• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.325-329
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• 2009

Objective : This is to report the effectiveness of intraoral distraction osteogenesis, iliac bone graft for alveolar augmentation in the extremely atrophied alveolar defects after infected allobone grafted area. Subjects and Methods : Anterior segmental osteotomy was performed and the trans-oral alveolar distractors (Martin, Germany) were applied in patient with the severe acquired anterior mandibular and mandibular defect after ameloblastoma enucleation. Iliac bone grafts were performed in defect sites and distraction osteogenesis were treated. After latent period for 1 week, the osteomized alveolar segments were distracted by 0.75 mm a day (0.25 mm/1 turn) for 10 days The consolidation period was about 12 weeks. Thereafter, 2 titanium threaded implants were simultaneously installed with removal of distractor. For oral rehabilitiation, The implants were installed in maxilla, mandible. It was tested with clinically and radiographically. Results : Amounts of acquired alveolar bone were 10 mm with the increased width of the ridge crests and soft tissue expansion. Dental implants installated on the augmented alveolar ridges in 12 weeks after distraction were confirmed as in good osseointegration and in good function without any complications. Conclusion : Intraoral distraction osteogenesis can be a good option for alveolar ridge augmentation of the severely atrophied ridges and soft-tissue defects.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.277-290
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• 2012

Dental implants are universal restorative method on edentulous site in oral cavity and generally recognized by patients as well as clinicians. Rapid bone resorption of labial portion of maxillary anterior area is performed due to dental trauma, chronic periodontitis, and so on. Accordingly, Implants on maxillary anterior alveolar ridge with narrow labiopalatal width would lead to bony defects of dehiscence or fenestration. In this case, guided bone regeneration procedure is used to augment maxillary anterior alveolar ridge. It can have mechanical and biological advantages to mix tissue adhesive with bone graft materials in guided bone regeneration procedure. In these cases, when the dehiscence or fenestration defects was occurred by dental implants on maxillary anterior alveolar ridge with narrow labiopalatal width, guided bone regeneration procedures were performed with various combination of particle bone graft materials(allograft, xenograft, and alloplast) mixed with fibrin glue, excepting autogerous bone. We reported that all of 4 cases showed favorable alveolar ridge augmentations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.1
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• pp.20-30
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• 2016

Objectives: To validate a critical-size mandibular bone defect model in miniature pigs. Materials and Methods: Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks. Results: In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the autograft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect. Conclusion: The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.

• Journal of Periodontal and Implant Science
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• v.49 no.4
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• pp.258-267
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• 2019

Purpose: Increased bone regeneration has been achieved through the use of stem cells in combination with graft material. However, the survival of transplanted stem cells remains a major concern. The purpose of this study was to evaluate the viability of transplanted mesenchymal stem cells (MSCs) at an early time point (24 hours) based on the type and form of the scaffold used, including type I collagen membrane and synthetic bone. Methods: The stem cells were obtained from the periosteum of the otherwise healthy dental patients. Four symmetrical circular defects measuring 6 mm in diameter were made in New Zealand white rabbits using a trephine drill. The defects were grafted with 1) synthetic bone (${\beta}$-tricalcium phosphate/hydroxyapatite [${\beta}-TCP/HA$]) and $1{\times}10^5MSCs$, 2) collagen membrane and $1{\times}10^5MSCs$, 3) ${\beta}-TCP/HA+collagen$ membrane and $1{\times}10^5MSCs$, or 4) ${\beta}-TCP/HA$, a chipped collagen membrane and $1{\times}10^5MSCs$. Cellular viability and the cell migration rate were analyzed. Results: Cells were easily separated from the collagen membrane, but not from synthetic bone. The number of stem cells attached to synthetic bone in groups 1, 3, and 4 seemed to be similar. Cellular viability in group 2 was significantly higher than in the other groups (P<0.05). The cell migration rate was highest in group 2, but this difference was not statistically significant (P>0.05). Conclusions: This study showed that stem cells can be applied when a membrane is used as a scaffold under no or minimal pressure. When space maintenance is needed, stem cells can be loaded onto synthetic bone with a chipped membrane to enhance the survival rate.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.141-144
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• 2010

Sialolithiasis is the common pathology of salivary gland. The size of sialoliths vary from 1 mm to a few cm, but most of that are less than 10 mm. Large sialoliths (larger than 15 mm) are extremely rare. It is called Giant sialolithiasis or megalith. Symptom of the giant sialolithiasis is similar to that of regular sialolithiasis. First choice of treatment is removal of the stone. Many literatures reported various methods to remove the sialoliths. For this case report, we accidentally found the giant sialolith on the computed tomography taken for dental implant, and successfully removed the stone by minimal invasive surgical approach. Base on this result, we report this case with literature reviews.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.279-283
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• 1998

The osteoporosis is a disease that represents a reduction in the volume of bony tissue relative to whole bone volume. And mandible also may be affected. Such porotic mandible may influence the result of the surgery like dental implant surgery relating mandible. So, the author examed the panoramic view of 89 persons for finding the possibility of useful diagnostic parameters of osteoporosis. To know the correlationship between the condition of vertebra and mandible, bone marrow density of lumbar spine from 2nd to 4th, and the number of residual tooth, panoramic mandibular index (PMI), angular cortical bone thickness (ACT) and ramus cortical bone thickness (RCT) were compared. The result is that PMI and ACT have similar relative weak linear correlationship, RCT have very weak linear correlationship, the number of residual tooth have not linear correlationship.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.367-371
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• 2009

Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 5-year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Materials and methods: One hundred and thirteen cases of 96 patients who visited our center from Aug 2004 to July 2009 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent augmentation sinus surgery with outfracture osteotomy technique. Feasibility of the outfracture osteotomy technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery of this new kind. Total fixture number available in follow-up period was 179, in which the lost 10 patients were excluded out of 96 patients. Results: Five-year cumulative survival rate was 97.2% with 5 failures of total 179 fixtures. The average follow-up period was 29 and a half months, with the minimum and maximum follow-up periods of 4 months 21 days and 59 months 14 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate of 97.2% (174 out of 179 fixtures), which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.

• Journal of Periodontal and Implant Science
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• v.51 no.4
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• pp.239-253
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• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.13-20
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• 2022

The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.323-335
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• 2000

The purpose of this study was to examine the frequency of dehiscence bone defect on peri-implant and to compare the difference between resorbable membrane and nonresorbable membrane in bone regeneration on peri-implant. Amomg the patients, 22 patientswho have recieved an implant surgery at the department of Periodontics in Dankook University Dental Hospital showed implant exposure due to the dehiscence defect and 27 implants of these 22 patients were the target of the treatment. $Gore-Tex^{(R)}$ and $Bio-mesh^{(R)}$ were applied to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 27 cases, 2 membrane exposures were observed and in these two cases, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively.(P<0.05) 4. In resorbable membrane, bone surface area was $14.80{\pm}8.25$ preoperatively and meaningfully widened to $17.61{\pm}10.67$ postoperatively.(P<0.05) 5 . The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$ and the increase of bone surface area in resorbable membrane was $2.80{\pm}3.00$ ;therefore, there was no significant difference between these two membranes(P<0.05). This study implies that the surgical method using DFDB and membrane on peri-implant bone defect is effective in bone regeneration regardless the kind of the membrane, and a similar result was shown when a resorbable membrane was used.