• 대한치과의사협회지
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• 제48권3호
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• pp.205-217
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• 2010

Purpose The aim of this study is to evaluate the survival rates and analyze the stability of lateral approach and trans-crestal approach for maxillary sinus floor elevation of simultaneous implant placement. Materials and method 407 patients who have been treated in LivingWell dental hospital between 2003 to 2009 were selected. Lateral window technique, osteotome technique and sinus drill technique were used for sinus floor elevation procedure. A total of 714 implants-MP-1 HA coated implant(Tapered Screw $Vent^{TM}$, $Spline^{TM}$, Zimmer, USA), FBR surfaced implant(Pitt-$Easy^{TM}$, Oraltronics, Germany)-were placed in grafted maxillary sinus simultaneously. The autogenous bone or a combination with the allograft or alloplast was grafted into sinus. Sinus floor elevation was combined with vertical/horizontal onlay bone grafts to reconstruct the defect of alveolar ridge. Results The average preoperative height of the maxillary alveolar bone was 5.78mm(range: 0.4mm~12.5mm). 14 implants failed during the healing period(lateral approach: 4, trans-crestal approach: 10) and 3 implant failed after prosthetic loading(lateral approach: 2, trans-crestal approach: 1). The cumulative survival rate of implants after 6 years was 97.6%. Trans-crestal approach(97.4%) and lateral approach(97.9%) had similar survival rates. Conclusion The results indicate that the trans-crestal approach and lateral approach for maxillary sinus elevation is a acceptable method at atrophic maxillary posterior area.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.325-331
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• 1999

We tested the bone regenerating capacity and histologic response of bioresorbable matrix-type implant, which was made with Poly(lactide-co-glycolide)(PLGA) and bone apatite for the carrier of bone morphogenetic protein(BMP). The critical size defect of 8mm in diameter was created at the calvaria of SD rats(n=18), and repaired with polymer implant with $15{\mu}g$ of rhBMP-2(n=9) or without it(n=9). At 2 weeks, 1 months after implantation, the animals were sacrificed(3 animals at every interval and group) and histologically evaluated. The calvarial defect which was repaired with polymer with BMP healed with newly formed bone about 70% of total defect. But that without BMP showed only 0 to under 30% bony healing. Inflammatory response was absent in both group through the experimental period, but there's marked foreign body giant response though it was a little less significant in polymer with BMP group. As the polymer was resorbed, the space was infiltrated and replaced by fibrovascular tissue, not by bone. In conclusion, our formulation of bioresorbable matrix implant loaded with bone morphogenetic protein works good as a bone regenerating material. However, it is mandatory to devise our system to have better osteoinductive and osteoconductive property, and less multinucleated giant cell response.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.376-381
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• 1999

A variety of materials and procedures such as sinus floor elevation, sinus-lift graft, inlay bone graft using Le Fort I osteotomy, and onlay graft have been used to create adequate bone volume in the maxillary sinus for placement of endosseous implants in the posterior atrophic maxilla. Because of the frequent lack of bone in the posterior maxilla, sinus lift procedure has become a commonly practiced treatment modality. The 138 endosseous implants of 36 patients with sinus augmentation procedures performed in Korea University Hospital from January 1991 to December 1998 were summarized and analysed. The result of this study were as follows: 1. Age ranged from 39 to 57, with a mean of 50.7. 2. The mean survival rate for 138 implants with maxillary sinus lift procedure was 80.4%. 3. There was no corelationship between the fixture length, width and the survival rate. 4. The result showed that the healing period for 8-12 months was necessary if the residual alveolar bone height was less than 5mm. 5. Autogenous iliac corticocancellous block graft showed the most favorable survival rate(95%).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권1호
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• pp.42-49
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• 2007

Infections in oral and maxillofacial region are relativley common and self-limiting, but in some cases, infections spread to adjacent hard and soft tissue and to cause any complication, even threaten life. So we made retrospective study of patients with interfascial infection who had been hospitalized and been treated by surgical treatment in Dankook university about 10 years. We reviewed the charts of patient with interfascial infection from 1995 to 2005. The result were as follows: 1. In gender & age distribution, male(54.2%) & fouth decade were most frequently. 2. The most common cause of infection was dental caries(55.2%) and the most of involving teeth was lower posterior teeth(44.1%). 3. Submandibular space is most frequently involving space and most infection involved mainly one space. 4. The patients with systemic disease were 38.2%. Diabetic mellitus was 87.2% of systemic diease. The admission period was 19.5 days in systemic disease. 5. The most microorganism in culture was Streptococcus Viridans(36.2%) in all patient. Klebsiella Pneumoniae was found most in Diabetic Mellitus. 6. The patient were mainly treated I&D on admission day. Of them 5(1.1%) patients were received tracheostomy. 7. Serum albumin, CRP and body weight are associated with Nutritional Risk Index(NRI). High risk patient group according to NRI classification showed higher rate of complications & mortality. 8. The patients with complication were 28(6.7%) persons. 4(0.9%) patients were expired. Nutritional Risk Index was helpful to predict the prognosis. When interfascial infection starts to spread, we must pay attention to airway management. Fluid therapy with nutritional may support to healing of wound.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권3호
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• pp.217-220
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• 2010

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative lesion on oral mucosa featuring as a benign mass of self-limiting growth. It can be easily misdiagnosed as squamous cell carcinoma (SCC) due to its long healing period and elevated or rolled-up margin. A 57-year old male patient who visited our department was diagnosed as SCC according to the clinical features, results of positron emission tomography (PET) and magnetic resonance imaging (MRI) of the oral lesion. However, after performing incisional biopsy, histopathologically, there were no atypical cells, but eosinophil and CD 30+ T-cells were clustered in subcutaneous and muscle tissue. It is very significant to consider this reactive lesion in the field of oral and maxillofacial surgery because of its possibility of mistaken as malignant disease. Here, we will report a couple of cases of TUGSE with references and limit of radiographic tools used for diagnosis of head and neck cancer.

