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Integrating 3D facial scanning in a digital workflow to CAD/CAM design and fabricate complete dentures for immediate total mouth rehabilitation

  • Hassan, Bassam;Greven, Marcus;Wismeijer, Daniel
    • 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.

INTERRELATIONSHIP BETWEEN VIRULENT CLONAL TYPES, SEROTYPES AND LEUKOTOXICITY OF KOREAN STRAINS OF A. ACTINOMYCETEMCOMITANS (한국인 Actinobacillus actinomycetemcomitans 균주의 특이 독성 clone형과 혈청형 및 백혈구독성과의 관계)

  • Ku, Young
    • Journal of Periodontal and Implant Science
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    • v.25 no.3
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    • pp.487-496
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    • 1995
  • Previous studies have demonstrated that not all A. actinomycetemcomitans produced significant level of leukotoxic factor and its leukotoxicity have associated with serotype and genetic variation. Our aim was to investigate on the interrelationship between serotype and leukotoxicity of an A. actinomycetemcomitans consisting of 13 clinically well characterized. Korean isolates and to evaluate if particular virulent clonal types of A. actinomycetemcomitans are associated with periodontal disease. For this study, 13 strains of A. actinomycetemcomitans from 6 patients with periodontal disease were isolated and identified by using a selective medium(tryptic soy agar supplemented with 10% serum, $75{\mu}g$ of bacitracin and $5{\mu}g$ of vancomycin per ml) in 10% C02 incubator for 3days with routine Gram staining, colony morphology and biochemical test..For serotyping, antisera were prepared from reference strains of 5 serotypes. (ATCC 29523,Y4, SUNY aB 67, IDH 781, IDH 1705) and then ammonium sulfate precipitation, immunoabsorption and indirect immunofluoroscent procedures were done. For analysis of leukotoxicity, sonic extract of A. actinomycetemcomitans exposed to PMN, and trypan blue was stained for counting the cell viability. Finally Southern blot analyses of genomic DNA digested with the restriction enzyme Tag I was done and the Southern blots were hybridized with the 530bp fragment, termed delta 530, originating from the ltx promoter of strain 652 and deleted from strain JP2. Also ltxA-3.1 and SC2 probe from strain JP2 were hybridized with genomic DNA fragments. Results reveal that strains isolated showed approximately equal proportions of 3 serotypes(b, d, e) and serotype b was not detected. 2 patients harbored 2 different serotypes in the same disease site. The prevalence of leukotoxic strain was 23% and there was no relationship between serotype, leukotoxicity and clinical observations. Especially virulent clonal types of Actinobacillus actinomycetemcomitan (JP2 strain) could not found. Further studies are necessary on the genetic polymorphism of leukotoxin and its relations to clinical status.

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THE RELATIONSHIP BETWEEN PERIODONTAL DISEASE SEVERITY AND Actinobacillus actinomycetemcomitans SEROTYPE & GENOTYPE DISTRIBUTION (Actinobacillus actinomycetemcomitans의 혈청형과 유전자형 분포가 치주질환 심도에 미치는 영향)

  • Kim, Eun-Gyoung;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • v.24 no.3
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    • pp.541-560
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    • 1994
  • The present study was performed to evaluate the relationship between the serotype or the genotype of Actnobacillus actinomycetemcomitans (A. a.) and the severity of periodontal disease. Total 64 A. a. clinical isolates were sampled from 46 sites of 20 subjects classified into the group I (1 periodontally healthy subject, 2 gingivitis patients, 5 ealry adult periodontitis patients), group II (3 moderatelly adult periodontitis patients) and group III (1 advanced adult periodontitis patient, 8 RPP patients). Southern bolt hybridization (fingerprinting) patterns of the five reference strains, A. a. strain ATCC 29523 (serotype a), ATCC 29522 (Serotype b), ATCC 43719 (serotype c), IDH 781 (serotype d) and IDH 1705 (serotype e), were used as the five basic genotypic patterns (A, B, C, D, E). NT type was designated as one which did dnot represent any of those five basic types. The serotypes were determined by ELISA technique with the serum samples from pre-immunized rabbit. Based on subject-based analysis, it was noted that genotypes A and C, NT, and B, D, E were significantly related to the disease groups I, II, and III, respectively. It was also noted that both the serotypes a and c were significantly related to the disease group I and II, while serotypes were significantly related bm), and serotypes b and nd were frequently found in sites with severe attachment loss (LA>6mm). The results indicated that the significant relationship can be delineated beteen the genotypes and the serotypes of Acinobacillus actinomycetemcomitans and the periodontal disease severity. The results also indicated that genotyping can provide more detailed information on its relationship with the disease severity based on both the patient-based and the site-based analyses.

