A case of oral rehabilitation using implant fixed prosthesis (skeletal class III malocclusion patient) / 대한치과보철학회지

When the patient with class III malocclusion needs extensive oral rehabilitation due to multiple missing teeth, accurate diagnosis, and careful analysis, such as the patient’s occlusal relationship, facial changes, and evaluation of the temporomandibular joint are essential. Orthognathic surgery is often performed for aesthetic improvement, depending on the patient’s chief complaint. If it is not possible due to certain circumstances, partial aesthetic improvement can be achieved through minimal elevation of the vertical dimension. As this patient may have unexpected issues, such as temporomandibular joint disorder, oral habits like bruxism, and masticatory muscle tension, it was determined whether the patient could adjust to a reversible temporary removable partial denture. After this, the maxillary implant-supported fixed prostheses and the mandibular fixed prostheses were used to achieve stable posterior support and to partially improve the maxillary anterior esthetics. The patient was satisfied with the results both aesthetically and functionally. The prognosis is expected to be good if regular check-ups are conducted.

Enhanced Bone Formation by Rapidly Formed Bony Wall over the Bone Defect Using Dual Growth Factors

BACKGROUND@#In guided bone regeneration (GBR), there are various problems that occur in the bone defect after the wound healing period. This study aimed to investigate the enhancement of the osteogenic ability of the dual scaffold complex and identify the appropriate concentration of growth factors (GF) for new bone formation based on the novel GBR concept that is applying rapid bone forming GFs to the membrane outside of the bone defect. @*METHODS@#Four bone defects with a diameter of 8 mm were formed in the calvaria of New Zealand white rabbits each to perform GBR. Collagen membrane and biphasic calcium phosphate (BCP) were applied to the bone defects with the four different concetration of BMP-2 or FGF-2. After 2, 4, and 8 weeks of healing, histological, histomorphometric, and immunohistochemical analyses were conducted. @*RESULTS@#In the histological analysis, continuous forms of new bones were observed in the upper part of bone defect in the experimental groups, whereas no continuous forms were observed in the control group. In the histomorphometry, The group to which BMP-2 0.5 mg/ml and FGF-2 1.0 mg/ml was applied showed statistically significantly higher new bone formation. Also, the new bone formation according to the healing period was statistically significantly higher at 8 weeks than at 2, 4 weeks. @*CONCLUSION@#The novel GBR method in which BMP-2, newly proposed in this study, is applied to the membrane is effective for bone regeneration. In addition, the dual scaffold complex is quantitatively and qualitatively advantageous for bone regeneration and bone maintenance over time.

Rehabilitation of Partial Edentulism with a Crown-type Implant-assisted Removable Partial Denture through Guided Implant Surgery: A Case Report with a 12-month Follow-up

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.

Comparative evaluation of two sets of complete dentures fabricated by digital and conventional workflow in a single patient: A case report / 대한치과보철학회지

Application of digital technology in dental treatments can simplify the treatment process and reduce patient discomfort. In regards of digital complete dentures, several commercial systems are available. However, these systems are not being routinely applied in Korea. In this case report, comparative analyses were performed regarding the two sets of complete dentures fabricated in digital and conventional workflow in a single patient. Complete dentures made with digital workflow were able to form an ideal occlusion because customized teeth were used. Compared to that, there were also limitations such as lower retention of mandibular dentures, so we would like to report this.

Comparative evaluation of two sets of complete dentures fabricated by digital and conventional workflow in a single patient: A case report / 대한치과보철학회지

Application of digital technology in dental treatments can simplify the treatment process and reduce patient discomfort. In regards of digital complete dentures, several commercial systems are available. However, these systems are not being routinely applied in Korea. In this case report, comparative analyses were performed regarding the two sets of complete dentures fabricated in digital and conventional workflow in a single patient. Complete dentures made with digital workflow were able to form an ideal occlusion because customized teeth were used. Compared to that, there were also limitations such as lower retention of mandibular dentures, so we would like to report this.

