• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.5
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• pp.232-239
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• 2015

Objectives: The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods: Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results: No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was $74.6%{\pm}8.4%$. Conclusion: Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.

• Imaging Science in Dentistry
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• v.42 no.4
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• pp.225-229
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• 2012

Purpose: This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. Materials and Methods: The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either "non-cleft side" or "cleft side". The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. Results: The pixel area showed a significant difference between the "non-cleft side" and "cleft side" in group 0 ($404.27{\pm}103.72/117.73{\pm}92.25$; p=0.00), group 1 ($434.29{\pm}86.70/388.31{\pm}109.51$; p=0.01), and group 4 ($430.98{\pm}98.11/366.71{\pm}154.59$; p=0.02). No significant differences were found in group 2 ($423.57{\pm}98.12/383.47{\pm}135.88$; p=0.06) or group 3 ($433.02{\pm}116.07/384.16{\pm}146.55$; p=0.19). Conclusion: Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.238-247
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• 2005

The placement of different graft materials and/or the use of occlusive membranes to cover the extraction socket entrance are techniques aimed at reducing alveolar ridge resorption and enhancing bone formation. However, in spite of its clinical advantage, the use of graft materials in fresh extraction socket has been questioned because particles of the grafted material have been found in alveolar sockets with fibrous union. The purposes of this study were to evaluate whether alveolar ridge resorption following tooth extraction could be reduced and bone formation could be enhanced by the application of absorbable gelatin spongy or gelatin spongy soaked with platelet rich plasma(PRP) used as a space filler in clinical and radiographic aspects. Eighty patients who were scheduled for extraction of both third molars were participated and carried out by one experienced surgeon. Following extraction of teeth, one extracted socket were treated with gelatin spongy as an experimental group A and the other were treated with gelatin spongy and PRP as an experimental group B. The routine extracted socket were healed without any treatment as a control group. From the period of extraction to 12 weeks postoperatively, we examined the clinical course and radiographic evaluation on socket at regular interval. Both experimental groups showed faster wound healing process than control clinically. Vertical gingival height of the extraction socket were less changed statistically in both experimental groups than control. The horizontal width change of the extraction socket were not significant statistically in any group. Radiographic changes of the alveolar bone height were less changed in both experimental groups and bone density were showed higher than control. There were a little difference between experimental group A and B. In conclusion, absorbable gelatin sponge and with PRP were considered as having preservation effects of extraction socket and stimulation of bone formation process after extraction.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.207-214
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• 2008

Purpose: The aim of augmentation of the alveolar ridge is to restore absorbed alveolar ridges for future implant site or esthetic prosthodontic restoration. The present clinical report describes the anterior maxillary augmentation cases using a soft tissue rotated palatal flap, and considers various problems of before and after surgery. Method: First & second patients were treated by vascularized interpositional periosteal-connective tissue(VIP-CT) flap for horizontal soft tissue augmentation. Especially second patient was progressed with bone grafting at the same time. Third patient was treated by the same flap with bone graft and implant placement in single tooth missing premaxillary area. Result: The obtained horizontal augmentation width measured $0.5{\sim}2.7\;mm$. Conclusion: This technique constitutes a viable approach for augmentation the anterior sector of alveolar ridge with the placement of dental implants. But it needs correct diagnosis preparation and careful surgery skill.

• The Journal of the Korean dental association
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• v.54 no.9
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• pp.692-702
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• 2016

A short dental implant is considered as possible solution in difficult clinical situations for the placement of a regular length implant. Using a short implant avoiding more invasive surgical procedures simplifies the treatment plan and shortenes the duration of treatment. In this case, 71-year-old female came up with discomfort from her old mandibular denture. As she had fully edentulous mandible and got a negative feedback from removable denture, implant-supported fixed prosthesis was planned. Six short implants were placed on her mandible with severe alveolar bone loss. After 1 year follow up period, implants were well retained with any other abnormal findings. The patient was satisfied with her prostheses and satisfactory outcomes were attained in terms of both esthetic and functional clinical results.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.31 no.2
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• pp.40-46
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• 2022

In maxilary anteriors, aesthetic aspect are of critical importance. but it is difficult to achieve esthetic results because of the narrow buccal-lingual alveolar bone width compared to the posterior teeth and alveolar bone resorption during tooth extraction. This case report describes how to minimize alveolar bone resorption and soft tissue collapse when immediate implant placement is done after extraction of the maxillary anterior teeth due to trauma.

