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

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.

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.

Full mouth implant rehabilitation with double scanning of provisional restoration / 대한치과보철학회지

It is important to produce a provisional restoration reflecting the patient's jaw relation, occlusal plane, lip support, shape of teeth, and occlusion type for fully edentulous patients before making a definite prosthesis. The patient introduced in this study showed bad prognosis of remained tooth after severe periodontal diseases. Therefore, remaining teeth were extracted and replaced with dental implants. Provisional restorations were fabricated and the the patient's vertical and horizontal jaw relationship, occlusal plane, amount of overjet and overbite, size of teeth, and length of anterior tooth were recorded. Provisional restorations were scanned and CAD/CAM techniques were used to fabricate a monolithic zirconia bridge, which contour is identical with the provisional restorations. The patient was satisfied with the treatment results on functional, esthetic aspects and the prosthesis retained stable during the four-month clinical observation period.

Full mouth rehabilitation for a disabled patient: a case report / 대한치과보철학회지

The spectrum of physically challenged patients who visit to a dental clinic for treatments are diverse: from ones of mild disabilities, who lead their lives in a similar way of ordinary people, to others who suffer from diseases that are difficult to be diagnosed, and need medical expertise due to systemic care or special techniques and instruments because of behavior management and difficulty of treatments. The patient in this case was 25-year-old autistic male patient who visited the clinic on account of overall treatment for multiple carious lesions. He could perform normal daily life to some degree under the care of a guardian. This case report describes predicaments of making a treatment plan resulted from lack of information about disabled patients, and difficulties of proceeding treatment procedures under general anesthesia. It is considered that sufficient consultation and history taking are needed before treatment for disabled patients.

Three-dimensional finite element analysis of stress distribution for different implant thread slope and implant angulation / 대한치과보철학회지

PURPOSE: The purpose of this study was to find an inclination slope of the screw thread that is favorable in distributing the stresses to alveolar bone by using three dimensional finite element analysis. MATERIALS AND METHODS: Three types modelling changed implant thread with fixed pitch of 0.8 mm is the single thread implant with 3.8degrees inclination, double thread implant with 7.7degrees inclination and the triple thread implant with 11.5degrees inclination. And three types implant angulation is the 0degrees, 10degrees and 15degrees on alveolar bone. The 9 modelling fabricated for three dimensional finite element analysis that restored prosthesis crown. The crown center applied on 200 N vertical load and 15degrees tilting load. RESULTS: 1. The more tilting of implant angulation, the more Von-Mises stress and Max principal stress is increasing. 2. Von-Mises stress and Max principal stress is increasing when applied 15degrees tilting load than vertical load on the bone. 3. When the number of thread increased, the amount of Von-Mises stress, Max principal stress was reduced since the generated stress was effectively distributed. 4. Since the maximum principal stress affects on the alveolar bone can influence deeply on the longevity of the implants. When comparing the magnitude of the maximum principal stress, the triple thread implant had a least amount of stress. This shows that the triple thread implant gave a best result. CONCLUSION: A triple thread implant to increase in the thread slope inclination and number of thread is more effective on the distribution of stress than the single and double thread implants especially, implant angulation is more tilting than 10degrees on alveolar bone. Thus, effective combination of thread number and thread slope inclination can help prolonging the longevity of implant.

Reestablishing the occlusal plane in full mouth rehabilitation patient, using Shilla system / 대한치과보철학회지

Occlusal plane is a sagittal expression of dental arch form, and it composes the shape of occlusion, which is one of the most important elements of Maxillo-oral system. In this case, vertical, horizontal coordinates of bionic-median-sagittal plane was produced in articulator, and to achieve relation of left and right position of upper, lower teeth and deficits in alveola, Shilla system was used to reconstruct occlusal plane. In this case, a 41 year-old male patient visited for fracture of 10 unit metal-ceramic fixed partial denture of upper anterior teeth and for overall treatment. Clinical, radiographical, model examination was held, full mouth rehabilitation was achieved by placing dental implant. Maxillo-oral relation was recorded using Gothic arch Tracer complex and were mounted. And for the next step, we estimated original occlusal plane using Shilla system. After analysis we produced diagnosis wax pattern. On the basis of this, radiography stent was manufactured and dental implant was placed, and temporary prosthesis was made by using diagnosis wax pattern. Cross mounting and anterior guiding table were performed in order to reproduce temporary restoration morphology and bite pattern, followed by final restoration made of all ceramic crown with zirconia coping. As stated above, appropriately esthetic and functional results can be seen in using Shilla system in diagnosis and treatment procedure of full mouth rehabilitation patient.

