ABSTRACT
PURPOSE@#. This in vitro study aimed to compare the accuracy of the conventional facebow system and the newly developed POP (PNUD (Pusan National University Dental School) Occlusal Plane) bow system for occlusal plane transfer in asymmetric ear position. @*MATERIALS AND METHODS@#. Two dentists participated in this study, one was categorized as Experimenter 1 and the other as Experimenter 2 based on their clinical experience with the facebow (1F, 2F) and POP bow (1P, 2P) systems. The vertical height difference between the two ears of the phantom model was set to 3 mm. Experimenter 1 and Experimenter 2performed the facebow and POP bow systems on the phantom model 10 times each, and the transfer accuracy was analyzed. The accuracy was evaluated by measuring the angle between the reference virtual plane (RVP) of the phantom model and the experimental virtual plane (EVP) of the upper mounting plate through digital superimposition. All data were statistically analyzed using a paired t-test (P .05). @*CONCLUSION@#. In cases of asymmetric ear position, the POP bow system may transfer occlusal plane information more accurately than the facebow system in the frontal view, regardless of clinical experience.
ABSTRACT
PURPOSE@#. This study aims to clinically compare the fitness and trueness of zirconia crowns fabricated by different combinations of open CAD-CAM systems. @*MATERIALS AND METHODS@#. Total of 40 patients were enrolled in this study, and 9 different zirconia crowns were prepared per patient. Each crown was made through the cross-application of 3 different design software (EZIS VR, 3Shape Dental System, Exocad) with 3 different processing devices (Aegis HM, Trione Z, Motion 2). The marginal gap, absolute marginal discrepancy, internal gap(axial, line angle, occlusal) by a silicone replica technique were measured to compare the fit of the crown. The scanned inner and outer surfaces of the crowns were compared to CAD data using 3D metrology software to evaluate trueness. @*RESULTS@#. There were significant differences in the marginal gap, absolute marginal discrepancy, axial and line angle internal gap among the groups (P .05). @*CONCLUSION@#. All 9 groups showed clinically acceptable level of marginal gaps ranging from 74.26 to 112.20 μm in terms of fit comparison. In the comparison of trueness, no significant difference within each group was spotted. Within the limitation of this study, open CAD-CAM systems used in this study can be assembled properly to fabricate zirconia crown. [J Adv Prosthodont 2023;15:155-70]
ABSTRACT
PURPOSE@#This prospective clinical study was conducted to evaluate the clinical usefulness of the freely detachable zirconia ball- and spring-retained implant prosthesis (BSRP) through a comparative analysis of screw- and cement-retained implant prosthesis (SCRP). @*MATERIALS AND METHODS@#A multi-center, randomized, prospective clinical study evaluating the clinical usefulness of the detachable zirconia ball- and spring-retained implant prostheses was conducted. Sixty-four implant prostheses in 64 patients were examined. Periodic observational studies were conducted at 0, 3, 6, and 12 months after delivery of the implant prosthesis. Factors such as implant success rate, marginal bone resorption, periodontal pocket depth, plaque and bleeding index, and prosthetic complications were evaluated, respectively. @*RESULTS@#During the 1-year observation period, all implants survived without functional problems and clinical mobility, showing a 100% implant success rate. Marginal bone resorption was significantly higher in the SCRP group than in the BSRP group only at the time of implant prosthesis delivery (P = .043). In all observation periods, periodontal pocket depth was slightly higher in the BSRP group than in the SCRP group, but there was no significant difference (P > .05). The modified plaque index (mPI) scores of both groups were moderate. Higher ratio of a score 2 in modified sulcus bleeding index (mBI) was observed in the BSRP group in the 6- and 12-months observation. @*CONCLUSION@#Within the limitations of this study, the newly developed zirconia ball- and spring-retained implant prosthesis could be considered as an applicable and predictable treatment method along with the existing screw- and cement-retained prosthesis.
