• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.241-248
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• 2008

Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

• Journal of Periodontal and Implant Science
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• v.46 no.2
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• pp.116-127
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• 2016

Purpose: The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. Methods: We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. Results: SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (P<0.01) while SPF demonstrated significant negative correlations with other microstructural parameters (Tb.Sp, Tb.Pf, and SMI) using micro-CT and CBCT (P<0.01). Conclusions: There was an increase in implant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses.

• Imaging Science in Dentistry
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• v.41 no.1
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• pp.23-28
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• 2011

Purpose : This study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region. Materials and Methods : All eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibrous dysplasia was confirmed by histopathological report. Results : All cases showed the ill-defined margins of lesions except in the region where the lesions were extending to cortex of the involved bone. Internal structure of all cases showed ground glass appearance. Four cases of maxillary lesion showed the displacement of maxillary sinus maintaining the shape of maxillary sinus. Two cases showed complete obliteration of maxillary sinus. Displacement of inferior alveolar canal did not follow any typical pattern in any of the cases but was displaced in different directions. Conclusion : The craniofacial type of fibrous dysplasia is as common as fibrous dysplasia of jaw. The margins, extent, internal structure and effect on surrounding structure are well detected on computed tomographic images.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.22 no.2
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• pp.283-290
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• 1992

The purpose of this study was to evaluate the spatial relationship of facial bone more accurately. For this study, the three-dimensional images of dry skull were reconstructed using computer image analysis system and three-dimensional reconstructive program involved CT. The obtained results were as follows: 1. Three-dimensional reconstructive CT results in images that have better resolution and more contrast 2. It showed good marginal images of anatomical structure on both three-dimensional CT and computer image analysis system, but the roof of orbit, the lacrimal bone and the squamous portion of temporal bone were hardly detectable. 3. The partial loss of image data were observed during the regeneration of saved image data on three-dimensional CT. 4. It saved the more time for reconstruction of three-dimensional images using computer image analysis system. But, the capacity of hardware was limited for inputting of image data and three-dimensional reconstructive process. 5. We could observe the spatial relationship between the region of interest and the surrounding structures by three-dimensional reconstructive images without invasive method.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.1
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• pp.104-119
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• 1998

The purpose of this study was pertinent design of the framework of the fixed bone anchored bridge using implants in the edentulous mandible through analysis of stress distribution by the three dimensional finite element analysis method. The results were as follows: 1. The L-shaped framework was favorable in restoring the edentulous mandible by implants and fixed bone anchored bridge. 2. The structure of the framework should be designed to endure the occlusal load because of stress concentration at the most distal abutment of the framework. 3. The stress at the distal implant where cantilever starts was twice as much as that of other portions. 4. Compressive stress was generated on the framework of the mesial side of the distal implant and extrusive force was induced to the mesially positioned implants. 5. The height of vertical plate was high as possible as can be to distribute stresses concentrating bucco-lingually and labio-lingually in the framework between abutments, 6. Reinforcement of the horizontal plate thickness was needed because stress was loaded more on the horizontal plate than on the vertical plate of the framework. 7. Lengthening of the vertical plate can compensate for any limitations in horizontal plate width.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.31.1-31.5
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• 2015

Background: Pathologic fractures are caused by diseases that lead to weakness of the bone structure. This process sometimes occurs owing to bony change after radiation therapy. Treatment of pathologic fractures may be difficult because of previous radiation therapy. Methods: In this study, we analyzed clinical and radiographic data and progress of five patients with mandibular pathological fractures who had received postoperative radiation therapy following cancer surgery. Result: Patients received an average radiation dose of 59.2 (SD, 7.2) Gy. Four of five patients exhibited bone union regardless of whether open reduction and internal fixation (OR/IF) was performed. Patients have the potential to heal after postoperative radiation therapy. Treatment of a pathologic fracture following postoperative radiation therapy, such as traditional treatment for other types of fractures, may be performed using OR/IF or CR. OR/IF may be selected in cases of significant bone deviation, small remaining bone volume, or occlusive change. Conclusion: Patients have the potential to heal after postoperative radiation therapy.

