• Title/Summary/Keyword: Posterior maxilla

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Soft tissue changes of upper lip and nose following posterosuperior rotation of the maxilla by Le Fort I osteotomy (Le Fort I 골절단술을 통한 상악의 후상방 회전에 따른 상순과 비부의 연조직 변화)

  • Kwon, Young-Wook;Pyo, Sung-Woon;Lee, Won;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.457-463
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    • 2011
  • Introduction: This study evaluate the soft tissue changes to the upper lip and nose after Le Fort I maxillary posterosuperior rotational movement. Materials and Methods: Twenty Skeletal class III patients, who had undergone bimaxillary surgery with a maxillary Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included in the study. The surgical plan for maxilla was posterosuperior rotational movement, with the rotation center in the anterior nasal spine (ANS) of maxilla. Soft and hard tissue changes were measured by evaluating the lateral cephalograms obtained prior to surgery and at least 6 months after surgery. For cephalometric analysis, four hard tissue landmarks ANS, posterior nasal spine [PNS], A point, U1 tip), and five soft tissue landmarks (pronasale [Pn], subnasale [Sn], A' Point, upper lip [UL], stomion superius [StmS]) were marked. A paired t test, Pearson's correlation analysis and linear regression analysis were used to evaluate the soft and hard tissue changes and assess the correlation. A P value <0.05 was considered significant. Results: The U1 tip moved $2.52{\pm}1.54$ mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved $0.97{\pm}1.1$ mm downward (P<0.05), UL moved $1.98{\pm}1.58$ mm posteriorly (P<0.05) and $1.18{\pm}1.85$ mm inferiorly (P<0.05), and StmS moved $1.68{\pm}1.48$ mm posteriorly (P<0.05) and $1.06{\pm}1.29$ mm inferiorly (P<0.05). The ratios of horizontal soft tissue movement to the hard tissue were 1:0.47 for the A point and A' point, and 1:0.74 for the U1 tip and UL. Vertically, the movement ratio between the A point and A' point was 1:0.38, between U1 tip and UL was 1:0.83, and between U1 tip and StmS was 1:0.79. Conclusion: Posterosuperior rotational movement of the maxilla in Le Fort I osteotomy results in posterior and inferior movement of UL. In addition, nasolabial angle was increased. Nasal tip and base of the nose showed a tendency to move downward and showed significant horizontal movement. The soft tissue changes in the upper lip and nasal area are believed to be induced by posterior movement at the UL area.

Retrospective Study of Success Rate of the $XiVE^{(R)}$ Implant;Early evaluation of clinical performance (($XiVE^{(R)}$ 임프란트의 성공률에 관한 후향적 연구;임상성적에 관한 조기평가)

  • Park, Jin-Woo
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.65-76
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    • 2005
  • This retrospective study evaluates the clinical performance of the recently introduced $XiVE^{(R)}$ implant(Dentsply-Friadent) with a new macro-design to improve primary stability. A total of 208 $XiVE^{(R)}$ implants (101 in the maxilla and 107 in the mandible) were placed in 71 patients. The average age of the patients was 49 years. Of the 208 implants, 190 (91.3%) were posterior implants and 82 (39.4%) were placed in compromised sites (grafted sites). Clinical and radiographic evaluation were made at second stage surgery for exposure and after functional loading. 192 implants in 64 patients were evaluated at exposure and 146 implants in 50 patients were loaded (average 170 days-loading) and evaluated after functional loading. Of 192 implants available for evaluation before loading, 3 implants failed (early failure) ; 1 before exposure, 1 at exposure and 1 during prosthetic procedure. 2 implants were in the maxilla and 1 was in the mandible. The success rate before loading was 98.4%. After functional loading, no implant failure was occurred in 146 implants evaluated during this period (100% interval success rate). This preliminary data with a new implant showed excellent success rate although the majority of implants evaluated in this study were placed in the posterior region of the jaw and compromised sites.

ORIGINAL ARTICLE - Analysis of RFA related to stabilities by types and areas of dental implants (ORIGINAL ARTICLE - 임플란트 종류 및 식립부위에 따른 안정성에 대한 RFA 분석)

  • Yi, Hee-Yong;Park, Min-Ju;Cho, Hyun-Jae;Yu, Ki-Jun;Ha, Jung-Eun;Baek, Dae-Il;Bae, Gwang-Hak
    • The Journal of the Korean dental association
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    • v.50 no.1
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    • pp.31-37
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    • 2012
  • Objective : This research compared stabilities between two types of dental implant ($SLA^{TM}$, Institut Straumann AG, Waldenburg, Switzerland and $SSII^{TM}$, Osstem co, Busan, Korea) using Osstell Mentor (Integration Diagnostics AB, Goteborg, Sweden) considering surgery methods, surgery area, diameter of implant, systemic disease, and smoking for obtaining prognosis information when installing fixture of dental implant. Materials & Methods : 206 implants of 131 patients taken by resonance frequency analysis (RFA) were determined as a final sample. Dental implants were installed as protocol of supplier by a excellent dentist who had 10 years experience about dental implants. Before connecting abutments (3 months after installation of fixture), RFA were measured twice for buccal and lingual direction to obtain average value. Results : Dental implants at mandible showed significantly higher stabilities significantly than at maxilla (p<0.001). Diameter 4.8 implants had also higher stabilities than diameter 4.1 in case of $SLA^{TM}$ implants (p<0.001). $SLA^{TM}$ implants showed more excellent stabilities than $SSII^{TM}$ implants, especially at posterior area of mandible (p=0.045) and premolar area of maxilla (p=0.032). Conclusions : This research revealed higher stabilities of $SLA^{TM}$ implants than $SSII^{TM}$ implant, especially at posterior area of mandible (p=0.045) and premolar area of maxilla (p=0.032).

