Implant-supported milled bar overdenture with two implant surgical guides / 대한치과보철학회지

For fully edentulous patients, implant-supported overdenture can be considered to enhance chewing efficiency and denture stability. Implant planning software can be used to fabricate a surgical guide for a more precise consideration of anatomic factors and prediction of the shape of definitive prosthesis. Though there are many possible attachments for implant overdenture, milled bar can be useful due to its splinting effect of implants and rigid support of overdenture. This report presents a case of implant-supported milled bar overdenture after guided implant surgery performed with two surgical guide that was fabricated before and after bone reduction.

Comparison of treatments for maxillary full denture and mandibular implant-supported fixed prosthesis in completely edentulous patients: A case report / 대한치과보철학회지

There are various approaches to treatment for patients with fully edentulous jaw. In maxilla, it is easy to obtain sufficient stability, support, and retention with the traditional full denture method. In mandible, however, there are difficulties caused by anatomical limitations. In this case, treatment with implants can be considered. If it is difficult to place implants in posterior area, a fixed complete denture can be considered, using 4 - 5 implants anterior to mental foramen. This approach has changed in many ways, such as surgical methods and materials used, over the years. This case report compares two approaches and their changes over time, especially in the cases of mandibular fixed prostheses using implants, paired with maxillary complete denture.

Aesthetic implant restoration with alveolar bone graft and digital method on maxillary central incisor: a case report / 대한치과보철학회지

In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.

Rehabilitation of posterior support and vertical dimension in a class 3 malocclusion patient: A case report / 대한치과보철학회지

A crossed occlusion resulting from the presence of posterior teeth in one arch but no opposing teeth in the opposite arch results in collapse of the vertical dimension. In this case, the patient has a class III malocclusion with crossed occlusion and anterior crossbite. In order to evaluate the proper vertical dimension, provisional denture was used to stabilize the vertical occlusal dimension for 3 months. After, provisional fixed restoration was used for the stabilizing occlusal relationship and aesthetic improvement for lip support. Definitive prosthesis in implants in the mandible and abutments in the maxillary were using Porcelain-fused-to-metal crown (PFM) crown and the maxillary unilateral edentulous area was treated with removable partial dentures. Through this, proper support of the posterior region and normal anterior occlusal relationship were formed, and the patient was able to obtain aesthetically and functionally satisfactory treatment results.

Axial displacement in single-tooth implant restoration:Case report / 대한치과보철학회지

Axial displacement of an implant-supported prosthesis is frequently reported in clinical and laboratory studies. However, limited information is available about the behavior of the axial displacement of implant-supported prostheses functioning in intraoral situations. The present case report evaluated the three-dimensional displacement of posterior single implant-supported prostheses in 2different patients. Internal connection type implants were placed, and screw and cement-retained prosthesis (SCRP) type prosthesis were delivered after an appropriate healing period. Intraoral digital scans were performed using an intraoral scanner (Cerec Omnicam, Dentsply Sirona, USA) on the day of crown delivery and one week, one month, and one year after delivery. The amount of 3-dimensional displacement of the prosthesis was evaluated by using a digital inspection software (Geomagic Control X, 3D systems, USA). The axial displacement of implant-supported prosthesis occurred in both patients. Furthermore, the amount of displacement increased over time.

Accuracy of conventional and digital mounting of dental models: A literature review / 대한치과보철학회지

Accurate transfer of the maxillo-mandibular relationship to an articulator (i.e., mounting) is critical in prosthetic treatment procedures. In the current study, a PubMed search was performed to review the influencing factors for the maxillo-mandibular relationship’s accuracy. The search included digital mounting as well as conventional gypsum cast mounting. The results showed that a greater amount of displacement was introduced during positioning the maxillary and mandibular models to interocclusal records rather than the dimensional change of registration material. Most intraoral scanners resulted in an accurate reproduction of the maxillo-mandibular relationship for posterior quadrant scanning;however, the accuracy was declined as the scan area increased to a complete arch scan. The digital mounting accuracy was also influenced by the image processing algorithms and software versions, especially for complete arch scans.

