• 대한치과의사협회지
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• 제50권6호
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• pp.329-338
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• 2012

Introduction: The purpose of this study is to evaluate the clinical results of vertical alveolar ridge augmentation using autogenous block bone graft, especially resorption rate, and outcomes of dental implants placed in the grafted site. Patients and Methods: Medical records and radiographs were reviewed. Twenty-seven patients who have been received the autogenous block bone graft which harvested from chin, ramus, and ilium, and the implant installation on 31 areas(22 maxillas and 9 mandibles) were included. Eight implants were installed simultaneously at the time of bone graft in 4 patients, and 65 implants were installed after 4.9 months(range 2~18 months) of autogenous block bone graft in 23 patients. The resorption amount and rate of augmented bone, and the success and survival rates implants were evaluated. Results: Mean height of the augmented block bone was $5.9{\pm}2.3mm$(range from 2.5 to 13.0 mm). Mean follow-up period after block bone graft was 30.4 months(range from 16 to 55 months). Mean resorption of the augmented block bone was $2.0{\pm}1.5mm$ (range from 0.5 to 7.24 mm). The success and survival rates of the implants were 78.1 % and 98.6%, respectively. Conclusion: This study indicates that the autogenous block bone graft is a useful and stable method for alveolar ridge augmentation for dental implant. And more augmentation is needed to compensate the resorption of the grafted bone.

• 구강회복응용과학지
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• 제29권1호
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• pp.23-36
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• 2013

이 연구의 목적은 상악동 골증대술과 동반된 이식된 골의 3차원적인 형태를 평가하고 골이식 재료 및 임플란트의 종류, 수술 방법과 골흡수 정도 사이의 관계를 평가하는 것이다. 임플란트 식립을 위한 상악동 골증대술을 시행받은 환자들의 차트를 후향적으로 검토하였고 골이식재의 부피 및 부위의 방사선학적 분석을 시행하였다. 임플란트 식립 6개월 후 잔존 골 이식재의 비율로 측정된 부피 재생은 이식 재료의 형태 및 수술 방법과 연관성이 있었다. 원광대학교 산본 치과병원에서 15명의 환자에서 상악동 골이식술과 동반하여 53개의 임플란트가 식립되었다. 임플란트 식립 6개월 후 촬영된 컴퓨터 단층촬영에서 $Puros^{(R)}$ 와 다른 여러 가지 골이식재를 혼용한 그룹에비해 $Puros^{(R)}$ 이식재를 단독으로 사용한 그룹에서 더 높은 골흡수 정도를 보였다 (P<0.05). 그리고 수술 방법에 따른 골흡수 정도는 통계학적으로 유의성있는 차이를 보였다 (P<0.05). 골이식과 동시에 임플란트를 식립한 그룹에 비해 지연된 임플란트 식립을 시행한 그룹에서 더 높은 골이식재의 부피 변화율을 보였다. 후향적 자료 분석을 통해 $Puros^{(R)}$ 와 다른 여러 가지 골이식재를 혼용한 그룹에 비해 $Puros^{(R)}$ 이식재를 단독으로 사용한 그룹에서 더높은 골흡수 정도를 보였다. 또한 골이식과 동시에 임플란트를 식립한 그룹에서 지연 식립한 그룹보다 더 낮은 흡수율을 보여주었다.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.597-602
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• 2013

Background The forehead, which occupies about one third of the face, is one of the major determinants of a feminine or masculine look. Various methods have been used for the augmentation of the forehead using autologous fat grafts or alloplastic materials. Methylmethacrylate (MMA) is the most appropriate material for augmentation of the forehead, and we have used an injection-molding technique with MMA to achieve satisfactory results. Methods Under local anesthesia with intravenous (IV) sedation, an incision was made on the scalp and a meticulous and delicate subperiosteal dissection was then performed. MMA monomers and polymers were mixed, the dough was injected into the space created, and manual molding was performed along with direct inspection. This surgery was indicated for patients who wanted to correct an unattractive appearance by forehead augmentation. Every patient in this study visited our clinics 3 months after surgery to evaluate the results. We judged the postoperative results in terms of re-operation rates caused by the dissatisfaction of the patients and complications. Results During a 13-year period, 516 patients underwent forehead augmentation with MMA. With the injection-molding technique, the inner surface of the MMA implant is positioned close to the underlying frontal bone, which minimizes the gap between the implant and bone. The borders of the implant should be tapered sufficiently until no longer palpable or visible. Only 28 patients (5.4%) underwent a re-operation due to an undesirable postoperative appearance. Conclusions The injection-molding technique using MMA is a simple, safe, and ideal method for the augmentation of the forehead.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.325-329
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• 2009

Objective : This is to report the effectiveness of intraoral distraction osteogenesis, iliac bone graft for alveolar augmentation in the extremely atrophied alveolar defects after infected allobone grafted area. Subjects and Methods : Anterior segmental osteotomy was performed and the trans-oral alveolar distractors (Martin, Germany) were applied in patient with the severe acquired anterior mandibular and mandibular defect after ameloblastoma enucleation. Iliac bone grafts were performed in defect sites and distraction osteogenesis were treated. After latent period for 1 week, the osteomized alveolar segments were distracted by 0.75 mm a day (0.25 mm/1 turn) for 10 days The consolidation period was about 12 weeks. Thereafter, 2 titanium threaded implants were simultaneously installed with removal of distractor. For oral rehabilitiation, The implants were installed in maxilla, mandible. It was tested with clinically and radiographically. Results : Amounts of acquired alveolar bone were 10 mm with the increased width of the ridge crests and soft tissue expansion. Dental implants installated on the augmented alveolar ridges in 12 weeks after distraction were confirmed as in good osseointegration and in good function without any complications. Conclusion : Intraoral distraction osteogenesis can be a good option for alveolar ridge augmentation of the severely atrophied ridges and soft-tissue defects.

