular disc, maxilla, mandible, teeth, periodontal ligament and cranium. The FE model was used to simulate the bilateral clenching in intercuspal position. The loading condition was the force of the masseter muscle exerted on the mandible as reported by Korioth et al. degrees of freedom of the zygomatic region where the masseter muscle is attached were fixed as restraints. In order to reflect the actual action of the muscles force, the displacement of the region was attached where the muscle is connected to the temporal bone and restraint conditions were given values identical to values at the attachment region of the masticatory muscle but with the opposite direction of the reaction from when the muscle force is acted on the mandible. Although the mandible generally has higher displacement and von Mises stress than the maxilla, its mandibular corpus on the molar-loss side has a higher stress and displacement than the molar-presence side. Because the displacement and von Mises Stress was the highest on the lateral surface of mandibular corpus with molar loss, the stress level of the condyle on the molar-loss side is greater than that of the molar-presence side, which in turn caused the symphysis of the mandible to bend. In conclusion, the unilateral posterior bite collapse with molar loss under para-functional activities such as bruxism and clenching can affect the stress concentration on the condyle and mandibular corpus. It is therefore necessary to consider the biomechanical function of dento-skeleton under masticatory force while designing the occlusal scheme of restoration on alveolar bone with the posterior collapse.