• 대한치과보철학회지
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• 제26권1호
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• pp.197-206
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• 1988

The purpose of this study was to investigate the effect of wearing the removable partial denture on plaque accumulation. Twelve removable partial denture cases were examined. Patients were recalled three consecutive 3 day periods. Plaque index was measured after each 3 day period. (1) not wearing the denture, (2) wearing the denture, (3) wearing the denture after intensive tooth brushing instruction. The results were as follows: 1. Plaque indices of all the remaining teeth were higher following the wearing of removable partial denture than those of teeth not wearing the denture and those of teeth after intensive tooth brushing instruction. 2. Plaque indices showed statistical difference between all the tooth surfaces which were in contact with the denture and those which were not. 3. Plaque indices showed no statistical difference between buccal and lingual surfaces which were in contact with the denture and those which were not. 4. Plaque indices showed statistical difference between proximal surfaces which were in contact with the denture and those which were not.

• 대한치과보철학회지
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• 제30권2호
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• pp.203-224
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• 1992

The purpose of this study was to evaluate the stress distribution developed in supporting structures by distal extension removable partial denture with 4-types of direct retainer. The direct retainers examined were Akers clasp, RPI clasp, RPA clasp and RPL clasp in bilateral & unilateral free end case. 3-dimensional photoelastic stress analysis was used to record the isochromatic fringe patterns and to calculate the compressive stress at measuring points. The results were as follows. 1. In bilateral free end case, RPI clasp exhibited the similar stress distribution on distal and mesial alveolar crest but Akers clasp exhibited higher stress concentration on distal alveolar crest than mesial alveolar crest. 2. In bilateral free end case, RPA clasp and RPL clasp exhibited the similar stress distribution on distal and mesial alveolar crest and RPL clasp exhibited higher stress concentration on buccal alveolar crest than lingual alveolar crest. 3. Akers clasp produced high stress concentration on residual alveolar ridge distally, but RPI clasp, RPA clasp and RPL clasp produced even stress distribution on residual alveolar ridge. 4. Removable partial denture in unilateral free end case exerted higher stress on abutment tooth root apex than bilateral distal extension removable partial denture.

• The Journal of Advanced Prosthodontics
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• 제12권1호
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• pp.15-21
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• 2020

PURPOSE. The aim of the current study was to analyze treatment concepts of a cohort of German dentists for planning, fabrication, and maintenance of implant-supported fixed and removable restorations. MATERIALS AND METHODS. A questionnaire including queries about experiences with implant-supported restorations as well as prosthetic and maintenance treatment concepts for supplying patients with fixed and removable implant-supported prosthetic restorations was developed and sent to 350 dental offices registered in the municipal area of Leipzig, Germany. RESULTS. An overall total of 62 returned questionnaires were included in the analyses, which relates to a response rate of 17.7%. Participating dentists were more involved in the prosthetic aspects of implant dentistry rather than surgery, while prosthetic concepts such as backward planning, digital processing, and application of all-ceramic materials were not commonly performed. Simple attachments were preferred over complex retention systems in removable implant-supported restorations. Tooth/implant-supported fixed denture prostheses as well as removable denture prostheses with supporting posterior implants were not regarded as a favorable treatment option. CONCLUSION. Within the limitations of the study, the data indicate that dentists favor simple and conventional treatment approaches in implant prosthetics. Prosthetic aspects in the planning of implant-supported restorations are often neglected. Prosthetic treatment guidelines and aspects should commonly be considered in the planning phase of implant-supported prosthetic restorations, and awareness should be increased in postgraduate education.