Implant restoration considering maintenance for a patient with excessive crown height space / 대한치과보철학회지

Complications increases when crown height space is excessive and one should be careful of choosing type of fixed prosthesis in case crown height space is over 12 mm. In this condition, tooth seems to be longer, therefore, it is needed to use gingival shade in aesthetically important area for fixed prosthesis. In this case, fixed prosthesis which has inappropriate maintenance and hygiene could hold food, plaque, calculus, thus increase incidence of inflammation and infection. Moreover, it could lead to chronic inflammation and infection and in that case surgical improvement could be necessary. In present case report, gingival inflammation and swelling developed around prosthesis after having made it considering articulation and aesthetic view in patient who had excessive crown height space. Finding out that design of prosthesis is a factor to make it hard to maintain oral hygiene, a temporary prosthesis which has enough interproximal space and proper emergence profile was fabricated. After two months of observation, significant abnormal symptoms are not found and oral reconstruction is performed using fixed prosthesis with zircornia infrastructure and porcelain build-up based on convenient self hygiene design. Through serial treatment, inappropriate soft tissue response is not observed and satisfactory result in functional aspect comes out.

Removable partial denture restoration using single implant supported with Locator(R) attachment in a crossed occlusion patient: a case report / 대한치과보철학회지

When losing many of the remaining teeth, the relation among them can be put into dynamically unfavorable situation. In the case that the patient without any incompatibilityto the denture, overdenture can be considered. Moreover, we can overcome the dynamical disadvantage, and improve the support, stability, and retention of the partial denture by using implant at the edentulous area. In this case, patient with crossed occlusion between few remaining teeth was treated with maxillary and mandibular partial denture. Single implant fixture was placed at the edentulous space, opposing to the maxillary teeth occluded, and Locator(R) attachment was connected. The patient's esthetic satisfaction was improved by ideally adjusting the tilted occlusal plane. Since the patient was satisfied both esthetically and functionally, and maintained stable during the clinical observation for 6 months after the treatment, we would like to report about it.

Case report: Full mouth rehabilitation for patient with heavy occlusal force and excessive abrasion / 대한치과보철학회지

Many of the patients with extensive abrasion need comprehensive restorative treatment. The abrasion is usually caused by attrition, besides of it, there are many reasons for it. The plan of treatment should be started on assessment of the type of attrition and the etiologic analysis. Patient with well-developed masticatory muscle, alveolar process, and high occlusal force and also with little muscle length difference between the stable and the contracted state should be carefully assessed for the vertical dimensional loss and the restoration should be carefully designed. Decrease of tooth length can be compensated by the growth of the alveolar bone height; therefore, consistency of the occlusal vertical dimension is maintained. Accordingly, a careless increase of the vertical dimension can produce muscle fatigue, depressed tooth and pain, and fracture of the restoration. In this case, the patient with multiple tooth abrasion and clenching habit, the edentulous maxillary area is restored with amalgam inserted RPD, and the dentulous area of the maxilla and mandible are treated with fixed restoration accompanying with the increase of vertical dimension. Consequently, we are going to report about the satisfying result in both functional and esthetic aspects.

