• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.497-507
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• 2021

All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient's inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient's requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.73-76
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• 2020

Cranial implant removal is recommended if implants become exposed owing to scalp necrosis after cranioplasty. However, it carries the risk of extensive bleeding, and the resultant cranial defects can cause both aesthetic and functional problems. We present a case of a scalp defect exposing a cranial prosthetic implant that was reconstructed with a local flap and salvaged using an indwelling antibiotic irrigation system. A 73-year-old man presented with scalp necrosis after undergoing cranioplasty due to intracranial hemorrhage. The cranial implant was exposed through the scalp defect. Methicillin-resistant Staphylococcus aureus was detected in the culture from the open wound. After debridement of the necrotic tissue and burring of the superficial layer of the implant, a transposition flap was used to cover the defect and an indwelling antibiotic irrigation system was installed. Continuous irrigation with vancomycin was conducted for 5 days, and intravenous vancomycin was continued for 4 weeks. The flap was in good condition at 4 months postoperatively, with no infection. The convex contour of the scalp was well maintained. The patient's neurological status was stable. Exposed cranial implants can be salvaged with continuous antibiotic irrigation as an alternative to implant removal; thus, the risk of bleeding and possible disfigurement may be avoided.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.1
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• pp.39-44
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• 2020

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

• The Journal of the Korean dental association
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• v.38 no.6 s.373
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• pp.558-566
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• 2000

Osseointegrated dental implants have now become and accepted form of treatment for patients with a fully or partially missing dentition. The purpose of this study was to evaluate the performance of AVANA implant-Korea. A total of 323 AVANA implants were placed at 9 centers in the edentulous and partially edentulous jaws of 88 consecutive patients ranging in age form 18 to 79 years. So we get the clinical results. 1. Both patients (94.4%) & doctors (94%) were satisfied with the results, in patient's aspect 'most satisfaction' case were more common(52%) 2. The length of fixture which was frequently used was 13mm (168/319,44.5%) followed by 15mm and 10mm, and 3.75mm width implant (239/319,74.9%) was the most popularly used. 3. Mandibutar posterior was the most common installation site (140/317.43%) 4. A mean implant survival rate was 96.2%. That showed little difference which reported other paper. Cause of failure consisted of inflammation $ infection-36%, fall of osseointegration-18%, paln during masticatory function-9%. improper prosthetic function $ procedure-9%. 5. The most popularly used types of abutment was the UCLA abutment(168/305,55.5%)

• The Journal of Advanced Prosthodontics
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• v.12 no.1
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• pp.38-48
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• 2020

PURPOSE. The objective of this literature review was to analyze the cumulative survival rates (CSRs) of rigid and non-rigid double-crown-retained removable dental prostheses. MATERIALS AND METHODS. Screening of the literature published from January 1995 to December 2019 was performed by using electronic data base (Pubmed) and manual search. The CSRs of rigid and non-rigid double crown removable dental prostheses were investigated. RESULTS. A total of 403 articles were reviewed and 56 relevant articles of them were selected. Subsequently, 25 articles were included for data extraction. These articles were classified according to rigid and non-rigid type double crowns and further subdivided into teeth, implants, and teeth-implant combination types. The CSRs of rigid type double crown ranged from 68.9% to 95.1% of 5 to 10 years in tooth abutments, 94.02% to 100% over a 3-year mean observation periods in implant abutments, and 81.8% to 97.6% in tooth-implant combination. Non-rigid type double crowns had various CSR ranges from 34% to 94% maximum during 10 years observation in teeth abutment. The CSRs of non-rigid type had over 98% in implant abutments, and ranged from 85% to 100% in tooth-implant combination. CONCLUSION. The CSRs of double crowns varies according to types. With accurate evaluation of the remaining teeth and plan of the strategic implant placement, it could be successful treatment alternatives for partially or completely edentulous patients.

