Pul1+:|cdlvT|c^cudcmvofPcv+oPvo::|odon:+c:,Tu+wun 1Journal of Perio-Prosthodontics2008 l l l Volume 1 Number 1 January 2008 CONTENTS __________________________________________________________________________________

2 Oral Rehabilitation Using Implants in Patient with Angles Class II Division I Malocclusion and Deep Overbite - A Case Report 2 Yao-Min Chen, Chun-Cheng Hung, Chi-Cheng Tsai - 9 Alveolar Bone Height Preservation Using Immediate Implant Type in A Patient with Aggressive Periodontitis A Case Report 9 Chun-Cheng Su, Chun-Cheng Hung, Chi-Cheng Tsai -17 Full Mouth Rehabilitation by Application of Periodontal-supported Treatment and Telescopic Crown System - A Case Report 17 Pei-Yu Lee, Ling Auyeung, Guey-Lin Hou, Kun-Yen Ho, Chun-Cheng Hung

-25 Treatment of Guided Bone Regeneration and Implant-supported Fixed Prosthesis in Periodontal Prosthesis: A Case Report 25 Chin-Fu Wu, Jen-Chyan Wang, Kun-Yen Ho, Chun-Cheng Hung - 34 Dental Implant Combined Resorbable Membrane and Xenogenic Bone Graft in Perio-prosthetic Treatment - A Case Report 34 Chao-Lung Hsu, Chi-Cheng Tsai _______________________________________________________________ Official Publication of the Academy of Perio-Prosthodontics, Taiwan 2-

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References 1. Curtis TA, Langer Y, Curtis DA, Carpenter R. Occlusal considerulous skeletal class II patients. Part I: Background information. J Prosthet Dent 1988; 60: 202 -211. 2. Nanda R. The differential diagnosis and treatment of excessive overbite. Dent Clin North Am 1981; 25: 69-84. 3. Drago CJ, Caswell CW. Prosthodontic rehabilitation of patients with Class II mal- occlusions.J Prosthet Dent 19904: 435 - 445. rYTh}[x 2008; 1(1): 2-8 74. 5. Capp NJ, Warren K. Restorative treat- ment for patients with excessive vertical overlap.Int J Prosthdont 19914: 353-360. 6. Akerly WB. Prosthodontic treatment of traumatic overlap of the anterior teeth. J Prosthet Dent 1977; 38: 26 -34. 7. Schuyler CH. Problems associated with opening the bite which would contrain- dicate its common procedure. J Am Dent Asssoc 1939; 26: 734-741. 8. Ash/Ramfjord/Schmidseder , 1997; p135-140, 9. Willams J.K., Isaacson K.G. Fixed ortho- dontic appliances. 1995; p93-103 Butter- worth-Heinemann Ltd. 10. Burstone CR. Deep overbite correction by intrusion. Am J Orthod 1977; 38: 26-34. 11. Ambard A, Mueninghoff L. Planning restorative treatment for patients with severe Class II malocclusions. J Prosthet Dent 2002; 88: 200-207 12. Balshi TJ, Glenn J. Wolfinger. Restoring lost vertical dimension of occlusion using dental implants: a clinical report. Int J Prosthodont.1996; 9: 473-478. 13. Dawson PE. Evaluation, diagnosis and treatment of occlusal problems. St. Louis: CV Mosby Co, 1974; p282-295. 14. Yunus N, Abdullah H, Hanapiah F. The use of implants in the occlusal rehabilitation of a partially edentulous patient: A clinical report. J Prosthet Dent 2001 Jun; 85(6): 540-3. 15. Belser UC, Mericske-Stern R, Bernard JP, Taylor TD. Prosthetic management of the partially dentate patient with fixed implant restorations. Clin Oral Impl Res 2000; 11 (Suppl.): 126-145. 16. Ash M, Ramfjord S. Occlusion. 4th ed. Philadelphia, WB Saunders; 1995. p 72-73, 76. 17. Pullinger AG, Seligman DA, Solberg WK. Temporomandibular disorders. Part II: Occlusal factors associated with temporo- mandibular joint tenderness and dysfunction. J Prosthet Dent 1988; 59: 363 -367. 