• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.85-92
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• 2005

Reconstruction of defect in the anterior part of the maxilla to enable implant placement or prothesis is a complicated treatment due to the anatomical position and lack of soft tissues. Two cases are presented in which autogenous iliac PMCB(particulate marrow and cancellous bone) with titanium mesh were used for premaxilla reconstruction and alveolar bone repair of the anterior maxillas prior to denture and implants fixation respectively. Cancellous bone from the anterior iliac crest was compressed and placed against a titanium mesh fixed to the bone of palate in a patient with severe defect of the anterior maxilla. There were no problem in the healing, and the anterior maxillas of two patients had increased height and width during the initial healing and remodeling. The clinical reports describe the use of titanium mesh for reconstruction of premaxilla. Autogenous bone grafts were harvested from the iliac crest and were loaded on a titanium mesh that were left in the patient's maxilla for 6 months before they were removed respectively. The radiographic analysis demonstrated that a 10mm vertical ridge augmentation had been achieved. In guided bone regeneration, the quantity of bone regenerated under the barrier has been demonstrated to be directly related to the amount of the space under the membrane. This space can diminish as a result of membrane collapse. To avoid this problem which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, were used in association with autologous bone in 2 cases. The aim of this study was to evaluate the capability of a configured titanium mesh to serve as a mechanical and biologic device for restoring a vertically defected premaxilla.

• Journal of Periodontal and Implant Science
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• v.45 no.5
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• pp.169-177
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• 2015

Purpose: Despite the high success rates of endosseous dental implants, their placement is restricted according to the height and volume of bone available. The use of short or mini dental implants could be one way to overcome this limitation. Thus, this study aimed to compare standard, short, and mini dental implants with regard to associated clinical parameters and peri-implant crevicular fluid (PICF) levels of cathepsin-K (CTSK), RANK ligand (RANKL), and osteoprotegerin (OPG), after prosthodontic loading. Methods: A total of 78 non-submerged implants (Euroteknika, $Aesthetica^{+2}$, Sallanches, France) were installed in 30 subjects (13 male, 17 female; range, 26-62 years) who visited the clinic of the Periodontology Department, Faculty of Dentistry, Selcuk University. Sampling and measurements were performed on the loading date (baseline) and 2, 14, and 90 days after loading. Assessment of the peri-implant status for the implant sites was performed using the pocket probing depth (PPD), modified plaque index, modified gingival index, modified sulcular bleeding index, and radiographic signs of bone loss. PICF samples collected from each implant were evaluated for CTSK, RANKL, and OPG levels using the ELISA method. Keratinized tissue and marginal bone loss (MBL) were also noted. Results: Clinical parameters statistically significantly increased in each group but did not show statistical differences between groups without PPD. Although implant groups showed a higher MBL in the upper jaw, only the standard dental group demonstrated a statistically significant difference. At 90 days, the OPG:sRANKL ratio and total amounts of CTSK for each group did not differ from baseline. Conclusions: Within the limitations of this study, both short and mini dental implants were achieving the same outcomes as the standard dental implants in the early period after loading.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.361-371
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• 2014

PURPOSE. In case of large horizontal discrepancy of alveolar ridge due to severe resorption, cantilevered crown is usually an unavoidable treatment modality. The purpose of this study was to evaluate the clinical criteria for the placement of the aforementioned implant crown. MATERIALS AND METHODS. The mandible model with 2 mm thick cortical bone and cancellous bone was fabricated from CT cross-section image. An external connection type implant was installed and cantilevered crowns with increasing offset of 3, 4, 5, 6, and 7 mm were connected. Vertical load and $30^{\circ}$ oblique load of 300 N was applied and stress around bone and implant component was analyzed. A total of 14 cases were modeled and finite element analysis was performed using COSMOS Works (Solid works Inc, USA). RESULTS. As for the location of the vertical load, the maximum stress generated on the lingual side of the implant became larger according to the increase of offset distance. When the oblique load was applied at $30^{\circ}$, the maximum stress was generated on the buccal side and its magnitude gradually decreased as the distance of the offset load increased to 5 mm. After that point, the magnitude of implant component's stress increased gradually. CONCLUSION. The results of this study suggest that for the patient with atrophied alveolar ridge following the loss of molar teeth, von-Mises stress on implant components was the lowest under the $30^{\circ}$ oblique load at the 5 mm offset point. Further studies for the various crown height and numbers of occusal points are needed to generalize the conclusion of present study.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.470-475
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• 2017

PURPOSE. The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS. Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posterior-superior and lateral-superior direction. RESULTS. The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately $50^{\circ}$ posterior-superior and $41^{\circ}$ lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION. These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.

