• 대한치과의사협회지
• /
• 제17권2호통권117호
• /
• pp.129-135
• /
• 1979

This 27 year-old male patient had severe mandibular prognathism (right and left mesio-occlusion were 0.4㎝ and 1.2㎝ , respectively). He had good oral health relatively exception of missing teeth. We examined all of his oral and skeletal status with full mouth x-ray taking, study model, and cephalogram. His general condition was good but above examination indicated the surgical operation for the mandibular prognathism. His laboratory tests were within normal limits. We determined surgical operation which was done by extraoral approach bilaterally. Incisions were made bilaterally 1.5㎝ beneath the inferior border of the mandible in the selected area and then the inferior border of the ascending rami was exposed. Retracting the periosteum to the lingual and buccal a slight amount, the cut in the bone was performed by use of bone drill. Avoiding T.M.J. troubles, the proximal segmant was not fixed to anterior segment, being in overlapping state buccally, in order to expect a natural healing by the environmental muscles and ligaments. We had immobilization with intermaxillary fixation by using the multiple Stout's method. He was discharged 17 days after operation. His general condition and operation results were good and satisfactory.

• 대한치과의사협회지
• /
• 제56권4호
• /
• pp.208-216
• /
• 2018

Patients with malocclusion may present with preexisting mucogingival problems susceptible to attachment loss during or after orthodontic treatment. Lower anterior teeth especially show a high prevalence of gingival recession following orthodontic treatment. This case report demonstrates hard tissue augmentation of labially thin or deficient alveolar bone (dehiscences and fenestrations) to prevent attachment loss during or after orthodontic treatment. Three patients presented clinically prominent root surfaces and dehiscences and fenestrations on cone-beam computed tomography (CBCT) in lower anterior teeth. Labial hard tissue augmentation of lower anterior teeth was performed with deproteinized bovine bone mineral and collagen membrane. Six months later, hard tissue augmentation reduced root prominence and created a greater volume of hard tissue on lower anterior area in clinical and radiographic findings. Hard tissue augmentation using xenograft could prevent attachment loss associated with orthodontic treatment and maintain stability of healthy periodontium.

• 대한치과교정학회지
• /
• 제44권4호
• /
• pp.217-225
• /
• 2014

Single-tooth implantation has become a common treatment solution for replacement of a root-fractured maxillary incisor in adults, but the long-term esthetic results can be unfavorable due to progressive marginal bone loss, resulting in gingival recession. In this case report, a maxillary central incisor with a root fracture in its apical one-third was orthodontically extruded and extracted in a 21-year-old female. Implant surgery was performed after a 3-month healing period, and the final crown was placed about 12 months after extraction. After 12 years, favorable osseous and gingival architectures were visible with adequate bone height and thickness at the buccal cortical plate, and no gingival recession was seen around the implant-supported crown. Although modern dentistry has been shifting toward simplified, clinical procedures and shorter treatment times, both general dentists and orthodontists should be aware of the possible long-term esthetic advantages of orthodontic extrusion of hopelessly fractured teeth for highly esthetically demanding areas and should educate and motivate patients regarding the choice of this treatment solution, if necessary.

• Journal of Periodontal and Implant Science
• /
• 제51권4호
• /
• pp.239-253
• /
• 2021

Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.

• Restorative Dentistry and Endodontics
• /
• 제49권2호
• /
• pp.13.1-13.7
• /
• 2024

Chronic osteomyelitis with proliferative periostitis, known as Garre's osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre's osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre's osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient's symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.

• 대한치과교정학회지
• /
• 제37권3호
• /
• pp.220-230
• /
• 2007

골격성 I급이면서 수직적으로 정상인 환자 160명(남자 80명, 여자 80명)의 측모 두부방사선 계측사진을 대상으로 하악 전치부 치조골의 협설측 두께를 치축을 기준으로 계측하여 연령에 따른 차이를 조사하여 다음과 같은 결과를 얻었다. 하악전치부 치조골의 협설측 두께와 하악 전치부 설측 치조골의 두께는 연령이 증가함에 따라 여자의 CEJ 하방 2 mm 부위를 제외하고는 남녀 모두에서 유의한 감소를 보였다. 반면에, 하악 전치부 협측 치조골의 두께와 하악 이부 최대 풍융부의 두께는 연령이 증가함에 따라 유의한 차이를 보이지 않았다. 이상의 연구를 통하여 한국인에 있어서 수평적으로 I급의 골격형태이면서 수직적으로 정상인 환자에서는 성인보다는 성장기환자에서 하악 전치의 설측 치조골의 두께가 더 두꺼워 발치치료에서와 같은 하악 전치의 설측이동이 유리할 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권2호
• /
• pp.155-162
• /
• 2001