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PERIODONTAL REGENERATION FOLLOWING RECONSTRUCTIVE SURGERY INCLUDING TOPICAL APPLICATION OF TETRACYCLINE IN DOGS (테트라싸이클린이 치주결체조직의 재부착에 미치는 효과)

  • Choi, Sang-Mook;Han, Soo-Boo;Koo, Jea-Seung;Kang, Yun-Seon
    • Journal of Periodontal and Implant Science
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    • v.23 no.2
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    • pp.203-218
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    • 1993
  • This study was designed to examine the effect of tetracycline application to the planed periodontal surgery of the experimentally induced periodontal disease in dogs. Modified Widman flap surgery was done and aqueous tetracycline (1%) was applied to the root surface for 5min, after which the wound was rinsed with saline, and flaps were coronally repositioned. Root surface ntoches were used as reference points. The animals were sacrificed 1 week, 2 weeks, 4 weeks, and 8 weeks after surgery, and block sections of tooth and surround tissue were processed for conventional light and electron microscopy. The results were as follows : 1. A more coronal position of junctional epithelium was observed in the area treated with tetracycline. 2. In the most of the tetracycline - treated teeth, the new collagen fibrils of connective tissue were oriented vertical/or oblique and parallel to the root surface. The vertical or oblique fibers were inserted into the denuded dentin matrix and contacted with exposed dentin collagen fibrils. 3. In the tetracycline - treated root, new cementum apposition, most of acellular extrinsic fiber cementum, was seen with bundles of oriented collagen fibrils incoporating into the cementum. 4. In the control and tetracyclin - treated teeth, bone resorption was observed at the alveolar crest in the 1 week groups.

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The Effect Of Platelet - Derived Growth Factor And Insulin - Like Growth Factor On The Guided Tissue Regeneration In The Treatment Of Human Furcation Involvement (Platelet - derived growth factor-BB와 Insulin Iike gowth factor-1이 e- PTFE를 이용한 치근 이개부의 조직유도재생에 미치는 영향)

  • Ju, Ae-Ra;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.80-88
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    • 1996
  • The aim of the present investigation was to see the effect of combined use of PDGF BB and IGF -1 on the guided tissue regeneration(GTR) using barrier membrane in the treatment of human furcation involvement. Twelve patients with initially diagnosed as having moderate to advanced adult periodontitis with mandibular class II buccal furcation defects have been wer selected. Initial scaling and root planing has been performed and baseline data consisting of probing depths and attachment levels have been recorded prior to surgical procedures. The GTR procedures using either barrier membrane(control : ePTFE) alone or together with the application of PDGF - BB and IGF -l(experimental : ePTFE+PDGF/IGF) have been done under the routine guidelines. During the surgery, the distance from CEJ either to the bottom of the bone defects(CEJ - BD) or to the bone crest(CEJ-BC) were measured. Horizontal distance to the deepest area in the furcal defects were measured from the reference line connection the most prominent bony walls of the two buccal roots. 6 months following the GTR therapy, all the measurements were made repeatedly. The probing attachment gain of the experimental and the control grous were 2.14mm and l.07mm, respectively with no statically significnant difference. Amont of vertical bone fill in the experimental and the control groups were 2.43mm and 2.29mm, rexpectively. Amonut of horizontal bone fill were 2.86mm in the experimental group and 2.17mm in the control group, respectively. However, there were no significant differences in the amount of bone fill(both vertical and horizontal)between the two groups.

