• The korean journal of orthodontics
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• v.49 no.2
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• pp.124-136
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• 2019

Orthodontic treatment is more complicated when both soft and hard tissues must be considered because an impacted maxillary canine has important effects on function and esthetics. Compared with extraction of impacted maxillary canines, exposure followed by orthodontic traction can improve esthetics and better protect the patient's teeth and alveolar bone. Therefore, in order to achieve desirable tooth movement with minimal unexpected complications, a precise diagnosis is indispensable to establish an effective and efficient force system. In this report, we describe the case of a 31-year-old patient who had a labio-palatal horizontally impacted maxillary left canine with a severe occlusal alveolar bone defect and a missing maxillary left first premolar. Herein, with the aid of three-dimensional imaging, sequential traction was performed with a three-directional force device that finally achieved acceptable occlusion by bringing the horizontally impacted maxillary left canine into alignment. The maxillary left canine had normal gingival contours and was surrounded by a substantial amount of regenerated alveolar bone. The 1-year follow-up stability assessment demonstrated that the esthetic and functional outcomes were successful.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.43-48
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• 2004

Purpose: Among the various surgical methods used for the effective treatment of cystic lesion in the jaws historically, decompression procedure has some of superior prognosis compare to direct enucleation. In order to propose the efficacy of decompression we performed this retrospective study to compare decompression procedure with one-stage enucleation in clinical results and prognosis. Patients and Methods: We reviewed 175 patients who had been histopathologically diagnosed cystic lesions from 1996 to 2000 in our department. Patients who had been received decompression alone or secondary enucleation after decompression were 31 cases, and enucleation alone were 144 cases. The age and sex of the patients, the area, size, and histological type of the lesions, and detailed operation and complications including recurrence were investigated. The minimal follow-up period was 2 years. Results: In 31cases of decompression, male patients were 22cases(71%) similar to male predilection(62.3%) in total 175 cases. Cystic lesions were developed evenly in all age groups totally. Decompression was mainly performed in teenagers but enucleation was used in elder decades. In decompression cases the lesions were located in mandibular posterior, maxillary posterior, mandibular anterior, and maxillary anterior in order, which had some differences in total and enucleation cases. In enucleation cases, less than 3cm in size was 77.1% but larger than 3cm was 93.5% in decompression cases. Histopathologically, dentigerous cysts(54.8%), unicystic ameloblastomas(16.1%), and odontogenic keratocysts(12.9%) were seen in decompression cases and no recurrence or metaplasia and infection was observed. On the other hand, permanent tooth loss, numbness, recurrence, and so on were accompanied after enucleation. Conclusion: Although decompression procedure has disadvantages such as many of visiting times and slow recovery of the surgical defect, decompression is the best choice of treatment for large cystic lesions of the jaws, because it prevents functional and cosmetic defect, allows bone regeneration, and makes easy secondary enucleation.

• Journal of Periodontal and Implant Science
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• v.42 no.4
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• pp.119-126
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• 2012

Purpose: The aim of this study was to determine whether biphasic calcium phosphate (BCP) bone substitute with two different concentrations of Escherichia coli-expressed recombinant human bone morphogenetic protein 2 (ErhBMP-2) enhances new bone formation in a standardized rabbit sinus model and to evaluate the concentration-dependent effect of ErhBMP-2. Methods: Standardized, 6-mm diameter defects were made bilaterally on the maxillary sinus of 20 male New Zealand white rabbits. Following removal of the circular bony windows and reflection of the sinus membrane, BCP bone substitute without coating (control group) was applied into one defect and BCP bone substitute coated with ErhBMP-2 (experimental group) was applied into the other defect for each rabbit. The experimental group was divided into 2 subgroups according to the concentration of ErhBMP-2 (0.05 and 0.5 mg/mL). The animals were allowed to heal for either 4 or 8 weeks and sections of the augmented sinus and surrounding bone were analyzed by microcomputed tomography and histologically. Results: Histologic analysis revealed signs of new bone formation in both the control and experimental groups with a statistically significant increase in bone formation in experimental group 1 (0.05 mg/mL ErhBMP-2 coating) after a 4-week healing period. However, no statistically significant difference was found between experimental group 1 and experimental group 2 (0.5 mg/mL ErhBMP-2 coating) in osteoinductive potential (P<0.05). Conclusions: ErhBMP-2 administered using a BCP matrix significantly enhanced osteoinductive potential in a standardized rabbit sinus model. A concentration-dependent response was not found in the present study.

• Journal of Korean Dental Science
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• v.6 no.1
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• pp.13-21
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• 2013

Purpose: To report the successful results of using chin bone graft and autogenous tooth bone graft material (AutoBT) in alveolar cleft patients. Materials and Methods: Five patients with alveolar cleft defects underwent alveolar bone grafting. Three patients were treated using chin bone graft, and the other two patients underwent AutoBT graft. After implant site development using chin bone graft in the fi rst three cases, endosseous implant restorations were placed. In case #4 and 5, AutoBT graft material was placed to guide the normal eruption of partially impacted maxillary right canine and to the upper docking site after distraction osteogenesis. Result: Successful implant restorations with closure of the oronasal fistula were achieved in alveolar cleft defect reconstruction using either chin bone graft (Case #1, 2, 3) or AutoBT graft material (Case #4, 5). Case #4 showed enlarged follicle of the right maxillary canine, indicating a normal eruption guide pattern. Conclusion: Both chin bone graft and AutoBT graft showed favorable outcomes in reconstructing alveolar cleft defects. Autogenous tooth bone graft opens up the possibility of avoiding harvesting autogenous bone graft with complications and morbidities.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.287-292
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• 2005