Full-mouth rehabilitation with implant-supported fixed dental prostheses for the edentulous maxilla and partially edentulous mandible: A case report / 대한치과보철학회지

A conventional approach for the treatment of long-span edentulous areas is the use of removable dentures. However, placing implants in these areas results in superior functional outcomes by increasing the stability, support, and resistance of the prostheses and improving the masticatory efficiency. Treatment modalities utilizing implants can be further classified into either removable or fixed-type prostheses. Several factors such as the amount of alveolar bone resorption, inter-arch relationship, patient preferences, and socioeconomic status should be considered when determining the appropriate treatment approach. Monolithic zirconia has been considered a suitable material for implant-supported fixed dental prosthesis, because of the drastic improvement in its mechanical properties. It exhibits fewer incidences of fracture and chipping of the prostheses, and has greater bulk of material than metal-ceramic crowns and zirconia-veneered ceramics. Moreover, highly translucent monolithic zirconia is also available in the market, and its application is gradually increasing for anterior tooth rehabilitation. The present report describes a patient who underwent full-mouth rehabilitation with fixed dental prostheses (eight upper and three lower implant placements). All teeth, except bilateral mandibular canines and left mandibular first and second premolars, were extracted after the diagnosis of generalized chronic moderate-to-advanced periodontitis of the remaining teeth. The patient reported satisfactory esthetic and functional outcomes during the one-year follow-up visit.

Influence of internal connection length on screw loosening in internal connection implants / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate whether the internal abutment length affected screw stability in an internal connection implant. MATERIALS AND METHODS: Twenty long internal connection implants (Replus system, 4.7 × 11.5 mm) were selected for this investigation. Abutments were assigned to four groups depending on the length of the internal connection (abutments with internal lengths of 1, 2, 3, and 4 mm, respectively). Each implant fixture specimen was embedded in resin medium and connected to an abutment with an abutment screw. A load of 100 N, applied at an angle of 30° to the long axis of the implant, was repeated for 1.0 × 10⁶ cycles. Reverse torque values (RTV) were recorded before and after loading, and the change in RTV was calculated. Data were analyzed with the Kruskal-Wallis test. RESULTS: The change in RTV was not significantly different among the groups (P>.05). Screw loosening and fractures were not observed in any groups, and joint stability was maintained. CONCLUSION: The internal length of the abutment may not significantly affect the degree of screw loosening.

Comparison of shearbond strength between metal and indirect resin according to the different conditionings / 대한치과보철학회지

PURPOSE: The purpose of this study is to investigate the differences in bond strength of four different indirect composites to the gold alloy and Ni-Cr alloy according to type of metal surface treatment after water storage. MATERIALS AND METHODS: Type IV gold alloy and Ni-Cr alloy were used for casting alloy while four types of indirect composite resins (Gradia, Tescera Sinfony and in;joy) were used in this study. Metal specimens were produced by casting and total of 240 specimens (60 specimens per one indirect composite group) were prepared. After bonding indirect composite resin and undergoing 24 hours of polymerization, customized jig was attached to the metal specimen and shear bond strength were measured using universal testing machine. Also, differences in shear bond strength before and after water storage for 240 hours were also measured. RESULTS: In the measurement of shear bond strength according to the metal surface treatments, bead group showed high strength followed by loop and flatting group (P<.05). After being stored in water bath for 240 hours, Gradia showed statistically significant high bond strength compared to other indirect composite resins in all groups (P<.05). CONCLUSION: Shearbond strength was found to be different according to type of metal surface treatment and type of metal used after storage in water. Further studies need to be developed for clinical practices as three are still problems of microleakage, stain or wear.

