• Journal of Periodontal and Implant Science
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• 제49권1호
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• pp.47-57
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• 2019

Purpose: This study was designed to observe the resorption pattern of biphasic calcium phosphate (BCP) used for maxillary sinus augmentation over a 3- to 6-year healing period, and to investigate factors affecting the resorption of BCP. Methods: A total of 47 implants placed in 27 sinuses of 22 patients were investigated. All patients had residual bone height less than 5 mm at baseline. The modified Caldwell-Luc approach was used to elevate the maxillary sinus membrane, and the sinus cavity was filled with BCP (70% hydroxyapatite and 30% ${\beta}$-tricalcium phosphate). Implant placement was done simultaneously or in a staged manner. Serial radiographic analysis was performed up to 6 years postoperatively. Results: During the follow-up period, no implant loss was reported. The mean reduced height of the augmented sinus (RHO) was $0.27{\pm}1.08mm$ at 36 months, and $0.89{\pm}1.39mm$ at 72 months postoperatively. Large amounts of graft material (P=0.021) and a long healing period (P=0.035) significantly influenced the amount of RHO. In particular, there was a significant relationship between a healing period longer than 40 months and RHO. Conclusions: BCP can achieve proper dimensional stability with minimal reduction of the graft height in a 3- to 6-year healing period after maxillary sinus augmentation. The healing period and the amount of graft material influenced the resorption of BCP.

• Journal of Periodontal and Implant Science
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• 제41권2호
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate 3.5 years-cumulative survival rate of implants placed on augmentedsinus using Osteon, a bone graft material, and to assess the height of the grafted material through radiographic evaluation. Methods: Twenty patients were treated with maxillary sinus augmentation and 45 implant fixtures were installed simultaneously or after 6 months healing period. The height of the augmented sinus and the loss of marginal bone were measured by panoramic and intraoral radiographs immediately after augmentation and up to 42 months (mean, 19.4 months) subsequently. Changes in the height of the sinus graft material were calculated radiographically. Results: The cumulative survival rate was 95.56% in all 45 implants. Additionall, normal healing process without any complication was observed in all patients. The original sinus height was mean 4.3 mm and the augmented sinus height was mean 13.4 mm after the surgery. The mean marginal bone loss till 42 months was $0.52{\pm}0.56\;mm$. The reduced height of Osteon was $0.83{\pm}0.38\;mm$ and it did not show significant correlation with the follow up periods (P=0.102). There were no statistically significant differences in reduced height of Osteon according to the simultaneous/delayed implantation (P=0.299) and particle size of Osteon (P=0.644). Conclusions: It can be suggested that Osteon may have predictable result when it was used as a grafting material for sinus floor augmentation.

• Journal of Periodontal and Implant Science
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• 제51권3호
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• pp.179-188
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• 2021

Purpose: Due to the difficulty of the hygienic care and sanitary management of abutment teeth and subpontic areas associated with fixed dental prostheses (FDPs), intrabony defects occur and accelerate due to the accumulation of plaque and calculus. This study aimed to evaluate the efficacy of regenerative periodontal surgery for intrabony defects associated with FDPs. Methods: The study inclusion criteria were met by 60 patients who underwent regenerative treatment between 2016 and 2018, involving a total of 82 intrabony defects associated with FDPs. Periodontal osseous lesions were classified as 1-, 2-, and 3-wall intrabony defects and were treated with an enamel matrix derivative in combination with bone graft material. The changes in clinical (pocket probing depth [PPD] and clinical attachment level [CAL]) and radiographic (defect depth and width) outcomes were measured at baseline and at 6, 12, and 24 months. Results: Six months after regenerative treatment, a significant reduction was observed in the PPD of 1-wall (P<0.001), 2-wall (P<0.001), and 3-wall (P<0.001) defects, as well as a significant reduction in the CAL of 2-wall (P<0.001) and 3-wall (P<0.001) intrabony defects. However, there was a significant increase in the CAL of 1-wall intrabony defects (P=0.003). Radiographically, a significant reduction in the depth of the 3-wall (P<0.001) defects and a significant reduction in the width of 2-wall (P=0.008) and 3-wall (P<0.001) defects were observed. The depth decreased in 1-wall defects; however, this change was not statistically significant (P=0.066). Conclusions: Within the limitations of the current study, regenerative treatment of 2- and 3-wall intrabony defects associated with FDPs improved clinical and radiological outcomes. Additional prospective studies are necessary to confirm our findings and to assess long-term outcomes.

