• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.142-147
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• 2011

The authors installed implants combined with guided bony regeneration (GBR) using autogenous tooth bone graft material in the patients. In one patient, GBR and simultaneous implant placement were performed. In two patients, GBR was performed and the implants were placed after 6 months. All patients achieved favorable clinical outcomes. Excellent osteoconductive bony healing was observed in the 6 month histology examination after the bone graft.

• 대한치과교정학회지
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• 제34권2호
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• pp.131-142
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• 2004

본 연구는 골절단을 이용한 치아-치조골 분절의 급속 치아이동 후 치수, 치주인대 및 치조골의 변화를 유성견에서 평가하고자 하였다. 하악 제4소구치의 근심, 원심, 치근단 부위에서 피질골을 절단하여 치아-골 분절을 형성하고 하악 제3소구치를 발거하면서 협측, 설측 부위의 피질골을 삭제하였다. 1주 휴지기 부여에 따라 휴지기군과 비휴지기군으로 나누어 치아의존형 견인장치로 6일 동안 견인하고 강화기를 거친 후 0주, 1주, 2주, 4주, 6주, 8주에 희생시켜 치수 치주인대 및 치조골의 조직 변화를 임상적, 방사선적, 조직학적 및 면역화학적으로 평가하여 다음과 같은 결과를 얻었다. 1 치아이동 양과 강화기 동안의 조직 치유 양상에서 휴지기 유무에 따른 차이는 없었다. 2. 견인측에서 골형성은 강화기 8주까지 계속되었는데 강화기 1-2주에 가장 활발하였으며 6-8주간의 변화는 적었다. 3. 비휴지기군의 강화기 1주에서 치조골 흡수 및 파골세포 출현, 염증세포 침윤이 가장 많았으며, 특징적으로 파상아세포가 압박측의 치주인대와 치수 내에 나타났다. 4. $TGF-\beta$는 치조골의 골기질 및 골모세포, 파골세포, 치수 내 파상아세포에서 강양성 발현을 보인 반면 치수, 백악모세포, 무세포성 백악질에서 경미한 양성 발현을 나타내는 부위 특이성이 있었다. 5. $TGF-\beta$는 견인측 치주인대의 치조골에 인접한 혈관 및 치주인대세포, 골모세포에서 강화기 초기 1-2주에 주로 발현되었으며 6주 이후에는 발현이 크게 감소하였다.

• 대한치과교정학회지
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• 제37권5호
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• pp.351-363
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• 2007

유성견에서 periodontal distraction 과정을 통해 급속 견인 후에 치수와 치주조직의 변화를 평가하였다. 유성견의 상악 제2소구치를 발거하고 제3소구치 근심의 치간골을 부분 제거하였다. 견인장치는 6일 동안 하루에 2번씩 견인하고, 강화기 동안 0주, 1주, 3주, 5주, 7주, 9주에 치수와 치주조직의 변화를 임상적, 방사선학적, 조직학적, 면역조직화화학적으로 관찰하였다. 신장된 치주인대 내에서 견인 직후부터 4주까지 활발한 골밀도 증가를 보였으며, 특히 2-3주 사이에서 가장 활발하였다. 강화기 0주에 압박측 치조골의 흡수 및 파골세포 출현, 염증세포 침윤이 가장 많이 관찰되었고 1주의 신장측 치주인대에서 특징적인 골형성을 보이기 시작하였다. 신생골 형성은 1주와 3주에 가장 많이 관찰되었으며 9주에는 성숙골로의 대치 및 치주인대의 재생으로 대조군과 차이가 없었다. 실험군의 calcitonin gene-related peptide의 발현은 치수, 치주인대 내의 염증 부위에서 나타났으며 0주, 1주에 압박측 치주인대에서 증가하였다가 5주 이후에는 감소하여 대조군과 차이가 없었다. 이상과 같은 소견은 periodontal distraction에 의한 급속 치아 이동이 정상적인 골 재형성 과정을 도모하는 새로운 치아이동 방법이 될 수 있음을 시사한다.

• Journal of Periodontal and Implant Science
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• 제44권5호
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• pp.216-221
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• 2014

Purpose: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. Methods: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. Results: The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. Conclusions: Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.

