• 대한구강악안면임플란트학회지
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• 제22권4호
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• pp.220-235
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• 2018

Sinus lift procedure is frequently required for the maxillary molar implant placement. Previous studies have demonstrated alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. However, there is a lack of studies which evaluated the effect of ARP to avoid sinus lift procedure. Purpose of this study is to describe a method reducing the need of sinus lift surgery by ARP in maxillary molar areas and to assess the feasibility clinically, radiologically and histologically. Ten maxillary molars in ten patients had severe vertical bone resorption with minimal residual bone height. They were considered having the high possibility of the necessity of sinus lift procedure for dental implant after the extraction. After extraction, open healing ARP with deproteinized bovine bone mineral mixed with 10% collagen and resorbable collagen membranes was performed. After sufficient healing, dental implants were placed, and evaluated clinically and radiologically. Histological observation was conducted just before the implantation in one patient. Implants were successfully placed without sinus lift in all ten cases. All the implants were restored with no sign of complications, and patients are now in a close follow-up up to 20 months post-loading. Histological observation showed minimal inflammatory reaction and newly formed bone was substantially noted. The ARP technique has successfully avoided the sinus lift surgeries. It appears that this procedure may improve the simplicity of the clinical process for the clinicians and reduce the discomfort of patients.

• 구강회복응용과학지
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• 제27권1호
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• pp.109-115
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• 2011

점차적으로 폭경이 증가하는 나사들을 이용하여 치조능확장술을 시행하고 임프란트를 식립하였다. 임상적으로 양호한 결과를 얻었으며 수술 중 협측 피질골판 골절은 발생하지 않았다. 임프란트 주변 결손부와 협측 피질골판 상방에 자가치아골이식재를 이식함으로써 부가적인 치조능 확장 효과와 동시에 협측 피질골판 흡수를 보상하였다. 치조능 폭경이 협소한 부위에 임프란트를 식립할 때 나사를 이용한 확장술은 성공적이고 예측 가능한 술식이며 자가치아골이식재는 치조능증대술과 골유도재생술을 위해 사용될 수 있다.

• 대한심미치과학회지
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• 제22권1호
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• pp.47-55
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• 2013

치아의 상실로 인한 국소적 치조제 결손(localized alveolar defect)은 고정성 국소의치(fixed partial denture) 제작시에 많은 기능적, 심미적 문제점들을 야기한다. 특히 전치부에서의 치조제 결손 부위는 그 형태와 양상에 따라서 심미적 결과에 많은 영향을 미치게 되는데, 이 결손 부위의 회복 여부가 최종적인 심미적 결과의 성패를 좌우하게 된다. 치조제 결손의 양상은 발치 전 치조골의 상황과 염증 정도에 따라 다양하게 나타날 수 있는데, 그 양상은 크게 보면 수평적, 수직적, 혹은 복합적 결손 등으로 분류할 수 있다. 이러한 결손부의 형태와 양에 따라서 우리가 회복시켜 주어야 할 정도도 다르고, 그 난이도 또한 다르다고 할 수 있다. 여기에 추가적으로 고려되어야 할 요소가 결손부와 자연치가 만나는 proximal gingival height이다. 인접 치아와 접하는 gingival height는 그 부위의 치조골 높이에 많은 영향을 받게 되는데, 만약 이 부위에 결손이 존재한다면 역시 심미적 결과에 부정적인 영향을 줄 것이다. 하지만 결손부위 내에서도 치아와 인접한 부위의 gingival height를 동시에 증대시키기 위해 소개된 technique은 많지 않으며 시술의 예지성도 높지 않은 것이 사실이다. 이 case report에서 필자는 수평적 혹은 수직적 결손 및 복합적 결손에 다양하게 적용 가능하면서도 인접치아와 인접한 부위의 gingival height에도 도움이 될 수 있는 술식을 소개하려고 한다.