• Archives of Craniofacial Surgery
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• v.24 no.6
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• pp.284-287
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• 2023

The ultimate goal of cleft palate repair is to achieve an intact palate with the separation of the oral and nasal cavities. However, some patients develop an oronasal fistula in the secondary palate after palatoplasty. Postoperatively, a secondary palatal oronasal fistula may develop, leading to functional problems. In this study, we describe a patient with recurrent oronasal fistula and alveolar cleft with multiple failed previous reconstructions at another clinic. The oronasal fistula and alveolar cleft were repaired using a tongue flap and an iliac bone graft, respectively. The patient demonstrated excellent clinical progress with no recurrence of the oronasal fistula at the 1-year follow-up.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.4
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• pp.329-338
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• 2006

Objectives: Distraction osteogenesis has recently evolved a challenging technique to overcome the limitations of conventional augmentation procedures. The aim of this report was to evaluate the clinical result of alveolar distraction osteogenesis for implant installation. Methods: Twenty five patients with alveolar ridge deficiencies were treated with vertical alveolar distraction osteogenesis by intraoral device (total 27 devices: 25 extraosseous and 2 intraosseous devices). After the latency periods of 5-7 days, activation of the device was started. The distraction rhythm and rate was 0.75-1.0 mm a day with 2 or 3 times a day. After 3-4 months, dental implants were placed with removing the distractor simultaneously. Results: On average, a vertical gain of $9.8{\pm}3.4\;mm$ was obtained by distraction osteogenesis. Total 84 implants were installed. Average follow up period was $13.5{\pm}7.5$ months. No implant was removed during the follow up period. Three patients showed infection during the distraction osteogenesis. Three devices were broken and 2 devices among them were replaced with new one. Conclusion: Relatively larger amount of alveolar bone augmentation could be obtained with distraction osteogenesis. For the ideal anatomically and functionally ideal regeneration of alveolar bone to install dental implant, the complication of distraction should be controlled.

• The korean journal of orthodontics
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• v.47 no.5
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• pp.313-322
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• 2017

Objective: Miniscrew-assisted rapid palatal expansion (MARPE) is a means for expanding the basal bone without surgical intervention in young adults. Here, we assessed the differences in dental, alveolar, and skeletal measurements taken before (T0), immediately after (T1), and 1 year after (T2) MARPE. Methods: Twenty-four patients (mean age, 21.6 years) who had undergone MARPE and cone-beam computed tomography at T0, T1, and T2 were included. Changes in the following parameters were compared using paired t-tests: intercusp, interapex, alveolar, nasal floor, and nasal cavity widths; inclination of the first molar (M1) and its alveolus; and thickness and height of the alveolar bone. A linear mixed-effects model was used to determine variables that affected periodontal changes in the M1. Results: MARPE produced significant increases in most measurements during T0-T2, despite relapse of some measurements during T1-T2. The alveolar thickness decreased on the buccal side, but increased on the palatal side. The alveolar crest level at the first premolar moved apically. Changes in the thickness and height of the alveolar bone were affected by the corresponding initial values. Conclusions: MARPE can be used as an effective tool for correcting maxillomandibular transverse discrepancy, showing stable outcomes 1 year after expansion.

• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.671-689
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• 1994

The purpose of this study was to compare effects of various bone grafts on periodontal regeneration of alveolar bone defects in dogs. Seven adult dogs aged 12 to 18 months were used in this study. Experimental alveolar bone defects were created surgically with a #1/2 round bur at the furcation area of the buccal surface of the mandibular 3rd, 4th premolars and 1st molar. Each experimental alveolar bone defects were grafted with dense hydroxyapatite, natural coral, and decalcified freeze-dried bone, and respectively divided into DHA, NC, DFDB group. An area without bone graft was divided into control group. At 1,2,4,6, and 12 weeks, dogs were serially sacrificed and specimens were prepared with Hematoxylin-Eosin stain and Mallory stain for light microscopic evaluation. The results of this study were as follows : 1. In control group, the matrix change of granulation tissue was observed at 1 week. And in experimental groups, the appearance of connective tissue around graft materials was loosely formed at 1 week, but densely formed at 2 weeks. 2. In every group, the slight formation of new trabecular bone was seen from remaining bone at 1 week. 3. The DHA and NC particles were gradually encapsulated by new trabecular bone from remaining bone, and the osteoid tissue was directly induced from DFDB particles. 4. The presence of osteoblasts was first observed at 1 week in control group and at 2 weeks in NC group, but at 6 weeks in DHA group. 5. In DHA group, the resorption of particles was not observed until 12 weeks. But in NC and DFDB group, the particles were resorbed at 6 weeks and replaced by new bone. And the amount and size of particles were reduced, and their border represented irregular form. In summary, in three experimental groups the inflammatory or foreign body reaction were slight, but the regeneration of new osteoid tissue and the matrix change of dense connective tissue fiber were observed. Especially, NC and DFDB materials were considered as the biocompatible graft materials which were effective in the regenertion of new bone.