ABSTRACT
Pathological wear across the entire dentition causes problems such as collapsed occlusal plane, reduced vertical dimension, anterior premature contact, inadequate anterior guidance, and tooth migration, thereby induce symptoms such as temporomandibular joint disorder, reduced masticatory efficiency, and tooth hypersensitivity. For the treatment of patients with excessive wear, evaluation of vertical dimension should be preceded along with analysis of the cause. The patient in this case was a 45-year-old female with a history of orthognathic surgery. Through clinical examination, radiographic examination, and model analysis, overall tooth wear, interdental spacing in the anterior maxillary region, retruded condylar position, and insufficient interocclusal space for prosthetic restoration were confirmed. Full mouth rehabilitation with increased vertical dimension was planned, the patient’s adaptation to the new vertical dimension was evaluated with a removable occlusal splint and temporary prosthesis, and cross-mounting was performed based on the temporary restoration to fabricate the definitive zirconia prosthesis, maintaining the adjusted vertical dimension. It showed satisfactory functional and esthetic results through stable restoration of the occlusal relationship.
ABSTRACT
In order to manufacture functional and esthetic prostheses, it is essential to accurately transmit information about the patient’s occlusal plane. In particular, in the case of a completely edentulous patient, the occlusal plane is very important to correctly support the soft tissue, to achieve aesthetic harmony with the facial appearance, and to properly pronounce it, and to form a balanced occlusal relationship for stable mastication. In the conventional method, various facebow systems were used to transmit patient’s information from the clinic to the laboratory, but there were several limitations in the process of transferring them to CAD. To simplify this process, a prefabricated POP (PNUD Occlusal Plane) Bow system was recently developed. In this case, a CAD-CAM (Computer-aided design-computer-aided manufacturing) treatment dentures reflecting the patient’s occlusal plane information was manufactured using the POP Bow system during the treatment of a completely edentulous patient, and aesthetic and functional satisfaction was obtained.
ABSTRACT
Implant overdentures are widely used as a treatment method to restore oral function in completely edentulous or partially edentulous patients with severe bone resorption. Using a milled bar, it is mechanically advantageous as the implant fixtures are splinted. Applying additional attachments to the bar has the advantage of dispersing the stress applied to the implant. In this case, a patient who used implant overdentures using 4 implants wanted to fabricate a new prosthesis due to repeated fractures of the denture and weakened retention. Milled bar with ADDTOC attachment and zirconia prosthesis were fabricated by CAD-CAM method and mechanically and aesthetically satisfactory results were obtained.
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Mini-implant has been reported as an alternative method to conventional diameter implants in the treatment of mandibular anterior region with narrow ridge. However, one-piece type mini-implant showed biological and technical complications, such as peri-implantitis by residual cement and prosthetic detachment. Recently, one-piece type mini-implant with additional retentive structure has been introduced to increase the retention and stability of the mini-implant. The mini-implant is based on spreading the upper retentive structure with a spreader and connected it with the inner surface of the zirconia prosthesis. In two cases, we tried to reduce these complications through the mini-implant on the narrow mandibular anterior region, and it was possible to reduce the overall treatment period through a digital system. In this case report, restoration using the digital mini-implant system showed improvement of patient satisfaction on the aspect of function and esthetic in the narrow mandibular anterior region.
ABSTRACT
Among many contributing factors of implant failure, excessive loading and inflammation contribute mainly to increasing implant failure rate. Especially, poor oral hygiene around implants is one of the most common reasons for implant failure. When implant prosthesis fails to function, the clinician should re-diagnose and plan treatment using the remaining implants. Additional implantation may be needed to make a new type of prosthesis or either implant-assisted RPD and implant overdenture treatment may be performed using the remaining implants.In this article, a patient whose fixed implant prosthesis in the maxilla had failed of poor oral hygiene maintenance was reported to be recovered with removable implant overdenture by using remaining implant abutments and a milled bar with additional retentive elements. Through this treatment, the clinical results were satisfactory in terms of esthetics, masticatory function recovery and oral hygiene management.
