• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.346-352
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• 2009

There have been reports of successful bone formation with sinus floor elevation by simply elevating the maxillary sinus membrane and filling the sinus cavity below the lifted sinus membrane with a blood clot. But, in a review of the current literature, we found no animal study that substantiated blood clot's ability in this respect. The aim of this study was to investigate the effect of the method of maxillary sinus floor augmentation using the patient's own venous blood in conjunction with a sinus membrane elevation procedure. An implant was placed bilaterally in the maxillary sinus of six adult mongrel dogs so that it protruded 8 mm into the maxillary sinus after sinus membrane elevation. On one side of the maxillary sinus, the resultant space between the membrane and the sinus floor was filled with autologous venous blood retrieved from the dog. On the opposite side, the maxillary sinus was left untreated as a control. The implants were left in place for six months. The mean height of the newly formed bone in the sinus was 3.7 mm on the side without venous blood and 3.5 mm on the side with venous blood (p>0.05). There was no difference between the two sides regarding new bone height in the sinus. Our results indicate that filling the space between the lifted sinus membrane and the sinus floor with venous blood has no effect on bone formation around implants placed in the maxillary sinus cavity.

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.38-47
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• 2020

Purpose: The aim of this study was to investigate the available alveolar bone height between the maxillary molars and the sinus floor according to their anatomical relationship using cone-beam computed tomographic (CBCT) images. Methods: A total of 752 maxillary first (M1) and second molars (M2) on CBCT scans of 188 patients were selected. First, each maxillary molar was categorized as type 1, 2, 3, or 4 according to the relationship of the molar root with the maxillary sinus floor. The frequency distribution of each type was analyzed. Second, the shortest vertical distance (VD) of each molar was measured from the furcation midpoints of the roots to the lowest point of the sinus floor by 2 observers. Intraclass correlation coefficients and the t-test were calculated for the VD measurements. Results: For M1, type 3 was the most frequent, followed by type 2. For M2, type 3 was the most common, followed by type 1. The VD measurements of type 1 were 9.51±3.68 mm and 8.07±2.73 mm for M1 and M2, and those of type 3 were 3.70±1.52 mm and 4.03±1.53 mm for M1 and M2, respectively. The VD measurements of M2 were significantly higher in female patients than in male patients. Conclusions: Type 3 was the most frequent anatomical relationship in the maxillary molars, and showed the lowest alveolar bone height. This information will help clinicians to prevent complications related to the maxillary sinus during maxillary molar treatment and to predict the available bone height for immediate implant planning.

• The korean journal of orthodontics
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• v.52 no.5
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• pp.313-323
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• 2022

Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.30-42
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• 2023

Objectives: While the reliability of immediate implant placement in the maxillary molar has been discussed, its significance is questionable. There have been no guidelines for case selection and surgical technique for successful treatment outcomes of immediate maxillary molar implants. Therefore, in this study, we classified alveolar bone height and socket morphology of the maxillary molar to establish guidelines for immediate implant placement. Materials and Methods: From 2011 to 2019, we retrospectively analyzed 106 patients with 148 immediate implants at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. Inclusion and exclusion criteria were applied, and patient characteristics and treatment results were evaluated clinically and radiologically. Results: A total of 29 tapered, sand-blasted, large-grit, and acid-etched (SLA) surfaces of implants were placed in 26 patients. The mean patient age was 64.88 years. Two implants failed and were reinstalled, resulting in a 93.10% survival rate. Fluctuating marginal bone level changes indicating bone regeneration and bone loss were observed in the first year following installation and remained stable after one year of prosthesis loading, with an average bone loss of 0.01±0.01 mm on the distal side and 0.03±0.03 mm on the mesial side. Conclusion: This clinical study demonstrated the significance of immediate implant placement in maxillary molars as a reliable treatment with a high survival rate using tapered SLA implants. With an accurate approach to immediate implantation, surgical intervention and treatment time can be reduced, resulting in patient satisfaction and comfort.

• Journal of Periodontal and Implant Science
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• v.31 no.3
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• pp.581-595
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• 2001

In performing implant procedures in the anterior portion of the maxilla, many difficulties exist because of anatomical reasons, such as the proximity of the nasal floor, lateral extension of the incisive canal, and labial concavity. On the other hand, in the posterior region of the maxilla, there is often insufficient recipient bone between the maxillary sinus and alveolar ridge due to alveolar ridge resorption and pneumatization of the maxillary sinus. In order to perform implants in such regions, ridge augmentation procedures such as onlay bone graft, guided bone regeneration, and maxillary sinus grafting are performed. In studies of Caucasians, use of autograft from mandibular symphysis has been reported to be highly successful in maxillary sinus grafting. However, in a clinical study of Koreans, autograft of mandibular symphysis has been reported to have significantly low success rate. It has been hypothesized that this is because of insufficient cancellous bone due to thick cortical bone. In order to test this hypothesis, bone quality and morphology of Koreans can be compared with those of Caucasians. In this study, the bone density and morphology of the cortical bone and cancellous bone in the mandibular symphysis of 35 Korean cadavers were evaluated. The following results were obtained: 1. In terms of bone density, type I, type II, and type III consisted of 1.4%(3/213), 72.3%(154/213), and 26.3%(56/213) of the cross-sectioned specimens, respectively. In general, the bone density tended to change from type II to type III, as cross-sectioned specimens were evaluated from the midline to the canine. Type IV wasn't observed in this study. 2. The distance between the root apex and the lower border of the cancellous bone was 18.34mm-20.59mm. Considering that the bone has to be cut 5mm below the root apex during the procedure, autografts with about 15mm of vertical thickness can be obtained. 3. The thickness of cortical bone on the labial side increased from the root apex to the lower border of the mandible. The average values ranged from 1.43mm to 2.36mm. 4. The labio-lingual thickness of cancellous bone ranged from 3.43mm to 6.51mm. The thickness tended to increase from the apex to the lower border of the mandible and decrease around the lower border of cancellous bone. From the above results, the anatomic factors of the mandibular symphysis (bone density, thickness, quantity and length of the cortical bone and cancellous bone) didn't show any difference from Caucasians, and it cannot be viewed as the cause of failure in autografts in the maxillary sinus for implants.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.567-577
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• 2006

