• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권1호
• /
• pp.35-44
• /
• 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 Microbiology and Biotechnology
• /
• 제28권3호
• /
• pp.357-366
• /
• 2018

Periodontitis, an infective disease caused by oral pathogens and the intrinsic aging process, results in the destruction of periodontal tissues and the loss of alveolar bone. This study investigated whether Boesenbergia pandurata extract (BPE) standardized with panduratin A exerted anti-periodontitis effects, using an aging model representative of naturally occurring periodontitis. In aged rats, the oral administration of BPE ($200mg{\cdot}kg^{-1}{\cdot}day^{-1}$) for 8 weeks significantly reduced the mRNA and protein expression of $interleukin-1{\beta}$, nuclear factor-kappa B, matrix metalloproteinase (MMP)-2, and MMP-8 in gingival tissues (p < 0.01). In alveolar bone, histological analysis with staining and micro-computed tomography revealed the attenuation of alveolar bone resorption in the BPE-treated aged group, which led to a significant reduction in the mRNA and protein expression of nuclear factor of activated T-cells c1 (NFATc1), c-Fos, tartrate-resistant acid phosphatase, and cathepsin K (p < 0.01). BPE not only increased the expression of osteoblast differentiation markers, such as alkaline phosphate, and collagen type I (COL1A1), but also increased the ratio of osteoprotegerin to RANKL. Collectively, the results strongly suggested that BPE is a natural resource for the prevention or treatment of periodontal diseases.

• Journal of Korean Dental Science
• /
• 제5권1호
• /
• pp.37-44
• /
• 2012

Purpose: Among the facilitation of tooth movement in adult orthodontic treatment methods, surgical approaches are gaining popularity but complications following mechanical bone reduction are a problem. In this study, tooth movement was observed after alveolar bone was chemically demineralized to verify whether tooth movement had been facilitated. Materials and Methods: Twelve rabbits were used. In the experimental group, the alveolar bone of the left first molar area was exposed and demineralized. Thirty seven percents phosphoric acid was applied for 5 minutes for demineralization. The opposite first molar area was used as control. Two teeth were pulled with 200 g force and 4 rabbits each were sacrificed at 3, 7, and 14 days after the force was applied. Histologic examination was done with hematoxylin and eosin and tartrate-resistant acid phosphatase staining. Result: The histologic examination results revealed more bone resorption in the demineralized area. As time passed, the number of osteoclasts increased in the compressed area. The amount of tooth movement was larger in the experimental group compared to the control group but the difference was not statistically significant. Conclusion: The demineralization with etchant resulted in limited bone resorption, more tooth movement and less damage of the cementum after applied orthodontic force.

• 대한치과보철학회지
• /
• 제9권1호
• /
• pp.53-57
• /
• 1969

Trauma from occlusion causes apparent changes in the blood vessels of the periodontal ligament. The initial response is primarily mechanical, due to compression, and secondarily characterized by necrotic changes. Recently, many investigators are concerned with vascular changes in relation to the loss of the alveolar bone. Author observed vascular changes of the periodontium in the experimental trauma from occlusion on rats. The results were observed as follows.: 1) There were no remarkable changes in the gingiva. 2) The blood vessels that normally occupied a position closer to the bone surface showed a displace-ment toward the cemental surface due to trauma from occlusion. 3) There were no appreciable changes of the alveolar bone in the initial period of trauma from occlusion, whereas there was excessive resorption of the alveolar bone in the long range.

• Journal of Periodontal and Implant Science
• /
• 제26권2호
• /
• pp.334-349
• /
• 1996