Fabrication of immediate complete denture using Campagna tray technique / 대한치과보철학회지

An immediate complete denture is considered as restoration for lost natural teeth, which is fabricated following the extraction of the remaining teeth. Current esthetics and function can be retained by using immediate denture without edentulous period. However, the major disadvantages of immediate denture relate to the difficulties associated with taking accurate definitive impression and predicting the results of immediate denture. In this case report, the Campagna tray technique was used to take the final impression in a 49-year-old male patient presented with all remaining teeth diagnosed as hopeless teeth. Surgical templates were used for alveoloplasty after extraction. The immediate complete dentures were then delivered. The clinical assessments of immediate dentures showed good esthetic and functional outcomes. The patient showed high level of satisfaction.

Morphometric analysis of maxillary alveolar regions for immediate implantation

PURPOSE: The purpose of this study was to provide an actual guideline in determining the shape, diameter, and position of the implant in immediate implantation by the measurement of the thickness of facial and palatal plate, the thickness of cortical bone on the facial and palatal plate, the diameter of the root, and the distance between the roots in the cadavers. MATERIALS AND METHODS: The horizontal sections of 20 maxillae were measured and analyzed to obtain the average values. Resin blocks were produced and cut serially at 1 mm intervals from the cervical line to the root apex. Images of each section were obtained and the following measurements were performed: The thickness of the facial and palatal residual bone at each root surface, the thickness of the facial and palatal cortical bone at the interdental region, the diameter of all roots of each section on the faciopalatal and mesiodistal diameter, and the interroot distance. Three specimens with measurements close to the average values were chosen and 3-dimensional images were reconstructed. RESULTS: The thickness of the facial and palatal cortical bone at the interdental region in the maxilla, the buccal cortical bone was thicker in the posterior region compared to the anterior region. The interroot distance of the alveolar bone thickness between the roots increased from anterior to posterior region and from coronal to apical in the maxilla. CONCLUSION: In this study, the limited results of the morphometric analysis of the alveolar ridge using the sections of maxilla in the cadavers may offer the useful information when planning and selecting optimal implant for immediate implantation in the maxilla.

The effect of alendronates administration duration on the healing of extraction socket in rats: pilot study / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the effect of different administration duration of alendronate on initial wound healing and new bone formation of extraction socket in rats. MATERIALS AND METHODS: Fifteen male Sprague-Dawley rats (body weight 130-140 g, 4 weeks old, male) were divided into control group (no alendronate administration) and experimental group (alendronate administration). Experimental group was subdivided into 1 week administrated group, 2 week administrated group, 4 week administrated group and 6 week administrated group according to duration of administration. For the experimental groups, during the designated time period (at the time of extraction, 1 week before extraction, 3 week before extraction and 5 week before extraction) till 1 week after extraction, rats were subcutaneously injected with Alendronate at the dose of 1.0 mg/Kg three times a week. Each specimen from 6 week experimental group and control group were used for microarray analysis, and other specimens were used for histological analysis. The rate of new bone formation within the extraction site and bone loss activity was analyzed using TRAP staining. Statistical analysis was performed using Kruskal Wallis test. (alpha=.05) RESULTS: After one week from the time of extraction, the rate of new bone formation within extraction site for the control group (16.77% +/- 1.36%) compared to the 4 week experimental group (14.99% +/- 6.26%) was lower. However, no statistically significant difference was found. Increase in the number of inactive lacuna (empty lacuna) and decrease in the number of TRAP positive cell were identified with increased duration of administration. There was no significant difference. CONCLUSION: The results of this study showed as the duration of Alendronate administration increased the rate of new bone formation decreased with loss of bone activity and reduced number of osteoclast.

