• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.5
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• pp.318-325
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• 2022

Population aging and the usage of small devices in implant prosthetic procedures have led to many incidents of dental aspiration and ingestion. Various preventive measures have been introduced to prevent these accidents. However, accidents can occur at any time. Dental aspiration and ingestion lead to fatal consequences if the issue is not promptly and appropriately dealt with. Preparing a collaborative system for dealing with accidents before they occur can prevent further sequelae. This study involves ingestion and aspiration accidents that occurred during dental treatment: two ingestion cases and one aspiration case. All dental foreign bodies were removed according to the guidelines presented in our review. With the cooperation of other medical departments, the issues were quickly resolved. Simple and accurate protocols should be provided to all dentists and dental staff to respond to such dental emergencies. In addition, collaboration among other medical departments should be established before any accidental ingestion and aspiration events occur.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.1
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• pp.52-59
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• 2008

The geometric design of an implant surface may play an important role in affecting early osseointegration. It is well known that the porous surfaced implant had much benefits for the osseointegration and the early stability of implant. However, the porous surfaced implant had weakness from the transgingival contamitants, and it resulted in alveolar bone loss. The other problem identified with porous surface implant is the loss of physical properties resulting from the bead sintering process. In this study, we developed the new bead coating implant to overcome the disadvantages of porous surfaced implant. Ti-6Al-4V beads were supplied from STARMET (USA). The beads were prepared by a plasma rotating electrode process (PREP) and had a nearly spherical shape with a diameter of 75-150 ${\mu}m$. Two types of titanium implants were supplied by KJ Meditech (Korea). One is an external hexa system (External type) and the other is an internal system with threads (Internal type). The implants were pasted with beads using polyvinylalcohol solution as a binder, and then sintered at 1250 $^{\circ}C$ for 2 hours in vacuum of $10^{-5}$ torr. The resulting porous structure was 400-500 ${\mu}m$ thick and consisted of three to four bead layers bonded to each other and the implant. The pore size was in the range of 50-150 ${\mu}m$ and the porosity was 30-40 % in volume. The aim of this study was to evaluate the osseointegration of the newly developed dental implant. The experimental implants (n=16) were inserted in the unilateral femur of 4 mongrel dogs. All animals were killed at 8 weeks after implantation, and samples were harvested for hitological examination. All bead coated porous implants were successfully osseointegrated with peripheral bone. The average bone-implant contact ratios were 84.6 % (External type) and 81.5 % (Internal type). In the modified Goldner's trichrome staining, new generated mature bones were observed at the implant interface at 8 weeks after implantation. Although, further studies are required, we could conclude that the newly developed vacuum sintered Ti-6Al-4V bead coating implant was strong enough to resist the implant insertion force, and it was easily osseointegrated with peripheral bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.383-394
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• 1997

This study was done to examine adherence of oral bacteria to titanium dental implant and to know the effective prophylactic antibiotics using an in vivo model. Three samples each of the implant material were set in an acrylic resin flange and placed in the maxillary buccal sulcus of twenty volunteers. At 6- and 54-hour intervals, each sample was placed on blood agar plate (BAP) and chocolate agar, and then they were incubated and identified. Also antibiotic susceptibility test was performed. The results obtained mere as follows ; 1. The microorganisms were chain-like Gram positive cocci and staphyline Gram positive cocci, Gram positive bacilli in order of frequency were found at 6-hour and 54-hour samples by Gram staining. 2. Streptococci was found predominantly at both 6-hour and 54-hour samples, but number of streptococci was decreased as compared to 6-hour samples. 3. There was no difference in the bacterial species adherent to implant between 6-hour and 54-hour samples. 4. All the microbes were sensitive to AMC (amoxacillin clavulanic acid), chloramphenicol, quinolone and vancomycin in the antibiotic susceptibility test. Above results suggest that streptococcus are mainly adhered to titanium implant after implant was placed in the oral cavity and AMC is the most recommendable antibiotics to prevent the peri-implant inflammation.

