• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.391-396
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• 2007

The aim of this study was to evaluate implant stability placed in the maxillary sinus which was augmented with bovine bone mineral(Bio-$Oss^{(R)}$) mixed with autogenous bone from the maxillary tuberosity. Maxillary sinus floor augmentation with the mixture of bovine bone mineral and autogenous maxillary tuberosity bone was performed in 30 maxillary sinuses, and 68 implants were placed at the time of sinus graft. After 6 months of implant placement abutments were connected and implant stability quotient(ISQ) was measured by radio frequency analysis(RFA). In addition, bone level changes was evaluated by taking periapical radiograph. During surgical procedures, no complication was observed, and all patients healed uneventfully. At 6 months the implant showed stable ISQ values. The marginal bone level changes around the fixtures was stably maintained through out the follow up period. This study confirmed that maxillary sinus floor augmentation with mixture of bovine bone mineral and maxillary tuberosity bone could be reliable for bone regeneration in subantral space.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.46-52
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• 2009

The maxillary posterior edentulous region presents unique and challenging conditions in implant dentistry. The height of the posterior maxilla is reduced greatly as a result of dual resorption from the crest of the ridge and pneumatization of the maxillary sinus after the loss of teeth. Materials previously used for sinus floor grafting include autogenous bone, allogeneic bone, xenogenic bone and alloplastic materials. Autogenous bone is the material of choice, but its use is limited by donor-site morbidity, complications, sparse availability, uncontrolled resorption and marked volume loss. One way to overcome this problem would be to use bone substitutes alone as a osteoconductive scaffold for bone regeneration from the residual bone or in combination with allogeneic bone, which also has osteoinductive properties. The purpose of this article is to describe a double layers technique of demineralized and mineralized bone graft materials instead of autogenous bone in sinus floor augmentation of deficient posterior maxillary alveolar process and to report our experience with this technique. Our results show that maxillary sinus augmentation using mineralized and demineralized bone materials, when installed simultaneously with the implant or not, is good results for bone healing.

• Imaging Science in Dentistry
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• v.52 no.4
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• pp.365-373
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• 2022

Purpose: This study investigated whether the relationship between the maxillary sinus and the root of the maxillary premolar is correlated with the root position and whether there is a difference in the long axis angle of premolars and the buccal bone thickness according to the sinus-root relationship and root position. Materials and Methods: Cone-beam computed tomographic images of 587 maxillary first premolars and 580 second premolars from 303 patients were retrospectively reviewed. The maxillary sinus floor-root relationship was classified into 4 types, and the root position in the alveolar bone was evaluated as buccal, middle, or palatal. The long axis angle of the maxillary premolars in the alveolar bone and the buccal bone thickness were measured. The correlation between these parameters was analyzed. Results: The maxillary sinus floor-root relationship showed a statistically significant correlation with the root position in the alveolar bone. Most maxillary first premolars were buccally located, and more than half of the second premolars had their roots in the middle. The long axis angle of the premolars was significantly larger in buccal-positioned teeth than in middle-positioned teeth, and the buccal bone was thinner. Conclusion: When the root of the maxillary premolar was separated from the sinus floor, the premolar was often located on the buccal side. Most of the maxillary first premolars had a thinner buccal bone and larger inclination than the second premolars. It is recommended to evaluate the root position, sagittal angle and buccal bone thickness using CBCT for implant treatment planning.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.370-375
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• 2019

Background: Some parts of a maxillary fracture-for example, the medial and posterior walls-may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. Methods: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. Results: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). Conclusion: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.256-263
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• 2011

Purpose: The purpose of this study was to evaluate the effectiveness of autogenous tooth graft materials after maxillary sinus bone grafts. Methods: The study involved 23 implants in 22 patients who visited the Department of Oral and Maxillofacial Surgery and the Department of Periodontics, Chosun University Dental Hospital, in 2008 and received autogenous tooth graft materials for maxillary sinus bone grafts. Results: For eight patients with maxillary bone graft materials prior to implant placement, the healing period averaged five months. For eleven patients with simultaneous maxillary bone graft and implant placement, eight patients received a second surgery, with an average healing time of six months. Three patients had a longer observation period with only a fixture implanted. Three patients who received only a bone graft required more time to implant placement because of the lack of residual bone and also for personal reasons. Only 5 patients had biopsies performed and complications such as infection and dehiscence healed well. The application of autogenous graft materials to the maxillary bone graft sites did not exert any significant effects on the success rates. When a mixture of graft materials was used, the post-surgical bone resorption rate was reduced. Histological analysis showed that new bone formation and remodeling were initiated during the three-to-six month healing period. Bone formation capacity increased continuously up to six months after the maxillary bone graft. Conclusion: According to this analysis, excellent stability and bone-forming capacity were seen in cases where autogenous materials were used alone or mixed with other materials. Autogenous tooth graft materials may be substituted instead of autogenous bones.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.276-281
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• 2010

