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조선대학교 치의학연구원> Oral Biology Research (OBR)> Nasal packing with bupivacaine during nasotracheal intubation can reduce intubation-related epistaxis

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Nasal packing with bupivacaine during nasotracheal intubation can reduce intubation-related epistaxis

Ho Kyung Yu , Jiyoung Park , Young-hoon Kang , Hee Bin Park , Sung Il Bae , Soo Hee Lee , Seong-ho Ok , Sang-ho Jeong , Miyeong Park
  • : 조선대학교 치의학연구원
  • : Oral Biology Research (OBR) 45권3호
  • : 연속간행물
  • : 2021년 09월
  • : 107-114(8pages)
Oral Biology Research (OBR)

DOI


목차

Introduction
Materials and Methods
Results
Discussion
Conflicts of Interest
ORCID
References

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초록 보기

Epistaxis often is caused by nasal mucosal damage and vascular injury after nasotracheal (NT) intubation. Bupivacaine constricts blood vessels at low concentrations and dilates them at high concentrations. In this study, in which we evaluated the effects of intranasal packing with bupivacaine to prevent epistaxis and pain induced by NT intubation, we classified 180 patients into three groups: an untreated group (n=60), a group pretreated with epinephrine (n=60), and a group pretreated with bupivacaine (n=60). In all groups, we used nasal Ring-Adair-Elwyn tubes with the thermosoftening method for NT intubation. We classified the degree of epistaxis as Grade 0 (none), Grade 1 (mild), Grade 2 (moderate), or Grade 3 (severe). We assessed postoperative visual analog scale (VAS) scores for nose pain in the recovery room. We found that the incidence of epistaxis in the group pretreated with bupivacaine was significantly less than was that of the untreated group (55% vs. 35%, p<0.05). Univariate logistic regression analysis revealed a reduction in epistaxis with bupivacaine nasal packing (odds ratio=0.689, 95% confidence interval=0.478, 0.992). Postoperative VAS scores after 30 minutes in the nasal area were lower in the group pretreated with bupivacaine than were those in the untreated group or the group pretreated with epinephrine (p<0.05). Therefore, we conclude that nasal packing with bupivacaine can help reduce epistaxis and nasal pain more effectively as compared to cases without pretreatment with this anesthetic.

UCI(KEPA)

I410-ECN-0102-2022-500-000745272

간행물정보

  • : 의약학분야  > 기초치의학
  • : KCI등재
  • :
  • : 계간
  • : 2508-2558
  • : 2508-2566
  • : 학술지
  • : 연속간행물
  • : 1978-2022
  • : 1481


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The aim of this study was to evaluate the clinical and histologic outcomes of sinus floor augmentation using mixtures of cancellous and cortical freeze-dried bone allograft (AG) at two different ratios (5:5 and 3:7). The sinuses of 21 patients were grafted with the two types of mixed allografts. Cone-beam computerized tomography scans were obtained, and the radiographic parameters measured were residual bone height and bone gain after bone healing. Clinical examinations and histologic analyses were performed 6 months after the grafting procedure. Twenty implant sites in the 5:5 mixed AG group and 22 implant sites in the 3:7 mixed AG group were analyzed. The bone gain after bone healing was 13.0±3.1 mm in the 5:5 group and 14.5±3.5 mm in the 3:7 group. The survival rates of the implants in both groups were 100% during follow-up periods. The newly formed bone was 29.9±16.6% in the 5:5 AG group and 25.1±10.1% in the 3:7 AG group. Moreover, the percentage of residual graft material was 15.2±12.7% in the 5:5 AG group and 20.4±12.1% in the 3:7 AG group. The connective tissues were 55.0±14.0% and 54.6±10.0% in the 5:5 and 3:7 AG groups, respectively. The two different ratios of AG presented with different histological outcomes after bone healing. Additionally, adequate new bone formation for the placement of implants was achieved following maxillary sinus augmentation using both types of AG.