18. Bjarni E. Pjetursson, Tan K, Niklaus P. Lang, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years I. Implant-supported FPDs. Clin Oral Implant Res 2004; 15: 625 642 19. Lang NP, Berglundh T, Heitz-Mayfield LJ, Pjetursson BE, Salvi GE, Sanz M. Consensus statements and recom- mended clinic procedures regarding implant survival and complications. Int J Oral Maxillofac Implants 2004; 19suppl.: 150 -154. 20. Palacci P, Ericsson I, BoRangert PE. Optimal implant positioning and soft tissue management for the Branemark system. Quintessence Publishing Co. Ltd. 1995. p 21- 33. 21. . 1999; 3:197- 203.rYTh}[x 2008; 1(1): 2-8 8Oral Rehabilitation Using Implants in A Patient with Angles Class II Division I Malocclusion and Deep Overbite - A Case Report Yao-Min Chen 1,2 , Chun-Cheng Hung 2,3 ,Chi-Cheng Tsai 2,4 1. Department of Dentistry, Erhlin Branch of Changhua Christian Hospital, Changhua, Taiwan. 2. Graduate Institute of Dental Sciences (Faculty of Dentistry), Kaohsiung Medical University, Taiwan. 3. Department of Prosthodontics, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan. 4. Department of Periodontics, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan. Many studies in patients with Angle's class II division I focused on functional orthopedic or comprehensive orthodontic treatment. Although many literatures had discussed the etiology, diagnosis, influence, prevalence, and treatment consideration of such patients, but few studies discussed the prosthetic treatment for them. It is challenging to treat those patients, either partially or completely edentulous with Angle's class II division I malocclusion. Although esthetics, stability of the prosthesis, comfort, and efficiency of mastication are the major concerns for the dentists and patients, successful treatment depends on prosthetic occlusion. This case report describes a 66 years old female asking for implant prosthesis to replace her lower denture. From clinical and radiographic data, she is an Angle's class II division I with deep overbite patient. After implants placement, prosthesis and posterior occlusion/support were achieved, excessive overjet and overbite then were corrected with full mouth rehabilitation. (Published by the Academy of Perio- Prosthodontics,Taiwan). Key Words: dental implant, full mouth rehabilitation, malocclusion. Reprint requests: Dr. Chun-Cheng Hung, Graduate Institute of Dental Sciences (Faculty of Dentistry), College of Dental Medicine, Kaohsiung Medical University, Taiwan.100, Shih-Chung 1st Rd., Kaohsiung City 807, Taiwan, Tel: 886-7-3121101 ext. 2158; e-mail: chuchh@kmu.edu.tw Journal of Perio-Prosthodontics 2008; 1(1): 2-8 9 - 1,2 , 2,3 , 2,4 1. . 2. (`, 3.. 4.. () : ,(`,l00 l 70 0(9 8,0o 10 delaymodelingBone graft GBR Schroppl 1 2003 91% 96%Schropp 12-5 mm 76% dehiscence-type 25%(3-wall infrabony defect) 70% 5mm2mm 4mm 1984 Schulte 21985-1993 3-67-81995 Watzek9 1997 Schwartz-Arad Chaushu10 Novaes Jr Novaes11-12 2003 Arthur 13()()bone-Implant contact62.4% 66%Arthur 93.6% 14,15 61 92 1 11 III 131121 333437424345 2123 () (1-A.B) 18171615141222242526272838363532314144464748 21 37-47 373433424345132123 (probing pocket depth, PPD)5mm 13112137334345(clinical attachment level, CAL)5mm 37334345(gingival recession, GR)5mm3343 1-C l 70 0(9 8,0o 11Angles class I (2)/1 1121373433424345( periodontal ligament, PDL)1311213433424345( horizontal bone loss, HBL)11214243( vertical bone loss, VBL)131121373433424345 4243 33 50%13 Treatment plans: 42. 43. 33 37. 34. 45 32. 33. 43 33. 36. 43. 47 32. 33. 43 33. 36. 43. 47 a.b. stent( 3-A) 13.11.21.23. 92 2 19 (3-B)37.33.34.43.45 (4-A.B.C) 92 5 7 (4-D) 47 (45)> 8mm(5-A) 43(5-B) 33 ( 5-C) ( 5-D) (PME)x-ray (6-a.b) PME x-ray ( 6-c.d.e.f.) bar ( 7-a)(7-b.c.d.e) ( 8-A.B)(9-b)(9-a)(9-c)(9-e)( 9d)( 9-f)Fig. 1