Surface characteristics and osteoblastic cell response of alkali-and heat-treated titanium-8tantalum-3niobium alloy

PURPOSE: The aim of the present study was to evaluate the biological response of alkali- and heat-treated titanium-8tantalum-3niobium surfaces by cell proliferation and alkaline phosphatase (ALP) activity analysis. METHODS: Commercial pure titanium (group cp-Ti) and alkali- and heat-treated titanium-8tantalum-3niobium (group AHT) disks were prepared. The surface properties were evaluated using scanning electron microscopy, energy dispersed spectroscopy and X-ray photoelectron spectroscopy (XPS). The surface roughness was evaluated by atomic force microscopy and a profilometer. The contact angle and surface energy were also analyzed. The biological response of fetal rat calvarial cells on group AHT was assessed by cell proliferation and ALP activity. RESULTS: Group AHT showed a flake-like morphology microprofile and dense structure. XPS analysis of group AHT showed an increased amount of oxygen in the basic hydroxyl residue of titanium hydroxide groups compared with group cp-Ti. The surface roughness (Ra) measured by a profilometer showed no significant difference (P>0.05). Group AHT showed a lower contact angle and higher surface energy than group cp-Ti. Cell proliferation on group AHT surfaces was significantly higher than on group cp-Ti surfaces (P<0.05). In comparison to group cp-Ti, group AHT enhanced ALP activity (P<0.05). CONCLUSIONS: These results suggest that group AHT stimulates osteoblast differentiation.

Shear bond strength of veneer ceramic and colored zirconia by using aqueous metal chloride solutions / 대한치과보철학회지

PURPOSE: The purposes of this study was to evaluates shear bond strength between zirconia core and veneer-ceramic in order to examine the clinical practice of colored zirconia block fabricated by infiltration method into the metal chloride solution. MATERIAL AND METHODS: CNU block and Everest(R) ZS blank were used. VITA In-Ceram(R)2000 YZ Coloring liquid (LL1) and 3 aqueous metal chloride solutions containing chromium and molybdenum ingredients were used. 40 zirconia specimens were prepared into cuboid shape (5 x 5 x 10 mm). All specimens were divided into 5 groups by infiltrating into the coloring liquids. After that, porcelain was build up into the shape of 5 x 5 x 4 mm3, followed by sintering. The maximum loading and shear bond strength was measured. Failure patterns and failure sites were examined. RESULTS: 1. There were no statistical differences in shear bond strength between zirconia blocks (P > .05). 2. There were no statistically significant differences in shear bond strength between non-colored and colored zirconia blocks, while shear bond strength of non-colored zirconia blocks is higher than that of colored specimen (P > .05). 3. In the comparison with shear bond strength among colored zirconia blocks, there were no statistical differences according to kinds of coloring liquid (P > .05). 4. Mixed failure patterns were mainly observed in the failure between zirconia and veneering ceramic. The veneering ceramic failure of all specimens was observed in either interface of zirconia or veneering ceramic. CONCLUSION: Shear bond strength between colored zirconia and veneering ceramic shows lower tendency than non-colored zirconia, but there was clinically allowable value.

Evaluation on the bone regenerative capacity of hyaluronic acid applied poly (D,L-lactic-co-glycolic acid) membranes in rabbit calvarial defect / 대한치과보철학회지

PURPOSE: The objective of the present study was to histologically evaluate durability and bone regeneration capacity of new synthetic membranes in comparison to clinically available collagen membrane. MATERIAL AND METHODS: To the skulls of 12 rabbits, we created 4 bone defects of 6 mm in diameter on each of them. Each of defects were covered with at least one of 5 membranes: No membrane, Collagen (Ossix(TM)), PLGA, HA-coated-PLGA and HA-PLGA/PLGA. After 4, 8, 12 weeks, we cut the skulls and dyed with H-E. And then, the histologic observation was done. RESULTS: In current study, the control group which did not use the membrane showed bone regeneration at 12 weeks and covered the bone defect partially. New bones were formed through the underneath of endocranium, and the upper defect was filled with connective tissues and fats. Collagen membrane (Ossix(TM)) showed new bones after 4 weeks, and they were formed through the membrane which maintained until 12 weeks. PLGA, HA-coated-PLGA, HA-PLGA/PLGA showed bone regeneration after 4 weeks and after 8 weeks, they mostly filled defects. At 12 weeks, we could find new bones and previous bones almost look alike and also, they united well. Membranes were unnoticeable after 4 weeks and were absorbed. CONCLUSION: Bone formation and maturation of PLGA, HA-coated-PLGA and HA-PLGA/PLGA were faster than the control group. They showed no difference on the application of HA and after 4 weeks, they were absorbed.

