• Imaging Science in Dentistry
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• v.43 no.2
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• pp.85-90
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• 2013

Purpose: This study was performed to determine the buccal alveolar bone thickness following rapid maxillary expansion (RME) using cone-beam computed tomography (CBCT). Materials and Methods: Twenty-four individuals (15 females, 9 males; 13.9 years) that underwent RME therapy were included. Each patient had CBCT images available before (T1), after (T2), and 2 to 3 years after (T3) maxillary expansion therapy. Coronal multiplanar reconstruction images were used to measure the linear transverse dimensions, inclinations of teeth, and thickness of the buccal alveolar bone. One-way ANOVA analysis was used to compare the changes between the three times of imaging. Pairwise comparisons were made with the Bonferroni method. The level of significance was established at p<0.05. Results: The mean changes between the points in time yielded significant differences for both molar and premolar transverse measurements between T1 and T2 (p<0.05) and between T1 and T3 (p<0.05). When evaluating the effect of maxillary expansion on the amount of buccal alveolar bone, a decrease between T1 and T2 and an increase between T2 and T3 were found in the buccal bone thickness of both the maxillary first premolars and maxillary first molars. However, these changes were not significant. Similar changes were observed for the angular measurements. Conclusion: RME resulted in non-significant reduction of buccal bone between T1 and T2. These changes were reversible in the long-term with no evident deleterious effects on the alveolar buccal bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.269-274
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• 1993

This is the case report of huge complex odontoma treated with sagittal splitting of buccal bone plate and iliac bone graft in left mandible angle. The 22 years old patient was admitted to the department of Oral and Maxillofacial Surgery of Kyungpook National University Hospital with the chief complaint of swelling on the left mandible angle area. We used extra oral Risdon incision and splitted the buccal cortical bone after making the horizontal bone cut buccally. The tumor mass was removed with cutting into the pieces with surgical bur to prevent mandibular fracture. The dead space was grafted with autogenous iliac bone graft and the splitted buccal cortical bone was fixed with two L-type miniplate. After 12months follow up check, we noticed good process of bone healing and satisfactory aesthetic result. In this case, my operative approach provided the excellent surgical access to the hard tissue mass and minimized post operative complication comparing with the conventional surgical approaches.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.6
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• pp.387-395
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• 2020

Background: The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique. Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. Results: Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. Conclusions: The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.5
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• pp.217-223
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• 2013

Objectives: Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery. Materials and Methods: Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture. Results: Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible. Conclusion: Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.496-504
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• 2011

Introduction: This study compared the alveolar bone density of the mandible according to gender, age and position using Cone-beam computed tomography (CT). Materials and Methods: The maxillofacial CT scan data was obtained from 60 Korean patients. In addition, the alveloar bone density of 5 males and 5 females with normal occlusion aged from 10 to 70 years was measured at the buccal cortical bone, cancellous bone and lingual cortical bone, as well as at the position of the incisors, canines, premolars and molars. Results: The age-specific mean bone density was highest in patients in their third decade. The buccal cortical bone of the molars showed the highest bone density. Males in their fifties and sixties had a higher bone density in the cancellous bone in the region of the premolars and the buccal cortical bone of the molars, respectively, than females but there was no significant difference between males and females in the other parts. The cancellous bone density was highest in those in their twenties and thirties, and tended to decline up to their seventh decade. Conclusion: These results revealed a significantly different bone density according to gender, age and position in the Korean population. In addition, it is possible to predict the bone density based on these results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.6
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• pp.524-529
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• 2006

