• 대한치과보철학회지
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• 제59권4호
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• pp.497-507
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• 2021

무치악 환자에서 잔존 치조골을 최대의 효율로 활용해 임플란트 고정성 보철물을 수복하는 치료법 중 하나로 All-on-6 개념을 사용할 수 있으나, 치료과정에서 복잡함과 번거로움이 동반된다. 나날이 발전해 온 디지털 시스템을 활용한다면 무치악 환자의 임플란트 식립부터 보철물 제작 및 수복까지 높은 효용성으로 활용할 수 있다. 본 증례에서는 76세 상악 무치악 환자의 일체형 나사 유지형 고정성 임플란트 보철 수복(1-piece design, screw retained implant fixed prosthesis)에 대해 진단부터 임플란트 식립 그리고 보철물 제작까지 전 과정에서 디지털 시스템을 활용하였다. 술전 진단에서 구강직접스캔(Direct intraoral scan)을 통해 환자의 정보를 데이터화 하였으며 이를 토대로 임플란트 식립 수술 가이드와 식립직후 장착할 즉시 임시보철물을 디자인 하였다. 최적의 잔존 치조골 위치에 식립된 6개의 임플란트 위치정보에 따라 정밀하게 제작된 즉시 임시보철물을 수복하여 술 후 사용 가능하도록 하여 환자의 불편감을 최소화하였다. 디지털 시스템을 활용하여 환자의 요구사항, 안정된 수직고경과 교합, 심미성을 고려하여 제작한 새로운 임시보철물을 거쳐 최종보철물을 디자인하고 제작하였다. 디지털 시스템을 활용하여 무치악 환자의 효율적이고 정확한 임플란트 식립부터 보철물 제작까지 전 과정에 있어서 복잡한 임플란트 치료과정을 단순화하여 환자의 불편감을 최소화시키고 기능적이고 심미적인 결과를 얻어 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권4호
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• pp.353-360
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• 2007

In a one-stage approach, where the implant installation is performed simultaneously with the iliac bone graft, various complications are observed. The observed complications are as follows; severe bone resorption at the maxillary anterior region and the area adjacent to the nasal cavity, shortage of soft tissue to cover the augmented alveolar bone, difficulties with oral hygiene care caused by the diminished vestibular space and non-esthetic prosthesis. These are good reasons for choosing the two-stage approach over the one-stage approach in spite of all the advantages it has, and should be taken into careful consideration when diagnosing and planning treatment using the one-stage approach.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권3호
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• pp.265-269
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• 2010

Radiation therapy for malignancy of head and neck leads to secondary effects, such as mucositis, xerostomia, dental caries and osteoradionecrosis. Osteoradionecrosis is a delayed complication which causes chronic pain, infection and constant deformity after necrosis. It occurs spontaneously or after primary oncologic surgery, dental extraction or by trauma of prosthesis. To reduce the incidence of osteoradionecrosis, appropriate antibiotic usage, atraumic procedure, tension-free primary suture and hyperbaric oxygen therapy are essential. This case is about a 74 years old woman who was treated for osteoradionecrosis after extraction of right lower molar at year 2006. She had received radiation therapy for angiosarcoma on tongue at year 2004. At year 2008 the patient came to our hospital for extraction of the opposite premolar but despite careful treatment, osteoradionecrosis occurred again. She was successfully treated by surgical procedure so we report this case.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권4호
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• pp.135-139
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• 2014

Purpose: We review published research on temporomandibular joint (TMJ) total replacement that compares costochondral graft and customized total joint reconstruction (especially TMJ concepts), focusing on effectiveness. Methods: We searched PubMed databases, including prospective, retrospective, case-control or longitudinal studies and significant statistical analysis. In data analysis, we divided outcomes into 'Acceptable' or 'Non-acceptable'. Results: There were seven articles found dealing with costochondral graft and 180 patients. The majority of patients had satisfactory treatment outcomes (n=109, 61%). There were six articles including 275 patients using the alloplastic material TMJ concepts. Almost all patients had satisfactory treatment outcomes (n=261, 95%). Conclusion: Comparing customized total joint reconstruction with costochondral graft, use of TMJ concepts resulted in increased quality of life and fewer complications. In conclusion, we judged that alloplastic material such as TMJ concepts is more effective device in total joint replacement than costochondral graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.80-86
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• 2006

Cleidocranial dysplasia is rare inherited skeletal dysplasia. It was first reported by Martin in 1765. Subsequently, Marie and Sainton independently documented the criteria of the disease. Cleidocranial dysplasia is a bone disorder caused by a defect in the CBFA1 gene of chromosome 6p21. This gene guides osteoblastic differentiation and appropriate bone formation. Patient with cleidocranial dysplasia has maxillary deficiency, high and narrow palate, prolonged retention of primary teeth, unerupted permanent teeth and supernumerary teeth. Therapeutic options in these patients include of autotransplantation of selected impacted teeth, forced eruption of permanent teeth, full denture, overdenture and implant-supported prosthesis. We report a patient with cleidocranial dysplasia. This patient was treated with implant supported bar overdenture. Despite of gene defect that affects osteoblastic activity, bone remodeling and osseointegration occurred in our patient. So, we report this case with review of literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권1호
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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 the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권6호
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• pp.347-353
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• 2023

This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.