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Fig. 4 37.33.34.43.45 rYTh}[x 2008;1(1): 9-16 1293 3 19 panorax (10) () 94 8 2 X( 11) 95 4 14 95 1012 Schropp 12003 91% 96%Schropp 12-5 mmFig. 5 33,43 (05/07/2003) Fig. 6 Fig. 7 bar Fig. 8 a:b: Fig. 9 Fig. 10 X Fig. 11. 1 X rYTh}[x 2008;1(1): 9-16 1376%dehiscence-type 25% (3-wall infrabony defect)70% 5mm2mm 4mmx 1984 Schulte23-67,82-3mm 2mm 1995 Watzek 9 1997 Schwartz-Arad Chaushu1033,43 xNovaes Jr Novaes 11,12 2003 Arthur 13Bone-Implant contact62.4% 66% Novaes Jr Novaes14 Gomez- Roman1593.6% 1996 Rosenquist 1692.6% 95.84% 1994 Simon 17 3 X 3343 12mm 15mm dermalDFDBA) 2 mm 60 ( free gingival graft )18-20( acellular dermal allograft ) (attached gingival zone) dermal allograft tissue l 70 0(9 8,0o 14

References 1. Schropp L, Kostopoulos L, Wenzel A. Bone healing following immediate versus delayed placement of titanium implant into extraction sockets: A prospective clinical study. Int J Oral Maxillofac Implants. 2003; 18: 189 -199. 2. Schulte W. The intra-osseous Al2O3 (Frialit) Tuebingen implant. Develop- mental status after eight years (II). Quint Int 1984;15: 19-35. 3. Anneroth G, Hedstr KG, Kjellman O, Kdell P- Nordenram. Endosseous titanium implants in extraction sockets. An experimental study in monkeys. Int J Oral Surg 1985; 14: 50-55. 4. Lazzara RJ. Immediate implant place- ment into extraction sites: Surgical and restorative advantages. Int J Peri- odontics Restorative Dent 1989; 9: 332-343. 5. Novaes AB Jr, Novaes AB. IMZ implants placed into extraxtion sockets in association with membrane therapy (Gengiflex) and porous hydroxyapatite: A case report. Int J Oral Maxillofac Implants. 1992; 7: 536-540. 6. Novaes AB Jr, Novaes AB.Bone formation over a TiA16V4 (IMZ) implant placed into association with membrane therapy (Gengiflex). Clin Oral Implants Res 1993; 4: 106-110. 7. Parr GR, Steflik DE, Sisk AL. Histo- morphometric and histologic observa- tions of bone healing around immediate implants in dogs. Int J Oral Maxillofac Implants. 1993; 8: 534-540. 8. Barzilay I, Graser GN, Iranpour B, Natiella JR, Proskin HM. Immediate implantation of pure titanium implants into extraction sockets of Macaca fasci- cularis.Part II: Histologic observations. Int J Oral Maxillofac Implants 1996;11: 489- 497. 9. Watzek G, Haider R, Mensdoff-Pouilly N, Hass R. Immediate and delayed implant- ation for complete restoration of the jaw following extraction of all residual teeth: A restrospective study comparing different types of serial immediate implantation. Int J Oral Maxillofac Implants 1995; 10: 561-567. 10. Schwartz-Arad D, Chaushu G. The ways and wherefores of immediate placement of implants into fresh extraction sites: Aliterature rewiew. J Periodontol 1997; 68: 915-923. 11. Novaes AB Jr, Novaes AB. Immediate implants placed into infected sites: A clinical report. Int J Oral Maxillofac Implants 1995;10: 609-613. 12. Novaes AB Jr, Novaes AB. Soft tissue management for primary closure in guided bone regeneration: Surgical technique and case report. Int J Oral Maxillofac Implants 1997;12: 84-87. 13. Arthur B, Novaes Jr, Andrea M, Marcaccini SL, Souza S, Mario T Jr, Marcio F, Grisi M. Immediate placement of implants into periodontally infected sites in dogs. A histomorphometric study of bone-implant contact. Int J Oral rYTh}[x 2008;1(1): 9-16 15Maxillofac Implants 2003; 18: 391-398. 