• 대한치과보철학회지
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• 제46권2호
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• pp.201-208
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• 2008

연구목적: 시멘트 유지형 지대주를 인상용 코핑으로 이용하고 레진이나 금속 구조물에 접착하여 스플린팅하는 새로운 인상법을 시도하였다. 연구의 목적은 첫 번째, 3개의 임플랜트가 $15^{\circ}$ 경사지게 식립된 모형에서 closed tray 인상법과 레진 스플린팅한 open tray 인상법의 정확성을 비교하는 것이고 두 번째, 새로운 인상법의 정확성을 앞의 두 가지 인상법과 비교하는 것이다. 연구 재료 및 방법: 3개의 임플랜트 아날로그가 선상으로 배열되고 가운데 아날로그는 모형에 수직이고 양쪽 끝 아날로그는 이것에 앞뒤로 $15^{\circ}$ 경사지게 배열된 주모형과 주모형에 잘 적합되는 기준구조물을 제작하였다. closed tray 인상법, 레진 스플린팅한 open tray 인상법, 지대주-레진구조물 접착 인상법, 지대주-금속구조물 접착 인상법, 각 10개씩 40번의 인상을 채득하여 복제모형을 제작하였다. 이미지 처리할 수 있는 광학 현미경을 이용하여 기준구조물과 복제모형내의 아날로그와의 수직간격을 측정하여 인상의 정확성을 평가하였다. 통계처리는 one-way ANOVA와 사후 검정으로 Tukey test를 5% 유의수준으로 시행하였다. 결과: closed tray 인상법;74.3 (${\pm}33.4$)${\mu}m$의 간격은 레진 스플린팅한 open tray 인상법과 다른 두 가지 새로운 인상법보다 간격의 크기가 통계적 유의성 있게 컸다(P<.05). 지대주-금속구조물 접착 인상법;42.5 (${\pm}11.9$)${\mu}m$은 다른 인상법들 보다 간격의 크기가 통계적 유의성 있게 작았다(P<.05). 지대주-레진구조물 접착 인상법;51.0 (${\pm}14.1$)${\mu}m$은 레진 스플린팅한 open tray 인상법50.3 (${\pm}16.9$)${\mu}m$과 통계적 유의성 있는 차이를 보이지 않았다(P>.05). 결론: 이 연구의 한계 내에서, 레진 스플린팅한 open tray 인상법은 closed tray 인상법보다 우수한 정확성을 나타내었고, 지대주를 금속구조물에 접착하는 새로운 인상법의 정확성은 레진 스플린팅한 open tray 인상법보다 우수하였다.

• 대한치과보철학회지
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• 제59권1호
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• pp.71-78
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• 2021

완전무치악 환자한테 처음으로 시도되었던 임플란트 보철치료는 현재는 단일치아 상실된 경우까지 그 활용범위가 넓어졌으며, 임플란트 보철치료는 현대 치과에서는 거의 필수적인 치료방법으로 자리매김 하였다. 임플란트 보철물을 제작하는데 사용되는 재료도 초기에 비해 다양해졌는데, 그 중 하나가 고기능성 폴리머의 적용이다. 예전부터 의과에서 많이 사용되어 왔던 고기능성 폴리머를 치과에서도 시도하는 빈도가 점점 늘어나고 있다. 이에 고기능성 폴리머를 구치부 임플란트 지대주로 사용한 3가지 증례를 보고하고자 한다. 첫번째 증례는 하악 좌측 제2소구치가 상실된 부위에 PEKK 지대주 및 PFG 크라운(시멘트-나사-유지형)을 제작, 장착하였으며, 두번째 증례는 상실된 상악 좌측 제1대구치 부위에 PEKK 지대주 및 monolithic zirconia 크라운(시멘트-나사-유지형)을 제작, 장착하였으며, 마지막 증례는 상악 우측 제1,2 대구치 상실부위에 PEKK 지대주 및 splinted PFM 크라운(시멘트-나사-유지형)을 제작하여 장착하였다. 4년의 추적 관찰 결과 상기 환자 모두 심미적 및 기능적으로 만족스러운 결과를 얻었기에 증례를 보고하고자 한다.

• 구강회복응용과학지
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• 제28권3호
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• pp.253-268
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• 2012

수직적, 수평적 골흡수가 심한 환자에서 임플란트를 이용한 전악수복의 경우 경조직과 연조직 이식을 통해서 임플란트를 원하는 위치에 식립할 수도 있지만, 치은과 치아의 기능과 심미를 회복할 수 있는 fixed detachable prostheses를 대체 술식으로 사용할 수도 있다. 이러한 증례에서 다양한 재료가 수복물의 제작에 사용 가능하지만, metal/acrylic 보철물에서는 레진치아의 파절 및 탈락이 일어날 수 있고, metal/ceramic 혹은 zirconia/ceramic 보철물에서는 도재의 chipping이나 파절과 같은 문제가 발생할 수 있다. 이에 최근에 심미적이면서도 기능적인 보철수복을 위해 zirconia에 도재를 축성하지 않고 임상적으로 적용가능한 monolithic zirconia framework이 출시되어 사용되고 있다. 본 임상 증례는 심미적인 요구도가 높은 완전 무치악 환자에서 임플란트를 식립하고 chipping이나 파절의 위험을 감소시키기 위해 monolithic zirconia framework을 이용해 만들어진 complete fixed detachable 보철물을 이용한 수복에 대해 보고하고자 한다. 이번 증례에서 보철물은 심미적, 기능적으로 만족스러웠으며, 2년 간의 정기검사에서 임상적인 합병증은 보고되지 않았다.