Comparison of the accuracy of digital impressions and traditional impressions: Systematic review / 대한치과보철학회지

PURPOSE: This study systematically examines literatures on the suitability of prostheses and accuracy of obtained impressions to see if digital impressions using intraoral scanners can replace traditional impressions. MATERIALS AND METHODS: A MEDLINE/PubMed search and manual search was performed for studies written in English about accuracy of digital impression published in dental journals from August 1, 1997, to July 31, 2017. Depending on criteria, the data for the selected articles were independently organized into standardized spreadsheets by 2 reviewers. RESULTS: Among the total 35 studies met the inclusion criteria, there were 26 studies comparing the suitability of prostheses, and 9 studies comparing the accuracy of impressions through scan data without prostheses. Most studies used prostheses to compare the accuracy of impression techniques. CONCLUSION: This review suggests that making single crown or mesio-distally short prostheses with digital impressions is clinically reliable in natural teeth. However, there is still a limit to making mesio-distally long prostheses with digital impressions from the lack of related studies. Digital impression cannot fully replace traditional impressions in implant prostheses yet.

Denture wearers' recognition for their oral health status, denture cleansing methods, and insurance health system / 대한치과보철학회지

PURPOSE: The aim of the present investigation was to understand the incidence, prevalence of denture stomatitis in denture wearers, who were over 60 years old, and use the results for a fundamental data to promote public awareness about denture stomatitis and its education tools. MATERIALS AND METHODS: From August 21 to September 8 2017, 500 denture wearers, who were more than 60 years old in Seoul and 4 other metropolitan cities (Busan, Daegu, Gwangju, and Daejeon), received questionnaires. The questionnaires included denture wearers' demographic distributions, specific dental treatment experiences, discomforts with current dentures, their oral health conditions, and the method of denture cleansing. RESULTS: Thirty-two percent of 500 denture wearers responded that they have healthy oral conditions. Two hundred and eight respondents (41.6%) were aware of denture stomatitis. Only 131 (26.2%) were informed about the removable denture covered by national health insurance and 327 (65.4%) of denture wearers were using the improper denture cleansing methods. CONCLUSION: A large number of denture wearers still do not recognize the importance of proper treatment for denture stomatitis, insurance covered denture treatments, and adequate denture cleansing methods.

The effect of different cooling rates and coping thicknesses on the failure load of zirconia-ceramic crowns after fatigue loading

PURPOSE: The purpose of this study was to evaluate the influence of different coping thicknesses and veneer ceramic cooling rates on the failure load of zirconia-ceramic crowns. MATERIALS AND METHODS: Zirconia copings of two different thicknesses (0.5 mm or 1.5 mm; n=20 each) were fabricated from scanning 40 identical abutment models using a dental computer-aided design and computer-aided manufacturing system. Zirconia-ceramic crowns were completed by veneering feldspathic ceramics under different cooling rates (conventional or slow, n=20 each), resulting in 4 different groups (CONV05, SLOW05, CONV15, SLOW15; n=10 per group). Each crown was cemented on the abutment. 300,000 cycles of a 50-N load and thermocycling were applied on the crown, and then, a monotonic load was applied on each crown until failure. The mean failure loads were evaluated with two-way analysis of variance (P=.05). RESULTS: No cohesive or adhesive failure was observed after fatigue loading with thermocycling. Among the 4 groups, SLOW15 group (slow cooling and 1.5 mm chipping thickness) resulted in a significantly greater mean failure load than the other groups (P<.001). Coping fractures were only observed in SLOW15 group. CONCLUSION: The failure load of zirconia-ceramic crowns was significantly influenced by cooling rate as well as coping thickness. Under conventional cooling conditions, the mean failure load was not influenced by the coping thickness; however, under slow cooling conditions, the mean failure load was significantly influenced by the coping thickness.

