Implant supported prosthetic rehabilitation of severely atrophic mandible with fixed detachable prosthesis / 대한치과보철학회지

Implant supported prostheses have improved the quality of lives of totally edentulous patients. However, there are some limitations on the number of implants related to the residual bone level or the economic concern and so on. In this situation, applying fixed detachable prosthesis with bilateral cantilevers can be considered. This clinical report describes implant supported prosthetic rehabilitation of a patient with severe bone resorption. The patient was satisfied and felt comfortable with upper complete denture and lower fixed detachable prosthesis.

Implant esthetic restoration with bone graft in the extended maxillary anterior area: A case report / 대한치과보철학회지

The maxillary anteriors play an important role in esthetics. Therefore after extraction, it is crucial to preserve the hard tissue and soft tissue in order to promote esthetics of restoration. There are several challenges when restoring the maxillary anteriors via implant. Some of the challenges are be maintaining consistency with neighboring teeth in terms of shade, form, and texture : as well as having harmonious emergency with the gingival margin. In this case, a traumatized patient with crown-root fracture of the maxillary central and lateral incisors is presented. The cracked teeth were extracted, and implants were inserted with bone grafts to compensate the volume of damaged area of the maxillary anterior. Cantilever implant prosthetics were planned while precise adjustments to the gingival area were made using customized impression coping to perform the esthetic restorations. The final outcome of the treatment was satisfying in both esthetic and utilitarian perspective.

Implant esthetic restoration with bone graft in the extended maxillary anterior area: A case report / 대한치과보철학회지

The maxillary anteriors play an important role in esthetics. Therefore after extraction, it is crucial to preserve the hard tissue and soft tissue in order to promote esthetics of restoration. There are several challenges when restoring the maxillary anteriors via implant. Some of the challenges are be maintaining consistency with neighboring teeth in terms of shade, form, and texture : as well as having harmonious emergency with the gingival margin. In this case, a traumatized patient with crown-root fracture of the maxillary central and lateral incisors is presented. The cracked teeth were extracted, and implants were inserted with bone grafts to compensate the volume of damaged area of the maxillary anterior. Cantilever implant prosthetics were planned while precise adjustments to the gingival area were made using customized impression coping to perform the esthetic restorations. The final outcome of the treatment was satisfying in both esthetic and utilitarian perspective.

Effect of number of implants and cantilever design on stress distribution in three-unit fixed partial dentures: A three-dimensional finite element analysis / 대한치과보철학회지

STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. 4.1x10 mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three 4.1x10 mm implants and fixed prosthesis with no pontic, model 1-2 which has two 4.1x10 mm implants and fixed prosthesis with a central pontic and model 1-3 which has two 4.1x10 mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three 4.1x10 mm implants and fixed prosthesis with no pontic, model 2-2 which has two 4.1x10 mm implants and fixed prosthesis with a central pontic and model 2-3 which has two 4.1x10 mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N , it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2-3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.