Maxillary complete denture and mandibular All-on-4 implant restoration considering maintenance: a case report

In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.

Implant impression using closed mouth impression technique: a case report

Closed mouth impression technique by using bite tray is preferred for single tooth impression taking. However, for implant impression taking, open mouth impression technique by using single arch tray is generally used whether it is for single implant or multiple implant. Closed mouth impression technique by using bite tray can save time and materials. It also decreases the chance of error occurrence when a model is mounted on an articulator. In this case report, we tried to show a satisfying result of fabricating single implant fixed prosthodontics after bite tray impression taking by using two different copings for closed mouth impression.

Accuracy of several implant bite registration techniques: an in-vitro pilot study

PURPOSE: This study evaluated the accuracies of different bite registration techniques for implant-fixed prostheses using three dimensional file analysis. MATERIALS AND METHODS: Implant fixtures were placed on the mandibular right second premolar, and the first and second molar in a polyurethane model. Aluwax (A), Pattern Resin (P), and Blu-Mousse (B) were used as the bite registration materials on the healing abutments (H) or temporary abutments (T). The groups were classified into HA, HP, HB, TA, TP, and TB according to each combination. The group using the bite impression coping was the BC group; impression taking and bite registration were performed simultaneously. After impression and bite taking, the scan bodies were connected to the lab analogs of the casts. These casts were scanned using a model scanner. The distances between two reference points in three-dimensional files were measured in each group. One-way ANOVA and Duncan's test were used at the 5% significance level. RESULTS: The smallest distance discrepancy was observed in the TB group using the temporary abutments. The Blu-Mousse and HP groups showed the largest distance discrepancy. The TB and BC groups showed a lower distance discrepancy than the HP group (P=.001), and there was no significant difference between the groups using the temporary abutments and healing abutments (P>.05). CONCLUSION: Although this study has limitations as an in-vitro investigation, the groups using the temporary abutments to hold the Blu-Mousse record and bite impression coping showed greater accuracy than the group using the healing abutments to hold the pattern resin record.

Effects of SLA surface treated with NaOH on surface characteristics and response of osteoblast-like cell / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the surface characteristics and response of osteoblast-like cell at SLA surface treated with NaOH. MATERIALS AND METHODS: Three kinds of specimens were fabricated for the experiment groups. Control group was a machined surface, SLA group was a conventionally SLA treated surface, and SLA/NaOH gorup was SLA surface treated with NaOH. To evaluate the surface characteristics, the surface elemental composition (XPS), surface roughness and surface contact angle were evaluated in each group. And the cytotoxicity, cell adhesion, cell proliferation and ATP activity of osteoblast-like cells (MG-63 cells) were compared in each group for evaluatation of the cell responses. Statistical comparisons between groups were carried out via one-way ANOVA using the SPSS software (SPSS Inc., Chicago, USA), and then performed multiple comparisons. The differences were considered statistically significant at P<.05. RESULTS: SLA surface treated with NaOH (SLA / NaOH group) was changed to hydrophilic surface. All groups did not show the cytotoxicity to the MG-63. In cell adhesion studies, SLA / NaOH group showed the higher degree of adhesion than anothers (P<.05), Up to 7 days of incubation, the proliferation was showed the increasing tendency in all groups but SLA / NaOH group showed the highest cell proliferation between the three groups (P<.05). At 7 days of incubation, there was no difference in ALP activities between the three groups, but at 14 days, SLA / NaOH group showed significant increase in ALP activities (P<.05). CONCLUSION: In this study, SLA surface treated with NaOH promoted cell adhesion, proliferation and differentiation. It means that SLA/NaOH group is possible to promote osseointegration of implants.

