• 대한구순구개열학회지
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• 제6권2호
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• pp.131-135
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• 2003

Severe maxilla1y deficiency can be caused by cleft lip and palate(CLP), other craniofacial deformities, atrophy in the edentulous maxilla, and trauma. Patients with maxillary deficiency present a difficult treatment challenge. Traditionally, this skeletal deformity has been treated by Le Fort osteotomy, skeletal repositioning, and fixation with mini-plates and screws. The drawbacks of this method include a limited amount of anterior maxillary advancement often requiring simultaneous mandibular setback, the inability to create new bone, and minimal soft tissue adaptation to the new position, all of which increase the potential of relapse in case of large advancement. The alternative method of maxillary distraction osteogenesis offers promising results for successfully treatment of these patients while potentially minimizing the risk of relapse.

• Journal of Periodontal and Implant Science
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• 제44권5호
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• pp.259-264
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• 2014

Purpose: The aim of this case report is to present the longitudinal results of sinus grafting using a new demineralized bovine bone material (DBBM) in human cases. Methods: A patient with a resorbed maxilla was treated by maxillary sinus grafting using a new deproteinized bovine bone material. After a healing period of 6.5 months, three implants were placed and restored. The patient was periodically recalled and followed up for 5 years after restoration. Results: Twelve partially edentulous patients (average age, 55.7 years) were followed up. All patients had insufficient residual height in their maxillary posterior area and underwent maxillary sinus graft surgery to increase the height of their maxilla. In all, 27 fixtures were placed in the augmented bone area. On average, 8.6 months later, implants were loaded using provisional or final restorations. The observation period ranged from 27 to 75 months (average, 43.3 months), and the patients did not show any severe resorption of the graft material or any infection during this time. Conclusions: Our results show that the new DBBM is useful for a maxillary sinus graft procedure. Good healing responses as well as reliable results were obtained for an average follow-up period of 43.3 months.

• 대한치과보철학회지
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• 제52권4호
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• pp.346-351
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• 2014

흡착 의치는 의치상연 주위 전체를 가동 점막으로 봉쇄하여 연하나 교합 시 의치상 내면에 일시적으로 음압을 형성하여 의치의 유지와 안정을 강화한다. 본 증례의 환자는 81세의 남자 환자로 새로운 의치를 제작하고 싶다는 주소로 내원하였다. 의치의 유지와 저작 효율에 대한 환자의 높은 요구도를 고려하여 흡착 의치를 통한 총의치 제작을 계획하였다. 하악 후구치 융기 부위를 가압하지 않은 채로 예비 인상을 채득 후 상하악 진단모형을 제작하였다. 이후 개인 트레이 제작 후 최종 인상 채득과 동시에 고딕 아치 기록을 시행하여 중심위 및 수직 고경을 채득하였으며, 상악에는 해부학적 치아, 하악에는 비해부학적 치아를 배열하여 설측 교합을 형성하였다. 이상과 같이 완전 무치악 환자에서 하악 흡착 의치를 통한 총의치 수복은 만족스러운 유지와 기능을 회복할 수 있었기에 본 증례를 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.27-31
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• 2010

Purpose of study: The purpose of this study was to provide adequate diagnostic guideline for the maxillary sinuses prior to dental implant treatment for edentulous posterior maxillary areas. For this purpose, our procedure involves the estimation of the remaining alveolar bone height, the examination of the anatomical variation in the maxillary sinuses (e.g. sinus septum), and the evaluation of the incidence of preoperative pathological conditions in the maxillary sinuses. Materials and Methods: We selected 189 patients to undergo computerized tomography (CT) in order to account for the posterior maxillary anatomy found in patients of Korean ethnicity. We evaluated the following using Dentascan software: Remaining alveolar bone height, incidence of sinus septum, and rate of preoperative pathologic conditions in the maxillary sinus. The average amount of remaining alveolar bone height was analyzed using the student's t-test for differences according to anatomical site, and the ANOVA was used for the differences according to age group with the level of significance set at 0.05. Results: Alveolar bone heights of upper first premolar, second premolar, first molar, and second molar was 12.24 mm, 10.37 mm, 7.16 mm, and 7.15 mm, respectively with statistical significance (P < 0.05). Incidence of sinus septum as an anatomic variation was 17 out of 189 cases (9.0%). Incidence of mucosal thickening as a pathologic variation was 82 out of 189 cases (43.4%). Conclusion: In treatment planning of posterior maxillary edentulous area of Koreans, the consideration of augmentation surgery for maxillary sinus is required in maxillary molar area before dental implant installation, and preoperative screening of the asymptomatic maxillary sinuses can be regarded as a reasonable preoperative procedure in the planning of dental implant treatment on the posterior maxillary edentulous area.

• The Journal of Advanced Prosthodontics
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• 제1권3호
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• pp.136-139
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• 2009

STATEMENT OF PROBLEM. Many dental clinicians are concerned about immediate loading of inserted implants. However, there have been few clinical studies surveying the success rates of immediate loading, based on Korean implant systems. PURPOSE. The aim of this study was to evaluate the outcome of immediate functional loading of the implant ($SinusQuick^{TM}$EB, Neobiotech Co., Seoul, Korea) in partially edentulous maxilla or mandible. MATERIAL AND METHODS. Total 15 implants were placed. Within 2 weeks after implant insertion, provisional implant-supported fixed partial dentures were delivered to the patients. Quantitatively, marginal bone loss was measured at the time of immediate loading, after 3-months of continued loading and at the last follow-up. The mean follow-up period was 4.8 months. RESULTS. Mean marginal bone loss from implant surgery to early loading, 3-months follow-up and last follow-up was $0.03\pm0.07$ mm, $0.16\pm0.17$ mm and $0.29\pm0.19$ mm. No implant failed up to 6 months after insertion, resulting in a 100% survival rate. CONCLUSION. Immediate loading exhibited high success rate in partial edentulism for up to 6 months. Well-controlled long term clinical studies with large sample size are necessary to confirm this finding.

