Full mouth rehabilitation of mandibular edentulous patient using implant hybrid prosthesis / 대한치과보철학회지

Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported-overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

Effect of universal primer on shear bond strength between resin cement and restorative materials / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the difference in shear bonding strength between resin cements to dental materials when a universal primer (Monobond plus) was applied in place of a conventional primer. MATERIALS AND METHODS: Four groups of testing materials: gold alloy (Argedent Euro, n = 16), non precious metal (T-4, n = 20), zirconia (Cercon, n = 20) and glass ceramic (IPS e.max press, n = 20), were fabricated into discs, which were embedded in an acrylic resin matrix. The gold alloy specimens were airborne-particle abraded, 8 of the specimens were coated with Metal primer II, while the remaining 8 specimens were coated with Monobond plus. The non precious and zirconia specimen were airborne-particle abraded then, the control group received Alloy primer coating, while the other was coated with Monobond plus. Glass ceramic specimens were etched. 10 specimens were coated with Monobond-S and the remaining specimens were coated using Monobond plus. On top of the surface, Multilink N was polymerized in a disc shape. All of the specimens were thermal cycled before the shear bonding strength was measured. Statistical analysis was done with Two sample t-test or Mann-Whitney U test (alpha=.05). RESULTS: There were no significant differences in bonding strength depending on the type of primer used in the gold alloy and glass ceramic groups (P>.05), however, the bonding strengths of resin cements to non precious metal and zirconia groups, were significantly higher when the alloy primer was used (P<.05). CONCLUSION: Within the limitations of this study, improvement of universal primers which can be applied to all types of restorations is recommended to precious metals and zirconia ceramics. But, the bond strengths of non precious metals and zirconia ceramics were significantly lower when compared to a 10-MDP primer. More research is needed to apply universal primers to all types of restorations.

Oral rehabilitation of a young adult with amelogenesis imperfect using metal-ceramic restoration: a clinical report / 대한치과보철학회지

Some patients with generalized attrition and teeth discoloration may want their anterior teeth to be treated just for esthetic improvement. Ameologenesis imperfecta, however, should be considered for such patients prior to any treatment with thorough clinical and radiographic examination. If a patient is diagnosed with amelogenesis imperfecta, the treatment on anterior teeth just for esthetic purpose is not advisable. In this case, a young man with amelogenesis imperfecta was treated with metal-ceramic restorations. The patient had generalized attrition, teeth discoloration, crown fracture, and cross-bite on the left teeth. The ultimate objective of this treatment was to enhance esthetics and masticatory function. The cross-bite on the left anterior teeth was treated with restorations, whereas the reverse horizontal overlap was maintained on the posterior. The patient was satisfied with the result esthetically and functionally, and the third month recall examination revealed no pathologic changes associated with the treatment.

Maxillary anterior all ceramic restoration using digital impression and CAD/CAM / 대한치과보철학회지

The digital impression technique has been developed for more precise restorations and convenient procedures in prosthodontic treatment compared to the conventional impression technique. Along with the utilization of CAD/CAM, the introduction of digital impression technique actualizes the digitalization of dental treatments. This case is to compare two different prostheses introducing each procedure in detail; one from CAD/CAM after taking digital impression and the other from the conventional technique. A 22-year-old female visited the clinic with the chief complaint of correction of discoloration and shape on maxillary right central incisor. Due to the trauma 8 years ago, the tooth was endodontically treated with post and resin core. The treatment was planned and the procedures were conducted under the patient's consent to treat the tooth with all ceramic crowns in two different ways for comparison. In conclusion, both prostheses presented clinically acceptable results with comparing the internal fitness of two all ceramic crowns. The prosthesis from digital impression, however, showed more errors in respect of internal fitness.

Marginal fidelity of zirconia core using MAD/MAM system / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the fit of zirconia core using MAD/MAM system comparing to that of conventional metal-ceramic and CAD/CAM system. MATERIALS AND METHODS: Duplicating the prepared resin tooth, 50 improved stone dies were fabricated. These dies are classified as a group of 5 to create the core. The groups were composed of metal-ceramic, Cercon(R), Ceramill(R), Rainbow(TM), and Zirkonzhan(R). Each core was cemented to stone die, and then, absolute marginal discrepancy was measured with microscope at a magnification of x50. Statistical analysis was done with one-way ANOVA test and Tukey's HSD test. RESULTS: The mean absolute marginal discrepancy for metal-ceramic was 51.97 +/- 23.38 micrometer, for Cercon(R) was 62.16 +/- 25.88 micrometer, for Ceramill(R) was 67.64 +/- 40.38 micrometer, for Rainbow(TM) was 125.07 +/- 42.19 micrometer, and for Zirkonzhan(R) was 105 +/- 44.61 micrometer. CONCLUSION: 1. Fit of margin was identified as in the order of metal-ceramic, Cercon(R), Ceramill(R), Zirkonzhan(R), and Rainbow(TM). 2. Absolute marginal discrepancy of the zirconia core that designed by MAD/MAM system had significant differences in order of Ceramill(R), Zirkonzhan(R), and Rainbow(TM). 3. The mean absolute marginal discrepancy between Cercon(R) and Ceramill(R) did not show significant differences.

