• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.109-115
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• 2015

Odontoma is the most common odontogenic benign tumor, and the treatment of choice is generally surgical removal. After excision, bone grafts may be necessary depending on the need for further treatment, or the size and location of the odontoma. Although the osteogenic capacity of a demineralized tooth was verified as early as 1967 by Urist and many other investigators, the cumbersome procedure, including a long demineralization time, may be less than comfortable for clinicians. A modified ultrasonic technology, with periodic negative pressure and temperature control, facilitated rapid and aseptic preparation of demineralized teeth for bone grafts. This approach reduces the demineralization time dramatically (${\leq}80$ minutes), so that the graft material can be prepared chairside on the same day as the extraction. The purpose of this article is to describe two cases of large compound odonotomas used as graft material prepared chairside for enucleation-induced bony defects. These two clinical cases showed favorable wound healing without complications, and good bony support for future dental implants or orthodontic treatment. Finally, this report will suggest the possibility of recycling the benign pathologic hard tissue as an alternative treatment option for conventional bone grafts in clinics.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.43-53
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• 2007

The purpose of this experimental study was to examine the effect of the decontamination of carbon dioxide ($CO_2$) laser in treatment of ligature-induced peri-implantitis in dogs. A total 24 implants with a sandblasted with large-grit and acid-etched (SLA) surface were inserted in six mongrel dogs. After a 3-month healing period, experimental peri-implantitis characterized by a bone loss of about 3mm was established by inducing with wires. And then wires were removed and plaque control was implemented. Surgical treatment involving flap procedure + debridement of implants surface with chlorhexidine and saline (group 1), flap procedure + GBR with absorbable collagen membrane (Bio-Gide) and mineralized bone graft (Bio-Oss) (group 2), and flap procedure + $CO_2$ laser application + GBR (group 3) was performed. The animals were killed 8 weeks and 16 weeks after treatment, respectively. A histomorphometric analysis confirmed statistically considerable new bone formation within the limit of the 5 most coronal threads in group 3 compared with group 1 at 16 weeks (P<0.05). And intragroup analysis showed considerable increase of new bone formation in group 3 at 16 weeks compared with 8 weeks (P<0.05). The present study demonstrates considerable new bone formation after treatment of experimental peri-implantitis with flap procedure, $CO_2$ laser application and GBR.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.5
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• pp.444-450
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• 2007

In general, labiolingual or buccolingual widths of residual alveolar bone are insufficient in edentulous area, because of alveolar resorption. Horizontal augmentation is bone graft procedure with a view to reinforcing horizontally insufficient bone quantity for installation of implants. The standard method is taking appropriate amount of block bone from intraoral or extraoral autogenous bone, and solid fixation with screws or mini-plate on labial or buccal side of residual alveolar bone. The purpose of this study is to discuss clinical usefulness of horizontal augmentation with autogenous block bone by observation and analysis of course of 41 implants installed to 12 patients by horizontal augmentation in Seoul National University Bundang Hospital from July, 2002 to December, 2005. The mean age of patients is 52.7, from 19 to 70, and the number of men and women is each 2 and 10. Block bone was taken from symphysis, body, ramus of mandible or iliac bone. And 6 types of implants were installed simultaneously or not, the diameters of implants are from 3.3 to 5.5mm, the lengths are from 8 to 15mm. The operator added artificial bone grafting material and optionally covered with membrane. The mean periods of observation after operation and final prosthetics were 28.6 and 17.0 months. As a result, 40 among 41 implants survived, the survival rate was 97.6%. Average 0.9mm crestal resorption was observed at final point of time by periapical view of each patients. Major complication related to the procedure was numbness in 7 patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.138-141
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• 2006

Introduction : In recent years, vascularized, i.e., living bone grafts, have been widely applied in the field of oral and maxillofacial surgery, as a method of treatment of congenital or acquired non-unions, and a large defects in mandible. The vascularized fibular graft has been especially used for this purpose because of its shape and mechanical strength. The postoperative hypertrophy of grafted fibula is of particular interest to us. Material and methods : This study was undertaken to determine the volume change(indirect methods) and radiographic appearance of a free vascularized fibular graft as it responds to the mechanical and physiologic features of its new environment. In order to elucidate the long term effect on fibular mass after mandibular reconstruction, change in various method of volume change was utilized as indirect measure of change in long-term. Results : The younger the patient, the more prominent and rapid the hypertrophy of the graft. the hypertrophy of the graft never exceeded the diameter of the recipient bone, except for callus enlargement after stress fracture of the grafted bone. Conclusion : Etiologic explanations for this phenomenon have not been clarified in the previeous literature. some of the factors implicated include a periosteal reaction or new bone formation, as seen at the onset of bone union after a fracture in a child, a reaction to the mechanical loading on the graft and a reaction to the circulatory changes resulting from the grafting procedure.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.330-333
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• 2009

