• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.276-284
• /
• 2023

After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aesthetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal disease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.

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

• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.3
• /
• pp.277-290
• /
• 2012

Dental implants are universal restorative method on edentulous site in oral cavity and generally recognized by patients as well as clinicians. Rapid bone resorption of labial portion of maxillary anterior area is performed due to dental trauma, chronic periodontitis, and so on. Accordingly, Implants on maxillary anterior alveolar ridge with narrow labiopalatal width would lead to bony defects of dehiscence or fenestration. In this case, guided bone regeneration procedure is used to augment maxillary anterior alveolar ridge. It can have mechanical and biological advantages to mix tissue adhesive with bone graft materials in guided bone regeneration procedure. In these cases, when the dehiscence or fenestration defects was occurred by dental implants on maxillary anterior alveolar ridge with narrow labiopalatal width, guided bone regeneration procedures were performed with various combination of particle bone graft materials(allograft, xenograft, and alloplast) mixed with fibrin glue, excepting autogerous bone. We reported that all of 4 cases showed favorable alveolar ridge augmentations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.32 no.6
• /
• pp.575-579
• /
• 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.

• The Journal of Korean Academy of Prosthodontics
• /
• v.29 no.1
• /
• pp.73-89
• /
• 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
• /
• v.14 no.1
• /
• pp.1-11
• /
• 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
• /
• v.26 no.3
• /
• pp.238-244
• /
• 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
• /
• v.23 no.4
• /
• pp.324-331
• /
• 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
• /
• v.48 no.3
• /
• pp.193-200
• /
• 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.

• The Journal of the Korean dental association
• /
• v.51 no.11
• /
• pp.586-594
• /
• 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.