• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.3
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• pp.144-147
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• 2013

Damage to adjacent teeth is one of the various complications that may occur during implant placement and is often the result of improper direction during fixture placement or excessive depth of placement. In general, if detrimental symptoms, such as reaction to percussion in damaged teeth, mobility, and pulp necrosis, are not present, osseointegration should be observed at follow-up. In three cases, the possibility of root damage due to an implant fixture placed too close to each adjacent tooth was perceived on radiographs. However, in all of these cases, there were no clinical symptoms or radiographic changes present in the tooth, and the implants did not exhibit decreased stability or peri-implantitis. Therefore, we can carefully predict that the implant fixture close to the adjacent tooth did not invade the cementum of the root, and therefore did not produce the suspected pulpal damage or periradicular symptoms. In this study, we considered both the implant status as well as the adjacent tooth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.173-180
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• 2007

According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.

• Imaging Science in Dentistry
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• v.48 no.1
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• pp.59-65
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• 2018

Osseointegrated implants are now commonplace in contemporary dentistry. However, a number of complications can occur around dental implants, including peri-implantitis, maxillary sinusitis, osteomyelitis, and neoplasms. There have been several reports of a malignant neoplasm occurring adjacent to a dental implant. In this report, we describe 2 such cases. One case was that of a 75-year-old man with no previous history of malignant disease who developed a solitary plasmacytoma around a dental implant in the left posterior mandible, and the other was that of a 43-year-old man who was diagnosed with squamous cell carcinoma adjacent to a dental implant in the right posterior mandible. Our experiences with these 2 cases suggest the possibility of a relationship between implant treatment and an inflammatory cofactor that might increase the risk of development of a malignant neoplasm.

• The Journal of the Korean dental association
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• v.57 no.7
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• pp.372-378
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• 2019

The dental implants in modern dentistry brought out a new era in everyday dental practice. Increasing of dental implants usage, various failures and complications has occurred. Failures and complications of dental implant treatments that can happen in implant surgery, in mechanical or prosthetic problem and in biological aspect. The aim of this study was to assess implant failures for 6 years as well as find out how to overcome implant failure. In Jeju National University hospital, 26 dental implants in 17 patients were removed by implant failure through 2013.1.1.-2018.12.31. Each implant failure case was analyzed in report form with various informations about failure retrospectively. The present study showed 26 failed dental implants of 17 patients were removed. 13 implants(50%) of 8 patients(47.06%) were failed before functional loading and 13 implants(50%) of 9 patients(52.94%) were failed after functional loading. 11 implants(42.31%) of 7 patients(41.18%) with medical disease were extracted. 6 implants(23.08%) of 5 patients(29.41%) with additive bone graft were failed. We discuss with 26 failed dental implants of 17 patients about their causes, solutions and prevention retrospectively for 6 past years. Precise diagnosis and treatment planning are needed. Medically compromised patients and patients with implants and additive bone grafts should be cautiously treated with high failing possibilities.

• Imaging Science in Dentistry
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• v.50 no.2
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• pp.133-139
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• 2020

Purpose: This study compared 2 cone-beam computed tomography (CBCT) systems in the detection of mechanically simulated peri-implant buccal bone defects in dry human mandibles. Materials and Methods: Twenty-four implants were placed in 7 dry human mandibles. Peri-implant bone defects were created in the buccal plates of 16 implants using spherical burs. All mandibles were scanned using 2 CBCT systems with their commonly used acquisition protocols: i-CAT Gendex CB-500 (Imaging Sciences, Hatfield, PA, USA; field of view [FOV], 8 cm×8 cm; voxel size, 0.125 mm; 120 kVp; 5 mA; 23 s) and Orthopantomograph OP300 (Intrumentarium, Tuusula, Finland; FOV, 6 cm×8 cm; voxel size, 0.085 mm; 90 kVp; 6.3 mA; 13 s). Two oral and maxillofacial radiologists assessed the CBCT images for the presence of a defect and measured the depth of the bone defects. Diagnostic performance was compared in terms of the area under the curve (AUC), accuracy, sensitivity, specificity, and intraclass correlation coefficient. Results: High intraobserver and interobserver agreement was found (P<0.05). The OP300 showed slightly better diagnostic performance and higher detection rates than the CB-500 (AUC, 0.56±0.03), with a mean accuracy of 75.0%, sensitivity of 81.2%, and specificity of 62.5%. Higher contrast was observed with the CB-500, whereas the OP300 formed more artifacts. Conclusion: Within the limitations of this study, the present results suggest that the choice of CBCT systems with their respective commonly used acquisition protocols does not significantly affect diagnostic performance in detecting and measuring buccal peri-implant bone loss.

• Journal of Periodontal and Implant Science
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• v.33 no.3
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• pp.383-393
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• 2003

The aim of this retrospective study was to compare the amount of marginal bone loss between upper anterior area and upper posterior area with 71 upper single-tooth restorations on 2 stage machined $Br{{\aa}}nemark$ implants since Jan 1995. The second aim was to compare the bone defect group which had dehiscence and fenetration and the others in the upper anterior region. The results were as follows. 1. The most frequent reason of missing tooth in the upper anterior region was trauma by 61%. While upper posterior region showed various reasons such as congenital missing, advanced periodontitis, trauma. 2. Peri-implantitis with fistula occurred 1 of 41 implants in the upper anterior group in 1 year after loading and 2 of 32 implants in the upper posterior group failed before loading. The 1 year success rate of upper anterior group was 97.56 %, and 93.75 % for upper posterior group. 3. The mean marginal bone loss in the upper anterior group was 0.44${\pm}$0.25 mm, while 0.57${\pm}$0.32 mm in the upper posterior group. There was statistically significant difference in the amount of mean marginal bone loss (P${\pm}$0.10 mm at one year, and 0.48${\pm}$0.26 mm for the control group. No statistically significant difference of mean marginal bone loss was showen between bone defect group and the others at implantation. According to the results, the upper anterior region showed less marginal bone loss than the upper posterior region. In case of missing single upper tooth, careful consideration on recipient residual ridge to determine proper implant diameter and length, sufficient healing time, proper loading would lead to implant success. Single tooth implants in the maxilla seemed to be an alternative to fixed partial dentures without damage to adjacent teeth.

