• Title/Summary/Keyword: Maxillofacial defect

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Clinical application of bone graft materials in dental implant (임상가를 위한 특집 3 - 기능별 뼈이식재의 임프란트 적용방법)

  • Ahn, Kang-Min
    • The Journal of the Korean dental association
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    • v.48 no.4
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    • pp.275-279
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    • 2010
  • Dental implant restoration in partial or full edentulous state has become the standard treatment in recent years. Bone graft with guided bone regeneration technique has been regarded as one of the most reliable methods to restore the bone defect area due to periodontal disease or dental trauma. Bone graft materials and membrane are the essential component of guided bone regeneration; however, a variety of bone graft materials confuse us in implant dentistry. Autogenous bone is the recognized standards in implant dentistry owing to its osteogenesis potential. Despite of its disadvantages, grafting autogenous bone is the most reliable methods. Even though the development of new bone grafts materials, autogenous bone is useful in exposed implant thread and total lack of buccal or lingual bone. Allogenic, xenogenic and synthetic bone have the osteoconductive and osteoinductive potential. These materials could be used successfully in self-contained cavity such as sinus cavity and three-wall defects. In this article, application of bone graft material is suggested according to the function of bone graft materials.

Evaluation of Bone Change by Digital Subtraction Radiography after Implantation of Tooth Ash-plaster Mixture (치아회분과 석고혼합제제 매식후 Digital Subtraction Radiography에 의한 골량 변화의 평가)

  • Kim Jae-Duk;Kim Kwang-Won;Cho Yaung-Gon;Kim Dong-Kie;Choi Eui-Hwan
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.2
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    • pp.423-433
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    • 1999
  • Purpose : To assess the methods for the clinical evaluation of the longitudinal bone changes after implantation of tooth ash-plaster mixture into the defect area of human jaws. Materials and methods : Tooth ash-plaster mixtures were implanted into the defects of 8 human jaws. 48 intraoral radiograms taken with copper step wedge as reference at soon, 1st, 2nd, 4th, and 6th week after implantation of mixture were used. X-ray taking was standardized by using Rinn XCP device customized directly to the individual dentition with resin bite block. The images inputted by Quick scanner were digitized and analyzed by NIH image program. Cu­equivalent values were measured at the implanted sites from the periodic digital images. Analysis was performed by the bidirectional subtraction with color enhancement and the surface plot of resliced contiguous image. The obtained results by the two methods were compared with Cu­equivalent value changes. Results : The average determination coefficient of Cu-equivalent equations was 0.9988 and the coefficient of variation of measured Cu values ranged from 0.08~0.10. The coefficient of variation of Cu-equivalent values measured at the areas of the mixture and the bone by the conversion equation ranged from 0.06 ~0.09. The analyzed results by the bidirectional subtraction with color enhancement were coincident with the changes of Cu-equivalent values. The surface plot of the resliced contiguous image showed the three dimensional view of the longitudinal bone changes on one image and also coincident with Cu-equivalent value changes after implantation. Conclusion : The bidirectional subtraction with color enhancement and the surface plot of the resliced contiguous image was very effective and reasonable to analyze clinically and qualitatively the longitudinal bone change. These methods are expected to be applicable to the non-destructive test in other fields.

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A CLINICAL STUDY ON SKELETAL ANCHORAGE SYSTEM USING MINISCREW (구내고정원을 이용한 교정 치료중 miniscrew 탈락에 관한 연구)

