• Journal of Periodontal and Implant Science
• /
• 제38권2호
• /
• pp.253-262
• /
• 2008

Background: Incomplete flap coverage or early exposure over implants and/or barrier membranes have a negative effect on bone regeneration. In cases of using regenerative techniques, complete soft tissue coverage of the implant area is necessary to promote adequate conditions for guided bone regeneration. Primary socket closure may be difficult, when periosteal releasing incision is only used, due to the opening left by extracted tooth. Therefore, Soft tissue grafting techniques are used to achieve primary soft tissue closure. Materials and Methods: Soft tissue grafting techniques, with or without barrier membranes, were performed for primary closure in four cases of immediate placements. Three different methods were used (CTG, VIP-CT, Palatal advanced flap). Clinical results of the grafting were evaluated. Result: One case showed early exposure of cover-screw and, no other complications were noted. In the others, Primary closure was achieved by soft tissue grafting techniques. One of the cases, Graft showed partial necrosis, but there were no exposure over implants and/or barrier membranes. Conclusion: The use of grafting techniques, in immediate implant placement, can predictably obtain primary closure of extraction sockets, thereby providing predictable bone formation and improved implant results.

• Journal of Periodontal and Implant Science
• /
• 제37권2호
• /
• pp.209-221
• /
• 2007

Recently, immediately after losing teeth. implant placement has been greatly attempted. Implant can help restoration of tooth functions within short time. This study was an attempt to examine the extent of osseointergation when the implants will be placed immediately after teeth extraction using domestic implant systems. Implants were inserted in beagle dogs and evaluated the clinical, radiological, histological and histomorphometric assay at 6 weeks and 12 weeks. For experimental materals, $STAGE-1^{(R)}$($4.1{\times}8mm$, Lifecore, USA), $SS-III^{(R)}$($4.0{\times}8mm$, OSSTEM, Korea) and $IFI^{(R)}$($4.0{\times}8mm$, Dio, Korea) implants treated with RBM were placed. All the placed site showed normal results without fail and inflammation clinically and radiologically. As a result of measurement by periotest, it showed $-2\;{\sim}\;-5$ and stable status comprehensively. There was no statistically significant difference among implants(p<0.05). Bone tissue adjacent to implant showed increased marrow tissue at 6 weeks. Nevertheless, osteogenic structure was not observed remarkably. In a 12 weeks opinion, bone tissue composed of osseointegration along implant interface showed significantly decreased marrow tissue containing central vessels unlike a 6 weeks opinion and matured compact bone whose osteogenic structure is well formed. BIC were 42.4%, 32.0% and 34.9%, respectively in 6 weeks and there was no statistically significant difference among group(p<0.05). In 12 weeks, BIC were 58.8%, 61.9% and 57.5%. respectively and there was no statistically significant difference among groups(p<0.05). It is considered that all 3 implant systems are suitable for immediate implant placement.

• Journal of Periodontal and Implant Science
• /
• 제37권2호
• /
• pp.223-236
• /
• 2007

This study was attempted to evaluate home-manufactured implants by placing $Stage-1^{(R)}$ Implant (Lifecore, Co., USA) whose surface is treated with REM that has already been varified clinically,$Chaorum^{(R)}$ Implant(Chaorum Co., Korea) whose surface treatment is same as that of Stage-1 Implant and $Atlas^{(R)}$ Implant(Cewellmedi Co., Korea) whose surface is treated with anodic oxidation immediately after the teeth of experimental animals were extracted to compare histological findings among them. Stage-l Implant(diameter: 3.5mm, length: IOmm), Chaorum Implant(diameter: 3.3mm, length: 8.5mm) and Cowell medi Implant(diameter: 4.0mm, length: 8.0mm) were placed into the mandible premolars of 2 adult beagle dogs immediately after their teeth were extracted, and then histological findings were analyzed at 6 weeks. After those implants were inserted directly after their teeth were extracted, the results of periotest were recorded, radiography was done, the subjects went through thorough control for 6 weeks, and then comparison among periotest, radiography and histological finding was made. After comparison of those findings, the values of periotest were satisfactory and bone healing was relatively satisfactory on radiography at 6 weeks. For osseointegration with the bone tissue, Stage-1 was 45.3%, Chaorum 55.3%, and Cowellmedi 52.5%, which was a satisfactory result. Although implant surgery immediately after teeth were extracted involves difficulties among recent implant surgeries, it is being frequently used in that it may reduce surgery hours, the frequency of surgery, and bone loss for patients. This experiment was conducted to evaluate the technological levels of home-manufactured implants that have been remarkably developed in recent years and in conclusion, those implants showed nearly similar result.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제30권3호
• /
• pp.258-265
• /
• 2008