ABSTRACT
Excessive crown height space increases can cause crestal bone loss and screw loosening after prosthesis is placed. Milled bar and implant overdenture can be used as a treatment method for partially edentulous patients who have severe alveolar bone loss and excessive crown height space. Milled bar can provide primary splinting effect and stability between implants. Also, milled bar with additional retention device such as Advanced Dental Device-Treatment Of Choice (ADD-TOC) and magnet can provide additional retention force for implant overdenture. In this case, the patient has a partially edentulous mandible that has severe alveolar bone loss and multiple number of teeth loss after excision due to leiomyosarcoma. Because of the long-term loss of mandibular molars, the opposing teeth were extruded. Maxillary left molars were corrected to the occlusal plane through molar intrusion, and mandibular left molar region were treated with implant overdenture, using milled bar with ADD-TOC and magnet after implant placement. The clinical result was satisfactory on the aspect of esthetic and masticatory function.
ABSTRACT
One of the treatment options for edentulous state patients with residual ridge resorption is implant overdenture using milled bar and attachment. It not only provides improved retention and stability but can also reduce the coverage of palatal surface. In addition, when a small number of implants are used, milled bar has the effect of being splinted between implant fixtures, which makes it mechanically advantageous under functions such as mastication. The patient in this case was a maxillary edentulous state patient with a considerable amount of residual alveolar bone resorption after removing the existing failed implants. Three implants were planted on both sides and an implant overdenture was fabricated using milled bar and ADD-TOC attachment.
ABSTRACT
The use of implants could improve the support, retention, and stability of removable prosthetic restoration for fully edentulous patients with severe alveolar bone resorption. When the prosthesis is manufactured without accurate diagnosis and evaluation, this may lead to unfavorable treatment result. The patient in this case had the treatment of implant overdentures at a private dental clinic, but visited the hospital for retreatment due to soft tissue pain and decreasing retention of existing dentures. The vertical dimension was raised compared to the existing dentures, and overdentures were manufactured using milled bars and additional attachments. The clinical results were satisfactory in the aspect of improved oral hygiene maintenance, function and esthetics.
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PURPOSE@#The purpose of this study was to investigate changes in retention and wear pattern of Locator® and ADD-TOC attachments on a digital milled bar by performing chewing simulation and repeated insertion/removal of prostheses in fully edentulous models. @*MATERIALS AND METHODS@#Locator (Locator®; Zest Anchors Inc., Escondido, CA, USA) was selected as the control group and ADD-TOC (ADDTOC; PNUAdd Co., Ltd., Busan, Republic of Korea) as the experimental group. A CAD-CAM milled bar was mounted on a master model and 3 threaded holes for connecting a bar attachment was formed using a tap. Locator and ADD-TOC attachments were then attached to the milled bar. Simulated mastication and repeated insertion/removal were performed over 400,000 cyclic loadings and 1,080insertions/removals, respectively. Wear patterns on deformed attachment were investigated by field emission scanning electron microscopy. @*RESULTS@#For the ADD-TOC attachments, chewing simulation and repeated insertion/removal resulted in a mean initial retentive force of 24.43 ± 4.89 N, which were significantly lower than that of the Locator attachment, 34.33 ± 8.25 N (P < .05). Amounts of retention loss relative to baseline for the Locator and ADD-TOC attachments were 21.74 ± 7.07 and 8.98 ± 5.76 N (P < .05). @*CONCLUSION@#CAD-CAM milled bar with the ADD-TOC attachment had a lower initial retentive force than the Locator attachment. However, the ADD-TOC attachment might be suitable for long-term use as it showed less deformation and had a higher retentive force after simulated mastication and insertion/removal repetitions.
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Purpose@#The aim of this study was to evaluate the effects of four surface treatment methods to improve zirconia roughness and three types of resin cement on the shear bond strength (SBS). @*Materials and methods@#A total of 120 zirconia blocks were randomly divided into four surface treatments: non-treatment (Control), airborne-particle abrasion (APA) with 50 μm Al2O3 (APA50), APA with 125 μm Al2O3(APA125), and ZrO2 slurry (ZA). Three resin cements (Panavia F 2.0, Superbond C&B, and Variolink N) were applied to the surface-treated zirconia specimens. All specimens were subjected to SBS testing using a universal testing machine. The surface of the representative specimens of each group was observed by scanning electron microscope (SEM). SBS data were analyzed with oneway ANOVA, two-way ANOVA test and post-hoc Tukey HSD Test (α=.05). @*Results@#In the surface treatment method, APA125, APA50, ZA, and Control showed high shear bond strength in order, but there was no significant difference between APA125 and APA50 (P >.05). Also, ZA showed significantly higher shear bond strength than Control (P <.05). In the resin cement type, Panavia F 2.0, Superbond C&B, and Variolink N showed significantly higher shear bond strength in order (P <.05). In SEM images, the zirconia surfaces of the APA50 and APA125 showed quite rough and irregular shapes, and the zirconia surface of the ZA was observed small irregular porosity and rough surfaces. @*Conclusion@#APA and ZrO 2 slurry were enhanced the surface roughness of zirconia, and Panavia F 2.0 containing MDP showed the highest shear bond strength with zirconia.