14. Novaes AB Jr, Novaes AB. Bone formation over a TiA16V4 (IMZ) implant placed into association with membrane therapy (Gengiflex). Clin Oral Implants Res 1993; 4: 106-110. 15. Gomez-Roman G, Schulte W, dHoedt B, Aximan-Krcmar D. The Frialit-2 implant system: Five-year clinical experience in single tooth and immediate post- extraction applications. Intl J Oral Maxillofac Implants. 1997; 12: 299-309. 16. Rosenquist, GB. Immediate placement of implant into extraction socket: Implant survival. Int J Oral Maxillofac Implants 1996;11:205-209. 17. Simon M, Dahlin C, Trisi P, Piattelli A. Qualitative and quantitative comparative study on different filling materials used in bone tissue regeneration. A controlled clinical study. Int J Periodont Restorative Dent 1994; 14: 199-215. 18. Harris RJ: Cellular dermal matrix used for root coverage: 18-month follow-up observation. Int J Periodont Restorative Dent 2002; 22: 156-163. 19. Shulman J: Clinical evaluation of an acellular dermal allograft for increasing the zone of attached gingiva. Pract Periodont Aesthet Dent 1996; 8: 201-208. 20. Callan DP, Silverstein LH: Use of acellular dermal matrix for increasing keratinized tissue around teeth and implants. Pract Periodont Aesthet Dent 1998; 10: 731-734 rYTh}[x 2008;1(1): 9-16 16Alveolar Bone Height Preservation Using Immediate Implant Type in A Patient with Aggressive Periodontitis A Case Report Ching-Cheng Su 1,2, Chun-Cheng Hung 2,3, Chi-Cheng Tsai 2,4 1. Ching-Cheng Su Dental Clinics. 2. Graduate Institute of Dental Sciences (Faculty of Dentistry), Kaohsiung Medical University, Taiwan. 3. Department of Prosthodontics, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan. 4. Department of Periodontics, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan. Severe alveolar bone loss, in cases with aggressive periodontitis following extraction of teeth, usually resulted in uneven, irregular and concave alveolar ridge. This phenomenon often causes the difficulty of later prosthetic restoration. Even if bone grafting and tissue grafting have been conducted many times at the same area, it was also hard to increase even half of the original height of alveolar bone. In order not to let patients suffer the pain from the operations and to improve the effectiveness of the operation, immediate implant placement into the socket after the extraction of the teeth to gain/maintain the height of alveolar bone is the other choice in implant dentistry. This case report was to evaluate the preservation of height of alveolar bone using immediate implant placement type after teeth extraction in case with generalized aggressive periodontitis. Results showed that remarkable preservation of alveolar bone height was noted in the extraction sockets following placement of immediate implants after 3 years or more. In addition, absence of clinical symptoms and signs was found. More cases with generalized aggressive periodontitis and longer follow-up time were necessary. (Published by the Academyof Perio-Prosthodontics,Taiwan). Key Words: immediate implant placement, aggressive periodontal teeth, osseo- integration Reprint requests: Dr. Chun-Cheng Hung, Graduate Institute of Dental Science (Faculty of Dentistry), Kaohsiung Medical University,Taiwan.100 Shih-Chuan 1st Rd., Kaohsiung City 807, Taiwan. Tel: 886-7-3121101 ext. 7003-14. Journal of Perio-Prosthodontics 2008; 1(1): 9-16 17- 1,5 ,1 ,2 ,3,5 ,4,5 1.. 2.. 3.. 4.. 5.(`, () ,,,

