• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.274-282
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• 2013

Objectives: The posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach. Materials and Methods: In this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height. Results: The bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively. Conclusion: Maxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for implant rehabilitation.

• The Journal of the Korean dental association
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• v.46 no.4
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• pp.222-231
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• 2008

Various maxillary sinus floor augmentation techniques were common performed and in the most cases, many kinds of bone graft materials were used. The graft materials are autogenous bone or other biomaterials of human, animal or synthetic origin. But these cases report describes a new surgical technique by which dental implants are inserted in a void space created by elevating the sinus membrane without additional graft material in atrophic posterior maxilla. We created lateral bony window using piezoelectric device and elevated the schneiderian membrane in five patients and was repositioned with bony window in five patients, without any bone graft. From the clinical and histological results, it is found there is potential capacity for bone formation and placement of implants in the maxillary sinus without the use of bone grafts or bone substitutes.

• Journal of Periodontal and Implant Science
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• v.48 no.3
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• pp.174-181
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• 2018

Purpose: The aims of the present study were to quantitatively assess graft height changes after sinus lift procedures and to analyze the factors that influenced graft height changes, including the residual bone height before surgery, surgical approach, and tooth type. Methods: A total of 39 maxillary posterior implants placed during a simultaneous sinus lift procedure were evaluated. Panoramic radiographs of all patients were taken immediately after implant installation and at 3 months, 6 months, 1 year, 2 years, and 3 years. To analyze graft height changes over time, we measured the distance between the implant platform and the base of the grafted sinus floor at 3 locations. The radiographs were analyzed by a single examiner. Results: Graft height tended to decrease over time, and a statistically significant difference was observed at 2 years compared to baseline (P<0.05). There was no statistically significant difference in graft height change according to the surgical approach or tooth type. For residual bone height, a statistically significant difference in graft height change was found between those with 4-7 mm of residual bone height and those with ${\geq}7mm$ (P<0.05). Conclusions: Graft height after sinus lift procedures significantly decreased at 2 years compared to baseline after sinus augmentation. Further studies should be done with controlled variables, and prospective studies with 3-dimensional images are needed to clarify the factors that influence graft height changes.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.1
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• pp.23-36
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• 2013

To evaluate the 3-dimensional features of the grafted bone with maxillary sinus augmentation and to assess the relation between the degree of bone resorption and the type of bone grafting source and implant, and the operation method. A retrospective chart review of patients receiving sinus augmentation procedures for implant positioning was conducted: radiographic analysis of the volume and area of bone grafts was performed. The volumetric remodeling.measured at 6 months after implant positioning as the percentage of residual bone graft.was correlated to type of graft materials and operation methods. 53 dental implants positioned with sinus bone graft in 15 patients at Wonkwang University Sanbon Dental Hospital. Computed tomography scans,taken implant positioning after 6 months, showed greater resorption values for the group of $Puros^{(R)}$ graft alone from the group of mixed with $Puros^{(R)}$ and various bone graft (P<0.05, respectively). And resorption values according to operation methods have statistically significant difference(P<0.05). Volume change ratio of bone graft showed greater values for the group of delayed implant position from the group of simultaneously implant placement with bone graft. Retrospective data analysis shows that the method of graft with $Puros^{(R)}$ alone may occur greater resorption of graft materials than mixed graft material with $Puros^{(R)}$ and other graft materials. The group of simultaneously implant placement with bone graft also display smaller resorption ratio of bone graft than the group of delayed implant placement.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.19.1-19.4
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• 2016

Background: Implant surgery has become popular with the advance of surgical techniques such as sinus lifting, guided bone regeneration, and block bone graft. However, there were no data about the frequency of bone graft during implant surgery. The purpose of this study was to report the frequency and types of bone graft depending on dental implant patients' profile to complement the database regarding implant surgery. Methods: The implant operations had been performed from January 2006 to October 2014. The upper and lower jaws were divided into six sextants. A total of 792 sextants were included in this study. Patient information including sex, age, sites, bone graft, and types of bone were investigated. Results: A total of 1512 implants had been placed. Male and female sextants were 421 and 371, respectively (M:F = 1:0.88). Average age was 54.3 (ranging from 20 to 88 years old). Implants were placed in the posterior maxilla (322 sextants, 40.7 %), posterior mandible (286 sextants, 36.1 %), anterior maxilla (127 sextants, 16.1 %), and anterior mandible (57 sextants, 7.2 %). Bone graft was performed in 50.3 % of the sextants. Among the bone grafted sites, sinus lifting with lateral approach (22.1 %) and guided bone regeneration (22.7 %) were performed most frequently. Conclusions: Bone graft in implant surgery was necessary to augment defects. More than half of the sextants needed bone graft for implant installation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.5
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• pp.284-289
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• 2015

