In recent years, with the rapid development of digital technology, the application of oral virtual patients in prosthodontics, orthodontics, oral and maxillofacial surgery, and other disciplines has gradually increased. Although the focus on oral virtual patients varies in different disciplines, the application of oral virtual patients in assisting the prediction of treatment effects and the formulation of treatment plans will have good prospects. The construction accuracy and presentation effects of oral virtual patients can be influenced by the source of three-dimensional (3D) image, and methods of registration. Based on the studies and clinical experiences of our team, researches of other teams, the source of 3D images, the construction methods, and the clinical applications of virtual patients in prosthodontics will be presented, so as to provide a reference for normalized application and development of oral virtual patients and to offer a future development direction of oral virtual patients.
Humans ; Prosthodontics/methods* ; Imaging, Three-Dimensional ; Orthodontics ; Surgery, Oral

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

BACKGROUND: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. METHODS: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). RESULTS: For all groups, the duration of dental treatments was 43 ± 18 minutes, total sedation time was 73 ± 23 minutes, and total BIS values was 57 ± 12. The propofol maintenance dosage values for each group were: mental retardation, 3 ± 0.5 (2–4) µg/ml; autism, 3.1 ± 0.7 (2–5) µg/ml; brain lesion, 2.8 ± 0.7 (1.5–5) µg/ml; genetic disease, 2.9 ± 0.9 (1–4) µg/ml; and dementia 2.3 ± 0.7 (1–3.4) µg/ml. CONCLUSIONS: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.
Anesthesia, General ; Autistic Disorder ; Brain ; Consciousness ; Deep Sedation ; Dementia ; Dental Clinics ; Hemodynamics ; Humans ; Intellectual Disability ; Methods ; Minor Surgical Procedures ; Periodontics ; Propofol ; Prosthodontics ; Retrospective Studies ; Seoul

PURPOSE: This study aimed to assess the agreement between 2 raters in evaluations of students on a prosthodontic clinical practical exam integrated with directly observed procedural skills (DOPS). METHODS: A sample of 76 students was monitored by 2 raters to evaluate the process and the final registered maxillomandibular relation for a completely edentulous patient at Mansoura Dental School, Egypt on a practical exam of bachelor’s students from May 15 to June 28, 2017. Each registered relation was evaluated from a total of 60 marks subdivided into 3 score categories: occlusal plane orientation (OPO), vertical dimension registration (VDR), and centric relation registration (CRR). The marks for each category included an assessment of DOPS. The marks of OPO and VDR for both raters were compared using the graph method to measure reliability through Bland and Altman analysis. The reliability of the CRR marks was evaluated by the Krippendorff alpha ratio. RESULTS: The results revealed highly similar marks between raters for OPO (mean= 18.1 for both raters), with close limits of agreement (0.73 and −0.78). For VDR, the mean marks were close (mean= 17.4 and 17.1 for examiners 1 and 2, respectively), with close limits of agreement (2.7 and −2.2). There was a strong correlation (Krippendorff alpha ratio, 0.92; 95% confidence interval, 0.79–0.99) between the raters in the evaluation of CRR. CONCLUSION: The 2 raters' evaluation of a clinical traditional practical exam integrated with DOPS showed no significant differences in the evaluations of candidates at the end of a clinical prosthodontic course. The limits of agreement between raters could be optimized by excluding subjective evaluation parameters and complicated cases from the examination procedure.
Centric Relation ; Dental Occlusion ; Education, Dental ; Educational Measurement ; Egypt ; Humans ; Methods ; Prosthodontics ; Schools, Dental ; Vertical Dimension

PURPOSE: The purpose of this study is to analyze the factors affecting the longevity of failed prosthesis and the success rate of the prosthesis based on the data evaluated with the newly developed Korean Academy of Prosthodontics (KAP) criteria. MATERIALS AND METHODS: Evaluation was performed in the restored prosthesis for patients who visited the prosthodontics department of the 13 dental university hospitals and general hospitals. The status of the prosthesis was classified into four categories: Good, Fair, Bad, Worst. The success was recorded if only the category was classified in ‘good’. The mean duration of failed prostheses and the success rate through Kaplan-Meier method were analyzed. RESULTS: A total of 1,804 cases of prosthesis were evaluated: 810 cases of fixed dental prostheses (FDP), 519 cases of Removable Dental Prostheses (RDP), and 475 cases of implant prosthesis. The mean duration of failed FDP was 11.41 ± 0.30 years and the median was 10 years. The mean duration of failed RDP was 8.18 ± 0.29 years and the median was 7 years. The mean duration of failed implant prosthesis was 7.99 ± 0.30 years and the median was 7 years. The factors related to the failure were as follows: number of units, abutments, abutments treated with root canal, and plaque index in FDPs; treated and opposing dentition in RDPs; the number of implants, duration of use, and plaque index in implant prostheses. CONCLUSION: The average duration of failed prosthesis was 11.41 years for FDPs, 8.18 years for RDPs, and 7.99 years for implant prosthesis, according to the evaluation with newly developed KAP criteria.
Dental Prosthesis ; Dental Pulp Cavity ; Dentition ; Follow-Up Studies ; Hospitals, General ; Hospitals, University ; Humans ; Kaplan-Meier Estimate ; Korea* ; Life Expectancy ; Longevity* ; Methods ; Prostheses and Implants* ; Prosthodontics

