• Title/Summary/Keyword: Mandibular surgery

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Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

  • Chang, Hee-Yung;Park, Shin-Young;Kim, Jin-Ah;Kim, Young-Kyun;Lee, Hyo-Jung
    • Journal of Periodontal and Implant Science
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    • v.45 no.3
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    • pp.82-93
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    • 2015
  • Purpose: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.

Evaluating intra- and inter-examiner reproducibility in histometric measurement: one-wall intrabony periodontal defects in beagle dogs

  • Kim, Soo-Kyung;Choi, Eun-Hee;Lee, Jung-Seok;Kim, Tae-Gyun;Choi, Seong-Ho;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.40 no.4
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    • pp.172-179
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    • 2010
  • Purpose: Accurate and exact measurement is an important factor for generating meaningful results in any properly designed study. If all the participating examiners are able to yield similar results, it will be possible to evaluate the objective results of the study more easily and quickly. The purpose of this study was to evaluate the intra- and inter-examiner reproducibility of histometric measurements in the intrabony periodontal defect model. Methods: One wall intrabony defects were surgically created at the distal aspect of the second and the medial aspect of the fourth mandibular premolars in the right and left jaw quadrants in twenty beagle dogs and the defect sites received the following ${\beta}$-tri calcium phosphate, growth differentiation factor-0, growth differentiation factor-100 and sham surgery. Histometric analysis was performed after 8 weeks. Histometric parameters were recorded and repeated at three months interval by three examiners. Intra- and inter-examiner reproducibility was assessed. Results: Most parameters of all the groups showed high intra- and inter-examiner reproducibility. Parameters including defect height, bone regeneration height, cementum regeneration height, and formation of junctional epithelium yielded interexaminer correlation ${\geq}0.9$. The intra-examiner reproducibility showed a high result, over 0.9. Conclusions: Histometric evaluation of the one-wall intra-alveolar periodontal defect model showed high reproducibility not only for a single given examiner but also among the three examiners.

Evaluation of Autotransplantation (자가치아이식술의 장기적인 임상적 평가)

  • Lee, Jong-Sik;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.38 no.2
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    • pp.225-230
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    • 2008
  • Purpose: Many clinical studies have reported that higher success rates are achieved with teeth that have immature roots than other autotransplanted teeth that have more immature root. However, based on date published recently, the success rate of autotransplantation of teeth with complete root formation was higher. The purpose of this study was to examine the long term(2 to 6 years follow-up) success rate of autotransplantation of third molar with complete root formation and to discuss some conditions and prerequisites for success. Materials and Methods: 26 sites of 24 patients aged 26 to 55 (mean age 40.8) were autotransplanted with third molars with complete root formation. These cases were followed for 2 to 6 years after surgery. The success criteria included (1) no discomfort during functioning (2) absence of progressive root resorption and alveolar bone resorption. Result: Of 26 teeth 5 teeth were failed, therefore success rate is 81%(21/26 teeth). The results suggested that higher success rate is acquired from (1) extraction socket due to dental caries (2) mandibular recipient site (3) patient younger than 40 years old. Autotransplantation of third molar to replace molars with advanced periodontal disease also showed considerably high success rate(84%). Conclusion: With appropriate case selection, autotransplantation of third molar with complete root formation remains a viable alternative for replacing a missing molar tooth.

The long-term study on the guided tissue regeneration with poly(${\alpha}-hydroxy\;acid$} membranes in beagle dogs (Poly(alpha-hydroxy acids) 제제 생분해성 차폐막의 치주조직 재생유도능력에 관한 조직학적 장기관찰)

