• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.570-578
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• 2006

A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.2
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• pp.296-326
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• 1994

The purpose of this study was to evaluate the mechanical effects when one implant fixture was connected to the natural teeth with reduced alveolar bone height. This study also examined the effects of increasing the number of abutment teeth and the effects of the intramobile connector and the titanium connector as they were inserted between the implant superstructure and the fixture. The distribution and concentration load was applied to the fixed partial denture(FPD) supported by implant and the natural teeth with reduced alveolar bone height. The stress and displacement of each element was observed and compared by the two-dimensional finite element method. The following results were obtained : 1. The greater the loss of alveolar bone in natural teeth area, the greater the displacement of FPD and the stress concentration in alveolar bone around implant, especially at the stress concentration in the mesial alveolar bone crest around implant fixture. 2. The displacement of FPD was increased more and that of implants fixture was decreased more when intramobile connector was used than titanium connector was used. Also the stress concentration in alveolar bone around implant fixture was greater when intramobile connector than titanium connector. One implication of this finding was that the difference in stiffness of implant and the natural teeth with reduced alveolar bone height could be partially compensated in case of the POM intramobile connector. 3. The amount and direction of displacement and the stress distribution of the 4-unit FPD was better than those of the 3-unit FPD. It implied that the difference of stiffness of implant and natural teeth with reduced alveolar bone height could be partially compensated in case of the 4 unit FPD.

• The korean journal of orthodontics
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• v.21 no.2 s.34
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• pp.353-366
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• 1991

This study was performed to analyze the effects of forces to the alveolar bone by various molar uprighting spring such as helical uprighting spring. T-loop spring, Modified T-loop spring and open coil spring. The simplified two-dimensional photoelastic model was constructed with a lower left posterior quadrant containing the second molar, the first and second premolars and the canine, with the first molar missing. Several molar uprighting springs were fabricated from 0.017 by 0.022 inch blue Elgiloy and applied to the photoelastic model. Two-dimensional photoelastic stress analysis was performed, and the stress distribution was recorded by photography The results obtained were as follows; 1. In all the kinds of the springs, the center of rotation of the mandibular second molar was oserved at the apical 1/5-1/6 between the alveolar crest and the root apex. 2. In all the kinds of the spring, the stress induced in the mesial root surface of the mandibular second molar was relatively homogeneous but there was some difference in the magnitude of the stress. 3. In the kinds of the springs, the distal crown tipping moment of the second molar was increased in turn as open coil spring, helical uprighting spring, T-loop spring, and modified T-loop spring. 4. The largest extrusive force was occured in the T-loop spring, intrusive force was occured in Modified T-loop spring only, and the largest distal tipping force was occured in open coil spring. 5. In the T-loop spring with activation, the stress induced in the mesial root surface of the second molar was increased gradually from the root apex to the alveolar crest and highly concentrated in the alveolar crest.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.3
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• pp.455-469
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• 1994

Regular radiographic examination has been considered an essential diagnositic method for osseointegrated dental implantation. This study investigated marginal bone loss through the measurement on periapical radiographs and changes in bone density through digital subtraction image radiographic method around 88 endoseous root-form dental implants in 43 human subjects. Four types of endosseous dental implants were investigated : Standard series, Mini series and Hex-lock system of Steri-Oss Dental implant system, and $Br{\aa}nemark$-type implant from 3i dental implant system, in a 3 month interval for a total period of 12 months. The results were as follows : 1. Rapid bone loss occurred in the first 3 months in all 4 groups, and the bone level stabilized at the first thread of the implant fixtures. Amount of bone loss for 12 months showed correlation with the length of the polished neck portion. 2. Most of the implant systems showed resorption of alveolar bone up to the polished neck portion although a long polished neck could delay the resolution. 3. Alveolar bone loss apical to the polished neck portion stabilized at the first thread of the fixtures with no correlation to either the time of exposure of the polished neck or types of implant systems. 4. No changes in bone density around the implant threads were observed throughout the experimental period. Bone density decreased at the marginal bone, and increased at the newly-formed alveolar crest. These results indicate that most of the alveolar bone loss occur within the first 12 months after installation of endosseous root-form dental implants resulting in the exposure of polished neck portions, and the bone level stabilizes thereafter at the first thread portions of the implant fixtures. The experimental period of 12 months seems insufficient for observing changes in bone density, and a long-term observation should be needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.386-393
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• 2009

Objectives: This study was performed to evaluate course of the inferior alveolar canal in the mandibular ramus and to find safety zone when ramal bone is harvested. Patients and Methods: From January, 2009 to February, 2009, the 20 patients who visited in the Department of Oral and Maxillofacial Surgery, Sanbon Dental Hospital. Wonkwang University and the Conebeam CT was taken of various chief complaints, were selected. The patients who had left and right mandibular first molar and incisor missing, jaw fracture and bone pathology were excluded. The R point was defined as the point which occlusal plane was crossed to the mandibular anterior ramus(external oblique ridge). In the cross-sectional coronal and axial views, the inferior alveolar canal position to the R point, buccal bone width(BW), alveolar crest distance(ACD), distance from alveolar crest to occlusal plane(COD) and inferior alveolar canal to sagittal plane(CS) were measured and horizontal distance(HD), vertical distance(VD) and nearest distance(ND) were measured. Results: The inferior alveolar canal is located $6.19{\pm}1.21\;mm$ from the R point. Horizontal distance from the R point were $13.07{\pm}2.45\;mm$, vertical distance from the R point were $14.24{\pm}2.41\;mm$ and nearest distance from the R point were $10.12{\pm}1.76\;mm$. The course of the inferior alveolar canal was positioned within $0.61{\pm}0.68\;mm$. The distance from external buccal bone to the inferior alveolar canal was increased from the R point anteriorly. Conclusions: It is considered that the mandibular ramus from the R point to 10 mm anteriorly can be harvested safely at ramal bone grafting.