• Journal of Periodontal and Implant Science
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• 제40권5호
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• pp.227-231
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• 2010

Purpose: The healing process following tooth extraction apparently results in a pronounced resorption of the alveolar ridge. As a result, the width of alveolar ridge is reduced and severe alveolar bone resorption occurs. The purpose of this experiment is to clinically and histologically evaluate the results of using horse-derived bone mineral for socket preservation. Methods: The study comprised 4 patients who were scheduled for extraction as a consequence of severe chronic periodontitis or apical lesion. The extraction was followed by socket preservation using horse-derived bone minerals. Clinical parameters included buccal-palatal width, mid-buccal crest height, and mid-palatal crest height. A histologic examination was conducted. Results: The surgical sites healed uneventfully. The mean ridge width was $7.75{\pm}2.75\;mm$ at baseline and $7.00{\pm}2.45\;mm$ at 6 months. The ridge width exhibited no significant difference between baseline and 6 months. The mean buccal crest height at baseline was $7.5{\pm}5.20\;mm$, and at 6 months, $3.50{\pm}0.58\;mm$. The mean palatal crest height at baseline was $7.75{\pm}3.10\;mm$, and at 6 months, $5.00{\pm}0.82\;mm$. There were no significant differences between baseline and 6 months regarding buccal and palatal crest heights. The amount of newly formed bone was $9.88{\pm}2.90%$, the amount of graft particles was $42.62{\pm}6.57%$, and the amount of soft tissue was $47.50{\pm}9.28%$. Conclusions: Socket preservation using horse-derived bone mineral can effectively maintain ridge dimensions following tooth extraction and can promote new bone formation through osteoconductive activities.

• 대한치과보철학회지
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• 제37권1호
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• pp.104-126
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• 1999

The purpose of this study was to compare and evaluate the stress distribution and displacement developed in the abutment teeth and residual ridge area by madibular unilateral distal extension removable partial denture with 2 different retainer designs. The retainers on right and left canine and right 2nd molar were Alters clasp in one model and telescopic crown in the other model. The stress distribution of abutment teeth and residual ridge area on two model were compared and analyzed with 3-dimensional finite element method. 150N and 400N forces were applied vertically, 30 degree and horizontally on the central fossa area of left 1st molar of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows 1. As the magnitude and angulation of applied force were increased, the magnitude of stress on the right and central residual ridge area and the right canine of the telescopic type increased and comparing to those of the Alters clasp type. 2. As the magnitude and angulation of applied force were increased, the mesial direction of displacement on the right residual ridge area and the right tooth of the telescopic type increased and the distal direction of displacement on left residual ridge area and the left canine increased comparing to those of Akers clasp type. 3. As the vertical force was applied, the distal direction of the displacement of the right tooth were greater and that of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. 4. As the 30 degree force was applied, the mesial direction of the displacement of the right tooth were greater and the distal direction of the displacement of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. In the horizontal force the results were same in right area tooth but the distal direction of displacement was greater in left canine. 5. In both removable partial dentures, as the magnitude and degree of force were increased, the stress and displacement were increased. The compressive force was dominative than the ten sile force. 6. In both removable partial dentures, the magnitude of stress was greater on mucosal tissue area than that of the alveolar bone area on distal extension residual ridge area but the result was reversed on anterior residual ridge area. The displacement was always greater on mucosal tissue area than that of alveolar bone area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권6호
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• pp.324-331
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• 2023

Objectives: The purpose of this study was to evaluate the outcomes of implants placed in horizontally augmented alveolar ridges using porcine bone grafts and to investigate the long-term stability of the porcine bone grafts. Materials and Methods: A retrospective analysis was conducted on 49 sites that underwent horizontal ridge augmentation using porcine bone grafts and implant placement with a follow-up period longer than 5 years. Furthermore, additional analysis was conducted on 24 sites where porcine bone grafts were used exclusively for horizontal ridge augmentation and implant placement. Results: The mean follow-up period after prosthesis loading was 67.5 months, with a mean marginal bone loss of 0.23 mm at 1 year and a cumulative mean marginal bone loss of 0.40 mm over the entire follow-up period. Of the 49 implants, 2 were lost and 3 did not meet the success criteria, resulting in a survival rate of 95.9% and a success rate of 89.8%. In 24 sites, the mean marginal bone loss was 0.23 mm at 1 year and 0.41 mm at 65.8 months, with 100% survival and success rates. Conclusion: Porcine bone grafts can be successfully used in horizontal ridge augmentation for implant placement in cases of ridges with insufficient horizontal width.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.108-121
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• 2024

