The occlusal treatment including prosthetic treatment should be considered when the pathologic symptom was observed with the excessive discrepancy between the centric relation occlusion (CRO) and the maximum intercuspal position (MIP). Through careful diagnosis, the malocclusion and interarch relationship can be analyzed, and occlusal adjustment, restorative treatment, orthodontic therapy, or orthognathic surgery can be performed depending on the degree of disharmony. The patient in this case report complained the unstable occlusion and loss of masticatory function that had been occurring for several years. At the time of the visit, the patient showed severe occlusal disharmony, with only the upper right second molar contacting the lower jaw at the maximum intercuspal position. Based on the analysis of the occlusion, it was difficult to solve the problem with just occlusal adjustment or restorative treatment. In addition, the patient had the skeletal class II malocclusion between the upper and lower jaws. Therefore, for resolving the severe skeletal class II malocclusion, pre- and post-orthodontic treatment, bilateral sagittal split ramus osteotomy (BSSRO) was performed. After that, the occlusal adjustment was performed for stable occlusion, and the missing teeth area was restored with dental implants. During the follow-up period, a periodic follow-up visits and additional occlusal adjustments were performed to achieve a stable centric occlusion and harmonious anterior and lateral guidance. As a result, the final prosthodontic treatment was completed, and the patient’s masticatory function was restored.

Based on rapid improvement in digital fields, many advanced digital technologies are utilized in prosthodontic treatment. Especially, intraoral scanners and 3D printing technology are commonly used, and facial scanning technology is recently being attempted to be part of these digital routines. This case report aims to introduce a digital procedure using the intraoral scanner, facial scanner, and 3D printing technology to create definitive restorations, which are esthetic and harmonious with patient’s face. From thoroughly evaluated full-mouth provisional restoration which was manufactured and fitted conventionally, definitive prostheses were fabricated using various digital technique. Stable occlusion with functionally and aesthetically satisfying results were achieved.

The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.
Acromegaly ; Consensus ; Expert Testimony ; Insurance Coverage ; Insurance, Health ; Octreotide ; Somatostatin

A patient who went through maxillectomy can have soft palate defects including oronasal fistulas and suffer from dysphagia and dysarthria due to velopharyngeal insufficiency. This defect causes the food to enter nasal cavity and creates hypernasal sound which debilitates a quality of life. An obturator can rehabilitate the substantial oral tissue defects. The maxillary obturator separates the nasopharynx from the oropharynx during speech and deglutition by closing of the defect. For edentulous obturator patient, it is difficult to obtain proper retention due to reduced peripheral sealing. Therefore, the contours of the defects must be used to maximize the retention, stability, and support. Hollow type obturator can improve physiologic function by reducing weight than the traditional obturator. This case report describes a patient with hemi-maxillectomy who recovers mastication, speech, deglutition, and appearance with a maxillary obturator using physiological border molding of the velopharyngeal area and double-processing method.
Deglutition ; Deglutition Disorders ; Dysarthria ; Fistula ; Fungi ; Humans ; Mastication ; Maxillofacial Prosthesis ; Methods ; Nasal Cavity ; Nasopharynx ; Oropharynx ; Palatal Obturators ; Palate, Soft ; Quality of Life ; Rehabilitation ; Velopharyngeal Insufficiency

PURPOSE: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. MATERIALS AND METHODS: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The Kaplan-Meier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. RESULTS: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. CONCLUSION: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications
Dentists ; Follow-Up Studies ; Humans ; Jeollabuk-do ; Kaplan-Meier Estimate ; Medical Records ; Methods ; Mucositis ; Proportional Hazards Models ; Prostheses and Implants ; Prosthodontics ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tooth

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.
Acromegaly ; Expert Testimony ; Growth Hormone ; Humans ; Octreotide ; Pituitary Neoplasms ; Somatostatin

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.

Implant supported removable partial denture (ISRPD) using the implants enables favorable rehabilitation by complementing biomechanical limitations of the conventional removable partial denture (RPD). However, continuous recall check is necessary for evaluation of the mechanical and biological complications to ensure good long-term prognosis of ISRPD. This clinical report describes the complication and management in patient of Kennedy class I edentulism with ISRPD using healing abutment. The wear and fracture of healing abutment occurred at 36 months after delivery. So, healing abutment was replaced by connecting Locator® abutment for altering into the implant retained partial overdenture.
Complement System Proteins ; Denture, Overlay ; Denture, Partial, Removable* ; Humans ; Prognosis ; Rehabilitation

In edentulous mandible, implant supported overdenture was considered as a first treatment option. Konus type attachment supplies rigid support and cross arch stabilization so that more favorable force transmission and distribution can be attained. In the dentistry, computer aided design-computer aided manufacturing (CAD-CAM) system makes it possible to fabricate restorations with high precision and effectiveness. Recently, Palladium-silver (Pd-Ag) alloy which is millable has been developed. This article presents that application of CAD-CAM Konus type attachment can be provide satisfactory stability and function on four-implant supported mandibular overdenture.
Alloys ; Computer-Aided Design* ; Dentistry ; Denture, Overlay* ; Equipment and Supplies ; Mandible

PURPOSE: The purpose of this study was to assess the impact of the core materials, thickness and fabrication methods of veneering porcelain on prosthesis fracture in the porcelain fused to metal and the porcelain veneered zirconia. MATERIALS AND METHODS: Forty nickel-chrome alloy cores and 40 zirconia cores were made. Half of each core group was 0.5 mm-in thickness and the other half was 1.0 mm-in thickness. Thus, there were four groups with 20 cores/group. Each group was divided into two subgroups with two different veneering methods (conventional powder/liquid layering technique and the heat-pressing technique). Tensile strength was measured using the biaxial flexural strength test based on the ISO standard 6872:2008 and Weibull analysis was conducted. Factors influencing fracture strength were analyzed through three-way ANOVA (alpha< or =.05) and the influence of core thickness and veneering method in each core materials was assessed using two-way ANOVA (alpha< or =.05). RESULTS: The biaxial flexural strength test showed that the fabrication method of veneering porcelain has the largest impact on the fracture strength followed by the core thickness and the core material. In the metal groups, both the core thickness and the fabrication method of the veneering porcelain significantly influenced on the fracture strength, while only the fabrication method affected the fracture strength in the zirconia groups. CONCLUSION: The fabrication method is more influential to the strength of a prosthesis compared to the core character determined by material and thickness of the core.
Alloys ; Dental Porcelain* ; Prostheses and Implants ; Tensile Strength