• Title/Summary/Keyword: prosthesis and implants

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Rehabilitation of maxillary partial edentulous patients using implant assisted removable partial denture (상악 소수치 잔존 환자에서 임플란트를 이용한 가철성 부분틀니 수복 증례)

  • Lee, Bo-Ra;Kim, Jee-Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.2
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    • pp.128-135
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    • 2014
  • Treatment options for partially edentulous patients are fixed partial denture, removable partial denture and implant supported fixed partial denture. In case of a patient with a few remaining teeth, removable partial denture and implant supported fixed prosthesis are available. For implant fixed prothesis, enough implant fixtures are required and the patient's general condition, local factors and economic status must be considered. When the condition of the abutments and the residual ridge is favorable and the prosthesis is well designed, removable partial denture can be an option. In removable partial denture, the bilateral support is important. If the teeth remain unilateral, harmful stress is put on the abutments by the fulcrum line. In this situation, strategic implantation and implant-retained or assisted removable partial denture is beneficial to the retention and support of the denture. And this can be cost-effective, functional and esthetic choice of treatment. This article describes the prosthodontic rehabilitation of Maxillary Kennedy class I partially edentulous patients. In these two cases, the patients had a small number of teeth and they were restored by the combination of a removable partial denture and dental implants.

The Factors Influencing to the Implant Patients Discomfort (임플란트 식립 후 불편감에 영향을 주는 요인)

  • Yoon, Hyun-Seo;Heo, Soo-Hee;Chun, Jin-Ho
    • Journal of dental hygiene science
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    • v.11 no.4
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    • pp.325-332
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    • 2011
  • To get the evidences for decreasing the discomfort, dissatisfaction, and for improving management of the implant prothesis through assessment implant patients' awareness and discomforts about care of the prostheses. The subjects were 300 implant patients who treated in the 20 dental clinics in Pusan, Ulsan and Daegu. The general characteristics, recognition, maintenance, discomfort and dissatisfaction, and oral hygiene status were collected. Level of the discomfort and dissatisfaction was measured by a 5 Likert scale, and analyzed by the equivalent of 100. The life-span of the implants was overestimated, however, periodic recall check and scaling were underwent. The level of discomfort and dissatisfaction was generally good, but many of them (65.3%) complained the food impaction. As a result of the multiple regression analysis, level of the discomfort and dissatisfaction increased in case of more number of the prosthesis ($\beta$=0.864), however decreased in case of more frequent teeth brushing ($\beta$=0.737), more frequent periodic check ($\beta$=-0.737), longer duration from the implantation ($\beta$=-0.090). It is very important for the implant patients to be recognized that the lack of care may shorten the life-span of the implant prosthesis. Therefore, efforts of the continuous oral hygiene care such as, periodic recall check, scaling, teeth brushing, the correct using of additional oral hygiene product, and education would be more emphasized.

The incidence of the abutment screw loosening and its affecting factors in posterior implant restorations (구치부 임플란트 고정성 수복물에서의 지대주 나사 풀림 현상과 이에 영향을 미치는 요인)

  • Hong, Su-Jung;Bae, Jung-Yoon;Kim, Hyun-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.3
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    • pp.212-217
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    • 2018
  • Purpose: This study was to assess clinically the incidence of abutment screw loosening of posterior implant-supported fixed prosthesis and its affecting factors. Materials and methods: 391 implant-supported crowns restored from January 2013 to January 2016 were included in this study. All restorations were fabricated with either a single crowns or a splinted crown, and cemented with temporary cement. The incidence of abutment screw loosening is investigated and gender, restoration position, opposing teeth, restoration type, abutment connection type were assessed as possible factors affecting abutment screw loosening. Results: During the observation period (2 - 5 years), abutment screw loosening was found in 29 restorations (7.4%). It took 3 to 48 months (means 19.5 months) to loose the screw, and three of these implants were fractured. Among the factors considered, there were statistically significant differences at abutment screw loosening rate between molar group (9.4%) and premolar group (2.6%) (P<.019). According to the type of opposing teeth, there were statistically significant differences between nature teeth (74.7%) and implant (25.0%), removable denture (3%) (P<.019). The other possible factors did not have a significant effect on loosening of the abutment. Conclusion: The incidence of abutment screw loosening in posterior restoration was 7.4%. Abutment screw loosening were more likely to occur in molars group than premolar group, and according to the opposing teeth, there were the greatest frequency in nature teeth than implant and removal denture. There was a statistically significant difference.