Reinforcing the retention of provisional restoration using provisional implant on maxillary anterior region: clinical case report / 대한치과보철학회지

Proper management of provisional prosthesis is key to success in prosthodontics. Provisional restoration on maxillary anterior missing area frequently come across a incident of falling off especially in patients with long span pontics and oval arch shape. This is because maxillary anterior teeth are more exposed to horizontal force than the posterior teeth and additional anterior cantilever effect will negatively affect to the retention of provisional prosthesis. Beside that maxillary anterior provisional prosthesis should provide proper incisal guidance during the mandibular functional movements. However occlusal contacts on the prosthesis in maximum intercuspal position are located on opposite side of fulcrum line of prosthesis which will cause removing force against the provisional prosthesis. This case report present that provisional implant prevent pre-described harmful effect on maxillary anterior fixed provisional prosthesis and provide comfort and satisfactory result during post-extraction healing period.

Effect of alendronate on bone remodeling around implant in the rat

PURPOSE: The purpose of this study was to evaluate the effect of alendronates on bone remodeling around titanium implant in the maxilla of rats. MATERIALS AND METHODS: The maxillary first molars were extracted and customized-titanium implants were placed immediately in thirty male Sprague-Dawley rats. The rats were divided into experimental (bisphosphonate) group and control group. At 4 weeks after implantation, the rats in the bisphosphonate group were subcutaneously injected with alendronate three times a week for 6 weeks where as the rats in control group were injected with saline. The rats were sacrificed at 1, 2, 3, 4, or 6 weeks after starting of injection and maxillary bones were collected subsequently. Alveolar bone remodeling around the implants were evaluated by radiographic and histologic analysis. Microarray analysis and immunohistomorphologic analysis were also performed on one rat, sacrificed at 6 weeks after starting of injection, from each group. Statistical analysis was performed using repeated measures analysis of variance and independent t test at a significance level of 5%. RESULTS: There was no statistically significant difference in the bone area (%) around implant between the bisphosphonate group and the control group. However, the amount of empty lacuna was significantly increased in the bisphosphonate group, especially in the rats sacrificed at 4 weeks after starting of injection compared to that of the corresponding control group. The bisphosphonate group showed the same level of TRAP positive cell count, osteocalcin and angiopoietin 1 as the control group. CONCLUSION: Alendronate may not decrease the amount of osteoclast. However, the significantly increased amount of empty lacuna in the bisphosphonate group may explain the suppression of bone remodeling in the bisphosphonate group.

Development of implant loading device for animal study about various loading protocol: a pilot study

PURPOSE: The aims of this pilot study were to introduce implant loading devices designed for animal study and to evaluate the validity of the load transmission ability of the loading devices. MATERIALS AND METHODS: Implant loading devices were specially designed and fabricated with two implant abutments and cast metal bars, and orthodontic expansion screw. In six Beagles, all premolars were extracted and two implants were placed in each side of the mandibles. The loading device was inserted two weeks after the implant placement. According to the loading protocol, the load was applied to the implants with different time and method,simulating early, progressive, and delayed loading. The implants were clinically evaluated and the loading devices were removed and replaced to the master cast, followed by stress-strain analysis. Descriptive statistics of remained strain (microepsilon) was evaluated after repeating three cycles of the loading device activation. Statistic analysis was performed using nonparametric, independent t-test with 5% significance level and Friedman's test was also used for verification. RESULTS: The loading devices were in good action. However, four implants in three Beagles showed loss of osseointegration. In stress-strain analysis, loading devices showed similar amount of increase in the remained strain after applying 1-unit load for three times. CONCLUSION: Specialized design of the implant loading device was introduced. The loading device applied similar amount of loads near the implant after each 1-unit loading. However, the direction of the loads was not parallel to the long axis of the implants as predicted before the study.

