• Journal of Dental Rehabilitation and Applied Science
• /
• v.23 no.2
• /
• pp.145-155
• /
• 2007

The advent of osseointegration and advances in biomaterials and techniques have contributed to increased application of dental implants in the restoration of maxillary partial edentulous patients. Often, in these patients, soft and hard tissue defects result from a variety of causes, such as infection, trauma, and tooth loss. These create an anatomically less favorable foundation for ideal implant placement. Reconstruction of the atrophic maxillary alveolar bone through a variety of regenerative surgical procedures has become predictable; it may be necessary prior to implant placement or simultaneously at the time of implant surgery to provide a restoration with a good long-term prognosis. Regenerative procedures are used for horizontal and vertical ridge augmentation. Many different techniques exist for effective bone augmentation. The approach is largely dependent on the extent of the defect and specific procedures to be performed for the implant reconstruction. It is most appropriate to use an evidenced-based approach when a treatment plan is being developed for bone augmentation cases. The cases presented in this article clinically demonstrate the efficacy of using a autogenous block graft, guided bone regeneration, ridge split, immediated implant placement technique on the atrophic maxillary area.

• The Journal of the Korean dental association
• /
• v.53 no.8
• /
• pp.545-557
• /
• 2015

The modified ridge splitting/expansion technique combined with guided bone regeneration (GBR) for implant surgery is used to expand the narrow and atrophied edentulous alveolar ridge. Also, the simultaneous implant placement after ridge splitting/expansion technique can reduce the treatment and healing time. This case report includes three patients with a narrow edentulous alveolar ridge of the 2 to 4mm. All three patients underwent a fracture of thin buccal cortical bone plate, and these defects were corrected by the use of the guided bone regeneration (GBR). After 7 to 18 months, all surgical area was stable, and all implant showed a good healing state on the clinical and radiographic examination. In conclusion, though this surgical method is technique sensitive, the modified ridge splitting/expansion technique combined with GBR for implant surgery is recommended for a horizontal augmentation in the narrow edentulous alveolar ridge.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.33 no.4
• /
• pp.359-362
• /
• 2011

Purpose: This study evaluated the clinical applications of implant placement and guided bone regeneration using a mineralized bone allograft and a barrier membrane derived from ox pericardium Methods: From January 2007 to June 2009, among the patients who received an implant at Chosun University Dental Hospital, patients were selected if they were treated with guided bone regeneration (GBR) with simultaneous implant placement or GBR prior to implant placement. The selected patients were sorted according to the materials and membranes used in GBR, and the implant survival rate was recorded by clinical examination and reviewing the medical records and the radiographs. Each study list was analyzed by SPSS (version 12.0, SPSS Inc., USA) software and the survival rate was verified by Chi-square tests. $P$ values less than 0.05% were deemed significant. Results: 278 implants were placed on a total of 101 patients and 8 implants resulted in failure. Three implants failed among 15 implants with only a mineralized bone allograft. No failure was shown among the 74 implants placed with mineralized bone allograft and a barrier membrane derived from ox pericardium. One group of 4 implant placements showed failure among the 102 implants placed with a mineralized bone allograft and another bone graft material. The group that had a barrier membrane derived from ox pericardium with a mineralized bone allograft or other bone materials showed no implant failure. Three failures were shown among the 21 implants placed with only bone graft and not using a membrane. The group with membranes other than a barrier membrane derived from ox pericardium showed 5 failures among 170 implants. Conclusion: The implant survival rate of the group with GBR using a mineralized bone allograft was 96.3%, which meant there was little difference compared to the groups of another bone graft materials (98.9%). The implant survival rate of the group without a membrane-was 85.7% and it showed a significant difference compared to the group using a barrier membrane derived from ox pericardium (100%) and the group using another membrane (97.1%).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.4
• /
• pp.275-279
• /
• 2010

