• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.477-482
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• 2010

In a case of multiple posterior teeth loss, antagonistic teeth extrude to the edentulous space and compensatory occlusion on the remained anterior teeth leads to occlusal trauma. Extrusion of antagonistic teeth breaks down occlusion plane and loss of posterior support bring about severe wear of remained teeth. In this situation, it is needed to restore remained teeth and edentulous space by increasing vertical dimension to obtain prosthodontic rehabilitation space and to correct occlusion plane. In this case report, the patient had a masticatory problem with loss of posterior teeth support and an esthetic problem of shortened anterior teeth. Before the tooth preparation for the prosthodontic restoration, the patient used removable device for 2 months to increase vertical dimension reversibly. After that, he got provisional fixed restoration with irreversible tooth reduction and used it for 3 months. It had spent 5 month to evaluate the adaptation state on final restoration with incresed vertical dimension. The increasing amount was 3 mm, which was relatively in less degree and masticatory system adapted to the increased vertical dimension without any pathologic changes. Final restoration was made to have equal-intensity contacts on all teeth in a verifiable centric relations and immediate disclusion of all posterior contacts the moment the mandible moves in any direction from centric relation. In addition, metal occlusion surface on posterior teeth was applied to prevent excessive muscle activation, occlusal trauma and the porcelain fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.34.1-34.14
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• 2015

Background: Over the past 30-40 years, various carbon implant materials have become more interesting, because they are well accepted by the biological environment. The traditional carbon-based polymers give rise to many complications. The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon). The aim of this study is to present the long-term clinical results of carbon/carbon implants, and the results of the scanning electron microscope and energy dispersive spectrometer investigation of an implant retrieved from the human body after 8 years. Methods: Mandibular reconstruction (8-10 years ago) was performed with pure (99.99 %) carbon implants in 16 patients (10 malignant tumours, 4 large cystic lesions and 2 augmentative processes). The long-term effect of the human body on the carbon/carbon implant was investigated by comparing the structure, the surface morphology and the composition of an implant retrieved after 8 years to a sterilized, but not implanted one. Results: Of the 16 patients, the implants had to be removed earlier in 5 patients because of the defect that arose on the oral mucosa above the carbon plates. During the long-term follow-up, plate fracture, loosening of the screws, infection or inflammations around the carbon/carbon implants were not observed. The thickness of the carbon fibres constituting the implants did not change during the 8-year period, the surface of the implant retrieved was covered with a thin surface layer not present on the unimplanted implant. The composition of this layer is identical to the composition of the underlying carbon fibres. Residual soft tissue penetrating the bulk material between the carbon fibre bunches was found on the retrieved implant indicating the importance of the surface morphology in tissue growth and adhering implants. Conclusions: The surface morphology and the structure were not changed after 8 years. The two main components of the implant retrieved from the human body are still carbon and oxygen, but the amount of oxygen is 3-4 times higher than on the surface of the reference implant, which can be attributed to the oxidative effect of the human body, consequently in the integration and biocompatibility of the implant. The clinical conclusion is that if the soft part cover is appropriate, the carbon implants are cosmetically and functionally more suitable than titanium plates.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.243-247
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• 2013

Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.3
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• pp.196-204
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• 2002