Purpose: The aim of this study was to compare changes in soft and hard tissue and the histologic composition following early implant placement in sites with alveolar ridge preservation or spontaneous healing (SH), as well as implant performance up to 1 year after crown insertion. Methods: Thirty-five patients with either intact buccal bone plates or dehiscence of up to 50% following single-tooth extraction of incisors, canines, or premolars were included in the study. They were randomly assigned to undergo one of three procedures: deproteinized bovine bone mineral with 10% collagen (DBBM-C) covered by a collagen matrix (DBBM-C/CM), DBBM-C alone, or SH. At 8 weeks, implant placement was carried out, and cone-beam computed tomography scans and impressions were obtained for profilometric analysis. Patients were followed up after the final crown insertion and again at 1 year post-procedure. Results: Within the first 8 weeks following tooth extraction, the median height of the buccal soft tissue contour changed by -2.11 mm for the DBBM-C/CM group, -1.62 mm for the DBBM-C group, and -1.93 mm for the SH group. The corresponding height of the buccal mineralized tissue changed by -0.27 mm for the DBBM-C/CM group, -2.73 mm for the DBBM-C group, and -1.48 mm for the SH group. The median contour changes between crown insertion and 1 year were -0.19 mm in the DBBM-C/CM group, -0.09 mm in the DBBM-C group, and -0.29 mm in the SH group. Conclusions: Major vertical and horizontal ridge contour changes occurred, irrespective of the treatment modality, up to 8 weeks following tooth extraction. The DBBM-C/CM preserved more mineralized tissue throughout this period, despite a substantial reduction in the overall contour. All 3 protocols led to stable tissues for up to 1 year.

• Journal of Periodontal and Implant Science
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• 제46권2호
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• pp.72-83
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• 2016

Purpose: The goal of this study was to evaluate the long-term success of horizontal alveolar crest augmentation of the retromolar region of the mandible with particulated bone, as well as factors affecting subsequent peri-implant bone loss. Methods: A total of 109 patients (68 female, 41 male) suffering from alveolar ridge deficiencies of the maxilla and mandible were included in this study. All patients were treated with particulated retromolar bone grafts from the mandible prior to the insertion of endosseous dental implants. Mesial and distal peri-implant crestal bone changes were assessed at six time points. Several parameters, including implant survival and the influence of age, gender, localisation of the implant, diameter, covering procedures, and time points of implant placement, were analysed to identify associations with bone level changes using the Mann-Whitney U-test, the Kruskal-Wallis test, and Spearman's rank-order correlation coefficient. Results: A total of 164 dental implants were placed in the maxilla (n=97) and in the mandible (n=67). The mean observation period was $105.26{\pm}21.58$ months after implantation. The overall survival rate was 97.6% after 10 years. Overall, peri-implant bone loss was highest during the first year, but decreased over time. The mean amount of bone loss after 10 years was 2.47 mm mesially and 2.50 mm distally. Bone loss was significantly influenced by implant type and primary stability. Conclusions: The use of particulated autologous retromolar bone grafts is a reliable technique for the horizontal reconstruction of local alveolar ridge deficiencies. Our results demonstrate that implants placed in augmented bone demonstrated similar bone level changes compared to implants inserted in non-augmented regions.

• Journal of Periodontal and Implant Science
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• 제45권6호
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• pp.216-222
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• 2015

Purpose: After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. Methods: This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. Results: The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was $1.43{\pm}0.65mm$. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. Conclusions: After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.

• Journal of Periodontal and Implant Science
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• 제44권1호
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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.