Regeneration of the periodontal tissue destroyed by periodontal disease is one of the final goals of periodontal therapy. In the past few years, periodontists have used various alloplastic grafting materials in an attempt to regenerate bone lost from periodontal disease. These materials have used widely because they have shown to be nontoxic, biologically compatible with surrounding host tissue and chemically similar to bone. The purpose of this study was to investigate the effect of Porous Resorbable Calcium Carbonate and Porous Replamineform Hydroxyapatite on the regeneration of the alveolar bone and the healing of roots transplanted into the periodontally diseased extraction sockets of dogs. The experimental chronic periodontitis was induced by elastic ligatures on the 2nd and 3rd mandibular premolars of 2 adult dogs for 8weeks after surgically creating periodontal defect. The extracted root were split in half along the long-axis, and the extend of plaque exposure was marked on the root surfaces with burs. The roots were inserted in extraction sockets with Porous Resorbable Calcium Carbonate(PRCC) in left side and with Porous Replaminefrom Hydroxyapatite(PRH) in right side. The flaps were sutured to cover the sockets completely. The animals were sacrificed after 12 weeks of healing, and the specimens were examined histologically. The results were as follows: 1. No inflammatory reactions were observed in either groups. 2. Hoot resorption was observed in both groups while the general outline of the roots were maintained. 3. PRCC was almost completely resorbed and replaced with new bone, while R.H.A. was not resorbed & remained encased in newly-formed C-T and alveolar bone. 4. PRH was encapsulated with alveolar bone which has been deposited from apical & lateral area of the sockets, while the coronal portion of the sockets were filled with C-T. 5. In both groups, the resorbed portions of the roots were replaced with new bone. These results suggest that either PRCC or PRH may not interfere with bone formation or healing in extraction sockets, and in some degree, retard the root resorption. Because the roots maintained in anatomy, we think that graft materials prevent the root resorption.

• Journal of Periodontal and Implant Science
• /
• 제25권1호
• /
• pp.67-75
• /
• 1995

The progress of periodontal disease and the wound healing process after treatment result in alveolar bone bone change. So, detection of it is very important in the diagnosis and the radiograph of periodontal disease. Various effects have been made to assess the subtle alveolar bone change and digital subtraction radiography (DSR) has been reported to be the best method in evaluating it qualitatively and quantitatively. The present study was performed to estimate the detectable alveolar bone change qualitatively with digital subtraction radiography. For the in vitro study, 10 intraoral standard radiographs were taken from porcine dry mandible which a rectangular cortical bone chip of 0.1mm to 1.0mm thickness with 0.1mm increment was attached on the buccal surface. The radiographs without and with bone plates were reviewed at the same time by 10 observers and requested to detect the presence of cortical bone plates. Digital Subtraction radiograph was reviewed subsequently by using the DSR system(digital converter-256 grey-levels,DT 2851,Data Translation Co., U.S.A;IBM 386 ; CCD camera, FOTOVIX, Tamrom Co., Japan). The detectable thickness of cortical bone plate was O.4mm on the intraoral radiograph and 0.2mm on the subtaction images. For the human study, radiographs were taken from patients by using intraoral film holding device and aluminum reference wedge before and 3 month after bone graft and 1 week after osteoplasty. The grey level change was estimated in the subtraction images and calculated to aluminum equivalent thickness. The grey level of the grafted site was higher that that of healthy controls. Average grey levels of change on healthy controls were O.48mm aluminum equivalent. However, the amount of changes in grafted sites were 1.87mm aluminum thickness equivalent and in the site of osteoplasty were -1.49mm aluminum thickness equivalent. In conclusion, digital subtraction radiography was more effective in detecting as subtle change of alveolar bone than intraoral standard radiography. With the aid of quantitative analysis of digital subtraction radiography, alveolar bone resorption of apposition can be estimated during diagnosis and treatment of periodontally diseased patients.

• 대한심미치과학회지
• /
• 제23권2호
• /
• pp.70-76
• /
• 2014

After extraction of tooth, alveolar ridge resorption is inevitable in most cases. Clinicians confront with horizontal and vertical resorption of alveolar bone. Without massive amount of bone and soft tissue graft, dental implant will be placed apically to gain stability. In those cases, not only white esthetic part, but also pink esthetic part should be restored with pink porcelain. The margin of prosthesis should be located apically to reproduce natural look with adjacent teeth. However, when the margin is located apically, it is always hard to remove remaining cement, thus complications may arise. In this report, a novel design of implant prosthesis is introduced to solve those issues. The novel design is consisted of zirconia framework with pink porcelain and separate crowns on top of the framework. It eliminates the possibility of cement remnants by bringing the crown margin coronally. Pink esthetic part is incorporated in abutment part instead of crown part and the screw hole is covered with separate crowns.

