ABSTRACT
There are very few case reports of the diagnosis and management of concurrent oral cavity and parapharyngeal space tumors. We present a case involving a 49-year-old female who presented with oral cavity squamous cell carcinoma confirmed by biopsy. Initial diagnostic workup revealed a concurrent parapharyngeal mass. Diagnostic studies and surgical therapy were tailored to account for both pathological entities. The patient was treated with a combination of surgery and adjuvant therapy. The surgical strategy was designed to address both lesions simultaneously. One year post-surgery, the patient had good response to therapy with no evidence of persistent or recurrent disease. This report discusses the outcome and treatment of a rare case of concurrent squamous cell carcinoma with a complicating parapharyngeal space tumor. It explores the diagnostic process, comprehensive workup, and the surgical management.
ABSTRACT
Further study is warranted to determine the association between estimated glomerular filtration rate (eGFR) or albuminuria and the risk of death from diverse causes. Methods: We screened >10 million general health screening examinees who received health examinations conducted in 2009 using the claims database of Korea. After the exclusion of those previously diagnosed with renal failure and those with missing data, 9,917,838 individuals with available baseline kidney function measurements were included. The primary outcome was mortality and cause-specific death between 2009 and 2019 identified through death certificates based on the diagnostic codes of International Classification of Diseases, 10th revision. Multivariable Cox regression analysis adjusted for various clinicodemographic and social characteristics was used to assess mortality risk. Results: The hazard ratio of death was significantly high in both the eGFR <60 mL/min/1.73 m2 and in the eGFR ≥120 mL/ min/1.73 m2 groups in univariable and multivariable regression analyses when compared to those within the reference range (eGFR of 90–120 mL/min/1.73 m2). The results were similar for death by cardiovascular, cancer, infection, endocrine, respiratory, and digestive causes. We also found that albuminuria was associated with higher risk of death regardless of eGFR range, and those in the higher categories of dipstick albuminuria showed higher risk. Conclusion: We reconfirmed the significant association between eGFR, albuminuria, and mortality. Healthcare providers should keep in mind that albuminuria and decreased eGFR as well as kidney hyperfiltration are independent predictors of mortality.
ABSTRACT
The long-term use of an implant overdenture shows problems, such as wear of attachment, concentrated occlusal forces on the anterior teeth, fracture of artificial teeth and rotation of denture. By transitioning to an Implant-assisted removable partial denture (IARPD) using additional implant placement, the problems can be solved. In this case report, a transition was made from implant overdenture to IARPD utilizing surveyed crowns to distribute occlusal forces concentrated on anterior teeth and to prevent denture rotation in a skeletal Class III patient. Design of definitive prosthesis with appropriate function and aesthetics was determined through several stages of provisional restorations. In this case, appropriate posterior occlusion and maintenance of peri-implant bone level of definitive prosthesis were observed.
ABSTRACT
Tolvaptan reduces height-adjusted total kidney volume (htTKV) and renal function decline in autosomal dominant polycystic kidney disease (ADPKD). This study was aimed at investigating the efficacy and safety of tolvaptan in Korean patients with ADPKD during the titration period. Methods: This study is a multicenter, single-arm, open-label phase 4 study. We enrolled 108 patients with ADPKD (age, 19–50 years) with an estimated glomerular filtration rate (eGFR) of >30 mL/min/1.73 m2 and factors defined as indicative of rapid disease progression. After tolvaptan titration, we evaluated efficacy and side effects and assessed factors associated with the effects. Results: After titration for 4 weeks, eGFR and htTKV decreased by 6.4 ± 7.9 mL/min/1.73 m2 and 16 ± 45 mL/m, respectively. No serious adverse drug reactions were observed during the titration period. The greatest eGFR decline was observed in the first week, with a starting tolvaptan dose of 45 mg. Multivariate linear regression for htTKV decline showed that the greater the change in urine osmolality (Uosm), the greater the decrease in htTKV (β, 0.436; p = 0.009) in the 1D group stratified by the Mayo Clinic image classification. Higher baseline eGFR was related to a higher htTKV reduction rate in the 1E group (β, –0.642; p = 0.009). Conclusion: We observed short-term effects and safety during the tolvaptan titration period. The decline of htTKV can be predicted as a short-term effect of tolvaptan by observing Uosm changes from baseline to end of titration in 1D and baseline eGFR in 1E groups.