Implant assisted removable partial denture with implant surveyed crown: A 20-month follow-up case report (단일 임플란트 서베이드 크라운을 이용한 하악 임플란트 융합 국소의치: 20 개월 경과 관찰 증례 보고)

  • Roh, Kyoung-Woo;Jeon, Young-Chan;Jeong, Chang-Mo;Yoon, Mi-Jung;Lee, So-Hyoun;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.323-329
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    • 2018
  • Traditional options for posterior edentulous treatment include removable partial dentures and implant fixed prostheses. Recently, the concept of implant assisted removable partial denture, in which two treatments are fused, has been introduced in consideration of systemic health and patient's needs, costs, residual alveolar bone status and so on. Implant assisted removable partial denture has the advantage of increasing the retention and stability of the denture and improving its esthetics in cases of large bone defects or biomechanical disadvantages. In addition, it is possible to strategically place the implants in a site where the alveolar bone is relatively sufficient, thereby overcome the limit of the conventional removable partial denture design as well as reducing the burden on a wide range of implant surgery. Cost reduction is also expected. In this case, the patient was treated by placing the implant in both premolar sites of the mandible and fabricating the distal extension removable partial denture with the implant fixed prosthesis as an abutment. After delivering the definitive prosthesis, the patient showed satisfaction with the masticatory function and esthetics. and has been regularly followed-up for more than one year. The following 20-months follow-up case report describes the design of an implant-assisted-removable partial denture (IARPD) in which two cementretained implant crowns used to provide support and stability.

Three-Dimensional Printing Technology in Orthopedic Surgery (정형외과 영역에서의 삼차원 프린팅의 응용)

  • Choi, Seung-Won;Park, Kyung-Soon;Yoon, Taek-Rim
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.103-116
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    • 2021
  • The use of 3-dimensional (3D) printing is becoming more common, and its use is increasing in the orthopedic surgery. Currently, there are four major methods of using 3D printing technology in orthopedic surgery. First, surgical planning simulation using 3D printing model; second, patient-specific surgical instruments; third, production of customized prosthesis using 3D printing technique; fourth, patient-specific prosthesis produced by 3D printing. The areas of orthopedic surgery where 3D printing technology can be used are shoulder joint, spine, hip and pelvis, knee joints, ankle joint, and tumors. Since the diseases and characteristics handled by each area are different, the method of using 3D printing technology is also slightly different in each area. However, using 3D printing technology in all areas can increase the efficiency of surgery, shorten the surgery time, and reduce radiation exposure intraoperatively. 3D printing technology can be of great help in treating patients with particularly complex and difficult orthopedic diseases or fractures. Therefore, the orthopedic surgeon should make the most of the benefits of the 3D printing technology so that patient can be treated effectively.

Three key factors for successful esthetic anterior implant restoration (성공적인 전치부 심미 임플란트를 위한 3가지 요소)

  • Lim, Pil
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.25 no.1
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    • pp.35-49
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    • 2016
  • With the increasing demand for aesthetic implant dentistry, the importance of implant restoration is emphasized not only in the functional aspect but also in the aesthetic aspect. The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. The soft tissue aesthetics are dependent upon the condition of the supporting hard tissue because the osseous structure provides a framework for the development of a healthy and aesthetic soft tissue interface. Therefore, the augmentation of hard tissue is a first step and especially, optimal 3-dimensional position of implant is the most important factor in aesthetic implant restoration. The management of soft tissue is a second step, and the final step is a restoration of harmonic prosthesis using provisional restoration with proper emergence profile. This clinical report describes the procedure of bone augmentation in labial dehiscence defect, Vascularized Interpositional Periosteal-Connective Tissue (VIP-CT) flap for aesthetic anterior soft tissue, and the importance of provisional restoration and impression taking stage with customized impression coping.

