• Implantology
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• v.22 no.4
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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.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.121-124
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• 2014

A 7-year-old, intact female Jindo dog was presented for assessment of weight-bearing lameness of the right hindlimb. On physical examination, crepitus and pain was noted in the right coxofemoral joint upon extension. Radiographs revealed a craniodorsal luxation of the right coxofemoral joint and degenerative joint disease (DJD) of both coxofemoral joints. Total hip replacement (THR) was performed for the right coxofemoral joint. Intraoperatively, dorsal acetabular rim (DAR) deficiency was noted, which can be related to a high risk for acetabular cup implant dislocation. Deficiency of the dorsal acetabular rim realigned with the acetabular cup using universal locking plate (ULP) and polymethylmethacrylate (PMMA) bone cement. After surgery, the patient had an uneventful course and a successful outcome. The ROM and thigh girth were dramatically improved. There were no complications associated with prosthesis implants. Hip luxation with dorsal acetabular rim deficiency in a dog was successfully repaired with THR and dorsal acetabular rim augmentation using ULP and PMMA bone cement. This technique should be considered when conventional THR is precluded by dorsal acetabular rim deficiency.

• Journal of Korean Dental Science
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• v.7 no.1
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• pp.38-42
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• 2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.19-27
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• 1989

Hemifacial microsomia is characterized underdevelopment of the TMJ, mandibular ramus, and associated muscles of mastication. The Maxilla and malar bones on the affected side frequently are underdeveloped. The contiguous parotid gland may be hypoplastic. Preauricular sinus tracts and tags may exist, along with underdevelopment of the associated external ear, and affected facial nerve and muscles of facial expression may also show dysfunction. Children exhibiting the more classic signs will be identified at birth. Little is known about the etiology of hemifacial microsomia. We have corrected surgically a 22-year-old woman with hemifacial microsomia. We have performed leveling Le Fort I osteotomy with iliac bone graft on the maxilla, reverse-L osteotomy and iliac bone graft on the right mandibular ramus, vertical ramus osteotomy on the left side, onlay bone graft on the right mandibular body, and augmentation genioplasty. The postoperative course was uneventful and restoration of facial asymmetry was achieved.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.5
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• pp.431-437
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• 2005

Fibrin glue is composed of fibrinogen and thrombin and used in various regions for multiple use. Basic principle is that thrombin converts fibrinogen to fibrin in the presence of $Ca^{2+}$. The structure of fibrin is loose at the beginning, but after about 5 minutes a tight structure is formed under the influence of factor VIII which changes fibrin monomer into fibrin polymer. Fibrin glue is used for tissue adhesive, suture, local hemostasis, wound healing, closure of subdural space. Fibrin adhesive has been used in oral and maxillofacial surgery for hemostasis after tooth extraction in patients with coagulation disorders, skin graft fixation, reattachment of periodontal flaps, in combination with autogenous bone chips to fill the bony cavities following cyst removal, and for securing the hydroxyapatite granules for maxillary alveolar ridge augmentation. This study was designed for researching influence of fibrin glue during healing phase after making artificial bone defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.2
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• pp.71-77
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• 2012

Objectives: This study sought to investigate the positioning of the posterior superior alveolar artery in relation to the performance of the maxillary sinus bone graft procedure in a Korean population. Materials and Methods: We identified the position of the posterior superior alveolar artery relative to 93 maxillary sinuses in 58 patients and determined the distance from the inferior border of the artery in the premolar and molar areas to the alveolar ridge and sinus floor. Results: The mean distance from the alveolar ridge to the posterior superior alveolar artery in the dentate group ($20.62{\pm}3.05mm$ in the premolar region, $17.50{\pm}2.84mm$ in the molar region) was greater than as compared to the edentulous group ($18.83{\pm}2.79mm$ in the premolar region, $15.50{\pm}1.64mm$ in the molar region), and this difference was statistically significant (P<0.05). In contrast, there was no statistically significant difference (P>0.05) between the mean distance from the sinus floor to the posterior superior alveolar artery in the dentate group ($8.21{\pm}2.79mm$ in the premolar region, $7.52{\pm}2.07mm$ in the molar region) or in the edentulous group ($7.75{\pm}3.31mm$ in the premolar region, $7.97{\pm}2.31mm$ in the molar region). Conclusion: Prior to surgery, it is important to evaluate the position of the posterior superior maxillary artery by using computed tomography scans. The premolar area is safer than the molar area for performing the maxillary sinus bone graft without bleeding.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.123-130
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• 2011