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2Correlation analysis of the oral mucosal microbiome and diabetes mellitus using microbial DNA in elderly male subjects

저자 : Jong-hoon Lee , Young Lee , Seong-ho Choi , Eunsin Bae , Dong-woon Lee

발행기관 : 조선대학교 치의학연구원 간행물 : Oral Biology Research (OBR) 46권 1호 발행 연도 : 2022 페이지 : pp. 10-20 (11 pages)

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Oral microbiomes are associated with various systemic diseases, and the need for a deeper understanding of oral microbiomes has garnered substantial research interest. The differences between oral mucosal microbiomes of individuals with and without diabetes were analyzed in this study, to improve disease evaluation and therapeutic development. Mucosal samples were collected from 10 and 16 individuals with and without diabetes, respectively, during an implant-uncovering procedure. Subsequently, genomic DNA from the samples was used for 16S rRNA sequencing, and the compositions of the microbiomes were compared between the two groups. There were no significant differences in the alpha and beta diversities of the groups of individuals with and without diabetes. However, the group of individuals with/without diabetes presented a relatively higher abundance of the Corynebacteriaceae family (p=0.004) and the genus Corynebacterium (p=0.019). Our findings serve as a basis for future studies on the association between diabetes and bacterial species in the aforementioned taxonomic groups. The divergence between our results and past studies indicates the need for a unified study design for sample collection and the methods used for statistical analysis, when implementing a bioinformatics-based approach to assess microbiome sequencing data from oral mucosal samples.

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We evaluated the effects of lidocaine-maltodextrin-thrombin (LMT) collagen on new bone formation on a rat calvarial defect model. Thirty-six rats were randomly divided into three groups. A single bone window was prepared in the middle of the calvarium, and each bone defect was treated separately. In Group 1, the bone defect was sutured without any treatment. In group 2, only the collagen plug was inserted into the bone defect, and in group 3, the collagen plug soaked with LMT collagen was inserted. After four weeks, six animals were sacrificed randomly in each group, and samples of the skull area were then collected and subjected to micro-computed tomography and hematoxylin and eosin and Masson's trichrome staining. At eight weeks postsurgery, the remaining six rats in each group were treated identically. Consequently, no significant differences were noted in the bone formation between the groups at week 4. At week 8, a significant increase in new bone formation was observed in rats treated with collagen plug plus LMT collagen compared with untreated rats and rats treated only with the collagen plug. Therefore, the combination of LMT collagen and collagen plug is expected to function as an effective scaffold, which can provide clinicians with various possibilities and options for repairing bone defects.

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발행기관 : 조선대학교 치의학연구원 간행물 : Oral Biology Research (OBR) 46권 1호 발행 연도 : 2022 페이지 : pp. 29-35 (7 pages)

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The aim of this study is to investigate factors that affect the prognosis of adjacent and antagonistic teeth after an implant restoration. In total, 102 implant placement sites of 91 patients who underwent implant placement in Kyungpook National University Dental Hospital were included in this study. The average follow-up period was 68.27 months, whereas the maximum was 136 months. The cause of the previous extraction and implant-related factors were investigated. Radiographic evaluations were performed after the surgery and prosthetic treatment. Extraction and other treatments, including restorative or endodontic treatment of the antagonistic and adjacent teeth, were analyzed during the follow-up period. The chi-square test and Fisher exact test were used to analyze which factors could affect the implant prognosis. Of the studied antagonistic teeth, a total of 4.9% were treated and 12.7% were extracted. Furthermore, of the studied adjacent teeth, a total of 2.9% underwent treatment and 3.9% were extracted. The causes of previous extractions and types of restoration materials showed a significant difference in the treatment rate of adjacent teeth (p=0.05). Furthermore, implant surface types showed a significant difference in the extraction rate of antagonistic teeth (p=0.05). In conclusion, it can be suggested that the cause of the previous extraction and the material of the implant restoration may affect the prognosis of the teeth adjacent to the implant. Moreover, a specific type of implant surface may be a risk factor for antagonistic teeth.

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저자 : Ryeon Jin , Ju-hee Jeong , A-ra Cho , Hyoung-hoon Jo

발행기관 : 조선대학교 치의학연구원 간행물 : Oral Biology Research (OBR) 46권 1호 발행 연도 : 2022 페이지 : pp. 36-41 (6 pages)

