The treatment of areas demanding esthetic requirements, such as maxillary anterior teeth, should take into account the achievement of a healthy, harmonious to the surrounding tissue, and an attractive smile line. In this case report, smile line, soft tissue and hard tissue morphology, and the anatomy and proportion of the tooth, must be considered. In patients with unesthetic maxillary anterior ratio due to inadequate gingival contour and diastema caused by peg lateralis, it would be challenging to achieve an esthetic restoration by orthodontic treatment alone. In such case, after orthodontic treatment, dento-gingivo-facial compositional diagnosis and analysis, followed by gingivectomy and prosthodontic restoration is needed to improve the interdental mesial/distal, width/length ratio to achieve a satisfactory esthetic result. In addition, when improving the tooth proportion of peg lateralis by prosthodontic treatment, Porcelain laminate veneer (PLV), which results in less tooth structure loss, reproduction of similar shade to that of the proximal tooth and high transparency, is recommended. This case report demonstrates esthetic improvements by prosthodontic restoration through systematic diagnosis and treatment procedure in patients with unesthetic maxillary anterior proportion after orthodontic treatment due to peg lateralis by means of two female patients aged twenty years old.
Dental Porcelain ; Diagnosis* ; Diastema ; Esthetics ; Female ; Gingivectomy ; Humans ; Prosthodontics ; Reproduction ; Tooth*

Accuracy is the most important thing in implant prosthesis, for this reason it is essential procedure to check the accuracy of impression taking. However, impression material has its own error and the error occurs in model-making procedure. As an alternative way to this, using intraoral scanner can be suggested and many studies were issued reporting that there's no statistically significant difference in accuracy between intraoral scanner and conventional impression. Therefore, the purpose of this study is to report the process of making of implant prosthesis using intraoral scanner, which is more convenient, fast, accurate compared with conventional method.
Prostheses and Implants*

In fully edentulous cases, which are accompanied by severe residual ridge resorption and impairment of supporting tissues of complete dentures, proper diagnosis and systemic treatment planning are required for the improvement in retention, stability, and support of prosthesis. Provisional restoration, while it is unfamiliar in complete denture restoration, can be used as a valuable tool, which makes possible to evaluate the stability of complete dentures and receive feedback from patients in complex clinical situations. In this case, a provisional denture was used to improve stability of impression, polished, and occlusal surfaces of complete denture, and to consider esthetic requirements before final denture construction. The result was clinically satisfactory in terms of functional and esthetical aspects.
Denture, Complete ; Dentures* ; Diagnosis* ; Humans ; Mouth, Edentulous ; Prostheses and Implants

With the recent progress of digital technology, the computer guided surgery utilizing a guide template in the placement of implant has been actively performed, and the method employing the intraoral scanner at the implant prosthesis introduced. Fabrication method of the guide template can be largely classified into design-related rapid prototyping (RP) system and vector milling system, and each of the method has its own weakness in the clinical application despite of excellent accuracy. Thus, in this case study, a working model was fabricated by the wax RP technology using images acquired by CBCT and an intraoral scanner, and the metal bushing was picked up with orthodontic resin cast upon the wax model. Using this method, a surgical guide template was fabricated and used in surgery. From this, we could obtain a satisfactory outcome clinically in the implant placement and the fabrication of the final prostheses and thus report this case herein.
Prostheses and Implants

Developing of digital technique, it is possible to fabricate implant prostheses for edentulous area using intraoral 3-dimentional information throughout implant diagnosis and treatment process. It is being changed that from the method using CAD/CAM, producing prostheses by model scanning after conventional impression and model processing, to the method of fabricating implant provisional restorations and customized abutments by digital impression after connecting digital impression copings (scanbody) and implant fixtures without models. But, this digital method has not been actively used for implant prostheses not yet. Specially, it is short of intraoral digital impression cases for immediate provisional restorations of the maxillary anterior implants. The gingival contour impression of maxillary anterior area is very important for esthetic restorations. Accordingly, in this case report, the using a digital impression coping (scanbody) and digital impression by CEREC Omnicam (Sirona, Bensheim, Germany) or Trios (3shape, Copenhagen, Denmark) were introduced for immediate provisional restorations in 3 cases needed a single implant restoration in maxillary anterior area. The clinical results were satisfactory on the convenience and accuracy of digital impression technique and the good esthetics of final restorations.
Diagnosis ; Esthetics ; Prostheses and Implants

Loss of teeth may not only imply impaired oral function and loss of alveolar bone but is also often accompanied by reduced self-confidence. This results in a larger problem with the fully edentulous patient. The patient introduced in this study showed multiple missing teeth and mobility of remaining teeth and wanted to have fixed dental prosthesis using implants. Remaining teeth were extracted because of periodontally bad prognosis. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using implant hybrid prosthesis in fully edentulous patient.
Dental Prosthesis ; Humans ; Mouth Rehabilitation* ; Prognosis ; Prostheses and Implants* ; Tooth

Aesthetic impression is emphasized in the recent field of implant restoration. However, there is limitation of creating proper shape of soft tissue as well as cervical emergence profile due to the use of pre-existing healing abutment in the process of initial post-operative soft tissue healing period. Designing the shape of abutment into the final customized abutment instead of its original shape helped to achieve more aesthetic implant restoration by applying healing abutment which could minimize the malposition and recession of soft tissue. In this study, soft tissue healing was promoted using the post-operative customized healing abutment and thereby obtained the result of more aesthetic and functional restoration by minimizing displacement of soft tissue in the process of applying final customized abutment.