Rehabilitation of edentulous maxilla with implant-supported milled bar overdenture using CAD/CAM customized abutment: A case report / 대한치과보철학회지

In patients with fully edentulous maxilla, fabrication of implant-supported overdenture can be a viable treatment option, when a minimum of six implants were strategically placed. Among several attachment systems used for implant-supported overdentures, milled-bars prevent rotational movement of denture, thus showing great stability, and have the advantage of splinting multiple implants with each other. In this case report, a milled-bar supported overdenture was fabricated for a patient suffering from condition of fully edentulous maxilla with severe ridge resorption in the anterior residual ridge. Seven implants composed of three different systems were effectively utilized by CAD/CAM customized abutment and cement-retained milled bar.

Superimposition: a simple method to minimize occlusal adjustment of monolithic restoration / 대한치과보철학회지

The development of translucent zirconia enabled clinicians to choose a monolithic zirconia crown as one treatment modality in the posterior dentition. Careful occlusal adjustments are recommended for monolithic zirconia crowns because grinding zirconia inevitably causes phase transformation, which may deteriorate mechanical properties. intraoral scanners enable the clinician to scan and superimpose a complete tooth structure before preparation onto the prepared abutment. This technique helps to reproduce the original tooth form and occlusion of the patient. In this case report, prostheses were fabricated for patients with cracked or fractured tooth by applying intraoral scanner, Computer aided design-computer aided manufacturing (CAD-CAM) and monolithic zirconia crown to reproduce the occlusion of original tooth and to minimize occlusal adjustment. The clinical results were satisfactory in both esthetic and functional aspects.

Submucosal zirconia implant prosthesis fabricated with CAD/CAM / 대한치과보철학회지

They have been recently introduced many aesthetic implant prosthesis using with zirconia and CAD/CAM. However, there are many limitations in their gingival and occlusal region. In this case, submucosal zirconia implant prosthesis were fabricated with CAD/CAM system. The connection of these screw cement retained prosthesis and titanium abutment was designed to 1mm above the fixture. The clinical results were satisfactory on the aesthetics and function.

The effet of cooling rate on the residual stresses in the veneer ceramics of zirconia-ceramic restorations: a literature review / 대한치과보철학회지

Nowadays, dental zirconia is widely used as a framework material for a fixed dental prosthesis as well as a single restoration. However, clinical studies have reported high incidence of veneer chipping of zirconia-ceramic restorations compared to that of metal-ceramics. Several factors were raised as the possible causes of veneer ceramic chipping, however, it is still in debate. Recently, residual stresses in the veneer ceramics after cooling process gathers attention as one possible cause of chipping and many studies reported that the rate of cooling significantly influenced the types and the amount of residual stress. The purpose of current review was to briefly describe the effect of cooling rate on the residual stress in zirconia-ceramics. It was also described that the different behavior of residual stress between zirconia-ceramics and metal-ceramics following different cooling rate.

Influence of air abrasion and different dentin sealing techniques on microtensile bond strength to dentin / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the effect of various methods of dentin bonding agent application and air abrasion pretreatment on microtensile bond strength between dentin and resin, using a self-etching adhesive system. MATERIAL AND METHODS: Thirty freshly extracted human molars were obtained and divided into 6 groups of 5 teeth. A 2-step self etching adhesive system (Clearfil SE Bond) was used for all groups. The control specimens were prepared using a direct immediate bonding technique. The delayed dentin sealing specimens were prepared using an indirect approach without dentin prebonding. The immediate dentin sealing specimens were prepared using dentin prebonding immediately following preparation. Immediate dentin sealing teeth and delayed dentin sealing teeth had provisional restorations using Fermit for two weeks. Then all specimens of each group were divided into two groups of three, depending on air abrasion pretreatment. Composite "crowns" were incrementally built on and specimens were stored in water for 24 hours. All teeth were prepared for a microtensile bond strength test. Bond strength data were analyzed with a one-way ANOVA test, and post hoc comparison was done using the Scheffe's test. RESULTS: The mean microtensile bond strengths of all groups were not statistically different from each other. CONCLUSION: When preparing teeth for indirect restorations, IDS and DDS with Clearfil SE bond, have no difference on the microtensile bond strength between dentin and resin. Air abrasion pretreatment did not affect the microtensile bond strength when using IDS and DDS with Clearfil SE bond.