• Proceedings of the Materials Research Society of Korea Conference
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• 2010.05a
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• pp.42.2-42.2
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• 2010

Recently, highly porous bone substitutes, which have interconnected open pore structure, have been focused on improving their mechanical properties and modifying their functions. Especially, it is highly required to develop functional gradient structured bone substitute which is available for controlling their material properties such as bioresorption rate and elastic modulus. Porous $ZrO_2$ scaffold was fabricated by the sponge replica method using PU sponge. After 3 times of dip coating and the subsequent oven drying, burning out and microwave sintering were carried out. Various $ZrO_2$-BCP powder mixtures were prepared depending on the ratio and coated on the $ZrO_2$ scaffold by dip coating process. X-ray diffraction analysis was performed to characterize the phase identification of the scaffolds. Microstructures of the bone substitutes were observed using scanning electron microscopy.

• International Journal of Oral Biology
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• v.46 no.3
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• pp.127-133
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• 2021

We previously showed that γ-glutamyltranspeptidase (GGT), an enzyme involved in glutathione metabolism, in Bacillus subtilis acts as a virulence factor for osteoclastogenesis via the RANKL-dependent pathway. Hence, it can be hypothesized that GGT of periodontopathic bacteria acts as a virulence factor in bone destruction. Because Fusobacterium nucleatum, which is a periodontopathic pathogen, has GGT with a primary structure similar to that of B. subtilis GGT (37.7% identify), the bone-resorbing activity of F. nucleatum GGT was examined here. Recombinant GGT (rGGT) of F. nucleatum was expressed in Escherichia coli and purified using the His tag of rGGT. F. nucleatum rGGT (Fn rGGT) was expressed as a precursor of GGT, and then processed to a heavy subunit and a light subunit, which is characteristic of general GGTs, including the human and B. subtilis enzymes. Osteoclastogenesis was achieved in a co-culture system of mouse calvaria-derived osteoblasts and bone marrow cells. Fn rGGT induced osteoclastogenesis to a level similar to that of B. subtilis rGGT; furthermore, osteoclastogenesis was induced in a dose-dependent manner. These results suggest that F. nucleatum GGT possesses a virulent bone-resorbing activity, which could play an important role in the pathogenesis of periodontitis.

• Journal of the Korean Society of Manufacturing Process Engineers
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• v.19 no.12
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• pp.105-112
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• 2020

The increase in the edentulous jaw which occurs in the aged population has led to personal dental health concerns. In the case of dental implant surgery, the duration of a patient's recovery depends on the surgical plan and their physicical ability. A device may be required to assist a physician in controlling vibration reduction of free-hand drilling and prescribing a good treatment plan that is suitable for the patient's condition. In this work, an artificial tooth-root implant assistant manipulator was studied. The structure and the vibration analysis of the dynamic restraint manipulator that is for drilling the alveolar bone in the mandible bone were performed, and the structural stability was analyzed. Further, a virtual prototype of an artificial tooth-root implant assisted manipulator was fabricated and tested. Hence, the state of the Remote Center of Motion (RCM) point and the driving state of the manipulator were confirmed. Furthermore, the drilling experiments were performed by using materials similar to a human jawbone in order to evaluate the performance of the drilling process that is operated using the assistant manipulator.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.6
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• pp.354-359
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• 2023

The temporomandibular joint is a unique structure composed of the joint capsule, articular disc, mandibular condyles, glenoid fossa of the temporal bone, surrounding ligaments, and associated muscles. The condyle is one of the major components of a functional temporomandibular joint. Reconstruction of large mandibular defects involving the condyle is a surgical challenge for oral and maxillofacial surgeons. To restore large mandibular defects, there are different options for free flap method such as fibula, scapula, and iliac crest. Currently, the vascularized fibula free flap is the gold standard for reconstruction of complex mandibular defects involving the condyle. In the present report, neocondyle regeneration after mandible reconstruction including the condyle head with fibula free flap was evaluated. In this report, two patients were evaluated periodically, and remodeling of the distal end of the free fibula was observed in both cases after condylectomy or mandibulectomy. With preservation of the articular disc, trapezoidal shaping of the neocondyle, and elastic guidance of occlusion, neocondyle bone regeneration occured without ankylosis. Preservation of the articular disc and maintenance of proper occlusion are critical factors in regeneration of the neocondyle after mandible reconstruction.