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This study aimed to evaluate the effect of file size in measuring the electronic working length of teeth with open apex. Twenty teeth were prepared to make the open apex models. A bur was used to cut a 2-mm apical end; the point where #10K file's tip was reflected on the cut root surface was set to the actual root canal length (AL). A divergent open apex was prepared by retrograde apical preparation. The teeth that were covered with a gauze soaked with saline were inserted in a plastic mold, and an electronic apex locator was connected with it. In each tooth, #10, #20, #30, #40, #50, #60, #70, and #80 files were inserted into the root canal, and the electronic working length (EL) was measured at the “Apex” signal. Then, the mean difference (ΔL) between the AL and EL was evaluated for each file size. EL measurements with all file sizes were short of the apical foramen, and there was a significant difference when the file size increased from #10 to #20 and #40 to #50. Within this study's limitations, the file size showed an impact in measuring the teeth's EL with open apex. When the size of the apical foramen is 1.14 mm, it is more accurate to use a file of #50 size or larger when measuring the working length with an electronic apex locator.

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저자 : Do-hyung Kim , Ji-hoo Han , Seong-nyum Jeong

발행기관 : 조선대학교 치의학연구원 간행물 : Oral Biology Research (OBR) 46권 1호 발행 연도 : 2022 페이지 : pp. 42-49 (8 pages)

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This study aimed to investigate the factors that affect marginal bone loss after the prosthesis delivery of a dental implant with an internal conical connection and a sandblasted, large-grit, acid-etched surface and to compare and investigate the marginal bone loss of dental implants and adjacent teeth in the same interproximal unit. Radiographic measurements using panoramic radiographic images obtained at 1 year and final follow-up (minimum 2 years) were performed to measure the marginal bone loss of the dental implant and adjacent teeth and the distance between them. The arch in which the dental implants were placed significantly affected the marginal bone loss of dental implants at the final follow-up (maxilla>mandible, p<0.05). At each period, the dental implants showed significantly less marginal bone loss (p< 0.05) than adjacent teeth. Dental implants placed >4 mm away from adjacent teeth showed significantly less marginal bone loss (p<0.05).

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1Evaluation of superoxide dismutase 3, heme-oxygenase, and myeloperoxidase expression levels associated with oxidative stress in chronic periodontitis

저자 : Yong Yoon , Hyerin Kim , Jae Mok Lee

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This study aimed to investigate the expression levels of antioxidative enzymes such as superoxide dismutase 3 (SOD3), heme-oxygenase (HO), and myeloperoxidase (MPOs), which are known to be associated with oxidative stress induction in chronic inflammatory conditions like periodontitis. We compared the expression levels of SOD3, HO, and MPO in the periodontal tissues of healthy individuals with those in the periodontal tissues of chronic periodontitis patients. The expression levels of SOD3, HO, and MPO were determined by Western blot technique, and the data were statistically analyzed. The expression levels of SOD3 and HO increased in periodontitis patients compared with those in healthy controls, and the degree of increase was dependent on the severity of periodontitis (p<0.05). In contrast, the expression level of MPO was lower in the periodontal tissues of healthy controls than that in the periodontal tissues of periodontitis patients (p<0.05). SOD and HO are involved in oxidative stress via antioxidative activity, and MPO is involved in oxidative stress via peroxidative activity. Hence, these findings suggest that antioxidative activity depends on the severity of inflammation. In conclusion, SOD3, HO, and MPO may play a role in oxidative stress-induced periodontitis, and these three factors may be related to the severity of inflammation. These factors are expected to be applied to the diagnosis and treatment of periodontitis through more comprehensive studies.

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2Nasal packing with bupivacaine during nasotracheal intubation can reduce intubation-related epistaxis

저자 : Ho Kyung Yu , Jiyoung Park , Young-hoon Kang , Hee Bin Park , Sung Il Bae , Soo Hee Lee , Seong-ho Ok , Sang-ho Jeong , Miyeong Park

발행기관 : 조선대학교 치의학연구원 간행물 : Oral Biology Research (OBR) 45권 3호 발행 연도 : 2021 페이지 : pp. 107-114 (8 pages)