  • Rhyu, In-Chul;Ku, Young;Chung, Chong-Pyoung;Han, Soo-Boo;Choi, Sang-Mook
    • Journal of Periodontal and Implant Science
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    • v.27 no.3
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    • pp.633-645
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    • 1997
  • The recent trend of research and development on guided tissue regeneration focuses on the biodegradable membranes, which eliminate the need for subsequent surgical removal. They have demonstrated significant and equivalent clinical improvements to the ePTFE membranes. This study evaluate guided tissue regeneration wound healing in surgically induced intrabony periodontal defects following surgical treatment with a synthetic biodegradable membranes, made from a copolymer of glycolide and lactide, in 8 beagle dogs. After full thickeness flap reflection, exposed buccal bone of maxillary and mandibular canine and premolar was removed surgically mesiodistally and occlusoapically at $6mm{\times}6mm$ in size for preparation of periodontal defects. In experimental sites a customized barrier was formed and fitted to cover the defect. Flap was replaced slightly coronal to CEJ and sutured. Plaque control program was initiated and maintained until completion of the study. In 4, 8, 16 and 24 weeks after surgery, the animals were sacrificed and then undecalcified specimens were prepared for histologic evaluation. Histologic examination indicated significant periodontal regeneration characterized by new connective tissue attachment, cementum formation and bone formation. These membranes showed good biocompatibility throughout experiodontal period. The barriers had been completely resorbed with no apparent adverse effect on periodontal wound healing at 24 weeks. These results implicated that present synthetic biodegradable membrane facilitated guided tissue regeneration in periodontal defect.

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Periodontal tissue reaction to customized nano-hydroxyapatite block scaffold in one-wall intrabony defect: a histologic study in dogs

  • Lee, Jung-Seok;Park, Weon-Yeong;Cha, Jae-Kook;Jung, Ui-Won;Kim, Chang-Sung;Lee, Yong-Keun;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.42 no.2
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    • pp.50-58
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    • 2012
  • Purpose: This study evaluated histologically the tissue responses to and the effects of a customized nano-hydroxyapatite (n-HA) block bone graft on periodontal regeneration in a one-wall periodontal-defect model. Methods: A customized block bone for filling in the standardized periodontal defect was fabricated from prefabricated n-HA powders and a polymeric sponge. Bilateral $4{\times}{\times}4{\times}5$ mm (buccolingual width${\times}$mesiodistal width${\times}$depth), one-wall, critical-size intrabony periodontal defects were surgically created at the mandibular second and fourth premolars of five Beagle dogs. In each dog, one defect was filled with block-type HA and the other served as a sham-surgery control. The animals were sacrificed following an 8-week healing interval for clinical and histological evaluations. Results: Although the sites that received an n-HA block showed minimal bone formation, the n-HA block was maintained within the defect with its original hexahedral shape. In addition, only a limited inflammatory reaction was observed at sites that received an n-HA block, which might have been due to the high stability of the customized block bone. Conclusions: In the limitation of this study, customized n-HA block could provide a space for periodontal tissue engineering, with minimal inflammation.

The effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets (치근단 병소를 갖는 발치와에 즉시 임플란트 식립 시 비흡수성 차폐막이 치조골의 흡수에 미치는 영향에 관한 연구)

  • Shin, Seung-Yun;Yang, Seung-Min;Kye, Seung-Beom
    • Journal of Periodontal and Implant Science
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    • v.39 no.1
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    • pp.71-76
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    • 2009
  • Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.

BONE REGENERATION OF THE EXPERIMENTAL ENDODONTIC-PERIODONTIC COMBINED DEFECTS IN THE MANDIBLES OF THE DOGS (성견 하악의 치주-치근단 실험적 복합병소에서 골조직 재생에 관한 연구)

  • Kim, Jeong-Hye;Baek, Seung-Ho;Yoon, Soo-Han
    • Restorative Dentistry and Endodontics
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    • v.24 no.2
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    • pp.286-298
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    • 1999
  • The endodontic-periodontic combined lesions have been difficult to get correct diagnosis and predictable treatment. This study was to make the experimental endodontic-periodontic combined defects in dogs for the study of the periodontal regeneration and to evaluate the efficacy of the enamel matrix protein and e-PTFE membrane in the experimental endodontic-periodontic combined defects. 5 mongrel dogs were used. The pulp chambers were opened and the plaque was inserted into the chambers to induce the periapical lesions on the mandibular second, third and fourth premolars of the dogs. 1 month later, the root canal treatments were done with gutta perch a and ZOE sealer. On the day of surgery, the periapical defects were standardized by trephine bur. The buccal dehiscence defects were made by the dental bur and bone chisels. The apicoectomy with retrofilling was done. The prepared roots were randomly selected for test and control groups. In the experimental groups, the enamel matrix derivative and e-PTFE membrane were used. Nothing was placed on the control group. Fluroscent labelling was used to evaluate the bone formation. After 4 and 12 weeks, the dogs were sacrificed and undecalcified sections were prepared and stained with toluidine blue. Those histologic sections were examined by fluorescent microscopy and light microscopy. The results were as follows. 1. In the control group, new bone was formed in the periapical defects and scarcely in the buccal dehiscence defects. New cementum was not detected at 4 and 12 weeks. 2. In the experimental groups, new bone, new cementum and periodontal ligament were found in the periapical and buccal dehiscence defects. The relative amount and the quality of the new bone, new cementum and periodontal ligament tissue that had formed on the experimental groups were superior to those of the control group. 3. The current observation implicated that e-PTFE membrane and enamel matrix protein could be the effective tools for the guided tissue regeneration of the endo-perio combined defects.

