Immediate implant placement and restoration have the advantage of shortening the treatment period and maintaining aesthetics until final restoration. However, single implant restoration in the maxillary anterior region may be aesthetically difficult, and surgical trauma delivered to soft and hard tissues during implant placement may affect future aesthetic results. In order to obtain predictable results during anterior implant placement and restoration, surgery and restoration plans must consider the height of the interdental bone, characteristics of the gingiva, and morphological characteristics of the patient’s teeth. In this case, we attempted to reproduce the emergence profile and stabilized soft tissue through gingiva modification and digital impression of a labially placed maxillary anterior implant in a patient who desired porcelain fused-metal (PFM) restoration due to economic issues.

To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors.Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.

The concept of ‘Implant Supracrestal Complex (ISC)’ was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant.Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the longterm stability of the implant.

Recently, computer-aided design and computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of prosthesis. The diagnostic wax-up by using digital technology simplifies the laboratory process and provides clinical efficiency and convenience. In this case, Digital diagnostic wax-up was superimposed on extra-oral photo to consider the patient’s facial appearance and utilized to produce the final prosthesis. It can be more efficient and esthetic than a diagnostic wax-up that was made only on a model. The digital diagnostic wax-up that superimposed on extra-oral photo not only visualizes the predicted outcome of prosthodontic treatment but also improves satisfaction and facilitates the communication between patient and dentist. We report aesthetically and functionally satisfactory results that obtained after restoration.

Long-term use of inappropriate prosthesis often results in habitual closure or irregular mandibular movements. In that case, guide to the stable centric position is difficult. Therefore, by using a treatment denture, the muscles and TMJ should be stabilized and the jaw relation should be acquired with the treatment position. Compared to the conventional method, digital technology in fabrica-tion complete denture has the advantage of reproducing a stable tooth arrangement in cases of difficult tooth alignment, minimiz-ing laboratory errors and reducing denture fabrication time. Therefore, in this case, the final denture was fabricated by digitally re-producing the stable treatment position, vertical dimension, and lip support with a treatment denture, and satisfactory results wereobtained.

Recently with the advance in digital dentistry, the fabrication of dentures using computer-aided design and computer-aided manufacturing (CAD-CAM) is on the rise. The denture designed through a CAD software can be produced in a 3-dimensional manufacturing process. This process includes a subtractive processing method such as milling and an additive processing method such as 3D printing and in which it can be applied efficiently in more complex structures. In this case, complete dentures were fabricated using Stereolithography (SLA)-based 3D printing to shorten the production time and interval of visits in patient with physical disabilities due to cerebral infarction. For definitive impression, the existing interim denture was digitally replicated and used as an individual tray. The definitive impression obtained with polyvinyl siloxane impression material was including information about the inclination and length of the maxillary anterior teeth, vertical dimension, and centric relation. In addition, facial scan data with interim denture was obtained so that it can be used as a reference in determination of the occlusal plane and in arrangement of artificial teeth during laboratory work. Artificial teeth were arranged through a CAD program, and a gingival festooning was performed. The definitive dentures were printed by SLA-based 3D printer using a FDA-approved liquid photocurable resin. The denture showed adequate retention, support, and stability, and results were satisfied functionally and aesthetically.

