• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.879-889
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• 2006

The early exposure of cover screws is a common complication of 2-stage implant technique. The exposure of cover screws between stage I and IT surgery may cause inflammation in the soft tissues surrounding the implants, and lead to peri-implantitis or marginal bone loss. The purpose of this study was to evaluate the effect of the early exposure of cover screws on implants placed using 2-stage technique. Two hundred and nineteen implants in 77 patients were examined for cumulative survival rate, radiographic marginal bone level change, cause and frequency of the early exposure. The results were as follows: 1. Twenty-five implants showed early exposure of cover screws with a frequency of 11.4%. 2. Cumulative survival rate of the implants with early cover screw exposure was 88.0%, and that of the implants without cover screw exposure was 96,9%. 3. At the time of stage IT surgery and 1 year after loading, the marginal bone loss was greater around the implants with early exposure of cover screws than around the implants without cover screw exposure(p <0.05), 4, There was no statistically significant difference in the frequency of the early exposure according to the implant diameter, gender, and smoking(p >0,05).

• Archives of Plastic Surgery
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• v.43 no.2
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• pp.197-203
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• 2016

Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.457-464
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• 2008

Purpose: The aim of this study was to evaluate the clinical results of implants which were installed with maxillary sinus elevation by using lateral window technique. Materials and methods: We performed the maxillary sinus elevation by lateral window technique to 87 patients who visited Dept. of Oral & Maxillofacial Surgery, Chonnam National University Hospital from January, 2003 to January, 2007. When the residual bone height was from 3 mm to 7 mm, the sinus elevation and simultaneous implant installation was mostly performed. When the residual bone height was less than 3 mm, the sinus elevation was performed and the delayed implant installation was done after 5 or 6 months. No artificial membranes were used for coverage of the lateral bony window site and freeze dried fibrin sealant was applied to the grafted bone. The mean follow-up period was 28.5 months (ranged from 10 months to 48 months) Results: 1. Unilateral sinus elevations were performed in 51 patients and bilateral sinus elevations were performed in 36 patients. And the total number of sinus elevation procedure was 123 cases. 2. The sinus elevation and simultaneous implant installation was performed in 89 sinuses and 249 implants were installed. The sinus elevation and delayed implant installation was performed in 44 sinuses and 141 implants were installed. The total number of implants were 390 in 133 sinuses. The average healing period after sinus elevations was 6.1 months in delayed implant installation. 3. Only autogenous bone, autogenous bone mixing with allografts or autogenous bone mixing with xenografts were used as graft materials. 4. The average period from first surgery to second surgery was about 7.2 months. 5. Some patients complications, such as perforation of sinus membrane, swelling, infection and exposure of cover screw. Two implants were removed in the infected sinus. 6. The survival rate of implants with maxillary sinus elevation by lateral window technique was 99.5% and the success rate of implants was 95.1%. Conclusions: These results indicated that the implants which were installed with maxillary sinus elevation by lateral window technique showed high survival and success rates.

• Journal of Interdisciplinary Genomics
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• v.4 no.1
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• pp.1-6
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• 2022

Purpose: Mastectomy is performed as a surgical treatment for patients with breast cancer who have the BRCA 1/2 mutation. In this study, we have reported the trends in Korea for both immediate breast reconstruction and prophylactic mastectomy. Methods: This retrospective study was conducted from 2019 to 2021. Both skin-sparing mastectomy and immediate implant-based breast reconstruction with prepectoral and/or subpectoral techniques were performed in five patients with BRCA 1/2 mutations. Data on age; body mass index; cancer stage; BRCA 1/2 mutation; estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression; diagnosis; and complications were collected. Results: The average (±standard deviation [SD]) age was 44.0±6.48 years old; BMI 24.5±2.25 kg/m²; and breast volumes were 365.8±70.34 and 382.4±96.33 cc for right and left ones, respectively. The BRCA 1 and 2 were diagnosed in four and one patients, respectively. The estrogen and progesterone receptors and human epidermal growth factor receptor 2 were detected in one (20%), one (20%), and three (60%) patients, respectively. The applied implant-based breast reconstruction techniques for ten breasts were subpectoral technique (n=7, 70%) and prepectoral technique (n=3, 30%). For the cancer stage, those with I, II, and III stages were one (20%), two (40%), and one (20%), respectively. There were no major complications such as Infection, seroma. Conclusion: When mastectomy is performed as surgical treatment in BRCA 1/2 mutation positive breast cancer patients, it is possible to obtain a better outcome with both implant-based breast reconstruction and different circumstances between breast cancer and contralateral breast.

