• Imaging Science in Dentistry
• /
• v.52 no.2
• /
• pp.197-207
• /
• 2022

Purpose: This study evaluated the associations of the dental arch form, age-sex groups, and sagittal root position (SRP) with alveolar bone thickness of the maxillary central incisors using cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT images of 280 patients were categorized based on the dental arch form and age-sex groups. From these patients, 560 sagittal CBCT images of the maxillary central incisors were examined to measure the labial and palatal bone thickness at the apex level and the palatal bone at the mid-root level, according to the SRP classification. The chi-square test, Kruskal-Wallis test, and multiple linear regression were used for statistical analyses. Results: Significant differences were found in alveolar bone thickness depending on the arch form and SRP at the apex level. The square dental arch form and class I SRP showed the highest bone thickness at both levels of the palatal aspect. The taper dental arch form and class II SRP presented the highest bone thickness at the apex level of the labial aspect. No association was found between the dental arch form and SRP. Elderly women showed a significant association with thinner alveolar bone. Age-sex group, the dental arch form, and SRP had significant associations with alveolar bone thickness at the apex level. Conclusion: The patient's age-sex group, dental arch form, and SRP were associated with alveolar bone thickness around the maxillary central incisors with varying magnitudes. Therefore, clinicians should take these factors into account when planning immediate implant placement.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.3
• /
• pp.266-275
• /
• 2008

Dental endosseous implants require sufficient alveolar bone volume and quality for complete bone coverage and initial stability. But, atrophy or resorption of alveolar bone height and width according to patient's age and period of tooth loss can prevent ideal implant placement. Bone graft procedure has been proposed before or simultaneously with the placement of dental implants in patients with insufficient alveolar bone volume. While allografts, xenografts, and alloplastic bone grafts have been proposed and studied for alveolar ridge augmentation, the use of autogenous bone grafts represents the 'gold standard' for bone augmentation procedures. Conventional bone grafts are usually harvested from distant sites such as the ilium or ribs. Recently there is a growing use of intraoral bone grafts from intraoral donor sites such as mandibular symphysis, mandibular ramus and maxillary tuberosity. We recommend that the mandibular ramus is a safe autogenous bone graft donor site for bone harvesting with low morbidity. We report various effective autogenous bone graft procedures from mandibular ramus for the implant placement on various atrophic alveolar ridges.

• The korean journal of orthodontics
• /
• v.50 no.3
• /
• pp.157-169
• /
• 2020

Objective: The aim of this retrospective study was to evaluate the pre- and postsurgical bone densities at alveolar and extra-alveolar sites following two-jaw orthognathic surgery. Methods: The sample consisted of 10 patients (mean age, 23.2 years; range, 18.0-27.8 years; 8 males, 2 females) who underwent two-jaw orthognathic surgery. A three-dimensional imaging program (Invivo 5) was used with multidetector computed tomography images taken pre- and postoperatively (obtained 32.3 ± 6.0 days before surgery and 5.8 ± 2.6 days after surgery, respectively) for the measurement of bone densities at the following sites: (1) alveolar bone in the maxilla and mandible, (2) extra-alveolar sites, such as the top of the head, menton (Me), condyle, and the fourth cervical vertebrae (C4). Results: When pre- and postsurgical bone densities were compared, an overall tendency of decrease in bone density was noted. Statistically significant reductions were observed in the densities of cancellous bone at several areas of the maxillary alveolar bone; cortical and cancellous bone in most areas of the mandibular alveolar bone; cortical bone in Me; and cancellous bone in C4. There was no statistically significant difference in bone density in relation to the depth of the alveolar bone. In a comparison of the bone densities between groups with and without genioplasty, there was almost no statistically significant difference. Conclusions: Accelerated tooth movement following orthognathic surgery may be confirmed with reduced bone density. In addition, this study could offer insights into bone metabolism changes following orthognathic surgery, providing direction for further investigations in this field.

• Journal of Korean Dental Science
• /
• v.3 no.2
• /
• pp.50-59
• /
• 2010

Implant placement is frequently complicated and challenging because of the poor quality and inadequate height of bone. Clinicians should consider various surgical procedures to overcome the problems. We report a case with various surgical procedures used such as inferior alveolar nerve repositioning, sinus bone graft, and autogenous block bone graft using the coronoid process and ramus to overcome severe vertical and horizontal alveolar bone atrophy.

• The korean journal of orthodontics
• /
• v.30 no.4 s.81
• /
• pp.413-421
• /
• 2000

The purpose of this study was to observe the effects of pregnancy on the experimental tooth movement and alveolar bone turnover process of Sprague-Dawley female rat. Sixty rats were divided into pregnant-tooth movement group(P-Tm), normal-tooth movement group(N-Tm) and normal group(N). Maxillary first molar appliances were inserted bilaterally and activated to 40grams. To measure the amount of tooth movement, x-ray was taken 2 times after appliance insertion and before sacrifice. Animals were sacrificed at 1,3,7,14 days(N=5). Just after sacrifice, alveolar bones were collected and frozen immediately for biochemical analysis. Tooth movement was assessed cephalometrically and tartrate-resistant acid(TRAP) and alkaline phosphatase (ALP) activities were measured in extracts of paradental alveolar bone. The results were as follows: 1. The amount of tooth movement in P-Tm group was greater than that of N-Tm group(p<0.01). 2. Alveolar bone ALP of normal tooth movement group was not significantly different from the control, TRAP was significantly different from the control(p<0.01). In normal tooth movement group, alveolar bone ALP was increased gradually and peak(day 7) fell off significantly at day 14(p<0.05). The Peak of alveolar bone TRAP(day 7) fell off slightly, sustained day 14(p<0.01). 3. Alveolar bone ALP and TRAP of pregnant tooth movement group were not significantly different from that of normal tooth movement group. In pregnant tooth movement group, alveolar bone ALP was increased at day 3(p<0.01) and fell off significantly at day 7-14, alveolar bone TRAP were increased at day 3 and sustained day 14. 4. The peak of alveolar bone phosphatases in pregnant tooth movement group(day3) preceded the peak in normal tooth movement group(day7) (p<0.01). According to the above results, we suggested that bone resorption activity was increased in alveolar bone of pregnant rat, and the degree of tooth movement in pregnancy may be greater than that of normal group because of high bone turnover of alveolar bone in pregnant rat.

