Gingival recession is exposure of the root surface with apical shift in the position of gingiva. The incidence of gingival recession is 8% in children and 100% after the age of 50. Recession tends to be found in patients with healthy gingiva, but more frequentely found in patients with periodontal disease, and it often causes mucogingival defects. Buccal surface of premolar is the area not only for severe gingival recession and cervical abrasion, but also the area of numbers of buccal frenum and less keratinized gingiva. Threrfore, the goal of this study was to observe the patients with periodontitis and examine whether there are clinical relations between gingival recession and cervical abrasion of premolar and other factors related with the condition of periodontal health. Generally healthy 218 patients who had periodontitis, aged between 18 and 78, were examined for depth of periodontal poket, width of attached gingival, gingival recession, cervical abrasion, and frenum of mid-buccal surface of premolar at the Department of Periodontics in Dankook University Dental Hospital and following is the result. 1. The average gingival recession and cervical abrasion of premolar with periodontal disease was 0.76mm and 0.29mm and each has 43% and 14% of incidence. Also the width of attached gingiva of mid-buccal surface was 1.77mm. the average periodontal pocket depth is 2.0mm and 47% of frequently seen was narrow single shaped frenum, and the interdistance of the frenum was mostly over 4mm. 2. With statistical significance(P<0.05), the incidence of gingival recession increased with age and was related much more with female than male, the first premolar than the second premolar, and with narrow attached gingiva and frenum. 3. With statistical significance(p<0.05), the incidence of cervical abrasion increased with age and was related with the area of the first premolar and narrow attached gingiva, but the sexual and frenum differences were not statistically significant (p>0.05). 4. The severity of gingival recession increased with age and was more related with female than male, the first premolar than the second premolar. And the area of narrow attached gingiva and frenum showed more gingival recession and the distance of frenum was more highly related than shape, and they were statistically significant (p<0.05). 5. With statistical significance(p<0.05), the severity of cervical abrasion increase with age and was observed at the first premolar and narrow attached gingiva. But the sexual and frenum differences were not statistically significant (p>0.05).
Introduction: The fibular free flap is now considered as the first choice for long mandibular discontinuity defect. In spite of its good bone quality for implant installation, its diameter is too narrow to rehabilitate the masticatory function with implant installation. In this report, distraction osteogenesis was used for the augmentation of bone to install the dental implant in the mandible which was reconstructed with a vascularized fibular free flap. Patients and Methods: Three patients undertook the vertical augmentation of grafted fibular bone and dental implants were installed. On the day 8 post-surgery, the activation of the distractor was started at the rate of 1 mm twice a day. The total amount of distraction was 15 mm in two patients and 12.5 mm in one patient. Twelve implants were installed in three patients. Dental implants were simultaneously installed during removal of the distraction device in two patients. In one patient, the implant installation was delayed after device had been removed. All three patients showed the symptoms of mild to severe postoperative infection during the activation and consolidation. However, the distracted site showed undisturbed bone regeneration. Conclusion: The distraction osteogenesis showed the reliable results for the vertical augmentation of fibular bone which was used for the mandibular reconstruction. However, the great tendency of postoperative infection must be considered and clinically controlled.
Proceedings of the Korean Society For Composite Materials Conference
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2001.05a
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pp.263-267
/
2001
The changes of interfacial properties and microfailure degradation mechanisms of bioabsorbable composites with hydrolysis were investigated using micromechanical test and acoustic emission (AE). As hydrolysis time increased, the tensile strength, the modulus and the elongation of PEA and bioactive glass fibers decreased, whereas those of chitosan fiber changed little. Interfacial shear strength (IFSS) of bioactive glass fiber/poly-L-lactide (PLLA) composite was significantly higher than that two other systems. The decreasing rate of IFSS was the fastest in bioactive glass fiber/PLLA composite, whereas that of chitosan fiber/PLLA composite was the slowest. With increasing hydrolysis time, distribution of AE amplitude was narrow, and AE energy decreased gradually.
Journal of the Korean Academy of Esthetic Dentistry
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v.31
no.2
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pp.40-46
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2022
In maxilary anteriors, aesthetic aspect are of critical importance. but it is difficult to achieve esthetic results because of the narrow buccal-lingual alveolar bone width compared to the posterior teeth and alveolar bone resorption during tooth extraction. This case report describes how to minimize alveolar bone resorption and soft tissue collapse when immediate implant placement is done after extraction of the maxillary anterior teeth due to trauma.
