• Journal of the Korean Academy of Esthetic Dentistry
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• v.26 no.1
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• pp.17-23
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• 2017

Purpose: This retrospective study is to evaluate whether the timing of implant placement and the result of esthetic outcomes are related. Materials and Methods: Among the patients who had undergone single implant surgery on anterior area from 2010 to 2013 in Veterans Health Service Medical Center, 34 implants in 27 patients (24 male and 3 female) were selected and categorized into 3 groups according to the timing of placement, which are group D (Delay), group E (Early) and group I (Immediate). Aesthetic indices used included the Pink Esthetic Score (PES). It has 7 variables scores, such as mesial papilla, distal papilla, a level of soft-tissue margin, soft-tissue contour, alveolar process, soft-tissue color, and soft-tissue texture. Each variable ranges from 0 to 2, therefore total 14 points are highest. All patients were received by regular follow-up at least 1-year. One examiner measured PES on the intraoral photos. Each patient was considered as a statistical unit for statistical analysis. Statistical analyses were performed using a commercially available statistical software (SPSS Statistics 21.0, IBM Corp., Armonk, NY, USA). Kruskal-Wallis test was used for inter-group comparisons. Statistical significance was set at P<0.05. Result: Mean score in Group D, Group I, and Group E were $11.5{\pm}1.5$, $11.4{\pm}1.8$, and $11.3{\pm}1.8$ respectively. In Kruskal-Wallis test, there are no differences (P=0.989). Conclusion: In this limited study suggests that clinical aesthetic results can be achieved with all treatment protocols. Finally, various factors can be considered to produce the esthetic results.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.125-134
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• 2023

When the patient with class III malocclusion needs extensive oral rehabilitation due to multiple missing teeth, accurate diagnosis, and careful analysis, such as the patient's occlusal relationship, facial changes, and evaluation of the temporomandibular joint are essential. Orthognathic surgery is often performed for aesthetic improvement, depending on the patient's chief complaint. If it is not possible due to certain circumstances, partial aesthetic improvement can be achieved through minimal elevation of the vertical dimension. As this patient may have unexpected issues, such as temporomandibular joint disorder, oral habits like bruxism, and masticatory muscle tension, it was determined whether the patient could adjust to a reversible temporary removable partial denture. After this, the maxillary implant-supported fixed prostheses and the mandibular fixed prostheses were used to achieve stable posterior support and to partially improve the maxillary anterior esthetics. The patient was satisfied with the results both aesthetically and functionally. The prognosis is expected to be good if regular check-ups are conducted.

• Implantology
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• v.22 no.4
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• pp.242-254
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• 2018

The aim of the current study was to evaluate the results of horizontal guided bone regeneration (GBR) with xenograf t (deproteinized bovine bone mineral, DBBM), allograf t (irradiated allogenic cancellous bone and marrow), titanium membrane, resorbable collagen membrane, and advanced platelet-rich fibrin (A-PRF) in the anterior maxilla. The titanium membrane was used in this study has a three-dimensional (3D) shape that can cover ridge defects. Case 1. A 32-year-old female patient presented with discomfort due to mobility and pus discharge on tooth #11. Three months after extracting tooth #11, diagnostic software (R2 GATE diagnostic software, Megagen, Daegu, Korea) was used to establish the treatment plan for implant placement. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$, Rocky Mountain Tissue Bank, Denver, USA), 3D-titanium membrane ($i-Gen^{(R)}$, Megagen, Daegu, Korea), resorbable collagen membrane (Collagen $membrane^{(R)}$, Genoss, Suwon, Korea), and A-PRF because there was approximately 4 mm labial dehiscence after implant placement. Five months after placing the implant, the second stage of implant surgery was performed, and healing abutment was connected after removal of the 3D-titanium membrane. Five months after the second stage of implant surgery was done, the final prosthesis was then delivered. Case 2. A 35-year-old female patient presented with discomfort due to pain and mobility of implant #21. Removal of implant #21 fixture was planned simultaneously with placement of the new implant fixture. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$), 3D-titanium membrane ($i-Gen^{(R)}$), resorbable collagen membrane (Ossix $plus^{(R)}$, Datum, Telrad, Israel), and A-PRF because there was approximately 7 mm labial dehiscence after implant placement. At the second stage of implant surgery six months after implant placement, healing abutment was connected after removing the 3D-titanium membrane. Nine months after the second stage of implant surgery was done, the final prosthesis was then delivered. In these two clinical cases, wound healing of the operation sites was uneventful. All implants were clinically stable without inflammation or additional bone loss, and there was no discomfort to the patient. With the non-resorbable titanium membrane, the ability of bone formation in the space was stably maintained in three dimensions, and A-PRF might influence soft tissue healing. This limited study suggests that aesthetic results can be achieved with GBR using 3D-titanium membrane and A-PRF in the anterior maxilla. However, long-term follow-up evaluation should be performed.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.4
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• pp.356-362
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• 2020

