• The Journal of the Korean dental association
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• v.50 no.3
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• pp.126-139
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• 2012

Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.484-487
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• 2010

Cemento-ossifying fibroma is a true osteogenic neoplasm. It is also called as ossifying fibroma or cementify-ing fibroma. Small lesions seldom cause any symptoms and are detected only on radiographic examination. Large lesions result in a painless swelling of the involved bone. In radiographic features the lesion most often is well defined and unilocular. It may appear completely radiolucent, or more often varying degrees of rdiopacity. It is composed of fibrous tissue that contains a variable mixture of bony trabeculae,cementum-like spherules, or both. Treatment of most lesions generally is enucleation of tumor. However, some lesions which have grown large and destroyed considerable bone, may necessitate surgical resection and bone grafting. This case was the bony lesion that was found by accident in patient with mandibular left body and subcondylar fracture. In radiographic examination, there was a mixed radiolucent and radiopaque lesion in mandibular left body area with fracture line. We treated on mandibular left body and subcondylar fracture and enucleated the lesion on the left body area simultaneously. At surgical exploration, the lesion was well demarcated from the surrounding bone, thus permitting relatively easy separation of the tumor from its bony bed. In histopathologic examination, the lesion contained bony trabeculae and cementum-like spherules within a background of cellular fibrous connective tissue. It finally diagnosed as cemento-ossify-ing fibroma from the result of biopsy.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.669-678
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• 2008

Purpose: The purpose of this study was to evaluate 2 years cumulative survival rate of implants on augmented sinus area using MBCP, mixture of MBCP and ICB, and mixture of MBCP and autogenous bone by means of clinical and radiologic methods. Materials and Methods: In a total of 37 patients, 41 maxillary sinuses were augmented and 89 implant fixtures were installed simultaneously or after a regular healing period. The patients were divided in 3 groups: MBCP only, MBCP combined with ICB, MBCP combined with autogenous bone. After delivery of prosthesis, along 2 years of observation period, all implants were evaluated clinically and radiologically. And the results were as follows. Results: The results of this study were as follows. 1. A 2 year cumulative survival rate of implants placed with sinus augmentation procedure using MBCP was 97.75%. 2. Survival rate of implants using MBCP only was 97.62%, MBCP and ICB was 100%, MBCP and autogenous bone was 95%. There was no statistically significant difference between 3 groups. 3. Only 2 of 89 implants were lost before delivery of prosthesis, so it can be regarded as an early failure. And both were successfully restored by wider implants. Conclusion: It can be suggested that MBCP may have predictable result when used as a grafting material of sinus floor augmentation whether combined with other graft(ICB, autogenous bone) or not. And the diameter, length, location of implants did not have a significant effect on 2 year cumulative survival rate.

• Journal of Periodontal and Implant Science
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• v.48 no.3
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• pp.174-181
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• 2018

Purpose: The aims of the present study were to quantitatively assess graft height changes after sinus lift procedures and to analyze the factors that influenced graft height changes, including the residual bone height before surgery, surgical approach, and tooth type. Methods: A total of 39 maxillary posterior implants placed during a simultaneous sinus lift procedure were evaluated. Panoramic radiographs of all patients were taken immediately after implant installation and at 3 months, 6 months, 1 year, 2 years, and 3 years. To analyze graft height changes over time, we measured the distance between the implant platform and the base of the grafted sinus floor at 3 locations. The radiographs were analyzed by a single examiner. Results: Graft height tended to decrease over time, and a statistically significant difference was observed at 2 years compared to baseline (P<0.05). There was no statistically significant difference in graft height change according to the surgical approach or tooth type. For residual bone height, a statistically significant difference in graft height change was found between those with 4-7 mm of residual bone height and those with ${\geq}7mm$ (P<0.05). Conclusions: Graft height after sinus lift procedures significantly decreased at 2 years compared to baseline after sinus augmentation. Further studies should be done with controlled variables, and prospective studies with 3-dimensional images are needed to clarify the factors that influence graft height changes.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.259-264
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• 2014

Retrograde peri-implantitis (RPI) is defined as a clinically symptomatic periapical lesion. RPI is generally accompanied by symptoms of pain, tenderness, swelling and fistula. Several etiologic factors of RPI were possible, residual bacteria would be the main cause of RPI. Various treatment modalities have been introduced: debridement only or a combination of debridement with the grafting material accompanied by a detoxification of the infected implant surfaces, apicoectomy and so on. Although the definitive management methods remain undefined, many favorable clinical results of a treatment of RPI have been published. This case report introduces the 7-year long-term clinical result of the application the principle: implant surface detoxification using saline and chlorhexidine and guided bone regeneration with bone graft material and barrier membrane. If the implant was not mobile, it would be possible to treat RPI according to surgical approach and good results will be maintained over long term.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.314-318
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• 2011

Purpose: The purpose of this study is to evaluate the results of alveolar bone grafting in patients with various types of cleft lip and to compare the success rates according to the lateral incisors and canines. Methods: The postoperative radiographs of 20 patient with a cleft lip and alveolar process alone (CLAP), complete unilateral cleft lip and palate (UCLP) and complete bilateral cleft lip and palate (BCLP) were retrospectively analyzed. The alveolar bone height was classified according to ${\AA}$byholm (1981) and Bergland (1986) and we evaluated the dentition at the time of surgery and the existence of a lateral incisor and impacted canines. Results: 16 (80%) of the 20 patients were assigned to Type I & II and they were considered successful. In the UCLP group, the success rate was significantly better than that of the UCLP and BCLP groups. The success rate was significantly better than when the cleft was grafted with the existence of a lateral incisor and before the eruption of the canines. Conclusion: The severity of the deformity influenced the success rate. The timing of the operation was a critical variable that affected the outcome in patients with cleft lip and palate.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.276-292
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• 1996