,(`,l00 l 70 0( 0b,l8 18 1,2 3CSC template splinting4anchorage5telescope1886 Starr 6Konuskrone7crown and sleeve-copingCSC8konuskrone cylinder type telescope9CSC 52 15173537464721222314x1611x24 & 254445 Angle Class II canine relationship14mm 7mm 1 1416 1125 1213 26 1213 36 4445 43 1314162436 rYTh}[x 2008;1(1); 17-24 1914x16 11xxx24 & 25 1011 25 24 44&45 5 43 1213 4243 26361213 (palatal surface)36 37 1(Periodontal examination) 1314162433 36 2 mm 131416242627 36 (bleeding on probing)1116 171636 12(2) 2(Radiographic examination) 11141624 142734 36112536 (radiographic lucency) l 2 l 70 0( 0b,l8 20 2 11141624 14 27 34 36 (Dignosis) (generalized chronic periodontitis with bite collapse and secondary occlusal trauma) (basic therapy) 3a ~ d1112131416232426 36 416 525 6 (Re-evaluation) 0 24 (Restorative phase) 254445 Knus 14 36 coping 3a: 3b: 3c: 3d: rYTh}[x 2008;1(1); 17-24 21 4:36 36 5:16 16 6:25 1314hopeless1524 Rivera-Morales Mohl16hyperactivityHarper17123456 Polson18repair9 198 Knus 9rigid support rYTh}[x 2008;1(1); 17-24 22 7: 8: CSC coping crown20CSC Knus 1436 0 2116 16 8 16 1436 coping crown 22,23,2425,2627,28Wennstrm Lindhe 29,30 References 1. Stahl SS. Marginal lesion. In: Goldman HM, Cohen DW., ed: Periodontal Therapy, 4 ed. St. Louis: Mosby; 1968;120-121. 2. Amsterdam M. Periodontal prosthesis: Twenty-five years in retrospect. Alpha Omegan 1974; 12 -13. 3. ,,. Dental rYTh}[x 2008;1(1); 17-24 23Graphic Series Konuskrone. ,1984: 9 -19. 4. Beschnidt SM, Chitmongkolsuk S, Prull R. Telescopic crown retained removable partial dentures: review and case report. Compendium 2001; 22: 927-940. 5. Langer A. Telescopic retainers and their clinical application. J Prosthet Dent 1980; 44: 516-522. 6. Starr BW. Removable bridge-work porce- lain cap-crowns. Dent Cos 1886; 28:17-19, 209-213, 497-500. 7. Krber KH. Konuskronen Tele Scope, 3. Aufl. A. Hthig, Heidel- berg,1973. 8. Yalisove IL, Dietz JB: Telescopic Pros- thetic Therapy. George F. Stickley Co., Philadelphia,1977. 9. . . Dental Dia- mond 1985; 12:16 -30. 10. Nyman S, Lindhe J. Examination of patients with periodontal disease. In: Lindhe J, Lang NP, Karring T., ed. Clinical Periodontal and Implant Dentistry. 4ed. Blackwell Pulishing Co.: Munksgaard; 2003; 403-413. 11. Flemmig TF. Periodontitis. Ann Peri- odontol 1999; 4: 32-38. 12. Hamp SE, Nyman S, Lindhe J. Peri- odontal treatment of multirooted teeth. Result after 5 years. J Clin Periodontol 1975; 2: 126 -135. 13. y HB, Keough BE, Rosenberg MM, Holt RL. Presurgical prosthetic diagnosis and management. In Rosenberg MM., ed. Periodontal and prosthetic management for advanced cases. 1ed. Quintessence Publishing Co.: Chicago; 1988; 80~92. 14. Vahidi F. The provisional restoration. Dent Clin North Am 1987; 31: 363-381. 15. Hou GL, Tsai CC, Weisgold AS. Treat- ment of molar furcation involvement using root separation and a crown and sleeve coping telescopic denture. A longitudinal study. J Periodontol 1999; 70:1098 -1109. 16. Rivera-Morales WC, Mohl N. Relation- ship of occlusal vertical dimesion to the health of the masticatory system. J Prosthet Dent 1991; 65: 547-553. 17. Harper RP. Clinical indications for altering vertical dimension of occlusion. Quint Int 2000; 31: 275 -280. 18. Polson AM, Adams RA, Zander HA. Osseous repair in the presence of active tooth hypermobility. J Clin Periodontol 1983; 10: 370-379. 19. Badersten S, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy. III.Single versus repeated instrumentation. J Clin Periodontol 1984; 11:114-124. 