• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권4호
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• pp.337-343
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• 2010

Purpose: By reviewing literature on the subject, we compared the survival rate of implants placed in various graft materials used for maxillary sinus augmentation. Materials and Methods: The search protocol used the Pubmed electronic database, with a time limit from 1998 to 2009. Keywords such as 'sinus lift,' 'sinus augmentation,' 'sinus floor elevation,' 'sinus graft,' 'bone graft,' 'implants,' 'oral implants,' and 'dental implants' were used, alone and in combination, to search the database. We selected articles and divided them into three groups by type of graft materials: Group 1. Autogenous bone group: autogenous bone alone; Group 2. Combined bone group: autogenous bone in combination with bone substitutes; and Group 3. Substitute group: bone substitutes alone or bone substitute combinations. Results: We selected 37 articles concerning a total of 2,257 patients and 7,282 implants; 417 implants failed. The total implant survival rate (ISR, %) was 94.3%. In Group 1, 761 patients and 2,644 implants were studied; 179 implants failed and the ISR was 93.2%. In Group 2, 583 patients and 1,931 implants were studied; 126 implants failed and the ISR was 93.5%. In Group 3, 823 patients and 2,707 implants were studied; 112 implants failed and the ISR was 95.9%. Conclusion: Implants inserted in grafts composed of bone substitutes alone or in grafts composed of autogenous bone in combination with bone substitutes may achieve survival rates better than those for implants using autogenous bone alone (P<0.05).

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.461-471
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• 2006

In order to achieve a satisfactory esthetic result of periodontal surgery or implant in maxillary anterior area, periodontists must be aware of normal alveolar bone anatomy. The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 78(mean age : 25 yrs) periodontally healthy volunteers participated in this study. Two maxillary central incisor and one lateral incisor were selected to study. With minimal local anesthesia, gutta-percha cone inserted to labial gingival sulcus of selected teeth just after bone sounding with periodontal probe. Metal ball (4mm diameter) attached to palatal fossa of central incisor. Then, periapical radiograph was taken according to long cone paralleling technique. After film scan, labial alveolar bone profile reproduced along interproximal bone and apical ends of gutta-percha cones on computer screen. By utilizing computer program, the distance from height of interproximal bone to the labial bone crest in central incisor-central incisor and central incisor-lateral incisor area was measured and converted to real distance by using vertical length of metal ball on film. After measuring crown length & width of central incisor, the 10 individuals ranked lowest GW/L ratio (crown width/length ratio) and the 10 ranked highest were selected as having a long-narrow(group N), or a short-wide(group W) form of the central incisors. Means of the distance from height of interproximal bone to the labial bone crest of group N, W were calculated and compared by means of independent t-test. The results were as follows: 1. Mean distance from the height of the interproximal bone to the labial bone crest was $3.5{\pm}0.7mm$ between two central incisor, and $2.8{\pm}0.6mm$ between central and lateral incisor. 2. Mean GW/L ratio of group N was 0.57, and group W was 0.8. Mean distance from the height of the interproximal bone to the labial bone crest of group N was higher than group W in both measured area(measurements of group N, W were $3.9{\pm0.2mm$ and $3.5{\pm}0.2mm$ between two central incisor, $3.0{\pm}0.2mm$ and $2.8{\pm}0.2mm$ between central and lateral incisor), but there were no statistically significant differences when the groups were compared. Within the limits of the present study, there was a tendency that subjects with long-narrow teeth have more scalloped alveolar bone profile than subjects with short-wide teeth in upper anterior area, but no statistically significant differences were found.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.122-126
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• 2011

Introduction: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. Materials and Methods: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. Results: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. Conclusion: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권6호
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• pp.529-536
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• 2010

Purpose: The Purpose of this study is to show the total survival rate of implants with maxillary sinus grafting and the effects that reach the survival rate by classifying types of graft materials, implant type, operation method, residual bone height and evaluate graft material resorption rate after sinus grafting Patients and Methods: 61 dental implants placed with sinus bone grafting in 24 patients at Wonkwang University Sanbon Dental Hospital were installed simultaneously or after regular healing. Various bone grafts (autograft, xenograft, allograft, alloplast) and fourth implant type (GSII, Xive, Implantium, Novel biocare) were used. All implants were investigated clinically and radiographically, being with average 20 months follow-up period after installation. Results: 3 fixtures were lost, resulting in 95.1% cumulative survival rate of 61 osseointegrated dental implant. Survival rate according to bone material type, Implant type, operation method, residual bone height, have no statistically significant differencies. The mean preoperative residual alveolar bone height was 4.75 mm, average postoperative height of graft materials 10.8 mm, vertical bone resorption rate was 10% after 2 years. Resorption rate according to operation method was 7% (simultaneous) and 5% (delayed) after 1 year. Conclusion: It can be suggested that maxillary sinus grafting may have predictable result with various bone graft materials and implant type, residual bone height, operation method