• Imaging Science in Dentistry
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• v.49 no.4
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• pp.265-272
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• 2019

Purpose: To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) with that of parallel(PPA) and oblique projected periapical(OPA) radiography for the detection of different types of peri-implant bone defects. Materials and Methods: Forty implants inserted into bovine rib blocks were used. Thirty had standardized bone defects(10 each of angular, fenestration, and dehiscence defects), and 10 were defect-free controls. CBCT, PPA, and OPA images of the samples were acquired. The images were evaluated twice by each of 2 blinded observers regarding the presence or absence and the type of the defects. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were determined for each radiographic technique. The 3 modalities were compared using the Fisher exact and chi-square tests, with P<0.05 considered as statistical significance. Results: High inter-examiner reliability was observed for the 3 techniques. Angular defects were detected with high sensitivity and specificity by all 3 modalities. CBCT and OPA showed similar AUC and sensitivity in the detection of fenestration defects. In the identification of dehiscence defects, CBCT showed the highest sensitivity, followed by OPA and PPA, respectively. CBCT and OPA had a significantly greater ability than PPA to detect fenestration and dehiscence defects(P<0.05). Conclusion: The application of OPA radiography in addition to routine PPA imaging as a radiographic follow-up method for dental implantation greatly enhances the visualization of fenestration and dehiscence defects. CBCT properly depicted all defect types studied, but it involves a relatively high dose of radiation and cost.

• Imaging Science in Dentistry
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• v.46 no.3
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• pp.173-178
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• 2016

Purpose: Optical coherence tomography (OCT) has been investigated as a novel diagnostic imaging tool. The utilisation of this equipment has been evaluated through several studies in the field of dentistry. The aim of this preliminary study was to determine through basic experiments the effectiveness of OCT in implant dentistry. Materials and Methods: To assess detection ability, we captured OCT images of implants in each of the following situations: (1) implants covered with mucosae of various thicknesses that were harvested from the mandibles of pigs; (2) implants installed in the mandibles of pigs; and (3) implants with abutments and crowns fixed with temporary cement. The OCT images were captured before cementation, after cementation, and after removing the excess submucosal cement. Results: If the thickness of the mucosa covering the implant body was less than 1 mm, the images of the implants were clearly detected by OCT. In the implants were installed in pigs' mandibles, it was difficult to capture clear images of the implant and alveolar bone in most of the samples. Remnants of excess cement around the implants were visible in most samples that had a mucosa thickness of less than 3 mm. Conclusion: Currently, OCT imaging of implants is limited. Cement remnants at the submucosal area can be detected in some cases, which can be helpful in preventing peri-implant diseases. Still, though there are some restrictions to its application, OCT could have potential as an effective diagnostic instrument in the field of implant dentistry as well.

• Journal of Periodontal and Implant Science
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• v.48 no.2
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• pp.84-91
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• 2018

Purpose: The purpose of this study was to visualize and identify peri-implant bone defects in optical coherence tomography (OCT) images and to obtain quantitative measurements of the defect depth. Methods: Dehiscence defects were intentionally formed in porcine mandibles and implants were simultaneously placed without flap elevation. Only the threads of the fixture could be seen at the bone defect site in the OCT images, so the depth of the peri-implant bone defect could be measured through the length of the visible threads. To analyze the reliability of the OCT measurements, the flaps were elevated and the depth of the dehiscence defects was measured with a digital caliper. Results: The average defect depth measured by a digital caliper was $4.88{\pm}1.28mm$, and the corresponding OCT measurement was $5.11{\pm}1.33mm$. Very thin bone areas that were sufficiently transparent in the coronal portion were penetrated by the optical beam in OCT imaging and regarded as bone loss. The intraclass correlation coefficient between the 2 methods was high, with a 95% confidence interval (CI) close to 1. In the Bland-Altman analysis, most measured values were within the threshold of the 95% CI, suggesting close agreement of the OCT measurements with the caliper measurements. Conclusions: OCT images can be used to visualize the peri-implant bone level and to identify bone defects. The potential of quantitative non-invasive measurements of the amount of bone loss was also confirmed.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.423-430
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• 2016

The implant prosthesis can be divided into the screw retained prosthesis and cement retained prosthesis. Each type has advantages as well as disadvantages which is unfavorable to maintain the implants. To overcome these drawbacks, T-screw system was developed. T-screw system which utilizes a lingual direction of the screw to retain the implant prosthesis, has advantages of retrievability of the prosthesis, passive fit, and possibility to form esthetic and functional occlusal surface. The prior prosthesis which utilized horizontal screws had difficulty in fabrication especially in the case of multiple units, and also limited use with all-ceramic prosthesis. In this case, fabricating the implant prosthesis by using the T-screw system showed superior results in easy maintenance, esthetics, and also functions. In addition, we are to report the method of using the T-screw system in implant prosthesis, such as multiple units of implant prosthesis and all ceramic prosthesis.