The effects of local factors on the survival of dental implants: A 19 year retrospective study / 대한치과보철학회지

PURPOSE: The aim of this retrospective study was to provide long-term data about the correlation between multifactorial local factors and the survival of implants. MATERIAL AND METHODS: During 19 years (1991 to 2009), 2796 implants were placed in 879 patients. From dental charts and radiographs, the following data were collected: patient's age at implant placement, gender, implant system, surface, length, diameter, location of implant placement, bone quality, primary stability, type of prosthesis. The correlations between these data and implant survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival analysis, Chi-square test, odds ratio. RESULTS: 1. Among the 2796 implants, 150 implants failed that resulted in a cumulative survival rate of 94.64%. The cumulative survival rate of smooth surface implants (91.76%) was lower than rough surface implants (96.02%). 2. Anatomic location, implant surface, diameter of smooth surface implant, primary stability, type of prosthesis, patient's age and gender were significantly associated with implant survival (P < .05). 3. No significant difference in implant survival was found in relation to the following factors: implant length, bone quality, diameter of rough surface implants and type of rough surface according to implant manufacturer (P < .05). CONCLUSION: Local factors such as anatomic location, implant surface, diameter of smooth surface implant, primary stability and type of prosthesis have a significant effect on implant survival.

The comparison of microtensile bond strength with immediate and delayed dentin sealing / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the effect of various methods of dentin bonding agent application on microtensile bond strength between dentin and resin, using a 2-step etch-and-rinse dentin bonding agent. MATERIAL AND METHODS: Twenty freshly extracted human molars were obtained and divided into 4 groups of 5 teeth. 2-step etch-and-rinse dentin bonding agent was used for all groups. The control specimens were prepared using a direct immediate bonding technique. The delayed dentin sealing (A, C) specimens were prepared using an indirect approach with delayed dentin sealing. For group A, resin was built-up on uncured dentin bonding agent, and for group C, resin was built-up on pre-cured dentin bonding agent. Preparation of the immediate dentin sealing (B) specimens also used an indirect approach with immediate dentin sealing immediately following preparation. All teeth were prepared for a microtensile bond strength test. Specimens were stored in water for 24 hours. Ten beams (1.0 x 1.0 x 11 mm) from each tooth were selected for testing. Bond strength data (MPa) were analyzed with a one-way ANOVA test, and post hoc comparison was done using the Scheffe's test. RESULTS: The mean microtensile bond strengths of control group, B and C (DDS with pre-cure) were not statisticaaly different from each other at 32.7, 33.3, 34.2 MPa. the bond strength for group A (DDS without pre-cure), 19.5 MPa, was statistically different (P < .01) from the other 3 groups. CONCLUSION: When preparing teeth for indirect bonded restorations, DDS with pre-curing dentin bonding agent and IDS results in the same bond strength between dentin and resin. On the contrast, the bond strength was decreased when DDS without pre-curing dentin bonding agent was used.

Bonding between resin and ceramics / 대한치과보철학회지

STATEMENT OF PROBLEM: Literature showed different results on the durability of bonded ceramic restoration. PURPOSE: The purpose of this article is to review the effect of surface treatment of ceramics in resin-ceramic bond to get predictable results. MATERIAL AND METHOD: PubMed data base was utilized to search the articles which were written in English and published in 1986 and 2006. Some electronic published articles which are forthcoming to publish in paper were also included for this review. This review article focused on the effect of acid etching and silane application on the silica based ceramics. The durability of resin-ceramic bonding, the methodology for bond strength test and resin bonding to alumina or zirconia based ceramics were compared in brief at the end of the review. RESULTS AND CONCLUSION: the effect of silane application can be influenced by the contaminations of saliva or solutions. Micromechanical retention by acid etching as well as silane application plays an important role in initial and durable bond strength between resin and ceramic. The use of phosphate modified resin cement following tribochemical silica coating and silane application produced best bond strength for alumina or zirconia based ceramics.