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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.
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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]
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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.
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Orofacial dystonia is a neuromotor disorder that causes irregular or repetitive movements of the face, lips, tongue, and jaw involuntarily, also called tic disorder. Edentulous patients with these symptoms experience functional and aesthetic problems, including difficulty using complete dentures, speech and swallowing difficulties, and orofacial pain. In this case, for a patient with orofacial dystonia who experienced complete edentulism at a relatively young age, restorative treatment was performed with a maxillary complete denture with bilateral posterior zirconia occlusal surfaces and a mandibular implant-supported fixed prosthesis, and continuous smile training was performed. The aim was to improve the aesthetics of facial muscles. As a result of the treatment, the patient was very satisfied with not only improved chewing function and aesthetics, but also regained psychological stability and was able to lead a normal daily life, so we would like to report this.
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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.
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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.
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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.
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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.
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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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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.
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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.
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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.
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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.
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Implant-Assisted Removable Partial Dentures (IARPDs) treatment is being performed in a fully edentulous patient using implant surveyed prosthesis as an abutment. Implant-supported prosthesis as an abutment of IARPDs is classified into screw-retained and cement-retained type according to the retention type, and each has advantages and disadvantages. The EZ crown system (Samwon DMP, Yangsan, Korea) has a cylinder combined with abutment, and the nickel-titanium spring in this cylinder provides a constant force on the zirconia ball to obtain retention in EZ crown system. In this patient, the natural abutment teeth of the mandibular overdenture was hopeless. We planned implant assisted removable partial denture using anterior implant surveyed prosthesis considering functional and esthetical rehabilitation, cost and patient's needs. When fabricating IARPDs using implant as abutment, we could compensate for the shortcomings of existing implant-supported prosthesis retention type and made the design of removable partial denture easy due to using EZ crown system.
Sujets)
Humains , Couronnes , Overdenture , Prothèse dentaire partielle amovible , Prothèses et implants , Rétention de prothèse , Réadaptation , DentRésumé
Traditionally, gingival retraction has been performed to obtain customized abutment impressions with subgingival margins of the implant supported prosthesis. However, gingivalretraction may have side effects such as gingival recession and bleed, leading to an inaccurate impression. In order to prevent these problems, in this case, the new techniquehas been introduced; a customized abutment which is designed for superimposition is used. Before the connection of the abutment to the implant fixture, pre-scannedshape data are stored, and then the optical impression without gingival retraction is obtained after connecting to the fixture. The suprastructure is fabricated by superimposingthe two data. This technique showed the clinical efficacy of fabricating the implant supported prosthesis with subgingival margin, which satisfied the aesthetics, convenience,and clinically acceptable marginal and internal fit. (J Korean Acad Prosthodont 2020;58:169-75)
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Failure of fixed implant supported prosthesis is caused by biomechanical factors such as excessive occlusal stress and biological factors such as bacterial infections andinflammation. Implants with severe bone resorption that have worsened without being resolved due to implant complications should be removed and then new treatmentsshould be planned, taking into account remaining teeth, remaining implants, and residual alveolar. The patient of this case removed some of fixed implant prosthesis of mandible.The condition of the remaining alveolar bone was reassessed for further implant replacement and a few implants were placed. Then implant assisted removable partialdenture (IAPRD) treatment is performed using implant surveyed bridge as abutment. Through this treatment, the clinical results were satisfactory on aspect of masticatoryfunction recovery and oral hygiene management. (J Korean Acad Prosthodont 2020;58:161-8)
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were satisfactory on the aspect of esthetic and masticatory function. (J Korean Acad Prosthodont 2020;58:137-44)
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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.
Résumé
PURPOSE: The purpose of this study was to compare the clinical outcomes of lithium disilicate ceramic pressed zirconia prostheses and monolithic zirconia prostheses and to investigate the complications after two years of follow-up in posterior edentulous site. MATERIALS AND METHODS: A total 17 patients (male: 12, female: 5) were treated with 60 posterior fixed implant-supported prostheses (LP. lithium disilicate ceramic pressed zirconia prostheses: n = 30, MZ. monolithic zirconia prostheses: n = 30). After 24-month, clinical examination of Implant survival rate, marginal bone resorption, probing depth, plaque index, bleeding index, calculus and complications were evaluated. RESULTS: There were no failed implants and all implants were normal in function without mobility. Marginal bone resorption was lower in LP group than MZ group at 12-month (P < .05), and 12-month probing depth and calculus deposit in LP group were significantly higher than MZ group (P < .05). Most common complications in MZ were marginal bone resorptions more than 1.5.mm and 2 chipping occurred in LP group. CONCLUSION: Within the limitations of the present study, lithium disilicate ceramic pressed zirconia is considered as a predictable treatment option as much as monolithic zirconia in posterior fixed implant-supported prostheses.
Sujets)
Femelle , Humains , Résorption osseuse , Calculs , Céramiques , Implants dentaires , Études de suivi , Hémorragie , Lithium , Études prospectives , Prothèses et implants , Taux de survieRésumé
Clinicians are faced with many difficulties when planning prosthodontic restorations with implants in a complete edentulous patient. When planning fixed implant prosthetics, it is often necessary to have additional surgery due to highly reduced alveolar bone, as well as high treatment costs and long-term treatment durations can be required. In addition, lack of interocclusal space can be a problem when planning implant supported overdentures. In this study, we planned to place a small number of implants on the anterior maxilla and used them as the abutments for distal-extension removable partial dentures on the posterior side in a maxillary fully edentulous patient. This would reduce the possibility of additional invasive operations such as alveolar bone graft, shorten the treatment time, and be relatively easy for elderly patients to burden. In this case, the patient was provided with a distal-extension removable partial denture and anterior implant fixed prostheses, which was similar to the previous one, and showed good adaptation, and chewing efficiency and esthetics was recovered.