• 구강회복응용과학지
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• 제39권4호
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• pp.276-284
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• 2023

발치 후 시간이 지남에 따라 치조골이 흡수되는 것은 자연스러운 현상이다. 치조골 소실과 상부 연조직의 감소는 추후 임플란트 식립 및 임플란트의 장기 생존 가능성에 어려움을 준다. 이번 증례보고는 치주질환에 이환된 발치와에 치조제 증강술과 연조직 대체제 중 이종 콜라겐 기질을 함께 이용하여 임플란트 식립 부위의 연조직과 경조직을 증가시키는 데 중점을 둔다. 각각의 증례에서 치조골의 너비가 6 mm, 8 mm, 4 mm로 증가하였고, 임플란트 주변으로 치간 유두의 재생과 각각 4 mm, 6 mm, 4 mm의 협측 각화치은을 보여준다. 증대된 치조골은 임플란트 수술을 용이하게 하며 치간 유두와 각화치은은 심미적인 보철이 가능하게 한다. 이 연구는 치주질환이 이환된 발치와를 가진 환자에게 치조제 증강술을 시행하고 연조직 대체제를 추가로 사용함으로써 임플란트 식립을 위한 보다 나은 환경을 제공하고 심미적이고 예지성 있는 임플란트 수술을 위한 긍정적인 효과를 보여준다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권5호
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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.

• 구강회복응용과학지
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• 제28권3호
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• pp.277-290
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• 2012

최근 치과 임플란트는 구강 내 무치악 부위의 보편적인 수복 방법으로 임상가 뿐만 아니라 환자들에게도 널리 인식되어 있다. 외상, 만성 치주염 등 다양한 원인에 의해 상악 전치부는 발치 후 급속한 순측 골흡수가 진행될 수 있다. 그로 인해 협소한 순구개 폭경을 가진 상악 전치부 치조제 상에 임프란트 식립 시 열개 및 천공형 골결손이 발생할 수 있다. 이 경우 골유도 재생술을 사용하여 상악 전치부 치조제를 증강시킬 수 있다. 골유도 재생술시 골이식재에 조직 접착제를 혼합하여 기계적 및 생물학적 이점을 얻을 수 있다. 본 증례에서는 순설 폭경이 얇은 상악 전치부 치조제 상에 임플란트 식립에 의한 열개 및 천공형 골결손 발생시 자가골을 제외한 동종골, 이종골, 그리고 합성골 입자형 골이식재 등을 다양하게 조합한 후 조직 접착제와 혼합하여 골유도 재생술을 진행하였다. 모든 증례에서 양호한 치조제 증강을 보였음에 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권6호
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• pp.575-579
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• 2006

Purpose : The purpose of this study was to evaluate peri-implant bone loss and implant success on anterior maxillary alveolar ridges and Compare Class III and Class IV ridges in the aspect of peri-implant bone loss. Material and Methods : 14 patients (aged 21 to 68, 6males and 8females), who lacked maxillary anterior teeth and were installed from January 2000 to April 2003 at Samsung Medical Center, were selected. The type of implant used included 30 $Br\ddot{a}nemark$ implant. They were taken with digital tomographic and conventional intraoral radiographic examinmation, and were treated with implant installaion without bone augmentation. The peri-implant bone resorption was measured at the mesial and distal aspect of implant on the conventional intraoral radiographs. Results : The study classified the anterior maxillary alveolar ridge and measured peri-implant bone resorption from the period of implant installation to the 2nd year after functional loading radiographically. The study revealed no statistically significant difference between two groups, which was classified by its morphology. The average bone resorption on healing period before loading was 0.18mm and 0.18mm, the 1st year of loading period, 0.77 mm and 0.84mm, and on the 2nd year of loading period, 0.07mm and 0.06mm, respectively on both Class III and class IV. Conclusion : In the knife edge form of anterior maxillary residual ridges(Class IV), implant placement without ridge augmentation does not have significant difference with that of Class III alveolar ridge in the concern of Implant success after 2 year functional loading period in the aspect of peri-implant bone resorption radiographically.

