• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.4
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• pp.146-153
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• 2014

Purpose: This study compares and evaluates the efficacy of graft materials after maxillary sinus bone grafts with autogenous tooth bone graft material (AutoBT), demineralized freeze-dried bone allograft (DFDBA) and deproteinized bovine bone mineral (DBBM). Methods: The study involved 30 sinuses in 26 patients who visited the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital and received either AutoBT, DFDBA or DBBM with sinus elevation using the lateral window technique. Sinus graft height was measured before, immediately after, and six months after bone graft with panoramic radiography and the height changes of the sinus floor was compared according to the graft materials. Results: After six months, the decrease ratio of graft heights were 13.57% for AutoBT group, 14.30% for DFDBA group, and 11.92% for DBBM group. There was no statistically significant difference. Conclusion: The new maxillary sinus floor formed by the upper border of bone graft material, can repneumatize after the maxillary sinus elevation. Thus, long-term stability of sinus graft height represents an important factor for implant success. We found that the three graft materials for sinus elevation do not differ significantly and all three graft materials showed excellent resistance to maxillary sinus repneumatization. However, due to the special circumstances of the maxillary sinus and small sample, the actual difference between the three graft materials may not have been detectable. Therefore further study needs to be conducted for more reliable study results.

• The Journal of the Korean dental association
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• v.57 no.3
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• pp.149-160
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• 2019

Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.

• Imaging Science in Dentistry
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• v.30 no.2
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• pp.109-116
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• 2000

Purpose : To compare the size and bone wall thickness of the maxillary sinus in normal, preoperative and postoperative maxillary sinusitis patients. Materials and Methods : The author analyzed CT images of both left and right maxillary sinuses in 357 patients who visited Chonbuk National University Hospital between January 1997 and December 1998. The size and bone wall thickness of the maxillary sinus of normal, inflammatory and post-Caldwell-Luc groups were compared. Results: The significant differences of transverse, maximum medio-lateral, maximum supero-inferior dimensions and medio-lateral dimension at nasal floor level between normal and post-Caldwell-Luc groups were found (P<0.05). And the significant differences of antero-posterior dimensions between inflammatory and post-Caldwell-Luc group were found (P<0.05). But, no significant differences of vertical height dimensions between groups was found (P>0.05). The significant differences of postero-lateral, infero-lateral and medial wall thickness between normal and post-Caldwell-Luc groups were found (P<0.05). Conclusion : The results of this study will aid in the diagnosis and treatment of maxillary sinus diseases and post operative treatment planning.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.314-323
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• 2020

Objective: To identify the available evidence on the effects of rapid maxillary expansion (RME) with three-dimensional imaging and provide meta-analytic data from studies assessing the outcomes using computed tomography. Methods: Eleven electronic databases were searched, and prospective case series were selected. Two authors screened all titles and abstracts and assessed full texts of the remaining articles. Seventeen case series were included in the quantitative synthesis. Seven outcomes were investigated: nasal cavity width, maxillary basal bone width, alveolar buccal crest width, alveolar palatal crest width, inter-molar crown width, inter-molar root apex width, and buccopalatal molar inclination. The outcomes were investigated at two-time points: post-expansion (2-6 weeks) and post-retention (4-8 months). Mean differences and 95% confidence intervals were used to summarize and combine the data. Results: All the investigated outcomes showed significant differences post-expansion (maxillary basal bone width, +2.46 mm; nasal cavity width, +1.95 mm; alveolar buccal crest width, +3.90 mm; alveolar palatal crest width, +3.09 mm; intermolar crown width, +5.69 mm; inter-molar root apex width, +2.85 mm; and dental tipping, +3.75°) and post-retention (maxillary basal bone width, +2.21 mm; nasal cavity width, +1.55 mm; alveolar buccal crest width, +3.57 mm; alveolar palatal crest width, +3.32 mm; inter-molar crown width, +5.43 mm; inter-molar root apex width, +4.75 mm; and dental tipping, 2.22°) compared to pre-expansion. Conclusions: After RME, skeletal expansion of the nasomaxillary complex was greater in most caudal structures. Maxillary basal bone showed 10% post-retention relapse. During retention period, uprighting of maxillary molars occurred.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.4
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• pp.313-326
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• 2007

With rising prevalency of mouth breathing children caused by developing civilization and increasing pollution, there are many maxillary transverse discrepancy patients with undergrowth of maxilla. For improving this, maxillary mid-palatal suture splitting was often performed. The purpose of this study was to analyse the stress distribution on the craniofacial suture and cranium after rapid maxillary expansion by finite element model. The boy(13Y6M) was chosen for taking computed-tomography for finite element model. Three-dimensional model of maxilla, first premolar, first molar, buccal and lingual part of rapid maxillary expansion were constructed. 1. The alveolar bone adjacent to the first molar and the first premolar that was affected directly by rapid maxillary expansion was displaced laterally approximately 4.04mm at maximum. The force decreased toward anterior region and frontal alveolar bone displaced laterally about 3.18mm. 2. A forward maximum displacement was exhibited at zygomatic process middle region. 3. At maximum, maxillary median part experienced 0.973mm downward repositioning and 0.65mm upward repositioning at lateral alveolar bone. 4. Von mises stress was observed the largest stress distribution around teeth and zygomatic buttress. 5. The largest tensile force was observed around alveolar bone of teeth, while compression force was observed at zygomatic buttress.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.4
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• pp.219-225
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• 2003