FINITE ELEMENT ANALYSIS OF CYLINDER TYPE IMPLANT PLACED INTO REGENERATED BONE WITH TYPE IV BONE QUALITY (IV형의 골질로 재생된 골내에 식립된 원통형 임플란트의 유한요소법적 연구)

  • Kim, Byung-Ock;Hong, Kug-Sun;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.331-338
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    • 2004
  • Stress transfer to the surrounding tissues is one of the factors involved in the design of dental implants. Unfortunately, insufficient data are available for stress transfer within the regenerated bone surrounding dental implants. The purpose of this study was to investigate the concentration of stresses within the regenerated bone surrounding the implant using three-dimensional finite element stress analysis method. Stress magnitude and contours within the regenerated bone were calculated. The $3.75{\times}10-mm$ implant (3i, USA) was used for this study and was assumed to be 100% osseointegrated, and was placed in mandibular bone and restored with a cast gold crown. Using ANSYS software revision 6.0, a program was written to generate a model simulating a cylindrical block section of the mandible 20 mm in height and 10 mm in diameter. The present study used a fine grid model incorporating elements between 165,148 and 253,604 and nodal points between 31,616 and 48,877. This study was simulated loads of 200N at the central fossa (A), at the outside point of the central fossa with resin filling into screw hole (B), and at the buccal cusp (C), in a vertical and $30^{\circ}$ lateral loading, respectively. The results were as follows; 1. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were increased from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, concentrated on the top of the cylindrical collar loading point B and C in vertical loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were increase from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in vertical loading. 2. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were decreased from loading point A to C in lateral loading. Stresses according to the depth of regenerated bone were concentrated on the top of the cylindrical collar in loading point A and B, distributed along the implant evenly in loading point C in lateral loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were decreased from loading point A to C in lateral loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in lateral loading. In summary, these data indicate that both bone quality surrounding the regenerated bone adjacent to implant fixture and load direction applied on the prosthesis could influence concentration of stress within the regenerated bone surrounding the cylindrical type implant fixture.

Implant Fixture Installation in the Anterior Mandible by Use of a Mucosa Supported Surgical Template Based on Computer Assisted Treatment Planning (컴퓨터보조 기반 점막지지 서지컬템프레이트를 이용한 하악전치부 임플란트 식립)

  • Lee, Jee-Ho;Kim, Soung-Min;Kim, Myung-Joo;Park, Jung-Min;Seo, Mi-Hyun;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.158-165
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    • 2011
  • A 73-year-old Korean female patient with a fully edentulous mandible was planned to have five implant fixtures installed in the anterior mandible for the fixed prosthesis. After 3-dimensional (3D) computed tomographic scanning was transferred to OnDemand3D$^{(R)}$ (Cybermed Co., Seoul, Korea) software program for the virtual planning, five fixtures of MK III Groovy RP implants of Branemark System$^{(R)}$ (Nobel Biocare AB Co., Goteborg, Sweden) were installed in the anterior mandible between both mental foramens using In2Guide$^{(R)}$ (CyberMed Co., Seoul, Korea) mucosa-supported surgical template with Quick Guide Kit$^{(R)}$ (Osstem Implant Co., Seoul, Korea) systems. Fixture installations were completed successfully without any complications, such as mental nerve injury, bony bleedings, fenestrations and other unexpected events. Postoperative computed tomographic scans were aligned and fused to the planned implant, then angular and linear deviations were compared with the planned virtual implants. The mean angular deviation between the planned and actual implant axes was $3.42{\pm}1.336^{\circ}$. The mean distance between the planned and actual implant at the neck area was $0.544{\pm}0.290$ mm horizontally and $0.118{\pm}0.079$ mm vertically. The average distance between the planned and actual implant at the apex area was $1.166{\pm}0.566$ mm horizontally and $0.14{\pm}0.091$ mm vertically. These results could be considered more precise and accurate than previous reports, and even our recent results. The entire procedures of this case are reported and reviewed.