The definitive correction of secondary lip nasal deformities is a great challenge for plastic surgeons. To rectify the secondary lip nasal deformities, various procedures and its modifications have been reported in many centers. However, no universal agreement exist to correct the various components of secondary nasal deformities. The secondary nasal deformity of the unilateral cleft lip has its own characteristic abnormalities including the retroplaced dome of the ipsilateral nasal tip, hooding of the alar rim, a secondary alar-columellar web, short columella, depressed alar base and so forth. Among these components of secondary nasal deformity, maxillary hypoplasia, especially in the area of piriform aperture, and alveolar bone defect can make the alar base depressed, which in turn, leads to wide and flat nasal profile, obtuse nasolabial angle coupled with subnormal nasal tip projection in aspect of aesthetic consideration. Moreover, the maxillary hypoplasia contributes to reduced size of the nasal airway in combination with other component of external nasal deformity and therefore the nasal obstruction may be developed functionally. Therefore, the current authors have performed corrective rhinoplasty with the augmentation of alar base with various methods which include rearrangement of soft tissue, vertical scar tissue flap and use of allogenic or autologous materials in 42 patients between 1998 and 2003. The symmetric alar base could be achieved, which provides the more accurate evaluation and more appropriate management of the various component of any coexisting secondary nasal deformity. In conclusion, the augmentation of alar base, as a single procedure, is a basic and essential to correct the secondary lip nasal deformities.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.31-36
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• 2010

Purpose: The primary goal of palatoplasty is to enable normal speech with harmonious growth of face. Some children who had palatoplasty display typical findings of transverse maxillary deficiency requiring orthodontic widening of the maxilla. Levi (2009) described a cleft palate repair coupled with pedicled buccal fat pad flaps to cover bone exposed areas of the hard palate. Hence we report clinical experiences of cleft palate repair using pedicled buccal fat pad flap. Methods: Four Veau class II and a Veau class I cleft palate patients underwent palatoplasty with buccal fat pad flap by single surgeon from April 2009 to August 2009. Two patients received 2-flap palatoplasty and three patients 1-flap palatoplasty, respectively. After the cleft palate repair, sharp mosquito scissors was placed in the superior buccal sulcus just lateral to the maxillary tuberosity and inserted directly through the mucosa resulting in buccal fat pad extrusion. The elevated flap was moved to cover mucoperiosteal defect in hard palatal area. Results: Five patients underwent primary palatoplasty using buccal fat pad flap. Flap harvest and inset took on average 9 minutes per flap. Mucosal epithelization took 18 days on average. No patients had complications related to the buccal fat pad flap. Conclusion: Buccal fat pad pedicled flap has significant potential to function as an added vascularized tissue layer in cleft palate repair and we can expect better growth of maxilla with this method although longer duration of follow-up was unavailable.

• Restorative Dentistry and Endodontics
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• v.32 no.6
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• pp.483-490
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• 2007

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice. but combined endodontic-peri-odontic treatment allowed the tooth to be saved.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.28 no.2
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• pp.74-85
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• 2019

The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. A newer technique, VIP-CT (Vacularized Interpositional Periosteal Connective Tissue) graft has been introduced as an alternative to these technique which allows the clinicians perform large volume soft tissue augmentation in esthetic sites with a single procedure. The advantages of the VIP-CT graft technique are that it allows the reconstruction of large soft tissue deficiency, with little constriction postoperatively. Furthermore, it facilitates improved hard tissue augmentation due to the additional blood supply and improved bone healing by mesenchymal cells. Moreover, this technique reduces patient discomfort and treatment time. This clinical report describes the procedure of bone augmentation during immediate implantation in facial dehiscence defect, especially Vascularized Interpositional Periosteal Connective Tissue(VIP-CT) graft for aesthetic anterior soft tissue.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.4
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• pp.229-236
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• 2023

Maxillary bone defects may follow surgical treatment of benign and malignant tumors, trauma, and infection. Palatal defects often lead to problems with swallowing and pronunciation from the leakage of air into the nasal cavity and sinus. Obturators have been commonly used to solve these problems, but long-term use of the device may cause irritation of the oral mucosa or damage to the abutment teeth. Utilizing implants in the edentulous area for the fabrication of the obturators has gained attention. This case report describes a patient, who had undergone partial resection of the maxilla due to adenocarcinoma, in need of a new obturator after losing abutment teeth after long-term use of the previous obturator. Implants were placed in strategic locations, and an implant-retained maxillary obturator was fabricated, showing satisfactory results in the rehabilitation of multiple aspects, including palatal defect, masticatory function, swallowing, pronunciation, and aesthetics.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.717-722
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• 2008

Purpose: The subepithelial connective tissue graft(SCTG) has been proven to be a highly predictable treatment modality for coverage of gingival recession. This case report was performed to evaluate the effect of various root coverage procedures using SCTG on gingival recession. Materials and Methods: Three patients presents with Miller's class I recession defect on the maxillary canine. Each other SCTG(coronally advanced flap, Bruno's Tech., envelope Tech.) were performed for root coverage. Clinical parameters assessed included recession depth, recession width, and keratinized gingival width. Measurements were taken at baseline and 2 months and follow up end. Results: The average of root coverage was 4 mm(100% of the pre-operative recession depth) at the 2, 5 months examination. The average increase of keratinized tissue between the baseline and the 2 months amounted to 3.2mm. Conclusion: Within the above results, various root coverage using SCTG is an effective procedure to Miller's class I recession defect and patient could be satisfied aesthetic requirement.