Fabrication of closed hollow obturator for hard palate defect patient undergone maxillectomy / 대한치과보철학회지

Maxillectomy is performed to remove the tumor in the palate, maxillary sinus, buccal mucosa or nasal cavity. The resection range depends on the size and the extent of the tumor and it affects speech production or cause nasal regurgitation during feeding. Obturator can occlude an opening such as an oro-nasal fistula and protect the defect area. Successful reconstrucion of the patient's oral cavity who have gone over the maxillectomy is a difficult task. The condition and number of teeth, the remaining support area, and the extent of the defect area have a great influence on manufacturing the obturator. If these factors are disadvantageous, the prognosis of the prosthesis is uncertain. The final obturator must have a sufficient retention in the patient's oral cavity and must not irritate the surrounding tissue and support area where the resection was performed.In this case, a 55 year old female went through the maxillectomy and the only 3 teeth remained. And the retention of the maxillary prosthesis seems to be poor. So that, we fabricated the closed hollow obturator which has reduced weight compared to the conventional obturator. Consequently the closed hollow obturator can give better sealing and the adaptation.

Comparison of different impression techniques for edentulous jaws using three-dimensional analysis

PURPOSE: The purpose of this study was to compare two novel impression methods and a conventional impression method for edentulous jaws using 3-dimensional (3D) analysis software. MATERIALS AND METHODS: Five edentulous patients (four men and one woman; mean age: 62.7 years) were included. Three impression techniques were used: conventional impression method (CI; control), simple modified closed-mouth impression method with a novel tray (SI), and digital impression method using an intraoral scanner (DI). Subsequently, a gypsum model was made, scanned, and superimposed using 3D analysis software. Mean area displacement was measured using CI method to evaluate differences in the impression surfaces as compared to those values obtained using SI and DI methods. The values were confirmed at two to five areas to determine the differences. CI and SI were compared at all areas, while CI and DI were compared at the supporting areas. Kruskal-Wallis test was performed for all data. Statistical significance was considered at P value .05); the difference was .05). CONCLUSION: The CI, SI, and DI methods were effective in making impressions of the supporting areas in edentulous patients. The SI method showed clinically applicability.

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption using mandibular suction denture with closed mouth technique: a clinical report

When it comes to treat patient with loss of vestibule, conventional denture impression have limitation which can cause problems of excessive border extension. Suction denture with closed mouth technique which was introduced to solve this problem, forms negative pressure being sealed denture flanges by mobile mucosa when the patient swallows and chews. Also, it can decrease patient's visiting time by taking impression and gothic arch tracing at once. In this case, considering patient's chief complain which is a loose fit of present lower denture, suction dentures with closed mouth technique was planned.

Full mouth rehabilitation of the patient with severe tooth loss and tooth wear with vertical dimension gaining: A case report / 대한치과보철학회지

Multiple tooth loss and excessive occlusal wear can result in damage to occlusal disharmony, functional disorders and esthetic problems, requiring comprehensive prosthetic treatments. Changing vertical dimension harmonized with surrounding muscle tissue is important. In this case, the patient with loss of vertical dimension caused by severe tooth loss and tooth wear was treated with the analysis of vertical dimension, such as diagnostic model, radiography and various clinical exams. the patient was satisfied with favorable functions and esthetics for 1 years of follow-up.

Single implant restoration with esthetic prosthodontic treatment in maxillary anterior tooth: A case report / 대한치과보철학회지

In a single implant restoration of maxillary anterior teeth, it is difficult to accomplish an aesthetic restoration of the implant prosthesis in the case of gingival recession and bone defect problems. To maintain aesthetic stability in the long term, it is important to place the implant in the ideal position as well as the recovery of the soft tissue and harmony with the prosthesis. Not only ideal implant position but also the harmony with surrounding soft tissues are important to fabricate aesthetic implant prosthesis for these cases. for these cases, a 47- years -old male with lowered level of osseous crest and gingival recession on maxillary anterior tooth was treated with guided bone regeneration and gingival recontouring.

