• The korean journal of orthodontics
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• v.46 no.1
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• pp.42-54
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• 2016

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

• The Journal of Advanced Prosthodontics
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• v.8 no.3
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• pp.235-240
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• 2016

PURPOSE. In this study, the aim of this study was to evaluate the effect of implant surface treatment on cell differentiation of osteoblast cells. For this purpose, three surfaces were compared: (1) a modified SLA (MSLA: sand-blasted with large grit, acid-etched, and immersed in 0.9% NaCl), (2) a laser treatment (LT: laser treatment) titanium surface and (3) a laser and acid-treated (LAT: laser treatment, acid-etched) titanium surface. MATERIALS AND METHODS. The MSLA surfaces were considered as the control group, and LT and LAT surfaces as test groups. Alkaline phosphatase expression (ALP) was used to quantify osteoblastic differentiation of MC3T3-E1 cell. Surface roughness was evaluated by a contact profilometer (URFPAK-SV; Mitutoyo, Kawasaki, Japan) and characterized by two parameters: mean roughness (Ra) and maximum peak-to-valley height (Rt). RESULTS. Scanning electron microscope revealed that MSLA (control group) surface was not as rough as LT, LAT surface (test groups). Alkaline phosphatase expression, the measure of osteoblastic differentiation, and total ALP expression by surface-adherent cells were found to be highest at 21 days for all three surfaces tested (P<.05). Furthermore, ALP expression levels of MSLA and LAT surfaces were significantly higher than expression levels of LT surface-adherent cells at 7, 14, and 21 days, respectively (P<.05). However, ALP expression levels between MSLA and LAT surface were equal at 7, 14, and 21 days (P>.05). CONCLUSION. This study suggested that MSLA and LAT surfaces exhibited more favorable environment for osteoblast differentiation when compared with LT surface, the results that are important for implant surface modification studies.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.5
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• pp.617-627
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• 2006

Statement of problem: HA has been used as a coating material on Ti implants to improve osteoconductivity. However. it is difficult to form uniform HA coatings on implants with complex surface geometries using a plasma spraying technique. Purpose : To determine if Ti6Al4V sintered porous-surfaced implants coated with HA sol-gel coated and hydrothermal treated would accelerate osseointegration. Materials and Methods : Porous implants which were made by electric discharge were used in this study. Implants were anodized and hydrothermal treatment or HA sol-gel coating was performed. Hydrothermal treatment was conducted by high pressure steam at $300^{\circ}C$ for 2 hours using a autoclave. To make a HA sol, triethyl phosphite and calcium nitrate were diluted and dissolved in anhydrous ethanol and mixed. Then anodized implant were spin-coated with the prepared HA sols and heat treated. Samples were soaked in the Hanks solution with pH 7.4 at $37^{\circ}C$ for 6 weeks. The microstructure of the specimens was observed with a scanning electron microscope (SEM), and the composition of the surface layer was analyzed with an energy dispersive spectroscope (EDS). Results : The scanning electron micrographs of HA sol-gel coated and hydrothermal treated surface did not show any significant change in the size or shape of the pores. After immersion in Hanks' solution the precipitated HA crystals covered macro- and micro-pores The precipitated Ca and P increased in Hanks' solution that surface treatment caused increased activity. Conclusion : This study shows that sol-gel coated HA and hydrothermal treatment significantly enhance the rate of HA formation due to the altered surface chemistry.

• Journal of Periodontal and Implant Science
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• v.47 no.1
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• pp.2-12
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• 2017

The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.

• The korean journal of orthodontics
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• v.38 no.1
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• pp.31-40
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• 2008

Objective: This study investigated the skeletal and dentoalveolar changes after intrusion of maxillary posterior teeth using miniscrew implants during the treatment and posttreatment period. Method: The subjects consisted of 11 adults (1 male, 10 females) whose open bites were treated by posterior teeth intrusion with miniscrew. The lateral cephalometric x-rays of pre-treatment, post-treatment, and the retention period were evaluated. Results: The average intrusion of maxillary posterior teeth at the end of the treatment period was 2.22 mm (p < 0.001) and the average extrusion of maxillary posterior teeth at the end of the 17.4 month retention period was 0.23 mm (p = 0.359). The relapse rate was calculated at 10.36%. A decrease in overbite after the 17.4 month retention period was 0.99 mm (p < 0.05). The relapse rate was calculated at 18.10%. The skeletal changes and vertical height change of maxillary posterior teeth during the retention period was statistically insignificant, but there was a significant decrease in overbite (mean 0.99 mm, p < 0.05). The amount of intrusion and the overbite improvement from treatment significantly correlates to the degree of relapse. Conclusions: The results indicate that intrusion of the maxillary posterior teeth using miniscrews is an effective, non-surgical treatment modality which can reasonably be used to address adult open bite.