• 대한치과보철학회지
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• 제29권1호
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• pp.73-89
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• 1991

Impression ragistration is an improtant and difficult phase of prosthodontic treatment procedures and a tray of appropriate size and shape is essential to obtain the accurate impression. Particularly, in edentulous patients, the size and forms of their residual alveolar ridges are different from one another. Therefore, in this study, various measurements were taken on the edentulous models. And the measurements were analyzed and compared with one another. The results were as follows ; 1. The mean of denture bearing area was $32.86cm^2$ in the upper jaws, $24.20cm^2$ in the lower jaws and the variation of denture bearing area was greater in the upper than in the lower jaws and in males than in females. 2. The mean of A-P(anteroposterior) ridge length was 48.72mm in the upper jaws, 53.05mm in the lower jaws and that of males was longer than that of females. 3. The mean of most posterior ridge width was 47.23mm in the upper jaws, 58.03mm in the lower jaws and the difference of that between males and females was least in both jaws. 4. In the upper jaws, the mean of ridge width was 29.66mm on anterior 1/4, 42.79mm on middle, 48.95mm on posterior 1/4 line and the mean of palatal height was 4.56mm on anterior 1/4, 10.01mm on middle, 10.84mm on posterior 1/4 line. 5. In the lower jaws, the mean of ridge width was 33.24mm on anterior 1/4, 50.19mm on middle, 59.16mm on posterior 1/4 line and the mean of lingual ridge height was 5.49mm on anterior 1/4, 9.16mm on middle, 16.72mm on posterior 1/4 line. 6. The correlation coefficient(=r) between denture bearing area and A-P ridge length was 0.83 in the upper jaws and 0.75 in the lower jaws. The corelation between denture bearing area and AP ridge length was statistically significant, but, between denture bearing area and A-P ridge length and between A-P ridge length and the most posterior ridge width was not statistically significant in both jaws. 7. Alveolar ridge forms were classified into three(ovoid, "u" shape, and "v"shape) categories. In the upper jaws, ovoid was 66%, "u" shape was 24%, and "v" shape was 10%, in the lower jaws, ovoid was 66.7%, "u" shape was 20%, and "v" shape was 13.3%.

• Journal of Korean Dental Science
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• 제14권1호
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• pp.1-11
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• 2021

Purpose: The alveolar ridge preservation (ARP) is widely conducted for implant placement. However, experimental results using deproteinized porcine bone mineral (DPBM) have been scarce. This retrospective study evaluated factors affecting the primary stability of implants in an area where ARP was performed using DPBM. Materials and Methods: Thirty-eight patients were divided into two groups based on the primary stability, with torque value of 30 Ncm as borderline. To determine the factors that affect the primary stability of implants, we collected data from patients' medical records including age, sex, reentry time, socket location, remaining bone wall at the time of extraction, and type of collagen membrane, as well as from radiographs and histomorphometric analysis. Result: The results showed statistically significant difference for the remaining extraction socket wall (P=0.014), residual graft (P=0.029), and fibrovascular tissue (P=0.02) between the two groups. There was an insignificant tendency toward the time of reentry surgery (P=0.052) and location (P=0.077). All implants placed in sites using DPBM functioned well up to 3 years. Conclusion: Within the limitations of the present study, extraction socket wall, residual graft, and fibrovascular tissue can affect the primary stability at the time of implant placement on grafted sites using DPBM and collagen membranes. In addition, reentry time and locations can be considered. In future studies, comparative experiments in quantified models will be required to supporting the findings.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권3호
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• pp.238-244
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• 2000

