• The Journal of Korean Academy of Prosthodontics
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• v.45 no.2
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• pp.228-239
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• 2007

Statement of problem: Following tooth loss, the edentulous alveolar process of maxilla is affected by irreversible reabsorption process, with progressive sinus pneumatization leads to leaving inadquate bone height for placement of endosseous implants. Grafting the floor of maxillary sinus by sinus lifting surgery and augmentation of autologous bone or alternative bone material is a method of attaining sufficient bone height for maxillary implants placement and has proven to be a highty successful. Purpose: This study was undertaken to clarify the morphometric characteristics of inferior maxillary sinus and alveolar process for installation of implants. Material and method: Nineteen skulls (37 sinuses, 10M / 9F) obtained from the collection of the department of anatomy and cell biology of Hanyang medical school were studied. The mean age of the deceased was 69.9 years (range 44 to 88 years). The distance between alveolar border and inferior sinus margin at each tooth, the height of alveolar process and the thickness of cortical bone of the outer and inner table of alveolar process and the inferior wall of maxillary sinus were measured. Results and Conclusion: 1. The septum of inferior maxillary sinus were observe 28 sides (76.%) and located at the third molar (52.6%) and the second molar (26.3%). The deepest points of inferior border of maxillary sinus were located the first or second molar. The distance between alveolar margin and the deepest point of inferior maxillary sinus is $9.7{\pm}4.9mm$. 2. The length of the outer table of alveolar process were $4.9\sim28.2mm$ and the shortest point was between the first and the second molors. The thickness of them were $0.9\sim3.2mm$. The length of the inner table of alveolar process were $7.4\sim25.8mm$ and the shortest point was between the first and the second molars. The thickness of the were $0.9\sim4.6mm$. The results of this study are useful anatomical data for installing of maxillary implants.

• Imaging Science in Dentistry
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• v.53 no.1
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• pp.1-9
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• 2023

Purpose: The aim of this study was to evaluate 3-dimensional cone-beam computed tomography (CBCT) images of alveolar bone changes in patients who underwent minimally invasive periodontal surgery-namely, the pinhole surgical technique (PST). Materials and Methods: Alveolar bone height was measured and compared on CBCT images of 254 teeth from 23 consecutive patients with Miller class I, II, or III recession who had undergone PST. No patient with active periodontal disease was selected for surgery. Two different methods were used to assess the alveolar bone changes postoperatively. In both methods, the distance between the apex of the tooth and the mid-buccal alveolar crestal bone on pre- and post-surgical CBCT studies was measured. Results: An average alveolar bone gain >0.5 mm following PST was identified using CBCT(P=0.05). None of the demographic variables, including sex, age, and time since surgery, had any significant effect on bone gain during follow-up, which ranged from 8 months to 3 years. Conclusion: PST appears to be a promising treatment modality for recession that results in stable clinical outcomes and may lead to some level of resolution on the bone level. More long-term studies must be done to evaluate the impact of this novel technique on bone remodeling and to assess sustained bone levels within a larger study population.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.427-433
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• 2010

Purpose: The objective of this study was to evaluate the efficacy of the subperiosteal tunneling technique with iliac block bone graft for bone augmentation in an edentulous alveolar ridge. Patients and Methods: Total of 8 sites in 7 patients were included in this study. The bone height was evaluated by CBCT preoperatively and 4 months after operation. Total of 11 implants were inserted and evaluated clinically and radiographically. Results: Mean value of the increased bone height was 6.29 mm and no implant failure was observed. There were no complications such as soft tissue dehiscence, exposure of the grafted bone and infection. Conclusion: We have achieved excellent clinical outcomes by this technique, so we concluded that it is useful for augmentation of severely deficient alveolar ridge.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.217-226
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• 2020

Purpose: The purpose of this study was to analyze the quantity and quality of the mandibular anterior alveolar bone in terms of alveolar width, density, and total alveolar height (TAH) based on dental status, gender, and age. Additionally, this study aimed to quantitatively evaluate the available alveolar height for graft harvesting (AHGH) and examine its variability based on the aforementioned factors. Materials and Methods: This retrospective cone-beam computed tomographic study included a total of 100 subjects. On the basis of gender, dental status, and age, the scans were divided into 3 primary groups and 8 subgroups. The mandibular alveolar width and density were measured 5 mm mesial to the mental foramen bilaterally and at the midline. The TAH was measured at the midline, and the AHGH was measured as the midline distance between 5 mm apical to the root of the canines and 5 mm superior to the lower border. Results: The mandibular alveolar width was statistically similar between dentulous and edentulous patients (P>0.05). A significantly greater density was observed at the midline in edentulous patients (P<0.05). The TAH was significantly greater in edentulous male patients than in edentulous female patients (P<0.05). Dentulous and male patients had significantly greater AHGH than edentulous and female patients, respectively (P<0.05). Conclusion: Based on the data evaluated in this study, it can be concluded that the mandibular symphyseal area has adequate bone quality and quantity for bone graft harvesting for dental implant therapy.