• Steel and Composite Structures
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• v.21 no.4
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• pp.863-882
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• 2016

This study aims to introduce a new bracing system by which even super-wide frames with large openings can be braced. The proposed system, hereafter called Cable-Pulley Brace (CPB), is a tension-only bracing system with a rectilinear configuration. In CPB, a wire rope passes through a rectilinear path around the opening(s) and connects the lower corner of the frame to its opposite upper one. CPB is a secondary load resisting system with a nonlinear-elastic hysteretic behavior due to its initial pre-tension load. As a result, the required energy dissipation would be provided by the MRF itself, and the main intention of using CPB is to contribute to the initial and post-yield stiffness of the whole system. Using a stiffness calibration technique, optimum placement of the CPBs is discussed to yield a uniform displacement demand along the height of the structure. A displacement-based design procedure is proposed by which the MRF with CPB can be designed to achieve a uniform distribution of inter-story drifts with predefined values. Obtained results indicated that CPB leads to significant reductions in maximum and residual deformations of the MRF at the expense of minor increase in the maximum base shear and developed axial force demands in the columns. In the case of a typical 5-story residential building, compared to SMRF system, CPB system reduces maximum amounts of inter-story and residual drifts by 35% and 70%, respectively. Moreover, openings of the frame are not interrupted by the CPB. This is the most appealing feature of the proposed bracing system from architectural point of view.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4137-4140
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• 2012

The authors present five cases of combined oral mucosa-mandible defects reconstructed with the vascularized internal oblique-iliac crest myoosseous free flap. This technique has many advantages compared to other conventional methods such as the radial flap, scapula flap, and fibula flap. Vascularized iliac crest flaps provide sufficient high-quality bone suitable for reconstructing segmental madibular defects. Although fibular flaps allow longer donor bone tissue to be harvested, the iliac crest can provide an esthetic shape for mandibular body reconstruction and also provides sufficient bone height for dental implants. Conventional vascularized iliac crest myoosseous flaps have excessive soft tissue bulk for reconstruction of intraoral soft tissue defects. The modification discussed in the present article can reduce soft tissue volume, resulting in better functional reconstruction of the oral mucosa. Another advantage is that complete replacement of the oral mucosa is observed in as early as one month post-operation. The final mucosal texture is much better than that obtained with other skin paddle flaps, which is especially beneficial for the placement of dental implant prostheses. Donor site morbidity looks to be similar to, if not less than that observed for other modalities in terms of function and esthetics. For combined oral mucosa-mandible defects, the vascularized internal oblique-iliac crest myoosseous free flap shows good results with respect to hard and soft tissue reconstruction.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.361-368
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• 1994

Radiographic planning is needed for implant placement in order to determine implant length, jaw bone volume, anatomical stucture and so on. Radiographic examination includes conventional radiography, conventional tomography and CT scan. The most accurate mesurement can be obtained from CT scan. For the cross-sectional view of mandible, CT scan reconstruction is generally needed. But the cross-sectional view of mandible can be reformed by personal computer. This study was performed to examine the clinical usefulness of reformed image using personal computer in comparison with CT scan reconstructed image. CT axial slices of 4 mandibles of 4 volunteers were used. Digital imaging system was composed of Macintosh Ⅱ ci computer, high resolution Sony XC-77 CCD camera, Quick Capture frame grabber board and 'NIH Image' program. Seven reconstructed cross-sectional images within CT machine(CT group) were obtained. And seven reformed cross-sectional images(PC group) after digitization of CT axial slices into the personal computer were obtained. PC group was compared with CT group in the objective and subjective aspects. The results were as follow: 1. Measurement of mandibular height & width in both group showed insignificant difference(P>0.05). 2. Subjective assessment of the mandibular canal in both group showed insignificant difference(P>0.05). 3. Image reformation using personal computer could provide panoramic view, which could not be obtained in CT scan reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.1
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• pp.28-39
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• 2007