Clinical application of mandibular removable partial denture using implant-supported surveyed crown: A case report / 대한치과보철학회지

When making conventional removable partial denture for the remaining teeth where the remaining teeth are only on one side, rotation of the denture occurs -in function- on the axis of the connected remaining teeth. If the edentulous portion is long, it becomes harder to obtain retention and stability for the abutment as the importance of the mucous membrane support is elevated. Such movements of denture decrease denture retention and stability, put excessive stress on the abutment, and give bad influence on periodontal health. Therefore, additional implant placement can be of a good choice in gaining additional retention and stability for partial denture. Thus hereby we report this clinical case as successful results were obtained by placing implants symmetrical to the remaining teeth and putting implant-supported surveyed crowns on the implants, allowing the partial denture to be designed to accept varying components and to have suitable path of insertion.

Aesthetic restoration n patients with unaesthetic maxillary anterior teeth using double scan : A case report / 대한치과보철학회지

In case of the treatment of maxillary anterior teeth, it should be taken into account the proper morphology, arrangement and color satisfying patient's esthetic demands. For this purpose, facial composition, dentofacial composition, dental composition and dentogingival composition should be considered making diagnosis and treatment plan in an esthetic point of view. In adjustable temporary crown state, careful evaluation and correction of the esthetic and functional aspect were performed, and the definite restoration was reproduced using double scan.

Effect of ferrule on the fracture resistance of mandibular premolars with prefabricated posts and cores

PURPOSE: This study evaluated fracture resistance with regard to ferrule lengths and post reinforcement on endodontically treated mandibular premolars incorporating a prefabricated post and resin core. MATERIALS AND METHODS: One hundred extracted mandibular premolars were randomly divided into 5 groups (n=20): intact teeth (NR); endodontically treated teeth (ETT) without post (NP); ETT restored with a prefabricated post with ferrule lengths of either 0 mm (F0), 1 mm (F1), or 2 mm (F2). Prepared teeth were restored with metal crowns. A thermal cycling test was performed for 1,000 cycles. Loading was applied at an angle of 135 degrees to the axis of the tooth using a universal testing machine with a crosshead speed of 2.54 mm/min. Fracture loads were analyzed by one-way ANOVA and Tukey HSD test using a statistical program (α=.05). RESULTS: There were statistical differences in fracture loads among groups (P<.001). The fracture load of F2 (237.7 ± 83.4) was significantly higher than those of NP (155.6 ± 74.3 N), F0 (98.8 ± 43.3 N), and F1 (152.8 ± 78.5 N) (P=.011, P<.001, and P=.008, respectively). CONCLUSION: Fracture resistance of ETT depends on the length of the ferrule, as shown by the significantly increased fracture resistance in the 2 mm ferrule group (F2) compared to the groups with shorter ferrule lengths (F0, F1) and without post (NP).

Analysis of the width ratio and wear rate of maxillary anterior teeth in the Korean population

PURPOSE: The purpose of this study was to compare the width ratio of maxillary anterior teeth according to age in the Korean population and to evaluate the maxillary central incisor width-to-length (W/L) ratio, given differences in age and gender. MATERIALS AND METHODS: Ninety-three Korean adults were divided into 3 groups (n = 31) by age. Group I was 20 - 39 years old, Group II was 40 - 59 years old, and Group III was over 60 years of age. After taking an impression and a cast model of the maxillary arch, the anterior teeth width ratio and central incisor W/L ratio were calculated from standard digital images of the cast models using a graph paper with a digital single lens reflex (DSLR) camera. The calculated ratios were compared among all groups and central incisor W/L ratio were analyzed according to age and gender. All comparative data were statistically analyzed with one-sample t-tests, one-way ANOVAs with Tukey tests, and independent t-tests. RESULTS: No significant differences in maxillary anterior teeth ratios were found among the age groups. The maxillary central incisor W/L ratios in Group III were the greatest and were significantly higher than those in the other groups. The central incisor W/L ratio of men was higher than that of women in Group II. CONCLUSION: Maxillary anterior teeth width ratios were similar in all age groups in the Korean population. The maxillary central incisor was observed as worn teeth in the group over 60 years of age, and a significant difference between genders was found in 40 to 50 year olds.