ABSTRACT
Class III malocclusion with mandibular protrusion can be divided into skeletal and pseudo malocclusion due to tooth displacement.For skeletal malocclusion, favorable treatment results can be obtained by establishing an appropriate vertical and horizontal intermaxillary relationship in order to secure a restoration space and obtain aesthetic and functional results. In this case, complete mouth rehabilitation was performed using an implant and a fixed prosthesis in a patient with mandibular protrusion and anterior teeth wear and reduced occlusal vertical dimension. After cast analysis and digital diagnosis, a provisional restoration with increased vertical dimension was fabricated to secure posterior support and evaluate stable centric occlusion. With the definitive prosthesis reflecting the provisional restoration, favorable function and aesthetics were obtained.
ABSTRACT
PURPOSE@#The aim of this study was to classify the shapes of retromolar pads and assess their morphometric differences using a 3D model. @*MATERIALS AND METHODS@#Two hundred fully edentulous or Kennedy Class I partially edentulous patients (400 retromolar pads) were enrolled. Scan data of the definitive mandibular casts produced through functional impressions were obtained using a 3D laser scanner. Seven parameters (transverse diameter, longitudinal diameter, transverse-contour length, longitudinal-contour length, longitudinal/transverse diameter ratio, longitudinal/transverse-contour length ratio, and angle of the retromolar pad line to the residual alveolar ridge line) were measured using image analysis software. Subsequently, the pads were classified according to the shape. Statistical analyses were performed using 95% confidence intervals. @*RESULTS@#Classifying the retromolar pads into three shapes led to high intra-examiner reliability (Cronbach’s alpha = 0.933). The pear shape was the most common (56.5%), followed by oval/round (27.7%) and triangular (15.8%) shapes. There were no significant differences between the left and right sides according to the shape and no significant differences in any parameter according to age. The transverse diameter and longitudinal/transverse diameter ratio differed between sexes (P < .05). The triangular shape had a significantly different transverse diameter, transverse-contour length, longitudinal/transverse diameter ratio, and longitudinal/transverse-contour length ratio compared with the pear and oval/round shapes (P < .05). @*CONCLUSION@#From a clinical reliability standpoint, classifying retromolar pads into three shapes (oval/round, pear-shaped, and triangular) is effective. The differences in the sizes among the shapes were attributed to the transverse measurement values.
ABSTRACT
In vitro studies are essential to predict the clinical performance of ceramic widely used as restorative materials. Traditional experiments such as fracture toughness and flexural strength have been used to evaluate the properties of brittle ceramics. However, these experiments have a limitation that the load conditions, failure patterns, and load values at which failure occurs are not similar to human occlusal force ranges or clinical failures. On the other hand, the edge chipping test (ECT), which was recently introduced to study chipping fracture of ceramics, has similar failure patterns to clinical trials. In addition, the failure loads from ECT were similar to human occlusal force. ECT can be usefully used in the study of ceramic properties. In this literature review, a more clinically meaningful experimental study of ceramics by examining the meaning and limitations of traditional ceramic failure tests and comparing them with ECT.
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Clinical applications of translucent zirconia as well as traditional zirconia (3 mol% yttria stabilized tetragonal zirconia polycrystal, 3Y-TZP) are increasing. For this reason, studies on factors affecting the optical properties of dental zirconia have been continuously reported. The optical effect of dental zirconia may vary depending on the yttria content, the thickness of the prosthesis, the sintering process, polishing, glazing and cementation in laboratory and clinical procedures. Increasing the yttria concentration can reduce the masking effect. Translucency decreases as the thickness of the restoration increases, but the required thickness may vary depending on the properties of the zirconia block. The high-speed sintering method can shorten the manufacturing time, but in some cases, the translucency of the prosthesis may decrease. In addition, the optical properties can be affected by the surface roughness of zirconia and the polishing process. The use of an appropriate colored cement can help with the masking effect of zirconia and can be useful for color matching for more esthetic results.