The purpose of this study is to evaluate the regenerative capacity of reconstruction in the atrophied posterior maxilla by comparing bone graft procedures and alveolar distraction osteogenesis (ADO) techniques. We performed the autogenous iliac bone graft (AGB group, 5 specimens in 3 patients), and the combination (Mixed group, 3 specimens in 3 patients) of the autogenous and deproteinized bovine bone ($Bio-Oss^{(R)}$, Geistlich Co., Switzerland) as the ratio of 2:1 in the sinus floor elevation procedures. ADO procedures using $TRACK^{(R)}$ (KLS Martin Co., Germany) were also performed to augment vertical alveolar height in atrophied posterior maxilla (ADO group, 5 specimens in 4 patients). Newly generated bone tissues were obtained with the 2.0mm diameter trephine bur (3i Co., USA) during implant fixture installation after 5-7 months. Routine histolomorphological observation, immunodot blot assay for quantitative evaluation, and immunohistochemical staining with antibodies to MMP-1, -9, -10, TIMP-1, -2, and BMP-2, -4 were all carried out. Lamellar bone formation was well shown in all specimens and new bone formations of ADO group increased than those of other procedures. In immunohistochemical staining, the strong expression of BMP-2 was shown in all specimens, and immunodot blot assay showed that bone formation is accompanied by the good induction of factors associated with angiogenesis and appeared more increased amount of osteogenic and angiogenic factors in ADO group. ADO is the most effective technique for new bone formation compared to sinus floor elevation with autogenous or mixed bone graft in the atrophied posterior maxilla. In the quantitative immunodot blot assay, the regenerated bone after ADO showed more increased products of VEGF, BMP-2, PCNA and MMP-1 than those after the other procedures, and these findings were able to be confirmed by immunohistochemical stainings.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.2
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• pp.100-105
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• 2017

Objectives: Localization of the mandibular canal (MC) and measurement of the height and width of the available alveolar bone at the proposed implant site in the posterior segment of the mandible using cone-beam computed tomography (CBCT) in patients with a single missing tooth. Materials and Methods: A cross-sectional study was performed where CBCT scans of the patients with a single missing tooth in the posterior segment of the mandible-premolar, I (1st) molar, and II (2nd) molar were used. The scans were assessed using OnDemand3D software (version 1.0; CyberMed Inc., Seoul, Korea) for localization of the MC asnd remaining alveolar bone both vertically (from the superior position of the MC to the crest of the alveolar ridge) and horizontally (buccolingual, 3 mm below the crest of the alveolar ridge). The findings were statistically analyzed using independent t-test. Results: A total of 120 mandibular sites (40 sites for each of the three missing premolar, I molar, and II molar) from 91 CBCT scans were analyzed. The average heights (from the alveolar crest to the superior margin of the MC) at the premolar, I molar, and II molar areas were $15.19{\pm}2.12mm$, $14.53{\pm}2.34mm$, and $14.21{\pm}2.23mm$, respectively. The average widths, measured 3 mm below the crest of the alveolar ridge, at the premolar, I molar, and II molar areas were $6.22{\pm}1.96mm$, $6.51{\pm}1.75mm$, and $7.60{\pm}2.08mm$, respectively. There was no statistically significant difference between males and females regarding the vertical and horizontal measurements of the alveolar ridges. Conclusion: In the study, the measurements were averaged separately for each of the single missing teeth (premolar, I molar, or II molar), giving more accurate information for dental implant placement.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.376-381
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• 1999

A variety of materials and procedures such as sinus floor elevation, sinus-lift graft, inlay bone graft using Le Fort I osteotomy, and onlay graft have been used to create adequate bone volume in the maxillary sinus for placement of endosseous implants in the posterior atrophic maxilla. Because of the frequent lack of bone in the posterior maxilla, sinus lift procedure has become a commonly practiced treatment modality. The 138 endosseous implants of 36 patients with sinus augmentation procedures performed in Korea University Hospital from January 1991 to December 1998 were summarized and analysed. The result of this study were as follows: 1. Age ranged from 39 to 57, with a mean of 50.7. 2. The mean survival rate for 138 implants with maxillary sinus lift procedure was 80.4%. 3. There was no corelationship between the fixture length, width and the survival rate. 4. The result showed that the healing period for 8-12 months was necessary if the residual alveolar bone height was less than 5mm. 5. Autogenous iliac corticocancellous block graft showed the most favorable survival rate(95%).