• The korean journal of orthodontics
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• v.54 no.1
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• pp.69-73
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• 2024

Since its inception in Europe in the 1950s, alveolar molding treatment for neonates with complete cleft lip and palate has undergone significant evolution in both design and application methodology, demonstrating effectiveness in normalizing the alveolar cleft and nasal shape. However, excessively wide alveolar clefts accompanied by disproportionately wide total maxillary arch pose significant challenges when utilizing conventional alveolar molding methods involving cyclical adding and grinding of acrylic on molding plates. The current report introduces a novel alveolar molding method named Biocreative Alveolar Molding Plate Treatment (BioAMP), which can normalize the maxillary alveolar cleft and arch shape without laborious conventional acrylic procedures. BioAMP sets the target arch form and provides unrestricted space for natural growth of the maxillary alveolar bones while systematically reducing the total maxillary arch width in precise increments. Two exemplary cases are presented as proof-of-concept, showcasing the clinical innovation of BioAMP.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.53-58
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• 2022

Alveolar cleft belongs to the spectrum of cleft lip and/or palate, affecting 75% of cleft lip/palate patients. The goals of alveolar cleft treatment are stabilizing the maxillary arch, separating the nasal and oral cavities, and providing bony support for both erupting teeth and the nasal base via the piriform aperture. Secondary alveolar bone grafting is a well-established treatment option for alveolar cleft. Secondary alveolar bone grafting is performed during the period of mixed dentition using autologous bone from various donor sites. There are several issues relevant to maximizing the success of secondary alveolar bone grafting, including the surgical timing, graft material, and surgical technique. In this study, we reviewed issues related to surgical timing, graft materials, and evaluation methods in secondary alveolar bone grafting.

• The Korean Journal of Physiology
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• v.28 no.1
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• pp.71-77
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• 1994

In the animal model of acute respiratory distress syndrome (ARDS) induced by N-nitroso-N-methylurethane (NNNMU) the secretory activity of alveolar type H cells during acute alveolar injury was investigated by determining phospholipid and pulmonary surfactant associated proteins in crude surfactant. The mechanism of the secretory change was studied by determination of DNA and RNA levels in the lung tissue. After induction of acute alveolar injury with NNNMU, pulmonary hemorrhage, atelectasis and gross hypertrophy were observed. Seven days after NNNMU treatment the level of total DNA in lung homogenate was increased markedly indicating that a hypertrophy was induced by cellular proliferation. Although the total DNA level increased, the RNA/DNA ratio was gradually decreased after NNNMU treatment. Seven days after NNNMU treatment the RNA/DNA ratio returned to the normal control level. During the acute alveolar injury, phospholipid and surfactant associated proteins were reduced significantly as compared with the control, implying that the secretory activity of alveolar type II cells was altered during acute alveolar injury induced by NNNMU. The protein content in crude surfactant during peak injury(7 days after NNNMU) was decreased significantly but phospholipid/protein ratios were identical in both control and NNNMU treatment groups. SDS-PAGE of proteins in crude pulmonary surfactant showed a decrease in major surfactant associated protein(M.W. 38,000) during acute alveolar injury. The present study may suggest that while alveolar type H cells proliferate markedly, transcription of alveolar type ll cell gene was inhibited by an unknown mechanism such as DNA methylation induced by NNNMU. Such an inhibition of transcriptional activity is thought to be associated with the decreased secretory activity of alveolar type ll cells, which may lead to pulmonary atelectasis and edema during the acute alveolar injury.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.216-222
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• 2015

Purpose: After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. Methods: This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. Results: The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was $1.43{\pm}0.65mm$. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. Conclusions: After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.

• The korean journal of orthodontics
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• v.48 no.6
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• pp.349-356
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• 2018

Objective: This study was performed to investigate the alveolar bone of lower incisors in skeletal Class III adults of different vertical facial patterns and to compare it with that of Class I adults using cone-beam computed tomography (CBCT) images. Methods: CBCT images of 90 skeletal Class III and 29 Class I patients were evaluated. Class III subjects were divided by mandibular plane angle: high (SN-MP > $38.0^{\circ}$), normal ($30.0^{\circ}$ < SN-MP < $37.0^{\circ}$), and low (SN-MP < $28.0^{\circ}$) groups. Buccolingual alveolar bone thickness was measured using CBCT images of mandibular incisors at alveolar crest and 3, 6, and 9 mm apical levels. Linear mixed model, Bonferroni post-hoc test, and Pearson correlation analysis were used for statistical significance. Results: Buccolingual alveolar bone in Class III high, normal and low angle subjects was not significantly different at alveolar crest and 3 mm apical level while lingual bone was thicker at 6 and 9 mm apical levels than on buccal side. Class III high angle group had thinner alveolar bone at all levels except at buccal alveolar crest and 9 mm apical level on lingual side compared to the Class I group. Class III high angle group showed thinner alveolar bone than the Class III normal or low angle groups in most regions. Mandibular plane angle showed negative correlations with mandibular anterior alveolar bone thickness. Conclusions: Skeletal Class III subjects with high mandibular plane angles showed thinner mandibular alveolar bone in most areas compared to normal or low angle subjects. Mandibular plane angle was negatively correlated with buccolingual alveolar bone thickness.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.5
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• pp.421-428
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• 2011

