• The Journal of Korean Academy of Prosthodontics
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• v.62 no.1
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• pp.64-71
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• 2024

The most critical aspect of full-arch prosthodontic treatment is evaluating whether the patient's vertical occlusal dimension is appropriate, and if necessary, restoring it through increasing vertical dimension. If the vertical occlusal dimension is too low, it can lead to reduced chewing efficiency, as well as not only aesthetic concerns but also potential issues like hyperactivity of muscles and posterior displacement of the mandible. This report is about the patient dissatisfied with pronunciation and aesthetics due to an inappropriate vertical occlusal dimension resulting from prior prosthetic interventions, underwent full-arch prosthodontic restoration treatment. Through the utilization of digital diagnostic apparatus, a comprehensive evaluation was undertaken for patient's vertical occlusal dimension, occlusal plane orientation, and the condition of prosthetic restorations. Through 3D facial scanning, the facial landmarks were discerned, and subsequently, the new occlusal plane was established. This provided the foundation for a digitally guided diagnostic wax-up. An elevation of 5 mm from the incisor was determined. Comprehensive dental rehabilitation was then executed for all remaining teeth, excluding the maxillary four incisors. The treatment protocol followed a systematic approach by initially creating implant-supported restorations on both sides of the dental arch to establish a stable occlusal contact. Subsequently, prosthetic restorations for the natural dentition were generated. Diagnostic and treatment planning were established through the utilization of facial scanning. This subsequently led to a reduction in treatment complexity and an expedited treatment timeline.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.471-478
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• 2004

Electromyogram (EMC) signal generated by voluntary contraction of muscles is often used in a rehabilitation devices such as an upper limb prosthesis because of its distinct output characteristics compared to other bio-signals. This paper proposes an EMG-based human-computer interface (HCI) for the control of the above-elbow prosthesis or the wheelchair. To control such rehabilitation devices, user generates four commands by combining voluntary contraction of two different muscles such as levator scapulae muscles and flexor-extensor carpi ulnaris muscles. The muscle contraction is detected by comparing the mean absolute value of the EMG signal with a preset threshold value. However. since the time difference in muscle firing can occur when the patient tries simultaneous co-contraction of two muscles, it is difficult to determine whether the patient's intention is co-contraction. Hence, the use of the comparison method using a single threshold value is not feasible for recognizing such co-contraction motion. Here, we propose a novel method using double threshold values composed of a primary threshold and an auxiliary threshold. Using the double threshold method, the co-contraction state is easily detected, and diverse interface commands can be used for the EMG-based HCI. The experimental results with real-time EMG processing showed that the double threshold method is feasible for the EMG-based HCI to control the myoelectric prosthetic hand and the powered wheelchair.

• Journal of dental hygiene science
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• v.11 no.4
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• pp.299-303
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• 2011

The purpose of this case report was to present an example of an esthetic and functional rehabilitation of anterior teeth with tetracycline discoloration and minor morphological abnormality of a 39-year old female. A chairside computer-aided design/computer-aided manufacturing (CAD/CAM) system with CEREC AC was applied for the prosthetic procedure and all ceramic crowns made with lithum disilicate (IPS e.max CAD) restored the esthetic and functional features of sixteen anterior teeth successfully.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.4
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• pp.279-285
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• 2016

Reliable recording and analysis of peripheral nerve activity is important to recognize the user's intention for controlling a neuro-prosthetic hand. In this paper, we present a peripheral nerve recording system that consisted of an intrafascicular multi-electrode array, an electrode insertion device, and a multi-channel neural amplifier. The 16 channel multi-electrode array was stably implanted into the sciatic nerve of the rat under anesthesia using the electrode insertion device. During passive movements and mechanical stimuli, muscle and cutaneous afferent signals were recorded with the multi-channel neural amplifier. Furthermore, we propose a spike sorting method to isolate individual neuronal unit. The muscle proprioceptive units were classified as muscle spindle afferents or Golgi tendon organ afferents, and the skin exteroceptive units were categorized as slow adapting afferents or fast adapting afferents. Experimental results showed that the proposed method could be applicable to record and analyze peripheral nerve activity in neuro-prosthetic systems.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.198-204
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• 2017

Maxillofacial defect comes from congenital defect, trauma and surgical resection. Patients with intraoral defect are commonly related to maxillary defect and they need prosthetic rehabilitation. Functional reconstruction of partially edentulous mandible has many limitations. However, if both condyles are intact, maxillofacial prosthesis using partial denture give competent results. In this case, a patient of 58 year-old male has a defect on palate and left mandibular posterior teeth from gunshot. The maxillary defect of this patient is Class IV according to Aramany classification and the mandibular one is Type V according to Cantor and Curtis classification. For retention of the obturator, remaining teeth are fully utilized and artificial teeth are arranged harmoniously to provide stable occlusion. Mandibular RPD covered limited range of deformed soft tissue derived from mandibular resection surgery. With these treatments, the patient in this case showed improvements in mastication, swallowing and speech.

• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.381-386
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• 2017

PURPOSE. To integrate extra-oral facial scanning information with CAD/CAM complete dentures to immediately rehabilitate terminal dentition. MATERIALS AND METHODS. Ten patients with terminal dentition scheduled for total extraction and immediate denture placement were recruited for this study. The patients were submitted to a facial scanning procedure using the in-office PritiMirror scanner with bite registration records in-situ. Definitive stone cast models and bite records were subsequently submitted to a lab scanning procedure using the lab scanner (iSeries DWOS; Dental Wings). The scanned models were used to create a virtual teeth setup of a complete denture. Using the intra-oral bite records as a reference, the virtual setup was incorporated in the facial scan thereby facilitating a virtual clinical evaluation (teeth try-in) phase. After applying necessary adjustments, the virtual setup was submitted to a CAM procedure where a 5-axis industrial milling machine (M7 CNC; Darton AG General) was used to fabricate a full-milled PMMA immediate provisional prosthesis. RESULTS. Total extractions were performed, the dentures were immediately inserted, and subjective clinical fit was evaluated. The immediate provisional prostheses were inserted and clinical fit, occlusion/articulation, and esthetics were subjectively assessed; the results were deemed satisfactory. All provisional prostheses remained three months in function with no notable technical complications. CONCLUSION. Ten patients with terminal dentition were treated using a complete digital approach to fabricate complete dentures using CAD/CAM technology. The proposed technique has the potential to accelerate the rehabilitation procedure starting from immediate denture to final implant-supported prosthesis leading to more predictable functional and aesthetics outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.4
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• pp.444-450
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• 2017

Prosthetic decision-making is complex because of various factors, and involves a combination of the individual dentist's interpretation of the objective clinical data and his or her interaction with the patient. Increasing therapeutic options and emerging outcome data demand the constant re-evaluation of our decision-making process. In this case, fixed prosthetic restorations were selected as a treatment method to reconstruct the occlusal plane of a patient with disharmonious occlusal plane. And the occlusal plane was re-established by establishing a treatment plan through diagnostic wax-up. Provisional restorations obtained by continuous re-evaluation for a sufficient period of time was replicated to definitive restorations using CAD/CAM technology. The results were satisfactory when they were observed through clinical follow-up for 3 months after the end of treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.126-131
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• 2016

Surgical management of oral cancer results in compromised masticatory and swallowing function which affects patient in social and psychological aspects due to reduced phonetic ability and facial deformity, thus, it is imperative to provide applicable prosthetic treatment to overcome such complications. This clinical study describes rehabilitation of a patient with squamous cell carcinoma treated with marginal mandibulectomy and implantation on preserved posterior portion of mandible to provide stability and support for subsequent denture treatment. Kennedy class IV removable partial denture has provided satisfactory results in esthetics and function. Bone level stability around implants was reported to be maintained during eight months of clinical observation.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• Journal of Korean Dental Science
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• v.17 no.2
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• pp.84-91
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• 2024

Achieving both esthetic and functional implant rehabilitation is crucial for the successful treatment of the anterior maxilla. Adequate peri-implant alveolar bone and soft tissue are essential for optimal rehabilitation of the esthetic area, and there is a direct association between the implant position and prosthetic outcomes. Immediate provisionalization may also be advantageous when combined with augmentation. This case report described the implant placement in a 25-year-old female patient who had lost her right maxillary lateral incisor (#12) due to trauma-induced avulsion. The treatment involved simultaneous grafting and collagenated, deproteinized bovine bone mineral, along with subepithelial connective tissue taken from the right maxillary tuberosity. A polyetheretherketone abutment and non-functional immediate provisionalization were performed by removing both the proximal and occlusal contacts on the composite resin crown. Clinical and radiographic evaluations revealed maintenance of stable ridge contour aspects for six months following surgical treatment. In summary, implant rehabilitation in the esthetic zone can be successful using simultaneous soft and hard tissue grafts. Moreover, soft tissue stabilization post-subepithelial connective tissue grafting can be achieved through early or immediate visualization, along with immediate implant placement.