This is a clinical study on patients who had visitied the Emergency Room of Pusan National University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years, from 1992 to 1996. The results were as follow ; 1. The total number of patients was 2,680 and the ratio of male to female was 1.96:1, The highest monthly incidence was shown in September(12.1%) and October(10.5%) and the age distribution peaks was the third decade(24.3%), followed by the first(23.1%) and the fourth decade(17.2%). 2. Soft tissue injury group(29.1%) was the most prevalent, followed by tooth injury group(16.1%), facial bone injury group (16.0%), toothache group(11.2%), socket bleeding group(11.1%), infection group(9.8%) and TMJ dislocation group(5.9%). 3. The percentage of in-patients and out-patient were 21.6% and 78.4%, respectively. The frequent causes of admission were facial bone fracture(73.8%), infection(20.8%) and soft tissue injury(4.8%) in order. However, soft tissue injury was the most frequent cause in out-patient, followed by tooth injury(20.5%), toothache(14.3%), socket bleeding(14.2%) and TMJ dislocation(7.6%). 4. In the facial bone injury group, the mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%) and nasal bone fractures(4.0%). 5. In the mandibular bone fracture, the most common location was symphysis(36.7%), followed by the mandibular angles(33.1%) and the condyles(21.8%). 6. The common causes of facial bone fractures were violence, fall and traffic accident in order. 7. The common causes of soft tissue injury were fall down, fight and traffic accident in order and the highest incidence was observed in infants before the age of 10 years(44.0%). 8. In the group of tooth injury, tooth luxation(38.5%) showed the highest incidence followed by tooth fracture(33.2%) and tooth loss(17.1%). The common causes of tooth injury were fall, fight and traffic accident in order. 9. In infected patients group, the ratio of in-patients to out-patients was 1 : 1.28, Buccal(24,7%) and infraorbital space abscess(23.3%) showed the highest incidence. 10. The pain caused by dental caries(39.0%) and pericoronitis(26.6%) showed high incidence in the toothache group. 11. The high incidence was observed during third(34.0%) and fourth (24.5%) decades in TMJ dislocation group. 12. In the group of socket bleeding patients, 92% was post-operative hemorrhage and 8% was accompanied with other systemic hemorrhagic diseases.

• 구강회복응용과학지
• /
• 제28권2호
• /
• pp.127-138
• /
• 2012

본 연구에서는 임플란트 고정체와 지대주 간의 전하중 크기가 임플란트 주위 변연골의 응력분포에 미치는 영향에 대해 조사하였다. 해석 모델은 하악골에 식립되는 단일 임플란트(solid형 지대주와 submerged 형 고정체)로 제작되었고, 외력 조건으로는 임플란트 지대주 상부에 100N의 기능력이 협설 방향으로 30도 경사져 협측으로 작용하도록 설정하였다. 전하중의 크기가 변연골 응력 분포에 어떠한 차이가 생기게 하는지를 조사하기 위해 다섯개의 다른 전하중의 크기(0, 200, 400, 600, 800N)를 부여하였다. 모든 분석은 선형 탄성을 가정하여 ABAQUS/CAE(ver6.10-1, HKS, Fremont, CA, USA) 프로그램을 사용하였다. 임플란트 주위 변연골 응력분포의 차이는 전하중의 크기와 관련이 있었다. 100N의 교합력 하에 전하중이 0인 경우 변연골(임플란트 벽에서 0.1mm 떨어진 부분)에서 압축 응력은 28.33MPa이었는데, 전하중을 200N 증가시킬 때마다 1.76MPa씩 증가하였다. 이런 방식으로 800N의 전하중을 가할 때 나타나는 최대 압축 응력은 35.18MPa이었다. 반면 변연골에서의 인장 응력은 전하중이 증가할 수록 감소하였다. 임플란트 고정체와 지대주 간의 전하중은 변연골에서의 압축 응력을 증가시킬 수 있으나 기능력에 비하면 그 효과는 미미할 것으로 판단된다.

• 대한치과보철학회지
• /
• 제46권3호
• /
• pp.290-297
• /
• 2008

STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. $4.1{\times}10$ mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 1-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 1-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 2-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 2-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N, it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2- 3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.

• Journal of Periodontal and Implant Science
• /
• 제33권4호
• /
• pp.693-703
• /
• 2003

The present study evaluated the effects of guided tissue regeneration using xenograft material(deproteinated bovine bone powder), with and without Calcium sulfate membrane in beagle dogs. Contralateral fenestration defects (6 ${\times}$ 4 mm) were created 4 mm apical to the buccal alveolar crest of maxillary premolar teeth in 5 beagle dogs. Deproteinated bovine bone powders were implanted into fenestration defect and one randomly covered Calcium sulfate membrane (experimental group). Calcium sulfate membrane was used to provide GTR. Tissue blocks including defects with soft tissues which were harvested following four & eight weeks healing interval, prepared for histo-phathologic analysis. The results of this study were as follows, 1. In control group, at 4 weeks after surgery, new bony trabecular contacted with interstitial tissue and osteocytes lie cell were arranged in new bony trabecule. Bony lamellation was not observed. 2. In control group , at 8 weeks after surgery, scar-like interstitial tissue was filled defect and bony trabecule form lamellation. New bony trabecular was contacted with interstitial tissue but defect was not filled yet. 3. In experimental group, at 4 weeks after surgery, new bony trabecular partially recovered around damaged bone. But new bony trabecule was observed as irregularity and lower density. 4. In experimental group, at 8 weeks after surgery, lamella bone trabecular developed around bone cavity and damaged tissue was replaced with dense interstitial tissue. In conclusion, new bone formation regenerated more in experimental than control groups and there was seen observe more regular bony trabecular in experimental than control groups at 4 weeks after surgery. In control group, at 8 weeks after surgery, the defects was filled with scar-like interstitial tissue but, in experimental group, the defects was connected with new bone. Therefore xenograft material had osteoconduction but could not fill the defects. We thought that the effective regeneration of periodontal tissue, could be achieved using GTR with Calcium sulfate membrane.