  • Woo, Soon-Seop;Jeong, Soon-Tai;Huh, Young-Sung;Hwang, Kyung-Gyun;Yoo, Im-Hag;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.102-107
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    • 2003
  • At orthodontic treatment, we have made every effort to get rigid anchorage which is not stirred when teeth move. As a result, the miniscrew that is rigid anchorage was invented recently, and now it is used widely. Concerning the advantage of miniscrew, it is reduced dependence of extraoral anchorage and it shortens treatment time for rapid tooth movement. In contrast, the defect of miniscrew is falling off it resulted from increasing of the mobility. So the purpose of this research is to be of help to prognose clinical use of miniscrew, which is inserted for intraoral anchorage, by investigating and comparing the failure rate of miniscrew for loading time. This study researches the failure rate of miniscrew for teeth movement at the orthodontic treatment. The failure rate of miniscrew in mid course, after inserting 147 miniscrews in 51 patients, is 13%(20/147). It showed no statistically significant differences as compared man with woman, maxilla with mandible, double-head with uni-head miniscrew, and drilling and non-drilling before inserting the miniscrew. In comparison below twenties with over twenties and the times that we give load to miniscrew, it produced that the failure rate of miniscrew is 9.7% higher in the case of below the twenties than over the twenties. Also, the failure rate of loading immediately is 10.8% higher than loading after 7 days. According to using driver for the insertion of miniscrew, the failure rate of miniscrew is higher in the case of using machined driver than in the case of using hand driver when the level of significance is 95%. According to the research, we can suppose that the failure rate has no concern with using miniscrew on man or woman, maxilla or mandible, the shape of head, and drilling or non-drilling before insertion of miniscrew. Therefore, we can choose eclectic miniscrew as demands. In addition, we must notify the patient, below twenties, to be possibility of high failure rate. And It is strongly recommended to give load after $1{\sim}2$ weeks for healing of the insertion area.

The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis

  • Isler, Sila Cagri;Unsal, Berrin;Soysal, Fatma;Ozcan, Gonen;Peker, Elif;Karaca, Inci Rana
    • Journal of Periodontal and Implant Science
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    • v.48 no.3
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    • pp.136-151
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    • 2018
  • Purpose: The decontamination procedure is a challenging aspect of surgical regenerative therapy (SRT) of peri-implantitis that affects its success. The purpose of the present study was to determine the impact of additional topical gaseous ozone therapy on the decontamination of implant surfaces in SRT of peri-implantitis. Methods: A total of 41 patients (22 males, 19 females; mean age, $53.55{\pm}8.98years$) with moderate or advanced peri-implantitis were randomly allocated to the test group (ozone group) with the use of sterile saline with additional ozone therapy or the control group with sterile saline alone for decontamination of the implant surfaces in SRT of peri-implantitis. Clinical and radiographic outcomes were evaluated over a period of 12 months. Results: At the 12-month follow-up, the plaque and gingival index values were significantly better in the ozone group (P<0.05). Probing depth decreased from $6.27{\pm}1.42mm$ and $5.73{\pm}1.11mm$ at baseline to $2.75{\pm}0.7mm$ and $3.34{\pm}0.85mm$ at the end of the 12-month observation period in the ozone and control groups, respectively. Similarly, the clinical attachment level values changed from $6.39{\pm}1.23mm$ and $5.89{\pm}1.23mm$ at baseline to $3.23{\pm}1.24mm$ and $3.91{\pm}1.36mm$ at the 12-month follow-up in the ozone and control groups, respectively. According to the radiographic evidence, the defect fill between baseline and 12 months postoperatively was $2.32{\pm}1.28mm$ in the ozone group and $1.17{\pm}0.77mm$ in the control group, which was a statistically significant between-group difference (P<0.05). Conclusions: Implant surface decontamination with the additional use of ozone therapy in SRT of peri-implantitis showed clinically and radiographically significant. Trial registry at ClinicalTrials.gov, NCT03018795.

Benign Tumor-Like Developmental Salivary Gland Defect (양성 종양과 유사한 형태를 가진 발육성 타액선 골결손)

  • An, Seo-Young;Kim, Yong-Gun;Jung, Jae-Kwang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.301-307
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    • 2012
  • 50-year-old female and 50-year-old male were referred to the department of the oral and maxillofacial surgery of Kyungpook national university dental hospital with asymptomatic lesions on their posterior mandibular body areas. They were discovered incidentally on panoramic radiographs during routine dental examination. Physical examination revealed no remarkable findings. Each panoramic radiograph showed well defined radiolucent lesions without hyperostotic border on their posterior mandibular body area. At first they were diagnosed as benign tumors because they looked like multilocular pattern and one of the patient showed discontinuity of mandibular canal within the lesion. CT scans demonstrated well demarcated and irregular lingual depression filled with fat tissue and they were diagnosed as developmental salivary gland defects. One of the lesion showed no change on follow-up panoramic radiograph after 4 months. Developmental salivary gland defects resembling benign tumor are atypical cases and it is suggested that confirmatory imaging using CT or MRI should be taken.