• Journal of Periodontal and Implant Science
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• v.40 no.2
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• pp.86-89
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• 2010

Purpose: Osteotome sinus floor elevation (OSFE) is an often-used technique of great utility in certain implant patients with resorbed posterior maxilla. Recently benign paroxysmal positional vertigo (BPPV) has been reported as an early postoperative complication following OSFE. Although OSFE-induced BPPV commonly resolves itself within a month without treatment, this complication can be a cause of trouble between the implant surgeon and patient. This report presents a case of BPPV following OSFE. Methods: A 27-year-old man without any significant medical problems and missing his maxillary right first molar, was scheduled for OSFE and simultaneous implant placement. Results: The patient suffered dizziness accompanied by nausea immediately after implant placement using OSFE. Following referral to the ear nose throat clinic, "right posterior canal BPPV" was diagnosed. Despite anti vertigo medication and a single episode of the Epley maneuver, the condition did not improve completely. The Epley maneuver was then applied 7 and 8 days later and the symptoms of BPPV disappeared. One year later, the patient remained symptom-free. Conclusions: Before sinus elevation with an osteotome, implant surgeons should screen out patients with a history of vertigo, to diminish the possibility of BPPV. Operators should be aware of BPPV symptoms. As the symptoms may be very incapacitating, immediate referral to an otorhinolaryngologist is recommended.

• The Journal of the Korean dental association
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• v.48 no.4
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• pp.275-279
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• 2010

Dental implant restoration in partial or full edentulous state has become the standard treatment in recent years. Bone graft with guided bone regeneration technique has been regarded as one of the most reliable methods to restore the bone defect area due to periodontal disease or dental trauma. Bone graft materials and membrane are the essential component of guided bone regeneration; however, a variety of bone graft materials confuse us in implant dentistry. Autogenous bone is the recognized standards in implant dentistry owing to its osteogenesis potential. Despite of its disadvantages, grafting autogenous bone is the most reliable methods. Even though the development of new bone grafts materials, autogenous bone is useful in exposed implant thread and total lack of buccal or lingual bone. Allogenic, xenogenic and synthetic bone have the osteoconductive and osteoinductive potential. These materials could be used successfully in self-contained cavity such as sinus cavity and three-wall defects. In this article, application of bone graft material is suggested according to the function of bone graft materials.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.2
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• pp.131-139
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• 2005

The therapeutic goal of implant dentistry is not merely tooth replacement but total oral rehabilitation. Considering dental implants as a treatment option can be provided patients with positive, long-term results. Implant dentistry has gone through many phases over the years. Modern technology and design allows us to predictably place our dental implants often load the implants at the time of placement. The purpose of this study is to evaluate the implant stability after immediate loading in dogs. The control group was performed delay loading and experimental group was immediate loading. Each group was measured periotest value(PTV) to evaluate clinical mobility and performed radiographic examination to evaluate marginal bone loss. Statistically significant difference was not founded in control group between experimental group in PTV(P>0.05) and marginal bone loss(P>0.05). Finally, implant stability after immediate loading was similar to delay loading implant.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.204-211
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• 2018

Background and Objectives : Unilateral maxillary sinus lesions are relatively common but may occur in variety of causes. Therefore, accurate diagnosis and appropriate treatment are needed. The aim of this study is to review patients with unilateral maxillary sinus lesion who underwent surgical treatment and to analyze causes and characteristics of unilateral maxillary sinus lesions with literature review. Materials and Methods : A retrospective chart analysis was completed on 318 patients with unilateral maxillary sinus lesions who underwent surgical treatment from January, 2008 through May, 2018. Clinical history and data such as age, sex, symptoms of initial, radiologic and dental finding, operation type were collected from medical record. Results : Patients mean age was 50.7 years with slight male gender dominance. Most common type was sinusitis (42.7%), followed by odontogenic sinusitis (22.3%) and fungal ball (19.5%). In particular, the most common cause of odontogenic sinusitis was post dental surgery such as implant. Middle meatal antrostomy (90.9%) was accounted for a great part of surgery underwent to patients. Patients complained of post nasal discharge (62.9%), nasal obstruction (40.9%) and odor smell(35.2%) most commonly. Periapical lucency (35.8%) was the most common in CT finding followed by implant perforation (17.3%) and oroantral fistula (12.3%) in odontogenic sinusitis. Conclusions : Unilateral maxillary sinus lesions are relatively common, but they are increasing recently with dental procedures such as implant surgery, and serious adverse effects due to malignant tumors or improper treatment may occur, so accurate diagnosis and treatment are needed.