• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.36.1-36.8
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• 2019

Background: This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods: From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results: The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of periimplantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions: When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.

• Journal of Periodontal and Implant Science
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• v.45 no.5
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• pp.184-189
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• 2015

Purpose: The purpose of the present study was to evaluate the effect of root planing on the reduction of probing pocket depth and the gain of clinical attachment depending on the pattern of bone resorption (vertical versus horizontal bone loss) in the interproximal aspect of premolar teeth that showed an initial probing pocket depth of 4-6 mm. Methods: In this study, we analyzed 68 teeth (15 from the maxilla and 53 from the mandible) from 32 patients with chronic periodontitis (17 men and 15 women; mean age, 53.6 years). The probing pocket depth and clinical attachment level at all six sites around each tooth were recorded before treatment to establish a baseline value, and then three months and six months after root planing. Results: The reduction in interdental pocket depth was 1.1 mm in teeth that experienced horizontal bone loss and 0.7 mm in teeth that experienced vertical bone loss. Interdental attachment was increased by 1.0 mm in teeth with horizontal bone loss and by 0.7 mm in teeth with vertical bone loss. The reduction of probing pocket depth and the gain of clinical attachment occurred regardless of defect patterns three and six months after root planing. Conclusions: The reduction of pocket depth and gain in the clinical attachment level were significantly larger in horizontally patterned interproximal bone defects than in vertical bone defects.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.216-222
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• 2015

Purpose: After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. Methods: This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. Results: The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was $1.43{\pm}0.65mm$. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. Conclusions: After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.389-398
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• 2021

Purpose: This study introduces a standardized 2-plane approach using 8 landmarks to assess alveolar bone levels in mice using micro-computed tomography. Materials and Methods: Bone level differences were described as distance from the cemento-enamel junction (CEJ) to alveolar bone crest (ABC) and as percentages of vertical bone height and vertical bone loss, comparing mice infected with Porphyromonas gingivalis (Pg) to controls. Eight measurements were obtained per tooth: 2 in the sagittal plane (mesial and distal) and 6 in the coronal plane (mesiobuccal, middle-buccal, distobuccal, mesiolingual, middle-lingual, and distolingual). Results: Significant differences in the CEJ-to-ABC distance between Pg-infected mice and controls were found in the coronal plane (middle-lingual, mesiobuccal, and distolingual for the first molar; and mesiobuccal, middle-buccal, and distolingual for the second molar). In the sagittal plane, the distal measurement of the second molar was different. The middle-buccal, mesiobuccal, and distolingual sites of the first and second molars showed vertical bone loss relative to controls; the second molar middle-lingual site was also different. In the sagittal plane, the mesial sites of the first and second molars and the distal site of the second molar showed loss. Significantly different vertical bone height percentages were found for the mesial and distal sites of the second molar (sagittal plane) and the middle-lingual and distolingual sites of the first molar(coronal plane). Conclusion: A reliable, standardized technique for linear periodontal assessments in mice is described. Alveolar bone loss occurred mostly on the lingual surface of the coronal plane, which is often omitted in studies.

• Journal of Periodontal and Implant Science
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• v.47 no.4
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• pp.231-239
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• 2017

Purpose: To retrospectively evaluate the relationship between the vertical position of the implant-abutment interface and marginal bone loss over 3 years using radiological analysis. Methods: In total, 286 implant surfaces of 143 implants from 61 patients were analyzed. Panoramic radiographic images were taken immediately after implant installation and at 6, 12, and 36 months after loading. The implants were classified into 3 groups based on the vertical position of the implant-abutment interface: group A (above bone level), group B (at bone level), and group C (below bone level). The radiographs were analyzed by a single examiner. Results: Changes in marginal bone levels of $0.99{\pm}1.45$, $1.13{\pm}0.91$, and $1.76{\pm}0.78mm$ were observed at 36 months after loading in groups A, B, and C, respectively, and bone loss was significantly greater in group C than in groups A and B. Conclusions: The vertical position of the implant-abutment interface may affect marginal bone level change. Marginal bone loss was significantly greater in cases where the implantabutment interface was positioned below the marginal bone. Further long-term study is required to validate our results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.386-390
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• 2007

