ISSN : 0376-4672
ntroduced and have become popular to the implant dentistry. The designs of the connection between implant fixture and abutment are divided into external vs internal connection. From beginning, the Brånemark system was characterized by an external hexagon. Internal connection has been developed to reduce stress transferred to the bone. These differences may have impact on the clinical procedures and protocols, laboratory and components costs, and incidence of complications. Therefore, the clinician has to know the different biomechanical features and understand their implications to produce successful implant-supported prosthesis with an external or an internal connection system.
임플란트 보철치료 방법은 구강 내에서 기성 지대주를 직접 연결하고 인상을 채득하여 보철물을 제작하는방법과 고정체 수준에서 인상을 채득하여 기공과정에서 기성 지대주를 연결하고 보철물을 제작하는 방법이있다. 그러나 흔히 사용하고 있는 기성 지대주 형태는자연치아 형태와 차이가 있어 심미적인 보철물 제작에한계가 있다. 또한 임플란트 식립시 이상적인 보철물의 위치와 각도를 바탕으로 고정체를 식립하는 것이중요하나 부족한 치조골의 양, 얇은 연조직, 큰 결손부위가 있는 경우는 고정체가 이상적인 위치를 벗어나 게 되어 기성 지대주 사용이 불가능하게 된다. 다수 임플란트 보철치료시에도 임플란트의 식립 각도, 임플란트의 위치, 환자의 상태에 따라 기성 지대주, 맞춤형 지대주, Titanium-based 지르코니아보철물 등을 선택적으로 사용할 수 있다. 이에 다양한지대주의 선택 기준과 함께 각각의 임상적용 사례를정리하여 보고하고자 한다.
다수의 인접한 치아가 상실된 경우이를 수복하기 위한 임플란트 보철치료에서 연결 고정혹은 개별 수복의 의미를 현재까지 발표된 실험 연구와 최근 임상 연구를 바탕으로 정리하고자 한다. 특히오늘날 많이 사용되고 있는 내측 연결형 임플란트에서상부 보철의 연결 고정 여부가 갖는 임상적 의미를 살펴본다.
The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient’s oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.
Objectives The aim of this study was to evaluate the antibacterial effect of xanthorrhizol (XTZ) on E. faecalis, compared with 2% chlorhexidine (CHX). Materials and Methods Normal physiological state (NS), starvation state (SS), and alkalization state (AS) of E. faecalis were used. A solution containing 1% XTZ in 30% ethanol, 1% dimethyl sulfoxide (DMSO), and 100 mg/ml sodium methyl cocoyl taurate was used and is referred to as Xan in this study. To determine the minimal bactericidal concentration (MBC) of Xan and CHX, 500 of E. faecalis (NS and two stress states) was added to a microtube containing 500 of serial 2-fold dilutions of 1% Xan and 2% CHX (1:2-1:128). The MBC of each antimicrobial was determined by the plate count method. Results The antibacterial effect of Xan was more effective on E. faecalis in AS than in the other states (NS, SS) at 0.125% Xan and 0.03325% Xan (P<0.05). In contrast, the antibacterial effect of CHX was more effective against E. faecalis in SS than the other states (NS, AS) at 0.0625% CHX (P<0.05). In SS, the antibacterial effect of CHX was more effective than that of Xan at 0.125% and 0.0625% (P<0.05). However, in AS, the antibacterial effect of Xan was more effective than that of CHX at 0.0625% and 0.03325% (P<0.05). Conclusions In endodontic retreatment cases in which it is important to effectively remove E. faecalis from the infected root canal, Xan may be more suitable when combined with NaOCl than CHX.
본 연구의 목적은 3차원 얼굴 스캔 영상을 이용하여상악 전방견인 치료 후의 얼굴 연조직의 변화를 3차원적으로 평가하는 것이었고, 구내장치로 RME를 사용한 군과 miniplate를 사용한 군을 비교 평가하였다.
Purpose: The aim of this study was to evaluate the soft-tissue change after the maxillary protraction therapy using threedimensional (3D) facial images. Materials and Methods: This study used pretreatment (T1) and posttreatment (T2) 3D facial images from thirteen Class III malocclusion patients (6 boys and 7 girls; mean age, 8.9 2.2 years) who received maxillary protraction therapy. The facial images were taken using the optical scanner (Rexcan III 3D scanner), and T1 and T2 images were superimposed using forehead area as a reference. The soft-tissue changes after the treatment (T2-T1) were three-dimensionally calculated using 15 soft-tissue landmarks and 3 reference planes. Results: Anterior movements of the soft-tissue were observed on the pronasale, subnasale, nasal ala, soft-tissue zygoma, and upper lip area. Posterior movements were observed on the lower lip, soft-tissue B-point, and soft-tissue gnathion area. Vertically, most soft-tissue landmarks moved downward at T2. In transverse direction, bilateral landmarks, i.e. exocanthion, zygomatic point, nasal ala, and cheilion moved more laterally at T2. Conclusion: Facial soft-tissue of Class III malocclusion patients was changed three-dimensionally after maxillary protraction therapy. Especially, the facial profile was improved by forward movement of midface and downward and backward movement of lower face.
