• Title/Summary/Keyword: Alveolar bone height

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Vertical distraction osteogenesis of a reconstructed mandible with a free vascularized fibula flap: a report of two cases

  • Saito, Naoaki;Funayama, Akinori;Arai, Yoshiaki;Suda, Daisuke;Takata, Yoshiyuki;Kobayashi, Tadaharu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.32.1-32.8
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    • 2018
  • Background: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. Case presentation: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. Conclusions: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

Clinical Comparative Study for Maxillary Sinus Augmentation Using Deproteinized Bovine Bone Mineral and Mineralized Allograft (탈단백우골과 비탈회 동종골을 사용한 상악동 거상술의 임상적 연구)

  • Jo, Ji-Ho;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.442-446
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    • 2010
  • Purpose: The purpose of this study was to compare the clinical efficacy of popular bone graft materials mineralized allograft and deproteinized bovine bone mineral. Materials and Methods: One hundred seven implants of 78 patients, accompanied by sinus lift using the lateral window technique and simultaneous implantation, were sampled. In addition, some patients with severe systemic conditions were excluded. The initial bone heights of all patients ranged from 3-6 mm. All of the sample cases were treated at our hospital from January 2005 to January 2008. Techniques other than the lateral window technique were excluded, and only one graft material ($Tutoplast^{(R)}$ or Bio-$Oss^{(R)}$) was accepted for inclusion. $Tutoplast^{(R)}$ was used in 63 implants of 41 patients, whereas Bio-$Oss^{(R)}$) was chosen for the remaining 44 implants of 37 patients. The diameters of the particles used ranged from 0.25-1.0 mm, and the volume was 0.5-2 cc (mean, 1.5 cc). Results: The survival rate of the implant fixtures was 99.07% when the lateral window technique was used. Among all of the cases, cases in which $Tutoplast^{(R)}$ was used demonstrated a survival rate of 98.4%, whereas Bio-$Oss^{(R)}$) resulted in 100% survival. With respect to the alveolar bone height, no significant differences were detected between the two graft materials that failed. Conclusion: According to the result reported above, the two common materials for sinus augmentation do not have clinically significant difference. Rather, host factors, such as the height of residual bone, which could be disclosed during questioning patients' systemic conditions, might have greater effects on the prognosis.

A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS ON THE LOCATION OF CENTER OF RESISTANCE DURING INTRUSION OF UPPER ANTERIOR TEETH (상악 전치 intrusion시 저항중심의 위치에 관한 3차원 유한요소법적 연구)

  • Park, Chun-Keun;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.259-272
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    • 1997
  • This study was performed to locate the anteroposterior position of the center of resistance of upper anterior teeth when intrusive forces are acted on them by applying segmented arch mechanics. Three-dimensional finite element model of upper six anterior teeth, periodontal ligament and alveolar bone was constructed The locations of the center of resistance were compared according to the three variables, which are number of teeth contained in anterior segment, axial inclination of anterior teeth, and degree of alveolar bone loss. The following conclusions were drawn from this study; 1. When the axial inclination and alveolar bone height were normal, the locations of center of resistance of anterior segment according to the number of teeth contained were as follows; 1). In 2 teeth segment, the center of resistance was located in the distal area of lateral incisor bracket 2) In 4 teeth segment, the center of resistance was located in the distal 2/3 of the distance between the brackets of lateral incisor and canine. 3) In 6 teeth segment, the center of resistance was located in 3mm distal of canine bracket, which is interproxirnal area. between canine and 1st premolar. 4) As the number of teeth contained in anterior segment increased, the center of resistance shifted to the distal side. 2. As the labial inclination of incisors increased, the center of resistance shifted to the distal side. 3. As the alveolar bone loss increased, the center of resistance shifted to the distal side.

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Healing pattern of the mucous membrane after tooth extraction in the maxillary sinus

  • Yoo, Ji-Young;Pi, Sung-Hee;Kim, Yun-Sang;Jeong, Seong-Nyum;You, Hyung-Keun
    • Journal of Periodontal and Implant Science
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    • v.41 no.1
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    • pp.23-29
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    • 2011
  • Purpose: To investigate the healing pattern of the mucous membrane after tooth extraction necessitated by periodontal disease in the maxillary sinus. Methods: One hundred and three patients with 119 maxillary sinuses were investigated. Before implant placement, cone-beam computed tomography (CT) scanning was performed. The causes of extraction, the time elapsed since extraction, smoking, periodontal disease in adjacent teeth, and gender were recorded. In addition, the thickness of the mucous membrane of the maxillary sinus and the height of residual alveolar bone at the extracted area were calculated from CT images. Results: The thickness of the mucous membrane in the periodontal disease group ($3.05{\pm}2.71\;mm$) was greater than that of the pulp disease group ($1.92{\pm}1.78\;mm$) and the tooth fracture group ($1.35{\pm}0.55\;mm$; P<0.05). The causes of extraction, the time elapsed since extraction, and gender had relationships with a thickening of the mucous membrane of the maxillary sinus (P<0.05). In contrast, the height of the residual alveolar bone at the extracted area, periodontal disease in adjacent teeth, and smoking did not show any relation to the thickening of the mucous membrane of the maxillary sinus. Conclusions: The present study revealed distinct differences in healing patterns according to the causes of extraction in the maxillary sinus, especially periodontal disease, which resulted in more severe thickening of the mucous membrane.