Retrospective study of the Implantium(R) implant with a SLA surface and internal connection with microthreads / 대한치과보철학회지

STATEMENT OF PROBLEM: Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. PURPOSE: The aim of this retrospective study was to provide long-term data on the Implantium(R) implant, which features a sandblasted and acid-etched surface and internal connection with microthreads. MATERIAL AND METHODS: 106 Implantium(R) implants placed in 38 patients at Yonsei University Hospital were examined to determine the effect of various factors on implant success and marginal bone loss, through clinical and radiographic results during a 6 to 30 month period. RESULTS: 1. Out of a total of 106 implants placed in 38 patients, one fixture was lost, resulting in a 99.1% cumulative survival rate. 2. Among the 96 implants which were observed throughout the study period, the survival rates were 97.0% in the maxilla and 100% in the mandible. The survival rate in the posterior regions was 98.9% and 100% in the anterior regions. 3. The mean bone loss during the first year after prosthesis placement was 0.17 mm, while the mean annual bone loss after the first year was 0.04 mm, which was statistically less than during the first year (P .05), but after the first year, the mean annual bone loss in patients above 50 years was significantly greater (P < .05) compared with patients under 50 years. 5. No significant difference in marginal bone loss was found according to the following factors: gender, jaw, location in the arch, type of implant (submerged or non-submerged), presence of bone grafts, type of prostheses, and type of opposing dentition (P < .05). CONCLUSION: Based on these results, the sole factor influencing marginal bone loss was age, while factors such as gender, jaw, location in the arch, type of implant, presence of bone grafts, type of prostheses and type of opposing dentition had no significant effect on bone loss. In the present study, the success rate of the Implantium(R) implant with a SLA surface and internal connection with microthreads was satisfactory up to a maximum 30 month period, and the marginal bone loss was in accord with the success criteria of dental implants.

Changes of the surface roughness depending on immersion time and powder/liquid ratio of various tissue conditioners / 대한치과보철학회지

STATEMENT OF PROBLEM: Volume stability, microstructure reproducibility and fluidity along with compatibility with dental stone must be in consideration in order to use tissue conditioner as a material for functional impression. There are few studies concerning the influence of time factor in oral condition on surface roughness of the stone and optimal retention period in the oral cavity considering such changes in surface roughness. PURPOSE: The purpose of this study was to find out the influence of various kinds of tissue conditioner, its powder/liquid ratio and immersion time on surface roughness of the stone. MATERIAL AND METHODS: Materials used in this study were the three kinds of tissue conditioners (Coe-Comfort, Visco-Gel, Soft-Liner) and were grouped into three: group R - mixed with standard powder/liquid ratio that was recommended by the manufacturers, group M - mixed with 20% more powder, group L - mixed with 20% less powder. Specimens were made with the size of 20 mm diameter and 2 mm width. Each tissue conditioner specimens were subdivided into 5 groups according to the immersion time (0 hour, 1 day, 3 days, 5 days, 7 days), completely immersed into artificial saliva and were stored under 37degrees C. Specimens of which the given immersion time elapsed were taken out and were poured with improved stone, making the stone specimens. Surface roughness of the stone specimens was measured by a profilometer. RESULTS: Within the limitation of this study, the following results were drawn. 1. Major influencing factor on surface roughness of the stone model made from tissue conditioner was the retention period (contribution ratio (rho) = 62.86%, P < .05) of the tissue conditioner in oral cavity to make functional impression. 2. In case of Coe-Comfort, higher mean surface roughness value of the stone model with statistical significance was observed compared to that of Soft-Liner and Visco-Gel as immersion time changes (P < .05). 3. In case of group L (less), higher mean surface roughness value of the stone model with statistical significance was observed compared to that of R (recommended) and M (more) group as immersion time changes (P < .05). CONCLUSION: We may conclude that as the retention period of time in oral cavity influences surface roughness of the stone model the most and as the kind of tissue conditioner and its P/L ratio may influence also, clinician should well understand the optimal retention period in oral cavity and choose the right tissue conditioner for the functional impression, thus making the functional impression with tissue conditioner usefully.