All the faculties at the prosthodontic department in Kyung Hee University Dental Hospital at Gangdong, have been implementing the Top-Down concept of treatment approach since 2006 in which the outcomes of the last prosthetic treatment are predicted in advance during the treatment planning stage of patients with dental tissue defects. Based on the Top-Down concept, this report is also an example of how the final prosthetic treatment was performed in advance before going into implant surgery for the missing teeth. Among the various methods of connecting implant fixture and restoration, the cement-retained method is relatively simple to manufacture restoration without being constrained by the angle of the implants placed, but difficult to remove remaining subgingival excess cement completely, and to detach it being when necessary. In the report, SB-locking method will be introduced which enables an aesthetic implant restoration without either a screw hole or residual excess cement.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.183-192
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• 2008

Modern dental reconstructions do not only aim at restoring the patient's mastication, but rather at improving general well-being and quality of life, especially in terms of esthetics. The media, the internet, advertising, and many other facts of society contribute to an increased cosmetic awareness. A 35-year-old male patient presented with as follows: 1) the porcelain fracture of ceramo-metal restoration on #11 and #23, 2) the inclination of incisal plane to horizontal reference plane, 3) the dental midline deviation to facial midline, and 4) the lack of symmetry on upper anterior dentition. The patient requested an aesthetic improvement using fixed prosthodontics including implant-supported restorations. In the upper anterior region, one of the goals of the conventional as well as implant prosthesis is to achieve restorations with the dental attractiveness and beauty in the respect of dental, dentofacial, and facial compositions. This case report presents geometrically improvement of dental esthetics using conventional and implant prosthesis with soft and hard tissue augmentation.

• Journal of Periodontal and Implant Science
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• v.50 no.4
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• pp.209-225
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• 2020

Purpose: Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs. thin (<2-mm) mucosa. Methods: A PICO question was defined. Manual and electronic searches were performed of the MEDLINE/PubMed and Cochrane Oral Health Group databases. The inclusion criteria were prospective studies that documented soft tissue thickness with direct intraoperative measurements and that included at least 1 year of follow-up. When possible, a meta-analysis was performed for both the overall and subgroup analyses. Results: Thirteen papers fulfilled the inclusion criteria. A meta-analysis of 7 randomized clinical trials was conducted. Significantly less bone loss was found around implants with thick mucosa than around those with thin mucosa (difference, -0.53 mm; P<0.0001). Subgroups were analyzed regarding the apico-coronal positioning, the use of platform-matched vs. platform-switched (PS) connections, and the use of cement-retained vs. screw-retained prostheses. In these analyses, thick mucosa was found to be associated with significantly less MBL than thin mucosa (P<0.0001). Among non-matching (PS) connections and screw-retained prostheses, bone levels were not affected by mucosal thickness. Conclusions: Soft tissue thickness was found to be correlated with MBL except in cases of PS connections used on implants with thin tissues and screw-retained prostheses. Mucosal thickness did not affect implant survival or the occurrence of biological or aesthetic complications.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.654-659
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• 2009