Implant Fixture Installation in the Posterior Maxilla Using a Tooth-supported Surgical Template Based on Computer Assisted Treatment Planning (컴퓨터 보조 기반 치아 지지 서지컬 템프레이트를 이용한 상악구치부 임플란트 식립)

  • Kim, Soung Min;Kim, Myung Joo;Lee, Jee Ho;Myoung, Hoon;Lee, Jong Ho;Kim, Myung Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.6
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    • pp.381-389
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    • 2013
  • Two patients with partial edentulous maxilla were scheduled to undergo installation of implant fixtures using a tooth-supported surgical template based on computer assisted treatment planning. After 3-dimensional (3D) computed tomographic scanning was transferred to the OnDemand3D (Cybermed Co., Seoul, Korea) software program for virtual planning, fixtures of MK III Groovy RP implant of the Br${\aa}$nemark System (Nobel Biocare AB Co., G$\ddot{o}$teborg, Sweden) was installed using the In2Guide (CyberMed Co., Seoul, Korea) tooth-supported surgical template with a Quick Guide Kit (Osstem Implant Co., Seoul, Korea) system in the posterior maxilla of each patient. Sinus floor elevation with a xenogenic bone graft procedure was also performed simultaneously in one patient. Fixture installations were completed successfully without complications, such as sinus mucosa perforation, bony bleedings, fenestrations, or others. During the last two-year follow-up period after prosthetics delivery, each implant was found to be fine with no other minor complications. The entire procedures are reported and the literatures on use of tooth-supported surgical template was reviewed.

Prognostic factors associated with the success rates of posterior orthodontic miniscrew implants: A subgroup meta-analysis

  • Hong, Sung-Bin;Kusnoto, Budi;Kim, Eun-Jeong;BeGole, Ellen A;Hwang, Hyeon-Shik;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.46 no.2
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    • pp.111-126
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    • 2016
  • Objective: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. Methods: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. Results: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ${\geq}20$ years of age, and for long MIs (${\geq}8mm$) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). Conclusions: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery

  • Hong, Mihee;Kim, Myung-Jin;Shin, Hye Jung;Cho, Heon Jae;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.5
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    • pp.293-303
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    • 2020
  • Objective: To investigate the three-dimensional (3D) surgical accuracy between virtually planned and actual surgical movements (SM) of the maxilla in two-jaw orthognathic surgery. Methods: The sample consisted of 15 skeletal Class III patients who underwent two-jaw orthognathic surgery performed by a single surgeon using a virtual surgical simulation (VSS) software. The 3D cone-beam computed tomography (CBCT) images were obtained before (T0) and after surgery (T1). After merging the dental cast image onto the T0 CBCT image, VSS was performed. SM were classified into midline correction (anterior and posterior), advancement, setback, anterior elongation, and impaction (total and posterior). The landmarks were the midpoint between the central incisors, the mesiobuccal cusp tip (MBCT) of both first molars, and the midpoint of the two MBCTs. The amount and direction of SM by VSS and actual surgery were measured using 3D coordinates of the landmarks. Discrepancies less than 1 mm between VSS and T1 landmarks indicated a precise outcome. The surgical achievement percentage (SAP, [amount of movement in actual surgery/amount of movement in VSS] × 100) (%) and precision percentage (PP, [number of patients with precise outcome/number of total patients] × 100) (%) were compared among SM types using Fisher's exact and Kruskal-Wallis tests. Results: Overall mean discrepancy between VSS and actual surgery, SAP, and PP were 0.13 mm, 89.9%, and 68.3%, respectively. There was no significant difference in the SAP and PP values among the seven SM types (all p > 0.05). Conclusions: VSS could be considered as an effective tool for increasing surgical accuracy.

