• Archives of Plastic Surgery
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• v.49 no.2
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• pp.158-165
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• 2022

Background Implant-based breast reconstruction has evolved tremendously in the last decades, mainly due to the development of new products and techniques that make the procedure safer and more reliable. The purpose of this study was to compare the outcomes in immediate one-stage breast reconstruction between acellular dermal matrix (ADM) and inferior dermal flap (IDF). Methods We conducted a retrospective comparative study of patients submitted to immediate breast reconstructions with an anatomical implant and ADM or IDF in a single center between 2016 and 2018. Outcomes evaluated included major complications, early complications, reinterventions, readmissions, and reconstruction failure. Simple descriptive statistics and univariate analysis were performed. Results A total of 118 breast reconstructions (85 patients) were included in the analysis. Patients in the IDF group had a higher body mass index (median = 27.0) than patients in the ADM group (median = 24). There were no statistically significant differences among both groups regarding immediate major complication, early complications, readmissions, and reinterventions. Conclusion There are no significant differences in complications between the ADM and IDF approach to immediate implant breast reconstruction. In patients with higher body mass index and large, ptotic breasts, we recommend an immediate implant reconstruction with IDF.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.226-231
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• 2001

Modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Five transpositions of the inferior alveolar nerve together with the installation of 10 implants were performed in four patients. The mean postoperative follow-up time was 17 months, with a range of 8 to 20 months. All implants with functioning pontics remained stable, with no mobility or symptoms of pain and infection during the follow-up period. Neurosensory evaluation was performed using the two-point discrimination test. Two patients had objective neurosensory dysfunction at postoperative, but all the nerve function were reported as normal by the patients 4 months postoperatively.

• Korean Journal of Cleft Lip And Palate
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• v.5 no.2
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• pp.85-93
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• 2002

Simultaneous implant installation with bone graft was performed in 15 cases. Four cases were cleft alveolus patients. 56 implants were placed immediately with block bone grafts. 2 cases were cranial bone grafts and the others were iliac bone grafts. Three of 56 implants were lost(94.6% Survival rate). One of three was cleft alveolus case. The cleft alveolus patients with simultaneous implants installation showed functional and esthetic results without infraocclusion and positional changes. Bergland index was considered to be type I after 12 months later. Immediate implant installation with bone graft is one of choice of treatment in closing cleft alveolus hoping simultaneous implant installation could be related with function which might result in less resorption of graft. Functional and esthetic results are satisfaction ; there was no infraocclusion and positional changes.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.233-245
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• 2011

With the use of computed tomography (CT), computer-aided design/computer-assisted machining (CAD/CAM) technology and internet, the implant dentistry has been evolved. The surgical templates made by CAD/CAM technology and precise installation of implants, permit restorations to be inserted immediately after implants have been placed. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla and mandible received 7 implants in mandible using CAD/CAM surgical templates. Prefabricated provisional fixed prostheses were connected immediately after implant installation. Provisional prostheses were evaluated for aesthetics and function during 6 months. Definitive prostheses were fabricated. At 6 months recall appointment, patient's occlusion was slightly changed. To prevent additional adverse effect, regular check-up and occlusal adjustment would be needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.8.1-8.6
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• 2018

Background: This study was to evaluate the effect of bone graft procedure on the primary stability of implants installed in fresh sockets and assess the vertical alteration of peri-implant bone radiographically. Methods: Twenty-three implants were inserted in 18 patients immediately after tooth extraction. The horizontal gap between the implant and bony walls of the extraction socket was grafted with xenografts. The implant stability before and after graft procedure was measured by Osstell Mentor as implant stability quotient before bone graft (ISQ bbg) and implant stability quotient after bone graft (ISQ abg). Peri-apical radiographs were taken to measure peri-implant bone change immediately after implant surgery and 12 months after implant placement. Data were analyzed by independent t test; the relationships between stability parameters (insertion torque value (ITV), ISQ abg, and ISQ bbg) and peri-implant bone changes were analyzed according to Pearson correlation coefficients. Results: The increase of ISQ in low primary stability group (LPSG) was 6.87 ± 3.62, which was significantly higher than the increase in high primary stability group (HPSG). A significant correlation between ITV and ISQ bbg (R = 0.606, P = 0.002) was found; however, age and peri-implant bone change were not found significantly related to implant stability parameters. It was presented that there were no significant peri-implant bone changes at 1 year after bone graft surgery. Conclusions: Bone graft procedure is beneficial for increasing the primary stability of immediately placed implants, especially when the ISQ of implants is below 65 and that bone grafts have some effects on peri-implant bone maintenance.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.36-41
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• 2024