Nowadays, digital dentistry is generally applied to prosthodontics with fabrication of inlays or any other fixed prostheses by utilizing CAD/CAM (computer-aided design/computer-aided manufacturing) technology and intraoral scanner. However, in fabricating removable prosthesis, there are some limitations for digital technology to substitute conventional casting method. Therefore, approaching removable prostheses fabrication with CAD/CAM technology would be a meaningful trial. In this case report, Kennedy class III mandibular edentulous patient who was in need of increasing the vertical dimension of occlusion was treated with removable partial denture using CAD and rapid prototyping technique. Surveying and designing the metal framework of the partial denture was performed with CAD, and sacrificial plastic pattern was fabricated with rapid prototyping technique. During the follow up period of nine months, the removable partial denture has provided satisfactory results in esthetics and function.
Computer-Aided Design* ; Dentistry ; Denture, Partial ; Denture, Partial, Removable ; Esthetics ; Follow-Up Studies ; Humans ; Inlays ; Methods ; Plastics ; Prostheses and Implants ; Prosthodontics ; Vertical Dimension

Target restoration space (TRS) is the most precise space required for designing optimal prosthesis. TRS consists of an internal or external tooth space to confirm the esthetics and function of the final restoration. Therefore, assisted with quantitive analysis transfer, TRS quantitative analysis is a significant improvement for minimum tooth preparation. This article presents TRS quantity-related measurement, analysis, transfer, and internal relevance of three TR. classifications. Results reveal the close bond between precision and minimally invasive treatment. This study can be used to improve the comprehension and execution of precise esthetic prosthodontics.
Esthetics ; Esthetics, Dental ; Humans ; Prosthodontics ; methods ; Tooth Preparation

PURPOSE: The most important factor in longevity studies of dental prostheses is objective and consistent evaluation of the prosthesis. The Korean Academy of Prosthodontics suggested developing a standardized method for longevity studies of dental prostheses. The purpose of this study is to evaluate previously-used criteria and to develop new criteria, in the form of a procedure flowchart and an evaluation sheet. These new criteria may be able to provide a unified standard for future longevity studies of dental prostheses. MATERIALS AND METHODS: A literature review was performed about the evaluation of dental prostheses. Taking into account the strengths and weaknesses of previously used criteria, a novel, intuitive and objective method was developed for assessment of dental prostheses. Then, a pilot survey was performed with the newly developed flowchart and evaluation sheet to determine problems and implement possible improvements. RESULTS: Thirty cases of fixed dental prosthesis (FDP), 25 cases of removable dental prosthesis (RDP), and 13 cases of implant supported prosthesis (ISP) were evaluated. The average life expectancy estimate was 12.82 years for FDP, 5.96 years for RDP, and 4.82 years for ISP with Kaplan-Meier survival analysis. Additionally, possible improvements discovered by the pilot survey were reflected in the flowchart and evaluation sheet. CONCLUSION: The newly developed KAP criteria, flowchart and evaluation sheet enabled objective and consistent results in trial longevity studies of dental prostheses. It is expected that future studies will not only use the KAP criteria but also further improvement will be made on them.
Data Collection ; Dental Prosthesis* ; Kaplan-Meier Estimate ; Korea* ; Life Expectancy ; Longevity* ; Methods ; Prostheses and Implants ; Prosthodontics* ; Software Design ; Survival Rate

Dental Prosthesis ; Humans ; Prosthodontics ; methods

Teeth wear and extrusion of antagonist are commonly observed in deep bite patient having severe vertical and horizontal overlap. These problems cause collapse of occlusal plane and abnormal anterior guidance. Without restoring harmonious occlusion, loss of multiple teeth and decreased masticatory function could not be prevented. To resolve problems associated with deep bite, multidisciplinary treatment including oral surgical, orthodontic and prosthetic treatment should be performed. This clinical report describes the results of increasing occlusal vertical dimension with a full-mouth restoration procedure. The treatment procedures include extraoral and intraoral examination, diagnosis, treatment planning, diagnostic wax-up, segmental osteotomy, orthodontic intrusion and prosthodontic rehabilitation. Full mouth rehabilitation with increasing occlusal vertical dimension can solve esthetic and functional problems.
Dental Occlusion ; Diagnosis ; Humans ; Methods ; Mouth Rehabilitation* ; Osteotomy* ; Overbite* ; Prosthodontics ; Rehabilitation ; Tooth ; Vertical Dimension