• 치위생과학회지
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• 제16권1호
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• pp.70-76
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• 2016

이번 연구의 목적은 하이드록시아파타이트를 이용하여 블라스팅 처리한 뒤 양극산화 방법을 이용하여 하이드록시아파타이트와 이산화티탄이 복합된 표면을 만들고, 이에 대해 세포부착양상을 관찰하고 ALP 활성도와 칼슘 침착량을 측정함으로써 세포 분화능을 평가하여 표면의 생체적합성을 평가하는 데 있다. 이를 위해 실험을 진행한 결과 다음과 같은 결과를 얻었다. 접촉각 분석 결과, 복합처리된 HA+100과 HA+MAO 150은 유의하게 낮은 접촉각을 나타내었다(p<0.05). 세포부착 관찰 결과 연마 처리한 SM 시편에서는 납작한 모양으로 세포가 붙어있는 모습을 관찰할 수 있었으나, 표면 처리된 실험군에서는 세포의 모양이 시편을 따라 좀 더 길게 뻗어 부착된 모습을 관찰할 수 있었다. ALP 활성도 측정 결과 HA+MAO 150과 HA+MAO 200은 1, 2, 3주 모든 기간에서 가장 높은 ALP 활성도를 나타내었다(p>0.05). 칼슘양 측정 결과 HA+MAO 150 과 HA+MAO 200은 1, 2, 3주 모든 기간에서 가장 많은 칼슘양을 나타내었다(p<0.05). 따라서 하이드록시아파타이트 이산화티탄이 복합 코팅된 표면은 높은 표면에너지를 가지며 우수한 세포활성도를 나타내어 치과용 임플란트 표면으로 유용하게 사용될 수 있을 것이라고 생각된다.

• Journal of Periodontal and Implant Science
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• 제39권3호
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• pp.359-365
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• 2009

Purpose: The purpose of this study was to investigate the ability of Mineral trioxide aggregate(MTA) to support osteoclastic differentiation from fetal rat calvarial cell. Methods: In this study, response of IL-6, RANKL, and OPG in fetal rat calvarial cells stimulated with IL-$1{\beta}$ on MTA was evaluated by ELISA and RT-PCR. Results: The results were as follows; there was no significant difference between glass and MTA at 5days. In ELISA analysis, Glass group and MTA group showed similar IL-6 expression, Glass+IL-$1{\beta}$ group and MTA+IL-$1{\beta}$ group showed similar IL-6 expression. In RT-PCR analysis, Glass group and MTA group showed similar IL-6, RANKL, OPG mRNA expression, MTA+IL-$1{\beta}$ group and Glass+IL-$1{\beta}$ group showed 3 fold increase of IL-6 and RNAKL mRNA expression when compared with MTA group. All groups showed similar OPG mRNA expression. Conclusions: MTA does not suppress cell proliferation and increase the proinflammatory cytokine that induce osteoclastogenesis. Thus, MTA is biocompatible material that could be used in various clinical conditions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.108-118
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• 2010

Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

• Journal of Periodontal and Implant Science
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• 제23권3호
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• pp.400-410
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• 1993

Dental implants have been widely used in the treatment of esthetic and functional problems of the mouth due to alveolar bone loss, after tooth extraction. The success of implantation strongly depends on osseointegration. For osseointegration, implant material, methodology, and design have been investigated. For materials, two popular materials at present are titanium and hydroxyapatite. For methods, immediate implantation is being used recently. The purpose of this study is to evaluate osseointegration between the unthreaded cylindrical TPS implant and the HA-coated implant by a histomorphometric analysis. For this analysis, experimental periodontits was induced on the 3, 4 premolars of adult dogs by the ligation of orthodontic threads. Thereafter, each tooth was extracted. TPS. Implants and HA-coated implants were immediately inserted in the extraction socket. In control group, TPS implants were immediately inserted, and In experimental group, HA implants were immediately inserted. The dogs were sacrificed after 12 weeks, then the specimens were prepared for LM and histomorphometric analysis. The conclusion of this study is as follows l. In both control and experimental group, no inflammatory cells were observed. 2. The results of the histomorphometric analysis showed that the total osseointegration was 48.5% in control group, and 68.8% in expermental group. The experimental group was higher than the control group, and the difference was not statistically significant (p<0.05). 3. The results of the histomorphometric analysis showed that the osseointegration in the hole was 40.6% in control group, and 70.2% in experimental group. The experimental group was higher than the control group, and the difference was statistically significant (p<0.05). In both control and experinental group, no inflammatory cells were observed. 4. The results of the histomorphometric analysis showed that the osseointegration in the lower part was 52.1% in control group, and 73.3% in experimental group. The experimental group was higher than the control group, and the difference was statistically significant (p<0.05). 5. In experimental group, the bone to HA interface seemed to be mixed of bone and HA. We could not distinguish HA from the bone. The HA coating was detached from the titanium surface.