Evaluation of changes in adhesive strength and cytotoxicity of a denture adhesive according to time / 대한치과보철학회지

STATEMENTS OF THE PROBLEM: Many denture wearers occasionally use denture adhesives to improve denture retention, stability and chewing efficiency. An ideal denture adhesive is nontoxic, non-irritating, and provides comfort to the oral mucosa. PURPOSE: The purpose of this study was to evaluate the cytotoxicity and adhesive properties of a selected denture adhesive. MATERIAL AND METHODS: To test cytotoxicity of the selected denture adhesive, mouse fibroblast cells were used in MTT testing. Cytotoxicity was examined according to the concentration of the denture adhesive and incubated for 1 to 4 days. To examine adhesive property, a denture base was fabricated on an edentulous dentiform. The adhesive was applied to the denture base, then tensile bond strength was measured, to evaluate the change in retention during 3 days. RESULTS AND CONCLUSION: 1. 1% and 2% concentration denture adhesive cream had no cytotoxicity. 2. The tensile bond strength of the group with both denture adhesive and artificial saliva was significantly higher than that of the group with only denture adhesive (P < .05). The tensile bond strength of the group with denture adhesive was significantly higher than that of with only artificial saliva (P < .05). 3. The tensile bond strength had no significant change during 1 hour, and then gradually decreased. After 1 day, it decrease to half. Within the limitation of this study, the tested denture adhesive had no cytotoxicilty and was effective in improving denture retention. The adhesive strength began to continuously decrease after 1 hour and it decreased to half at 1 day after application.

Multilateral analysis of Renova(R) implant placement and its Survival rate / 대한치주과학회지

PURPOSE: Given the predictability of dental implant procedure from the studies of successful osseointegration, implant dentistry is often the treatment of choice to replace missing teeth in edentulous patient instead of the fixed prosthesis or removable denture. The Renova(R) dental implant has a RBM(Resorbable Blast Media) surface, internal hex prosthetic connection and a tapered design. At this study gives the analysis of the implant and the short term survival rate of the implant. MATERIAL AND METHODS: In this study, a multilateral analysis was performed on the subjects undergoing placement with Renova(R) implant between August 2006 and February 2008 in Yonsei University dental hospital. 96 implants were placed in 56 patients and they were surveyed for cumulative survival rate. Among them 78 implants in 44 patients were surveyed for the rest analyses. RESULT: 1. The cumulative survival rate was 96.88% of 96 implants in 56 patients. 2. The mean marginal bone loss was 0.803mm and the marginal bone loss in augmentation group has higher value than the marginal bone loss in non augmentation group. 3. The health scale for the implants were 87% in success group, 9% in satisfactory survival group, 1% in compromised survival group, and 3% in failure group. 4. Two implants placed in poor bone posterior area by 2-stage failed during prosthetic procedure. CONCLUSION: Renova(R) dental implant showed high cumulative survival rate in installation on partial edentulous ridge and could be a predictable implant system.

New maxillary anterior ridge classification according to ideal implant restorative position determined by CAT / 대한치주과학회지

No abstract available.

Shear bond strength of heat-cured denture base resin to surface treated Co-Cr alloy with different methods / 대한치과보철학회지

STATEMENT OF PROBLEM: For the long-term success of removable partial dentures, the bonding between metal framework and denture base resin is one of the important factors. To improve bonding between those, macro-mechanical retentive form that is included metal framework design has been generally used. However it has been known that sealing at the interface between metal framework and denture base resin is very weak, because this method uses mechanical bonding. PURPOSE: Many studies has been made to find a simple method which induces chemical bond, now various bonding system is applied to clinic. In this experiment, shear bond strengths of heat-cured denture base resin to the surface-treated Co-Cr alloy were measured before and after thermocycling. Chemically treated groups with Alloy Primer(TM), Super-Bond C&B(TM), and tribochemically treated group with Rocatec(TM) system were compared to the beadtreated control group. The data were analyzed with two-way ANOVA. RESULT: 1. Shear bond strength of bead-treated group is highest, and Alloy Primer(TM) treated group, Super-Bond C&B(TM) treated group, Rocatec(TM) system treated group were followed. Statistically significant differences were found in each treated group(p0.05). 3. Shear bond strengths of bead-treated group and Alloy Primer(TM) treated group showed no statistically significant difference before and after thermocycling(p>0.05), and those of Super-Bond CBTM treated group and RocatecTM system treated group showed statistically significant difference after thermocycling(p<0.05).

