• 구강회복응용과학지
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• 제22권2호
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• pp.161-171
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• 2006

Endosseous implants have restored normal function and dental health to many patients. When implants were introduced as an effective treatment modality, their efficacy was limited by the amount of available bone. Today, various grafting procedures can surgically create bone width and volume. Implants can be placed in more ideal locations for successful prosthetic reconstruction. The use of autogenous bone grafts represents the "gold standard" for bone augmentation procedures. Either intraoral or extraoral sites may be considered for donor sites. Alveolar ridge augmentation using autogenous bone block, can be done during implant placement or staged with implant placement, after bone graft healing. In the staged technique, a better implant positioning and the use of wide diameter implants are possible. Alveolar ridge augmentation using autogenous block graft is a predictable way of treatment, for the atrophic alveolar ridge before implant placement. The cases presented in this article clinically demonstrate the efficacy of using a autogenous block graft in generating effective new bone fill for dental implant placement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.483-489
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• 2011

Introduction: This study examined the cumulative resorption of implants placed in a severely atrophic mandible and analyzed the radiologic bone resorption in the marginal bone, after an autogenous bone graft including both block and particulates that had been harvested from the ramus and iliac crest. Materials and Methods: A retrospective study was performed on patients who had bone grafts for augmentation followed by implant installation in the mandible area from 2003 to 2008. Twelve patients (6 men and 6 women) who received 34 implants in the augmented sites were evaluated. Cumulative radiologic resorption around the implants was measured immediately, 3 months, 6 months and 12 months after implant installation surgery. Results: The installed implant in grafted bone showed 0.84 mm marginal bone resorption after 3 months and 50% total cumulative resorption after 1 year. The mean marginal bone resorption around the implant installed in the grafted bone was 0.44 mm after 3 months, 0.52 mm after 1 year, after which it stabilized. The implant survival rate was 97% (failed implant was 1/34). Marginal bone resorption of the installed implant in the autogenous onlay block bone grafts was 0.98 mm after 3 months, which was significantly higher than that of a particulated bone graft (0.74 mm) (P <0.05). Conclusion: An autogenous graft including block type and particulate type is a predictable procedure for the use of dental implants in a severely atrophic mandible. Implant placement in augmented areas show a relatively high survival and minimal bone loss, as revealed by a radiologic evaluation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.340-345
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• 2009

Purpose: The purpose of this study was to evaluate the surgical success of bone reconstruction of the severely atrophic maxilla using autogenous block bone onlay graft from the ramus and ilium prior to dental implantation. And we measured the amount of vertical height change Material and Methods: 26 partially edentulous patients(32 case) who needed block onlay bone graft before implant placement in posterior maxillary area from 2002 to 2009 were selected for this study. Patients consisted of 20 males & 6 females and the average of their age was 54.2. Patients who were treated with ramal bone were 19 case and patients who were treated with iliac bone were 11 case. Digital panoramic X-ray was taken at the day of surgery, 3 months and 6 months later after the surgery. Vertical height change & resorption rate of grafted bone were measured with the same X-rays and compared Results: Two out of 32 bone grafts had to be removed because of inflamation at the grafts area(97.3%). The mean of radiographic vertical height change(change rate) of post-op. 3 month was 0.54mm(8.5%)and 6 month was 0.99mm(15.9%). Compairing to intraoral donor site(ramus), iliac bone had more vertical height change(1.18mm) at 6 month after surgery. Conclusions: Within the limit of this study, autogenous block onlay grafts can be considered a promising treatment for severely atrophic maxilla.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권1호
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• pp.55-59
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• 2013

In the oral and maxillofacial area, bone defects are created by various reasons and demand for bone grafts, while dental implant implantation has been increased consistently. To solve these problems, there has been development of autogenous tooth-bone graft material (AutoBT$^{(R)}$, Korea Tooth Bank Co., Korea), and we have collected ground reasons to substitute free autobone graft with this material in clinical use. This autogenous tooth-bone graft material is produced in powder type and block type. Block type is useful in esthetic reconstruction of the defect site and vertical and horizontal augmentation of alveolar bone because this type has high strength value, well maintained shape and is less absorbed. Therefore, the author of this study gained favorable result by grafting the block type autogenous tooth-bone graft material after dental implant implantation on the bone defects of the mandibular molar extraction site. Moreover, the author represents this case with literature review after confirming bone remodeling on the computed tomography image and by histological analysis.