• Imaging Science in Dentistry
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• v.51 no.2
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• pp.175-185
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• 2021

Purpose: The primary objective of this study was to analyze the thickness and height of alveolar bone around the maxillary and mandibular incisors. Additionally, this study aimed to compare bone parameters between Caucasian (CC) and African American (AA) female patients. Materials and Methods: In this retrospective pilot study, 50 female subjects(25 CC and 25 AA) were included. The inclusion criteria were AA or CC women between the ages of 18 and 50 with a normo-divergent facial pattern and Angle's class I, end-on class II, or mild class III malocclusion. The distance from the cementoenamel junction (CEJ) to the buccal and lingual alveolar crest; the alveolar ridge thickness at the mid-root and apex; and the buccal and lingual bone thickness at 3, 6, and 9mm from the CEJ were measured. Results: No significant difference was found (P>0.05) in the cortical bone thickness at 3mm, 6mm, or 9mm from the alveolar crest between CC and AA populations for most measurements. A significant difference in bone thickness was found (P<0.05) for the lingual surface of the central incisor, with maxillary bone thickness found to be higher than mandibular bone thickness. The measurements of lingual thickness were larger than those of buccal thickness for both races. Conclusion: There were no differences in maxillomandibular anterior alveolar bone measurements between normo-divergent adult AA and CC women, except for a few parameters at varying locations. However, future studies can be planned based the current pilot study data, which may provide valuable information.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.1
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• pp.35-44
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• 1997

The most critical factor in determining which type of implant to be used would be the available bone of the patient. Usually a minimum of 5mm in the bone width and 8mm in the bone height is necessary to ensure primary implant stability and maintain the integrity of bone contact surface. Placement of implant is limited by the several anatomic strutures such as maxillary sinus, floor of the nose, inferior alveolar neurovascular bundle and nasopalatine foramen, etc. When severe resorption of alveolar ridge is encountered, implant placement would be a problematic procedure. A number of techniques to improve the poor anatomic situations have been proposed. This article reports 4 cases of patients using surgical procedures such as blade implant technique, cortical split technique in the anterior maxillary area, sinus lifting and lateral repositioning of inferior alveolar nerve, We treated dental implant candidates with unfavorable alveolar ridge utilizing various surgical techniques, resulted in successful rehabilitation of edentulous ridge.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.274-282
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• 2013

Objectives: The posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach. Materials and Methods: In this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height. Results: The bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively. Conclusion: Maxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for implant rehabilitation.

• Journal of Periodontal and Implant Science
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• v.40 no.2
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• pp.61-68
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• 2010

Purpose: The present study was performed to clarify the relationship between periodontal disease severity and selected immunological parameters consisting of serum IgG titer against periodontopathogenic bacteria, the expression of the helper T-cell cytokine by gingival mononuclear cells, and patients' immunoreactivity to cross-reactive heat shock protein (HSP) epitope peptide from P. gingivalis HSP60. Methods: Twenty-five patients with moderate periodontitis had their gingival connective tissue harvested of gingival mononuclear cells during an open flap debridement procedure and peripheral blood was drawn by venipuncture to collect serum. The mean level of interproximal alveolar bone was calculated to be used as an index for periodontal disease severity for a given patient. Each of selected immunologic parameters was subject to statistical management to seek their correlations with the severity of periodontal disease. Results: A significant correlation could not be identified between serum IgG titers against specific bacteria (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Streptococcus mutans) and the severity of periodontal disease. Expression of interleukin (IL)-10 by gingival mononuclear cells was statistically significant in the group of patients who had higher levels of alveolar bone height. However, a similar correlation could not be demonstrated in cases for IL-4 or interferon-$\gamma$. Patients' serum reactivity to cross-reactive epitope peptide showed a significant correlation with the amount of alveolar bone. Conclusions: It was concluded that expression of IL-10 by gingival mononuclear cells and patients' sero-reactivity to the cross-reactive HSP peptide of P. gingivalis HSP60 were significantly correlated with alveolar bone height.

• Imaging Science in Dentistry
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• v.51 no.2
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• pp.155-165
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• 2021

Purpose: This study aimed to evaluate changes of the alveolar bone and interdental bone septum of the mandibular incisors through cone-beam computed tomography (CBCT) after orthodontic treatment of mandibular dental crowding without dental extraction. Materials and Methods: The sample consisted of 64 CBCT images(32 pre-treatment and 32 post-treatment) from 32 adult patients with class I malocclusion and an average age of 23.0±3.9 years. The width and height of the alveolar bone and interdental septum, the distance between the cementoenamel junction (CEJ) and the facial and lingual bone crests, and the inclination of the mandibular incisors were measured. Results: The distance between the CEJ and the marginal bone crest on the facial side increased significantly (P<0.05). An increased distance between the CEJ and the bone crest on the facial and lingual sides showed a correlation with the irregularity index (P<0.05); however, no significant association was observed with increasing mandibular incisor inclination (P>0.05). The change in the distance between the CEJ and the marginal bone crest on the facial side was correlated significantly with bone septum height(P<0.05). Conclusion: Bone dehiscence developed during the treatment of crowding without extraction only on the incisors' facial side. Increasing proclination of the mandibular incisor was not correlated with bone dehiscence. The degree of dental crowding assessed through the irregularity index was associated with the risk of developing bone dehiscence. The interdental septum reflected facial marginal bone loss in the mandibular incisors.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.276-282
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• 2008

Objective: This is to report the efficacy of the sandwich technique for bone augmentation in a moderate atrophic posterior mandible through clinical and histological results in two cases. Subjects and Method: Two patients selected had moderate bone resorption in left lower edentulous area. Sandwich osteotomy using the piezosurgery was performed and the osteomized alveolar segments were elevated by 6mm in each two patients. The interpositional mineral allograft materials were inserted in the atrophic posterior mandibles. After four months healing period, bone biopsies in the grafted areas and placement of dental implants were performed. In both cases, panoramic views were taken preoperatively to measure the alveolar bone height for diagnosis, to monitor patient healing, and to evaluate bone healing and bone gain. Results: Sufficient vertical bone height was gained by using the sandwich technique and implants were placed successfully. In radiological evaluation, there was minimal resorption of bone height after the second operation and in histomorphometric evaluation, they showed favorable new bone formation without inflammation in the grafted areas. Conclusion: The sandwich technique can be an effective choice for augmenting vertical bone height in the atrophic mandible. More of cases and long term follow-up are needed to evaluate bone resorption and implant prognosis.