• 대한치과교정학회지
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• 제49권4호
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• pp.235-245
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• 2019

Objective: This study examined bone microstructure restoration after rapid maxillary expansion (RME) with and without corticotomy over multiple retention periods. Methods: Eighteen male Dorper sheep were randomly distributed into three groups (n = 6 each group): group 1, RME with corticotomy on the buccal and palatal sides; group 2, conventional RME treatment; and group 3, no treatment. Post-RME, trabecular bone microstructure and new bone formation were evaluated by using microcomputed tomography (microCT) and histomorphometry after a 4- or 12-week retention period. Intergroup differences in bone quality and bone remodeling were analyzed by using two-way analysis of variance with Bonferroni post-hoc test. Results: The bone volume fraction (bone volume [BV]/total volume [TV]) values relative to the control in groups 1 and 2 were 54.40% to 69.88% after the 4-week retention period and returned to approximately 80% after the 12-week retention period. The pooled BV/TV values of the banded teeth in groups 1 and 2 were significantly lower than those of the control after the 4-week retention period (p < 0.05). However, after the 12-week retention period, the pooled BV/TV values in group 2 were significantly lower than those in groups 1 and 3 (p < 0.05). Histomorphological analysis showed that the new bone formation area in group 1 was approximately two to three times of those in group 2 and control. Conclusions: Corticotomy significantly enhanced the restoration of bone quality after the retention periods for banded teeth. This benefit might result from the increased new bone formation after corticotomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권2호
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• pp.189-197
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• 1999

The use of osseointegrated implant has been reported that is an acceptable procedure for the restoration of totally or partially edentulous patient and that offers good predictability of long term success. It is difficult to get high success rate in edentulous maxillae with inadequate bony quality and quantity, and anatomic limitations such as pneumatic maxillary sinus and nasal floor. The various trials such as sinus lifting, bone grafting, guided bone regeneration, trabecular condensation with osteotome, and the use of wide-diameter implant have been introduced to solve these problems. This study was undertaken to assess the evaluation of clinical prognosis of the implant restorations with these various implantation techniques in the maxillary edentulous area. One hundred eight patients were treated with a total of 386 endosseous implants from March 1994 to January 1998 at Dept. of Dentistry, Korea Veterans Hospital in Seoul Korea. The various techniques for implantation in the edentulous maxillae were supplied to overcome the limitations of implant fixation. These techniques consist of sinus lifting, guided bone regeneration, onlay bone grafting, and osteotome trabecular condensation technique. The total success rate of implant restoration of this study was 93% in the maxillae. The success rate of implant restorations with conventional technique was 94.6%, with osteotome trabecular condensation technique was 94.1%, with guided bone regeneration technique was 93.3%, with bone grafting technique was 92.9%, with sinus lifting technique was 83.8%. The success rate on the maxillary anterior area was 95.2% and that on the posterior area was 91.9%. The failures were associated not only with surgical installation techniques but also bony quality and quantity, characteristics of implant, and stress distribution when in function.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.459-466
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• 2010

Alveolar distraction osteogenesis (ADO) has been regarded as an acceptable treatment for the alveolar bone deficiency. For ADO at anterior maxillary area, the vector should be oriented to forward and down-ward direction to get an adequate occlusion with mandibular teeth and to increase bone length and width for implant placement. However, the conventional commercial distraction devices for ADO are designed to allow mainly downward movement of alveolar segment, even though a forward movement can be obtained a little by controlling of inclination of device. To make ADO with controllable bidirectional vector possible, we used customized devices using self-manufactured ABDUL (Alveolar Bone Distractor Using Lag screw principle) and commercial orthodontic palatal expansion device ($Hyrex^{(R)}$). In all cases (n = 4), ADO could be performed successfully and dental implants were able to placed with adequate occlusion. We report the procedures, advantages and disadvantages of these methods.

• Journal of Korean Dental Science
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• 제13권2호
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• pp.67-72
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• 2020

Purpose: This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. Materials and Methods: Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment. Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. Conclusion: Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.188-193
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• 2017

Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

• 대한심미치과학회지
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• 제31권2호
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• pp.40-46
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• 2022

상악전치부는 심미적 회복이 가장 중요한 부위이지만 구치에 비해 좁은 협설측 치조골 폭 및 발치시의 치조골 흡수로 인하여, 그만큼 심미적인 결과를 얻기가 어려운 부위이다. 본 증례 보고를 통해 외상으로 인한 상악전치부의 발치 즉시 임플란트 식립을 통해 치조골 및 연조직 소실을 최소화 하며 심미성을 확보하기 위한 고려 사항에 대해 살펴 보고자 한다.