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Epistaxis often is caused by nasal mucosal damage and vascular injury after nasotracheal (NT) intubation. Bupivacaine constricts blood vessels at low concentrations and dilates them at high concentrations. In this study, in which we evaluated the effects of intranasal packing with bupivacaine to prevent epistaxis and pain induced by NT intubation, we classified 180 patients into three groups: an untreated group (n=60), a group pretreated with epinephrine (n=60), and a group pretreated with bupivacaine (n=60). In all groups, we used nasal Ring-Adair-Elwyn tubes with the thermosoftening method for NT intubation. We classified the degree of epistaxis as Grade 0 (none), Grade 1 (mild), Grade 2 (moderate), or Grade 3 (severe). We assessed postoperative visual analog scale (VAS) scores for nose pain in the recovery room. We found that the incidence of epistaxis in the group pretreated with bupivacaine was significantly less than was that of the untreated group (55% vs. 35%, p<0.05). Univariate logistic regression analysis revealed a reduction in epistaxis with bupivacaine nasal packing (odds ratio=0.689, 95% confidence interval=0.478, 0.992). Postoperative VAS scores after 30 minutes in the nasal area were lower in the group pretreated with bupivacaine than were those in the untreated group or the group pretreated with epinephrine (p<0.05). Therefore, we conclude that nasal packing with bupivacaine can help reduce epistaxis and nasal pain more effectively as compared to cases without pretreatment with this anesthetic.

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Oral viridans streptococcus is the most common bacterial species present in human dental plaque. The Rapid ID 32 Strep (bioMerieux, Marcy-l'Etoile, France) test system allows for the identification of most streptococci within 4 hours. The aim of this study was to evaluate the reliability of this test in identifying isolates of α-hemolytic oral streptococci in human dental plaque and compare it with that of the 16S rRNA sequencing method. A total of eighty-five α-hemolytic streptococcal isolates were identified using 16S rRNA gene sequencing and Rapid ID 32 Strep. The Rapid ID 32 Strep method correctly identified 80% of the species and 87% of the streptococcal groups but failed to accurately identify five isolates (three S. cristatus, one S. australis, and one S. tigurinus).

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For the diagnosis of oral candidiasis, the most commonly used method is culturing the Candida strains acquired by rubbing the mucous membrane in the mouth using a sterile cotton swab on the medium. This study was conducted to compare the accuracy of Potato Dextrose Agar (PDA) and chromogenic CHROMagar media in diagnosing oral candidiasis. This study included patients diagnosed with oral candidiasis who visited Chosun University Dental Hospital between January 1, 2018 and February 28, 2019. All study subjects were tested using the culture method to diagnose oral candidiasis. For statistical analysis of this study, IBM SPSS version 25.0 (IBM Co., Armonk, NY, USA) was used. Cross analysis was used to compare the diagnostic accuracy of PDA and CHROMagar media as well as treatment effects and diagnoses using each medium. When diagnosed using PDA medium, the sensitivity was high at 91.3% but the specificity was relatively low at 46.0%. It was observed that the accuracy of the diagnosis method using PDA medium was relatively lower than that of the diagnosis method using CHROMagar medium. But the treatment effects in groups diagnosed with PDA medium were higher than those diagnosed with CHROMaga medium. According to the results of our study, CHROMagar medium is recommended for the diagnosis of oral candidiasis; as an alternative, a nonselective medium, such as PDA medium, can be used for the diagnosis of oral candidiasis.

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5Image findings of filler-related radiopacities and multiple miliary osteoma in facial region

저자 : Young-eun Kwon , Seo-young An

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The identification of radiopacities in the facial region is important during routine radiographic examination. This study analyzed the radiographic findings of filler-related radiopacities (FRR) and multiple miliary osteomas (MMO) in this region using dental radiographs. Image data were obtained from patients at the Kyungpook National University Dental Hospital. Cone-beam computed tomography (CBCT)/CT data of patients with multiple facial radiopacities on plain images (panoramic and periapical images; 16 FRR and 224 MMO) were collected and matched with the corresponding conventional images. In the CBCT/CT images, the FRRs were mainly observed in the cheek (87.5%) and retromaxillary space (68.8%) whereas the MMOs were mostly located in the superficial areas of the cheek (81.3%) and chin (36.2%). The statistical differences were only in the retromaxillary space (p<0.05). The FRRs were mostly ring-shaped (68.8%) or nodular in appearance (56.3%), whereas the MMOs presented as calcific foci (96.4%). The results of the chi-square test revealed statistically significant differences in the detection of FRRs and MMOs in the panoramic images (p<0.05), but not the periapical images. The FRRs were located in the deeper layers of the skin and were more diverse in appearance than the MMOs. Moreover, FRRs were better identified than MMO in the panoramic images. Dentists should have knowledges about image findings of FRRs and be able to differentiate them from MMOs based on the radiographic images.