• Archives of Craniofacial Surgery
• /
• v.16 no.2
• /
• pp.49-52
• /
• 2015

The alveolar cleft has not received as much attention as labial or palatal clefts, and the management of this cleft remains controversial. The management of alveolar cleft is varied, according to the timing of operation, surgical approach, and the choice of graft material. Gingivoperiosteoplasty does not yet have a clear concensus among surgeons. Primary bone graft is associated with maxillary retrusion, and because of this, secondary bone graft is the most widely adopted. However, a number of surgeons employ presurgical palatal appliance prior to primary alveolar bone graft and have found ways to minimize flap dissection, which is reported to decrease the rate of facial growth attenuation and crossbite. In this article, the authors wish to review the literature regarding various advantages and disadvantages of these approaches.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.5
• /
• pp.459-466
• /
• 2010

Alveolar distraction osteogenesis (ADO) has been regarded as an acceptable treatment for the alveolar bone deficiency. For ADO at anterior maxillary area, the vector should be oriented to forward and down-ward direction to get an adequate occlusion with mandibular teeth and to increase bone length and width for implant placement. However, the conventional commercial distraction devices for ADO are designed to allow mainly downward movement of alveolar segment, even though a forward movement can be obtained a little by controlling of inclination of device. To make ADO with controllable bidirectional vector possible, we used customized devices using self-manufactured ABDUL (Alveolar Bone Distractor Using Lag screw principle) and commercial orthodontic palatal expansion device ($Hyrex^{(R)}$). In all cases (n = 4), ADO could be performed successfully and dental implants were able to placed with adequate occlusion. We report the procedures, advantages and disadvantages of these methods.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.25 no.4
• /
• pp.350-355
• /
• 1999

Purpose : The purpose of this study was 1) to find nerve damage after inferior alveolar nerve transposition and 2) to examine whether the soft tissue or bone changes around the nerve produce the compression to the nerve in the healing period. Materials and Method : Inferior alveolar nerve was exposed through the bony window and the scratch was made in the bone to be thought as the inferior alveolar canal. Suture was made after the nerve was repositioned. The nerve and surrounding tissues were examined with the light microscope and the fluorescent microscope before surgery and at 1 month, 3 months, and 5 months after surgery. Results : After surgery, the epineurium was damaged and the nerve was divided to several fascicles covered with the perineurium The newly formed fibrous connective tissue and vessels were seen around fascicles. There was new bone formation. However the nerve was not compressed by the connective tissue or the new bone. Conclusion : The results of this study suggest that neurosensory disturbances after inferior alveolar nerve transposition are resulted by the direct trauma in surgery rather than the compression to the nerve by the scar or new bone formation in the healing period.

• Korean Journal of Cleft Lip And Palate
• /
• v.7 no.1
• /
• pp.47-61
• /
• 2004

The closure of a wide alveolar cleft and fistula in cleft patients and the reconstruction of a maxillary dentoalveolar defect in bilateral cleft lip and palate (BCLP) patients are challenging for both orthodontists and oromaxillofacial surgeons. It is due to the difficulty in achieving complete closure by using local attached gingiva (palatal flap) and the great volume of bone required for the graft. In this article, the authors used bifocal distraction-compression osteosynthesis(BDCO) to create a segment of new alveolar bone and attached gingiva for the complete approximation of a wide alveolar cleft/fistula and the reconstruction of a maxillary dentoalveolar defect. Since the alveoli and gingivae on both ends of the cleft were approximated after BDCO, the need for extensive alveolar bone grafting was eliminated. It also could create new alveolar bone and gingiva for orthodontic tooth movement and implant.

• The korean journal of orthodontics
• /
• v.11 no.1
• /
• pp.7-15
• /
• 1981

Tooth movement by orthodontic force is based upon alveolar bone resorption at compression site and bone formation at tension site of tooth. The function of cyclic AMP is to participate not only in initial action of bone cells by mechanical forces but also in the continuous cellular response leading to bone remodeling. This experiment was performed to clarify the role of cyclic AMP in bone remodeling by mechanical forces. The orthodontic forces of about 80 gm and 100 gm were applied to the right canines of maxillary and mandibular bone, respectively, in cats, treated for periods of time ranging from one hour to 28 days. Alveolar bones were obtained from compression and tension sites surrounding tipping maxillary and mandibular canines as well as from contralateral control sites. The samples were extracted, boiled and homogenized, and the supernatants were assayed for cyclic AMP by a radioimmunoassay method. The results were as follows: 1. The orthodontic movement of canines was increased to the end of experimental period and the action of orthodontic forces on tooth movement was more effective in maxillary canine. 2. The cyclic AMP levels of alveolar bones in compression and tension sites initially decreased, then increased and remained elevated to the end of experiment. The differences of the cyclic AMP levels between treated sites and non-treated sites were gradually increased. 3. The cyclic AMP levels in treated sites of mandibular alveolar bone was higher than that of maxillary alveolar bone.