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Additive manufacturing (AM) for dental materials can produce more complex forms than conventional manufacturing methods.Compared to milling processing, AM consumes less equipment and materials, making sustainability an advantage. AM can be categorized into 7 types. Polymers made by vat polymerization are the most suitable material for AM due to superior mechanical properties and internal fit compared to conventional self-polymerizing methods. However, polymers are mainly used as provisional restoration due to their relatively low mechanical strength. Metal AM uses powder bed fusion methods and has higher fracture toughness and density than castings, but has higher residual stress, which requires research on post-processing methods to remove them. AM for ceramic use vat polymerization of materials mixed with ceramic powder and resin polymer. The ceramic materials for AM needs complex post-processing such as debinding of polymer and sintering. The low mechanical strength and volumetric accuracy of the products made by AM must be improved to be commercialized. AM requires more research to find the most suitable fabrication process conditions, as the mechanical properties and surface of any material will vary depending on the processing condition.
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Loss of posterior bite support might cause unstable occlusal relationship and when the mandible slides forward in the centric or habitual occlusion, excessive load is applied to the anterior region followed by causing the occlusal plane to collapse or leading to a decrease in occlusal vertical dimension. In addition, disorder of temporomandibular joint function may occur. The inter-dental arch discrepancy causes a mismatch in the vertical and horizontal overlap of the anterior and posterior regions. The deep bite in the anterior region and the scissor bite in the posterior region cause unstable occlusal contact and insufficient occlusal contact area. This report was to rehabilitate a patient with above-mentioned complex problems. Physiologic adaptation to increased vertical dimension and new occlusal plane were evaluated using provisional prostheses, and definitive prostheses was fabricated using cross-mounting technique. Stable occlusion, harmonious teeth overlap and adequate occlusal plane were established, so functionally and aesthetically satisfactory results are obtained.
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Purpose@#The aim of this study is to compare the hardness according to the conditions of metal alloys. Moreover, the correlation between the cast crown hardness before and after wear testing and the degree of wear for each dental alloy was assessed. @*Materials and Methods@#Cast crowns of three metal alloys (Co-Cr, gold, and Ni-Cr alloys) opposing smooth-surface monolithic zirconia were used. The Vickers microhardness of the ingot (which did not undergo wear testing) and the cast crown before and after wear testing were measured for each alloy. Two-way ANOVA and Scheffé tests were used to compare the measured hardness values. Moreover, the Pearson correlation coefficient was used to evaluate the relationship between the surface hardness and the wear of the cast crown (α=.05). @*Results@#There was no significant difference in the hardness before and after wear testing for the gold alloy (P >.05); however, the hardness of the worn surface of the cast crown increased compared to that of the cast crown before the wear tests of Ni-Cr and Co-Cr alloys (P .05). @*Conclusion@#There was a significant difference in hardness between dental alloys under the same conditions. No correlation existed between the surface hardness of the cast crown before and after wear testing and the wear of the cast crown.
ABSTRACT
Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.
ABSTRACT
Implant prostheses and removable partial dentures are mainly used as treatment methods for partial edentulous patients who have lost a number of teeth. The implant-assisted removable partial denture (IARPD) is strategically selected. The defect in maxillofacial structure due to osteomyelitis, a type of facial bone infection, causes dysfunction such as mastication, swallowing, and pronunciation, as well as social and psychological effects, so a removable restoration is required to restore the supporting tissue. Design of abutment and partial dentures is an essential factor in the success of treatment. In this case, IARPD, which has superior retention and stability compared to traditional removable partial dentures, can have a good prognosis. In a partial edentulous patient with bone defects due to osteomyelitis treatment, the stability of the denture was secured with IARPD restoration. Moreover, maintenance problem that may occur in the future was minimized by providing an appropriate denture design and occlusal scheme through several provisional restorations. This case can be expected to have a favorable prognosis in the long term.