Purpose. This multicenter retrospective study was performed to evaluate the survival and success rates of immediate placement of USII and SSII Osstem implant (Osstem implant Co, Korea) on the maxillary and mandibular anterior and premolar areas. Materials and methods. Dental records were obtained in 37 patients who were treated with immediate implantation on the maxillary and mandibular anterior and premolar areas in 6 different clinics. The 98 implants were evaluated both clinically and radiographically using predefined success criteria. Results. There was no failed implant in all patients. The mean follow up period was 24.7 months (ranged from 12 to 58 months), and 25.1 months (ranged from 16 to 35 months) in USII and SSII implants, respectively. The crestal bone loss was 3 mm in 3 USII implants during 41 months, and in 1 SSII implant during 22 months. The overall success rate was 94.2% and 97.7% in USII and SSII implants, respectively. The age, gender, diameter, or length of implants, and type of surgery were not influenced to the success rate of immediate implantation. Conclusion. These results suggest that USII and SSII Osstem implant can be used successfully in immediate implantation on the maxillary and mandibular anterior and premolar areas.

• Journal of Yeungnam Medical Science
• /
• 제20권1호
• /
• pp.45-52
• /
• 2003

Background: Immediate implant placement has become an acceptable treatment for the edentulous area. The advantages of the immediate implant placement include considerable decrease in time from tooth extraction to placement of the finial prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plans. But the success is dependent on the quantity and quality of the extraction socket. The purpose of this study is to evaluate the success of the immediate implant placement. Materials and Methods: Twenty-one sites in 16 patients were selected for the evaluation of the immediate implant placement. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent pain or sign of infection. Results: Of the 21 implants, 13 implants have been succeeded. Of the 13 implants, 10 implants were replaced for the periodontal disease and 3 implants were replaced for the trauma. Conclusion: The criteria of the success in immediate implant placement are as follows. 1) Implants placed into fresh extraction sockets have a high rate of survival. 2) Implant should be placed as close as possible to the alveolar crest. 3) Implant placed into available bone beyond the apex have a high success rate.

• Journal of Periodontal and Implant Science
• /
• 제37권3호
• /
• pp.637-646
• /
• 2007

Implants placed immediately after tooth extraction have been shown to be a successfully predictable treatment modality. Several clinical papers suggest that placing implants immediately after tooth extraction may provide some advantages: reduction of the number of surgical procedures or patient visits, preservation of the dimensions of alveolar ridge, and shortening of the interval between the removal of the tooth and the insertion of the implant supported restoration. In this case report, three patients received single immediate implant placements to replace a maxillary anterior tooth at the time of extraction. As the three cases were somewhat different, treatment protocols had to be modified as follows: Case 1. Immediate implant placement with healing abutment connection. Case 2. Immediate implant placement with immediate provisionalization. Case 3. Immediate implant placement with Guided Bone Regeneration(GBR). Every implant of these cases was placed in proper position buccolingually, mesiodistally and apicocoronally, The procedures following implantation such as immediate provisionalization and GBR were free of problem. Healing of each case was uneventful. In all cases, treatment outcomes were mostly satisfactory and the results maintained during follow-up periods. However, one case (Case 3) showed some papilla loss due to failure in delicate soft tissue handling during surgery. This papilla loss was compromised by prosthetic means. In conclusion, immediate implant placement in the fresh extraction socket can be a valid and successful option of treatment in aesthetic area. Moreover, this treatment protocol seems to maintain the preexisting architecture of soft and hard tissues in most cases.

