• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.4
• /
• pp.475-479
• /
• 2008

Aim: The aim of this study was to investigate the arterial arcade of maxillary sinus by determining the distance between the alveolar crest and the inferior border of the vessels in Korean population. Materials and methods: 76 patients and 87 available sinuses were determined by CT scan (Implagraphy, Vatech, Seoul, Korea). The distance between alveolar crest and inferior border of the vessel was determined considering the tooth area of posterior maxilla. Results: The lowest distance was observed on first molar area and the average distance is 16.9 mm. Discussions: it is important in sinus lift surgery that the vessels not to be damaged and that the anastomosis is situated in the lateral wall of maxillary sinus, which has to be exposed to gain access to the maxillary sinus. The knowledge of arterial arcade of maxillary sinus is important to perform the sinus floor elevation procedure effectively.

• Journal of Korean Dental Science
• /
• v.7 no.1
• /
• pp.38-42
• /
• 2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

• Journal of Korean Dental Science
• /
• v.3 no.1
• /
• pp.25-31
• /
• 2010

This study sought to evaluate the effect of the type of grafts used in sinus lifting. A review of literature through MEDLINE search covering the period 1980 ~ 2006 was performed. After screening, this study was narrowed down to 2,452 patients receiving sinus lift grafts wherein 7,151 implants were placed. In this study, the types of grafts used in sinus augmentation were autogenous bone, allogenic bone, corticocancellous block bone, and various alloplastic materials. The success rate varied from 69% to 100% depending on the graft material type. The highest success rate was reported for the autogenous bone, with high success rates recorded for the most part in most studies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.44 no.1
• /
• pp.29-33
• /
• 2018

Sinonasal mucosal melanoma (SNMM) in the maxillary sinus is a rare disease condition. Compared to oral mucosal melanoma, SNMM has a bulky, exophytic, and polypoid appearance, is weakly pigmented, and associated with unspecific symptoms. Due to these features, SNMM in the maxillary sinus has been misdiagnosed as nasal polyps and chronic sinusitis. In this case report, we described SNMM occurring in the right maxillary sinus simulated as a cystic or benign lesion. Cortical bone thinning and expansion were observed around the mass. The excised soft mass was encapsulated and weakly pigmented. The mass was clearly excised and covered with a pedicled buccal fat pad graft. Diagnosis using immunohistochemistry with S-100 and homatropine methylbromide-45 (HMB-45) is critical for proper treatment.

• Archives of Plastic Surgery
• /
• v.34 no.4
• /
• pp.524-527
• /
• 2007

Purpose: Globe displacement due to a blowout fracture is a rare clinical phenomenon. The authors present reduction of a globe displacement to the maxillary sinus due to trauma suffered in a fall and the reconstruction of a large defect left in the medial and inferior orbit. Methods: A 39-year-old male patient was unable to open his left eye after being struck on the periorbital area by a metal edge. Laceration was not noted in that area but we were unable to observe the intraorbital globe. A facial computed tomography (CT) scan showed that the globe was displaced through the maxillary sinus. A transconjunctival approach was used to access the infraorbital margin and the globe entrapped in the inferior margin of the orbit was successfully reduced. A large defect in the medial and inferior orbit was reconstructed using a graft from the iliac bone. Results: In 5 months after the operation, no atrophy of the globe was seen. Both sides retained a similar shape. A satisfactory functionality outcome in terms of improved extraocular muscle movement, and a satisfactory aesthetical outcome were achieved. Conclusion: The authors report the reduction of a globe displaced to the maxillary sinus following a fall and the reconstruction of the large defect left in the medial and inferior orbit.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.3
• /
• pp.243-248
• /
• 2009

Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.49 no.5
• /
• pp.297-303
• /
• 2023

A resorbable barrier membrane is commonly used for the repair of perforated sinus membranes during sinus lifting surgeries. However, repairing largescale perforations poses challenges for clinicians as the protection and isolation of graft material remain uncertain. With this technique, we aimed to prevent graft material loss and subsequent sinus-related complications using intra-sinus rigid fixation of the resorbable barrier membrane in cases with a large perforation of the sinus membrane.

• Journal of Korean Dental Science
• /
• v.13 no.2
• /
• pp.73-80
• /
• 2020

Purpose: The purpose of this case study series was to introduce successful implant cases that used the palatal bone in patients with severe maxillary alveolar bone atrophy or defects. Case Presentation: In this case series study, a total of four patients underwent implant placement in the palatal bone of the maxilla. A total of 6 implants were installed using the palatine bone. The patients' ages ranged from 40 to 73 years with an average age of 63.5 years. The patients had maxillary sinus-related diseases, such as maxillary sinusitis, oroantral fistula, and dentigerous cysts, prior to implantation. To achieve initial stability, the implants were placed on the palatal side, and buccally tilted. The average postoperative recovery period was 8 months. No postoperative complications occurred in any of the cases, and the approach was used without reported issues. Conclusion: Implant treatment by securing the initial fixation in the palatal bone is a good alternative when an implant must be installed in a patient who requires extensive and invasive bone graft.

• Journal of Periodontal and Implant Science
• /
• v.47 no.2
• /
• pp.86-95
• /
• 2017

Purpose: The aim of this study was to determine the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded synthetic bone substitute on implants that were simultaneously placed with sinus augmentation in rabbits. Methods: In this study, a circular access window was prepared in the maxillary sinus of rabbits (n=5) for a bone graft around an implant (${\varnothing}3{\times}6mm$) that was simultaneously placed anterior to the window. Synthetic bone substitute loaded with rhBMP-2 was placed on one side of the sinus to form the experimental group, and saline-soaked synthetic bone substitute was placed on the other side of the sinus to form the control group. After 4 weeks, sections were obtained for analysis by micro-computed tomography and histology. Results: Volumetric analysis showed that the median amount of newly formed bone was significantly greater in the BMP group than in the control group ($51.6mm^3$ and $46.6mm^3$, respectively; P=0.019). In the histometric analysis, the osseointegration height was also significantly greater in the BMP group at the medial surface of the implant (5.2 mm and 4.3 mm, respectively; P=0.037). Conclusions: In conclusion, an implant simultaneously placed with sinus augmentation using rhBMP-2-loaded synthetic bone substitute can be successfully osseointegrated, even when only a limited bone height is available during the early stage of healing.

• Journal of Periodontal and Implant Science
• /
• v.40 no.2
• /
• pp.69-75
• /
• 2010

Purpose: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. Methods: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. Results : All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. Conclusions: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.