• Journal of Periodontal and Implant Science
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• v.41 no.6
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• pp.302-308
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• 2011

Purpose: The emergence profile concept of an implant restoration is one of the most important factors for the esthetics and health of peri-implant soft tissue. This paper reports on two cases of gingival recontouring by the fabrication of a provisional implant restoration to produce an optimal emergence profile of a definitive implant restoration. Methods: After the second surgery, a preliminary impression was taken to make a soft tissue working cast. A provisional crown was fabricated on the model. The soft tissue around the implant fixture on the model was trimmed with a laboratory scalpel to produce the scalloped gingival form. Light curing composite resin was added to fill the space between the provisional crown base and trimmed gingiva. After 4 to 6 weeks, the final impression was taken to make a definitive implant restoration, where the soft tissue and tooth form were in harmony with the adjacent tooth. Results: At the first insertion of the provisional restoration, gum bleaching revealed gingival pressure. Four to six weeks after placing the provisional restoration, the gum reformed with harmony between the peri-implant gingiva and adjacent dentition. Conclusions: Gingival recontouring with a provisional implant restoration is a non-surgical and non-procedure-sensitive method. The implant restoration with the optimal emergence profile is expected to provide superior esthetic and functional results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.2
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• pp.106-111
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• 2009

Bisphosphonates have been approved for Paget's disease, cancer-related hypercalcemia, bone involvement in multiple myeloma or solid tumors and osteoporosis. Although, underlying pathophysiological mechanisms remain unclear, it seems that bisphosphonates inhibit osteoclast precursor cells, modulate migratory and adhesive characteristics and induce apoptosis of osteoclasts. Furthermore impacts on angiogenesis, microenvironment and signal transduction between osteoclasts and osteoblasts. In this report, we present a case of oral bisphosphonates induced osteonecrosis of the mandible in a 84-year-old patient who received for two years. Two tapered screw vent implants(Zimmer, USA) were placed in the area of first and second molar. Two weeks later after crowns restored, some inflammatory signs and symptoms were observed on the second molar area. Sequestrum was formed and the sequestrum was removed with the implant. Frequent follow-up checks and oral hygiene maintenances were done and the first molar implant was restored. There is insufficient evidence suggests that duration of oral bisphosphonate therapy correlates with the development and severity of osteonecrosis. Therefore, dentists should not overlook the possibility of development of bisphosphonate induced osteonecrosis in patients who have taken oral forms of medication for less than three years.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.238-245
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• 2008

STATEMENT OF PROBLEM: Interpoximal papilla could be re-established without immeidate support with a provisional resotration following an immdiate implant placement. PURPOSE: Successful esthetic outcomes were reported utilizing immediate provisionalization following immediate implant placements. The aim of this study was to evaluate the soft tissue esthetics around immediately placed single tooth implant restorations with or without immediate provisional restorations. METHODS: A total of ten patients, who had a hopeless maxillary anterior tooth, were enrolled in this study. Screw retained provisional restorations were delivered to the randomly chosen 5 patients (immediate provisionalization group) on the day of immediate implant placement and maintained for about 5 months. For the remaining five patients (non-immediate provisionalization group), healing abutments were delivered on the day of surgery, replaced with screw retained provisional restorations approximately 3 months afterwards, and the provisional restorations were maintained for about 3 months. Digital photographs were taken at the delivery of final restorations in order to assess following variables; mesial papilla, distal papilla, soft tissue level, soft tissue contour and facial soft tissue prominence. The variables were compared to those of the contralateral natural tooth and scored by prosthodontists, periodontists, orthodontists and dental students. RESULTS: The immediate provisionalization group marked significantly higher scores on the following variables; soft tissue level and facial soft tissue prominence. In evaluating each variable, there were no notable differences in opinion between four dentist groups. CONCLUSION: Immediate provisionalization can be a treatment option to achieve superior soft tissue esthetics around immediately placed single implant restorations rather than non-immediate provisionalization approaches.

• Journal of Periodontal and Implant Science
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• v.51 no.6
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• pp.422-432
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• 2021

Purpose: The aim of this study was to compare straight and tapered implant designs in terms of marginal bone loss, the modified plaque index (mPI), and the modified bleeding index (mBI) for 5 years after functional loading. Methods: Twelve patients were recruited. Two types of implants were placed adjacent to each other: 1 straight implant and 1 tapered implant. Marginal bone loss, mPI, and mBI were measured every year for 5 years after loading. Results: The straight implants showed 0.2±0.4 mm of marginal bone loss at 5 years after loading, while the tapered implants showed 0.2±0.3 mm of marginal bone loss; this difference was not statistically significant (P=0.833). Our analysis also showed no statistically significant differences in mPI (straight implants: 0.3±0.3 vs. tapered implants: 0.2±0.3; P=0.414) or in mBI (straight implants: 0.3±0.4 vs. tapered implants: 0.2±0.3; P=0.317) at 5 years after prosthesis delivery. Conclusions: Straight and tapered implants showed no significant differences with respect to marginal bone loss, mPI, and mBI for 5 years after loading.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.307-314
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• 2005