Early implant placement in sites with ridge preservation or spontaneous healing: histologic, profilometric, and CBCT analyses of an exploratory RCT

  • Stefan P. Bienz;Edwin Ruales-Carrera;Wan-Zhen Lee;Christoph H. F. Hammerle;Ronald E. Jung;Daniel S. Thoma
    • Journal of Periodontal and Implant Science
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    • v.54 no.2
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    • pp.108-121
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    • 2024
  • Purpose: The aim of this study was to compare changes in soft and hard tissue and the histologic composition following early implant placement in sites with alveolar ridge preservation or spontaneous healing (SH), as well as implant performance up to 1 year after crown insertion. Methods: Thirty-five patients with either intact buccal bone plates or dehiscence of up to 50% following single-tooth extraction of incisors, canines, or premolars were included in the study. They were randomly assigned to undergo one of three procedures: deproteinized bovine bone mineral with 10% collagen (DBBM-C) covered by a collagen matrix (DBBM-C/CM), DBBM-C alone, or SH. At 8 weeks, implant placement was carried out, and cone-beam computed tomography scans and impressions were obtained for profilometric analysis. Patients were followed up after the final crown insertion and again at 1 year post-procedure. Results: Within the first 8 weeks following tooth extraction, the median height of the buccal soft tissue contour changed by -2.11 mm for the DBBM-C/CM group, -1.62 mm for the DBBM-C group, and -1.93 mm for the SH group. The corresponding height of the buccal mineralized tissue changed by -0.27 mm for the DBBM-C/CM group, -2.73 mm for the DBBM-C group, and -1.48 mm for the SH group. The median contour changes between crown insertion and 1 year were -0.19 mm in the DBBM-C/CM group, -0.09 mm in the DBBM-C group, and -0.29 mm in the SH group. Conclusions: Major vertical and horizontal ridge contour changes occurred, irrespective of the treatment modality, up to 8 weeks following tooth extraction. The DBBM-C/CM preserved more mineralized tissue throughout this period, despite a substantial reduction in the overall contour. All 3 protocols led to stable tissues for up to 1 year.

Radiomorphometric analysis of edentulous posterior mandibular ridges in the first molar region: a cone-beam computed tomography study

  • Magat, Guldane
    • Journal of Periodontal and Implant Science
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    • v.50 no.1
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    • pp.28-37
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    • 2020
  • Purpose: The aim of our study was to determine the prevalence and degree of lingual concavities in the first molar region of the mandible to reduce the risk of perforating the lingual cortical bone during dental implant insertion. Methods: A total of 163 suitable cross-sectional cone-beam computed tomography images of edentulous mandibular first molar regions were evaluated. The mandibular morphology was classified as a U-configuration (undercut), a P-configuration (parallel), or a C-configuration (convex), depending on the shape of the alveolar ridge. The characteristics of lingual concavities, including their depth, angle, vertical location, and additional parameters, were measured. Results: Lingual undercuts had a prevalence of 32.5% in the first molar region. The mean concavity angle was 63.34°±8.26°, and the mean linear concavity depth (LCD) was 3.03±0.99 mm. The mean vertical distances of point P from the alveolar crest (Vc) and from the inferior mandibular border were 9.39±3.39 and 16.25±2.44, respectively. Men displayed a larger vertical height from the alveolar crest to 2 mm coronal to the inferior alveolar nerve (Vcb) and a wider LCD than women (P<0.05). Negative correlations were found between age and buccolingual width at 2 mm apical to the alveolar crest, between age and Vcb, between age and Vc, and between age and LCD (P<0.05). Conclusions: The prevalence of lingual concavities was 32.5% in this study. Age and gender had statistically significant effects on the lingual morphology. The risk of lingual perforation was higher in young men than in the other groups analyzed.

Functional Endoscopic Sinus Surgery for a Patient with Maxillary Sinusitis Occurring after Implant Placement

  • You, Jae-Seek;Kim, Su-Gwan;Oh, Ji-Su;Jeong, Gyeong-Dal;Mah, Deuk-Hyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.5
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    • pp.331-336
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    • 2013
  • Maxillary sinus membrane elevation and bone graft have been performed routinely in alveolar bone with insufficient residual bone height. There are a number of causes for development of maxillary sinusitis after these procedures. When maxillary sinusitis is caused by sinus membrane elevation, bone graft, and implant placement, various treatment such as medication, incision and drainage (I&D), implant removal, and the Caldwell-Luc procedure can be considered. Removal of an implant or the Caldwell-Luc procedure can be harmful if inflammation is not present in the oral cavity and survival of grafted bone and implant osseointegration can be expected despite the presence of maxillary sinusitis. In this case, functional endoscopic sinus surgery, which was often used in the otorhinolaryngology department, was performed without removal of the implant for a patient with maxillary sinusitis after one month following implant placement. Thus, we report on this case with a review of the literature.