• 대한치과보철학회지
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• 제38권4호
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• pp.552-560
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• 2000

Purpose : The purpose of this study was to determine proper position and angulation of an implant for immediate implantation. Materials and Method : From the years 1997 to 2000. 52 Denta $scan^R$ views, 22 upper and 32 lower jaw with an average age of 43 and 40 respectively, were investigated, which comprise intact upper and lower 6 anterior teeth and premolars. On the Denta $scan^R$, the optimal placement for the immediated implantation was simulated. The measuring methods included 1) Angulation difference between tooth long axis and alveolar bone process. 2) Angulation difference of long axis between tooth and installing fixture 3) Distance between center of tooth at cervical area and center of fixture. 4) Distance from root apex to the bone limit of vital structure. One sample t-test was used for statistical analysis. Result : The results were as follows. 1) At the maxillary central incisor and lateral incisor, angulation difference of long axis between tooth and installing fixture was respectively 0.5 and 3.2 degrees with the fixture center's palatally positioned 2mm apart from tooth center. 2) At the lower anterior 6 teeth, that was about $-2.8^{\circ}\;to\;-4.6^{\circ}$ with the fixture center's lingually positioned 1mm apart from tooth center. 3) At the maxillary canine and premolar, that was respectively $11.8^{\circ}\;and \;7.2^{\circ}$ with the fixture center palatally positioned $2\sim2.4mm$ apart from tooth center. 4) At the lower premolar area, that was about $0^{\circ}\;to\;2^{\circ}$ with the fixture center's lingually positioned $0.5{\sim}1mm$ apart from tooth center. 5) Distance from root apex to the bone limit of vital structure, at the maxillary anterior and premolars. was the range of 10 to 12mm, and at the mandibular anterior teeth and the 1st premolar, that was the range of 18 to 20mm. Conclusion : The proper implant position of maxillary anterior and premolar teeth is as paralleled as or more buccally angulated than long axis of tooth with the fixture center's palatally positioned. In mandiblular anterior region, long axis of implants is lingully angulated compared with long axis of tooth and in premolar, almost parelleled with long axis of tooth and alveolar process.

• Restorative Dentistry and Endodontics
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• 제35권4호
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• pp.273-284
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• 2010

본 연구의 목적은 흰 쥐(rat)를 이용하여 미성숙 단계의 치아를 발치 후 즉시 재식 하였을 때 나타나는 치수의 치유 양상을 조직학적으로 관찰하고자 하는 것이다. 생후 4주된 암컷 Sprague-Dawley 계 흰쥐의 상악 우측 제1대구치를 발거 후 원래의 치조골와 내로 위치시켰다. 재식 후 3일째부터 국소적으로 치수 내 염증 소견이 관찰되었으나, 치근 부위에서는 이미 치수의 재혈관화 및 치유가 진행되고 있는 소견이 관찰되었다. 재식 후 5일째부터는 odontoblast-like cell이 관찰되기 시작하였다. 삼차 상아질의 형성은 재식 후 1주째부터 관찰되기 시작하였으며, 2주째부터는 확실히 관찰할 수 있었다. Odontoblast-like cell 및 삼차상아질 형성은 4주째까지도 계속 관찰되었다. 재식 후 4주째에는 bone-like tissue 및 cementum-like tissue이 형성되었음을 관찰하였다. 본 실험을 통하여 흰 쥐 치아 재식 시 석회화 과정은 초기에는 삼차상아질 침착에 의해서 진행되나, 시간이 경과하면서 점차 bone-like tissue 또는 cementum-like tissue가 차지하는 비율이 증가하는 것을 관찰하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권4호
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• pp.280-285
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• 2012

From the standpoint of general guidelines of a dentist, the following conditions should be considered before replanting a permanent tooth. The avulsed tooth should be without advanced periodontal disease. The alveolar socket should be reasonably intact in order to provide a seat for the avulsed tooth. The extra-alveolar period should be considered, i.e. periods exceeding. 2 hours are usually associated with marked root resorption. But, the above mentioned regulations are often difficult to keep in the actual situation of the medical emergency room, owing it to the delay of primary medical care in multiple trauma patients. The successful cases have been reported with minimal root resorption in the long-term periods, in spite of extra-alveolar periods of several hours and combined alveolar bone fracture. This is a case report regarding the effect of endodontic drainage in delayed replantation after a prolonged extra-alveolar period of the avulsed teeth with alveolar bone fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.167-170
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• 1994

