• Archives of Plastic Surgery
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• v.43 no.2
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• pp.197-203
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• 2016

Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.306-318
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• 2008

Anodic spark deposition method(ASD) surface treated titanium implant possesses a considerable osteoconductive potential that promoting a high level of implant osseointegration in normal bone. The purpose of this study was to observe the ASD implant's osseointegration in the osteoporosis-induced animal model. Twenty four rats, 10 weeks of age, were ovarectomized and 5 weeks later divided into two groups : ASD implant group and control implant group. Titanium screw implants (diameter; 2.0 mm, length, 3.5 mm; pitch-height, 0.4 mm) were designed for this study. Experimental implants were ASD treated and no treatment on control implants. ASD implants and control implants were placed in to left tibiae of rats. The rats were sacrificed at different time interval(1, 2, 4 and 8 weeks after implantation) for histopathologic observation and immunohisto-chemistrical observation, with collagen type Ⅰ, fibronectin, integrin ${\alpha}_2{\beta}_1$ and integrin ${\alpha}_5{\beta}_1$ antibodies. The results obtained from this study were as follow: 1. Histopathologic findings, overall tissue response and the pattern of bone formation in both groups were similar. In ASD group, more newly formed bone was seen at 1 week and 2weeks than control group. 2. The levels of type Ⅰ collagen and fibronectin expression were the most abundant at 2weeks and decreased gradually in both groups. Fibronectin and type Ⅰ collagen expression in ASD group were stronger than control group but no significance. 3. The levels of integrin ${\alpha}_2{\beta}_1$ and Integrin ${\alpha}_5{\beta}_1$ expression were most abundant at 2 weeks and decreased gradually in both groups. No significant difference was observed in both groups. From this results, anodic oxidized titanium implants were more advantages in early stage of bone formation than control group, but have no significance in tissue responses and late bone formations. It could be stated that although anodic oxidized titanium implant possesses considerable osteoconductive potential but in osteoporotic bone condition dental implant procedure should performed after improving or treating the osteoporotic bone condition.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.3
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• pp.333-340
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• 2021

Although gag reflex is an essential function and a useful physiological defense mechanism, it can become an obstacle in a dental treatment. In this case, a questionnaire was designed and used in consultations to objectify the factors associated with gag reflex. Based on the questionnaire, various treatment protocols were planned, such as behavioral control, which is a systematic desensitization that adapts by placing dental instruments in the oral cavity, and habit control to eliminate vomiting habits after drinking. Except for the placement of the implant fixture under general anesthesia, all restoration procedures were performed in the outpatient clinic in the same manner as the conventional implant fixed prosthetic restoration. The systematic desensitization and behavior technique were repeated until the patient was able to endure discomfort and relieve gag reflex in dental treatment. The patient was successfully received the implant-fixed prosthetic restoration in the partial edentulous region.

• The korean journal of orthodontics
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• v.44 no.6
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• pp.342-349
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• 2014

Because of the potential morbidity and complications associated with surgical procedures, limiting the extent of orthognathic surgery is a desire for many orthodontic patients. An eighteen-year-old woman had a severe Class III malocclusion and required bi-maxillary surgery. By changing the patient's maxillary occlusal plane using orthodontic mini-implants, she was able to avoid the maxillary surgery; requiring only a mandibular setback surgery. To accurately predict the post-surgery outcome, we applied a new soft tissue prediction method. We were able to follow and report the long-term result of her combined orthodontic and orthognathic treatment. The changes to her occlusal plane continue to appear stable over 6 years later.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.302-309
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• 2002

In order to improve the success rate of implants, various implant designs have been developed. Although there have been enough efforts to handle the surface of the implant with careful choice of material and mechanics so that the bone and the implant can be tightly joined together, they have still failed to play the role of periodontal ligaments of the natural teeth in the past. The role of periodontal ligaments is very important since it can improve the initial stability of implant by absorbing the impacts. The purpose of this study is, thus, to test the possibility of alleviating the impact when the surface of the implant was coated with chitosan, a natural polymer, and making sure that the coated material stayed on. Then, the condition of newly developed bone formation and the degree of inflammation in response was closely observed in the surface level. In the main experiment, Chitosan coated implant ($3.3mm{\times}7mm$) was implanted on both the right and the left side of rabbit's femur. The animals were each sacrificed on the $1^{st}$, $2^{nd}$, $3^{rd}$, $7^{th}$, $14^{th}$, $21^{st}$ and 28th day. The process was observed under an light microscope after the Toluidin Blue staining. From the experiment, it was found that the chitosan was evenly distributed on the surface of the screws, and the implant was adjoined with adjacent bone. There was a sign of inflammation on the $3^{rd}$ day, but on the $14^{th}$ day, the formation of woven bone and newly formed bones were noticed. Also, chitosan filled the gap was formed between the implant and the newly formed bone. The implant, the chitosan and the newly formed bone were forming one unit as a result. Therefore, it was found that chitosan coated implant could absorbe the impact in the initial stage of implant.