The present study was aimed to investigate the effect of osseointegration according to implant placement timing in the distracted alveolar bone using intraoral distraction device. Six adult mongrel dogs of either sex, weighing about 15kg, were used. The animals were divided into 4-week and 8-week groups according to the timing of implant installation. The left upper and lower premolars and first molars were extracted and an alveoloplasty was performed to simulate an atrophic ridge. After 12 weeks of healing, a segmental osteotomy was made and an intraoral distraction device which was designed for augmentation of vertical height of the edentulous ridge was applied. Latency period was allowed for 5 days and then distraction was made at a rate of 1.2mm/day for 8 days. Four or eight weeks after distraction, implants were installed. Twelve weeks after implant installation, the animals were sacrificed. Macroscopic, radiographic, and histologic examinations of distracted alveolar ridge were performed. No significant abnormalities such as infection and dehiscence of overlying soft tissue were observed. Radiographically, there was slight bone resorption around the medial and distal edges of the alveolar bone segment, and a new bone deposition was observed in the neighboring alveolar crest area in the both groups. The satisfactory osseointegration was achieved in the distracted gap of the both groups, but fibrous tissue appeared on the buccal side of implant in the distracted gap in 4-week group. These results suggest that proper timing of implant installation is 8 weeks rather than 4 weeks after distraction when dental implant is to be placed onto the distracted bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권4호
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• pp.324-331
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• 2001

The present study was aimed to investigate the effects of latency period on alveolar ridge distraction using the intraoral distraction device. Nine adult mongrel dogs of either sex, weighing about 15kg, were used. They were divided into 3-day, 5-day, and 7-day groups according to the latency period. The left upper and lower premolars and first molars were extracted. Twelve weeks after the extraction, an osteotomy was performed and the distraction device was applied. After the latency period, the distraction was applied at a rate of 1.2mm for 8 days. The distraction device was left in place for 2 weeks to allow consolidation and was then removed. The animals were sacrified at 8 weeks after completion of distraction and were examined macroscopically, radiographically, and histologically. After completion of the distraction, the alveolar crest protruded prominently, showing the vertical augmentation of the alveolar bone. Soft tissues were broken down after the 6th day of distraction in 3-day latency group, and premature union occurred on the 7th day of distraction in the 7-day latency group. The average distance was $9.40{\pm}0.3mm$ in 3-day latency group, $9.35{\pm}0.1mm$ in 5-day latency group, and $8.85{\pm}0.1mm$ in 7-day latency group. In the radiograph taken at 8 weeks after distraction, there was slight bone resorption around the medial and distal edges of the alveolar bone segment, and a new bone deposition was observed in the neighboring alveolar crest area in all groups. Fibrous tissues were present in a part of the buccal cortical bone area of the distraction gap, and the woven and lamellar bones were observed in the distracted gap. There were bony bridges in the distraction gap in all animals examined. These results suggest that optimal time of latency period on alveolar ridge distraction using the intraoral distraction device is about 5 days in dogs, and about 7days in human beings.

• Journal of Periodontal and Implant Science
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• 제48권3호
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• pp.193-200
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• 2018

Purpose: The present study describes 3 patients with chronic periodontitis and consequent vertical resorption of the alveolar ridge who were treated using implant-based restoration with guided bone regeneration (GBR). Methods: After extraction of a periodontally compromised tooth, vertical bone augmentation using a K-incision was performed at the healed, low-level alveolar ridge. Results: The partial-split K-incision enabled soft tissue elongation without any change in buccal vestibular depth, and provided sufficient keratinized gingival tissue during GBR. Conclusions: Within the limits of this study, the present case series demonstrated that the novel K-incision technique was effective for GBR and allowed normal implant-based restoration and maintenance of a healthy periodontal condition. However, further long-term follow-up and a large-scale randomized clinical investigation should be performed to evaluate the feasibility of this technique.

• 대한치과의사협회지
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• 제51권11호
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• pp.586-594
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• 2013

The critical factors affecting the esthetics of anterior implants can be summarized as following: 1) Correct positioning of implant fixture 2) Enough amount of alveolar bone 3) Optimum volume of soft tissue. The position of implant is probably the most important factor in obtaining esthetic treatment outcome. The 3-dimensional orientation of implant is determined by the position on the alveolar ridge and its direction. Clinicians often try to mimic natural teeth when fabricating restorations. During the course of esthetic diagnosis and treatment, however, one should not forget to consider the correlation between facial pattern, lips, gingiva, alveolar ridge, as well as remaining dentition. Since anterior region is biologically unfavorable when compared with posterior region, one minor discrepancy in positioning of implant can cause esthetically undesirable treatment outcome. If one understands the biological and prosthetic meaning of implant's 3-dimensional position, he or she can achieve superior esthetic outcome in anterior region.