• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.278-286
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• 2011

Introduction: This study examined the predictability of new bone formation in the pneumatized maxillary sinus using only fibrin-rich blocks with concentrated growth factors as an alternative to bone grafts. Materials and Methods: Maxillary sinus augmentation was performed in thirty-three patients with a deficient alveolar bone height (mean 3.9 mm). All patients were treated consecutively with sinus membrane elevation via the lateral window approach and panoramic radiograms and cone-beam computed tomograms were taken to evaluate the remaining bone height and the new bone formation in the maxillary sinus, before and after surgery. Four biopsy specimens were taken at the time of implant consolidation (after an average of five months healing) and were stained by H & E and Trichrome staining. Results: None of the patients had postoperative complications during implant consolidation. After an average of 5 months since sinus augmentation, newly formed bone was observed in all cases by a radiographic evaluation. In 4 biopsy samples, newly formed bone was observed along the floor of the replaced bony window. The osteoblast lining and well distinguished Osteocytes in the lacunas were observed in the newly formed bone. Of the 74 implants (4 different surfaced implants - resorbable blast media-surfaced (RBM), Hydroxyapatite (HA) coated, acid-etched, sintered porous-surfaced implant) placed, one RBM implant failed. The success rate was 98.6% after a mean of 15 months. Discussion: These results suggest that maxillary sinus augmentation using fibrin rich block with concentrated growth factors is a successful and predictable technique.

• Journal of Periodontal and Implant Science
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• 제33권4호
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• pp.563-571
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• 2003

One of the central components of periodontal therapy is the improvement of esthetics. The presence and appearance of interdental papillae plays an important role of periodontal esthetics. The aim of the present study was to investigate how immediate provisional restoration preserve the shape of interdental papilla around the extraction socket and the width of bucco-lingual of gingiva. Another aim was to investigate the change in the interdental papilla and the amount of vertical bone fill of a extraction socket in relation to the interdental alveolar bone levels adjacent the alveolar socket. A total of 19 patients (11 male, 8 female, mean age of 50.57${\pm}$8.16), who visited the Department of Periodontology, Pusan National University and had more than one anterior tooth scheduled to be extracted due to an advanced periodontal disease were included in the present study. After initial periodontal therapy, the extracted teeth were reshaped of the root and placed into the socket followed by splinting with adjacent teeth with self-curing resin. The width of hucco-lingual of gingiva and interdental papilla height were measured at baseline, 1, 3, 6, 9 and 12 month and the periapical radiographic examination were taken at baseline, 6 and 12month following the extraction. The amount of vertical bone fill in the extraction socket were calculated. At 12 months following the extraction, the changes in mesial and distal interdental papilla and the width of bucco-lingual showed -1.06${\pm}$0.48mm, -0.844${\pm}$0.50mm, -1.50${\pm}$0.96m, relatively. The positional change in the interproximal papillae was significantly associated with the interdental bone level adjacent to the extraction socket(p=0.028). The higher the interproximal bone level adjacent the extraction socket, the greater the amount of bone fill in the extraction socket(p<0.001). In conclusion, it was thought that immediate provisional restoration could minimize the loss of the width of bucco-lingual and interproximal papillae around the extraction socket. In addition, the higher the interproximal bone level adjacent the extraction socket, the greater the amount of bone fill and the smaller the reduction of papillary height around the extraction socket.

• 대한치과교정학회지
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• 제29권2호
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• pp.165-181
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• 1999

