• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.251-258
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• 2014

Purpose: The preferred material for bone augmentation beyond the envelope of skeletal bone is the bone block graft, due to its dimensional stability. We evaluated the necessity of rigid fixation for the bone block graft, and compared the bone regeneration and volume maintenance associated with grafting using a synthetic hydroxyapatite block (HAB) and an autogenous bone block (ABB) without rigid fixation on rabbit calvaria over two different periods. Methods: Cylinder-shaped synthetic HAB and ABB were positioned without fixation on the rabbit calvarium (n=16). The animals were sacrificed at 4 or 8 weeks postoperatively, and the grafted materials were analyzed at each healing period using microcomputed tomography and histologic evaluation. Results: Integration of the graft and the recipient bed was observed in all specimens, although minor dislocation of the graft materials from the original position was evident in some specimens (six ABB and ten HAB samples). A tendency toward progressive bone resorption was observed in the grafted ABB but not in the grafted HAB, which maintained an intact appearance. In the HAB group, the area of new bone increased between 4 and 8 weeks postoperatively, but the difference was not statistically significant. Conclusions: The nonfixed HAB was successfully integrated into the recipient bed after both healing periods in the rabbit calvaria. In spite of limited bone formation activity in comparison to ABB, HAB may be a favorable substitute osteoconductive bone material.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.466-472
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• 2012

The loss of mandibular continuity due to trauma, neoplasm, or infection results in major esthetic and biologic compromise. The reconstruction of the mandibular bone defect still poses a challenge to oral and maxillofacial surgeons. There have been a number of variety graft materials. Among them, free block bone graft with rigid fixation has been widely used. However, cases using free block bone grafts may lead to a marked invasion of the donor site, mal-union, and absorption of the block bone. In this respect, particulate cortical bone using a titanium mesh tray can be an effective alternative option in order to achieve a proper bone contour and good oral rehabilitation. We have developed an intraoral approach for the mandibular reconstruction method using a titanium mesh tray with autogenous particulate cortical bone graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.19.1-19.4
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• 2016

Background: Implant surgery has become popular with the advance of surgical techniques such as sinus lifting, guided bone regeneration, and block bone graft. However, there were no data about the frequency of bone graft during implant surgery. The purpose of this study was to report the frequency and types of bone graft depending on dental implant patients' profile to complement the database regarding implant surgery. Methods: The implant operations had been performed from January 2006 to October 2014. The upper and lower jaws were divided into six sextants. A total of 792 sextants were included in this study. Patient information including sex, age, sites, bone graft, and types of bone were investigated. Results: A total of 1512 implants had been placed. Male and female sextants were 421 and 371, respectively (M:F = 1:0.88). Average age was 54.3 (ranging from 20 to 88 years old). Implants were placed in the posterior maxilla (322 sextants, 40.7 %), posterior mandible (286 sextants, 36.1 %), anterior maxilla (127 sextants, 16.1 %), and anterior mandible (57 sextants, 7.2 %). Bone graft was performed in 50.3 % of the sextants. Among the bone grafted sites, sinus lifting with lateral approach (22.1 %) and guided bone regeneration (22.7 %) were performed most frequently. Conclusions: Bone graft in implant surgery was necessary to augment defects. More than half of the sextants needed bone graft for implant installation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.2-8
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• 2012

Introduction: Auto-tooth bone graft material consists of 55% inorganic hydroxyapatite (HA) and 45% organic substances. Inorganic HA possesses properties of bone in terms of the combining and dissociating of calcium and phosphate. The organic substances include bone morphogenetic protein and proteins which have osteoinduction capacity, as well as the type I collagen identical to that found in alveolar bone. Auto-tooth bone graft material is useful as it supports excellent bone regeneration capacity and minimizes the possibility of foreign body reaction,genetic diseases and disease transmission. Materials and Methods: Implant placement combined with osteoinductive regeneration,preservation of extraction socket, maxillary sinus augmentation, and ridge augmentation using block type,powder type, and block+powder type autobone graft materialwere performed for 250 patients with alveolar bone defect and who visited the Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University from September 2009 to August 2011. Results: Clinical assessment: Among the 250 patients of auto-tooth bone graft, clinical assessment was performed for 133 cases of implant placement. The average initial stabilization of placed implants was 74 implant stability quotient (ISQ). Radiological assessment: The average loss of crestal bone in the mandible as measured 6 months on the average after the application of prosthesis load was 0.29 mm, ranging from 0 mm to 3.0 mm. Histological assessment: In the histological assessment, formation of new bone, densified lamellated bone, trabecular bones, osteoblast, and planting fixtures were investigated. Conclusion: Based on these results, we concluded that auto-tooth bone graft material should be researched further as a good bone graft material with osteoconduction and osteoinduction capacities to replace autogenous bone, which has many limitations.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.207-215
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• 2009