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6Awareness of national health insurance-covered dental care of adults in Jeju province

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Advancements in medical care resulted in increase of average longevity. In turn, people have become more concerned about health, oral health, and quality of life. Such change has led to need for systematic and prevention-oriented healthcare service. This study aimed to provide preliminary information on the level of familiarity with national health insurance (NHI) benefits by the general public in order to help make decisions regarding education and advertisement policies. 337 adults who visited Korea Association of Health Promotion health examination center in Jeju were given self-administered surveys regarding personal oral health status, familiarity with NHI-covered procedures, and personal interest in oral health, and the results were analyzed statistically. 83.4% answered 'Yes,' to awareness of NHI coverage of dental scaling. Most people answered 'Yes' to awareness of the fact that NHI-covered dental scaling begins at 19 years of age, while relatively few people were familiar with NHI-covered denture and dental implant procedures. According to this study, many respondents were still not familiar with the expanded NHI coverage. Especially the younger population lacked information on NHI-covered denture and dental implant, indicating need for public education and advertisements. In order to efficiently advertise and educate, joint effort by the government and medical facilities is recommended. Utilization of social media in addition to the more traditional mass media should be effective in conveying information to the younger population. Age-appropriate education for policy change and coverage expansion regarding NHI-covered denture and dental implant is also advised.

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7Correction of facial asymmetry using a patient-specific three-dimensional printed polycarprolactone/beta tricalcium phosphate scaffold: a case report

저자 : Min-keun Kim , Jin-woo Han , Kwang-jun Kwon , Young-wook Park , Jin-hyung Shim

발행기관 : 조선대학교 치의학연구원 간행물 : Oral Biology Research (OBR) 45권 3호 발행 연도 : 2021 페이지 : pp. 143-149 (7 pages)

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Facial asymmetry is difficult to correct mainly because of the large volume of implant required for reconstruction, which is hard to estimate. Computer-aided surgical planning using three-dimensional (3D)-printed implants is developing rapidly, with promising clinical results being reported in reconstructive, orthognathic, and other surgical fields. A 54-year-old male patient presented with facial asymmetry caused by fibular free flap displacement. This was surgically corrected using a customized, 3D-printed polycarprolactone/beta tricalcium phosphate scaffold. The implant fit well and was easily fixed to the right mandibular angle area, resulting in an improvement in the facial contour of the patient. Throughout the follow-up period, the PCL/β-TCP implant was detected using an ultrasonic device and remained without volumetric change. There was also no wound dehiscence or implant displacement. Thus, a patient-specific 3D-printed biodegradable scaffold can effectively facilitate surgical correction of facial asymmetry. However, facial contour sequelae, stability, and resorption must be assessed over a long-term follow-up period.

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Verruciform xanthoma is a benign growth found on the oral mucosa. Clinically, verruciform xanthoma is an asymptomatic lesion, and depending on the amount of keratin present on the surface of the oral mucosa, it can appear as a reddish-gray papillary, flat lesion or a slightly raised, rough lesion. The verrucous structure and exophytic properties of these lesions are similar to those of malignant tumors; therefore, histopathological assessment is required for an accurate and definitive diagnosis. The purpose of this case report is to present the clinical, histological, and deep learning-based assessments and treatment of verruciform xanthoma of the maxillary palatal gingiva.

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발행기관 : 조선대학교 치의학연구원 간행물 : Oral Biology Research (OBR) 45권 3호 발행 연도 : 2021 페이지 : pp. 156-163 (8 pages)

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The disadvantages of the traditional approach for fabricating dental implant prostheses have been addressed via oral scanning and the use of computer-aided design/computer-aided manufacturing systems. The use of an intraoral scanner can eliminate the need for impression materials and impression trays, which are inconvenient for patients, particularly those with limited mouth opening or an overly sensitive gag reflex. Moreover, it can reduce the additional costs of fabricating, storing, and handling the patients' models. This case report describes the fabrication of a posterior implant prosthesis using double scanning technique, which produced satisfactory results both esthetically and functionally. The double scanning technique produces a more accurate image of the target region by overlapping data from both intraoral and extraoral scans. Therefore, it can address the disadvantages of both traditional and digital impressions, reduce patient discomfort, and decrease the incidence of remakes, which can arise due to potential errors during the fabrication process.

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