• Journal of Korean Dental Science
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• 제3권1호
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• pp.25-31
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• 2010

This study sought to evaluate the effect of the type of grafts used in sinus lifting. A review of literature through MEDLINE search covering the period 1980 ~ 2006 was performed. After screening, this study was narrowed down to 2,452 patients receiving sinus lift grafts wherein 7,151 implants were placed. In this study, the types of grafts used in sinus augmentation were autogenous bone, allogenic bone, corticocancellous block bone, and various alloplastic materials. The success rate varied from 69% to 100% depending on the graft material type. The highest success rate was reported for the autogenous bone, with high success rates recorded for the most part in most studies.

• Journal of Korean Dental Science
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• 제17권2호
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• pp.64-74
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• 2024

This case report presents the long-term radiographic outcomes of a novel approach for simultaneous lateral augmentation and implant surgery. A 60-year-old male patient who required tooth extraction of the maxillary central and lateral incisors due to trauma visited the clinic. After tooth extraction, severe horizontal and vertical deficiencies occurred owing to atrophy of the alveolar ridge, and a simultaneous guided bone regeneration (GBR) procedure was planned along with the installation of two implants. In the present case, a modification of the conventional 'sandwich technique' was used by placing the mixture of autogenous bone chips and xenografts at the outermost layer to maximize the osteogenic potential at the coronal part of augmentation while applying solely xenografts at the inner layer. To enhance volumetric stability, an autogenous block of periosteum harvested from the maxillary tuberosity was incorporated between the two layers. Cone-beam computed tomography was performed at baseline and 3 years after the surgery to compare radiographic outcomes. Dehiscence after fixture installation was successfully observed at the re-entry of the surgery site. Three years after the surgery, average horizontal bone gains of 6.11 mm and 4.12 mm were observed in the maxillary central and lateral incisor areas, respectively. Healthy peri-implant mucosa and well maintained marginal bone levels were observed 8 years after the surgery, meeting the criteria for implant success. The findings of this case suggest that a substantial amount of horizontal bone gain can be obtained with a layered approach using autogenous bone materials and xenografts, highlighting the advantages of incorporating autogenous blocks into the simultaneous GBR procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.533-539
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• 2000

Recent development of dental implantology has taken an interest in the bone graft procedure. This is a review of literature, published from 1994 to November 1999. This study is provided by MEDLINE search. In this study, 718 patients received 829 graft with placing 2,677 endosseous implants. In mandible, nonvascularized or vascularized block bone grafts provided better results(success rate 95.2%) than particulate grafts(83.6%). But in maxilla, particulate grafts provided better results(93.7%, 86.2%) and more cases especially in sinus elevation. There were many cases using autogenous bone graft and revealed good results, but allogenic or alloplastic bone graft materials also were used by many surgeons.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.467-473
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• 2009

Purpose: The aim of this study is to compare volume and revascularization of autogenous block bone grafts in simultaneously cortical perforation of recipient beds and grafts, and only cortical perforation of recipient beds. Materials and methods: Two block bone in 8mm diameter was harvested in both skull using trephine bur on 20 New Zealand white rabbits. Harvested block bone was grafted on both inferior border of mandible. On the left side(experimental side), cortical bone of recipient beds and graft were perforated, and on the right side(control side), the only recipient bed was perforated. The rabbits had been sacrificed and infused the India ink for the observation of revascularization at 20 day and 40 day after surgery. The specimens were processed for H-E staining and quantitative analysis(independent t-test, p<0.01) was made under an optical microscope. In additional, specimens were processed for the observation of revascularization. Results: After 20 days, more bone volume was observed in experimental group, but no significant difference between two groups(p=0.106). There were significantly more bone volume in the experimental group at 40 days after surgery(p<0.01). After 20 days, more discrete vascular sprouts were observed in experimental side, but no difference at 40 days after surgery. Conclusion: We conclude that the cortical perforation of both the recipient beds and grafts improve revascularization at early stage and overall graft persistence.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.466-472
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• 2012

The loss of mandibular continuity due to trauma, neoplasm, or infection results in major esthetic and biologic compromise. The reconstruction of the mandibular bone defect still poses a challenge to oral and maxillofacial surgeons. There have been a number of variety graft materials. Among them, free block bone graft with rigid fixation has been widely used. However, cases using free block bone grafts may lead to a marked invasion of the donor site, mal-union, and absorption of the block bone. In this respect, particulate cortical bone using a titanium mesh tray can be an effective alternative option in order to achieve a proper bone contour and good oral rehabilitation. We have developed an intraoral approach for the mandibular reconstruction method using a titanium mesh tray with autogenous particulate cortical bone graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권6호
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• pp.570-578
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• 2006

A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.