교정치료시 치아와 주위조직의 부작용을 최소로 하면서 최대의 치료결과를 얻기 위해서는 치료역학을 각 환자의 치아 및 주위 해부학적 환경에 맞도록 개인화 시켜야한다. 특히 성인 교정시 문제되기 쉬운 치근흡수 또는 치주질환으로 인한 치조골 손실로 인하여 치관/치근 비율이 변했을 때 치아의 저항중심위치의 변화와 관련된 생역학적 반응의 차이에 주의하여야 한다. 본 연구에서는 정상 치주조직뿐만 아니라 다양한 비정상적 치주 및 치아상태에서 치관/치근 비율이 변하였을 때 일정한 교정력하에서의 치아의 초기이동 양상을 연구하기 위하여, 성인의 인체 건조 두개골 및 하악골상에서 laser 반사측정법 및 lever and pulley force applicator와 photodetector를 이용하여, 상악 6전치군을 대상으로는 치조골높이를 각각의 치아에 대하여 2mm씩 총 8mm까지 감소시켰고, 하악 6전치군을 대상으로는 치근길이를 각각의 치아에 대하여 2mm씩 총6mm까지 감소시키면서, 이렇게 다양하게 정량화된 변수들 하에서 상하악6전치군의 저항중심의 위치변화를 연구한 결과 다음과 같은 결론을 얻었다. 1. 초기상태에서 상악 6전치군의 초기이동시의 저항중심점의 위치는 6전치 전체 평균치아 치근의 치경부(CEJ)로부터 치근첨 방향으로 약 $42.4\%$되는 위치에 있었으며, 각 치아의 치조골의 높이가 감소할수록 저항중심점은 치근첨방향으로 약 $76.7\%$되는 부위까지 이동하였다. 2. 상악 6전치군에서 저항중심점의 6전치 전체 평균 치조정으로부터의 거리는 치조골의 감소와 함께 지속적으로 감소하였으나, 치조골내의 평균 치근의 길이에 대한 비율은 치조골의 감소에 상관없이 약 $33\%$내외에서 비교적 일정하였다. 3. 초기상태에서 하악 6전치군의 초기이동시의 저항중심점의 위치는 6전치 전체 평균치아 치근의 CEJ로부터 치근첨방향으로 약 $43\%$되는 위치에 있었으며, 각 치아의 치근의 길이가 감소할수록 이 비율은 약 $54\%$까지 증가하였다. 그러나 CEJ로부터 저항중심점까지의 거리는 5.3mm전후로부터 3.3mm내외까지 감소하여 치근의 길이가 감소할수록 저항중심점이 CEJ방향으로 이동하였다. 4.치조골 또는 치근흡수시, 각각의 단위 흡수량에 따른 저항중심위치의 변화에 미치는 영향은 초기에는 치조골이 감소 될 때가 더 컸으나 전체 평균 치근길이의 중간부위에서의 영향은 비슷했다.

• 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 Yeungnam Medical Science
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• 제20권2호
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• pp.169-176
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• 2003

Background: Although dental implantation has become widespread and acceptable treatment for dental prosthodontics, maxillary posterior jaw region is often complicated by the pneumatization of the maxillary sinus and physiological resorption of the alveolar bone. When this occurs, the residual bone between the floor of the sinus and the crestal ridge is inadequate for the placement of implants. The sinus elevation procedure provides a way to increase the amount of available bone and to allow the placement of longer implants. Materials & methods: We studied 11 patients requiring the implant placements and the maxillary sinus elevation simultaneously from 1996 to 2003 in our clinic. Nine patients were males and two patients were females, aged from 39 to 72(mean=51.6). Four patients had medical compromised states; angina pectoris, diabetes, hypertension, hepatitis. Patients didn't show any pathologic findings clinically or radiographically. We studied the success and survival rate of implants, factors increasing the osseointegrating capacity of implants. Results: The success rate of osseointegration of implants was 93%. At least 6 months after loading on implants, the survival rate of implants was 78.5%. Autogenous bone graft and adequate residual bone height(>6mm) increased survival rate of implants. Conclusion: Successful implant placement with maxillary sinus elevation mainly depends on sufficient residual bone height, healthy maxillary sinus, autogenous bone graft.

• 대한소아치과학회지
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• 제37권2호
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• pp.252-259
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• 2010

외상으로 치주 인대의 손상이 심한 치아에서는 치아-치조골 유착이 흔히 나타난다. 성장기 아동에서의 치아 유착의 경우 치조골의 성장 중단을 초래하여 저위 교합이 나타나며 이로 인하여 청소년기에 심미적 불만족이 생길 뿐 아니라 인접치의 경사가 발생한다. 이는 교정 또는 보철 치료를 어렵게 만들 수 있으므로 유착된 치아는 비교적 조기에 치료한다. 하지만 저위 교합된 치아를 발치할 경우 치조제의 상당한 소실을 유발할 수 있으며 특히 상악 전치부의 얇은 순측골의 위축을 가져와 심미적인 보철물을 형성하기가 어려워진다. 이러한 치조골의 소실을 방지하기 위하여 치아의 치관부는 제거하고 유착된 치근은 골에 의해 대체되도록 치조골에 남겨두는 치관절제술을 행하는 것이 바람직할 것으로 생각된다. 본 증례에서는 만 9세와 10세에 상악 전치부 치아의 외상을 받은 후 치근 유착이 발생하여 저위 교합을 보이는 성장기 남아에서 추후 예상되는 보철적, 교정적 합병증의 가능성을 감소시키기 위하여 치관절제술을 시행하였다. 저위교합이 2-3 mm 정도 진행되었을 때 술식을 행하였으며, 환아의 성장을 고려하여 한국인의 최대 성장 완료 시기인 16세 이전에 술식을 행하였다. 계속적인 임상적, 방사선학적 검사 결과 수평적 치조골의 소실이 방지될 뿐 아니라, 치조골의 수직적 증가를 보이며, 남겨진 치근은 서서히 흡수되는 양상을 보였기에 이를 보고하고자 한다.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.791-803
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• 2007

