• 대한두개안면성형외과학회지
• /
• 제10권1호
• /
• pp.29-32
• /
• 2009

Purpose: Alloplastic implants, such as $Silastic^{(R)}$, $Supramid^{(R)}$, Porous polyethylene, $Teflon^{(R)}$ have been used to prevent reherniation of orbital tissue and are known to be inert for many years, though complications are infrequently reported many years after their insertion. Complications associated with implants are infrequent, but infection, orbital hemorrhage, implant extrusion, motility restriction, migration of implant causing dacryocystitis, cystic formation have been described. The latter was known as a rare late complication of blow-out fracture repair. Methods: We report the case of a discovery of a intraorbital hemorrhagic cyst which developed after silicon implant insertion. This patient developed diplopia, unilateral proptosis, exophthalmos, vertical dystopia, ectropion 10 years after repair of blow-out fracture. In this case, orbital CT scan revealed intraorbital cyst surrounding the orbital implant. At surgery, a fibrous capsule surrounded the silicon implant and was filled with mucin pools. Results: Proptosis, diplopia, exophthalmos, ectropion, vertical dystopia were resolved after surgical removal of the cyst and implant. Conclusion: This case illustrate that it is important for us to be aware of the complication of cyst formation around the silicon implants.

• The Journal of Advanced Prosthodontics
• /
• 제6권5호
• /
• pp.361-371
• /
• 2014

PURPOSE. In case of large horizontal discrepancy of alveolar ridge due to severe resorption, cantilevered crown is usually an unavoidable treatment modality. The purpose of this study was to evaluate the clinical criteria for the placement of the aforementioned implant crown. MATERIALS AND METHODS. The mandible model with 2 mm thick cortical bone and cancellous bone was fabricated from CT cross-section image. An external connection type implant was installed and cantilevered crowns with increasing offset of 3, 4, 5, 6, and 7 mm were connected. Vertical load and $30^{\circ}$ oblique load of 300 N was applied and stress around bone and implant component was analyzed. A total of 14 cases were modeled and finite element analysis was performed using COSMOS Works (Solid works Inc, USA). RESULTS. As for the location of the vertical load, the maximum stress generated on the lingual side of the implant became larger according to the increase of offset distance. When the oblique load was applied at $30^{\circ}$, the maximum stress was generated on the buccal side and its magnitude gradually decreased as the distance of the offset load increased to 5 mm. After that point, the magnitude of implant component's stress increased gradually. CONCLUSION. The results of this study suggest that for the patient with atrophied alveolar ridge following the loss of molar teeth, von-Mises stress on implant components was the lowest under the $30^{\circ}$ oblique load at the 5 mm offset point. Further studies for the various crown height and numbers of occusal points are needed to generalize the conclusion of present study.

• Journal of Periodontal and Implant Science
• /
• 제50권3호
• /
• pp.183-196
• /
• 2020

Purpose: This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods: Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results: Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions: The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제21권2호
• /
• pp.189-197
• /
• 1999

The use of osseointegrated implant has been reported that is an acceptable procedure for the restoration of totally or partially edentulous patient and that offers good predictability of long term success. It is difficult to get high success rate in edentulous maxillae with inadequate bony quality and quantity, and anatomic limitations such as pneumatic maxillary sinus and nasal floor. The various trials such as sinus lifting, bone grafting, guided bone regeneration, trabecular condensation with osteotome, and the use of wide-diameter implant have been introduced to solve these problems. This study was undertaken to assess the evaluation of clinical prognosis of the implant restorations with these various implantation techniques in the maxillary edentulous area. One hundred eight patients were treated with a total of 386 endosseous implants from March 1994 to January 1998 at Dept. of Dentistry, Korea Veterans Hospital in Seoul Korea. The various techniques for implantation in the edentulous maxillae were supplied to overcome the limitations of implant fixation. These techniques consist of sinus lifting, guided bone regeneration, onlay bone grafting, and osteotome trabecular condensation technique. The total success rate of implant restoration of this study was 93% in the maxillae. The success rate of implant restorations with conventional technique was 94.6%, with osteotome trabecular condensation technique was 94.1%, with guided bone regeneration technique was 93.3%, with bone grafting technique was 92.9%, with sinus lifting technique was 83.8%. The success rate on the maxillary anterior area was 95.2% and that on the posterior area was 91.9%. The failures were associated not only with surgical installation techniques but also bony quality and quantity, characteristics of implant, and stress distribution when in function.