Introduction: The purpose of this study was to evaluate the clinical result of vertical alveolar distraction, especially the distracted alveolar bone and installed implants. Materials and Methods: Twenty-one patients who have been received the vertical alveolar distraction and implant installation on 22 areas (3 maxilla and 19 mandible) using intraoral alveolar distraction device were examined. After consolidation period of 3-4 months, distraction devices were removed and 91 implants were installed in the distracted alveolar bone. The distracted bone and implants were evaluated clinically and radiographically. Results: Mean height of distracted alveolar bone was $7.5{\pm}3.2$ mm (range: 2.5-15.0 mm). Mean follow-up period after completion of the distraction was 3.1 years (range: 1.4-11.5 years). Mean resorption of distracted alveolar bone was $1.6{\pm}1.8$ mm. The success and survival rates of implants was 95.3% and 100%, respectively. Conclusion: Results of this study indicate that vertical alveolar distraction procedure is a useful and stable method for alveolar ridge augmentation and implantation.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.445-449
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• 2009

Purpose: A successful surgical treatment for a wide alveolar cleft with bone graft is difficult to achieve due to several factors such as the limitation of gingivoperiosteal flap, the presence of large scar tissues, and the poor blood circulation. To overcome these problems, alveolar distraction osteogenesis using Liou alveolar distraction device was applied. We analyzed the consequences of this surgical treatment. Method: Between 2006 January and 2007 August, we have conducted analysis on the methods and consequences of Liou alveolar distraction osteogenesis for 6 patients. The age of patients was 12 years and 6 months in average. The follow up period was 19 months in average. The Reverse L osteotomy followed by the placement of the Liou alveolar distraction device was performed. After serial distraction, the distractor was removed after 5 months of the process of osteogenesis, and the result was analyzed using the computed tomography and the x-ray films of the alveolar bone and the teeth. Results: The alveolar cleft with 12.5 mm in average width was filled with 8.5 mm of newly formed bone tissue in average width after 5 months of osteogenesis. Among the 6 cases, 5 required the additional bone graft and 1 case only required the gingivoperioplasty. The newly formed bone tissues did not show any signs of bone resorption. However, a considerable degree of teeth displacement was shown. Conclusion: For the alveolar cleft too wide to be reconstructed by a general bone graft, it is strongly recommended to perform the reverse L osteotomy of the cleft side with Liou alveolar distraction device to initiate the alveolar osteogenesis. However, the migrated teeth showed some degree of relapse, thus, the orthodontic treatment is essential following the distraction osteogenesis treatment.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.542-545
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• 2013

Background The aims of alveolar bone grafting are closure of the fistula, stabilization of the maxillary arch, support for the roots of the teeth adjacent to the cleft on each side. We observed nostril base augmentation in patients with alveolar clefts after alveolar bone grafting. The purpose of this study was to evaluate the nostril base augmentation effect of secondary alveolar bone grafting in patients with unilateral alveolar cleft. Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bone grafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 were reviewed. Preoperative and postoperative worm's-eye view photographs and reconstructed three-dimensional computed tomography (CT) scans were used for photogrammetry. The depression of the nostril base and thickness of the philtrum on the cleft side were measured in comparison to the normal side. The depression of the cleft side pyriform aperture was measured in comparison to the normal side on reconstructed three-dimensional CT. Results Significant changes were seen in the nostril base (P=0.005), the philtrum length (P=0.013), and the angle (P=0.006). The CT measurements showed significant changes in the pyriform aperture (P<0.001) and the angle (P<0.001). Conclusions An alveolar bone graft not only fills the gap in the alveolar process but also augments the nostril base after surgery. In this study, only an alveolar bone graft was performed to prevent bias from other procedures. Nostril base augmentation can be achieved by performing alveolar bone grafts in children, in whom invasive methods are not advised.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.325-329
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• 2009

Objective : This is to report the effectiveness of intraoral distraction osteogenesis, iliac bone graft for alveolar augmentation in the extremely atrophied alveolar defects after infected allobone grafted area. Subjects and Methods : Anterior segmental osteotomy was performed and the trans-oral alveolar distractors (Martin, Germany) were applied in patient with the severe acquired anterior mandibular and mandibular defect after ameloblastoma enucleation. Iliac bone grafts were performed in defect sites and distraction osteogenesis were treated. After latent period for 1 week, the osteomized alveolar segments were distracted by 0.75 mm a day (0.25 mm/1 turn) for 10 days The consolidation period was about 12 weeks. Thereafter, 2 titanium threaded implants were simultaneously installed with removal of distractor. For oral rehabilitiation, The implants were installed in maxilla, mandible. It was tested with clinically and radiographically. Results : Amounts of acquired alveolar bone were 10 mm with the increased width of the ridge crests and soft tissue expansion. Dental implants installated on the augmented alveolar ridges in 12 weeks after distraction were confirmed as in good osseointegration and in good function without any complications. Conclusion : Intraoral distraction osteogenesis can be a good option for alveolar ridge augmentation of the severely atrophied ridges and soft-tissue defects.

• The Journal of the Korean dental association
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• v.57 no.12
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• pp.768-777
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• 2019

Alveolar bone resorption are unpredictable and always occur after tooth extraction. Such bone resorption causes insufficient alveolar ridge which make implant placement difficult. There are many techniques to increase the alveolar ridge. Representative procedures include ridge split, guided bone regeneration, bone graft using autogenous block bone, and alveolar distraction. In each procedure, there are indications and complications. Depending on the shape and the width of bone defects, we can choose procedures for horizontal bone augmentation and vertical bone augmentation.