In candidates for aortic valve replacement [AVR]it is our primary intention to implant the largest possible vale prosthesis of at least 23 mm in diameter in patients with severe valvular aortic stenosis. However, in many patients there is an additional subvalvular asymmetric septal hypertrophy which in some cases may cause an postextrasystolic increase of the LV-aortic gradient. Another component of the aortic stenosis syndrome is a narrow valvular ring, or a combination of both. After complete removal of the diseased valve and decalcification the narrow aortic ring [< 23 mm] can be widened firstly by transaortic subvalvular septal myectomy- [TSM] thus unfolding the left ventricular outflow tract[LVOT]and secondly by extending the oblique aortic incision into the aortic valve ring or further down into the anterior leaflet of the mitral valve. The sub-and supra-valvular defect will be closed by patch enlargement of the aortic root [PEAR] using autologous pericardium. These techniques allow a considerable enlargement of the valvular ring of about 4 to 10 mm in circumference. In a retrospective study using a computerized program, 847 patients with AVR [1980-1984]were reviewed to evaluate the intraoperative hemodynamic results mainly concerning relief of the transvalvular gradient. In 626 patients AVR was performed, 151 patients had double valve replacement [AVR+MVR], and 70 patients had AVR plus additional surgical procedures. Concentrating on the AVR-group [n=626] there were 103 patients with TSM, 24 patients with PEAR and 20 patients with TSM+PEAR which demonstrated that in a total, of 147 patients of this groups [23.5%] an additional procedure was necessary. The Statistical evaluation of the intraoperative pressure measurements before and after AVR in relation to the size of the implanted prostheses indicated the lowest preoperative mean gradient in patients with AVR alone, the highest in patients who afforded TSM plus PEAR. However, after AVR the mean gradients in all three groups were very low [mean 5 to 10 mmHg]. These data indicate that in patients with a narrow aortic ring and additional considerable ASH, TSM and PEAR are suitable techniques to enlarge the aortic root to enable the implantation of an adequate aortic valve prosthesis. Long-term controls have shown that autologous pericardium is a qualified graft material for the ascending aorta.
Seo, Hyo-Seok;Chung, Chin-Hyung;Lim, Sung-Bin;Hong, Ki-Seok
Journal of Periodontal and Implant Science
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v.36
no.2
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pp.461-471
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2006
In order to achieve a satisfactory esthetic result of periodontal surgery or implant in maxillary anterior area, periodontists must be aware of normal alveolar bone anatomy. The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 78(mean age : 25 yrs) periodontally healthy volunteers participated in this study. Two maxillary central incisor and one lateral incisor were selected to study. With minimal local anesthesia, gutta-percha cone inserted to labial gingival sulcus of selected teeth just after bone sounding with periodontal probe. Metal ball (4mm diameter) attached to palatal fossa of central incisor. Then, periapical radiograph was taken according to long cone paralleling technique. After film scan, labial alveolar bone profile reproduced along interproximal bone and apical ends of gutta-percha cones on computer screen. By utilizing computer program, the distance from height of interproximal bone to the labial bone crest in central incisor-central incisor and central incisor-lateral incisor area was measured and converted to real distance by using vertical length of metal ball on film. After measuring crown length & width of central incisor, the 10 individuals ranked lowest GW/L ratio (crown width/length ratio) and the 10 ranked highest were selected as having a long-narrow(group N), or a short-wide(group W) form of the central incisors. Means of the distance from height of interproximal bone to the labial bone crest of group N, W were calculated and compared by means of independent t-test. The results were as follows: 1. Mean distance from the height of the interproximal bone to the labial bone crest was $3.5{\pm}0.7mm$ between two central incisor, and $2.8{\pm}0.6mm$ between central and lateral incisor. 2. Mean GW/L ratio of group N was 0.57, and group W was 0.8. Mean distance from the height of the interproximal bone to the labial bone crest of group N was higher than group W in both measured area(measurements of group N, W were $3.9{\pm0.2mm$ and $3.5{\pm}0.2mm$ between two central incisor, $3.0{\pm}0.2mm$ and $2.8{\pm}0.2mm$ between central and lateral incisor), but there were no statistically significant differences when the groups were compared. Within the limits of the present study, there was a tendency that subjects with long-narrow teeth have more scalloped alveolar bone profile than subjects with short-wide teeth in upper anterior area, but no statistically significant differences were found.