• 대한치과보철학회지
• /
• 제58권4호
• /
• pp.363-368
• /
• 2020

적절하지 않은 위치에 식립된 임플란트의 보철물은 심미적, 기능적 문제를 나타낼 수 있으나 이를 해결하기는 어려운 때가 많다. 이러한 경우에 재식립 혹은 연조직 및 경조직 이식을 포함하는 외과적 방법을 고려해 볼 수 있지만 결과 예측이 힘들며 긴 치유 기간 및 술 후 불편감과 추가적인 수술 비용이 동반된다. 반면, 보철적 방법으로는 치은 색상의 세라믹이 포함된 고정성 보철물을 제작하거나 가철성 보철물인 gingival mask 제작 등을 생각해볼 수있다. 본 증례에서는 80세의 남환이 과도하게 구개측으로 식립된 임플란트로 인한 상순과 보철물 사이의 음식물 저류에 대한 불편감 및 심미적인 부분에 대한 불만족을 주소로 내원하였고, gingival mask를 제작하여 단 기간 내에 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

• Journal of Periodontal and Implant Science
• /
• 제50권2호
• /
• pp.97-105
• /
• 2020

Purpose: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions: NDIs in the anterior and posterior jaws functioned equally well in terms of periimplant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

• Archives of Plastic Surgery
• /
• 제41권5호
• /
• pp.571-575
• /
• 2014

Background Disulfiram implantation is a widely used treatment alternative for alcohol abuse, yet reports on the surgical aspect of disulfiram implantation with respect to patient and drug-related treatment efficacy and wound complications are very limited. We present our clinical experiences with disulfiram implantation and discuss the surgical outcomes obtained with different anatomical planes for implantation. Methods Medical records of all patients referred to our clinic from the psychiatry department between 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantation was carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing 100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly in either a subcutaneous or an intramuscular plane. The location and the plane of implantation and the complications were recorded for each patient and compared to determine the differences in the outcomes. Results A total of 32 implantation procedures were evaluated for this study. Twenty-five implants were placed in the intramuscular plane (78.2%), while seven implants were placed subcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneous implants (42.9%), while no exposure was seen with the intramuscular implants. Incomplete absorption of the tablets was encountered in one patient with a previous subcutaneous implant who presented 1 year later for re-implantation as part of the continuation of therapy. Conclusions To overcome the issue of treatment continuation in the case of disulfiram therapy, which may be ceased due to frequently encountered wound complications, we believe that implantation in the subscapular intramuscular plane allows both uneventful healing and an out-of-reach implant location.

• 구강회복응용과학지
• /
• 제30권2호
• /
• pp.170-175
• /
• 2014

성장장애는 두개안면부의 골격성장과 영구치의 조기상실에 영향을 미친다. 본 증례는 성장장애 환자에서 치아를 조기 상실한 부위에 무피판 술식으로 임플란트를 식립 시 컴퓨터 단층촬영(CT)을 통한 인접치아의 확인과 임플란트 가이드의 필요성을 살펴보았다. 특발성 저신장과 3급 정신지체의 20세의 여환에서 구치의 회복을 위해 임플란트 고정성 보철을 계획하였다. CT 영상에서 인접치가 심하게 협측으로 위치되어 있었고, 이를 반영하여 가이드를 제작후 임플란트를 식립하였다. 이상 위치된 인접치를 기준으로 임플란트를 식립할 경우 협측 골의 천공이 발생할 수 있다. 그러므로 성장장애 환자에서 치아 조기 상실부에 임플란트를 식립 시 CT를 통한 치아의 위치 확인과 가이드의 제작이 요구된다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제40권
• /
• pp.3.1-3.8
• /
• 2018

Background: In this research article, we evaluate the use of sub-periosteal tunneling (tunnel technique) combined with alloplastic in situ hardening biphasic calcium phosphate (BCP, a compound of β-tricalcium phosphate and hydroxyapatite) bone graft for lateral augmentation of a deficient alveolar ridge. Methods: A total of 9 patients with deficient mandibular alveolar ridges were included in the present pilot study. Ten lateral ridge augmentation were carried out using the sub-periosteal tunneling technique, including a bilateral procedure in one patient. The increase in ridge width was assessed using CBCT evaluation of the ridge preoperatively and at 4 months postoperatively. Histological assessment of the quality of bone formation was also carried out with bone cores obtained at the implant placement re-entry in one patient. Results: The mean bucco-lingual ridge width increased in average from 4.17 ± 0.99 mm to 8.56 ± 1.93 mm after lateral bone augmentation with easy-graft CRYSTAL using the tunneling technique. The gain in ridge width was statistically highly significant (p = 0.0019). Histomorphometric assessment of two bone cores obtained at the time of implant placement from one patient revealed 27.6% new bone and an overall mineralized fraction of 72.3% in the grafted area 4 months after the bone grafting was carried out. Conclusions: Within the limits of this pilot study, it can be concluded that sub-periosteal tunneling technique using in situ hardening biphasic calcium phosphate is a valuable option for lateral ridge augmentation to allow implant placement in deficient alveolar ridges. Further prospective randomized clinical trials will be necessary to assess its performance in comparison to conventional ridge augmentation procedures.

• Journal of Korean Dental Science
• /
• 제10권2호
• /
• pp.87-95
• /
• 2017

This case study was to report the possible increase in the denture retention and psychological relief using the implant-supported fixed prostheses in a completely edentulous patient. The implants were placed in the anterior portion of the mandible in a patient who had completely edentulous state following the extraction of residual abutment teeth, and consequently a distal extension removable partial denture was fabricated. The patient's adaptation and satisfaction to the new prosthesis was monitored and confirmed in terms of masticatory function and esthetics, by restoring the oral condition similar to initial status before the residual teeth extraction. After 6 months, radiographic examination confirmed that both the abutment teeth and the implants were stable and well maintained. Considering the relatively short clinical follow-up period, however, continuous long-term monitoring was required.