• 대한치과의사협회지
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• 제49권2호
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• pp.77-84
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• 2011

The benefits of implant supported overdenture are readily apparent for the fully edentulous patients and have been well documented, however, there is deficiency of the studies regarding the combination of implants with removable partial dentures for partially edentulous patients. The purpose of this article is to review the literature concerning implants with removable partial dentures and evaluate the evidence for this clinical approach. Through many clinical case reports and studies we have searched from a broad variety of journals, we present the six considerations needed to contemplate respecting implants with removable partial denture in partially edentulous patients. First, the connection between abutment tooth and removable partial denture has to be rigid and the link between implant and removable partial denture should be hinged. Second, a mesial rest acts better in the point of force distribution for distal extension removable partial denture and splinting between implants is also a favorable choice. Third, T bar has an advantage for implants which are used as abutments in distal extension removable partial denture. Forth, as we all known functional impression is better way to reproduce movement for distal extension removable partial denture. Fifth, indirect retainer and guiding plane on the proximal surfaces of terminal abutment teeth are important in preventing denture base lifting. Sixth, implants in conjunction with removable partial denture is superior in the esthetic and phonetic as well as cost-effective point of view. We also suggest that which place we should install implants for force distribution and which diameter and length of implants should be used. in this review article, we recommend to locate the implant near of the abutment tooth for esthetics or near of first molar position for good stress distribution. The diameter and length of implant also influence to stress distribution. When we compare to conservative partial denture, patients go for removable partial denture using implants due to convenience, better support and retention according to several studies. But it is true that we need to study more on this subject and collect long term follow up cases before we discuss on it. So it is enough to bring this subject into the surface of prosthetic treatment by this article.

• 구강회복응용과학지
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• 제33권2호
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• pp.135-142
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• 2017

컴퓨터를 이용한 CAD/CAM milling 방식이 치과 분야에도 적용됨에 따라 보다 분석적이고 정밀한 보철물이 제작 가능하게 되었다. 특히, 국소의치의 지대치로 사용되는 서베이드 크라운을 제작하는데 있어 이러한 디지털 방식의 정밀함은 국소의치의 삽입철거로와 언더컷 등이 정확하게 부여될 수 있게 한다. 본 증례는 상악의 다수 치아 상실을 보이는 환자에서 CAD/CAM을 이용하여 전자 서베잉을 통해 적절한 삽입철거로를 부여하고 지르코니아 서베이드 크라운을 제작하였다. 국소의치의 적합도는 우수했으며, 장착 후 안정성과 착탈 시의 유지력 또한 임상에서 적용하는 데에 문제가 없었다.

• 대한치과의사협회지
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• 제55권12호
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• pp.842-849
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• 2017

The term, 'crossed occlusion' implies clinical situation in which the residual teeth in one arch have no contact with those in the antagonistic arch, resulting in the collapse of occlusal vertical dimension. The treatment goal of this pathologic condition is restoration of the collapsed vertical dimension and stabilization of abnormal mandibular position. Previously, konus removable prostheses or tooth supported overdentures were suggested to solve crossed occlusion. Nowadays, dental implants have been used for definitive support to solve this problem. In this case report, a 65 years old female patient had a crossed occlusion, in which the maxillary posterior residual teeth and mandibular anterior residual teeth cross. Interim removable and fixed dental prostheses were used to confirm the proper vertical and horizontal jaw relation. After that, the mandibular posterior edentulous region was restored with implant-supported fixed dental prostheses. Computer tomography guided implant surgery was performed according to the concept of the restoration-driven implant placement. The maxillary anterior edentulous region was restored with Kennedy class IV removable prosthesis, considering the patient's economic status. The patient's jaw position and prostheses have been well maintained at the follow-up after 6 months of definitive restoration. The antero-posterior crossed occlusion problems appeared to be effectively solved with the combination of removable in one arch and implant-supported fixed prostheses in the other.

• 대한치과보철학회지
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• 제62권2호
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• pp.140-145
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• 2024

가철성 국소의치를 사용하는 환자의 잔존 치아가 우식, 마모, 부식, 파절 등의 이유로 보철 수복이 필요한 경우가 있다. 가철성 국소의치의 구조물과 접촉하는 부분이 많은 지대치의 보철 수복이 필요한 경우, 서베이드 크라운을 제작 후 가철성 국소의치를 새로 제작하는 것이 통상적인 방법이다. 이럴 경우, 환자가 적응하기까지 오랜 시간이 걸리고, 시간적, 경제적 비용이 발생한다. 한편, 손상된 치아 외에 구강 내 다른 부분에서 가철성 국소의치의 지지, 유지 및 안정을 일부분 제공하는 경우 기존 국소의치의 사용은 임상적으로 양호하다. 이 때 기존 국소의치를 유지하면서 해당 치아를 보철 수복한다면, 환자는 불편과 비용을 줄이면서 기존 가철성 국소의치를 사용할 수 있다. 이처럼 국소의치에 맞추어 보철을 제작하는 retrofit crown 제작과정에서 Computer Aided Design-Computer Aided Manufacturing(CAD-CAM)의 발전과 지르코니아의 물리적 성질이 개선되면서 디지털 방식이 적용되고 있다. 본 증례는 하악에서 가철성 국소의치를 사용하는 환자의 지대치가 심하게 마모되어 국소의치에 맞추어 지르코니아 크라운을 제작한 케이스로, 환자와 술자 모두 만족하는 결과를 얻었기에 본 증례를 보고하는 바이다.