In cases of severe alveolar bone atrophy in the posterior maxillary area, which has only a thin sinus floor, the autogenous tooth bone graft block (ABTB) was used to wrap the implant to enhance its primary stability and osseointegration in the sinus. These cases with four years of clinical follow-up demonstrate the applicability of the ABTB in maxillary sinus membrane elevation to improve the outcomes of implant placement.

• The Journal of the Korean dental association
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• v.44 no.1 s.440
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• pp.45-54
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• 2006

Piezosurgery uses modulated ultrasonic vibration to allow controlled cuting of bony structures. delicate bony structures can be cut easily and with great precision without destruction of soft tissue. Piezosurgery can be used to harvest the chin bone for intra-oral augmentation. Maxillary sinus membrane perforation is the most common complication that occurs with the sinus elevation augmentation procedure. This complication can occur during the osteotomy, which is performed with burs, or during the elevation of the membrane using manual elevators. The purpose of this study is to introduce new surgical technique that simplifies chin bone graft and maxillary sinus surgery, thus avoiding perforating the membrane.

• Journal of Periodontal and Implant Science
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• v.34 no.2
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• pp.377-392
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• 2004

The purpose of this present study was to investigate the effect of autogenous bone with histological evaluation of regenerated bone after sinus elevation. The study involved genaral healthy 6 patients participated in this study and were treated with 2-stage sinus elevation procedures using a combination of demineralized freezed-dried bone allograft (DFDBA) and coralline calcium carbonate with or without autogenous bone. At 6months after sinus elevation, bone specimens were obtained and stained with Hematoxylin-Eosin for light microscopic evaluation. The results of this study were as follows : 1. Autogenous bone grafts present trabecular patterns at 6 months in test groups, consist of woven bone and lamellar bone, but more compact than control groups. 2. Resorption of bone graft particles, osteoblast-like cells, newly formed osteoid tissue were observed at 6 months in test groups, but seems to be more frequently than control groups. 3. New osteoid tissue was formed from the surface of graft materials and gradually expanded around them. 4. The appearance of connective tissue around graft materials was densely formed, but more prominent in test groups than control groups. 5. Bone graft particles were resorbed incompletely and slight inflammatory infiltrate, newly formed capillaries, and adipocytes were observed. From the above results, autogenous bone is effective in bone regeneration after sinus elevation, could provide favorable conditions in implant placement.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.16-22
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• 2010

Objective: Bisphosphonate related osteonecrosis of the jaw (BRONJ) is reported in patients taken bisphosphonate for a long time, however, the mechanism of osteonecrosis in BRONJ was not clarified yet. This study was designed to investigate the effect of short administraion zoledronate on the healing pattern of periosteum and sinus membrane after iliac bone graft into maxillary sinus. Methods: In this study, 18 Newzeland rabbits were used. The animals were divided into 2 group. In the experimental group, rabbits were treated with weekly peritoneal injection (0.06 mg/kg/week) of zoledronate for three times. In the control group, rabbits were treated with saline solution injection instead of zoledronate. Periosteum and sinus membrane were harvested from one rabbit of the experimental group and one of the control group in the fourth week. The autogeneous bone was harvested from ilium and grafted into maxillary sinus. The rabbits were sacrificed at 1, 2, 4 and 8 weeks after bone graft. The healing pattern of periosteum and sinus membrane were evaluated histologically. Results: Inflammatory reaction in the periosteum was less conspicuous and healing process appeared earlier in experimental group compared with control group at 1, 2, 4 weeks. There were no differences of microscopic findings of sinus membrane between both groups at any weeks. Conclusion: Short-term use of zoledronate decreased the inflammatory reaction and enhanced healing process in the periosteum. These findings suggest the possibility that zoledronte suppress the function of macrophages.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.33-36
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• 2011

Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.