20. ,,.Dental Graphic series Konuskrone..1984: 21-25. 21. Horng CJ, Tsai JW, Wang JC, Lee HE, Hong JM. Clinical applications of the Konuskrone Part I-Rationale. J Formosan Dent Assoc 1988; 11:359 -365. 22. Bowers GM. A study of the width of attached gingiva. J Periodontol 1963; 34: 201 -209. 23. Corn H. Periosteal separation - Its clinical significance. J Periodontol 1962; 33: 140-152. 24. Lang NP, Le H. The relationship bet- ween the width of keratinized gingiva and gingival health. J Periodontol 1972; 43: 923-627. 25. Friedman N. Mucogingival surgery: the apically repositioned flap. J Periodontol 1962; 33: 328-340. 26. De Trey E, Bernimoulin J. Influ- ence of free gingival grafts on the health of the marginal gingiva. J Clin Periodontol 1980; 7: 381-393. 27. Miyasato M, Crigger M, Egelberg J. Gingival condition in areas of minimal and appreciable width of keratinized gingiva. J Clin Periodontol 1977; 4: 200-209. 28. Grevers A. Width of attached gingiva and vestibular depth in relation to gingival health. Thesis. University of Amster- dam ,1977. 29. Wennstrm JL, Lindhe J. The role of attached gingiva for maintenance of peri- odontal health. Healing following excisional and grafting procedures in dogs. J Clin Periodontol 1983;10: 206-221. 30.Wennstrm JL, Lindhe J. Plaque- induced gingival inflammation in the absence of attached gingiva in dogs. J Clin Periodontol 1983; 10: 266-276. rYTh}[x 2008;1(1); 17-24 24Full Mouth Rehabilitation by Application of Periodontal- supported Treatment and Telescopic Crown System - A Case Report Pei-Yu Lee1,5, Ling Auyeung1, Guey-Lin Hou2 , Kun-Yen Ho3,5 , Chun-Cheng Hung4,5 1. Department of Periodontics, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan. 2. Hous Dental Clinic. 3. Department of Periodontics, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan. 4. Department of Prosthodontics, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan. 5. Graduate Institute of Dental Sciences (Faculty of Dentistry), College of Dental Medicine, Kaohsiung Medical University, Taiwan. This is a case of generalized chronic periodontitis with bite collapse. In clinical examination, the broken fixed partial denture and poorly periodontal-supported abutment teeth under occlusal overloading led to secondary trauma from occlusion. In traditional treatment, the dentist had no choice but to pull out the hypermobile teeth which seemed to be poor prognosis, by the time the wound were healed, the proper prosthesis could be fabricated to provide occlusal function. However, as far as patient himself was concerned, he hoped that the dentist could do every effort to preserve all his retained teeth. And what is more, the edentulous condition would impair social activity. For all that reasons, the provisional prosthesis with a metal framework was fabricated to provide occlusal support, function and esthetic. Until the periodontal condition was stable, the re-evaluation would be done to check the design of permanent prosthesis. (Published by the Academy of Perio-Prosthodontics,Taiwan). Key Words: periodontal supportive treatment, telescopic denture, bite collapse, trauma from occlusion.

Reprint requests: Dr. Chun-Cheng Hung, Graduate Institute of Dental Sciences (Faculty of Dentistry), College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chung 1st Rd., Kaohsiung City 807, Taiwan. Tel: 886-7-3121101ext.2158; e-mail: chuchh@kmu.edu.tw Journal of Perio-Prosthodontics 2008; 1(1):17-24