• The Journal of Advanced Prosthodontics
• /
• v.8 no.5
• /
• pp.396-403
• /
• 2016

PURPOSE. Early loading of implant can be determined by excellent primary stability and characteristic of implant surface. The implant system with recently improved surface can have load application 4-6 weeks after installing in maxilla and mandible. This study evaluated the effect of healing period to the stability of hydrophilic tapered-type implant at maxillary posterior area. MATERIALS AND METHODS. This study included 30 patients treated by hydrophilic tapered-type implants (total 41 implants at maxilla) and classified by two groups depending on healing period. Group 1 (11 patients, 15 implants) was a control group and the healing period was 12 weeks, and Group 2 (19 patients, 26 implants) was test group and the healing period was 6 weeks. Immediately after implant placement, at the first impression taking, implant stability was measured using Osstell Mentor. The patients also took periapical radiographs after restoration delivery, 12 months after restoration and final followup period. The marginal bone loss around the implants was measured using the periapical radiographs. RESULTS. All implants were survived and success rate was 97.56%. The marginal bone loss was less than 1mm after 1 year postoperatively except the one implant. The stabilities of the implants were not correlated with age, healing period until loading, insertion torque (IT), the diameter of fixture and the location of implant. Only the quality of bone in group 2 (6 week) was correlated with the stability of implant. CONCLUSION. Healing period of 6 weeks can make the similar clinical prognosis of implants to that of healing period of 12 weeks if bone quality is carefully considered in case of early loading.

• The Journal of Korean Academy of Prosthodontics
• /
• v.46 no.6
• /
• pp.553-560
• /
• 2008

STATEMENT OF PROBLEM: Proximal contact plays an important role in the stability and maintenance of the integrity of the dental arches. However, it is difficult to evaluate quantitatively the tightness of proximal tooth contact (TPTC). PURPOSE: The aim of this study was to measure the TPTC in permanent dentition. MATERIAL AND METHODS: Ten young adult volunteers with healthy dentition participated in this experiment. The TPTC between the teeth of both the maxilla and the mandible was measured at rest state by a novel device which records the TPTC by pulling of a stainless steel strip (0.03 mm thick) using the electric motor. One-way ANOVA test was used to compare the values in all measured area. When a statistically significant difference was calculated, Bonferroni correction was applied. Independent samples t-test was used to compare the values in male and female. RESULTS: The lowest TPTC and the highest TPTC was measured between the lower central incisors (0.87 ${\pm}$ 0.20 N), and between the lower left first molar and second molar (1.99 ${\pm}$ 0.68 N), respectively. All TPTC per quadrant demonstrated a similar pattern of a continuous increased gradient in an anterior-posterior direction. There are no significant difference between the maxilla and mandible. CONCLUSION: The TPTC was measured quantitatively by a novel device and decreased progressively in a posterior-anterior direction.

• Imaging Science in Dentistry
• /
• v.38 no.1
• /
• pp.1-5
• /
• 2008

Purpose: The primary aims of this retrospective study were to compare subjective bone quality and bone quality based on the Hounsfield scale in different segments of the edentulous jaw, and to establish quantitative and objective assessment of the bone quality. Materials and Methods: Twenty eight randomly selected cone-beam computed tomographic (CBCT) scans were analyzed. For evaluation one hundred and twelve edentulous areas were selected. Implant recipient sites were evaluated visually for Lekholm and Zarb classification. The same sites were subsequently evaluated digitally using the Hounsfield scale with Vimplant$2.0^{TM}$, and the results were correlated with visual classification. Data was subject for statistical analysis in order to determine correlation between recorded HU and the regions of the mouth with the Kruskal-Wallis test. Results: The highest unit/mean density value (311 HU) was found in the anterior mandible, followed by 259 HU for the posterior mandible, 216 HU for the anterior maxilla, and 127 HU for the posterior maxilla. These results demonstrate a strong correlation for HU depending on the region of the mouth (p<0.001). The relationship between HU and type 4 bone was found to be significant (r=0.74). Conclusion: Knowledge of the Hounsfield value as a quantitative measurement of bone density can be helpful as a diagnostic tool by using $CBMercuRa6^{TM}$ with $Vimplant^{TM}$ software.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.4
• /
• pp.304-312
• /
• 2016

PURPOSE. The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site. MATERIALS AND METHODS. Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex. RESULTS. The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration. CONCLUSION. 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla.