The maxillary posterior area is the most challenging site for the dental implant. After missing of teeth on maxillary posterior area due to periodontal problems, the remaining alveolar ridge is usually very thin because of not only pneumatization of maxillary sinus but also destruction of alveolar bone. The maxillary sinus bone graft procedure is one of the most predictable and successful treatments for the rehabilitation of atrophic and pneumatized endentulous posterior maxilla. But, in case of severe destruction of alveolar bone due to periodontal problems, very long crown length is still remaining problem after successful sinus graft procedures. We performed vertical augmentation of maxillary posterior alveolar ridge using mandibular ramal block bone graft with simultaneous sinus graft. After this procedures, we could get more favorable crown-implant ratio of final prosthodontic appliance and more satisfactory results on biomechanics. This is a preliminary report of the vertical augmentation of maxillary posterior alveolar ridge using mandibular ramal block bone graft with simultaneous sinus graft, so requires more long-term follow up and further studies.

• The korean journal of orthodontics
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• v.44 no.2
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• pp.54-61
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• 2014

Objective: This study aimed to propose clinical guidelines for placing miniscrew implants using the results obtained from 3-dimensional analysis of maxillary anterior interdental alveolar bone by cone-beam computed tomography (CBCT). Methods: By using CBCT data from 52 adult patients (17 men and 35 women; mean age, 27.9 years), alveolar bone were measured in 3 regions: between the maxillary central incisors (U1-U1), between the maxillary central incisor and maxillary lateral incisor (U1-U2), and between the maxillary lateral incisor and the canine (U2-U3). Cortical bone thickness, labio-palatal thickness, and interdental root distance were measured at 4 mm, 6 mm, and 8 mm apical to the interdental cementoenamel junction (ICEJ). Results: The cortical bone thickness significantly increased from the U1-U1 region to the U2-U3 region (p < 0.05). The labio-palatal thickness was significantly less in the U1-U1 region (p < 0.05), and the interdental root distance was significantly less in the U1-U2 region (p < 0.05). Conclusions: The results of this study suggest that the interdental root regions U2-U3 and U1-U1 are the best sites for placing miniscrew implants into maxillary anterior alveolar bone.

• Imaging Science in Dentistry
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• v.33 no.1
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• pp.35-41
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• 2003

Purpose: To aid in determining the volume of graft bone required before a maxillary sinus lift procedure and compare the alveolar bone height measurements taken by panoramic radiographs to those by CT images. Materials and Methods : Data obtained by both panoramic radiographs and CT examination of 25 patients were used in this study. Maxillary sinus volumes from the antral floor to heights of 5 mm, 10 mm, 15 mm, and 20 mm, were calculated. Alveolar bone height was measured on the panoramic images at each maxillary tooth site and corrected by magnification rate (PBH). Available bone height (ABH) and full bone height (FBH) was measured on reconstructed CT images. PBH was compared with ABH and FBH at the maxillary incisors, canines, premolars, and molars. Results: Volumes of the inferior portion of the sinuses were 0.55 ± 0041 ㎤ for 5 mm lifts, 2.11 ± 0.68 ㎤ for 10 mm, 4.26 ± 1.32 ㎤ for 15 mm, 6.95 ± 2.01 ㎤ for 20 mm. For the alveolar bone measurement, measurements by panoramic images were longer than available bone heights determined by CT images at the incisor and canine areas, and shorter than full bone heights on CT images at incisor, premolar, and molar areas (p<0.001). Conclusion: In bone grafting of the maxillary sinus floor, 0.96 ㎤ or more is required for a 5 mm-lift, 2.79 ㎤ or more for a 10 mm-lift, 5.58 ㎤ or more for a 15 mm-lift, and 8.96 ㎤ or more for a 20 mm-lift. Maxillary implant length determined using panoramic radiograph alone could result in underestimation or overestimation, according to the site involved.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.236-244
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• 1996

The maxillary sinus elevation for simultaneous placement of dental implants and combination grafts of autogenous bone harvested from the maxillary tuberosity and demineralized freeze dried bone and HA is relatively easy and safely done under local anesthesia in out patients clinic. This article is to introduce the sinus floor elevation method which has been performed to 5 patients in the department of Dentistry/Oral & Maxillofacial Surgery, Kangnam Sacred Heart Hospital, Hallym University, from 1993.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.274-282
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• 2013

Objectives: The posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach. Materials and Methods: In this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height. Results: The bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively. Conclusion: Maxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for implant rehabilitation.