• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권3호
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• pp.57-62
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• 1990

Many alloplastic materials have been used as the bony substitute in large bony defects caused by fracture, periodontitis, & cyst, etc. Nowadays Hydroxyapatite(HAP) is the most usable material as the bony substitute. The reasonable properties of HAP are nontoxic, biocompatible to host tissues & have osteoconductivity. Other bioceramic materials are recommended as the bony substitute with high success rate. We have studied the clinical use of HAP as the bony substitute in the defected area caused by cyst. The reasonalbe & successful results are obtained. The results were as followed. 1. Better prognosis was obtained in the case of HAP & bone mixed graft than HAP graft only. And the best prognosis was obtained in the case of iliac bone graft. 2. Better prognosis was obtained in Mx. than in Mn. 3. It seems that the soft tissue ingrowth into the HAP granule play an important role in the success of the HAP graft. 4. Though the flap covering the HAP granules was perforated, the relative good prognosis was obtained by re-suturing the perforeated site.

• 한국임상수의학회지
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• 제24권3호
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• pp.350-357
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• 2007

Bone graft had been widely investigated for reconstruction of bone defects or acceleration of bone healing in orthopedics, neurosurgery and dental surgery. Autograft is the golden standard of bone graft but it is associated with donor site morbidity and is restricted in quantity. Xenograft has been researched an alternative method for autograft. The purpose of this study was to investigate the efficacy of new bone formation according to three different preparations of implants on rabbit xenograft. Cortical bone xenografts which made from bovine femoral cortical bone were treated by freezing, freeze-drying or defat-freezing implant preparations. They were transplanted into proximal diaphyseal shaft of bifibulae of 15 rabbits which were divided into three groups according to their implant preparation method. The fibulae transplantations were evaluated radiographically and examined osteoblast activity by bone alkaline phosphatase (BALP) biweekly for 16 weeks to observe new bone formation and union of the experimental defected region. New bone formation was observed in 7 cases in freeze-drying and defat-freezing group, respectively. Union of proximal and distal end of defected region, which was considered as success of bone graft, was observed in 4 cases (40%; 4 of 10 cases), respectively. In freezing group, new bone formation was observed in 6 cases but, there is no union observed. BALP value was increased over twice after two weeks of graft procedure in all union cases of freeze-drying and defat-freezing group (two of five animals, respectively) then gradually decreased to 16th week. In non-union cases, there is no significant variation in BALP value. Defat-freezing or freeze-drying preparations of implants are more efficacious in new bone formation than freezing method on rabbit xenograft. While it is difficult to propose which is superior between defat-freezing and freeze-drying, defatting of implants may enhance new bone formation in xenograft.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.515-519
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• 2010

Introduction: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. Materials and Methods: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. Results: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. Conclusion: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.134-138
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• 2000

Arthrodesis of the ankle joint is inevitable in the cases of severe arthrosis or defective bony structures around ankle joint. There have been many kinds of arthrodesis methods were introduced. In cases with failed athrodesis with previous arthrodesis surgery and neuropathic joints have difficulty to achieve fusion of joint with conventional methods. Authors underwent four cases of ankle fusion with vascularized fibular graft from 1997 in the cases of three failed fusions and one diabetic neuropatic joint. Two of four performed free vascularized fibular transplantation from contralateral side leg with microvascular anastomosis, two of four performed with pedicled fibular transposition to the ankle joint in same side leg. Three of four cases achieved arthrodesis average 9.2 months after surgery, one case was failed due to vascular thrombosis of the anastomosed site in diabetic neuropathic condition. The result of this technique revealed 75%(three of four) success rate and longer bone union time required. However, in these cases had no recommendable options with conventional bone graft and additional ankle joint fusions procedure because of poor bone quality and defect of distal tibia and talus portions. Free vascualrized fibular transfer to the failed athrodesis of ankle joint is one of the effective alternative methods in failed ankle fusion cases, especially the quality of the bone around previous fusion site is poor.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.249-257
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• 2008

The authors performed the clinical and radiographic evaluation in the 29 patients with sinus bone graft and $Osstem^{(R)}$ implant placement between Sep 2003 and Jan 2006 and got the following results. 1. Fifteen complications developed in the 13 patients. Intraoperative sinus membrane perforation and postoperative maxillary sinusitis developed frequently. 2. The mean preoperative residual alveolar bone height was 4.5 mm, postoperative height 18.5 mm, height 1 year after operation 16.9 mm. 3. Three primary osseointegration failures(3.7%) developed in 3 patients. 4. The survival rate of prosthodontics was 100% at the final follow up. The mean marginal bone resorption around the implants was 0.69 mm 1 year after prosthodontic loading. Marginal bone resorption more than 1.5 mm developed in nine implants and the success rate was 88%.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권6호
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• pp.274-282
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• 2013

Objectives: The posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach. Materials and Methods: In this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height. Results: The bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively. Conclusion: Maxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for implant rehabilitation.

• 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 Periodontal and Implant Science
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• 제38권3호
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• pp.535-542
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• 2008

Purpose: The aim of this retrospective study is to evaluate survival rate of implant and bone formation, to analyze failure contribution factor. Material and Methods: A total of 52 consecutive patients(35 male, 17 female, mean age 49 years) with 104 osseous defects were treated during the period from October 2004 to June 2007 with a simultaneous or staged GBR approach using non-resorbable or resorbable membranes combined with autogenous bone grafts or xenograft(Bio-Oss, Bio-cera, BBP). Result: A total of 32(30,8%) of 104 GBR-treated sites failed the bone formation and a total of 5(5.6%) of 89 implants were removed. Early exposure of the membrane has significantly affected bone formation(p<0.05). Non-resorbable membrane showed more exposure of the membrane and low success rate of bone formation than resorbable membrane(p<0.05). There were no difference between success rate of bone formation and using autogenous bone or graft materials. There were no statistically significant difference between success rate of bone formation and smoking or using PRP. Mandible showed more success rate of bone formation than maxilla(p<0.05). Conclusion: Early exposure of the membrane, membrane type and maxilla/mandible type have influence on success rate of bone formation during GBR.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.42.1-42.7
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• 2016

Background: The purpose of this retrospective study was to evaluate the clinical utility of an implant with a sandblasted, large-grit, acid-etched (SLA) surface and internal connection. Methods: Six patients who received dental implants in the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, were analyzed by factors influencing the success rate and marginal bone loss. Factors included patient's age, sex, implant installation site, whether bone graft was done, type of bone graft materials, approaching method if sinus lift was done, and the size of the fixture. In addition, the marginal bone loss was analyzed by using a radiograph. Results: All implants were successful, and the cumulative survival rate was 100 %. Average marginal bone loss of 6 months after the installation was 0.52 mm and 20 months after the functional loading was 1.06 mm. Total marginal bone resorption was 1.58 mm on average. There was no statistically significant difference in mesial and distal marginal bone loss. Conclusions: The short-term clinical success rate of the implant with an SLA surface and internal connection was satisfactory. Moreover, the marginal bone loss was also consistent with the implant success criteria.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.36.1-36.8
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• 2019

Background: This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods: From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results: The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of periimplantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions: When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.