Journal of Dental Rehabilitation and Applied Science
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v.28
no.3
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pp.277-290
/
2012
Dental implants are universal restorative method on edentulous site in oral cavity and generally recognized by patients as well as clinicians. Rapid bone resorption of labial portion of maxillary anterior area is performed due to dental trauma, chronic periodontitis, and so on. Accordingly, Implants on maxillary anterior alveolar ridge with narrow labiopalatal width would lead to bony defects of dehiscence or fenestration. In this case, guided bone regeneration procedure is used to augment maxillary anterior alveolar ridge. It can have mechanical and biological advantages to mix tissue adhesive with bone graft materials in guided bone regeneration procedure. In these cases, when the dehiscence or fenestration defects was occurred by dental implants on maxillary anterior alveolar ridge with narrow labiopalatal width, guided bone regeneration procedures were performed with various combination of particle bone graft materials(allograft, xenograft, and alloplast) mixed with fibrin glue, excepting autogerous bone. We reported that all of 4 cases showed favorable alveolar ridge augmentations.
For about half a century. dental implants made of titanium have developed as a method of restoration for the tooth loss. In these days. the titanium implants seem to be considered as the alternative for the conventional prosthodontics. But its hard to say that the titanium implants are superior to the treatments that preserve the natural tooth. As this is a general opinion among dentists. the implant will not be able to be the alternative for all the prosthetic treatments. Clinically, there are many causes for extracting tooth. The severe destruction of the tooth structure or periodontal diseases leads to inevitable tooth extraction. When the complete cure is doubtful because of narrow intraoral visibility and improper accessibility in approaching to the tooth and periodontal lesion, we. clinicians often inevitably extract tooth. Passive treatments like conventional restoration, curettage or surgical flap cant be the perfect treatments for the tooth that has subgingival root caries or severe periodontal diseases involved furcation. Many clinicians might have been forced to pull out the relatively healthy tooth by the difficulties of approaching to the lesions and poor prognosis. Though the intentional tooth replantation is performed sometimes. as it doesnt have enough scientific foundation. it has not been considered as a popular treatment method yet. I have been felt keenly the necessity of positive tooth preservation, so I have been attempting the treatment that has new concept. calling Natural Tooth Implantation (NTI) clinically. NTI differs from the tooth replantation in the goal for the treatment and biological healing process. Now. I confirm that NT! is a very positive and valid method of tooth preservation. Like you can get from the name. NTI is the dental implant procedure using natural teeth and similar to the healing process of the titanium implants in many aspects. I have been using biocompatible composite resin. DRM. with NTI and got affirmative clinical results from that. So I would like to introduce.roduce.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.28
no.1
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pp.7-16
/
1998
The Scanora/sup (R)/ X-ray unit uses the principles of narrow beam radiography and spiral tomography. Starting with a panoramic overview as a scout image. multiple tomographic projections could be selected. This study evaluated the accuracy of spiral tomography in comparison to routine panoramic radiography for dental implant treatment planning. An experimental study was performed on a cadaver mandible to assess the accuracy of panoramic radiography and spiral tomography film images for measurement of metallic spheres. After radiographic images of the metallic spheres on the surgical stent were measured and corrected for a fixed magnification of radiographic images. following results were obtained. 1. In the optimal position of the mandible. the minimal horizontal and vertical distortion was evident in the panoramic radiography images. The mean horizontal and vertical magnification error in anterior sites was 5.25% and 0.75%. respectively. The mean horizontal and vertical magnification error in posterior sites was 0.50% and 1.50%. respectively. 2. In the displaced forward or in an eccentric position of the mandible. the magnification error of the panoramic radiography images increased significantly over the optimal position. Overall, the mean horizontal magnification error of the anterior site in the different positions changed dramatically within a range of -17.25% to 39.00%, compared to the posterior range of -5.25% to 8.50%. However, the mean vertical magnification error stayed with the range of 0.5% to 3.75% for all the mandibular positions. 3. The magnification effects in the tomographic scans were nearly identical for the anterior and posterior with a range of 2.00% to 5.75% in the horizontal and 4.50% to 5.50% in the vertical dimension, respectively. 4. A statistically significant difference between the anterior and posterior measurements was found in the horizontal measurements of the panoramic radiography images of the displaced forward and backward position of the mandible(P<0.05). Also a significant difference between the optimal panoramic and tomographic projections was found only in the vertical measurement(P<0.05).
This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency (22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.
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