Shear bond strength of composite resin to titanium according to various surface treatments

STATEMENT OF PROBLEM: When veneering composite resin-metal restoration is prepared, the fact that bond strength between Ti and composite resin is relatively weak should be considered. PURPOSE: The purpose of this study is to evaluate the shear bond strength between the veneering composite resin and commercial pure (CP) Ti / Ti-6Al-4V alloy according to the method of surface treatment. MATERIAL AND METHODS: The disks were cast by two types of metal. Their surfaces were treated by sandblasting, metal conditioner, TiN coating and silicoating respectively. After surface treatment, the disks were veneered by composite resin (Tescera(TM), Bisco, USA) which is 5 mm in diameter and 3 mm in thickness. The specimens were stored in water at 25degrees C for 24 hours, and then evaluated for their shear bond strength by universal testing machine (STM-5(R), United Calibration, USA). These values were statistically analyzed. RESULTS: 1. All methods of surface treatment were used in this study satisfied the requirements of ISO 10477 which is the standard of polymer-based crown and bridge materials. 2. The metal conditioner treated group showed the highest value in shear bond strength of CP Ti, silicoated group, TiN coated group, sandblasted group, in following order. 3. The silicoated group showed the highest value in shear bond strength of Ti-6Al-4V alloy, metal conditioner treated group, sandblasted group, TiN coated group, in following order. CONCLUSION: Within the limitations of this study, all methods of surface treatment used in this study are clinically available.

Histologic evaluation and removal torque analysis of nano- and microtreated titanium implants in the dogs

STATEMENT OF PROBLEM: A number of studies about the nano-treated surfaces of implants have been conducting along with micro-treated surfaces of implants. PURPOSE: The purpose of this study was to get information for the clinical use of nano-treated surfaces compared with micro-treated surfaces by measuring removal torque and analyzing histological characteristics after the placement of various surface-treated implants on femurs of dogs. MATERIAL AND METHODS: Machined surface implants were used as a control group. 4 nano-treated surface implants and 3 micro-treated surface implants [resorbable blast media surface (RBM), sandblast and acid-etched surface (SAE), anodized RBM surface] were used as experimental groups. Removal torque values of implants were measured respectively and the histological analyses were conducted on both 4weeks and 8weeks after implant surgery. The surfaces of removed implants after measuring removal torque values were observed by scanning electron microscopy (SEM) at 8 weeks. RESULTS: 1. Removal torque values of the nano-treated groups were lower than those of micro-treated groups. 2. Removal torque values were similar in the anodized RBM surface groups. 3. On the histological views, there was much of bone formation at 8 weeks, but there was no difference between 4 and 8 weeks, and between the types of implant surfaces as well. CONCLUSION: It is suggested that implant topography is more effective in removal torque test than surface chemistry. To get better clinical result, further studies should be fulfilled on the combined effect of surface topography and chemistry for the implant surface treatments.

Oral rehabilitation for a patient with oligodontia and maxillary hypoplasia

An 18 year old female with oligodontia and maxillary hypoplasia was treated using an interdisciplinary team approach involving orthodontists, maxillofacial surgeons and prosthodontists. Full mouth one-piece fixed partial dentures were the final restoration. The fixed partial dentures fabricated for the maxilla and mandible using the concept of a shortened dental arch resulted in improved esthetics and the masticatory function. This paper describes the treatment procedures for an oligodontia patient with alveolar bone hypoplasia.

Effect of adhesive primers on bonding strength of heat cure denture base resin to cast titanium and cobalt-chromium alloy