Effect on bone formation of the autogenous tooth graft in the treatment of peri-implant vertical bone defects in the minipigs

  • Kim, Seok Kon;Kim, Sae Woong;Kim, Kyung Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.2.1-2.9
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    • 2015
  • Background: The aim of this study was to evaluate the effect of autogenous tooth bone as a graft material for regeneration of bone in vertical bony defects of the minipigs. Material and Methods: Six minipigs were used in this study. Four molars were extracted in the right mandibular dentition and sent to the Korea Tooth Bank for fabrication of autogenous tooth bone. Ten days later, each extraction site was implanted with MS Implant Narrow Ridge $3.0{\times}10mm$ fixture (Osstem, Seoul, Korea) after standardized 2mm-sized artificial vertical bony defect formation. Pineappleshaped Root-On type autogenous tooth bones were applied to the vertical defects around the neck area of the posterior three fixtures and the fore-most one was not applied with autogenous bone as a control group. Each minipig was sacrificed at 4, 8, 12 weeks after fixture installation and examined radiologically and histologically. Histological evaluation was done under light microscope with Villanueva osteochrome bone staining with semi-quantitative histomorphometric study. Percentage of new bone over total area (NBF) and bone to implant contact (BIC) ratio were evaluated using digital software for area calculation. Result: NBF were $48.15{\pm}18.02%$, $45.50{\pm}28.37%$, and $77.13{\pm}15.30%$ in 4, 8, and 12 weeks, respectively for experimental groups. The control group showed $37.00{\pm}11.53%$, $32.25{\pm}26.99%$, and $1.33{\pm}2.31%$ in 4,8,12 weeks, respectively. BIC ratio were $53.08{\pm}19.82%$, $45.00{\pm}28.37%$, and $75.13{\pm}16.55%$ in 4,8,12 weeks, respectively. Those for the control groups were $38.33{\pm}6.43%$, $33.50{\pm}29.51%$, and $1.33{\pm}2.31%$ in 4, 8, 12 weeks, respectively. Conclusion: Autogenous tooth bone showed higher score than control group in NBF and BIC in all the data encompassing 4,8,12 weeks specimens, but statistically significant only 12 weeks data in both NBF and BIC.

Maxillofacial rehabilitation of hemi-maxillectomy patient using a closed hollow bulb obturator fabricated by one-step polymerization technique: a clinical report (상악골 부분절제술 시행 환자에서 one-step 중합 기술로 만든 hollow bulb 폐색장치를 이용한 악안면 수복 증례)

  • Sim, Jae-Hyuk;Kim, Min-Kyoo;Han, Jung-Suk;Lee, Jai-Bong;Kim, Sung-Hun;Yeo, In-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.35-40
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    • 2016
  • The maxillary defects lead to anatomical and functional deformity of the maxillofacial region. As far as functions are concerned, such defects can produce difficulty in speech, mastication, and deglutition. Obturator prostheses play a very important role in functional recovery for post-maxillectomy patients. To achieve rigidity of the obturator, appropriate retention should be given, and the weight of the prosthesis be reduced. There are two types of hollow bulb obturator: open and closed. A closed type has many advantages. Nevertheless, some problems, including complexity of fabrication and water leakage into the bulb, have the closed hollow obturator not be widely used. The one-step polymerization technique described in this case overcomes the shortcomings by easily constructing a small hollow bulb with two thermoplastic resin sheets.