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The Comparison of Long-term Effect of Botox® injection on Lower Face Contouring after Single injection and Long-term Repeated injections by Standardized Photograph Analysis (Botox®를 이용한 하안면윤곽술에서 단일시술과 장기간 반복시술의 효과 지속 기간의 비교: 표준화된 사진 계측을 이용한 분석)

  • Park, Mee Young;Ahn, Ki Young
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.654-659
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    • 2009
  • Purpose: A botulinum toxin type A (BoNT - A) injection has been used as a noninvasive management for lower face contouring since 2000. The aim of this study was to compare reduction rate of lower face width for a longtime according to repeated Botox$^{(R)}$ injections on masseter muscles for lower face contouring procedure. Methods: Forty - five patients were analyzed for single session of Botox$^{(R)}$ injection and 13 patients were evaluated for repeated Botox$^{(R)}$ injections for over two years. Single injection group was tracked regular intervals at 1, 3, 6, 10, 12 months after injection, and repeated injection group was measured at every injection time. Twenty - five to thirty units of Botox$^{(R)}$ was injected into each masseteric muscle at five to six points at the prominent portions of the mandibular angle. Standardized frontal view of digital photographs were analyzed by Adobe Photoshop$^{(R)}$ (version CS3) to measure an reduction rate of lower face width. Results: Reduction rate was 3.7%, 6.9%, 6.2%, 4%, 4% at 1, 3, 6, 10, 12 months post injection each other in single injection group. However, more than 8% reduction rate was found in repeated injection group persistently for more than two years. Conclusion: This study shows that effective duration of Botox$^{(R)}$ injection for lower face contouring is expected to continue over one year clinically. Moreover, repeated injections maintained lower reduction rate consistently for a long time. Therefore, repeated injections on masseter muscles at regular intervals are most effective procedure for lower face contouring.

Fabrication of functionally customized fixed prosthesis in a hemimandibulectomy patient with fibular graft using double scan technique: A case report (비골이식을 받은 하악골절제술 환자에서 스캔중첩법을 이용한 기능적 고정성 보철물 제작: 증례 보고)

  • Win, Thaw Thaw;Lee, Du-Hyeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.195-201
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    • 2022
  • Hemimandibulectomy and free fibular flap (FFF) in patients with squamous cell carcinoma could disturb the functional movement of the mandible. The muscular function in the sectioned side was compromised because of the incompetency of the muscle attachment to the mandible, leading to the unstable occlusal contact in the centric and eccentric occlusion. In this report, we present a case of a 63-year-old male who underwent cancer surgery and reconstruction with fibular graft, and he needed a fixed dental prosthesis to restore tooth loss in the anterior region. Occlusal contact change and instability were found according to the bite force in the centric relation and eccentric movement. This case report aimed to present the prosthetic procedure for fabricating the functionally optimized fixed prosthesis wherein the functionally generated path (FGP) technique and digital imaging method were applied to replicate mandibular movement and vertical dimension of the patient.

Flexible IARPD considering the prevention of combination syndrome: a case report (Combination syndrome 예방을 고려한 flexible IARPD 증례)

  • Kim, So-yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.347-353
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    • 2022
  • Traditional denture treatment is often performed in patients with the completely edentulous maxilla and the bilateral edentulous posterior mandible. However, with a long-term prognosis, a complication called 'combination syndrome' may occur in this oral environment. In this case, by applying an implant-assisted removable partial denture (IARPD), it is possible to preserve the alveolar bone and prevent combination syndrome. In this case, when additional implants are placed in the edentulous area, the stress applied to the abutment due to the movement of the removable denture can be reduced, so it is possible to design an esthetic clasp using resin rather than metal, and flexible denture base resin is used. As a treatment for maxillary complete denture and mandibular flexible IARPD, it showed an esthetic and functional long-term prognosis with minimal cost and surgery.