• Journal of Korean society of Dental Hygiene
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• v.20 no.4
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• pp.469-478
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• 2020

Objectives: The aim of this study was to investigate the impact of oral hygiene education provided by dental hygienists in patients with dental implants. Methods: Data were obtained from a survey that involved 300 patients who had one or more dental implants. Based on the calculated sample size (n = 274), 300 questionnaires were used for further analyses. Results: The patients who received oral hygiene education had higher levels of satisfaction after dental implant surgery (p<0.05). Patients who had repeated educational sessions, in the form of interactive or hands-on sessions or lectures, with continuous feedback had higher scores for oral hygiene maintenance (p<0.05). Conclusions: This study indicated that patients who received oral hygiene education, in the form of interactive or hands-on sessions or lectures, with continuous post-educational feedback were better at maintaining oral hygiene.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.590-594
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• 2006

Dental implant has become one of the important option for completely or partially edentulous patients, But it is challenging to reconstruct the severely atrophic ridge. Insufficient bone volume could restrict to place the wide and long implant and because of excessive interocclusal clearance, improper prosthetics could be produced. In this case bone augmentation for implant dentistry is necessary procedure to improve the insufficient bone volume. Therefore, bone augmentation or GBR is the most important procedure for successful implant placement and for ideal crown- root ratio. There are various bone augmentation techniques have been introduced recently; like block bone graft, distraction osteogenesis, inlay graft, onlay graft, etc.... In severe bucco-lingual resorption area, ridge splitting is the first choice of the treatment, because it provides a place for implantation and also has compaction effect. This technique may be indicated for sharp mandible and maxillary ridges in patients whose bone quantity is inadequate for primary stabilization. We report that the clinical experience of bone augmentation using ridge splitting technique in bucco-lingual bone resorption area.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.229-235
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• 2010

Purpose: This study examined the significance of increased bone density according to time after implantation on maxilla using demographic data with CBCT and compared the bone density between before vs. after implantation using the Hounsfield index. Materials and Methods: Twenty-five implant site on maxilla were selected. Cone-beam computerized tomography (CBCT) scans were used for the analysis. The implant sites were evaluated digitally using the Hounsfield scale with EzImplant TM and the results were compared over time. Statistical data over time was carried out to determine the correlation between the recorded Hounsfield unit (HU) over time and gender difference using repeated ANOVA. Results: The bone density of implantation site over time showed an increase in the HU mean values. Immediately after implantation, bone density was significantly increased than bone density before implantation. Until 6 month follow-up, bone density showed stable increasement. There is no significant difference on gender. Conclusions: Using CBCT, bone density increased over time after implantation on maxilla. Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density and stability of implant.

• Journal of Periodontal and Implant Science
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• v.39 no.3
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• pp.339-348
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• 2009

Purpose: The purpose of the present study was to analyze the implant stability quotient(ISQ) values for Korean non-submerged type implant and determine the factors that affect implant stability. Methods: A total of 49 Korean non-submerged type implants were installed in 24 patients, and their stability was measured by resonance frequency analysis(RFA) at the time of surgery, and 1, 2, 3, 4, 8, 12 weeks postoperatively. The data for implant site, age, sex, implant length and diameter, graft performing, bone type, and insertion torque were analyzed. Results: The lowest mean stability measurement was at 3 weeks. There was significant difference between implant placement and 12 weeks. There was significant difference between implant placement and 12 weeks in diameters of 4.1 mm and 4.8 mm. Also, there were significant differences between diameters of 4.1 mm and 4.8 mm at implant placement and 12 weeks after surgery. This result suggests that the factor related to implant diameter may affect the level of implant stability. No statistically significant relationship was found between the resonance frequency analysis and the variables of maxilla/mandible, sex, anterior/posterior, implant length, age of patient, graft performing, bone type, insertion torque during initial healing period. Conclusions: These findings suggest that the factor related to implant diameter may affect the variance of implant stability, and ISQ value of implant was stable enough for proved stability level during initial healing period.

• The Journal of Advanced Prosthodontics
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• v.3 no.2
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• pp.96-100
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• 2011

An 18-year-old male presented severe hypodontia due to hypohidrotic ectodermal dysplasia was treated with Le Fort I maxillary osteotomy with simultaneous sinus floor augmentation using the mixture of cortical autogenous bone graft harvested from iliac crest and organic Bio-Oss to position the maxilla in a right occlusal plane with respect to the mandible, and to construct adequate bone volume at posterior maxilla allowing proper implant placement. Due to the poor bone quality at other sites, ridge augmentation with onlay graft was done to construct adequate bone volume allowing proper implant placement, using tissue harvested from the iliac bone. Seven implants were placed in the maxilla and 7 implants were inserted in the mandible and screw-retained metal ceramic FPDs were fabricated. The two year follow up data showed that dental implants should be considered as a good treatment modality for patients with ectodermal dysplasia.