The influence of collar design on peri-implant marginal bone tissue / 대한치과보철학회지

STATEMENT OF PROBLEM: Peri-implant marginal bone loss is an important factor that affects the success of implants in esthetics and function. Various efforts have been made to reduce this bone loss by improving implant design and surface texture. Previous studies have shown that early marginal bone loss is affected by implant neck designs. PURPOSE: The purpose of this study was to examine the influence of laser microtexturing of implant collar on peri-implant marginal bone loss. MATERIALS AND METHODS: Radiographical marginal bone loss was examined in patients treated with implant-supported fixed partial dentures. Marginal bone level was examined with 101 implant fixtures installed in 53 patients at three periods(at the time of implantation, prosthetic treatment and 6-month after loading). Four types of implants were examined. The differences of bone loss between implants(ITI standard) with enough biologic width and implants(ITI esthetic plus, Silhouette IC, Silhouette IC Laser-Lok(TM)) with insufficient biologic width have been compared. Resorption angles were examined at the time of prosthetic delivery and 6-month after loading. RESULTS AND CONCLUSION: Within the limitation of this study, the following results were drawn. 1. The marginal bone loss of ITI standard and Silhouette IC Laser-Lok(TM) was less than that of ITI esthetic plus and Silhouette IC(P0.05). There was no significant statistical difference between marginal bone loss of ITI esthetic plus and Silhouette IC(P>0.05). 2. There was no significant difference in marginal bone loss between maxilla and mandible(P>0.05). 3. There was no significant difference in resorption angle among four types of implants(P>0.05). The marginal bone of implants with supracrestal collar design of less than that of biologic width had resorbed more than those with sufficient collar length. The roughness and laser microtexturing of implant neck seem to affect these results. If an implant with collar length of biologic width, exposure of fixture is a possible complication especially in the anterior regions of dentition that demand high esthetics. Short smooth neck implant are often recommended in these areas which may lack the distance between microgap and the marginal bone level. In these cases, the preservation of marginal bone must be put into consideration. From the result of this study, it may be concluded that laser microtexturing of implant neck is helpful in the preservation of marginal bone.

A study on the gratification of the patient in the dental hospital / 대한치과보철학회지

STATEMENT OF PROBLEM: Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations'medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. PURPOSE: The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. MATERIAL AND METHOD: This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. RESULT: It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. CONCLUSION: The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients'satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

Oral health status and treatment need of institutionalized elderly patients / 대한치과보철학회지

STATEMENT OF PROBLEMS: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. PURPOSE: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. MATERIAL AND METHODS: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. RESULTS AND CONCLUSION: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (p < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (p < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (p < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (p < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.

Clinical and radiographic evaluation of Neoplant(R) implant with a sandblasted and acid-etched surface and external connection / 대한치과보철학회지

STATEMENT OF PROBLEM: Since the concept of osseointegration in dental implants was introduced by Branemark et al, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. PURPOSE: The aim of this retrospective study was to provide long-term data on the Neoplant(R) implant, which features a sandblasted and acid-etched surface and external connection. MATERIAL AND METHODS: 96 Neoplant(R) implants placed in 25 patients in Yonsei University Hospital were examined to determine the effect of the factors on marginal bone loss, through clinical and radiographic results during 18 to 57 month period. Results: 1. Out of a total of 96 implants placed in 25 patients, two fixtures were lost, resulting in 97.9% of cumulative survival rate. 2. Throughout the study period, the survival rates were 96.8% in the maxilla and 98.5% in the mandible. The survival rates were 97.6% in the posterior regions and 100% in the anterior regions. 3. The mean bone loss for the first year after prosthesis placement and the mean annual bone loss after the first year for men were significantly higher than that of women (P<0.05). 4. The group of partial edentulism with no posterior teeth distal to the implant prosthesis showed significantly more bone loss compared to the group of partial edentulism with presence of posterior teeth distal to the implant prosthesis in terms of mean bone loss for the first year and after the first year (P<0.05). 5. The mean annual bone loss after the first year was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. No significant difference in marginal bone loss was found in the following factors: jaws, type of prostheses, type of opposing dentition, and submerged /non-submerged implants (P<0.05). CONCLUSION: On the basis of these results, the factors influencing marginal bone loss were gender, type of edentulism, and location in the arch, while the factors such as arch, type of prostheses, type of opposing dentition, submerged / non- submerged implants had no significant effect on bone loss. In the present study, the cumulative survival rate of the Neoplant(R) implant with a sandblasted and acid-etched surface was 97.9% up to a maximum 57-month period. Further long-term investigations for this type of implant system and evaluation of other various domestic implant systems are needed in future studies.

The effort of various mixing methods on dynamic viscoelasticity of a temporary soft lining material; coe-comfort / 대한치과보철학회지

STATEMENT OF PROBLEM: Temporary soft relining materials are used in a diverse clinical situations such as tissue conditioner, relining material, functional impression by varying its viscoelasticity. However, reproduction of consistent viscoelasticity has been not possible. MATERIALS AND METHODS: Considering setting mechanism of this material, this study has measured the effect of varying amount of void in dynamic viscoelasticity of soft relining material, with three different mixing methods. In each methods 10 specimens were made and subjected to dynamic viscoelastic test which were measured at specific times over period of 72 hours. RESULTS: The analysis of the result shown that there was no statistically significant differences between different mixing methods. CONCLUSION: Different mixing methods had no effect over control of viscoelasticity of soft lining material. Further research is recommended for under similar oral environmental condition.