• Imaging Science in Dentistry
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• v.42 no.4
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• pp.225-229
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• 2012

Purpose: This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. Materials and Methods: The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either "non-cleft side" or "cleft side". The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. Results: The pixel area showed a significant difference between the "non-cleft side" and "cleft side" in group 0 ($404.27{\pm}103.72/117.73{\pm}92.25$; p=0.00), group 1 ($434.29{\pm}86.70/388.31{\pm}109.51$; p=0.01), and group 4 ($430.98{\pm}98.11/366.71{\pm}154.59$; p=0.02). No significant differences were found in group 2 ($423.57{\pm}98.12/383.47{\pm}135.88$; p=0.06) or group 3 ($433.02{\pm}116.07/384.16{\pm}146.55$; p=0.19). Conclusion: Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

• Imaging Science in Dentistry
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• v.31 no.2
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• pp.67-71
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• 2001

Purpose: To assess the possibility of using panoramic indices as an indicator of jaw osteoporosis. Methods: Mandibular cortical width (MCW), degree of mandibular alveolar bone resorption (ABR) and morphology of mandibular inferior cortex (MIC) on panoramic radiograph were used as panoramic indices. These panoramic indices were compared with bone mineral density (BMD) of lumbar (L1-L4) and femoral neck measured by dual energy X-ray absorptiometry. We also compared MCW and ABR of young men with those of postmenopausal women. Results : There was a significant correlation between ABR and BMD of lumbar and femoral neck. And also significant correlation between MIC and BMD of lumbar and femoral neck. ANOVA test of BMD of lumbar and femoral neck showed significant differences according to morphologic classification of inferior cortex. There was significant difference in MCW and ABR between young men and postmenopausal women. Conclusion: Our results suggested that ABR and MIC on panoramic radiograph could be reliable in screening of osteoporosis.

• Journal of Periodontal and Implant Science
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• v.51 no.2
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• pp.100-113
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• 2021

Purpose: Previous studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their remaining soft and hard tissues following tooth extraction. The aim of this study was to classify infected alveolar sockets and to provide the appropriate treatment approaches. Methods: A proposed classification of extraction sockets with chronic inflammation was developed based upon the morphology of the bone defect and soft tissue at the time of tooth extraction. The prevalence of each type of the suggested classification was determined retrospectively in a cohort of patients who underwent, between 2011 and 2015, immediate bone grafting procedures (ridge preservation/augmentation) after tooth extractions at Seoul National University Dental Hospital. Results: The extraction sockets were classified into 5 types: type I, type II, type III, type IV (A & B), and type V. In this system, the severity of bone and soft tissue breakdown increases from type I to type V, while the reconstruction potential and treatment predictability decrease according to the same sequence of socket types. The retrospective screening of the included extraction sites revealed that most of the sockets assigned to ridge preservation displayed features of type IV (86.87%). Conclusions: The present article classified different types of commonly observed infected sockets based on diverse levels of ridge destruction. Type IV sockets, featuring an advanced breakdown of alveolar bone, appear to be more frequent than the other socket types.

• The Journal of the Korean dental association
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• v.54 no.5
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• pp.328-341
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• 2016

An overall reduction in the horizontal and vertical dimensions occurs following tooth extraction and the resorption of the buccal part of the ridge is more pronounced than the lingual part. Thus, the resulting morphology of the healed alveolar ridge is often presenting with a discrepancy in bone height between the buccal and lingual aspects of the ridge. The implant with a sloped marginal configuration that is designed to match the sloped contour of the alveolar ridge provides the opportunity to maintain the buccal-lingual bone discrepancy and soft tissue around the implant. This paper introduces the OsseoSpeed TX Profile implants with sloped marginal configuration and explains the characteristics and clinical meanings of those implants.

• 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.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.33-38
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• 2014

Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

• The korean journal of orthodontics
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• v.53 no.2
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• pp.77-88
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• 2023

Objective: To develop a method for generating three-dimensional (3D) digital models of the periodontal ligament (PDL) using 3D cone-beam computed tomography (CBCT) reconstruction and to evaluate the accuracy and agreement of the 3D PDL models in the measurement of periodontal bone loss. Methods: CBCT data collected from four patients with skeletal Class III malocclusion prior to periodontal surgery were reconstructed at three voxel sizes (0.2 mm, 0.25 mm, and 0.3 mm), and 3D tooth and alveolar bone models were generated to obtain digital PDL models for the maxillary and mandibular anterior teeth. Linear measurements of the alveolar bone crest obtained during periodontal surgery were compared with the digital measurements for assessment of the accuracy of the digital models. The agreement and reliability of the digital PDL models were analyzed using intra- and interexaminer correlation coefficients and Bland-Altman plots. Results: Digital models of the maxillary and mandibular anterior teeth, PDL, and alveolar bone of the four patients were successfully established. Relative to the intraoperative measurements, linear measurements obtained from the 3D digital models were accurate, and there were no significant differences among different voxel sizes at different sites. High diagnostic coincidence rates were found for the maxillary anterior teeth. The digital models showed high intra- and interexaminer agreement. Conclusions: Digital PDL models generated by 3D CBCT reconstruction can provide accurate and useful information regarding the alveolar crest morphology and facilitate reproducible measurements. This could assist clinicians in the evaluation of periodontal prognosis and establishment of an appropriate orthodontic treatment plan.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.519-526
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• 2000