After dental implant are planted into their bony site among the various growth factors associated with bone formation. BMP is expressed in the bone surrounding the implant fixture. By taking a close look at BMP2, BMP4 which are growth factors that take put in bone formation, its histologic features and radiographic bone healing patterns we would like to examine the mechanism of osseointegration. We randomly used 8 male and female house rabbit amd used diameter 5 mm height spiral shaped implants(Ostem, Korea) for animal use handled as a resorbable blast machined(RBM) surface and machined surface. 2group were formed and each group had RBM surface and machined surface implant or a simple bone cavity. After 3, 7, 14 and 28 days post surgery 2 objects were sacrificed from each group and histologic specimens were acquired. RT-PCR analysis was conducted and after H&E staining the extent of osseointegration was measured applying a histologic feature and histomorphometric analysis program. Quanitity one -4.41(Bio-Rad, USA) was used after scanning the PCR product image of the growth factors manifested in each group. According to the histomorphometric features the RBM, Machined surface group showed increased contact between bone and implant surface at 3, 7, 14 and 28 days after surgery. The BMP2 level increased in both experiment groups but remained unchanged in the contrast group. BMP4 levels stayed steady after the early post implantation period for RBM but showed decreased in the machined surface group and contrast group. The amount of contact between bone and implant surface increased with the passage of time. BMP2, BMP4 were expressed in both experimental group and contrast group. These growth factors play a role in osseointegration of implant.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.3
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• pp.186-199
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• 2012

Purpose: Single implants, of which screw loosening has been observed frequently, presents problems such as fixtures fractures, marginal bone loss, and inflammation of the soft tissue around the implant. However, the single implant is more conservative, cost effective, and predictable compared to the 3 unit bridge with respect to the long-term outcome. This study evaluated the survival rate as well as future methods aimed at increasing the survival rate in single implants in posterior teeth. Methods: Among the implants placed in the Dankook University Dental Hospital department of Oral & Maxillofacial surgery from January 2001 to June 2008, 599 implants placed in the maxillar and mandibular posterior were evaluated retrospectively. Survival rates were investigated according to implant location, cause of tooth loss, gender, age, general disease, fixture diameter and length, surface texture, implant type and shape, presence of bone graft, surgery stage, surgeons, bone quality and opposite teeth. Results: Out of 599 single implants in posterior teeth, 580 implants survived and the survival rate was 96.8%. The difference in survival rate was statistically significant according to the implant location. The survival rate was low (84.2%) in implants exhibiting a wide diameter (${\geq}5.1mm$) and the surface treated by the acid etching group demonstrated a significantly lower survival rate (91.1%). One stage surgical procedure, which implemented a relatively better bone quality survival rate (100%), was higher than the two stage surgical procedure (96.1%). The survival rate of type IV bone quality (75%) was significantly lower than the other bone quality. Conclusion: Single posterior teeth implant treatments should use an improved surface finishing fixture as well as careful and safe procedures when performing implant surgery in the maxilla premolar and molar regions since bone quality is poor.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.3
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• pp.273-281
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• 2001

Digital subtraction radiography may be one of the most precise and noninvasive methods for assessing subtle density changes in peri-implant bone, providing additional diagnostic information on implant tissue integration in overall maintenance. The aims of this study were to evaluate density changes after first, second surgery of dental implant and to measure the amount of marginal bone loss 9 months after second surgery using digital subtraction radiography. Bone change around 30 screw-shaped implants in 16 patients were assessed on radiographs. 17 Branemark implants of 3.75mm in diameter(Nobel Biocare, Goteborg, Sweden), 2 Branemark implants of 5.0mm in diameter, 11 $Replace^{TM}$ implants of 4.3mm in diameter(Nobel Biocare, Goteborg, Sweden) were used. To standardize the projection geometry of serial radiographs of implants, customized bite block was fabricated using XCP film holder(Rinn Corporation, Elgin, IL.) with polyether impression material of Impregum(ESPE, Germany) and direct digital image was obtained. Qualitative and quantitative changes on radiographs were measured with Emago software(The Oral Diagnostic System, Amsterdam, Netherlands). The results were as follows: 1. The peri-implant bone density of 69.2% implants did not change and the peri-implant bone density of 30.8% implants decreased after 3 months following first surgery. 2. The crestal bone density of 53.9% implants decreased first 3 months after second surgery. The crestal bone density of 58.8% implants increased 9 months after second surgery. No density change was observed around the midportion of the implants after second surgery, 3. The amount of marginal bone loss between different kinds of implants showed no statistically significant differences (p>0.05). 4. More than 90% of total marginal bone loss recorded in a 9-month period occurred during the first 3 months.