• 대한치과보철학회지
• /
• 제56권1호
• /
• pp.77-87
• /
• 2018

완전 무치악 환자에서 임플란트를 이용한 보철 치료는 임플란트 고정성 보철수복, hybrid 고정성 보철수복, 임플란트 유지 혹은 지지 피개의치 등이 있으며 임플란트 고정성 보철 수복은 환자의 심리적 안정감, 발음 등의 측면에서 장점을 보인다. 전악 임플란트 고정성 보철 수복을 계획한 경우 발음, 심미, 구강 위생 등을 고려한 임플란트 식립이 필요하며 이를 위해서는 임상적 및 방사선학적 진단이 필수적이다. 진단 과정을 통해 파악된, 보철물이 필요한 곳에 임플란트를 식립(prosthetic-driven)하기 위해서는 충분한 양의 치조골과 연조직 지지 등이 필요하며 이를 충족시키지 못할 경우 광범위한 골이식술이 선행되어야 한다. 본 증례는 치주질환으로 인한 치아 상실로 인해 치조골 흡수가 심하게 진행된 완전 무치악 환자에서 상악동 골이식술 및 치조골 증대술을 선행하고 임플란트 식립 후 전악 임플란트 고정성 보철로 수복하여 기능 및 심미적으로 만족할만한 결과를 얻었기에 이를 보고하고자 한다.

• 대한치과보철학회지
• /
• 제29권3호
• /
• pp.55-74
• /
• 1991

The purpose of this study was to investigate the influence of early functional load around osseointegrated titanium implants. 24 titanium plasma spray coated implants (ITI HS-type) were placed into the previously extracted site in the mandible of six adult dogs. The implants were divided into three groups : the control group was the implants without abutment during the experimental period; the experimental group I was loaded by connecting the contoured abutment after 6 weeks of healing; the experimental group II was loaded after 12 weeks of healing: and the mandibular second premolar and surrounding tissues were selected for natural tooth group to compare the implanted group. All dogs were injected intravenously tetracycline, alizarin red S, and calcein for bone labeling. After the experimental period of 18 weeks, the dogs were sacrificed and longitudinal sections of the bone-implant interface were cut and observed using light microscope, scanning electron microscope, and fluorescence microscope. The results of the study were as follows: 1. Light and scanning electron microscopically, all implant surfaces were well contact with bone tissue at the cortical layer, but some areas of cancellous bone were not contact directly. 2. Fluorescence microscopically, number and size of the new secondary osteons around the implant were increased than those of the natural tooth. 3. Fluorescence microscopically, linear and concentrical fluorescence was observed at or near the surface of all implants, and the bone formation and remodeling of the implants loaded after 6 week of healing were great, and unloaded implants were worst. 4. Fluorescence microscopically, endosteal bone formation was greater than periosteal bone formation at or near the implants. 5. Fluorescence microscopically, number and size of linear and concentric fluorescence was increased at the lingual side than the buccal side of the loaded implants. The result of the study indicate the possibility of the early load to the implant via a prosthesis.

• Journal of Periodontal and Implant Science
• /
• 제47권4호
• /
• pp.240-250
• /
• 2017

Purpose: The aim of this study was to analyze the prevalence and risk indicators of peri-implantitis in Korean patients with history of periodontal disease. Methods: A total of 444 patients with 1,485 implants were selected from patients who had been treated at the Department of Periodontology, Chonbuk National University Dental Hospital between July 2014 and June 2015. A group with a history of peri-implantitis (HP) (370 patients with 1,189 implants) and a group with a current peri-implantitis (CP) (318 patients with 1,004 implants) were created based on the radiographic and clinical assessments of implants. The prevalence of peri-implantitis was calculated at both the patient and implant levels. The influence of risk variables on the occurrence of peri-implantitis was analyzed using generalized estimating equations analysis. Results: The prevalence of peri-implantitis in the HP and CP groups ranged from 6.7% to 19.7%. The cumulative peri-implantitis rate in the HP group estimated with the Kaplan-Meier method was higher than that in the CP group over the follow-up period. Among the patient-related risk variables, supportive periodontal therapy (SPT) was the only significant risk indicator for the occurrence of peri-implantitis in both groups. In the analysis of implant-related variables, implants supporting fixed dental prosthesis (FDP) and implants with subjective discomfort was associated with a higher prevalence of peri-implantitis than single implants and implants without subjective discomfort in the HP group. The presence of subjective discomfort was the only significant implant-related variable predictive of peri-implantitis in the CP group. Conclusions: Within the limitations of this study, the prevalence of peri-implantitis in Korean patients with a history of periodontal disease was similar to that reported in other population samples. Regular SPT was important for preventing peri-implantitis. Single implants were found to be less susceptible to peri-implantitis than those supporting FDP. Patients' subjective discomfort was found to be a strong risk indicator for peri-implantitis.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제17권2호
• /
• pp.149-155
• /
• 2017

Cerebral palsy is a non-progressive disorder resulting from central nervous system damage caused by multiple factors. Almost all cerebral palsy patients have a movement disorder that makes dental treatment difficult. Oral hygiene management is difficult and the risks for periodontitis, dental caries and loss of multiple teeth are high. Placement of dental implants for multiple missing teeth in cerebral palsy patients needs multiple rounds of general anesthesia, and the prognosis is poor despite the expense. Therefore, making the decision to perform multiple dental implant treatments on cerebral palsy patients is difficult. A 33-year-old female patient with cerebral palsy and mental retardation was scheduled for multiple implant treatments. She underwent computed tomography (CT) under sedation and the operation of nine dental implants under general anesthesia. Implant-supported fixed prosthesis treatment was completed. During follow-up, she had the anterior incisors extracted and underwent the surgery of 3 additional dental implants, completing the prosthetic treatment. Although oral parafunctions existed due to cerebral palsy, no implant failure was observed 9 years after the first implant surgery.