To investigate the perceptions and attitudes of dental hygienists toward radiation safety management in Korea. A total of 800 dental hygienists were randomly selected for an anonymous survey, and 203 of them participated. The questionnaire items included the following: sex, career period, type of installed radiographic equipment, recognition of the diagnostic reference level (DRL), participation in radiation safety education, and attitudes toward radiation protection for both patients and dental hygienists. The participants were divided into two groups according to their years of experience (< 10 years versus ≥ 10 years). The difference between the groups was investigated according to frequency distribution. Fisher’s exact test or Pearson’s chi-square (χ2 ) test was used as appropriate. A regression analysis was performed to investigate the impact of wearing a thyroid collar for personnel protection during patient radiation exposure. The types of installed radiographic equipment included panoramic radiography (96.1%), cephalometric radiography (76.9%), intraoral radiography (72.9%), and cone-beam computed tomography (69.5%). Significant differences were observed in the learning pathway for the DRL (Fisher’s exact test, p < 0.05), satisfaction with radiation safety education (Pearson’s χ2 test = 5.3975, Pr = 0.02), and use of personnel radiation monitoring systems (Pearson’s χ 2 test = 18.1233, Pr = 0.000) between the groups. Significant differences were also observed in personnel protection using a thyroid collar and patient protection during panoramic radiography (odds ratio = 14.2). Dental hygienists with more than 10 years of experience were more satisfied with radiation safety education and more interested in radiation monitoring. Considering career experience, customized, continuous, and effective radiation safety management education should be provided.

Conventional denture impression techniques have limitations for edentulous patients with severe alveolar bone resorption and can cause problems from excessive border extension. Especially when a patient has movable tissue it is difficult to make accurate impression, thus might interrupt stable seating of complete denture. Fabrication of complete denture using closed mouth technique for edentulous patient with severe ridge resorption is thought to provide better stability and retention. In this case, an 86-year-old patient had both edentulous jaws with epulis fissuratum on maxillary anterior ridge and severe mandibular ridge resorption. Thus, tentative vertical dimension was determined by using Centric tray and individual tray attached with gothic arch tracer was fabricated. Complete denture was fabricated using closed mouth technique and the patient was satisfied with better stability and retention of the complete denture.
Aged, 80 and over ; Bone Resorption ; Denture, Complete* ; Dentures ; Gingival Diseases ; Humans ; Jaw, Edentulous ; Mouth* ; Vertical Dimension

When it comes to treat patient with loss of vestibule, conventional denture impression have limitation which can cause problems of excessive border extension. Suction denture with closed mouth technique which was introduced to solve this problem, forms negative pressure being sealed denture flanges by mobile mucosa when the patient swallows and chews. Also, it can decrease patient's visiting time by taking impression and gothic arch tracing at once. In this case, considering patient's chief complain which is a loose fit of present lower denture, suction dentures with closed mouth technique was planned.
Bone Resorption ; Denture, Complete ; Dentures ; Humans ; Mouth ; Mucous Membrane ; Rehabilitation ; Suction ; Swallows

PURPOSE: The aim of this clinical study was to assess the accuracy of the implants placed using a universal digital surgical guide. MATERIALS AND METHODS: Among 17 patients, 28 posterior implants were included in this study. The digital image of the soft tissue acquired from cast scan and hard tissue from CBCT have been superimposed and planned the location, length, diameter of the implant fixture. Then digital surgical guides were created using 3D printer. Each of angle deviations, coronal, apical, depth deviations of planned and actually placed implants were calculated using CBCT scans and casts. To compare implant positioning errors by CBCT scans and plaster casts, data were analyzed with independent samples t-test. RESULTS: The results of the implant positioning errors calculated by CBCT and casts were as follows. The means for CBCT analyses were: angle deviation: 4.74 ± 2.06°, coronal deviation: 1.37 ± 0.80 mm, and apical deviation: 1.77 ± 0.86 mm. The means for cast analyses were: angle deviation: 2.43 ± 1.13°, coronal deviation: 0.82 ± 0.44 mm, apical deviation: 1.19 ± 0.46 mm, and depth deviation: 0.03 ± 0.65 mm. There were statistically significant differences between the deviations of CBCT scans and cast. CONCLUSION: The model analysis showed lower deviation value comparing the CBCT analysis. The angle and length deviation value of the universal digital guide stent were accepted clinically.
Casts, Surgical ; Clinical Study ; Humans ; Printing, Three-Dimensional ; Radiotherapy Planning, Computer-Assisted ; Stents ; Surgery, Computer-Assisted