For the repairing of bone defect, autogenous or allogenic bone grafting remains the standard. However, these methods have numerous disadvantages including limited amount, donor site morbidity and spread of diseases. Tissue engineering technique by culturing stem cells may allow for a smart solution for this problem. Adipose tissue contains mesenchymal stem cells that can be differentiate into bone, cartilage, fat or muscle by exposing them to specific growth conditions. In this study, the authors procured the stem cell from buccal fat pad and differentiate them into osteoblast and are to examine the bone induction capacity. Buccal fat-derived cells (BFDC) were obtained from human buccal fat pad and cultured. BFDC were analyzed for presence of stem cell by immunofluorescent staining against CD-34, CD-105 and STRO-1. After BFDC were differentiated in osteogenic medium for three passages, their ability to differentiate into osteogenic pathway were checked by alkaline phosphatase (ALP) staining, Alizarin red staining and RT-PCR for osteocalcin (OC) gene expression. Immunofluorescent and biochemical assays demonstrated that BFDC might be a distinguished stem cells and mineralization was accompanied by increased activity or expression of ALP and OC. And calcium phosphate deposition was also detected in their extracelluar matrix. The current study supports the presence of stem cells within the buccal fat pad and the potential implications for human bone tissue engineering for maxillofacial reconstruction.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.473-488
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• 2006

Adequate bone quality and stress distribution to the bone are of decisive importance for implant success. Even though the success rates of dental implants have been high, implant failures do occur. Overloading has been identified as a primary factor behind dental implant failure. The purpose of this study was to theoretically investigate the effect of two types of implants on the stress distribution in poor bone quality. Employing the finite element method, the study modeled a 4.1 mm diameter, 12.0 mm length implant placed in cortical or spongeous bone. A static loading of lOON was applied at the occlusal surface at 0, 30 degrees angle to the vertical axis of the implant. von Mises stresses concentrations in the supporting bone were analyzed with finite element analysis program. The results were as follows; 1. The stresses at the marginal bone were higher under buccal oblique load(30 degrees off of the long axis) than under vertical load. 2. Under buccal oblique load, the stresses were higher at the lingual marginal bone than at the buccal marginal bone, and the differences were almost the same. 3, Under vertical and oblique load, the stress was the highest at the marginal bone and lowest at the bone around apical portions of implant in cortical bone. 4, Under vertical load, Model 1 showed more effective stress distribution than Model 2 irrespective of bone types. On the other hand, Model 2 showed lower stress concentration than Model 1 under buccal oblique load.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.50.1-50.6
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• 2019

Purpose: Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. Materials and methods: We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. Results: A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19: 6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. Conclusions: The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.

• The korean journal of orthodontics
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• v.43 no.2
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• pp.83-95
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• 2013

Objective: To evaluate the changes in cortical bone thickness, alveolar bone height, and the incidence of dehiscence and fenestration in the surrounding alveolar bone of posterior teeth after rapid maxillary expansion (RME) treatment using cone-beam computed tomography (CBCT). Methods: The CBCT records of 20 subjects (9 boys, mean age: $13.97{\pm}1.17$ years; 11 girls, mean age: $13.53{\pm}2.12$ year) that underwent RME were selected from the archives. CBCT scans had been taken before (T1) and after (T2) the RME. Moreover, 10 of the subjects had 6-month retention (T3) records. We used the CBCT data to evaluate the buccal and palatal aspects of the canines, first and second premolars, and the first molars at 3 vertical levels. The cortical bone thickness and alveolar bone height at T1 and T2 were evaluated with the paired-samples t-test or the Wilcoxon signed-rank test. Repeated measure ANOVA or the Friedman test was used to evaluate the statistical significance at T1, T2, and T3. Statistical significance was set at p < 0.05. Results: The buccal cortical bone thickness decreased gradually from baseline to the end of the retention period. After expansion, the buccal alveolar bone height was reduced significantly; however, this change was not statistically significant after the 6-month retention period. During the course of the treatment, the incidence of dehiscence and fenestration increased and decreased, respectively. Conclusions: RME may have detrimental effects on the supporting alveolar bone, since the thickness and height of the buccal alveolar bone decreased during the retention period.

• Imaging Science in Dentistry
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• v.40 no.4
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• pp.179-185
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• 2010

Purpose : Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. Materials and Methods : Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of $Ez3D2009^{TM}$ (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. Results : Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p<0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. Conclusion : Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.