A case of unexpected adjacent tooth extrusion after implant fixed prosthetic treatment, who had undergone mandibular resection and reconstruction due to ameloblastoma (법랑모세포종으로 하악골 절제 및 재건술 시행한 환자에서 임플란트 고정성 보철물 수복 후 원인 미상의 인접 치아 정출이 발생한 증례 및 고찰)

  • Kim, Su-Jin;Ha, Tae-Wook;Kim, Hyung Jun;Kim, Jee Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.448-455
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    • 2019
  • Ameloblastoma is a benign odontogenic epithelial tumor with high recurrence rate and requires extensive resection of the surrounding tissue and reconstruction of defect site. Because of the anatomical limitation of the reconstruction site, prosthetic treatment with implants is the first recommendation. This is a case of prosthetic restoration of the reconstruction site with implant fixed prosthesis in patient who underwent mandibular resection and iliac bone reconstruction due to ameloblastoma. However 14 months after completion of implant prosthesis, adjacent natural tooth erupted unexpectedly, resulting in 1mm infra-occlusion occurred including posterior implant prosthesis and anterior natural teeth. In adults, implant infra-occlusion may occur due to residual growth after placement of the maxillary anterior implant. But this case, hypo-occlusion of molar implant and open bite of anterior natural teeth is occurred due to extrusion of adjacent tooth, is rare. Thus we report the treatment process including orthodontic treatment with intrusion of the posterior tooth, and investigate the causes of sudden, unexpected tooth extrusion.

Prosthetic rehabilitation by obturator considering the biomechanics in partially edentulous patient after maxillectomy (상악골 절제술을 받은 부분 무치악 환자에서 생역학을 고려해 제작한 구개 폐색장치를 이용한 보철 수복 증례)

  • Lee, Kang-Shin;Park, Ju-Mi;Ahn, Seung-Geun;Seo, Jae-Min;Park, Yeon-Hee;Lee, Jung-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.4
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    • pp.281-293
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    • 2021
  • Patients who went through maxillectomy can have severely impaired swallowing, mastication, and pronunciation functions because of palatal defects. Leakage occurs through the nasal cavity while eating, chewing becomes difficult due to the loss of teeth and alveolar ridges, and oral and nasal passages are not separated, leading to hyper-nasal sound, and significantly reducing the quality of life. To prosthetically reconstruct the defect, the weight of the obturator should be reduced as much as possible to minimize dropout because of gravity, and the bulb of the obturator should be properly extended into the defect to get additional retention and stability. In this case of a partially edentulous patient who underwent additional maxillary resection because of tumor recurrence, a metal framework was designed by applying the basic design principles of removable partial dentures. An obturator with improved retention, stability, and support was fabricated through functional impressions. The patient was satisfied with the improved facial expression, mastication, swallowing, and pronunciation, and showed stable occlusion and oral hygiene management during the follow-up period.

Mandible Reconstruction with 3D Virtual Planning

  • Woo, Taeyong;Kraeima, Joep;Kim, Yong Oock;Kim, Young Seok;Roh, Tai Suk;Lew, Dae Hyun;Yun, In Sik
    • Journal of International Society for Simulation Surgery
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    • v.2 no.2
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    • pp.90-93
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    • 2015
  • The fibula free flap has now become the most reliable and frequently used option for mandible reconstruction. Recently, three dimensional images and printing technologies are applied to mandibular reconstruction. We introduce our recent experience of mandibular reconstruction using three dimensionally planned fibula free flap in a patient with gunshot injury. The defect was virtually reconstructed with three-dimensional image. Because bone fragments are dislocated from original position, relocation was necessary. Fragments are virtually relocated to original position using mirror image of unaffected right side of the mandible. A medical rapid prototyping (MRP) model and cutting guide was made with 3D printer. Titanium reconstruction plate was adapted to the MRP model manually. 7 cm-sized fibula bone flap was designed on left lower leg. After dissection, proximal and distal margin of fibula flap was osteotomized by using three dimensional cutting guide. Segmentation was also done as planned. The fibula bone flap was attached to the inner side of the prebent reconstruction plate and fixed with screws. Postoperative evaluation was done by comparison between preoperative planning and surgical outcome. Although dislocated condyle is still not in ideal position, we can see that reconstruction was done as planned.