• 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.

• 대한치과보철학회지
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• 제47권2호
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• pp.240-246
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• 2009

연구목적: 이 연구는 측방접근법을 통해 상악동 골이식을 시행한 후 임플란트를 식립하였을 때, 누적 생존률 및 성별, 연령별, 이식재, 자가골의 공여부, 술전 잔존골 양, 무치악 형태, 식립 시기, 임플란트 종류, 직경과 길이에 따른 임플란트의 생존률 및 변연골의 방사선학적 결과의 차이를 분석하고자 시행되었다. 연구 재료 및 방법: 상악 구치에 측방접근법을 통해 상악동 골이식술 후 임플란트 보철치료를 시행한 71명을 대상으로 하였으며 표면 처리된 나사모양의 임플란트를 사용하였다. Osseotite(BIOMET 3i, Warsaw, USA), Neoplant(Neobiotec, Seoul, Korea), $Br\ddot{a}nemark$(Nobel Biocare, Goteberg, Sweden)과 SSII(Osstem, Busan, Korea)를 사용하였다. 최소 6개월 이상의 기간 관찰 누적 생존률은 Kaplan-Meier 분석법을 이용하였으며 다른 요소에 따른 임플란트의 생존률의 유의성은 Chi-square test로 검정하였다. 결과: 상악동골 이식술이 시행된 모든 증례에서 임플란트 식립이 가능한 골 양이 얻어졌으며 92%의 생존률을 보였다. 결론: 상악동 골이식술을 시행한 후 임플란트 보철 수복은 자가골 단독 사용시에 자가골과 골대체 물질이 혼합된 것보다 우수한 생존률을 보였다. 지연 식립하는 경우가 임플란트와 동시에 식립하는 경우보다 생존률이 높았다.

• 구강회복응용과학지
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• 제33권4호
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• pp.291-298
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• 2017

치조골 폭이 협소한 상악 전치부의 심미적인 임플란트 수복은 임플란트 식립체의 경사각과 위치가 제한되기 때문에 단순한 임플란트 식립만으로는 심미적인 임플란트 보철물을 제작하기 어려운 일이다. 임플란트 보철물이 변연 치은과 조화로운 출현윤곽을 재현하기 위해서는 임플란트 식립체의 이상적인 치조골 내 위치와 식립각이 설정될 수 있어야 하며, 이를 위해서는 종종 임플란트 식립 전 골증대술을 선행하여야 한다. 본 증례는 구개측의 심한 골 결손을 동반한 얇은 치조골 폭을 보이는 상악 전치 상실부에 골증대술을 시행한 후, 임플란트를 식립하여 심미 보철을 시행한 증례이다. 먼저 협측에 과량의 골증대술을 선행하여 불리한 임플란트 식립 위치를 보상할 수 있는 구개측 식립 경사를 확보하였으며, 임시보철물의 외형을 조정하여 인접 치아와 조화로운 변연 치은 높이와 치간 유두를 형성하였다. 최종적으로 지르코니아 코어를 가지는 도재수복물을 이용하여 보철 수복하였고 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.269-278
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• 2021

Objectives: The purpose of this animal research was to compare bone regeneration in augmented rabbit maxillary sinuses treated with demineralized particulate human-tooth graft and anorganic bovine bone by immunohistochemical analysis. Materials and Methods: Piezoelectric bilateral sinus augmentation was performed in eight adult rabbits. In the control group, anorganic bovine was grafted in the maxillary sinus following elevation of the sinus membrane. In the experimental group, demineralized human particulate tooth bone was grafted in the sinus. Bone regeneration in augmented sinuses was evaluated by immunohistochemical analysis using various markers of osteoprogenitor cells. Results: The number of bromodeoxyuridine-labeled cells was significantly higher in the experimental group than in the control group at eight weeks. The immunoreactivity of proliferating-cell nuclear antigen was increased slightly in the experimental group relative to the control group at eight weeks. Other bone markers were expressed equally in the two groups. Conclusion: In the rabbit maxillary sinus, higher osteoinduction was correlated with demineralized human particulate tooth bone grafting than with anorganic bovine grafting.

• 대한치과의사협회지
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• 제57권3호
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• pp.149-160
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• 2019

Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.

• Journal of Periodontal and Implant Science
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• 제29권4호
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• pp.943-953
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• 1999

Severe alveolar ridge deficiency can prevent ideal implant placement. Ridge augmentation procedures are necessary to regain lost alveolar structures. The corticocancellous block bone graft was harvested from the mandibular symphysis. This block bone was fixed to the lateral aspect of the ridge with titanium screws. Seven months later, the autogenous bone graft was reentered and sufficient bone volume was gained to allow implant placement. The fixation screws were removed and 3I implants were inserted. No complication and postoperative alteration in chin contour were observed. This report demonstrates that chin graft offers a predictable alternative in the reconstruction of ridge deficiency for implant placement.