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The Effects of the Combination of Calcium Carbonate and Fibrin Adhesive on the Periodontal Regeneration of Class II Furcation Defect in Dogs (Calcium carbonate와 fibrin adhesive의 병용이 성견 2급 치근 분지부 치주조직 재생에 미치는 영향)

  • Seo, Eun-Pyo;Chung, Hyun-Ju;Kim, Young-Jun
    • Journal of Periodontal and Implant Science
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    • v.30 no.2
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    • pp.229-242
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    • 2000
  • The purpose of this study was to evaluate the effect of fibrin tissue adhesive and porous resorbable calcium carbonate on the periodontal regeneration of the class II furcation defect in dogs. Class II furcation defect was surgically created on the second, third, and fourth premolars bilaterally in the mandibles of six mongrel dogs. The experimental sites were divided into four groups according to the treatment modalities: Control-surgical debridement only; Group I-calcium carbonate grafting; Group II-application of fibrin adhesive only; Group III-application of fibrin adhesive after calcium carbonate grafting. The animals were sacrificed at the 2, 4, and 12 weeks after periodontal surgery and the decalcified specimens were prepared for histological and histometrical examination. The results are as follows : Clinically, there were no inflammatory response in all groups after 2, 4, 12 weeks. In the Control group, junctional epithelium was grown downward to the reference notch. In Group I, graft materials were exfoliated from the defect throughout the experimenta periods andnew bone was seen in the notch area at 4 and 12 week specimens. In Group II, fibrin adhesive was absorbed at 2 week specimens, and connective tissue attachment increased than that of control group. New cementum and new bone were seen above the notch area. In Group III, the graft material was maintained in the defect throughout the experimental period and inducing the amount of periodontal tissue regeneration was higher than other groups. These results suggest that the use of fibrin tissue adhesive in conjunction with porous resorbable calcium carbonate would improves the stability of graft material and inhibit the epithelial down growth and make it be a feasible method for periodontal regeneration.

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An in vitro model of Fusobacterium nucleatum and Porphyromonas gingivalis in single- and dual-species biofilms

  • Tavares, Livia Jacovassi;Klein, Marlise Inez;Panariello, Beatriz Helena Dias;de Avila, Erica Dorigatti;Pavarina, Ana Claudia
    • Journal of Periodontal and Implant Science
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    • v.48 no.1
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    • pp.12-21
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    • 2018
  • Purpose: The goal of this study was to develop and validate a standardized in vitro pathogenic biofilm attached onto saliva-coated surfaces. Methods: Fusobacterium nucleatum (F. nucleatum) and Porphyromonas gingivalis (P. gingivalis) strains were grown under anaerobic conditions as single species and in dual-species cultures. Initially, the bacterial biomass was evaluated at 24 and 48 hours to determine the optimal timing for the adhesion phase onto saliva-coated polystyrene surfaces. Thereafter, biofilm development was assessed over time by crystal violet staining and scanning electron microscopy. Results: The data showed no significant difference in the overall biomass after 48 hours for P. gingivalis in single- and dual-species conditions. After adhesion, P. gingivalis in single- and dual-species biofilms accumulated a substantially higher biomass after 7 days of incubation than after 3 days, but no significant difference was found between 5 and 7 days. Although the biomass of the F. nucleatum biofilm was higher at 3 days, no difference was found at 3, 5, or 7 days of incubation. Conclusions: Polystyrene substrates from well plates work as a standard surface and provide reproducible results for in vitro biofilm models. Our biofilm model could serve as a reference point for studies investigating biofilms on different surfaces.