• Journal of Periodontal and Implant Science
• /
• 제38권4호
• /
• pp.603-610
• /
• 2008

Purpose: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. Materials and methods: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. Results: The control group showed a significantly higher bone to implant contact (BIC) ($74.14{\pm}16.18$) than experimental group 1 ($40.28{\pm}15.96$) and 2 ($48.70{\pm}17.75$)(p<0.05). However, there was no significant difference between experimental group 1 and 2. Conclusion: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.

• 한국임상수의학회지
• /
• 제20권2호
• /
• pp.207-211
• /
• 2003

This investigation aimed to determine the relative merit of osseointegration in immediate and delayed implantation in the dog mandible using radiography and bone scintigraphy. five adult mongrel dogs with a mean weight of 8.5 kg were used in this investigation. During the entire study period. all dogs were fed with a soft commercial diet and water ad libitum to minimize functional loading of the implant. Twenty titanium alloy systems 4 mm in diameter and 10 mm in length blasted with calcium phosphate were prepared for insertion. The second and third left mandibular premolars in each dog were extracted for the delayed implant insertion. Twelve weeks later, the second and third right mandibular premolars were extracted for the immediate implant insertion. Before the delayed and immediate implantation procedures and 0, 4, 8, and 12 weeks after the insertions, radiography and bone scintigraphy were conducted. Bone scans were obtained using a large field of view gamma camera equipped with a collimator about 3 hours after intravenous injection of Tc-99m-MDP to the dogs. All the dogs were evaluated weekly for inflammation, necrosis, and other of the bone or sort tissue. Significant macroscopic lesions were not detected. Radioisotope scintigraphy with Tc-99m-MDP hat proved to be a reliable method for measuring increased bone activity at specific skeleton tissue sites. In conclusion, osseointegration in peri-implant bone did not differ significantly between the immediate and delayed implant procedures during the experimental period. The immediate implant may be an alternative treatment of implant insertion in animals.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권4호
• /
• pp.334-338
• /
• 2009

Supernumerary teeth are extra teeth or tooth-like structures which may have either erupted or unerupted in addition to the 20 deciduous teeth and the 32 permanent teeth. Clinicians sometimes confront unerupted supernumerary teeth where implants would be placed. Many clinicians consider immediate placement of implant into an extracted socket as an effective technique compared to the conventional method of waiting several months for bone healing, because of the advantages such as reduction of treatment period, preservation of alveolar bone and soft tissue, etc. We could hardly find the case of immediate placement of implant after extraction of impacted supernumerary teeth and permanent teeth together. Therefore we report the case of immediate implantation following extraction of impacted supernumerary teeth and poor periodontal conditioned permanent teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제30권4호
• /
• pp.316-322
• /
• 2004

A low molecular weight component named bone morphogenetic protein(BMP) chemically isolated from the organic matrix of bone, induce postfetal connective tissue cells surrounding small blood vessels to differentiate into cartilage and bone. The end product of BMP is a spherical ossicle of lamella bone filled with red bone marrow for the functional loading. This is a important point that the graft material is embedded the defect site during the implant surgery. Because present knowledge of the relationship between BMP and bone regeneration arises mainly from studies of induced bone formation in heterotopic sites, it would be helpful to determine whether BMP plays any part in the process of bone healing. The BMPs have been shown to play crucial roles in normal skeletal development as well as bone healing and are able to activate transcription of genes involved in cellular migration, proliferation, and differentiation. The delivery of BMP on matrices has been efficacious in the treatment of defect bone in implant surgery. The purpose of the histologic study was to evaluate the effect of DLB(demineralized lyophilized bone) coated with purified human BMP(hBMP-I) in immediate implant surgery with bony defect to obtain the functional structure of implant asap. The ability of a graft of hBMP-I to accelerate bony defect repair provides a rationale for its use in immediate implant surgery that have large bone defect in edentulous area.