• 대한치과보철학회지
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• 제55권2호
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• pp.218-224
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• 2017

방사선치료를 받은 상악에 임플란트 지지 고정성 보철물을 이용하여 수복하는 것은 골치유능력이 낮기 때문에 상세한 치료계획이 필요하다. All-on-4 개념에 의한 임플란트 식립은 골이식을 피하면서 임플란트를 매식할 수 있어 유리하다. 일반적으로 경사된 임플란트에는 기성 경사형 지대주를 사용해왔다. 본 임상증례에서는 computer-aided design and computer-aided manufacturing (CAD/CAM)으로 제작된 지대주를 사용하였다. 본 증례는 all-on-4 개념에 의해 임플란트를 매식하고 CAD/CAM titanium 지대주를 제작한 다음 CAD/CAM zirconia 고정성 보철물로 수복하여 좋은 결과를 얻었기에 보고하고자 한다.

• 대한치과의사협회지
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• 제48권2호
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• pp.119-126
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• 2010

Introduction. In this study, we applied the immediate loading to implant using temporary prosthesis, and compared the treatment results by each placement site, amongst pre-loading period. The study was intended to search for occurrence of complications and the amount of marginal bone resorption. Materials and Methods. We retrospectively reviewed the medical records of 99 cases of implants from 29 patients who were treated at Seoul National University Bundang Hospital from September 2003 to September 2008. We grouped all the cases by placement arches and pre-loading periods, and subdivided each group by placement site(anterior/posterior), type of prosthesis(full-mouth cross splinting/Partial multiple splinting, Single). Results. In the cases of anterior maxilla, the average amounts of marginal bone resorption showed $1.71{\pm}0.71mm$ in group 1, and $1.44{\pm}0.69mm$ in group 2, which means they revealed no statistically significant difference between group 1 and group 2(p=0.646). In the cases of posterior maxilla, the average amounts of marginal bone resorption showed $1.25{\pm}0.72mm$ in group 1, and $1.14{\pm}1.15mm$ in group 2, which means they were not statistically significant. In the cases of anterior mandible, there was no cases classified as group 4, but the average amounts of marginal bone resorption in group 3 showed $1.38{\pm}0.79mm$. In the cases of posterior mandible, Group 3 showed $1.39{\pm}0.64mm$, and group 4 showed $1.84{\pm}1.19mm$ as amounts of marginal bone resorption, which means they revealed no statistically significant difference between group 3 and group 4(P=0.210). The survival rate of group1 was 97.14%, 92.1% of group3, and 100% of group 2 and group4. According to each type of prosthesis, each average amount of marginal bone resorption revealed no statistically significant difference in maxi11a(p=0.575) in mandible(p=0.206). Conclusion. It is concluded that the marginal bone resorption and the rate of complications might not be affected by placement sites and pre-loading periods. The marginal bone resorption and the rate of complications might vary as different bone quality of placement site and implant system, diameter, length, etc. It is suggested that the proper placement of immediate loading implants decreases the whole treatment period and any inconvenience occurred to patients.

• Journal of Korean Dental Science
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• 제9권1호
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• pp.35-41
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• 2016

Langerhans cell histiocytosis (LCH) is characterized by proliferation of histiocyte-like cells (Langerhans cell histiocytes) with characteristic Birbeck granules, accompanied by other inflammatory cells. Treatments of LCH include surgery, chemotherapy, and radiotherapy. One of the representative forms of chemotherapy is intralesional injection of steroids. Surgical treatment in the form of simple excision, curettage, or even ostectomy can be performed depending on the extent of involvement. Radiotherapy is suggested in case of local recurrence, or a widespread lesion. This article shows the case of repetitively recurrent LCH of a 56-year-old man who had been through surgical excision and had to have marginal mandibulectomy and radiotherapy when the disease recurred. After the first recurrence occurred, lesions involved the extensive part of the mandible causing pathologic fracture, so partial mandibular bone resection was performed from the right molar area to the left molar area followed by the excision of the surrounding infected soft tissues. The resected mandibular bone was reconstructed with a segment of fibula osteomyocutaneous free flap and overdenture prosthesis supported by osseointegrated implants.