• 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.

• International Journal of Oral Biology
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• v.41 no.1
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• pp.33-38
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• 2016

One of functions of Galla Rhois (GR) is reportedly an anti-inflammatory effect on the several inflammatory diseases. However, an effect of GR related to periodontitis has not been investigated. In the present study, we examined the effect of the hexane extract of Galla Rhois (GR-H) on periodontitis. Cytotoxicity was assessed by MTS analysis using human gingival fibroblast (hGF) cells. Experimental periodontitis was induced by injecting E.coli LPS into the palatal gingiva maxillary molar thrice weekly for 3 weeks (LPS group). GR-H diluted in 1xPBS was orally administrated using a syringe at 30 mg/kg body weight and 100 mg/kg body weight once a day (GR-H group). GR-H effect on the alveolar bone loss (ABL) was digitized with a micro-CT. GR-H treatment at concentrations exceeding 0.5 mg/ml showed cytotoxic effect in hGF cells. The micro-CT among groups were presented for the different distances from cemento-enamel junction (CEJ) to alveolar bone crest (ABC). The results indicated an inhibitory effect on alveolar bone loss for orally administered GR-H in a model of LPS-induced periodontitis.

• Journal of Periodontal and Implant Science
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• v.42 no.1
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• pp.20-24
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• 2012

Purpose: The purpose of this study was to evaluate the soft tissue and bone change around two adjacent implants in onestage implant surgery. Methods: Eleven subjects (7 males, 4 females) who were needed placement of 2 adjacent implants in the molar area were included. The two implants were placed with the platform at the level of the alveolar crest. The interproximal bone between the 2 implants was not covered with gingiva. After surgery, an alginate impression was taken to record the gingival shape and radiographs were taken to evaluate implant placement. Using a master cast, the gingival height was measured at baseline, 4 weeks, and 12 weeks. In the radiograph, the alveolar bone level was measured at the mesial and distal side of both implants at baseline and 12 weeks. Results: The exposed bone was covered with gingiva at both 4 and 12 weeks. Loss of alveolar bone around implants was found in all areas. The alveolar bone level in the exposed bone area did not differ from that in the non-exposed area. Conclusions: This study showed that the alveolar bone level and gingival height around 2 adjacent implants in the exposed bone area did not differ from that in unexposed bone area.

• Journal of Periodontal and Implant Science
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• v.46 no.2
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• pp.72-83
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• 2016

Purpose: The goal of this study was to evaluate the long-term success of horizontal alveolar crest augmentation of the retromolar region of the mandible with particulated bone, as well as factors affecting subsequent peri-implant bone loss. Methods: A total of 109 patients (68 female, 41 male) suffering from alveolar ridge deficiencies of the maxilla and mandible were included in this study. All patients were treated with particulated retromolar bone grafts from the mandible prior to the insertion of endosseous dental implants. Mesial and distal peri-implant crestal bone changes were assessed at six time points. Several parameters, including implant survival and the influence of age, gender, localisation of the implant, diameter, covering procedures, and time points of implant placement, were analysed to identify associations with bone level changes using the Mann-Whitney U-test, the Kruskal-Wallis test, and Spearman's rank-order correlation coefficient. Results: A total of 164 dental implants were placed in the maxilla (n=97) and in the mandible (n=67). The mean observation period was $105.26{\pm}21.58$ months after implantation. The overall survival rate was 97.6% after 10 years. Overall, peri-implant bone loss was highest during the first year, but decreased over time. The mean amount of bone loss after 10 years was 2.47 mm mesially and 2.50 mm distally. Bone loss was significantly influenced by implant type and primary stability. Conclusions: The use of particulated autologous retromolar bone grafts is a reliable technique for the horizontal reconstruction of local alveolar ridge deficiencies. Our results demonstrate that implants placed in augmented bone demonstrated similar bone level changes compared to implants inserted in non-augmented regions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.167-173
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• 2013

Purpose: The aim of this study is to analyze the series of panoramic radiograph of implant patients using the system to measure peri-implant crestal bone loss according to the elapsed time from fixture installation time to more than three years. Methods: Choose 10 patients having 45 implant fixtures installed, which have series of panoramic radiograph in the period to be analyzed by the system. Then, calculated the crestal bone depth and statistics and selected the implant in concerned by clicking the implant of image shown on the monitor by the implemented pattern recognition system. Then, the system recognized the x, y coordination of the implant and peri-implant alveolar crest, and calculated the distance between the approximated line of implant fixture and alveolar crest. By applying pattern recognition to periodic panoramic radiographs, we attained the results and made a comparison with the results of preceded articles concerning peri-implant marginal bone loss. Analyzing peri-implant crestal bone loss in a regression analysis periodic filmed panoramic radiograph, logarithmic approximation had highest $R^2$ value, and the equation is as shown below. $y=0.245Logx{\pm}0.42$, $R^2=0.53$, unit: month (x), mm (y) Results: Panoramic radiograph is a more wide-scoped view compared with the periapical radiograph in the same resolution. Therefore, there was not enough information in the radiograph in local area. Anterior portion of many radiographs was out of the focal trough and blurred precluding the accurate recognition by the system, and many implants were overlapped with the adjacent structures, in which the alveolar crest was impossible to find. Conclusion: Considering the earlier objective and error, we expect better results from an analysis of periapical radiograph than panoramic radiograph. Implementing additional function, we expect high extensibility of pattern recognition system as a diagnostic tool to evaluate implant-bone integration, calculate length from fixture to inferior alveolar nerve, and from fixture to base of the maxillary sinus.