The surgical removal of the wisdom teeth is obligate when forceps extraction fails or when the wisdom teeth are impacted. The surgical removal of impacted maxillary third molars is a commonly performed procedure usually associated with few complications & little morbidity. The most frequent complications are tooth root fracture, maxillary tuberosity fracture, tooth displacement into the maxillary sinus & oroantral fistula formation. A rarely reported complication is the displacement of a tooth into the infratemporal fossa. The method of prevention of this complication is by the placement of either a finger or periosteal elevator posterior to the tooth during extraction. To remove the displaced upper third molar is very difficult & has many complications, e.g., persistent bleeding & nerve damage. When the wisdom teeth is displaced, it is initially necessary to gain access to bone by developing a mucoperiosteal path of delivery is developed by additional bone removal or, preferably planned sectioning of the tooth. There are many approaching techniques to remove the displaced upper third molar. This following report describes the surgical technique of displaced upper third molar in the pterygopalatine fassa by the midpalatal ＆transpharyngeal approach.

• Journal of Periodontal and Implant Science
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• 제32권4호
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• pp.721-731
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• 2002

Recently, soluble TNF receptor homolog osteoprotegerin(OPG) and its membrane-bound ligand osteoclast differentiation factor(ODF) were found to regulate osteoclast formation and function, and bone metabolism. It is now well established that ODF acts via RANK expressed on hematopoietic osteoclast precursor cells to facilitate their differentiation to osteoclasts, and OPG prevents the formation of osteoclasts by interfering the binding of ODF and RANK. Expression of OPG and ODF was believed to be closely related to the pathogenesis of bone resorption and destruction from osteoporosis, periodontal diseases, malignant bone tumor, and arthritis. The periodontal ligament fibroblasts (PDLF), located between the tooth and tooth socket, has been thought to play an important role in maintaining bone homeostasis of periodontal tissues. However, the exact mechanism by which bone formation and resorption are regulated by PDLF is not well understood. In this study we have prepared primary cultures of human PDLF from periodontium of malaligned tooth extracted due to orthodontic reason, and determined steady state or inflammatory signal-induced OPG and ODF expression using RT-PCR and western blot analysis. OPG and ODF mRNA and protein were expressed constitutively in the PDLF and these expression were slightly increased by osteotropic cytokine IL-1 ${\beta}$. Lipopolysaccharide-treated PDLF showed decrease in OPG mRNA and protein expression, and increase in ODF mRNA and protein expression. These results indicated that PDLF influence the osteoclastogenesis by OPG and ODF expression in the inflammatory situation as well as physiological condition, and thereby pathogenesis of periodontal alveolar bone destruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권3호
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• pp.103-110
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• 2014

Purpose: The current gold standard for clinical jawbone formation involves autogenous bone as a graft material. In addition, demineralized dentin can be an effective graft material. Although demineralized dentin readily induces heterotopic bone formation, conventional decalcification takes three to five days, so, immediate bone grafting after extraction is impossible. This study evaluated the effect of vacuum ultrasonic power on the demineralization and processing of autogenous tooth material and documented the clinical results of rapidly processed autogenous demineralized dentin (ADD) in an alveolar defects patient. Methods: The method involves the demineralization of extracted teeth with detached soft tissues and pulp in 0.6 N HCl for 90 minutes using a heat controlled vacuum-ultrasonic accelerator. The characteristics of processed teeth were evaluated by scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Bone grafting using ADD was performed for narrow ridges augmentation in the mandibular area. Results: The new processing method was completed within two hours regardless of form (powder or block). EDS and SEM uniformly demineralized autotooth biomaterial. After six months, bone remodeling was observed in augmented sites and histological examination showed that ADD particles were well united with new bone. No unusual complications were encountered. Conclusion: This study demonstrates the possibility of preparing autogenous tooth graft materials within two hours, allowing immediate one-day grafting after extraction.