The purpose of this study was to evaluate whether removal of gingival epithelium with pulsed Nd :YAG laser could inhibit the downgrowth of junctional epithelium after alloplastic material grafting in periodontal bone defect. The periodontal bone defects were created surgically on the palatal aspect of the upper right and left molar teeth in 30 rats and filled with resorbable calcium carbonate($Biocoral\;450^{(R)}$: Inoteb, France). The control sites(right molar area) was sutured. The test side (left molar area) received controlled deepithelization of the oral and sulcular epithelium with pulsed Nd:YAG laser($Sunrise\;Maste^{(R)}$: Sunrise Technologies, U.S.A.) under the mode of 1.75W, 15Hz, 116mJ/pulse and was sutured. The control and test sites were evaluated clinically and histologically, at 1, 3, 7, 14, and 28 days postoperation. Clinically, the gingiva showed normal color and shape at the 5th day in the control site and at the 10th day in the test sites. Histologically, the junctional epithelium was formed at the 7th day in the control sites and at the 14th day in the test sites, and the long JE attachment were observed at the 28th day in both sites. The attachment of connective tissue to root surface was observed initially at the 7th day in the control sites and at the 14th day in the test sites, and completed at the 28th day in both sites. In summary, these results showed that the removal of oral epithelium using pulsed Nd:YAG Laser could not prevent epithelial downgrowth after alloplastic material implantation in rat periodontal bone defect.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.217-226
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• 2020

Purpose: The purpose of this study was to analyze the quantity and quality of the mandibular anterior alveolar bone in terms of alveolar width, density, and total alveolar height (TAH) based on dental status, gender, and age. Additionally, this study aimed to quantitatively evaluate the available alveolar height for graft harvesting (AHGH) and examine its variability based on the aforementioned factors. Materials and Methods: This retrospective cone-beam computed tomographic study included a total of 100 subjects. On the basis of gender, dental status, and age, the scans were divided into 3 primary groups and 8 subgroups. The mandibular alveolar width and density were measured 5 mm mesial to the mental foramen bilaterally and at the midline. The TAH was measured at the midline, and the AHGH was measured as the midline distance between 5 mm apical to the root of the canines and 5 mm superior to the lower border. Results: The mandibular alveolar width was statistically similar between dentulous and edentulous patients (P>0.05). A significantly greater density was observed at the midline in edentulous patients (P<0.05). The TAH was significantly greater in edentulous male patients than in edentulous female patients (P<0.05). Dentulous and male patients had significantly greater AHGH than edentulous and female patients, respectively (P<0.05). Conclusion: Based on the data evaluated in this study, it can be concluded that the mandibular symphyseal area has adequate bone quality and quantity for bone graft harvesting for dental implant therapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.3
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• pp.252-264
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• 1991

The purpose of this study was to compare the response of adjacent tissue and new bone formation after implantation by different methods of subperiosteal using using Proplast I and II in rabbit mandible. Microstructure of Proplast I and II was observed by scanning electron microscope. And the implantation procedure was carried out by dividing into tow groups, A and B. a group consisted of subperiosteal graft on the cortex, and the other B group was made up onlay graft following artificial decortication in the madibular body of rabbit. The experimental animals were sacrificed on the 1st, 2nd, 4th and 8th week after grafting for macroscopic and histopathologic examination. The samples extracted at the 6th postgrafting week were also used for biometric test. The result ere as follows : 1. By scanning electron microscopic observation, pore size was $50{\sim}180{\mu}m$ in the Proplast I and $100{\sim}220{\mu}m$ in Proplast II. 2. Macroscopically, infection of the graft site, deformation and displacement of the implanted materials were not observed in all experimental groups. 3. In the tissue response, infiltration of inflammatory cells and multinucleated giant cells were observed from the 2nd to the 8th week in Proplast I. Inflammatory cells decreased in number from the 2nd week in Proplast II suggesting that Proplast II is better than Proplast I. 4. Bone formation was not observed until the 8th week in the group A, but new bone formation from the surrounding graft bed and the periostium was appeared from the 4th week in the group B. 5. The maximum mean values of shear stress mere serially $65.5gf/mm^2$ in Proplast II of group B, $32.9gf/mm^2$ in Proplast I of group B, $17.0gf/mm^2$ in Proplast II of group A, and $15.7gf/mm^2$ in Proplast I. of group A.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.468-474
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• 2008

Purpose: Previous clinical investigations of sinus floor augmentation have demonstrated repneumatization of grafted sinus. The aim of this study is to evaluate and compare the height changes of sinus floor after grafting with deprotenized bovine bone mineral (DBBM) and beta tricalcium phosphate (TCP). Materials and methods: 34 sinuses in 28 patients were augmented with 100% DBBM or 100% TCP through lateral approaches. Sinusgraft height was measured before, immediately after, and 6 months after bone graft with panoramic radiography. Result: After 6 months, the decreases of graft heights were 14.53% for DBBM group and 15.15% for TCP group. There was no statistically significant difference. Discussion and Conclusion: Long-term stability of sinus-graft height represents an important factor for implant success. After the uses of DBBM and TCP for maxillary sinus floor augmentations, acceptable graft height maintenances were observed.