• Journal of Periodontal and Implant Science
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• v.35 no.2
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• pp.449-460
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• 2005

Objectives Aim of this study was to evaluate the clinical use and the efficacy of Frialit-2 implant system. Experimental Methods Fifty nine patients received placement of Frilalit-2 implants(137 implants) in their maxillary anterior and posterior sites(40 and 97 implants). Intraoral & clinical examination, chart review and radiographs were taken from each patient. Results 1. The total implant survival rate was 92.7% after a mean follow-up period of 19.9 months. 2. The implant survival rate placed in anterior region was 97.5%. 3. The implant survival rate placed in posterior region was 90.7%. 4. The implant survival rate placed in atrophic posterior maxilla with advanced technique (GBR, Sinus elevation) was 87.2%. 5. The implant survival rate placed in type N(D4) bone was 82%, while 95.7% in type III (D3), and 100% in type II(D2) bone. 6. Most of the failed implants(7 of 10) were removed during the maintenance stage after prosthodontic treatment. Conclusion It was concluded that Frialit-2 implant could be used satisfactorily in the esthetic anterior region, but the use in the posterior region, especially with poor bone quality and quantity, further studies are needed.

• Journal of Korean Dental Science
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• v.5 no.2
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• pp.54-59
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• 2012

Purpose: The purpose of this study was to evaluate the prognosis (clinical outcomes) of one-stage flapless implant surgery based on success and survival rate and marginal alveolar bone loss. Materials and Methods: Ninety dental implants were placed according flapless surgical procedure in forty-one patients at Hospital between April 2004 and May 2009. The mean age of the patients was 54, and the patients were comprised of 24 men and 17 women. Each patient was investigated radiographically and clinically being with average follow up 49.7 period. Result: Average healing period is 4.45 month (maxilla: 5.31 month, mandible: 3.20 month) after installation and survival rate is 95.7% in this period. The survival rate and success rate at 1 year after function (prosthodontics setting) are 92.4% and 88.0%. At final observation, the survival rate and success rate are 90.2% (maxilla: 89.1%, mandible: 92.9%) and 84.8% (maxilla: 82.8%, mandible: 89.3%). The mean residual alveolar bone resorption at 1-year after function and final observation are 0.8 mm and 1.07 mm. Conclusion: Our study suggest that if appropriate surgical technique with proper patients selection, flapless implants surgery is predictable simple and safety technique.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.3
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• pp.117-122
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• 2014

Objectives: The purpose of this study was to evaluate the sinus bone graft resorption over 3 years after two-stage implant placement. Materials and Methods: The subjects for this study included 30 patients whose maxillary posterior ridges were too atrophic for implants. Bone-added osteotome sinus floor elevation was used in 15 maxillary sinuses, while the bone graft by lateral approach technique was used in 25 maxillary sinuses. The height from the top of the fixture to the sinus floor was estimated immediately after implant placement and the follow-up period was over 3 years. The surgery was classified with two groups: sinus bone grafting with and without autogenous bone. All implants were placed simultaneously. Results: The mean vertical bone loss was $3.15{\pm}2.95mm$. The survival rate of implants was 94.7%. Conclusion: The amount of bone resorption was not significantly associated with the surgical methods, the type of bone graft materials used, or sinus perforation during surgery.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.557-562
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• 2023

Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

• Journal of Periodontal and Implant Science
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• v.44 no.3
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• pp.147-155
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• 2014

Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.

• Journal of Korean Dental Science
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• v.2 no.2
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• pp.12-17
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• 2009

Purpose : To determine whether peri-implant crestal bone loss could be affected by systemic disease, primary ISQ value, implantation method (submerged vs. non-submerged), surface treatment, and bone density Materials and methods : Patients who underwent fixture installation from June 24, 2005 to October 23, 2008 at Seoul National University Bundang Hospital were evaluated. A total of 157 patients (male: 52, female: 85) had 346 fixtures installed. Among them, 49 patients had periapical radiographs taken 1 year after prostheses were first set. A total of 97 fixtures were implanted. In particular, 30 fixtures were installed in patients with systemic diseases such as diabetes mellitus, cardiovascular disease, hypertension, and liver disease. The immediate stability of implants was measured with $Osstell^{tm}$. Implant surface treatment was classified into two groups (RBM, Cellnest (Anodized)), and bone density, into four groups (D1~D4). The bone resorption on the mesial and distal areas of fixtures was measured with periapical radiographs using the paralleling technique, and the mean value was calculated. The length determination program in IMPAX (AGFA, Belgium) was used. Results : At least 332 out of 346 (96%) installed GS II implants were successfully osseointegrated 1 year after prostheses were first set. The mean value of the bone resorption of the installed GS II implants was 0.44mm. The minimum value was 0mm, and the maximum value, 2.85mm. There was a statistically significant difference between the implantation methods (submerged, non-submerged) with regard to the amount of alveolar bone loss 1 year after prostheses were first set (p<0.05). Non-submerged implants showed less crestal bone loss. Note, however, that other variables had no correlation with crestal bone loss (p>0.05). Conclusion : There was a statistically significant difference between the 1-stage method and 2-stage method with regard to the amount of alveolar bone loss 1 year after prostheses were first set. Systemic disease, primary ISQ value, surface treatment, and bone density were not associated with alveolar bone loss. Other variables were assumed to have a correlation with alveolar bone loss.