Purpose: A botulinum toxin type A (BoNT - A) injection has been used as a noninvasive management for lower face contouring since 2000. The aim of this study was to compare reduction rate of lower face width for a longtime according to repeated Botox$^{(R)}$ injections on masseter muscles for lower face contouring procedure. Methods: Forty - five patients were analyzed for single session of Botox$^{(R)}$ injection and 13 patients were evaluated for repeated Botox$^{(R)}$ injections for over two years. Single injection group was tracked regular intervals at 1, 3, 6, 10, 12 months after injection, and repeated injection group was measured at every injection time. Twenty - five to thirty units of Botox$^{(R)}$ was injected into each masseteric muscle at five to six points at the prominent portions of the mandibular angle. Standardized frontal view of digital photographs were analyzed by Adobe Photoshop$^{(R)}$ (version CS3) to measure an reduction rate of lower face width. Results: Reduction rate was 3.7%, 6.9%, 6.2%, 4%, 4% at 1, 3, 6, 10, 12 months post injection each other in single injection group. However, more than 8% reduction rate was found in repeated injection group persistently for more than two years. Conclusion: This study shows that effective duration of Botox$^{(R)}$ injection for lower face contouring is expected to continue over one year clinically. Moreover, repeated injections maintained lower reduction rate consistently for a long time. Therefore, repeated injections on masseter muscles at regular intervals are most effective procedure for lower face contouring.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.3
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• pp.234-242
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• 2024

Immediate implant placement and restoration have the advantage of shortening the treatment period and maintaining aesthetics until final restoration. However, single implant restoration in the maxillary anterior region may be aesthetically difficult, and surgical trauma delivered to soft and hard tissues during implant placement may affect future aesthetic results. In order to obtain predictable results during anterior implant placement and restoration, surgery and restoration plans must consider the height of the interdental bone, characteristics of the gingiva, and morphological characteristics of the patient's teeth. In this case, we attempted to reproduce the emergence profile and stabilized soft tissue through gingiva modification and digital impression of a labially placed maxillary anterior implant in a patient who desired porcelain fused-metal (PFM) restoration due to economic issues.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.691-701
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• 2009

Purpose: Deviations of arterial palmar arches in the hand can be explained on the embryological basis. The purpose of this study was to provide new information about palmar arches through cadaver's dissection. The values of the location and diameter in these vessels were analyzed in order to support anatomical research and clinical correlation in the hand. Methods: The present report is based on an analysis of dissections of fifty - three hands carried out in the laboratory of gross anatomy. A reference line was established on the distal wrist crease to serve as the X coordinate and a perpendicular line drawn through the midpoint between middle and ring fingers, which served as the Y coordinate. The coordinates of the x and y values were measured by a digimatic caliper, and statistically analyzed with Student's t - test. Results: Complete superficial palmar archs were seen in 96.2 % of specimens. In the most common type of males, the superficial arch was formed only by the ulnar artery. In the most common type of females, the superficial arch was formed anastomosis between the radial artery and the ulnar artery. The average length of the superficial and deep palmar arch is $110.3{\pm}33.0mm$ and $67.9{\pm}14.0mm$ respectively. Regarding the superficial palmar arch, ulnar artery starts $-16.1{\pm}5.1mm$ on X - line, and $2.5{\pm}24.5mm$ on Y - line. Radial artery appears on palmar side $7.7{\pm}3.2mm$ on X - line, and $20.9{\pm}10.9mm$ on Y - line. But radial artery starts on $6.3{\pm}3.6mm$ on X - line, and $3.4{\pm}5.1mm$ on Y - line. Digital arteries of superficial palmar arch starts on $6.1{\pm}3.7mm$, $33.9{\pm}8.8mm$ on index finger, $1.8{\pm}3.4mm$, $40.1{\pm}7.3mm$ on middle finger, $-3.2{\pm}4.9mm$, $42.6{\pm}7.0mm$ on ring finger, and $-8.9{\pm}5.1mm$, $42.5{\pm}80mm$ on little finger in respective X and Y coordinates. Radial artery of deep palmar arches measured at the palmar side perforating from the dorsum of hand. It's coordinates were $9.7{\pm}4.8mm$ on X - line, $21.7{\pm}10.2mm$ on Y - line. Ulnar artery was measured at hypothenar area, and it's coordinates were $-20.4{\pm}6.3mm$ on X - line, and $30.6{\pm}7.4mm$ on Y - line. Conclusions: Anatomically superficial palmar arch can be divided into a complete and an incomplete type. Each of them can be subdivided into 4 types. The deep palmar arch is less variable than the superficial palmar arch. We believe these values of the study will be used for the vascular surgery of the hand using the endoscope and robot in the future.