ABSTRACT
There are very few reports of the restoration of tooth loss using dental implants in patients with diffuse sclerosing osteomyelitis (DSO). Because the patients with DSO have unfavorable bone quality for osseointegration of dental implants, additional considerations such as surgical trauma, infection control, and an extended healing period are essential when placing dental implants. The purpose of this study is to report on the success of osseointegration of a dental implant in the patient with DSO.
ABSTRACT
Purpose@#The aim of this study is to compare the hardness according to the conditions of metal alloys. Moreover, the correlation between the cast crown hardness before and after wear testing and the degree of wear for each dental alloy was assessed. @*Materials and Methods@#Cast crowns of three metal alloys (Co-Cr, gold, and Ni-Cr alloys) opposing smooth-surface monolithic zirconia were used. The Vickers microhardness of the ingot (which did not undergo wear testing) and the cast crown before and after wear testing were measured for each alloy. Two-way ANOVA and Scheffé tests were used to compare the measured hardness values. Moreover, the Pearson correlation coefficient was used to evaluate the relationship between the surface hardness and the wear of the cast crown (α=.05). @*Results@#There was no significant difference in the hardness before and after wear testing for the gold alloy (P >.05); however, the hardness of the worn surface of the cast crown increased compared to that of the cast crown before the wear tests of Ni-Cr and Co-Cr alloys (P .05). @*Conclusion@#There was a significant difference in hardness between dental alloys under the same conditions. No correlation existed between the surface hardness of the cast crown before and after wear testing and the wear of the cast crown.
ABSTRACT
Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.
ABSTRACT
Implant prostheses and removable partial dentures are mainly used as treatment methods for partial edentulous patients who have lost a number of teeth. The implant-assisted removable partial denture (IARPD) is strategically selected. The defect in maxillofacial structure due to osteomyelitis, a type of facial bone infection, causes dysfunction such as mastication, swallowing, and pronunciation, as well as social and psychological effects, so a removable restoration is required to restore the supporting tissue. Design of abutment and partial dentures is an essential factor in the success of treatment. In this case, IARPD, which has superior retention and stability compared to traditional removable partial dentures, can have a good prognosis. In a partial edentulous patient with bone defects due to osteomyelitis treatment, the stability of the denture was secured with IARPD restoration. Moreover, maintenance problem that may occur in the future was minimized by providing an appropriate denture design and occlusal scheme through several provisional restorations. This case can be expected to have a favorable prognosis in the long term.
ABSTRACT
There are very few reports of the restoration of tooth loss using dental implants in patients with diffuse sclerosing osteomyelitis (DSO). Because the patients with DSO have unfavorable bone quality for osseointegration of dental implants, additional considerations such as surgical trauma, infection control, and an extended healing period are essential when placing dental implants. The purpose of this study is to report on the success of osseointegration of a dental implant in the patient with DSO.
ABSTRACT
To use the external connection implant (EXT) appropriately, the inter-implant distance should be carefully considered during placement, and the bones raised above the implants should be trimmed during the second surgery. The hex abutment is more useful than the non-hex abutment. EXT is particularly useful when the inter-arch space is limited. The tissue level (TL, internal butt connection) implant has a biomechanical advantage of coronal wall thickness and a biological advantage of an inherent transmucosal smooth surface. During TL implant restoration, an abutment can be selected using the abutment and fixture margins with considerations for the inter-arch space. Since no single type of implant can satisfy all the cases, it is necessary to select the appropriate type, considering the occlusal force and the bone condition.
ABSTRACT
The typical biomechanical properties of an internal conical connection (ICC) are axial displacement and loss of preload. The axial displacement of an ICC without a vertical stop can cause the loss of preload and a lowered occlusion. The stress of an ICC is concentrated on the contact interface of the abutment and not on the screw, and during placement, it is important to choose a wider coronal wall thickness as much as possible. The ICC should also be placed below the level of the bone crest. During the restoration of an ICC, care should be taken to ensure an appropriate abutment shape and an accurate connection. To get the best clinical results, it is important to select its wall thickness and place it in the appropriate position to restore it adequately.