• 대한치과보철학회지
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• 제60권4호
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• pp.339-346
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• 2022

전통적인 총의치와 비교했을 때 하악 임플란트 피개의치는 2개의 임플란트로도 좋은 지지와 유지를 얻을 수 있다는 장점이 있다. 2개의 임플란트를 이용하여 하악 임플란트 피개의치를 제작할 때는 정확한 위치에 임플란트를 식립하는 것이 중요하다. 2개의 임플란트를 교합평면에 수직 방향으로, 견치 자리에 서로 평행하게 식립해야 피개의치의 장기적인 예후에 좋다. 하지만 무치악 환자에서 2개의 임플란트를 올바른 위치에 식립하는 것은 어려운 일이며, 이 때 서지컬 가이드를 이용한다면 보철적으로 유리한 위치에 임플란트를 식립하는데 도움을 받을 수 있다. 본 증례는 57세 남환으로 치주질환으로 인해 상, 하악의 모든 치아가 발거된 상태로 본원에 내원했다. 이에 상악은 전통적인 총의치, 하악은 2개의 임플란트를 이용한 임플란트 피개의치로 수복하여 기능 및 심미적으로 만족스러운 결과를 얻었으므로 이를 보고하고자 한다.

• 대한치과보철학회지
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• 제60권4호
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• pp.347-353
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• 2022

상악 완전 무치악과 하악 양측 후방 무치악 상태의 환자에서 전통적인 의치를 제작하는 방법은 흔히 볼수 있는 치료 방법이다. 그러나 장기적으로 볼 때 이와 같은 구강내 환경에서는 복합증후군(Combination syndrome)이라는 합병증이 발생할 수 있다. 이때 임플란트를 동반한 국소의치(Implant Assisted Removable Partial Denture, IARPD)의 적용으로 치조골 보존과 함께 Combination syndrome의 예방을 도모할 수 있다. 본 증례에서는 무치악 부위에 임플란트의 추가 식립 시 국소의치의 움직임에 의해 최후방 지대치에 가해지는 응력을 줄일 수 있으므로 금속이 아닌 레진 클라스프를 계획하였고 flexible 의치 레진을 사용하였다. 상악 총의치, 하악 flexible IARPD를 계획하여 최소한의 비용과 수술로서 심미적, 기능적인 장기적 예후를 얻어 보고하고자 한다.

• The Journal of Advanced Prosthodontics
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• 제16권4호
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• pp.201-211
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• 2024

PURPOSE. The aim of this prospective clinical study was to compare the influence of palatal vault forms on accuracy and speed of intraoral (IO) scans in completely edentulous cases. MATERIALS AND METHODS. Based on the palatal vault form, participants were divided into three equal groups (n = 10 each); Class I: moderate; Class II: deep; Class III: flat palatal vault. A reference model was created for each patient using polyvinylsiloxane impression material. The poured models were digitized using an extraoral scanner. The resultant data were imported as a solid CAD file into 3D analysis software (GOM Inspect 2018; Gom GmbH, Braunschweig, Germany) and aligned using the software's coordinate system to determine its X, Y, and Z axes. Five digital impressions (DIs) of maxilla were captured for each patient using an intraoral scanner (TRIOS; 3Shape A/S, Copenhagen, Denmark) and the resultant Standard Tessellation Language (STL) scan files served as test models. Trueness was evaluated by calculating arithmetic mean deviation (AMD) of the vault area between reference and test files while precision was evaluated by calculating AMD between captured scans to measure repeatability of scan acquisition. The scan time taken for each participant was also recorded. RESULTS. There was no significant difference in trueness and precision among the groups (P = .806 and .950, respectively). Average scan time for Class I and III palatal vaults was 1 min 13 seconds and 1 min 37 seconds, respectively, while class II deep palatal vaults showed the highest scan time of 5 mins. CONCLUSION. Palatal vault form in edentulous cases has an influence on scan time. However, it does not have a substantial impact on the accuracy of the acquired scans.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권6호
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• pp.644-651
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• 2000

In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre- and postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.381-389
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• 2013

Two patients with partial edentulous maxilla were scheduled to undergo installation of implant fixtures using a tooth-supported surgical template based on computer assisted treatment planning. After 3-dimensional (3D) computed tomographic scanning was transferred to the OnDemand3D (Cybermed Co., Seoul, Korea) software program for virtual planning, fixtures of MK III Groovy RP implant of the Br${\aa}$nemark System (Nobel Biocare AB Co., G$\ddot{o}$teborg, Sweden) was installed using the In2Guide (CyberMed Co., Seoul, Korea) tooth-supported surgical template with a Quick Guide Kit (Osstem Implant Co., Seoul, Korea) system in the posterior maxilla of each patient. Sinus floor elevation with a xenogenic bone graft procedure was also performed simultaneously in one patient. Fixture installations were completed successfully without complications, such as sinus mucosa perforation, bony bleedings, fenestrations, or others. During the last two-year follow-up period after prosthetics delivery, each implant was found to be fine with no other minor complications. The entire procedures are reported and the literatures on use of tooth-supported surgical template was reviewed.