Full mouth rehabilitation of the intellectually disabled patient with collapsed bite using partial removable dental prosthesis: a case report

Intellectual disability is an imperfect disorder in which mental development is permanently retarded and development of intellectual ability is inadequate. Having intellectual disabilities makes it difficult to handle their own work and adapt to social life. For this reason, it is difficult to hygienically manage the patient's oral condition, multiple caries are easily observed, and the periodontal disease incidence rate is high. The patient in this case is a 33-year-old female with a mental retardation first grade who had a problem with meals. In first visit, Patients had decreased occlusal vertical dimension and posterior bite collapse due to periodontitis and multiple caries. This case reports a satisfactory functional and esthetic results by reconstructing occlusion using partial removable dental prosthesis.

Maxillofacial rehabilitation of adenoid cystic carcinoma patient using full mouth fixed implant and pharyngeal obturator: a clinical report

Rehabilitation of maxillectomy patients is challenging. The maxillary defects need to functional restoration because of mastication, speech, swallowing problems. The goal of making obturator is to restore maxillary defects and give patients comfortable, esthetic prosthesis. This case report presents acquired masticatory and esthetic results and improved retention resulting from the pharyngeal obturator prosthesis using implant.

Overdenture with magnetic attachments for a patient with Parkinson's disease: a case report

It is very hard for edentulous patients to satisfy retention and stability with their complete denture. Especially, for patients with systemic diseases such as Parkinson's disease causing involuntary and limited movements, fabricating complete dentures may be challenging to both dentists and patients due to functional limitations. To overcome this problem, overdentures can be used through conserving retained roots. In this case, a 45-year-old male patient had to extract numerous teeth due to dental caries, and at the time of visit he was taking drugs for diabetes and Parkinson's disease for a period of long time. A complete denture was applied to maxilla, and for mandible, an overdenture on two preserved retained roots was applied where its retention and stability were obtained by magnetic attachments. This case reports that overdenture with retained roots improved overall functional limitations.

Overdenture treatment in patient with severely worn dentition: a case report

Overdenture is one of the methods of patients with severely worn dentition. Remaining natural teeth help preserve alveolar bone and proprioception and provide rigid support. Also, overdenture distributes the concentrated stress applied to the abutment tooth and denture supporting tissues. There is an advantage that it can provide long-term stability to denture. In this case, the patient with only a few teeth due to severe wear and caries was satisfied with good function and favorable esthetics by using overdenture.

Rehabilitation using twin-stage method for a Sjögren's syndrome patient with severe discoloration and attrition on upper and lower anterior teeth / 대한치과보철학회지

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.

Rehabilitation using twin-stage method for a Sjögren's syndrome patient with severe discoloration and attrition on upper and lower anterior teeth / 대한치과보철학회지

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.

Full mouth rehabilitation with a few remaining teeth and implants for a patient with chronic periodontitis: a case report

Chronic periodontitis involves subsequent loss of teeth, and if left untreated, can lead to adjacent teeth drifting and supraeruption of the rest dentition. Careful consideration has to be given when deciding extraction of remaining teeth in treatment of periodontally compromised dentitions. For tooth-supported fixed partial dentures or removable partial dentures, periodontally compromised teeth are extracted due to possible early failure from functional overload, but for implant restoration, the teeth could be used as supports for fixed partial dentures because implants can reduce overload on teeth. The remaining natural teeth can help clinicians restoring vertical dimension and normal occlusal plane in full mouth rehabilitation because it conserves patients' proprioceptive response. This clinical report describes treatment of a patient who has a few remaining teeth and supraeruption of the rest dentition from severe chronic periodontitis. Satisfactory clinical result was achieved with full mouth rehabilitation using a few teeth and implants.