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Purpose@#The purpose of this study was to evaluate the retentive characteristics of the additional attachments used with implant bar attachment under repeated insertion/removal cycles. @*Materials and methods@#The newly developed attachment and the commercially available attachment were investigated: ADD-Lock (AL), Locator blue (LB). Two fixtures were placed parallel to each other on the custom lower mounting, and patrix of each attachment was fixed to the fixture. Also, the matrix of each attachment was placed on the opposing upper mounting. A universal testing machine was used to measure the retentive force during initial, 100, 250, 500, 1000, 2000, and 2500 repeated insertion/removal cycles. Wear and deformation of the attachment s were observed by scanning electron microscopy (SEM).Mann-Whitney U test (α=.05) and wilcoxon signed-rank test (α=.05) were performed to compare retentive force between each group and before and after 2500 repeated insertion/removal cycles. @*Results@#In terms of initial retentive force and retentive force after 2500 repeated insertion/removal cycles, the AL group (15.24 ± 1.46 N and 9.74 ± 1.16 N) showed significantly smaller values than the LB group (43.53 ± 12.39 N and 22.99 ± 4.77 N) (P <.05). Also, in the loss of retentive force, the AL group (5.50 ± 1.08 N, 36.08%) showed a smaller value than the LB group (20.54 ± 11.89 N, 47.19%) (P <.05). Based on SEM analysis, The AL group showed noticeable wear and deformation in the patrix and the LB group in the matrix. @*Conclusion@#Locator showed a higher initial retentive force than newly developed attachment, while the loss of retentive force was also higher. Both additional attachments are considered to have sufficient retentive force after repeated insertion/removal cycles.
ABSTRACT
Excessive teeth wear can lead to reduced chewing efficiency, occlusal plane collapse, and facial changes. Full mouth rehabilitation with a change in vertical dimension may cause pain in the temporomandibular joint, masticatory muscle and teeth, so an accurate diagnosis and treatment plan is required. In this case, a 69-year-old man had excessive teeth wear with a loss of posterior support. We evaluated the degree of adaptation to the increased vertical dimension with the removable occlusal splint and provisional restoration. We report this case because the treatment result has been functionally and aesthetically satisfactory by providing stable anterior guidance, proper posterior teeth disclusion, and even contact of all teeth in centric occlusion.
ABSTRACT
Purpose@#The aim of this study was to evaluate the effects of four surface treatment methods to improve zirconia roughness and three types of resin cement on the shear bond strength (SBS). @*Materials and methods@#A total of 120 zirconia blocks were randomly divided into four surface treatments: non-treatment (Control), airborne-particle abrasion (APA) with 50 μm Al2O3 (APA50), APA with 125 μm Al2O3(APA125), and ZrO2 slurry (ZA). Three resin cements (Panavia F 2.0, Superbond C&B, and Variolink N) were applied to the surface-treated zirconia specimens. All specimens were subjected to SBS testing using a universal testing machine. The surface of the representative specimens of each group was observed by scanning electron microscope (SEM). SBS data were analyzed with oneway ANOVA, two-way ANOVA test and post-hoc Tukey HSD Test (α=.05). @*Results@#In the surface treatment method, APA125, APA50, ZA, and Control showed high shear bond strength in order, but there was no significant difference between APA125 and APA50 (P >.05). Also, ZA showed significantly higher shear bond strength than Control (P <.05). In the resin cement type, Panavia F 2.0, Superbond C&B, and Variolink N showed significantly higher shear bond strength in order (P <.05). In SEM images, the zirconia surfaces of the APA50 and APA125 showed quite rough and irregular shapes, and the zirconia surface of the ZA was observed small irregular porosity and rough surfaces. @*Conclusion@#APA and ZrO 2 slurry were enhanced the surface roughness of zirconia, and Panavia F 2.0 containing MDP showed the highest shear bond strength with zirconia.