STATEMENT OF PROBLEM: The poor chemical bonding of a denture base resin to cast titanium framework often introduces adhesive failure and increases microleakage. PURPOSE: This study evaluated the shear bond strengths of a heat cure denture base resin to commercially pure titanium, Ti-6Al-4V alloy and a cobalt-chromium alloy using two adhesive primers. MATERIAL AND METHODS: Disks of commercially pure titanium, Ti-6Al-4V alloy and a cobalt-chromium alloy were cast. Specimens without the primer were also prepared and used as the controls. The shear bond strengths were measured on a screw-driven universal testing machine. RESULTS: The primers significantly (P < .05) improved the shear bond strengths of the heat cure resin to all metals. However, the specimens primed with the Alloy primer(R) (MDP monomer) showed higher bond strength than those primed with the MR bond(R) (MAC-10 monomer) on titanium. Only adhesive failure was observed at the metal-resin interface in the non-primed specimens, while the primed specimens showed mixed failure of adhesive and cohesive failure. CONCLUSIONS: The use of appropriate adhesive metal primers makes it possible not only to eliminate the need for surface preparation of the metal framework before applying the heat cure resins, but also reduce the need for retentive devices on the metal substructure. In particular, the Alloy primer(R), which contains the phosphoric acid monomer, MDP, might be clinically more acceptable for bonding a heat cure resin to titanium than a MR bond(R), which contains the carboxylic acid monomer, MAC-10.

Comparion of stability in titanium implants with different surface topographies in dogs

STATEMENT OF PROBLEM: A few of studies which compared and continuously measured the stability of various surface treated implants in the same individual had been performed. PURPOSE: We aim to find the clinical significance of surface treatments by observing the differences in the stabilization stages of implant stability. MATERIAL AND METHODS: Eight different surface topographies of dental implants were especially designed for the present study. Machined surface implants were used as a control group. 4 nano-treated surface implants (20 nm TiO2 coating surface, heat-treated 80 nm TiO2 coating surface, CaP coating surface, heat treated CaP coating surface) and 3 micro-treated surface implants [resorbable blast media (RBM) surface, sandblast and acid-etched (SAE) surface, anodized RBM surface] were used as experiment groups. All 24 implants were placed in 3 adult dogs. Periotest(R) & ISQ values measured for 8 weeks and all animals were sacrificed at 8 weeks after surgery. Then the histological analyses were done. RESULTS: In PTV, all implants were stabilized except 1 failed implants. In ISQ values, The lowest stability was observed at different times for each individual. The ISQ values were showed increased tendency after 5 weeks in every groups. After 4 to 5 weeks, the values were stabilized. There was no statistical correlation between the ISQ values and PTV. In the histological findings, the bone formation was observed to be adequate in general and no differences among the 8 surface treated implants. CONCLUSIONS: In this study, the difference in the stability of the implants was determined not by the differences in the surface treatment but by the individual specificity.

Cell response to a newly developed Ti-10Ta-10Nb alloy and its sputtered nanoscale coating

STATEMENT OF PROBLEM: The success of titanium implants is due to osseointegration or the direct contact of the implant surface and bone without a fibrous connective tissue interface. PURPOSE: The purpose of this study was to evaluate the osteoblast precursor response to titanium - 10 tantalum - 10 niobium (Ti-Ta-Nb) alloy and its sputtered coating. MATERIAL AND METHODS: Ti-Ta-Nb coatings were sputtered onto the Ti-Ta-Nb disks. Ti6-Al-4V alloy disks were used as controls. An osteoblast precursor cell line, were used to evaluate the cell responses to the 3 groups. Cell attachment was measured using coulter counter and the cell morphology during attachment period was observed using fluorescent microscopy. Cell culture was performed at 4, 8, 12 and 16 days. RESULTS: The sputtered Ti-Ta-Nb coatings consisted of dense nanoscale grains in the range of 30 to 100 nm with alpha-Ti crystal structure. The Ti-Ta-Nb disks and its sputtered nanoscale coatings exhibited greater hydrophilicity and rougher surfaces compared to the Ti-6Al-4V disks. The sputtered nanoscale Ti-Ta-Nb coatings exhibited significantly greater cell attachment compared to Ti-6Al-4V and Ti-Ta-Nb disks. Nanoscale Ti-Ta-Nb coatings exhibited significantly greater ALP specific activity and total protein production compared to the other 2 groups. CONCLUSIONS: It was concluded that nanoscale Ti-Ta-Nb coatings enhance cell adhesion. In addition, Ti-Ta-Nb alloy and its nanoscale coatings enhanced osteoblast differentiation, but did not support osteoblast precursor proliferation compared to Ti-6Al-4V. These results indicate that the new developed Ti-Ta-Nb alloy and its nanoscale Ti-Ta-Nb coatings may be useful as an implant material.