• Journal of International Society for Simulation Surgery
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• v.3 no.2
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• pp.90-92
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• 2016

Horizontal bone defect in the anterior maxilla makes it difficult to place dental implant. The golden standard for bone augmentation is autogenous block bone graft. Tight contact with recipient site and rigid fixation are two key factors for successful block bone graft. Ramal bone graft has been the most reliable methods for dental implant field. However, the curvature of the alveolar ridge is different from ramal bone shape. Intraoperative trimming of ramal bone is cumbersome for surgeon. In this technical note, a simple way to design the ramal bone harvest using bone wax stent is reviewed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.324-331
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• 2001

The present study was aimed to investigate the effects of latency period on alveolar ridge distraction using the intraoral distraction device. Nine adult mongrel dogs of either sex, weighing about 15kg, were used. They were divided into 3-day, 5-day, and 7-day groups according to the latency period. The left upper and lower premolars and first molars were extracted. Twelve weeks after the extraction, an osteotomy was performed and the distraction device was applied. After the latency period, the distraction was applied at a rate of 1.2mm for 8 days. The distraction device was left in place for 2 weeks to allow consolidation and was then removed. The animals were sacrified at 8 weeks after completion of distraction and were examined macroscopically, radiographically, and histologically. After completion of the distraction, the alveolar crest protruded prominently, showing the vertical augmentation of the alveolar bone. Soft tissues were broken down after the 6th day of distraction in 3-day latency group, and premature union occurred on the 7th day of distraction in the 7-day latency group. The average distance was $9.40{\pm}0.3mm$ in 3-day latency group, $9.35{\pm}0.1mm$ in 5-day latency group, and $8.85{\pm}0.1mm$ in 7-day latency group. In the radiograph taken at 8 weeks after distraction, there was slight bone resorption around the medial and distal edges of the alveolar bone segment, and a new bone deposition was observed in the neighboring alveolar crest area in all groups. Fibrous tissues were present in a part of the buccal cortical bone area of the distraction gap, and the woven and lamellar bones were observed in the distracted gap. There were bony bridges in the distraction gap in all animals examined. These results suggest that optimal time of latency period on alveolar ridge distraction using the intraoral distraction device is about 5 days in dogs, and about 7days in human beings.

• Journal of Korean Dental Science
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• v.4 no.2
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• pp.59-66
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• 2011

Purpose: This research sought to determine the resorption rate of bone grafted to the maxillary sinus according to the grafted material's type, patient's age, systemic disease, implant size, site of implant placement, and residual ridge height. Materials and Methods: This research targeted 24 patients who had immediate Osstem$^{(R)}$ implant (US Plus$^{(R)}$) placement after bone graft. The panorama was taken before the surgery, after the surgery, and 6 months after the surgery. Vertical height change and resorption rate of the grafted bone were measured with the same X-rays and compared. The influence of the following factors on the grafted bone material's resorption rate was evaluated: grafted material type, patient's age, systemic disease, implant size, site of implant placement, and residual ridge height. Results: Patients in their 40s had $34.0{\pm}21.1%$ resorption rate, which was significantly higher compared to the other age groups (P<0.05). There was no significant relationship between systemic disease and grafted bone resorption. There was no significant relationship between implant size (diameter, length) and grafted bone resorption. There was no significant relationship between the site of implant placement and grafted bone resorption. The ramal bone-grafted site was significantly more resorbed than the ramal bone/Bio-Oss$^{(R)}$-grafted site, maxillary tuberosity bone/Bio-Oss$^{(R)}$-grafted site, and ramal bone/maxillary tuberosity bone/Bio-Oss$^{(R)}$-grafted site (P<0.05). There was no significant difference in the grafted bone resorption rate in the sinus between more than 4 mm and less than 4 mm residual ridge heights. After an average of 6 months, a second surgery was done; given an average follow-up of 1.9 years, the success rate and survival rate of the implant were 96.9% and 98.4%, respectively. Conclusion: These results indicate that the bone resorption rate of grafted bone among patients in their 40s is higher compared to patients in their 50s and over, and that only autogenous bone (ramus) shows higher resorption rate than the mixed graft of autogenous bone and xenogenous graft (Bio-oss) after maxillary sinus graft.

• Implantology
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• v.22 no.4
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• pp.220-235
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• 2018

Sinus lift procedure is frequently required for the maxillary molar implant placement. Previous studies have demonstrated alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. However, there is a lack of studies which evaluated the effect of ARP to avoid sinus lift procedure. Purpose of this study is to describe a method reducing the need of sinus lift surgery by ARP in maxillary molar areas and to assess the feasibility clinically, radiologically and histologically. Ten maxillary molars in ten patients had severe vertical bone resorption with minimal residual bone height. They were considered having the high possibility of the necessity of sinus lift procedure for dental implant after the extraction. After extraction, open healing ARP with deproteinized bovine bone mineral mixed with 10% collagen and resorbable collagen membranes was performed. After sufficient healing, dental implants were placed, and evaluated clinically and radiologically. Histological observation was conducted just before the implantation in one patient. Implants were successfully placed without sinus lift in all ten cases. All the implants were restored with no sign of complications, and patients are now in a close follow-up up to 20 months post-loading. Histological observation showed minimal inflammatory reaction and newly formed bone was substantially noted. The ARP technique has successfully avoided the sinus lift surgeries. It appears that this procedure may improve the simplicity of the clinical process for the clinicians and reduce the discomfort of patients.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.317-322
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• 2018