Juxtacortical Osteogenic Sarcoma of Chondroblastic Type on the Maxilla (상악골에 발생된 연골형성현 측피질골육종)

  • Choi Sun-Young;Choi Eun-Suk;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.2
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    • pp.539-563
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    • 1998
  • 39-year-old female had been treated for the exophytic mass on buccal aspect of the left, maxillary posterior area 2 years and 8 months ago. Tentative diagnosis was obtained as fibrous dysplasia on clinical and radiographic examinations and histopathologic findings revealed as osteochondroma after bone trimming at that time. She revisited for the treatment of recurred lesions. We reviewed this case with clinical. radiologic and histopathologic standpoints retrospectively, and came to a conclusion that the tumor primarily occurred was juxtacortical osteogenic sarcoma and recurred due to inadequate treatment and then expanded over intramedullary. This case shows that the diagnosis of osteosarcoma should take account of the patient history, clinical. radiographic and histopathologic findings and it requires attentive follow up check. Retrospectively reviewed results were as follows ; At first visit, oral examination revealed a bony hard swelling on the buccal aspect of the left maxillary posterior area. Radiographically, a dense radiopaque mass was noted on the site. The lesion showed hot uptake of /sup 99m/Tc-MDP. Histopathologic diagnosis was done as osteochondroma, but it was considered as osteogenic sarcoma when compared with the recurrent lesion. When she revisited for the treatment of multiple bony swelling on the left maxilla, radiograms showed typical features of malignancy such as widening of periodontal ligament space and sunray appearace, and coincided with benign characters as follows; relatively well circumscribed lesion and expansion and displacement of the adjacent structures. Finally, histopathologic findings of the lesion was well differentiated chondroblastic osteogenic sarcoma.

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A cephalometric evaluation of anterior j hook headgear traction to the maxilla (Anterior j hook headgear를 이용한 상악골 성장억제에 관한 연구)

  • Chung, Kyu-Rhim;Kang, Jang-Yun
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.387-398
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    • 2000
  • This study was aimed to observe the effect of Anterior J hook headgear on the craniofacial structures in mixed dentition with Class II malocclusion. The laterial cephalograms of 20 children treated by Anterior J hook headgear were traced, digitized and statistically analyzed. The results were as follows : 1. Forward growth of maxilla was inhibited. 2. Rotational effect of maxilla was not observed. 3. There was distal movement of maxillary dentition. 4. Maxillarly_dentoalveolar growth changes were more effective in anterior portion than posterior portion. 5. Mandible maintained a normal growth and mandibular plane angle was maintained during treatment period. 6. The ratio of anterior facial height to posterior facial height was almostly not changed.

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Simultaneous implant placement with sinus augmentation using a modified lateral approach in the pneumatized posterior maxilla: A Case Report (함기화된 상악 구치부에서 변형 측방 접근법을 이용한 상악동 거상술과 임플란트 동시식립에 대한 증례보고)

  • Sun, Yoo-Kyung;Cha, Jae-Kook;Lee, Jung-Seok;Jung, Ui-Won
    • The Journal of the Korean dental association
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    • v.56 no.3
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    • pp.142-150
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    • 2018
  • In the posterior maxillary area, due to resorption of the ridge after extraction and pneumatization of the maxillary sinus, the height of the alveolar ridge may not be sufficient for placement of implants. To solve this problem, sinus augmentation using both crestal and lateral approaches have been widely used. Jung et al. (2010) introduced the modified lateral approach technique, which is a simplified technique that combines the advantages of crestal and lateral approaches. The purpose of this case report is to report two cases in the posterior maxilla in which simultaneous implant placement with maxillary sinus augmentation has been performed using the modified lateral approach technique. In two female patients, 67 and 74 years old, respectively, simultaneous implant placement was performed using the modified lateral approach technique on the left maxillary second premolar and the first molar. In both patients, the residual bone height on the distal side of the maxillary second premolar was measured to be approximately 5 mm, and the residual bone height of the first molar was measured to be 2-3 mm. After flap elevation, osteotomy of the lateral window was performed in the form of a mesiodistally extended slot above the sinus floor and the Schneiderian membrane was elevated. Sequenced drilling was performed while protecting the membrane with a periosteal elevator. Bone graft and implant placement was performed after preparation of the implant site. Sufficient primary stability was achieved for each implant and sinus membrane was not perforated. After four and five months respectively, implant second surgery was performed. Clinically, the implants were observed to be stable. Implants and surrounding peri-implant mucosa were well maintained after prosthodontic treatment. In conclusion, the modified lateral approach could be a predictable and efficient technique for implant placement in the atrophied posterior maxilla.

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Adenocarcinoma of the parotid gland with calcification (석회화를 수반한 이하선내 선양암종)

  • Song Haeng-Eun;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.32 no.1
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    • pp.55-59
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    • 2002
  • A 78-year-old woman was referred to Chonbuk National University Dental Hospital complaining of facial palsy and palpable mass on the right parotid gland area. Clinical examination showed non-specific findings of the intraoral region, but showed asymmetrical facial appearance. Panoramic view showed a large amorphous calcified mass on the posterior to the mandibular ramus and thin cortical plate of the posterior ramus. Sialogram showed constriction of the main duct and no further filling of striated, intercalated ducts and parenchymal areas. CT scans demonstrated an irregular, infiltrating mass with slight enhancement in the right parotid gland. The mass showed necrotic areas and calcifications. Bone scan showed marked accumulation of /sup 99m/Tc-MDP on the right posterior maxilla. Microscopic findings demonstrated the minimal morphologic alterations and rare mitotic figures within tumor cells, and diagnosed as adenocarcinoma (NOS, Grade II). This report could be aid in the diagnosis of calcified lesions of the salivary gland.

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