• 대한치과의사협회지
• /
• 제58권8호
• /
• pp.496-504
• /
• 2020

The osseointegrated implants react biomechanically in a different pattern to occlusal force, due to lack of the periodontal ligament unlike the natural teeth. The implants show markedly less movement and limited tactile sensitivity compared with the natural teeth. The implant occlusion concept aims to avoid overloading on the implants and to direct occlusal loads along the longitudinal axis of the implants, in order to compensate for the different biomechanics of the implants. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Moreover, the outcome of treatment often quite successful in spite of different concepts of occlusion and there is an increasing tendency to doubt about the strict theoretical implant-specific occlusion concept. The purpose of this article is to review the previous reports about the concept of implant occlusion and discuss clinical occlusal considerations in implant rehabilitations.

• Archives of Plastic Surgery
• /
• 제45권2호
• /
• pp.158-164
• /
• 2018

Background During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20-38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. Results The mean follow-up period was 14 months (range, 6-24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160-300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. Conclusions Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.

• The Journal of Advanced Prosthodontics
• /
• 제13권4호
• /
• pp.216-225
• /
• 2021

PURPOSE. The aim of this study is to evaluate the effects of canine guidance occlusion and group function occlusion on the degree of stress to the bone, implants, abutments, and crowns using finite element analysis (FEA). MATERIALS AND METHODS. This study included the implant-prosthesis system of a three-unit bridge made of monolithic zirconia and hybrid abutments. Three-dimensional (3D) models of a bone-level implant system and a titanium base abutment were created using the original implant components. Two titanium implants, measuring 4 × 11 mm each, were selected. The loads were applied in two oblique directions of 15° and 30° under two occlusal movement conditions. In the canine guidance condition, loads (100 N) were applied to the canine crown only. In the group function condition, loads were applied to all three teeth. In this loading, a force of 100 N was applied to the canine, and 200-N forces were applied to each premolar. The stress distribution among all the components of the implant-bridge system was assessed using ANSYS SpaceClaim 2020 R2 software and finite element analysis. RESULTS. Maximum stress was found in the group function occlusion. The maximum stress increased with an increase in the angle of occlusal force. CONCLUSION. The canine guidance occlusion with monolithic zirconia crown materials is promising for implant-supported prostheses in the canine and premolar areas.

• 대한치과의사협회지
• /
• 제54권9호
• /
• pp.692-702
• /
• 2016

A short dental implant is considered as possible solution in difficult clinical situations for the placement of a regular length implant. Using a short implant avoiding more invasive surgical procedures simplifies the treatment plan and shortenes the duration of treatment. In this case, 71-year-old female came up with discomfort from her old mandibular denture. As she had fully edentulous mandible and got a negative feedback from removable denture, implant-supported fixed prosthesis was planned. Six short implants were placed on her mandible with severe alveolar bone loss. After 1 year follow up period, implants were well retained with any other abnormal findings. The patient was satisfied with her prostheses and satisfactory outcomes were attained in terms of both esthetic and functional clinical results.

• Journal of Korean Dental Science
• /
• 제15권1호
• /
• pp.75-83
• /
• 2022

Crown-type implant-assisted removable partial dentures (CIRPDs) can be a feasible treatment option for partially edentulous patients. Here we report a case with remaining unilateral mandibular teeth. Two implants were placed in the posterior portion of the mandible using a surgical guide, and a distal-extension removable partial denture with implant-supported surveyed crowns was fabricated. After 12 months, both the abutment teeth and implants were in good condition. The treatment outcomes were satisfactory in terms of masticatory function and esthetics. The advantages of CIRPDs and considerations for obtaining successful clinical outcomes with these dentures are also discussed.

• 대한치과보철학회지
• /
• 제40권4호
• /
• pp.374-385
• /
• 2002

A total of 605 implant fixture prosthesis delivered by 3 clinics and 2 laboratories were examined in this study, The object of this study was to determine the proper length of screw head. The depth of access hole were measured and compared to the type of fixture, abutment, gold screw and prosthesis. The results were as follows : 1 The average number of fixtures per patient were 2.97. 2. The number of fixture installed in the upper posterior area are 327(55.56 %), the upper posterior area 171 (28.25%). 3. The depth of access hole is 4.23 mm in shallow area, and 5.46 mm in deep area and the differences were 1.23 mm. 4. The average depth of the aceess hole of the UCLA abutment were 5.02 mm. 5. The number of 4-5 mm access hole depth were 60(22.39%) in abutment screw level and the number of 4-5 mm depth in fixture level were 101 (29.19%). 6. In the shape of screw head, hexed type were 576(95.21%), slotted type were 29(4.79%).