• The korean journal of orthodontics
• /
• v.19 no.3
• /
• pp.67-78
• /
• 1989

This study was designed to investigate the difference of teeth and craniofacial complex between normal occlusion and Angle's Class II, div. 1 malocclusion in Korean children. The sample was divided into 2 groups, the 66 subjects with normal occlusion and 96 subjects with Angle's Class II, div. 1 malocclusion in both sexes. The results obtained were as follows: 1. No significant differences were observed in ant. cranial base length & cranial flexure (saddle) angle) between normal occlusion & Angle's Class II, div. 1 malocclusion group, but posterior cranial base length of Class II, div. 1 malocclusion group was larger than that of normal occlusion group. 2. No significant difference was observed in the anteroposterior position of Maxilla to cranial base between two groups, but mandibular position in Class II, Div. 1 malocclusion was posterior and interior to that of normal occlusion. 3. The length of maxilla (ANS-PSN) was larger in Class II, div. 1 malocclusion than normal occlusion. The length of mandibular body (Go-Me) was nor different between Class II, div. 1 malocclusion and normal occlusion. 4. Maxillary incisor position of Class II, div. 1 malocclusion to cranial base was more protrusive than that of normal occlusion, but there was no difference in mandibular incisor position between two groups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.45 no.1
• /
• pp.21-28
• /
• 2019

Objectives: Osteoradionecrosis (ORN) is one of the most severe complications resulting from radiotherapy (RT) in patients with head and neck cancer (HNC). It is characterized by persistent exposed and devitalized bone without proper healing for greater than 6 months after a high dose of radiation in the area. To describe the profile and dental management of ORN in HNC patients undergoing RT in an oncological clinical research center. Materials and Methods: A retrospective descriptive study was performed to analyze dental records from HNC patients with ORN treated at an oncological clinical research center from 2013 to 2017. A total of 158 dental records for HNC patients were selected from a total of 583 records. Afterwards, this number was distributed to three examiners for manual assessments. Each examiner was responsible for selecting dental records that contained an ORN description, resulting in 20 dental records. Results: Mean patient age was 60.3 years with males being the most affected sex (80.0%). The most affected area was the posterior region of the mandible (60.0%) followed by the anterior region of the mandible (20.0%) and the posterior region of the maxilla (10.0%). The factors most associated with ORN were dental conditions (70.0%) followed by isolated systemic factors (10.0%) and tumor resection (5.0%). There was total exposed bone closure in 50.0% of cases. The predominant treatment was curettage associated with chlorhexidine 0.12% irrigation (36.0%). Conclusion: Poor dental conditions were related to ORN occurrence. ORN management through less invasive therapies was effective for the closure of exposed bone areas and avoidance of infection.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.33 no.1
• /
• pp.47-54
• /
• 2017

The atrophy of edentulous ridge and pneumatization of the maxillary sinus often limit the volume of bone available for implant placement on maxillary posterior teeth. Most clinicians suffer difficulties from poor bone quality and quantity on maxillary posterior site. Thus, the success of maxillary posterior implant surgery depends on the increase of the available bone and obtaining a good initial stability of the implant after maxillary sinus reconstruction. The maxillary sinus augmentation methods include a crestal approach and a lateral approach. Less morbidity and complications after operation is major advantage to sinus augmentation using crestal approach than lateral approach. However, when the residual ridge height is ${\geq}6mm$, it is known that crestal approach is appropriate. Also delayed implantation after sinus augmentation is recommended in severely atrophic ridge. We present the three cases of implant placement simultaneously sinus augmentation using crestal approach in posterior maxilla site with ${\leq}3mm$ of residual alveolar bone.

• Journal of Periodontal and Implant Science
• /
• v.34 no.1
• /
• pp.101-112
• /
• 2004

Osseointegrated implnats have proven to be successful in both full and partial edentulous patients since the 1960s and recently have shown successful results when used to restore single tooth missing. However, in most studies reporting the success of single implants, single implants replacing anterior teeth are more frequently mentioned than posterior single implants. Moreover, in studies regarding posterior single implants, the replaced region seemed to be variable; the maxilla, mandible and areas from the first premolar to the second molar were mentioned. However, considering the difference in bone quality in the mandible and maxilla, and the increased occlusal force in the posterior region, the success rates in each region may be different. In this study, the cumulative success rates and amount of bone loss of single implants replacing the mandibular first and second molar, respectively, were compared and analyzed to come to the following conclusion. 1. The 20 (20 persons) single implants that were placed in the mandibular first molar region were all successful and showed a 100% 5 year cumulative success rate. Among the 27 (24 persons) single implants replacing the mandibular second molar, 8 failed (27.63%) showing a 5 year cumulative success rate of 70.37%. 2. Among the 8 failed implants, one showed symptoms of postoperative infection and one complained of parenthesia. 6 implants failed after functional loading; 5 showed mobility and one resulted in fixture fracture. 3. After the attachment of the prosthesis, there was no significant statistical difference regarding the marginal bone loss in group 1 and group 2 during the checkup period (P>0.05). In conclusion, restoration of the mandibular first molar using single implants was found to be an excellent treatment modality, and when replacing mandibular second molars with single implants, poor bone quality and risk of overloading must be considered.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.34 no.3
• /
• pp.186-199
• /
• 2012