The Study of Implant Patient's Type and Implant Distribution (임플란트 환자의 유형 및 분포에 대한 연구)

  • Hong, Sung-Jae;Paik, Jeong-Won;Kim, Chang-Sung;Choi, Seong-Ho;Lee, Keun-Woo;Chai, Jung-Kiu;Kim, Chong-Kwan;Cho, Kyoo-Sung
    • Journal of Periodontal and Implant Science
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    • v.32 no.3
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    • pp.539-554
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    • 2002
  • It has been approximately 40 years since $Br{{\aa}}nemark$ first introduced osseo-integration for implants in the early 1960s. Unlike crown and bridge or denture treatment, implant treatment helps preserve existing bone and improve masticatory functions. Thus, the awareness of implant treatment has grown rapidly among dentists and patients alike in Korea, as it becomes a widely accepted treatment. The following results on patients type and implant distribution were compiled from 1814 implant cases of 640 patients treated at the periodontal dept. of Y University Hospital during 1992 to 2001. 1. There are no dissimilarities between men and women, with patients in their 40,50s accounting for 49% of patients and 56% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 59% of implant treatments followed by Mx. posterior area(21%), Mx anterior area(l4%) and Mn anterior area 2%. 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 98% and fully edentulous patient accounted for the remaining 2% 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. Compared to women, men are more likely to suffer from tooth loss due to periodontal disease. Also, older people are more likely to suffer from tooth loss due to periodontal disease rather than dental caries. 5. The distribution of bone quality for maxillae was 52% for type III, followed by 23% for type II, 20% for type IV and 0% for type I. As for mandible, the distribution was 52% for type II, followed by 37% for type III, 7% for type IV and 4% for type I. 6. The distribution of bone quantity for maxillae was 49% for type C, followed by 34% for type B, 14% for type D, 3% for type A, and 0% for type E. As for mandible, the distribution was 52% for type B, followed by 35% for type C, 6% for type D, 3% for type A and 0% for type E. 7. The majority of implants were those of 10-14mm in length (80%) and regular diameter in width (79%). The results provided us with basic data on patient type, implant distribution, bone condition, etc. We wish that our results coupled with other research data helps assist in the further study for better implant success/survival rates, etc.

A STUDY ON THE ELASTIC DEFORMATION AND STRESS DISTRIBUTION OF THE MANDIBLE WITH OSSEOINTEGRATED IMPLANT PROSTHESES USING THREE DIMENSIONAL FINITE ELEMENT ANALYSIS METHOD (골유착성 임플랜트 보철물 장착시 하악골의 탄성변형 및 응력분포에 관한 삼차원 유한요소법적 연구)

  • Kim, Yong-Ho;Kim, Yung-Soo;Kim, Chang-Whe
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.2
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    • pp.203-244
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    • 1998
  • The human mandible is always under the condition of loading by the various forces extorted by the attached muscles. The loading is an important condition of the stomatognathic system. This condition is composed of the direction and amount of forces of the masticatory muscles, which are controlled by the neuromuscular system, and always influenced by the movement of both opening and closing. Mandible is a strong foundation for the teeth or various prostheses, nevetheless it is a elastic body which accompanies deformation by the external forces on it. The elastic properties of the mandible is influenced by the various procedures such as conventional restorative treatments, osseointegrated implant treatments, reconstructive surgical procedures and so forth. Among the treatments the osseointegrated implant has no periodontal ligaments, which exist around the natural teeth to allow physiologic mobility in the alveolar socket. And so around the osseointegrated implant, there is almost no damping effect during the transmission of occlusal stress and displacements. If the osseointegrated implants are connected by the superstructure for the stabilization and effective distribution of occlusal stresses, the elastic properties of mandible is restricted according to the extent of 'splinting' by the superstructure and implants. To investigate the change of elastic behaviour of the mandible which has osseointegrated implant prosthesis of various numbers of implant installment and span of superstructre, a three dimensional finite element model was developed and analyzed with conditions mentioned above. The conclusions are as follows : 1. The displacements are primarily developed at the area of muscle attachment and distributed all around the mandible according to the various properties of bone. 2. The segmentation in the superstructure has few influence on the distribution of stress and displacement. 3. In the load case of ICP, the concentration of tensional stress was observed at the anterior portion of the ramus($9.22E+6N/m^2$) and at the lingual portion of the symphysis menti($8.36E+6N/m^2$). 4. In the load case of INC, the concentration of tensional stress was observed at the anterior portion of the ramus($9.90E+6N/m^2$) and the concentration of tensional stress was observed at the lingual portion of the symphysis menti($2.38E+6N/m^2$)). 5. In the load case of UTCP, the relatively high concentration of tensional stress($3.66E+7N/m^2$) was observed at the internal surface of the condylar neck.

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