Purpose: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. Materials and Methods: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were analysed with non-parameteric statistics method. Results: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced. In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. Conclusion: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.554-560
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• 2008

In posterior maxilla, it is difficult to achieve primary stability of implants due to sinus pneumatization, alveolar bone loss, and low bone quality. The accurate and objective primary stability assessment is important for good prognosis of implants. Purpose: The aim of this study was to assess the primary stability of the non-submerged, internal type implants with maxillary sinus augmentation using deproteinized bovine bone mineral by a resonance frequency analyzer, when residual alveolar bone height is under 8mm Materials and methods: A total of 20 implants was placed into 5 grafted maxillary sinuses in 5 patients. Deproteinized bovine bone mineral (Bio-$Oss^{(R)}$) was used as graft material. SS II implants (diameter 4.1mm, and length 11.5mm, SLA suface)) were placed. All of the patients received maxillary sinus graft procedure by 1-step technique. Residual bone height was $1.3{\sim}7.8mm$ (mean 4.4mm) measured by panorama radiography. After implant placement, RFA was measured at 4,8,12,20 weeks. The results were divided into 2 groups; RFA value under 4mm and over 5mm of bone height. It was statistically analyzed. Results: 1. The primary stability of implants was increased with time 2. The RFA value was above 65 ISQ at 12 weeks 3. There was no correlation between RFA and residual alveolar bone height in maxillary sinus augmentation by 1-step technique. Conclusion: 1-step surgical procedure is a feasible option for patients with as little as 4mm residual alveolar bone height, when utilizing non-submerged, internal type implants with xenografts.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.341-349
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• 2008

Purpose: The purpose of this study was to evaluate the $Osstem^{(R)}$ implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the $Osstem^{(R)}$ implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.

• The Journal of the Korean dental association
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• v.46 no.4
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• pp.222-231
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• 2008

Various maxillary sinus floor augmentation techniques were common performed and in the most cases, many kinds of bone graft materials were used. The graft materials are autogenous bone or other biomaterials of human, animal or synthetic origin. But these cases report describes a new surgical technique by which dental implants are inserted in a void space created by elevating the sinus membrane without additional graft material in atrophic posterior maxilla. We created lateral bony window using piezoelectric device and elevated the schneiderian membrane in five patients and was repositioned with bony window in five patients, without any bone graft. From the clinical and histological results, it is found there is potential capacity for bone formation and placement of implants in the maxillary sinus without the use of bone grafts or bone substitutes.

• The korean journal of orthodontics
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• v.6 no.1
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• pp.17-24
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• 1976

The primary objective of this study was to define the differences that exist. between different sexes on the dentoskeletal framework and the soft tissue profile around the mouth. For the purpose of this study, cephalometric radiographs were obtained from the centric occlusion with closed lip position, through the research on each 42 males and females aged from 17 to 22 years with normal occlusion and acceptable facial appearence. The results were as follows: 1. Maxillary to mandibular relationships. Among the angles formed by the long axis of the maxillary and mandibular anterior teeth, the maxillary and mandibular anterior alveolar bone, and the lower and upper lips (Fig.2), only the angle formed by the lips was more acute in males than in females. The males have a more rounded profile, and the females have a flatter profile in the lower third of the face. The differences is statistically significant for the angle formed by the lips. The fact that the lips have a difference greater than that of teeth or the alveolar bone indicates that the lip position is not entirely due to tooth and bony support. Possibly the thickness of the lips has an influence. 2. Occlusal plane. The occlusal plane was related to the anterior tooth inclination, anterior alveolar bone profile, and the lip contour, both maxillary and mandibular (Fig.3). Only the angle related to lower lip was statistically significant. The females again had the more obtuse angle, indicating a flatter profile than that of the males. 3.Skeletal planes. The angles formed by the anterior maxillary lips, teeth, and alveolar bone with the Frankfort plane and the angles of the mandibular lips, teeth, and, alveolar bone and the mandibular plane were investigated (Fig.4). Results were similar to those from maxillary to mandibular relationships. The results were statistically significant for the upper lip and the lower lip, only. 4. Esthetics. The facial line and the mandibular plane were compared with the esthetic line. These angles were different for the different sexes, but only the latter was statistically significant. This difference may be due to the profile contour of the nose.