A novel PRF1 gene mutation in a fatal neonate case with type 2 familial hemophagocytic lymphohistiocytosis / 소아과

Hemophagocytic lymphohistiocytosis (HLH) occurs in the primary form (genetic or familial) or secondary form (acquired). The familial form of HLH (FHL) is a potentially fatal autosomal recessive disorder that occurs because of constitutional defects in cell-mediated cytotoxicity. Here, we report a fatal neonatal case of type 2 FHL (FHL2) that involved a novel frameshift mutation. Clinically, the newborn presented with severe sepsis-like features and required mechanical ventilation and continuous venovenous hemodiafiltration. Flow cytometry analysis showed marked HLH and complete absence of intracytoplasmic perforin expression in cytotoxic cells; therefore, we performed molecular genetic analyses for PRF1 mutations, which showed that the patient had a compound heterozygous mutation in PRF1, that is, c.65delC (p.Pro22Argfs*2) and c.1090_1091delCT (p.Leu364Glufs*93). Clinical and genetic assessments for FHL are required for neonates with refractory fever and progressive multiple organ failure, particularly when there is no evidence of microbiological or metabolic cause.

Defining Remission of Korean Patients with Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: To define the state of remission based on American College of Rheumatology (ACR) preliminary criteria in Korean patients with rheumatoid arthritis (RA). METHODS: A hundred three patients of RA, followed up over 1 year, were selected at Ewha medical center from May 2000 to May 2006. Remission was defined by ACR preliminary criteria. Data were obtained from the initial and the last visit. Data on initial tender joint count (TJC) and swollen joint count (SJC), treatment, disease duration, remission duration were collected. Initial ESR, CRP, rheumatoid factor (RF), TJC and SJC were also performed at the last clinical visit or at the time of remission. RESULTS: Patients in remission were 35%. The maintenance duration of remission was 4.8+/-9.0 (mean+/-SD) months. Remission group had shorter disease duration (20.2+/-34.7 vs. 58.2+/-83.2 months, p=0.010), were at earlier stage of the disease (<2 years of symptom onset) (80.6 vs. 52.2%, p=0.006) compared to non-remission group. Percentage of patients showing decrease in RF titer was significantly higher in the remission group compared to the non-remission group (p=0.049). However, seronegative conversion of RF was not related to remission status (15.6 vs. 14.8%). In the non-remission group, pain was the most persistently non-satisfying clinical variable of the ACR preliminary criteria. CONCLUSION: Patients at early stage of disease achieved clinical remission in higher rate. Changes of RF titer was affected by clinical remission status.

The color stability of direct denture reline resins / 대한치과보철학회지

STATEMENT OF PROBLEM: Direct denture reline resins tend to discolor during service in the oral environment by intrinsic and extrinsic factor. PURPOSE: This study was designed to evaluate the color stability of direct denture reline resins. MATERIAL AND METHODS: Mild Rebaron(GC Corp., Japan), Meta Base M(Sun medical Co., Japan), Mild Rebaron LC(GC Corp., Japan) and as a control group, Vertex SC(Dentimex Zeist, Holland) were chosen for this study. Ten specimens of each direct denture reline resins were fabricated. Treatment methods designed for this study were the coffee staining test(7days) and the accelerated aging test(100hours). The color changes before and after treatment were measured by Tristimulous colorimeter(Yasuda seiki seisakusho, Ltd. Japan) and analyzed. RESULTS: All the direct denture reline resins subjected to the coffee staining test and the accelerated aging test showed noticible difference in color change. After coffee staining test, Meta Base M showed the highest color change followed by Vertex SC, Mild Rebaron LC and Mild Rebaron. There were no statistical differences between Meta Base M and Vertex SC and between Mild Rebaron LC and Mild Rebaron(p>0.05). After accelerated aging test, Mild Rebaron LC showed the highest color change followed by Vertex SC, Meta Base M and Mild Rebaron. There were no statistical differences only between Mild Rebaron and Mata Base M(p>0.05) but among the others, there were statistical differences(p<0.05). CONCLUSION: Within the limitation of this study, all the direct denture reline resins subjected to the extrinsic and intrinsic factors showed noticible difference in color change, and there were differences among manufacturers.