Changes of root lengths and crestal bone height In nail biting patients (손톱 깨물기 습관을 가진 아동의 전치부 치근길이와 치조골 높이 변화에 관한 연구)

  • Hwang, Chung-Ju;Kim, Jung-Suk
    • The korean journal of orthodontics
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    • v.29 no.6 s.77
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    • pp.689-698
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    • 1999
  • Although the purpose of orthodontic treatment is to increase the function and aesthetics of the jaws as well as to increase stability, there are side effects from the treatment itself such as root resorption and alveolar bone resorption. Such resoiption of the apical root is unpredictable and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effects of different oral habits, especially that ef nail biting, and their correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration. The possibility of root resorption and alveolar bone loss during orthodontic treatment can also be considered. Also, any legal problems that might occur may be pondered as well. Among the male md female patients of the ages 10~15, 63 were chosen as the test group with known nail biting habits at time of examination and within the same age range those without nail biting habits as the control group. The test group was composed of 30 males and 33 females. The control group had 31 males and 32 females. The result from this study were as follows : 1. Of the 63 patients of both the test and control groups, the male-to-female-ratio was 1:1, and had no statistically significant difference in male and female root resorption. 2. In comparing crown length of the test and control groups, no significant difference existed, but in root length, maxillary and mandibular right and left central incisors and mandibular right lateral incisors had a smaller value. (p<0.001) 3. Average crown-to-root ratio of the test group on the periapical view show a noticeably high value for the maxillary and mandibular right and left central incisors and mandibular right and left lateral incisors. (p<0.01) 4. In comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, mesial surfaces of the maxillary and mandibular right and left central incisors and distal surface of maxillary right central incisor of the test group showed greater loss of crestal bone than the control. (p<0.05)

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EFFECT OF DFDB AND GTAM BARRIERS ON BONE REGENERATION AROUND IMMEDIATE IMPLANTS PLACED IN SURGICALLY DFFECTIVE SOCKET (골결손부가 있는 발치직후 매식 임플란트에서 탈회동결건조골과 GTAM차단막이 골재생에 미치는 영향)

  • Kim, Hyeong-Soo;Yang, Hong-So
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.1
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    • pp.43-66
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    • 1997
  • Dental implant may be immediately placed in postextraction socket which has alveolar bone defect. The purpose of this study was to compare the bone regeneration and bone quality around defects adjacent to implants that were placed into extraction sockets according to EFEB, GTAM barrier and GTAM barrier with DFDB. Mandibular P2, P3 and P4 were extracted bilaterally in dogs, and buccal defects were created about 4mm in depth and 3.3mm in width. Screwed pure titanium implants, 3.8mm in diameter and 10mm in length, were placed into the extraction sockets. The experimental groups were divided into four groups : the G group was covered with a GTAM barrier on the defective area, the D+G group was filled with DFEB and covered with a GTAM barrier, the D group was filled with DFDB only and the control group was sutured without any special treatment on the defective area. The experimental animals were killed after 12 weeks and specimens were prepared for light microscopic evaluation and fluorescent dyes were administered daily for 2 weeks after implantation, and injected on the 4th and 11th week for fluorescent microscopic examination to observe new bone formation and bone remodeling. The new Bone height of the buccal defect was measured and compared with the another for bone gain and the removal torque for the implant was measured for the comparison of bone density and bone-implant osseointegration. Results obtained were as follows : 1. Experimental groups showed bone regeneration in oder from D+G, G, D group and control. D+G and G group was significantly from D group and control(P<0.01). 2. In the defective area of control the regenerated alveolar bone showed poorly developed lamellated structure and fibrous tissue intervention into the bone-implant interface but the others showed well developed lamellated structure and osseointegration. 3. All implant groups showed no significaant difference in the removal torque for implant(P>0.05) These results suggest that immediate implants placed in defective sockets were successfully osseointegrated and utilizing placed in defective sockets were successfully osseointegrated and utilizing not only the combination of GTAM and DFDB but also only the GTAM was favorable for the predictable regeneration of the defective area.

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Treatment including orthognathic surgery of a patient with Hypohidrotic ectodermal dysplasia with cleft palate: A Clinical report (구개열을동반한저한성외배엽형성이상환자의 악교정수술을포함한치료: A Clinical report)

  • Kim, Jwa-Young;Park, In-Young;Song, Yun-Jung
    • The Journal of the Korean dental association
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    • v.57 no.2
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    • pp.93-99
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    • 2019
  • Ectodermal dysplasia is a genetic disorder in which various clinical manifestations involve two or more of the differentiated tissues of the ectoderm. Facial deformity, which is frequently associated with ectodermal dysplasia, appears in the form of cleft lip or cleft palate, especially in the middle facial area.Cleft and tooth defects result in decreased alveolar bone development.This leads to severe skeletal incongruity. Facial features include frontal protrusion, malar bone hypoplasia, flat nose, mandibular prominence and long lower facial height. This clinical report presents treatment including orthognathic surgery of a patient with Hypohidrotic Ectodermal dysplasia with cleft palate.

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