• 대한치과보철학회지
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• 제43권2호
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• pp.218-231
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• 2005

Statement of problem. In the partially edentulous patients, removable partial dentures have been working as a important treatment modality. Clasps, a kind of direct retainers, received some amount of stresses during the insertion and removal of partial denture on the abutment tooth. Purpose. The study is to investigate stresses of the different clasps. Material and methods. In order to investigate the degree of stresses, maxillary partial edentulism (Kennedy Class II modification I) was assumed and removable partial dentures were designed on it with three kinds of metallic materials; cobalt-chromium alloy, type IV gold alloy and commercially pure (c.p.) titanium. Aker's clasp was applied on the left second molar. RPA (mesial rest-proximal plate-Aker's) clasp was on the left first premolar and wrought wire clasp was on the right first premolar. Three dimensional, non-linear, dynamic finite element analysis method was run to solve this process. Results. 1. Cobalt-chromium alloy had the highest von Mises stress value and c.p. titanium had the lowest one irrespective of the types of clasps. 2. In the Aker's clasps, stress on the retentive tips was shown shortly after the appearance of stresses of the middle and minor connector areas. These time lag was much shorter in the RPA clasps than in the Aker's clasp. 3. In general. retentive tips of wrought wire clasps had much less amount of stress than other clasps. Conclusion. The amount of stress was the highest in the RPA clasp and the lowest in the wrought wire clasp, in general.

• 대한치과보철학회지
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• 제54권1호
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• pp.21-27
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• 2016

국소의치 수복에서는 의치 장착에 의한 잔존 조직의 위해를 최소한으로 억제하는 것이 중요하다. 잔존 구강조직에 위해를 가하는 첫 번째 요인은 잔존치 및 치조제의 기능력 부담이며 두 번째는 구강 위생관리 부족에 의한 영향이다. 이중관을 활용한 국소의치는 rigid support를 통해 치조제에 미치는 부담을 경감시킬 수 있으며, 외관과 의치부에 부착되는 치태 및 침착물을 구강 외에서 쉽고 확실하게 관리할 수 있다. 또한 내관인 지대치 역시 모든 방향에서 청소가 용이해 변연 치은의 건강에 유리하다. 본 증례에서는 심한 치조골 흡수 및 불량한 구강 위생관리를 보이는 부분 무치악 환자에서 이중관을 이용한 국소의치로 상, 하악을 수복하여 기능과 심미, 구강 위생 관리 측면에서 만족할 만한 결과를 얻을 수 있었다.

• 대한치과보철학회지
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• 제60권1호
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• pp.110-118
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• 2022

다수의 치아 상실은 교합의 부조화를 일으키며, 수직고경 상실과 하악 운동의 변위를 유발할 수 있기 때문에 중심위에서 적절한 수직 고경과 교합을 재형성하는 것이 중요한 치료 목표가 될 수 있다. 한편, 임플란트 보조 국소의치는 국소의치의 유지, 지지 및 안정을 증가시켜 환자의 만족도를 높이기 때문에 최근에 자주 사용되는 임상 술식이다. 본 증례는 편측 구치부 및 전치부 지지의 소실로 편측 교합면간 거리가 소실된 환자에서 치료 의치를 제작하고 기존에 식립된 양측의 임플란트를 지대치로 이용한 임플란트 보조 국소의치를 제작하였고 양호한 임상 결과를 확인하였기에 이를 보고하고자 한다.