• 대한치과의사협회지
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• 제57권12호
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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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.386-390
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• 2007

This is about the case of loss of multiple teeth and alveolar bone caused by trauma, which needed alveolar bone augmentation before implant treatment. Alveolar bone was reconstructed using iliac bone graft, and thereafter first implant surgery was followed by consolidation period of 3 months. Iliac bone resorption was observed at the time of implant placement. And that resorption was more in the horizontal dimension than in the vertical. We conclude that additional treatment planning(e.g. using alveolar distraction osteogenesis or tissue expander) should be considered besides bone graft for vertical alveolar bone augmentation. For both maxilla and mandible, prosthodontic treatment was carried out $4{\sim}5$ months after implant placement. To compensate alveolar bone deficiency, partial hybrid overdenture on maxilla and implant-supported fixed bridge on mandible were fabricated, and the total treatment was finished.

• Archives of Plastic Surgery
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• 제40권5호
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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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• 제32권3호
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• pp.276-281
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• 2010

The maxillary posterior area is the most challenging site for the dental implant. After missing of teeth on maxillary posterior area due to periodontal problems, the remaining alveolar ridge is usually very thin because of not only pneumatization of maxillary sinus but also destruction of alveolar bone. The maxillary sinus bone graft procedure is one of the most predictable and successful treatments for the rehabilitation of atrophic and pneumatized endentulous posterior maxilla. But, in case of severe destruction of alveolar bone due to periodontal problems, very long crown length is still remaining problem after successful sinus graft procedures. We performed vertical augmentation of maxillary posterior alveolar ridge using mandibular ramal block bone graft with simultaneous sinus graft. After this procedures, we could get more favorable crown-implant ratio of final prosthodontic appliance and more satisfactory results on biomechanics. This is a preliminary report of the vertical augmentation of maxillary posterior alveolar ridge using mandibular ramal block bone graft with simultaneous sinus graft, so requires more long-term follow up and further studies.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.207-214
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• 2008

Purpose: The aim of augmentation of the alveolar ridge is to restore absorbed alveolar ridges for future implant site or esthetic prosthodontic restoration. The present clinical report describes the anterior maxillary augmentation cases using a soft tissue rotated palatal flap, and considers various problems of before and after surgery. Method: First & second patients were treated by vascularized interpositional periosteal-connective tissue(VIP-CT) flap for horizontal soft tissue augmentation. Especially second patient was progressed with bone grafting at the same time. Third patient was treated by the same flap with bone graft and implant placement in single tooth missing premaxillary area. Result: The obtained horizontal augmentation width measured $0.5{\sim}2.7\;mm$. Conclusion: This technique constitutes a viable approach for augmentation the anterior sector of alveolar ridge with the placement of dental implants. But it needs correct diagnosis preparation and careful surgery skill.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.3.1-3.8
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• 2018

Background: In this research article, we evaluate the use of sub-periosteal tunneling (tunnel technique) combined with alloplastic in situ hardening biphasic calcium phosphate (BCP, a compound of β-tricalcium phosphate and hydroxyapatite) bone graft for lateral augmentation of a deficient alveolar ridge. Methods: A total of 9 patients with deficient mandibular alveolar ridges were included in the present pilot study. Ten lateral ridge augmentation were carried out using the sub-periosteal tunneling technique, including a bilateral procedure in one patient. The increase in ridge width was assessed using CBCT evaluation of the ridge preoperatively and at 4 months postoperatively. Histological assessment of the quality of bone formation was also carried out with bone cores obtained at the implant placement re-entry in one patient. Results: The mean bucco-lingual ridge width increased in average from 4.17 ± 0.99 mm to 8.56 ± 1.93 mm after lateral bone augmentation with easy-graft CRYSTAL using the tunneling technique. The gain in ridge width was statistically highly significant (p = 0.0019). Histomorphometric assessment of two bone cores obtained at the time of implant placement from one patient revealed 27.6% new bone and an overall mineralized fraction of 72.3% in the grafted area 4 months after the bone grafting was carried out. Conclusions: Within the limits of this pilot study, it can be concluded that sub-periosteal tunneling technique using in situ hardening biphasic calcium phosphate is a valuable option for lateral ridge augmentation to allow implant placement in deficient alveolar ridges. Further prospective randomized clinical trials will be necessary to assess its performance in comparison to conventional ridge augmentation procedures.

• 구강회복응용과학지
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• 제22권2호
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• pp.161-171
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• 2006

Endosseous implants have restored normal function and dental health to many patients. When implants were introduced as an effective treatment modality, their efficacy was limited by the amount of available bone. Today, various grafting procedures can surgically create bone width and volume. Implants can be placed in more ideal locations for successful prosthetic reconstruction. The use of autogenous bone grafts represents the "gold standard" for bone augmentation procedures. Either intraoral or extraoral sites may be considered for donor sites. Alveolar ridge augmentation using autogenous bone block, can be done during implant placement or staged with implant placement, after bone graft healing. In the staged technique, a better implant positioning and the use of wide diameter implants are possible. Alveolar ridge augmentation using autogenous block graft is a predictable way of treatment, for the atrophic alveolar ridge before implant placement. The cases presented in this article clinically demonstrate the efficacy of using a autogenous block graft in generating effective new bone fill for dental implant placement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.326-329
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• 2002

저자들은 위축된 치조골과 외상 또는 종양으로 상실된 치조골의 재건을 위하여 수직적 치조골 신장술을 이용하여 104명의 환자에서 평균 10.2 mm의 치조골을 신장시킬 수 있었으며, 양호하게 재건된 치조골에 치과 임플란트를 식립함으로서 기능적, 심미적으로 좋은 결과를 얻을 수 있었다. 치조골 신장술은 기존의 치조골 수복술들을 대체할 수 있는 안전하고 효과적인 방법으로 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.83-85
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• 2000

The purpose of this study is to evaluate the effect of $HTR^{TM}$ (hard tissue replacement, Bioplant Inc, U.S.A) polymer on short-term healing as a grafting material for alveolar ridge augmentation. A 48-year-old female presented insufficient bone height and width for the placement of implants. $HTR^{TM}$ polymer was used for ridge augmentation. Bone biopsy was harvested 8 months after the ridge augmentation procedure. $HTR^{TM}$ polymer displayed rapid bone regeneration and mature lamellar and trabecular bone redevelopment. Clinical and histologic observation from the treatment of the patient presented suggest that $HTR^{TM}$ polymer seems to be a appropriate material for alveolar ridge augmentation.