For the study of its stability when the screw has been fixed after sagittal split ramus osteotomy(SSRO) of the mandible, the methods of screw arrangement are classified into two types, triangular and straight. The angles of screws to the bone surface are classified as perpendicular arrangements, the $60^{\circ}$ anterioinferior screw, known as triangular, and the most posterior screw, called straight arrangement, thus there are four types. The finite element method model has been made by using a three dimensional calculator and a supercomputer. The load directions are to the anterior teeth, premolar region, and molar region, and the bite force is 1 Kgf to each region. The distribution of stress, the von-Mises yield strength, and safety of margin refer to the total sum of transformed energy have been studied by comparison with each other. The following conclusion has been researched : 1. When shear stress is compared, in the triangular arrangement in the form of "ㄱ", the anterosuperior screw is seen at contributing to the support of the bone fragment. In the straight arrangement, substantial stress is seen to be concentrated on the most posterior angled screw. 2. When the von-Mises yield strength is compared, it seemed that the stress concentration on the angled anteroinferior screw is higher, it shows a higher possibility of fracture than any other screw. In the straight arrangement, stress appeared to be concentrated on the most posteriorly angled screw. 3. When the safety margins of the transfomed energy are compared, the energy conduction is much greater in the case of the angled screw than in the case of the perpendicular screw. The triangular arrangement in the form of "ㄱ" shows a superior clinical sign to that of the straight arrangement. Judging from the above results, when the screw fixation is made after SSRO in practical clinical cases, two screws should be inserted in the superior border of mandibular ramus and a third screw of mandibular inferior border should be inserted in the form of triangular. All screws on the bony surface should be placed perpendicularly-$90^{\circ}$ angles apparently best promote bony support and stability.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.89-112
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• 2002

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolarcrest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.

• The korean journal of orthodontics
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• v.18 no.1 s.25
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• pp.189-207
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• 1988

In almost all biologic systems, mechanically induced electric charge separation is a fundamental phenomenon. Since the hypothesis was established that the generation of electric potentials in bone by mechanical stress including muscular force might control the activity in bone by mechanical stress including muscular force might control the activity of osseous cells and their biopolymeric byproduct, the concept of electrically mediate growth mechanism, which involves biological growth and bone remodeling by any means, in living systems has been applied clinically and experimentally to orthopedic fracture repair, the regulation of orthodontic tooth movement, epiphyseal cartilage regeneration, etc. On the other hand, recent numerous research data available show apparently that the mandibular condyle has the characteristics of growth center as well as growth site. In addition, there exists a considerable difference of opinion as to the role of external pterygoid muscle in condylar growth. In view of these evidences, this. experiment was performed to investigate the effect of the galavic current on the growth of the mandible and condyle for elucidating the nature of condylar growth. The bimetallic device was composed of silver and platinum electrode connected with resistor (3.9 Mohm), which was expected to produce galvanic current of 23.6 nA according to the galvanic principle. The 25 Sprague-Dawley rats were divided into two group, 2 week group comprising 8 animals exposed to satanic current for 2 weeks and 3 control animals not exposed for 2 weeks, 4 week group comprising 10 animals in experimental group and 4 animals in control group applied for 4 weeks respectively. The experimental rats were subjected to application of the galvanic current invasively to codylar head surface and the control groups with sham electrode. On the basis of anatomic and histologic data from the mandibular condyle of experimental and control group, the following results were obtained. 1. After 2 weeks, there was no increase of mandibular size in experimental group over that of the control group. 2. After 4 weeks, the size of the condylar head was larger in experimental group than that of the control. 3. In 2 week group, the thickness of the mitotic compartment and hypertrophic chondroblastic layer was increased in experimental group. 4. In 4 week group, the number and the size of the hypertrophic chondroblasts were increased significantly on experimental group over that of the control group. 5. The application of the satanic current caused an increase in chondrocytic hypertrophy and intercellular matrix in both groups.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.4
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• pp.283-290
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• 2011

Purpose: This study compared the marginal bone loss around dental implant that were placed in the canine areas of the mandibles and finded the survival rate of implants, marginal bone loss around implants and prosthetic complications in 10 patients treated with overdentures retained with Locator attachments. Materials and methods: Ten patients who had received implant retained overdentures in the mandibules using two implants and Locator attachments at Daegu Catholic University Medical Center from 2004 to 2010 were included in this study. Evaluations of the survival rate of implants, marginal bone loss and prosthetic complications were performed. Results: Implants placed in this study showed a 100% survival rate and the average annual bone loss was 1.03 mm ${\pm}$ 0.20 mm in the first year. The patients have verbally indicated that they are comfortable and that their overdentures function well. But, implant retained overdentures had various prosthetic complications such as male change, relining, rebasing and denture fracture. Conclusion: Implant retained overdentures using two implant and Locator attachments in the fully edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.165-180
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• 2007

Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the $4{\sim}5$ years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; $26{\sim}75$) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 1O.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94,8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(${\geq}5.75$ mm) and the survival rate was significantly lower for wider implant diameter(p

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.374-381
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• 2019

A conventional approach for the treatment of long-span edentulous areas is the use of removable dentures. However, placing implants in these areas results in superior functional outcomes by increasing the stability, support, and resistance of the prostheses and improving the masticatory efficiency. Treatment modalities utilizing implants can be further classified into either removable or fixed-type prostheses. Several factors such as the amount of alveolar bone resorption, inter-arch relationship, patient preferences, and socioeconomic status should be considered when determining the appropriate treatment approach. Monolithic zirconia has been considered a suitable material for implant-supported fixed dental prosthesis, because of the drastic improvement in its mechanical properties. It exhibits fewer incidences of fracture and chipping of the prostheses, and has greater bulk of material than metal-ceramic crowns and zirconia-veneered ceramics. Moreover, highly translucent monolithic zirconia is also available in the market, and its application is gradually increasing for anterior tooth rehabilitation. The present report describes a patient who underwent full-mouth rehabilitation with fixed dental prostheses (eight upper and three lower implant placements). All teeth, except bilateral mandibular canines and left mandibular first and second premolars, were extracted after the diagnosis of generalized chronic moderate-to-advanced periodontitis of the remaining teeth. The patient reported satisfactory esthetic and functional outcomes during the one-year follow-up visit.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.197-205
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• 2007

Angiogenesis is a essential part for bone formation and bone fracture healing. Vascular endothelial growth factor (VEGF), one of the most important molecules among many angiogenic factors, is a specific mitogen for vascular endothelial cells. VEGF-mediated angiogenesis is required for bone formation and repair. However, the effect of VEGF on osteoblastic cells during osteogenesis is still controversial. In recent days, substantial progress have been made toward developing tissue-engineered alternatives to autologous bone grafting for maxillofacial bony defects. Periosteum has received considerable interest as a better source of adult stem cells. Periosteum has the advantage of easy harvest and contains various cell types and progenitor cells that are able to differentiate into a several mesenchymal lineages, including bone. Several studies have reported the bone formation potential of periosteal cells, however, the correlation between VEGF signaling and cultured human periosteal cell-derived osteogenesis has not been fully investigated yet. The purpose of this study was to examine the correlation between VEGF signaling and cultured human periosteal-derived cells osteogenesis. Periosteal tissues of $5\;{\times}\;20\;mm$ were obtained from mandible during surgical extraction of lower impacted third molar from 3 patients. Periosteal-derived cells were introduced into the cell culture and were subcultured once they reached confluence. After passage 3, the periosteal-derived cells were further cultured for 42 days in an osteogenic inductive culture medium containing dexamethasone, ascorbic acid, and ${\beta}-glycerophosphate$. We evaluated the alkaline phosphatase (ALP) activity, the expression of Runx2 and VEGF, alizarin red S staining, and the quantification of osteocalcin and VEGF secretion in the periosteal-derived cells. The ALP activity increased rapidly up to day 14, followed by decrease in activity to day 35. Runx2 was expressed strongly at day 7, followed by decreased expression at day 14, and its expression was not observed thereafter. Both VEGF 165 and VEGF 121 were expressed strongly at day 35 and 42 of culture, particularly during the later stages of differentiation. Alizarin red S-positive nodules were first observed on day 14 and then increased in number during the entire culture period. Osteocalcin and VEGF were first detected in the culture medium on day 14, and their levels increased thereafter in a time-dependent manner. These results suggest that VEGF secretion from cultured human periosteal-derived cells increases along with mineralization process of the extracellular matrix. The level of VEGF secretion from periosteal-derived cells might depend on the extent of osteoblastic differentiation.