• Journal of Periodontal and Implant Science
• /
• 제37권4호
• /
• pp.755-766
• /
• 2007

Purpose: The purposes of this study were to compare and quantify the expression of $PGE_2$, MMP-14 and TIMP-1 in the gingival tissues of patients with type 2 diabetes mellitus and healthy adults of chronic periodontitis with alveolar bone resorption. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflammed gingiva from patients of chronic periodontitis with alveolar bone resorption. Group 3(n=8) is inflammed gingiva from patients of chronic periodontitis with alveolar bone resorption associated with type 2 diabetes. Tissue samples were prepared and analyzed by Western blotting. The quantification of $PGE_2$ MMP-14 and TIMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: The expressions of MMP-14 and TIMP-1 were showed increasing tendency in group 2 & 3 compared to group 1. The expressions of $PGE_2$, MMP-14 were showed increasing tendency in group 3 compared to group 1 and group 2. According to MMP-14 levels were increasing, $PGE_2$ showed increasing tendency in group 3, and although $PGE_2$, MMP-14 levels were increasing, TIMP-1 levels were similar expressed comparing to group 2. Conclusion: In conclusion, this study demonstrated that the expression levels of MMP-14 and TIMP-1 had increasing tendency in inflammed tissue. It can be assumed that $PGE_2$ and MMP-14 may be partly involved in alveolar bone resorptive process and the progression of periodontal inflammation associated to type 2 DM.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권6호
• /
• pp.529-536
• /
• 2010

Purpose: The Purpose of this study is to show the total survival rate of implants with maxillary sinus grafting and the effects that reach the survival rate by classifying types of graft materials, implant type, operation method, residual bone height and evaluate graft material resorption rate after sinus grafting Patients and Methods: 61 dental implants placed with sinus bone grafting in 24 patients at Wonkwang University Sanbon Dental Hospital were installed simultaneously or after regular healing. Various bone grafts (autograft, xenograft, allograft, alloplast) and fourth implant type (GSII, Xive, Implantium, Novel biocare) were used. All implants were investigated clinically and radiographically, being with average 20 months follow-up period after installation. Results: 3 fixtures were lost, resulting in 95.1% cumulative survival rate of 61 osseointegrated dental implant. Survival rate according to bone material type, Implant type, operation method, residual bone height, have no statistically significant differencies. The mean preoperative residual alveolar bone height was 4.75 mm, average postoperative height of graft materials 10.8 mm, vertical bone resorption rate was 10% after 2 years. Resorption rate according to operation method was 7% (simultaneous) and 5% (delayed) after 1 year. Conclusion: It can be suggested that maxillary sinus grafting may have predictable result with various bone graft materials and implant type, residual bone height, operation method

• Journal of Periodontal and Implant Science
• /
• 제46권5호
• /
• pp.303-319
• /
• 2016

Purpose: The purpose of this animal study was to perform a 3-dimensional micro-computed tomography (micro-CT) analysis in order to investigate the influence of root surface distance to the alveolar bone and the periodontal ligament on periodontal wound healing after a guided tissue regeneration (GTR) procedure. Methods: Three adult Sus scrofa domesticus specimens were used. The study sample included 6 teeth, corresponding to 2 third mandibular incisors from each animal. After coronectomy, a circumferential bone defect was created in each tooth by means of calibrated piezoelectric inserts. The experimental defects had depths of 3 mm, 5 mm, 7 mm, 9 mm, and 11 mm, with a constant width of 2 mm. One tooth with no defect was used as a control. The defects were covered with a bioresorbable membrane and protected with a flap. After 6 months, the animals were euthanised and tissue blocks were harvested and preserved for micro-CT analysis. Results: New alveolar bone was consistently present in all experimental defects. Signs of root resorption were observed in all samples, with the extent of resorption directly correlated to the vertical extent of the defect; the medial third of the root was the most commonly affected area. Signs of ankylosis were recorded in the defects that were 3 mm and 7 mm in depth. Density and other indicators of bone quality decreased with increasing defect depth. Conclusions: After a GTR procedure, the periodontal ligament and the alveolar bone appeared to compete in periodontal wound healing. Moreover, the observed decrease in bone quality indicators suggests that intrabony defects beyond a critical size cannot be regenerated. This finding may be relevant for the clinical application of periodontal regeneration, since it implies that GTR has a dimensional limit.