Osteoporosis has recently been recognized as a major health problem in the elderly population. The disorder is manifested as a loss of bone mass accompanied by structural alteration of bone and increased incidence of fracture. Mandible also may be affected. So, I evaluated panoramic views of 66 postmenopausal women for finding the possibility of useful diagnostic mandibular parmeters of osteoporosis. To know the correlationship between skeleton and mandible, the average of the bone mineral density of lumbar from 2nd to 4th by the dual energy X-ray absorptiometry(DEXA, LUNAR DPZ. USA), and age and mandibular parameters, that is, the number of residual teeth, alveolar ridge resorption ratio, panoramic mandibular index (PMI), mandibular cortical width (MCW), angular cortical thickness (ACT), ramus cortical thickness (RCT), morphology of mandibular inferior cortical (MIC) were compared. And I divided the all tested women to the osteoporotic group and non-osteoporotic group by the use of T-score -2.0, which was derived from skeletal bone mineral density (BMD). To find the correlationship of the each group with mandibular parameters, t-test and discriminant analysis were done. The results of the t-test were that all parameters were highly related with 2 groups (p<0.05). Especially ACT, MIC, age have had even higher correlationship than others (p<0.001). The results of the discriminant analysis by the use of these ACT, MIC and age were that the discriminant function was Z = -2.973+(-1.447)$\times$(ACT)+1.131$\times$(MIC score)+(0.052)$\times$(age), the cutting score was 0.257 and the classification accuracy was 84.8%. Therefore I suggest that the consideration of the angular cortical thickness (ACT), the age of patient and the morphology of mandibular inferior cortical(MIC) may help find the osteoporosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.30-42
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• 2023

Objectives: While the reliability of immediate implant placement in the maxillary molar has been discussed, its significance is questionable. There have been no guidelines for case selection and surgical technique for successful treatment outcomes of immediate maxillary molar implants. Therefore, in this study, we classified alveolar bone height and socket morphology of the maxillary molar to establish guidelines for immediate implant placement. Materials and Methods: From 2011 to 2019, we retrospectively analyzed 106 patients with 148 immediate implants at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. Inclusion and exclusion criteria were applied, and patient characteristics and treatment results were evaluated clinically and radiologically. Results: A total of 29 tapered, sand-blasted, large-grit, and acid-etched (SLA) surfaces of implants were placed in 26 patients. The mean patient age was 64.88 years. Two implants failed and were reinstalled, resulting in a 93.10% survival rate. Fluctuating marginal bone level changes indicating bone regeneration and bone loss were observed in the first year following installation and remained stable after one year of prosthesis loading, with an average bone loss of 0.01±0.01 mm on the distal side and 0.03±0.03 mm on the mesial side. Conclusion: This clinical study demonstrated the significance of immediate implant placement in maxillary molars as a reliable treatment with a high survival rate using tapered SLA implants. With an accurate approach to immediate implantation, surgical intervention and treatment time can be reduced, resulting in patient satisfaction and comfort.

• The korean journal of orthodontics
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• v.24 no.2
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• pp.275-294
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• 1994

The occlusal interference during adolescent period makes some effects on growth and development and morphological changes. And so, if we could predict the the timing and results of orthodontic treatment who have occlusal interference during adolescent period, it may be helpful for diagnosis and treatment planning of orthodontic treatment. For about those, the purpose of this study was to evaluate the effects of the posterolateral displacement by the metal casting crown with inclined pathway on the mandibular condyle and morphologic changes of mandible in the rat. The experimental animals were thirty six Sprague-Dawley male rats of 8 weeks old. Eight of them was used as control group, and experimental group 1 ( continuous appliance wearing group ) was composed of sixteen and experimental group 2 ( appliance removal group after worn the appliances during 3 months ) was composed of remaining twelve. The animals of experimental grouop 1 were sacrificed after 1, 2, 3, 6 months from beginning of the experiment and experimental group 2 were sacrificed 1, 2, 3 months after removal of the appliance from worn the appliance during 3 months. Both of mandible and temporomandibular joint were observed histologically and radiologically. The results were as follows : 1. In experimental group 1, the mandibular length and lower posterior height were decreased with experimental period, while the lower anterior height was increased, and the curvature of lower incisors and lingual inclination of anterior alveolar bone were profound as compared with control group. 2. In experimental group 1, both of the thickness of the condylar cartilage were thinned in the posterosuperior region, and this phenomenon was more prominent on right than left in 3-Mo experimental period and both sides were marked thinned in 6-Mo experimental period. 3. In experimental group 2, the lower anterior height was low and lower posterior height was high as compared with experimental group 1, and the curvature of lower incisors and lingual inclination of anterior alveolar bone were recovered to control group. 4. In experimental group 2, both of the thickness of the condylar cartilage were thickened in the posterosuperior region, and this phenomenon was more prominent with experimental period. 5. In experimental group 2, the mandibular length was short, lower anterior height was hight, the curvature of lower incisors were profound, and in histologically, both of the thickness of the condylar cartilage were thickened in the posterosuperior region as compared with control group. As shown above, the occlusal interfemce affected the condylar cartilage, curvature of lower incisor, inclination of anterior alveolar bone, mandibular length, and anterior and posterior height. When the interference was removed, significant recover was found in condylar cartilage, mandibular length, and posterior height. Although no significance was found, other items of measurement showed trends for recovery.