Tensile bond strength between elastomeric impression materials and tray resins depending on the thickness of the tray adhesive / 대한치과보철학회지

STATEMENT OF PROBLEM: Elastomeric impression materials have been widely used to obtain an accurate impression. However there have not been enough studies on the influence of the thickness of the tray adhesives on the bonding strength between the trays and the elastomeric impression materials. PURPOSE: In order to understand the relationship between the thickness of the tray adhesive and the tensile bond strength and to suggest the thickness at which the bonding strength is strongest, tensile bond strength related to the thickness of adhesives of 3 different elastomeric impression materials were tested. MATERIALS AND METHODS: 3 impression materials, Permlastic(R) Regular Set(Kerr Corp., Romulus, Michigan, U.S.A.), Impregum(TM) Penta(TM)(3M ESPE, Seefeld, Germany), and Aquasil Ultra Monophase Regular Set Smart Wetting(R) (Dentsply Caulk, Milford, Delaware, U.S.A.), were used in this study, and tray adhesives from the same manufacturers of the impression materials were used, which were Rubber Base Adhesive, Polyether Adhesive, and Silfix, respectively. The tray specimens were prepared by autopolymerizing the tray material(Instant Tray Mix, Lang, Wheeling, Illinois, U.S.A.), and a PVC pipe was used to house the impression material. In group A, tray adhesives were applied in multiple thin layers of 1 to 5 and in group B, adhesives were applied only once, in the thickness equivalent to several applications. Lightness(L*) of the adhesion surface was measured with a spectrophotometer (CM-3500d, Konica Minolta, Sakai, Osaka, Japan). The tensile bond strength of the elastomeric impression material and the tray resin was measured with universal materials testing machines(Instron, Model 3366, Instron Corp, Nowood, Massachusetts, U.S.A.). A formula between the number of adhesive application layers and the lightness of the adhesion surface was deduced in group A, and the number of adhesive layers in group B was estimated by applying the lightness(L*) to the deduced formula. RESULTS: 1. In group A, a statistically significant increase in tensile bond strength appeared when the number of application layers increased from 1 to 2 and from 4 to 5, and no significant difference was present between 2, 3, and 4 layers in Permlastic. In Impregum, the tensile bond strength was significantly increased when the number of adhesive layers increased from 1 to 3, but no significant difference after 3 layers. In Aquasil, the tensile bond strength significantly increased as the number of application layers increased up to 4 but showed no significant difference between 4 and 5. 2. In group B, the tensile bond strength was decreased when the thickness of the adhesive increased in Permlastic. Impregum showed an increased tensile bond strength when the thickness of the adhesive was increased. In Aquasil, the tensile bond strength increased as the number of adhesive application layers increased up to approximately 2.5 layers but it sharply decreased after approximately 4.5. CONCLUSION: From the study, the common idea that it is better to apply a thin and single coat of tray adhesive needs correction in more detailed ways, and instructions on some of the tray adhesives should be reconsidered since there were several cases in which the tensile bond strength increased according to the increase in the thickness of the adhesives.

A study on the visco-elastic properties of four currently used tissue conditioners / 대한치과보철학회지

The dimensional stability of tissue conditioners characterizes the ability of the materials to yield accurate functional impressions of oral mucosa. This study evaluated the viscoelastic property and the linear dimensional changes with the factor of time and thickness of tissue conditioners (COE-COMFORT(TM), Visco-gel, COE-SOFT(TM), Soft-Liner) The thickness of these materials were changed (1.5mm, 3.0mm) and the percentage changes in dimension were measured at 1h, 12h, 24h, 36h, 3day, 7day after specimen preparation. From the results large differences appear between the various tissue conditioners. The results suggest that the period recommended for forming functional impression would be 2-3days after insertion in the mouth. in addition, it is important to select tissue conditioners suitable for functional impression because of the wide range of dimensional stability among the materials.