Background Several bone grafting materials have been used in sinus augmentation procedures. Macroporous Biphasic Calcium Phosphate($MBCP^{TM}$) consists of the mixture of 60% HA and 40% ${\beta}-TCP$. Therefore, it can provide good scaffold for the new bone to grow owing to HA, in the other hand, it can have bioactivity for bone remodeling owing to ${\beta}-TCP$. The purpose of this study was to evaluate bone formation following maxillary sinus augmentation using $MBCP^{TM}$ by means of histologic analysis. Material and Method $MBCP^{TM}$ was placed as a primary bone substitute for maxillary sinus augmentation. Three patients were selected after evalaution of their medical dental examination. $MBCP^{TM}$ only, $MBCP^{TM}$ combined with Irradicated cancellous bone and $MBCP^{TM}$ combined with autogenous bone were used for each patient. After about eight months, bone biopsies were harvested for histologic evaluation and fixtures installed. Results Eight months after surgery we observed new vital bone surrounding $MBCP^{TM}$ particle and the amount of new bone was about 30% even though there were discrepancies between specimens. This case report documents that $MBCP^{TM}$ when used as a grafting material for sinus floor augmentation whether combined other bone graft material or not, may lead to the predictable results for dental implants on posterior maxillary area with insufficient vertical height for fixture installation.

• The korean journal of orthodontics
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• v.18 no.2
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• pp.367-385
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• 1988

In case of skeletal Class III malocclusion with underdeveloped maxilla, the extraoral orthopedic force for the stimulation of maxillary growth or anterior reposition of the maxilla has been used clinically for the improvement of facial skeletal relationship. The purpose of this investigation was to examine the initial reaction of maxillofacial complex to the maxillary protraction by using extraoral orthopedic force. The dried human skull was used and this investigation was done by means of double exposure holographic interferometry. The protraction forces placed on the canine or the first molar were parallel, $10^{\circ}$ downward, $20^{\circ}$ downward to the occlusal plane. Fringe pattern of each protraction condition was compared and analized. The results were as follows: 1. Each maxillofacial bone displaced saparately. 2. More displacement was shown at the area of the teeth and the alveolar bone. 3. A counterclockwise rotation of the maxilla wa decreased by downward protraction and especially 20 degree downward protraction from the canine showed least rotation. 4. On the zygomatic arch, outward bend was observed and this effect was decreased by downward protraction. 5. On the zygomatic bone, the counter clockwise rotation was increased by the downward protraction. 6. When maxillary expansion was applied at the same time, outward and upward displacement with counterclockwise rotation was observed on the maxilla. 7. The lateral pterygoid plate of sphenoid bone was affected by maxillary protraction.

• Journal of Korean Dental Science
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• v.8 no.1
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• pp.36-40
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• 2015

Fibrous dysplasia is a bone disorder characterized by progressive replacement of normal bone by fibrous bone tissue. Common involving sites of fibrous dysplasia are the skeletal system including long bones, ribs, craniofacial bones and the pelvis. If maxilla were affected by fibrous dysplasia, antrum is almost always involved. And fibrous dyplasia in maxillary sinus were followed the shape of bone. In our case, the lesion involves antrum but, its shape was different from typical fibrous dysplasia pattern of maxillary sinus. Therefore we report a case of monostotic pediculated fibrous dysplasia in the maxillary sinus with a review of literature.

• Journal of Periodontal and Implant Science
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• v.49 no.6
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• pp.346-354
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• 2019

Maxillary implants are inserted in the upward direction, meaning that they oppose gravity, and achieving stable support is difficult if the alveolar bone facing the maxillary sinus is thin. Correspondingly, several sinus-lifting procedures conducted with or without bone graft materials have been used to place implants in the posterior area of the maxilla. Even with these procedures available, it has been reported that in about 5% of cases, complications occurred after implantation, including acute and chronic sinusitis, penetration of the sinus by the implant, implant dislocation, oroantral fistula formation, infection, bone graft dislocation, foreign-body reaction, Schneiderian membrane perforation, and ostium plugging by a dislodged bone graft. This review summarizes common maxillary sinus pathologies related to implants and suggests an appropriate management plan for patients requiring dental implantation.

• Imaging Science in Dentistry
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• v.32 no.2
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• pp.61-66
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• 2002

Purpose: To compare the bone height of implant sites measured using panoramic radiography and spiral CT. Materials and Methods : The available bone height was determined for 263 maxillary and mandibular implant sites in 59 patients. Distortion was calculated using the metal bar for the panoramic radiographs. Results: Significant differences in mean bone height between the two imaging modalities were found in maxillary and mandibular anterior regions (p<0.05). The mean difference in bone height recorded by the two techniques was smallest in the maxillary and mandibular molar areas (0.8 mm), and greatest in the mandibular anterior region (1.3 mm). With the exception of the mandibular anterior region, ninety percent of all the sites showed measurement differences within 2 mm. Conclusion: A safety margin of 2 to 3 mm is called for when utilizing panoramic radiography, otherwise additional imaging modality such as computed tomography is necessary to obtain accurate measurements.