Carriage and Antimicrobial Susceptibility of Haemophilus influenzae Isolated from Oropharynges of Children

PURPOSE: Haemophilus influenzae, one of the normal flora of the upper respiratory tract, can cause such infections as otitis, sinusitis, pneumonia, and meningitis in children. The oropharyngeal flora has therefore mainly been analyzed as a reservoir for pathogens. This study was performed to reveal the colonization rate of H. influenzae in the upper respiratory tract, their biotypes, their antimicrobial resistance and production of beta-lactamase in healthy children. METHODS: The specimens for H. influenzae were obtained through oropharyngeal swab from 209 healthy children, younger than 5 years of age in 4 day care centers from March 1998 to June 1998. These isolates of H. influenzae were tested for their biotypes, in vitro susceptibility to seven antimicrobial agents(ampicillin, ampicillin/sulbactam, aztreonam, chloramphenicol, cefotaxime, tetracycline and trimethoprim-sulfamedoxazole) by disc diffusion method and production of beta- lactamase. RESULTS: The carriage rate of H. influenzae in the day care center children was 13.4%(28/209). Of 24 isolates, 8 isolates(33%) were biotype II and 6 isolates(25%) were biotype I. The overall rates of resistance of 15 isolates are as follows; ampicillin 46.7%, tetracycline 28.6%, trimethop rim-sulfamedoxazole 14.3%, ampicillin/sulbactam 6.7%. The prevalence of beta-lactamase producing isolates was 65.2%. All beta-lactamase producing isolates were resistant to ampicillin. The resis tance rates of beta-lactamase producing isolates to tetracycline, trimethoprim-sulfamedoxazole, and ampicillin/sulbactam were 44.4%, 25.0%, and 11.1%, respectively. CONCLUSION: Children in day care centers in Seoul have high rates of H. influenzae carriage. The antimicrobial resistance of H. influenzae from the oropharyngeal specimens of healthy children was higher than expected.

Molecular Epidemiology of Methicillin-resistant Staphylococcus aureus Outbreak by Plasmid Restriction Analysis / 대한임상미생물학회지

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause of nosocomial infection and a molecular typing is necessary for proper epidemiologic investigations of sources and moles of spread in an outbreak. An nosocomial outbreak of MRSA in a neonatal intensive care unit at Ewha Womans University Mokdong Hospital was suspected. To investigate the clonality of isolates and control the spread of nosocomial outbreak, we performed plasmid restriction analysis of MRSA isolates from patients and medical staffs. METHODS: We studied 7 MRSA strains (umbilicus 4, blood 1, urine 1 and pus 1) from patients in a neonatal intensive care unit and the MRSA strains from nares and hands surveillance cultures of 26 medical staffs (4 medical doctors and 22 nurses). All MRSA strains were tested for antimicrobial susceptibility and plasmic analysis after EcoRI restriction. We analyzed the plasmid patterns of MRSA isolated from patients and compared with those from medical staffs. RESULTS: Ten MRSA strains (from 7 nares and 3 hands) were isolated from surveillance cultures of 26 medical staffs. Seven out of 10 MRSA strains from medical staffs revealed identical pattern of antibiogram which was the same pattern in all 7 MRSA strains from seven patients. Plasmid restriction patterns were classified 6 groups from A to F showing 2-10 bands. Six out of 7 MRSA strains from the patients showed group A(A1 5, A31) and 5 out of 10 MRSA strains from the medical staffs showed group A(A1 1, A21, A32, A41) and remainders showed different plasmid restriction analysis patterns. CONCLUSIONS: These results suggest that plasmid restriction analysis is a rapid, inexpensive, and good discriminating molecular typing of MRSA outbreak and is useful for the epidemiologic investigation of MRSA outbreaks in the clinical laboratory.