The purpose of this study was to evaluate exophytically vertical bone formation in residual ridge of the beagle dog by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with irradiated cancellous human bone. Twelve male beagle dogs(mean age 1.5 years and mean weight 12kg) were used for this study. The alveolar ridges after extraction of all mandibular premolars were surgically and horizontally removed. At 8 weeks after extractions, full-thickness flap was reflected and cortical bone was removed with round bur and copious irrigation. Rectangular parallelepiped(10mm in length, 5mm in width, and 4mm in height) bended with titanium-reinforced e-PTFE(TR e-PTFE) membrane was placed on the decorticated alveolar ridge, fixed with metal pins and covered with full-thickness flap and assigned as a control group. Test groups ere treated with TR e-PTFE membrane filled with irradiated cancellous human bone. Of twelve beagle dogs, four control dogs and four test dogs without membrane exposure to oral cavity were sacrificed at 8 and 16 weeks respectively. The surgical sites were dissected out, fixed in 4% buffered formaldehyde, dyed using a Villanueva staining technique, and processed for embedding in plastic resin. The cutting and grinding methods were routinely processed for histologic and histomophometric analyis of exophytic bone formation as well as statistical analysis. The results of this study were as follows: 1. Exophytic bone formation in the both of experimental groups was increased respectively after surgery from 23.40% at 8 weeks to 46.26% at 16 weeks in the control groups, from 40.23% at 8 weeks to 47.11% at 16 weeks in the test groups(p<0.05). 2. At 8 weeks after surgery, exophytic bone formation was made 40.23% in the test groups and 33.40% in the control groups. Exophytic bone formation was significantly made in the test group more than in the control group. At 16 weeks after surgery, exophytic bone formation was made 44.11% in the test groups and 46.26% in the control groups. Exophytic bone formation was made in the test groups more than in the control groups, but there was no statistically significant differences. 3. The membrane was fixed with metal pins to closely contact it to the bone surface. So, collapse and deviation of the membrane could be prevented and in growth of connective tissue also could be blocked from the periphery of the membrane. On the basis of these findings, wee suggest that intraoral experimental model for exophytic bone formation may be effective to evaluate the effect of bone graft material. And it indicates that combined use of membrane and ICB graft material is more effective than use of membrane only for exophytic bone formation.

• 대한치과의사협회지
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• 제22권11호통권186호
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• pp.953-960
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• 1984

The author applied the attachment fixation overdenture on the patient whose residual alveolar ridge height was poor to increase mechanical denture retention, and observed the periodontal condition of the abutment roots after insertion of attachment fixation overdenture. The author obtained the conclusions as follows; 1. Attachment fixation overdenture showed better mechanical retention than conventional overdenture did, but it resulted unfavorable crown-root ratio. 2. Within one year after insertion, there were not significant changes in periodontal health, which was indicated by plaque index, gingival index, pocket depth, tooth mobility gingival hyperplasia and alveolar bone change. 3. Mild periodontal thickening was observed. 4. This study emphasized the importance of adequate follow-up care and home care instructions.

• 대한치과의사협회지
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• 제37권4호통권359호
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• pp.279-286
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• 1999

In patients with severely atrophic mandibular posterior area, implant placement is a problematic surgical procedure. Inferior alveolar nerve transpositioning technique offers better initial stability of implant and reduce the risk of permanent nerve damages. In this case report, the patient has bilateral atrophic mandibular posterior edentulous area. We placed 3 implants on each mandibular posterior area in conjunction with bilateral inferior alveolar nerve transpositioning to achieve sufficient bone height. The patient complained of paresthesia in lower lip and chin area and ptosis of lower lip after surgery. Neurosensory function was normal in 10 weeks after surgery.