The tongue, especially its lateral part, is the most common site of oral tumors. Patients who undergo glossectomy for the treatment of tongue cancer may experience difficulty in proper functioning for pronunciation, chewing, swallowing, and oral hygiene maintenance; therefore, a palatal augmentation prosthesis can be used to restore function of the tongue. In this case, an implant overdenture was used in a patient who had residual ridge resorption and obliteration of alveololingual sulcus after undergoing glossectomy for tongue cancer treatment. In addition, a palatal augmentation prosthesis with a metal framework, support, and retention part was fabricated. The palatal vault was reduced, so that even with limited tongue movement, adequate tongue-palate contact could be achieved. After placement of the definitive prostheses, the patient showed improvement in the functions of chewing, swallowing, and pronunciation.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.33-38
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• 2014

Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.1
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• pp.107-118
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• 2007

Statement of problem: Implant-type distractor uses a removable distraction device that has an appearance similar to that of a dental implant and utilizes many of the same techniques for placement as are used for dental implants. Material and method: In this study, 48 implant type titanium distractors were inserted into the osteotomized alveolar bone of 12 beagle dogs. After a 7-day latency period, the alveolar bone was augmented by 5mm vertically at a rate of 1.0 mm/day. The dogs were sacrificed after 4weeks, 8weeks and 12 weeks for radiographic, histologic, and histomorphometric analysis. Result: Copper equivalent value showed significant difference between 4 weeks and the other weeks(8, 12 weeks)(p<0.05). But there was no significant difference between maxillary and mandibular groups. In the bone to metal contact analysis, there was a significant difference between 4 weeks and 12 weeks(p<0.05). On the contrary, there was no significant difference between maxilla and mandible. The bone area showed significantly higher values in 12 weeks compared to 4 weeks(p<0.05). Histologically mineralization began at the host bone margins. At 12 weeks, increasing accumulation of $Ca^{++}$ element was confirmed. Conclusion: From the results above, the new bone formation was increased according to consolidation period. Especially there was significant difference between 4 weeks and 12 weeks(p<0.05). Implant type distractors used in this study to augment vertical ridge defect may prove to be a clinically useful treatment option in selected cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.2
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• pp.71-77
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• 2012

Objectives: This study sought to investigate the positioning of the posterior superior alveolar artery in relation to the performance of the maxillary sinus bone graft procedure in a Korean population. Materials and Methods: We identified the position of the posterior superior alveolar artery relative to 93 maxillary sinuses in 58 patients and determined the distance from the inferior border of the artery in the premolar and molar areas to the alveolar ridge and sinus floor. Results: The mean distance from the alveolar ridge to the posterior superior alveolar artery in the dentate group ($20.62{\pm}3.05mm$ in the premolar region, $17.50{\pm}2.84mm$ in the molar region) was greater than as compared to the edentulous group ($18.83{\pm}2.79mm$ in the premolar region, $15.50{\pm}1.64mm$ in the molar region), and this difference was statistically significant (P<0.05). In contrast, there was no statistically significant difference (P>0.05) between the mean distance from the sinus floor to the posterior superior alveolar artery in the dentate group ($8.21{\pm}2.79mm$ in the premolar region, $7.52{\pm}2.07mm$ in the molar region) or in the edentulous group ($7.75{\pm}3.31mm$ in the premolar region, $7.97{\pm}2.31mm$ in the molar region). Conclusion: Prior to surgery, it is important to evaluate the position of the posterior superior maxillary artery by using computed tomography scans. The premolar area is safer than the molar area for performing the maxillary sinus bone graft without bleeding.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.64-71
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• 2013

Purpose: The objective of this study was to elucidate the role of collagen membranes (CMs) when used in conjunction with bovine hydroxyapatite particles incorporated with collagen matrix (BHC) for lateral onlay grafts in dogs. Methods: The first, second, and third premolars in the right maxilla of mongrel dogs (n=5) were extracted. After 2 months of healing, two BHC blocks ($4mm{\times}4mm{\times}5mm$) were placed on the buccal ridge, one with and one without the coverage by a CM. The animals were sacrificed after 8 weeks for histometric analysis. Results: The collagen network of the membranes remained and served as a barrier. The quantity and quality of bone regeneration were all significantly greater in the membrane group than in the no-membrane group (P<0.05). Conclusions: The use of barrier membranes in lateral onlay grafts leads to superior new bone formation and bone quality compared with bone graft alone.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.418-434
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• 2020

Purpose: The purpose of the present study was to evaluate the effect of silica-calcium phosphate composite (SCPC) granules on bone regeneration in extraction sockets. Methods: Ten patients were selected for a split-model study. In each patient, bone healing in SCPC-grafted and control ungrafted sockets was analyzed through clinical, radiographic, histomorphometric, and immunohistochemical assessments 6 months postoperatively. Results: A radiographic assessment using cone-beam computed tomography showed minimal ridge dimension changes in SCPC-grafted sockets, with 0.39 mm and 1.79 mm decreases in height and width, respectively. Core bone biopsy samples were obtained 6 months post-extraction during implant placement and analyzed. The average percent areas occupied by mature bone, woven bone, and remnant particles in the SCPC-grafted sockets were 41.3%±12%, 20.1%±9.5%, and 5.3%±4.4%, respectively. The percent areas of mature bone and woven bone formed in the control ungrafted sockets at the same time point were 31%±14% and 24.1%±9.4%, respectively. Histochemical and immunohistochemical analyses showed dense mineralized bundles of type I collagen with high osteopontin expression intensity in the grafted sockets. The newly formed bone was well vascularized, with numerous active osteoblasts, Haversian systems, and osteocytes indicating maturation. In contrast, the new bone in the control ungrafted sockets was immature, rich in type III collagen, and had a low osteocyte density. Conclusions: The resorption of SCPC granules in 6 months was coordinated with better new bone formation than was observed in untreated sockets. SCPC is a resorbable bone graft material that enhances bone formation and maturation through its stimulatory effect on bone cell function.