• Journal of International Society for Simulation Surgery
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• v.1 no.1
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• pp.13-15
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• 2014

Nowadays, with advanced 3D printing techniques, the custom-made implant can be manufactured for the patient. Especially in skull reconstruction, it is difficult to design the implant due to complicated geometry. In large defect, an autograft is inappropriate to cover the defect due to donor morbidity. We present the process of manufacturing the 3D custom-made implant for skull reconstruction. There was one patient with skull defect repaired using custom-made 3D titanium implant in the plastic and reconstructive surgery department. The patient had defect of the left parieto-temporal area after craniectomy due to traumatic subdural hematoma. Custom-made 3D titanium implants were manufactured by Medyssey Co., Ltd. using 3D CT data, Mimics software and an EBM (Electron Beam Melting) machine. The engineer and surgeon reviewed several different designs and simulated a mock surgery on 3D skull model. During the operation, the custom-made implant was fit to the defect properly without dead space. The operative site healed without any specific complications. In skull reconstruction, autograft has been the treatment of choice. However, it is not always available and depends on the size of defect and donor morbidity. As 3D printing technique has been advanced, it is useful to manufacture custom-made implant for skull reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.178-183
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• 2001

Since the introduction of the concept of osseointegration, the success rate of dental implant has increased dramatically. So, the uses of dental implant in the treatment of partially or fully edentulous patients have played an important role in dental rehabilitation. Regardless of high success rate of dental implant, some amounts of fixtures cannot help failing. We can classify dental implant failure according to timing, causative factor, etc. This study is focused on dental implant fixture failure, occurring during preprosthetic stage. There are various reasons that cause implant failure on this periods, such as improper patient selection, poor bone quality, and periimplantitis, etc. We investigate the survival rate of 1058 fixtures, which installed in 306 patients in our clinic from January 1997 to December 1999, according to type, sex, location, fixture length and width, using Kaplan-Meier product-limit method and to compare each other with log-rank test. Overall survival rate was 96.80%, and 33 implants failed over the preprosthetic stage. Our survey data identified posterior location of mandible as being associated with implant failure(P<0.05).

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.723-728
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• 2008

Purpose: During guided bone regeneration procedures for the augmentation of deficient alveolar ridge, primary closure of flap is necessary. For primary flap closure, flap is repositioned coronally and the zone of attached keratinized mucosa may decreased. The need for attached keratinized mucosa around dental implants is still controversial, but sufficient peri-implant attached keratinized mucosa would be beneficial for functional and esthetic aspects. This case report presents three cases that demonstrated free gingival graft for increasing the zone of peri-implant attached keratinized mucosa which was decreased after guided bone regeneration. Materials and Methods: In first case, maxillary incisors were extracted and guided bone regeneration was performed simultaneously. Because the membrane was exposed at 3 weeks after operation, the membrane was removed and free gingival graft was performed for primary flap closure. Free gingival graft was performed again at implant placement for the increase of attached keratinized mucosa. In second case, guided bone regeneration was performed on lower right first molar area, and implant was placed with free gingival graft. In third case, lower right molar area showed insufficient attached keratinized mucosa after implant placement with guided bone regeneration. When abutments were connected, free gingival graft with apically positioned flap was performed. Result: In these three cases, the zone of attached keratinized mucosa around dental implants was decreased after guided bone regeneration. And the increase of peri-implant attached keratinized mucosa could be obtained effectively by free gingival graft. Conclusion: Free gingival graft could be a effective treatment method increasing the zone of attached keratinized mucosa which was decreased after guided bone regeneration procedures.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.361-371
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• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.4
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• pp.519-527
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• 2005

Statement of problem : There are many articles that showed that the magnetism affected the bone formation around titanium implant. It means that a proper magnetism made the osseointegration improved around the implant. So after additional research on the other effect of magnetism on bone formation in implant therapy, we can conclude its possibility of clinical application on implant treatment. Purpose: The purposes of this study were to find out the intensity of magnetic field where magnetism in the titanium implant specimen inserted into the bone could affect the bone formation, and to discover the possibility of clinical application in the areas of dental implants and bone grafts. Material and method: Ten adult male rabbits(mean BW 2Kg) were used in this study. Titanium implant specimens were surgically implanted on the mesial side of the tibia of rabbits. Neodymium magnets(Magnedisc 500, Aichi Steel Corp. Japan) were placed into the implants of experimental group except control group, just after placement of the titanium implants. At 2, 4 and 8 weeks after the surgery, the animals were sacrificed, specimens were obtained and stained with Hematoxylin-Eosin for light microscopic evaluation and histomorphometric analysis. Conclusion : The results were as follows: 1. In radiographic findings, increased radiopacity downward from crestal bone was observed along the titanium implant specimen at experimental period passed by 2, 4, and 8 weeks in both control and experimental group. 2. In histoiogic findings, increased new bone formation was shown in both control and experimental group through the experiment performed for 2, 4, and 8 weeks. More new bone formation and bone remodeling were shown in experimental group. 3. In histomorphometric analysis, the bone contact ratios were 11.9% for control group and 38.5% for experimental group (p<0.05).