Treating patients with severely worn dentition often requires comprehensive prosthetic treatments. Oral rehabilitation and long-term stability could be achieved by analyzing the cause of the wear and changing vertical dimension. The temporary restoration procedure is executed and patient's adaptation is evaluated by long-term observation when treatment is accompanied with increasing vertical dimension. In this case, 54 year-old male presented with worn dentition and esthetic dissatisfaction. In oral manifestations, severely worn dentition with attrition and erosion is diagnosed. To evaluate change of vertical dimension, interocclusal rest space, facial appearance, pronunciation, clinical crown length, distance from incisor edge to labial vestibule are evaluated. Consequently, 2.5 mm increase of vertical dimension that based on articulator incisal pin is determined. After 8 weeks stabilization period with temporary prostheses, definitive prostheses are fabricated. After 6 months follow up period, satisfactory outcomes were achieved both in functional and esthetic aspects through this procedure.
Crowns ; Dental Articulators ; Dentition* ; Follow-Up Studies ; Humans ; Incisor ; Male ; Mouth Rehabilitation* ; Oral Manifestations ; Prostheses and Implants ; Rehabilitation ; Tooth Wear ; Vertical Dimension*

Due to the limitations of conventional removable partial denture prostheses to treat a cleft lip & palate patient who shows scar tissue on upper lip, excessive absorption of the maxillary residual alveolar ridge, and class III malocclusion with narrow palate and undergrowth of the maxilla, 4 implants were placed on the maxillary edentulous region and a maxillary removable implant-supported partial denture was planned using a CAD/CAM milled titanium bar. Unlike metal or gold casting technique which has shrinkage after the molding, CAD/CAM milled titanium bar is highly-precise, economical and lightweight. In practice, however, it is very hard to obtain accurate friction-fit from the milled bar and reduction in retention can occur due to repetitive insertion and removal of the denture. Various auxiliary retention systems (e.g. ERA(R), CEKA(R), magnetics, Locator(R) attachment), in order to deal with these problems, can be used to obtain additional retention, cost-effectiveness and ease of replacement. Out of diverse auxiliary attachments, Locator(R) has characteristics that are dual retentive, minimal in vertical height and convenient of attachment replacement. Drill and tapping method is simple and the replacement of the metal female part of Locator(R) attachment is convenient. In this case, the Locator(R) attachment is connected to the milled titanium bar fabricated by CAD/CAM, using the drill and tapping technique. Afterward, screw holes were formed and 3 Locator(R) attachments were secured with 20 Ncm holding force for additional retention. Following this procedure, satisfactory results were obtained in terms of aesthetic facial form, masticatory function and denture retention, and I hereby report this case.
Absorption ; Alveolar Process ; Cicatrix ; Cleft Lip* ; Denture Retention ; Denture, Partial* ; Denture, Partial, Removable ; Dentures ; Female ; Fungi ; Humans ; Lip ; Malocclusion ; Maxilla ; Palate* ; Prostheses and Implants ; Titanium

PURPOSE: We aimed to investigate the effect of combined various microgrooves and thermal oxidation on the titanium (Ti) and to evaluate various in vitro responses of human periodontal ligament cells (PLCs). MATERIALS AND METHODS: Grade II titanium disks were fabricated. Microgrooves were applied on titanium discs to have 0/0 microm, 15/3.5 microm, 30/10 microm, and 60/10 microm of respective width/depth by photolithography. Thermal oxidation was performed on the microgrooves of Ti substrata for 3 h at 700degrees C in air. The experiments were divided into 3 groups: control group (ST), thermal oxidation group (ST/TO), and combined microgrooves and thermal oxidation group (Gr15-TO, Gr30-TO, Gr60-TO). Surface characterization was performed by field-emission scanning microscopy. Cell adhesion, osteoblastic differentiation, and mineralization were analyzed using the bromodeoxyurdine (BrdU), Alkaline phosphatase (ALP) activity, and extracellular calcium deposition assays, respectively. Statistical analysis was performed using the oneway analysis of variance and Pearson's bivariate correlation analysis (SPSS Version 17.0). RESULTS: In general, the combined microgrooves and thermal oxidation group (Gr15-TO, Gr30-TO, Gr60-TO) showed significantly higher levels compared with the control (ST) or thermal oxidation (ST-TO) groups in the BrdU expression, ALP activity, and extracellular calcium deposition. Gr60-TO group induced highest levels of cell adhesion and osteoblastic differentiation. CONCLUSION: Within the limitation of this study, we conclude that the Ti surface treatment using combined microgrooves and thermal oxidation is highly effective in inducing the cell adhesion andosteoblastic differentiation. The propose surface is also expected to be effective in inducing rapid and strong osseointegration of Ti oral implants.
Alkaline Phosphatase ; Analysis of Variance ; Bromodeoxyuridine ; Calcium ; Cell Adhesion ; Humans ; Microscopy ; Osseointegration ; Osteoblasts* ; Periodontal Ligament ; Titanium*