ABSTRACT
Purpose@#The purpose of this study was to evaluate the retentive characteristics of the additional attachments used with implant bar attachment under repeated insertion/removal cycles. @*Materials and methods@#The newly developed attachment and the commercially available attachment were investigated: ADD-Lock (AL), Locator blue (LB). Two fixtures were placed parallel to each other on the custom lower mounting, and patrix of each attachment was fixed to the fixture. Also, the matrix of each attachment was placed on the opposing upper mounting. A universal testing machine was used to measure the retentive force during initial, 100, 250, 500, 1000, 2000, and 2500 repeated insertion/removal cycles. Wear and deformation of the attachment s were observed by scanning electron microscopy (SEM).Mann-Whitney U test (α=.05) and wilcoxon signed-rank test (α=.05) were performed to compare retentive force between each group and before and after 2500 repeated insertion/removal cycles. @*Results@#In terms of initial retentive force and retentive force after 2500 repeated insertion/removal cycles, the AL group (15.24 ± 1.46 N and 9.74 ± 1.16 N) showed significantly smaller values than the LB group (43.53 ± 12.39 N and 22.99 ± 4.77 N) (P <.05). Also, in the loss of retentive force, the AL group (5.50 ± 1.08 N, 36.08%) showed a smaller value than the LB group (20.54 ± 11.89 N, 47.19%) (P <.05). Based on SEM analysis, The AL group showed noticeable wear and deformation in the patrix and the LB group in the matrix. @*Conclusion@#Locator showed a higher initial retentive force than newly developed attachment, while the loss of retentive force was also higher. Both additional attachments are considered to have sufficient retentive force after repeated insertion/removal cycles.
ABSTRACT
Excessive teeth wear can lead to reduced chewing efficiency, occlusal plane collapse, and facial changes. Full mouth rehabilitation with a change in vertical dimension may cause pain in the temporomandibular joint, masticatory muscle and teeth, so an accurate diagnosis and treatment plan is required. In this case, a 69-year-old man had excessive teeth wear with a loss of posterior support. We evaluated the degree of adaptation to the increased vertical dimension with the removable occlusal splint and provisional restoration. We report this case because the treatment result has been functionally and aesthetically satisfactory by providing stable anterior guidance, proper posterior teeth disclusion, and even contact of all teeth in centric occlusion.
ABSTRACT
Fixed implant prostheses or removable partial dentures are common treatment for partially dentulous patients. Recently, an implant-assisted removable partial denture (IARPD) has been introduced and is widely used. In the case of removable partial dentures using implant attachment and surveyed fixed prostheses, the consideration about parallelism of insertion path between implants and surveyed fixed prostheses is an important factor for success of IARPDs. In this case, she complained of discomfort while using the mandibular removable partial denture. Thus, an IARPD using implant surveyed fixed prostheses was fabricated.Thereafter, more implants were placed by a digital guide surgery to have the same insertion path as the existing surveyed fixed prostheses. Locator attachments were installed to the left and right premolar implants, and the left molar was able to obtain support of the removable partial denture with healing abutment. The clinical results were satisfactory on the aspect of aesthetic and masticatory function.
ABSTRACT
For patients with unstable mandibular movements and centric relation of the mandible due to long-term use of ill-fitting dentures, the successful fabrication of new dentures is challenging. Before fabrication new dentures, registration of centric relation is the critical point in such cases. In this case, treatment dentures with a flat occlusal table were used to stabilize mandibular movements and to register centric relation. In order to reflect the patient's jaw relation and vertical dimension obtained through the treatment dentures to the final denture, the treatment dentures were digitally duplicated, and impressions and jaw relations were obtained using the duplicated therapeutic dentures. The clinical results were satisfactory on the aspect of aesthetic and masticatory functioned.