• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.36.1-36.8
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• 2019

Background: This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods: From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results: The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of periimplantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions: When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.

• The Journal of Advanced Prosthodontics
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• 제6권1호
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• pp.53-59
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• 2014

PURPOSE. The aim of this study was to obtain statistical data on the residual bone height at different natural tooth positions by panoramic radiography in edentulous Korean patients aged 60-90 years. MATERIALS AND METHODS. The study included the diagnostic panoramic radiographs of 180 randomly selected edentulous patients without systemic diseases affecting bone. The radiographic selection criteria included absence of obvious facial asymmetry, clearly visible anatomic structures, and no surgical and fracture history. The panoramic radiographs of 79 patients met these criteria and were used in the analysis. The same researcher processed all the radiographs by using a standardized method. The height of the residual bone was measured at 18 predetermined sites (7 in the maxilla and 11 in the mandible) on digitized and printed radiographs by using a Digimatic caliper, triangle, and ruler. Gender- and age-related differences were statistically analyzed by using the t-test and rank-sum test (${\alpha}=0.05$). RESULTS. The maxillary residual bone height did not show significant gender-related differences, but male patients had significantly higher residual bone in the mandible(P<.05). No significant height differences at the measured sites were noted among the 60s, 70s, and 80s age groups. CONCLUSION. Dentists should pay greater attention to older female edentulous patients because they are more prone to rapid residual bone resorption. Residual bone resorption may not be affected by age.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권4호
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• pp.231-239
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• 2012

Objectives: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. Materials and Methods: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. Results: The distance medially from the R point to the IAC along the axial plane was $6.19{\pm}1.21mm$. The HD from the R point, posteriorly to IAC, in the lateral view was $13.07{\pm}2.45mm$, the VD from the R point was $14.24{\pm}2.41mm$, and the ND from the R point was $10.12{\pm}1.76mm$. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within $0.56{\pm}0.70mm$. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. Conclusion: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.89-112
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• 2002

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolarcrest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.

• 대한치과의사협회지
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• 제40권9호통권400호
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• pp.709-715
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• 2002

Two patients with sufficient vertical bone height but insufficient bone width in the anterior mandibular edentulous area, less than 6mm in the buccolingual aspect, for implant placement were chosen for treatment with a ridge splitting procedure. The surgical technique involving greenstick fracture is described. This ridge splitting procedure could be simple placement of implants into ideal restorable positions in severely atrophic, knife-edged ridges and predictable for narrow edentulous alveolar ridge augmentation associated with implant placement. We experienced two cases to place implant with insufficient bone width in the anterior mandibular edentulous area for overdenture be ridge splitting technique. Thus, we will report two cases and review of the literature.

• 대한치과보철학회지
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• 제35권3호
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• pp.435-444
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• 1997

Transmandibular implant system은 하악골이 심하게 흡수된 환자에게 특히 유용하게 사용할 수 있다. 또한 여러 문헌에서도 높은 성공률을 보이고 있다. 저자가 시행한 증례에서도 환자는 높은 만족감과 의치의 안정성 및 저작효율의 증대를 보였다. 하지만 성공적인 보철물의 제작을 위해서는 신중한 진단과 치료계획 및 위에서 열거한 여러 가지 고려사항들을 참고해야 한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.137-141
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• 2011

The extraction of an impacted third molar tooth is associated with many complications during the procedure and postoperative care. These complications include bleeding, swelling, pain, infection, as well as root fracture, proximal tooth injury, alveolar bone fracture, lingual nerve and inferior alveolar nerve injury etc. With the exception of a fractured root dislocation in the submandibular space, no direct submandibular gland injury related to extraction surgery has been reported until now. A 40 year old man visited the department of oromaxillofacial surgery at Yeouido St. Mary's Hospital for an extraction of the right mandible third molar. A partial third molar impaction was diagnosed by a clinical and radiographic examination. A surgical tooth extraction was practiced including buccal cortical bone osteotomy. During socket curettage, an encapsulated cyst-like lesion and a verified $3{\times}3\;cm$ neoplasm in the apically lingual direction were found during process of dissection. A biopsy confirmed that the neoplasm involved the submandibular gland and nerve trunk. This unusual anatomical organ injury during the surgical tooth extraction procedure is reported as a new complication during impacted third molar extraction.

• 구강회복응용과학지
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• 제27권1호
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• pp.109-115
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• 2011

점차적으로 폭경이 증가하는 나사들을 이용하여 치조능확장술을 시행하고 임프란트를 식립하였다. 임상적으로 양호한 결과를 얻었으며 수술 중 협측 피질골판 골절은 발생하지 않았다. 임프란트 주변 결손부와 협측 피질골판 상방에 자가치아골이식재를 이식함으로써 부가적인 치조능 확장 효과와 동시에 협측 피질골판 흡수를 보상하였다. 치조능 폭경이 협소한 부위에 임프란트를 식립할 때 나사를 이용한 확장술은 성공적이고 예측 가능한 술식이며 자가치아골이식재는 치조능증대술과 골유도재생술을 위해 사용될 수 있다.

• Restorative Dentistry and Endodontics
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• 제33권1호
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• pp.39-44
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• 2008

심미적으로 중요한 전치부에서 단일치아 임플란트를 이용한 보철수복은 임상의에게 새로운 도전과제중의 하나가 되었다. 그러나 전치부에서 single-unit implant는 식립할 부위의 치조골 상태가 양호해야 하는데 치은연하 파절로 인해 치아 주위에 골 손실이 있는 경우 immediate implant는 심미적으로 문제를 야기 할 수 있다. 따라서 본 증례는 "orthodontic extrusive remodeling"을 통해 파절치와 주위 조직을 교정적으로 정출시켜 임플란트 식립을 위한 연조직과 경조직을 증대시킨 후 임플란트 식립을 통해 상악측절치에서 성공적 인 심미수복을 이룬 증례에 관한 것이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.23-26
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• 2010

The vascular changes in periodontal tissues cause local hypoxia which seems to affect the periodontal tissue cells. Abrupt changes in oxygen availability within the periodontium have been suggested to have a regulatory role in alveolar bone remodeling during tooth movement, bone growth or fracture healing. The purpose of this study was to study the effects of hypoxia on formation of osteoclast responsible for bone resorption, in vitro. Primary mouse bone marrow cells were cultured in normoxic (20% $O_2$) and hypoxic (1% $O_2$) conditions and assayed for cellular proliferation. The results obtained were as follows : 1. Reducing oxygen tension increased the formation of multinucleated osteoclasts. 2. Hypoxic stimulus increased the size of mature osteoclasts.