• The Journal of Advanced Prosthodontics
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• 제2권1호
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• pp.7-13
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• 2010

Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS. In vitro, the human platelets were activated with application of shear stress, $20\;{\mu}g/ml$ collagen, 2 mM $CaCl_2$ and 10U thrombin/$1\;{\times}\;10^9$ platelets. Level of vascular endothelial growth factor (VEGF) and platelet microparticle (PMP) in the activated platelets were checked. In the animal study, human angiogenic factors-enriched PRP was tested in 28 athymic rat's cranial critical bone defects with $\beta$-TCP. Angiogenesis and osteogenesis were evaluated by laser Doppler perfusion imaging, histology, dual energy X-ray densinometry, and micro-computed tomography. RESULTS. In vitro, this human angiogenic factors-enriched PRP resulted in better cellular proliferation and osteogenic differentiation. In vivo, increasing angiogenic potential of the PRP showed significantly higher blood perfusion around the defect and enhanced new bone formation around acellular bone graft material. CONCLUSION. Angiogenic factor-enriched PRP leads to faster and more extensive new bone formation in the critical size bone defect. The results implicate that rapid angiogenesis in the initial healing period by PRP could be supposed as a way to overcome short term effect of the rapid angiogenesis.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.681-690
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• 2007

Mini implants had been used provisionally for the healing period of implants in the beginning. But it becomes used for the on-going purpose, because it is simple to use, economic and especially suitable for the overdenture. But there is few studies about the stability of mini implants, that is most important factor for the on-going purpose, and particularly the implant parameters affecting the initial stability. The purpose of this study was to evaluate the stress and the strain distribution pattern of immediate-loaded screw type orthodontic mini-implant and the parameters affecting the initial stability of immediate-loaded mini-implant. Two dimensional finite element models were made and contact non-linear finite element analysis was performed. The magnitude and distribution of Von Mises stresses were evaluated. The obtained results were as follows: 1. The stress was concentrated on the thread tip of an implant in the cortical bone. 2. The direction of load is the most important factor for the stress distribution in cortical bone. 3. The diameter of an implant is the most important factor for the stress distribution in the trabecular bone. In conclusion, if the horizontal load vector is successfully controlled, mini-implants, which diameter is under 3mm, can be used for the on-going purpose.

• Korean Journal of Acupuncture
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• 제27권3호
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• pp.47-56
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• 2010

Objectives : The moxibustion is the method using the heat stimulation done by attached and burned a moxa on a healing point or acupuncture point with chemical stimulation of a resin made from burning them. The purpose of this study is to find the physical and thermal characteristics of moxibustion in order to standardize the moxa therapy method. Methods : In this study, the thermal changes were observed by means of a testo 845 device, which is an infra-red thermometer to measure the thermal changes. Results & Conclusions : 1. The thermal changes on the external surface of moxibustion did not depend on the weight of the moxa; the external surface temperature was about $500^{\circ}C$. 2. The central thermal changes depend on the weight of moxa; the central temperatures ranged from $500^{\circ}C$ to $700^{\circ}C$. 3. The burning duration of moxibustion depend on the weight of moxa but that of external surface temperature did not depend on the weight of moxa in high degree : about $400^{\circ}C$. 4. The integral values of central and external temperature curves were proportional to the weight of moxa; that is central temperature curves were higher than that of external.

• 대한족부족관절학회지
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• 제6권2호
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• pp.201-207
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• 2002

Purpose: To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach. Materials and Methods: From March 2000 to February 2002, thirty-eight displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type IV of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative care, all fractures healed without secondary displacement except 1 case on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed. Conclusion: Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.

• 대한치과의사협회지
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• 제51권4호
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• pp.190-197
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• 2013

A titanium based screw shaped dental implant was first introduced by Branemark and a treatment protocol where the restoration of edentulous area by connecting abutment after the osseointegration of the titanium surface of the implant and surrounding bone structure has been proposed. Although this protocol is widely accepted as a standard up to date, the healing duration of 3-6 months as well as the need for provisional prostheses during this period present as a major drawback. Immediate loading has been accomplished through the advent of various implant designs, enforced surface treatments, diverse forms of abutment, and delicate surgical techniques together with the increase in demand from the patients. The success rate of the immediate loading technique has been first reported as 85.7% by Dr. Schnitman in 1990 which recently has been reported up to 100% in the case of immediate loading in single tooth by Dr. Kan. To ameliorate the success rate of immediate loading technique, selection of patients presenting a sound bone quality and quantity, acquiring primary stability through delicate surgical techniques and fabrication of prostheses which accounts for biological stabilities should all be taken into consideration. This presentation introduces the understanding of biological stability of immediate loading, various methods for measurement of stability and clinical cases regarding immediate loading technique.