Alveolar bone resorption after extraction impairs the necessary bone volume and complicates the case for implant surgery and aesthetic implant prosthesis. Immediate implant surgery after extraction decreases the number of surgical procedures and the duration of treatment, while allowing minimum alveolar bone resorption and preserving the residual bone volume. Although immediate implant holds many advantages such as preservation of hard and soft tissue around the extraction socket, greater implant survival rate and higher patient satisfaction, various complications and high failure rate are discouraging factors for the clinicians. In this case report, severe alveolar bone resorption with soft tissue changes were predicted after the extraction of prolonged retained deciduous incisors and impacted maxillary canines and thus decided on immediate implant procedure. Immediate implant surgery after extraction was carried out with minimal bone reduction and tapered wide-neck implant to establish initial stability. Simultaneous bone graft was done by filling the defect area with iliac cancellous bone with additional onlay-type bone graft and absorbable membrane on the labial bone for upper lip support. A stable and esthetic result was obtained with shortened treatment period.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.157-169
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• 2023

Purpose: The aim of this study was to evaluate the impact of polydeoxyribonucleotide (PDRN) on histologic outcomes when implant placement and lateral sinus floor elevation are performed simultaneously. Methods: Three bimaxillary premolars (P2, P3, and P4) were extracted from 4 beagle dogs 2 months before lateral sinus floor elevation. After lateral elevation of the sinus membrane, each sinus was allocated to either the test or control group. Sinuses underwent either 1) collagenated synthetic bone graft with PDRN following lateral sinus floor elevation (test group) or 2) collagenated synthetic bone graft without PDRN after lateral sinus floor elevation (control group). Eight weeks after the surgical procedure, all animals were euthanised for a histologic and histomorphometric assessment. Augmented height (AH), protruding height (PH), and bone-to-implant contact in pristine (BIC_p) and augmented (BIC_a) bone were measured. The composition of the augmented area, which was divided into 3 areas of interest located in coronal, middle and apical areas (AOI_C, AOI_M, and AOI_A), was calculated with 3 parameters: the area percentage of new bone (pNB), residual bone graft particle (pRBP), and fibrovascular connective tissue (pFVT). Results: AH, PH, BIC_p, BIC_a total, BIC_a coronal, and BIC_a middle values were not significantly different between sinuses in the control and test groups (all P>0.05). The BIC_a apical of sinuses in the test group (76.7%±9.3%) showed statistically higher values than those of sinuses in the control group (55.6%±22.1%) (P=0.038). pNB, pRBP, and pFVT showed statistically significant differences between the 2 groups in AOI_A (P=0.038, P=0.028, and P=0.007, respectively). pNB, pRBP, and pFVT in AOI_C and AOI_M were not significantly different between samples in the control and test groups (all P>0.05). Conclusions: The histologic findings revealed that lateral sinus floor elevation with PDRN might improve early new bone formation and enable higher bone-to-implant contact.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.101-106
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• 2004

Purpose: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. Materials and Methods: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. Results: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improvedto 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. Conclusion: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.

• Journal of Periodontal and Implant Science
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• v.37 no.4
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• pp.691-704
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• 2007

Between 1997 May and 2007 May, One hundred and seventeen patients were treated. There were 129 cases of sinus elevation using a lateral window opening procedure and 258 implants placed simultaneously or delayed. The cumulative survival rate of the implants calculated. The implants were evaluated according to surgical site, quality and quantity of bone, graft material, membrane used, the length and diameter of the implant and complications. 1. The 10-year cumulative survival rate of the implants by sinus augmentation using lateral window approach was 96.90%. 2. There was no difference in the survival rate between the implant placed simultaneously with sinus elevation (one stage) and the procedure performed in the delayed procedure (two stage). 3. There was no difference in the survival rate according to the type and amount of graft materials. 4. There was no difference in the survival rate according to the implant site, bone quality and quantity. 5. There was no difference in the survival rate when the $CollaTape^{(R)}$ or Gore-Tex was placed in the window of the lateral wall. 6. There was no difference in the survival rate of the implant length and diameter. 7. The survival rate was as low as 75.00% when there were more than two complications. Implant placement with sinus augmentation using the lateral window approach is a predictable treatment method. Although the vertical height of residual ridge is insufficient and the quality of bone is poor, the normal survival rate of the implants would be expected if an appropriate graft material and membrane is used with greater effort to prevent complications.

• Journal of Korean Dental Science
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• v.17 no.2
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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.

• Clinics in Shoulder and Elbow
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• v.23 no.3
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• pp.152-155
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• 2020

Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.