The Articulation Characteristics of the Profound Hearing-Impaired Children with Reference to Formant Bandwidth (심도 청각장애 아동의 조음 특성: 포먼트 대역폭을 중심으로)

  • Choi, Eunah
    • Phonetics and Speech Sciences
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    • v.6 no.2
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    • pp.55-64
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    • 2014
  • This study measured formant bandwidths of profound hearing impaired children and examined the characteristics of their articulation. For this study, 10 cochlear implanted children(CI), 10 hearing aid children(HA) and 10 normal hearing children(NH) were asked to read 7 Korean vowels(/ɑ, ʌ, o, u, ɯ, i, ɛ/). The subjects' readings were recorded by NasalView and analyzed by Praat. The analysis of the formant bandwidths explains the degree of vocal fold opening and the characteristics of radiation. Through the analysis of formant bandwidth, we can see that the hearing-impaired maintain vocal fold tension when they speak high vowels and characteristics of radiation. Narrower B1 means better maintain vocal fold tension, wider B2 means more front and wider B3 means the rounder lips. CI's B1 was widest and NH's was narrowest. And females' B1 was wider than males'. Among vowels, B1 of /a/ was widest, and B1 of /i/ was narrowest. In the case of B2, HA and NH's B2 was wider than CI's. Females' B2 was wider than males'. And B2 of /i/ was widest, and B2 of /ʌ/ was narrowest. In the case of B3, NH's was widest, and CI's was narrowest. Males' was wider than females'. Among vowels, B3 of /o/ was widest, and B3 of /ɛ/ was narrowest. As a result, first, through the analysis of B1, we can find that NH and males could better maintain vocal fold tension than the hearing-impaired or females, and all children articulate /i/ with vocal fold tension than other vowels. Second, through the analysis of B2, NH and HA articulate vowels with the weaker rounded than CI does. And females articulate vowels with the weaker rounded than males do. Third, through the analysis of B3, NH articulate vowels with the rounder than HA or CI do, and males articulate vowels with the rounder than females do. Through the results, we can expect that the analysis of formant bandwidth will be applied to the therapy of articulation for the hearing-impaired with hearing aids or cochlear implant.

A comparative study for guided bone regeneration of silk fibroin nanomembrane(NanoGide-$S^{TM}$) (실크 피브로인 나노 차폐막(나노가이드-에스)을 이용한 치조골 유도재생능력에 관한 비교 연구)

  • Han, Dae-Hyun;Hong, Ki-Seok;Chung, Chin-Hyung;Yim, Sung-Bin
    • Journal of Periodontal and Implant Science
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    • v.38 no.3
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    • pp.475-482
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    • 2008
  • Purpose: To evaluate the safety and efficiency of bone regenerative abilities of silk fibroin nanomembrane(Nanoguide-S) Material and Methods: The objects were 38 patients who had large defect at extraction sockets caused by chronic periodontitis and silk fibroin nano matrix were used on experimental group(N=19) and PLA/PLGA matrix were used on control group(N=19). The width, height, and length by crown-apical direction(socket depth) of defects were measured with the occlusal plane as a reference plane, and tooth axis direction, perpendicular to tooth axis direction were measured on radiographs at 3 months pre-operative, 3 months post-operative. Result: Tissue response to silk fibroin nano matrix and Biomesh were clinically satisfactory and complications such as swelling, exudation, ulceration and vesicles were not found except the ordinary discomfort of operated portion. 3 months later, the width, height, and length by crown-apical direction (socket depth) of defects were clinically improved in both groups with no significant difference. 3 months later radiolucency of tooth axis direction and perpendicular to tooth axis direction were all increased in both groups with no significant difference. Conclusion: By these results biodegradadable silk fibroin nano matrix was efficient in GBR on alveolar bone resorption caused by periodontitis compared to Biomesh.

Long Term Clinical and Radiographical Evaluation of Tunneled Molars (터널화가 시행된 대구치의 장기적인 임상적 방사선학적 평가)

  • Baek, Young-Ran;Park, Jin-Woo;Suh, Jo-Young;Jin, Myoung-Uk;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.38 no.3
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    • pp.521-528
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    • 2008
  • Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries tree and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss ($3.59{\pm}1.69%$ vs $3.42{\pm}2.95%$) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program.