Background Among breast reconstruction methods, implant-based breast reconstruction has become the mainstream. However, periprosthetic infection is still an unresolved problem. Although published articles have revealed that limited use of antibiotics is sufficient to reduce infection rates, the number of surgeons still preferring elongated usage of antibiotics is not less. The aim of our study is to validate the appropriate duration of antibiotic use to reduce infection rate after implant-based breast reconstruction. Methods A retrospective study reviewed medical record of 235 patients (274 implants for reconstruction) who underwent prepectoral direct to implant breast reconstruction using acellular dermal matrix wrapping technique. Infection rates were analyzed for the patients administered postoperative prophylactic antibiotics until drain removal and those who received only perioperative prophylactic antibiotics for 24 hours. Results Of the 274 implants, 98 who were administered prophylactic antibiotics until drain removal had an infection rate of 3.06% (three implants) and 176 who received prophylactic antibiotics no longer than 24 hours postoperatively had an infection rate of 4.49% (eight implants). A total of 11 patients diagnosed with postoperative infection clinically, 8 were salvaged by antibiotic treatment, and 3 had implant removal and replacement with autologous flap. Postoperative antibiotic prophylaxis duration had no statistically significant effects in the risk of infection (p = 0.549). Conclusion The duration of prophylactic antibiotics after surgery was not related to infection risk. Further study with a large number of patients, randomized control study, and route of antibiotics is needed.

• The Journal of the Korean dental association
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• v.37 no.1 s.356
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• pp.62-68
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• 1999

Patients who present with severe maxillary bone loss Secondary to trauma or resorption provide a unique diagnosis and difficulty in implant installation. To solve this problem, various bone grafting methods and graft materials can be used in these compromised cases. But for the patients required wide reconstruction, autogenous iliac bone has been used widely because of easy harvesting of much corticocancellous bone. Usually, implant installations are performed 6-12 months later after grafting. but this method necessary long treatment period and additional surgery. To avoid this disadvantages, bone grafting with immediate implant installations are frequently used. But special care is necessary to prevent postoperative complication in this method. We present three cases of veneer grafting with immediate implant installation. These patients had a knife-edge shaped alveolar bone due to labial alveolar bone loss. We reconstructed this alveolar bone with veneer grafting with iliac bone and performed immediate implant installation. There was no complications during healing periods in these three cases. Six months later, we found good survival of grafting bone and osseointegration of these implants, so we could perform prosthetic treatment successfully.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.6
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• pp.814-820
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• 2000

Statement of Problem. Commonly used classification systems do not inform for dentists the dimension of the available bone at a potential implant site although regarding a variety of morphologic and pathophysiologic aspects using schematic graphs. However, for the implantologist the availability of bone substance is most important independent whether it concerns the jaw basis or the alveolus. Purpose of Study. The present article refers to a new evaluation form, to analyze the available bone with regard to optional immediate loading site by site. According to a new systematic implant planning concept will be presented in two case reports. Results. The feasibility of the classification for planning and documentation of immediately loaded implants is presented in two case reports. Conclusion. The factor of bone support for immediate functional stability is important in dental implantology. The new systematic implant planning helps to systematically estimate the dimension (ASCIi classification) of the alveolus site by site to evaluate the possibility of immediate loading. The Gottingen classification thus aids to determine the degree of stability that can be expected for the planned solution.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.79-83
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• 2019

Robotic surgery facilitates surgical procedures by employing flexible arms with multiple degrees of freedom and providing high-quality 3-dimensional imaging. Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed to avoid breast scars. Four patients with invasive ductal carcinoma underwent robot-assisted nipple-sparing mastectomy and immediate robot-assisted expander insertion. Through a 6-cm incision along the anterior axillary line, sentinel lymph node biopsy and nipple-sparing mastectomy were performed by oncologic surgeons. The pectoralis major muscle was elevated, an acellular dermal matrix (ADM) sling was created with robotic assistance, and an expander was inserted into the subpectoral, sub-ADM pocket. No patients had major complications such as hematoma, seroma, infection, capsular contracture, or nipple-areolar necrosis. The mean operation time for expander insertion was 1 hour and 20 minutes, and it became shorter with more experience. The first patient completed 2-stage prosthetic reconstruction and was highly satisfied with the unnoticeable scar and symmetric reconstruction. We describe several cases of immediate robot-assisted prosthetic breast reconstruction. This procedure is a feasible surgical option for patients who want to conceal surgical scars.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.334-338
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• 2009

Supernumerary teeth are extra teeth or tooth-like structures which may have either erupted or unerupted in addition to the 20 deciduous teeth and the 32 permanent teeth. Clinicians sometimes confront unerupted supernumerary teeth where implants would be placed. Many clinicians consider immediate placement of implant into an extracted socket as an effective technique compared to the conventional method of waiting several months for bone healing, because of the advantages such as reduction of treatment period, preservation of alveolar bone and soft tissue, etc. We could hardly find the case of immediate placement of implant after extraction of impacted supernumerary teeth and permanent teeth together. Therefore we report the case of immediate implantation following extraction of impacted supernumerary teeth and poor periodontal conditioned permanent teeth.