Purpose: The purpose of this study was to determine the biological effects of cyanoacrylate-combined calcium phosphate (CCP), in particular its potential to act as a physical barrier - functioning like a membrane - in rabbit calvarial defects. Methods: In each animal, four circular calvarial defects with a diameter of 8 mm were prepared and then filled with either nothing (control group) or one of three different experimental materials. In the experimental conditions, they were filled with CCP alone (CCP group), filled with biphasic calcium phosphate (BCP) and then covered with an absorbable collagen sponge (ACS; BCP/ACS group), or filled with BCP and then covered by CCP (BCP/CCP group). Results: After 4 and 8 weeks of healing, new bone formation appeared to be lower in the CCP group than in the control group, but the difference was not statistically significant. In both the CCP and BCP/CCP groups, inflammatory cells could be seen after 4 and 8 weeks of healing. Conclusions: Within the limits of this study, CCP exhibited limited osteoconductivity in rabbit calvarial defects and was histologically associated with the presence of inflammatory cells. However, CCP demonstrated its ability to stabilize graft particles and its potential as an effective defect filler in bone augmentation, if the biocompatibility and osteoconductivity of CCP were improved.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.2
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• pp.70-76
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• 2017

The purpose of this study was to perform a literature review of short implants in the posterior maxilla and to assess the influence of different factors on implant success rate. A comprehensive search was conducted to retrieve articles published from 2004 to 2015 using short dental implants with lengths less than 10 mm in the posterior maxilla with at least one year of follow-up. Twenty-four of 253 papers were selected, reviewed, and produced the following results. (1) The initial survival rate of short implants in the posterior maxilla was not related to implant width, surface, or design; however, the cumulative success rate of rough-surface short implants was higher than that of machined-surface implants especially in performance of edentulous dental implants of length <7 mm. (2) While bone augmentation can be used for rehabilitation of the atrophic posterior maxilla, short dental implants may be an alternative approach with fewer biological complications. (3) The increased crown-to-implant (C/I) ratio and occlusal table (OT) values in short dental implants with favorable occlusal loading do not seem to cause peri-implant bone loss. Higher C/I ratio does not produce any negative influence on implant success. (4) Some approaches that decrease the stress in posterior short implants use an implant designed to increase bone-implant contact surface area, providing the patient with a mutually protected or canine guidance occlusion and splinting implants together with no cantilever load. The survival rate of short implants in the posterior edentulous maxilla is high, and applying short implants under strict clinical protocols seems to be a safe and predictable technique.

• Journal of Biomedical Engineering Research
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• v.43 no.1
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• pp.61-70
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• 2022

Natural and synthetic forms of calcium phosphate cement (CPC) have been widely used in bone repair and augmentation. The major challenge of injectable CPC is to deliver the cells without cell death in order to regenerate new bone. The study objective was to investigate for the potential of stem cell-laden gelatin fibers containing injectable, nanocrystalline CPC to function as a delivery system. Gelatin noddle fiber method was developed to delivered cells into nCPC. Experimental groups were prepared by mixing cells with nCPC, mixing cell-laden gelatin fibers with nCPC and mixing cell-laden gelatin fibers containing BMP-2 with nCPC. Media diffusion test was conducted after dissolving the gelatin fibers. SEM examined the generated channels and delivered cell morphology. Fibers mixed with nCPC showed physical setting and hardening within 20 min after injection and showed good shape maintenances. The gelatin fibers mixed nCPC group had several vacant channels generated from the dissolved gelatin. Particularly, proliferation and attachment of the cells were observed inside of the channels. While live cells were not observed in the cell mixed nCPC group, cells delivered with the gelatin fibers into the nCPC showed good viability and increased DNA content with culture. Cell-laden gelatin fiber was a novel method for cell delivery into nCPC without cell damages. Results also indicated the osteogenic differentiation of gelatin fiber delivered cells. We suggest that the cell-laden gelatin fibers mixed with nCPC can be used as an injectable cell delivery vehicle and the addition of BMP-2 to enhances osteogenesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.362-366
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• 1997

골의 퇴축 혹은 수술시의 절제로 인해 임플란트를 식립하기엔 불충분한 악골을 가진 환자에 있어서 골 이식술의 필요성은 오랫동안 논의 되어왔다. 골이식술은 악골의 전체 두께(full thickness)결손시 연결성(continuity)의 수복, 혹은 표면(surface)에서의 골상실시 보강(augmentation)목적으로 쓰일 수 있다. 따라서 술자들은 임플란트를 식립하기에 불충분한 악골을 가진 환자에 있어 골 이식술에 권유하게된다. 그러나, 골 이식술은 donor site 의 morbidity혹은 수술에 대한 두려운, 추가되는 비용에 대한 염려등으로 인해 환자에 의해 거부될 때가 종종 있다. 악골 결손으로 인해 골이식없이는 임플란트를 식립하기 어려운 경우에 있어서도 임플란트 술식이 여전히 해결책이 될 수 있을까? 다음의 두가지 증례를 통해 저자등은 골이식술 없이는 임플란트르 식립하기 어려운 경우에 있어서도 임플란트 술식이 여전히 치료방법으로서 의미가 있었음을 보고하는 바이다.