Purpose: Single implants, of which screw loosening has been observed frequently, presents problems such as fixtures fractures, marginal bone loss, and inflammation of the soft tissue around the implant. However, the single implant is more conservative, cost effective, and predictable compared to the 3 unit bridge with respect to the long-term outcome. This study evaluated the survival rate as well as future methods aimed at increasing the survival rate in single implants in posterior teeth. Methods: Among the implants placed in the Dankook University Dental Hospital department of Oral & Maxillofacial surgery from January 2001 to June 2008, 599 implants placed in the maxillar and mandibular posterior were evaluated retrospectively. Survival rates were investigated according to implant location, cause of tooth loss, gender, age, general disease, fixture diameter and length, surface texture, implant type and shape, presence of bone graft, surgery stage, surgeons, bone quality and opposite teeth. Results: Out of 599 single implants in posterior teeth, 580 implants survived and the survival rate was 96.8%. The difference in survival rate was statistically significant according to the implant location. The survival rate was low (84.2%) in implants exhibiting a wide diameter (${\geq}5.1mm$) and the surface treated by the acid etching group demonstrated a significantly lower survival rate (91.1%). One stage surgical procedure, which implemented a relatively better bone quality survival rate (100%), was higher than the two stage surgical procedure (96.1%). The survival rate of type IV bone quality (75%) was significantly lower than the other bone quality. Conclusion: Single posterior teeth implant treatments should use an improved surface finishing fixture as well as careful and safe procedures when performing implant surgery in the maxilla premolar and molar regions since bone quality is poor.

• The korean journal of orthodontics
• /
• v.19 no.1 s.27
• /
• pp.201-218
• /
• 1989

This study was focused on the distribution of different facial types of the Class II division I malocclusion groups and skeletal characteristics of the each group and those that anteropsterior relationship of the maxilla and mandible calculated from the analysis of ANB angle and Wits appraisal was quite different from each other, as well. Cephalometric headplates of 140 persons of Class II division 1 malocclusion whose mean age was 11.2 years and 69 persons of normal occlusion whose mean age was 12.2 years were utilize as materials. Measurements were recorded, tabulated and statistically analyzed employing the tracings of the lateral cephalograms, then Class II division 1 malocclusion group was divided into 9 Types according to the angle of SNA and SNB for the anteroposterior relationship of the maxilla and mandible, another 9 Types according to the FH-NPog and SN-MP for the horisontal and vertical relationship, and the other 9 Types according to the ANB and Wits appraisal for intermaxillary relationship as well, with which was based on $Mean{\pm}$ 1SD of those of normal occlusion. The result allowed the following conclusion: 1. $37.1\%$ of population demonstrated maxilla within nounal range and retrognathic mandible to the cranial base, $30\%$ for both maxilla and mandible within normal range, $20\%$ for retrognathic maxilla and mandible and $12.9\%$ of the rest were ananged in Class II division 1 maloccusion groups. 2. Retrognathic mandible and hyperdivergent face accounted for $30.7\%$, mesognathic mandible and neutrodivergent face for $29.3\%$, mesognathic mandible and hyperdivergent face for $16.4\%$, retrognathic mandible and neutrodivergent face for $13.6\%$, mesognathic mandible and hypodivergent face for $10\%$ of population were computed in Class II division 1 malocclusion groups. 3. It was suggested that skeletal Class II malocclusion might be due to anomaly in size and shape of cranial base, underdevelopment of mandible, retropositioning of mandible, underdevelopment of posterior face against anterior face, or any combination of these factors. 4. Population with underdevelopment and / or retropositioning of the mandible showed hyperdivergent tendency of facia profile. 5. The ANB angle and Wits appraisal did not coincide the severity of anteroposterior dysplasia in $35.7\%$ of Class II division 1 malocclusion group each other, and this inconsistency was suggested to be related with mandibular rotation, inclination of cranial base, and anteroposterior position of the maxilla.