Overdentures of the patient with Parkinson's disease: A case report / 대한치과보철학회지

The retention of complete dentures in patients with Parkinson's disease is often poor due to their constant dislodgement by involuntary movements of the tongue and lips. Furthermore, insertion of the overdenture is expected to be difficult due to their limited voluntary movements. This case is about the bimaxillary overdenture restoration where its retention and stability are improved, using magnetic attachment of remained roots of maxilla and two implant Locator(R) attachments of mandible in patients with Parkinson's disease. This report describes the fabrication of this functionally improved prosthesis.

Fabrication of complete dentures using treatment dentures for a patient with erratic mandibular movements: A case report / 대한치과보철학회지

Long-term use of ill-fitting dentures may cause irregular movements of the mandible. In such cases, satisfactory outcomes both in terms of function and esthetics could be achieved by accurate registration of mandibular movement and centric relation when fabricating new dentures. In this case, treatment dentures with flat occlusal tables were used to register centric relation and mandibular movements of a patient with erratic mandibular movements

Influence of preparation depths on the fracture load of customized zirconia abutments with titanium insert

PURPOSE: This study evaluated the fracture load of customized zirconia abutments with titanium insert according to preparation depths, with or without 5-year artificial aging. MATERIALS AND METHODS: Thirty-six identical lithium disilicate crowns (IPS e.max press) were fabricated to replace a maxillary right central incisor and cemented to the customized zirconia abutment with titanium insert on a 4.5x10 mm titanium fixture. Abutments were fabricated with 3 preparation depths (0.5 mm, 0.7 mm, and 0.9 mm). Half of the samples were then processed using thermocycling (temperature: 5-55degrees C, dwelling time: 120s) and chewing simulation (1,200,000 cycles, 49 N load). All specimens were classified into 6 groups depending on the preparation depth and artificial aging (non-artificial aging groups: N5, N7, N9; artificial aging groups: A5, A7, A9). Static load was applied at 135 degrees to the implant axis in a universal testing machine. Statistical analyses of the results were performed using 1-way ANOVA, 2-way ANOVA, independent t-test and multiple linear regression. RESULTS: The fracture loads were 539.28 +/- 63.11 N (N5), 406.56 +/- 28.94 N (N7), 366.66 +/- 30.19 N (N9), 392.61 +/- 50.57 N (A5), 317.94 +/- 30.05 N (A7), and 292.74 +/- 37.15 N (A9). The fracture load of group N5 was significantly higher than those of group N7 and N9 (P<.017). Consequently, the fracture load of group A5 was also significantly higher than those of group A7 and A9 (P<.05). After artificial aging, the fracture load was significantly decreased in all groups with various preparation depths (P<.05). CONCLUSION: The fracture load of a single anterior implant restored with lithium disilicate crown on zirconia abutment with titanium insert differed depending on the preparation depths. After 5-year artificial aging, the fracture loads of all preparation groups decreased significantly.

Full mouth rehabilitation with maxillary implant overdenture using prefabricated bar attachment system: a case report / 대한치과보철학회지

In conventional bar- and clip-retained overdentures, all errors during impression making and cast fabrication result in non-passive fit of bars. SFI bar is prefabricated and assembled in the patient's mouth without the use of soldering, laser welding or conventional bonding techniques, thus reducing stress transmission to, bone loss around the implants and leading to fewer errors and lower costs. A clinical case will be presented below to demonstrate the use of the SFI Bar (Stress Free on Implant Bar) to restore an severe atrophy edentulous maxilla. In this case, no lateral stress could be applied to the implants due to the telescopic design of the bar joints. However, periodic recall check is necessary and long-term clinical results are required.