This is about the case of loss of multiple teeth and alveolar bone caused by trauma, which needed alveolar bone augmentation before implant treatment. Alveolar bone was reconstructed using iliac bone graft, and thereafter first implant surgery was followed by consolidation period of 3 months. Iliac bone resorption was observed at the time of implant placement. And that resorption was more in the horizontal dimension than in the vertical. We conclude that additional treatment planning(e.g. using alveolar distraction osteogenesis or tissue expander) should be considered besides bone graft for vertical alveolar bone augmentation. For both maxilla and mandible, prosthodontic treatment was carried out $4{\sim}5$ months after implant placement. To compensate alveolar bone deficiency, partial hybrid overdenture on maxilla and implant-supported fixed bridge on mandible were fabricated, and the total treatment was finished.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.4
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• pp.156-160
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• 2013

Objectives: Interest in bone graft material has increased with regard to restoration in cases of bone defect around the implant. Autogenous tooth bone graft material was developed and commercialized in 2008. In this study, we evaluated the results of vertical and horizontal ridge augmentation with autogenous tooth bone graft material. Materials and Methods: This study targeted patients who had vertical or horizontal ridge augmentation using AutoBT from March 2009 to April 2010. We evaluated the age and gender of the subject patients, implant stability, adjunctive surgery, additional bone graft material and barrier membrane, post-operative complication, implant survival rate, and crestal bone loss. Results: We performed vertical and horizontal ridge augmentation using powder- or block-type autogenous tooth bone graft material, and implant placement was performed on nine patients (male: 7, female: 2). The average age of patients was $49.88{\pm}12.98$ years, and the post-operative follow-up period was $35{\pm}5.31$ months. Post-operative complications included wound dehiscence (one case), hematoma (one case), and implant osseointegration failure (one case; survival rate: 96%); however, there were no complications related to bone graft material, such as infection. Average marginal bone loss after one-year loading was $0.12{\pm}0.19$ mm. Therefore, excellent clinical results can be said to have been obtained. Conclusion: Excellent clinical results can be said to have been obtained with vertical and horizontal ridge augmentation using autogenous tooth bone graft material.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.2
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• pp.111-121
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• 2010

Purpose: This 3D-FEA study was performed to investigate the influence of marginal bone loss pattern around the implant to the stress distribution. Material and methods: From the right second premolar to the right second molar of the mandible was modeled according to the CT data of a dentate patient. Teeth were removed and an implant ($\Phi\;4.0{\times}10.0mm$) was placed in the first molar area. Twelve bone models were created; Studied bone loss conditions were horizontal bone loss and vertical bone loss, assumed bone loss patterns during biologic width formation, and pathologic vertical bone loss with or without cortification. Axial, buccolingual, and oblique force was applied independently to the center of the implant crown. The Maximum von Mises stress value and stress contour was observed and von Mises stresses at the measuring points were recorded. Results: The stress distribution patterns were similar in the non-resorption and horizontal resorption models, but differed from those in the vertical resorption models. Models assuming biologic width formation showed altered stress distribution, and weak bone to implant at the implant neck area seams accelerates stress generation. In case of vertical bone resorption, contact of cortical bone to the implant may positively affect the stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.2
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• pp.241-268
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• 1995

Splint therapy, the immobilization of teeth, has been done for patient's masticatory comforts and an adjunctive aid in periodontal therapy. Mandibular premolars are frequently splinted in many distal extension removable partial denture cases. But splinting is an extensive restoration that may not be conservative of tooth structure and may prove to be quite costly to the patient. The two dimensional finite element analysis method was used to determine the magnitude and mode of distribution of the stresses of the periodontal ligament and supporting alveolar bone when abutments with different periodontal supports were splinted and distal-extension removable partial denture was subjected to different loading schemes. The results were as follows : 1. When abutments were splinted, stresses moved from apico-distal to apico-mesial of terminal abutment on a vertical force and from disto-alveolar crest to apex on a distally directed force. But stresses were generally diminished on a mesially directed force. 2. As vertical bone loss was proceeding, most of stresses were transmitted to residual ridge and the rest of stresses were concentrated on apex of distal abutment. But these apical stresses were minimized when abutments were splinted. 3. As mesially inclined bone loss was proceeding, it seemed to be dangerous that many stresses were concentrated on the distal alveolar crest, especially in the distally directed load case. Abutments splinting decreased the alveolar crestal stresses but not enough. 4. For all vertical stresses were effectively decreased on splinting, stresses were concentrated as highly on apico-mesial area of distal abutment in distally directed load cases as the distal inclination of bone level was severe. 5. The directions and magnitudes of abutment movements were decreased with teeth splinting.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.71-76
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• 2009

Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.