Introduction: Guided bone regeneration (GBR) is a common procedure for the treatment of bone defects and bone augmentation. The nonresorbable barriers are well-documented barriers for GBR because of their stability and malleability. However, few GBR studies have focused on the different types of non-resorbable barriers. Therefore, this study examined the clinical results of different non-resorbable barriers for GBR; expanded polytetrafluoroethylene (e-PTFE) (TR-Gore Tex, Flagstaff, AZ, USA), and high-density polytetrafluoroethylene (d-PTFE) (Cytoplast membrane, Oraltronics, Bremen, Germany). Materials and Methods: The analysis was performed on patients treated with GBR and implant placement from January 2007 to October 2007 in the department of the Seoul National University Bundang Hospital. The patients were divided into two groups based on the type of non-resorbable barrier used, and the amount of bone regeneration, marginal bone resorption after prosthetics, implant survival rate and surgical complication in both groups were evaluated. Results: The implants in both groups showed high survival rates, and the implant-supported prostheses functioned stably during the follow-up period. During the second surgery of the implant, all horizontal defects were filled with new bone, and there was no significant difference in the amount of vertical bone defect. Conclusion: In bone defect areas, GBR with non-resorbable barriers can produce favorable results with adequate postoperative management. There was no significant difference in bone regeneration between e-PTFE and d-PTFE.

• The Journal of the Korean dental association
• /
• v.56 no.11
• /
• pp.631-640
• /
• 2018

Nowadays computer-guided "flapless" surgery for implant placement using templates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical discomfort and reduced time required for definitive rehabilitation. Aim of this study is to describe the digital implant protocol, thanks to which is now possible to do a mini-invasive static guided implant surgery. This is possible thanks to a procedure named surface mapping based on the matching between numerous points on the surface of patient's dental casts and the corresponding anatomical surface points in the CBCT data. With some critical points and needing an adequate learning curve, this protocol allows to select the ideal implant position in depth, inclination and mesio-distal distance between natural teeth and or other implants enabling a very safe and predictable rehabilitation compared with conventional surgery. It represents a good tool for the best compromise between anatomy, function and aesthetic, able to guarantee better results in all clinical situations.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.30 no.2
• /
• pp.184-191
• /
• 2014

In the mandibular posterior molar area, ridge deficiency is an unfortunate obstacle in the field of implant dentistry. Many techniques are available to rebuild the deficient ridge. Selection and necessity of these techniques are associated with significant morbidity and often require a second surgical site. With the advent of guided bone regeneration (GBR), one may now graft the deficient ridge with decreased morbidity and without a second surgical site. In this case, guided bone regeneration procedures were performed with a combination of allograft, xenograft, and alloplast, excepting autogerous bone at severe defected mandibular alveolar ridge and then placed to the implant successfully. We report that implant placement were good in two cases.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.3
• /
• pp.207-213
• /
• 2016

PURPOSE. A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS. For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (${\alpha}=.05$). RESULTS. The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION. The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.1
• /
• pp.66-74
• /
• 2019

Excessive wear causes many complications when untreated, so that accurate diagnosis, analysis and predictive treatment plan should be made, and through evaluation of vertical dimension and stepwise treatment, a stable inter-arch relationship can be set. For the long-term success of implant treatment, ideal position and angle of implant is important, and its importance increases especially in multiple implant cases. Therefore, thorough diagnosis and planning, accurate surgery and prosthodontic procedures are significant. In this case, a 68-year-old male patient with a loss of vertical dimension due to multiple tooth loss and overall tooth wear was planned with systematic analyses from the pre-treatment stage to rehabilitate vertical dimension. Full-mouth fixed rehabilitation with computer tomography guided implant surgery was performed to the newly set vertical dimension and attained satisfactory outcomes both functionally and esthetically.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.34 no.3
• /
• pp.196-207
• /
• 2018

An accurate implant placement with ideal location is significant for long-term success of the implant. An exact evaluation of nearby anatomic structures such as quality of residual bone, an inferior alveolar bone and a maxillary sinus is required. For a prosthetic-driven treatment, planned surgery, precise prosthesis and communication with the patient are significant requisites especially for full-mouth rehabilitation. In this case, the patient with severe alveolar bone resorption had a CT guided surgery supported by CT data and the data from scanning diagnostic wax-up. Afterward, edentulous area was restored by full mouth implant-supported prosthesis by using monolithic zirconia and CAD/CAM technique. This paper reports the outcome of the procedure which was remarkable both esthetically and functionally.

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