Purpose: The aim of the present study is to evaluate the long term bone healing after horizontal ridge augmentation using auto block bone graft for implant installation timing. Materials and Methods: Five Beagle dogs(which were 14 months old and weighted approximately 10kg). In surgery 1(extraction & bone defect), premolars(P2, P3,P4) were extracted and the buccal bone plate was removed to create a horizontally defected ridge. After three months healing, in surgery 2(ridge augmentation). Auto block bone grafts from the mandibular ramus were used in filling the bone defects were fixed with stabilizing screws. The following fluorochrome labels were given intravenously to the beagle dogs: oxytetracycline 1week after the surgery, alizarin red 4 weeks after the surgery, calcein blue 8 weeks after the surgery. The tissue samples were obtained from the sacrificed dogs of 1, 4, 8, 12, 16 weeks after the surgery. Non-decalcified sections were prepared by resin embedding and microsection to find thickness of $10{\mu}m$ for the histologic examination and analysis. Results: 1. We could achieve the successful reconstruction of the horizontal bone defect by auto block bone graft. The grafted bone block remained stable morohologically after 16 weeks of the surgery. 2. In the histologic view. We observed osteoid tissue from the sample $4^{th}$ week sample and active capillary reconstruction in the grafted bone from the $12^{th}$ week sample. Healing procedures of auto bone grafts were compared to that of the host bone. 3. Bone mineralization could be detected from the $8^{th}$ week sample. 4. Fluorochrome labeling showed active bony changes and formation at the interface of the host bone and the block graft mainly. Bony activation in the grafted bone could be seen from the $4^{th}$ week samples. Conclusions: Active bone formation and remodeling between the grafted bone and host bone can be seen through the revascularization. After the perfect adhesion to host bone, Timing of successful implant installation can be detected through the ideal ridge formation by horizontal ridge augmentation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.340-345
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• 2009

Purpose: The purpose of this study was to evaluate the surgical success of bone reconstruction of the severely atrophic maxilla using autogenous block bone onlay graft from the ramus and ilium prior to dental implantation. And we measured the amount of vertical height change Material and Methods: 26 partially edentulous patients(32 case) who needed block onlay bone graft before implant placement in posterior maxillary area from 2002 to 2009 were selected for this study. Patients consisted of 20 males & 6 females and the average of their age was 54.2. Patients who were treated with ramal bone were 19 case and patients who were treated with iliac bone were 11 case. Digital panoramic X-ray was taken at the day of surgery, 3 months and 6 months later after the surgery. Vertical height change & resorption rate of grafted bone were measured with the same X-rays and compared Results: Two out of 32 bone grafts had to be removed because of inflamation at the grafts area(97.3%). The mean of radiographic vertical height change(change rate) of post-op. 3 month was 0.54mm(8.5%)and 6 month was 0.99mm(15.9%). Compairing to intraoral donor site(ramus), iliac bone had more vertical height change(1.18mm) at 6 month after surgery. Conclusions: Within the limit of this study, autogenous block onlay grafts can be considered a promising treatment for severely atrophic maxilla.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.5
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• pp.284-289
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• 2015

In cases of severe alveolar bone atrophy in the posterior maxillary area, which has only a thin sinus floor, the autogenous tooth bone graft block (ABTB) was used to wrap the implant to enhance its primary stability and osseointegration in the sinus. These cases with four years of clinical follow-up demonstrate the applicability of the ABTB in maxillary sinus membrane elevation to improve the outcomes of implant placement.

• Korean Journal of Cleft Lip And Palate
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• v.5 no.2
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• pp.85-93
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• 2002

Simultaneous implant installation with bone graft was performed in 15 cases. Four cases were cleft alveolus patients. 56 implants were placed immediately with block bone grafts. 2 cases were cranial bone grafts and the others were iliac bone grafts. Three of 56 implants were lost(94.6% Survival rate). One of three was cleft alveolus case. The cleft alveolus patients with simultaneous implants installation showed functional and esthetic results without infraocclusion and positional changes. Bergland index was considered to be type I after 12 months later. Immediate implant installation with bone graft is one of choice of treatment in closing cleft alveolus hoping simultaneous implant installation could be related with function which might result in less resorption of graft. Functional and esthetic results are satisfaction ; there was no infraocclusion and positional changes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.483-489
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• 2011

Introduction: This study examined the cumulative resorption of implants placed in a severely atrophic mandible and analyzed the radiologic bone resorption in the marginal bone, after an autogenous bone graft including both block and particulates that had been harvested from the ramus and iliac crest. Materials and Methods: A retrospective study was performed on patients who had bone grafts for augmentation followed by implant installation in the mandible area from 2003 to 2008. Twelve patients (6 men and 6 women) who received 34 implants in the augmented sites were evaluated. Cumulative radiologic resorption around the implants was measured immediately, 3 months, 6 months and 12 months after implant installation surgery. Results: The installed implant in grafted bone showed 0.84 mm marginal bone resorption after 3 months and 50% total cumulative resorption after 1 year. The mean marginal bone resorption around the implant installed in the grafted bone was 0.44 mm after 3 months, 0.52 mm after 1 year, after which it stabilized. The implant survival rate was 97% (failed implant was 1/34). Marginal bone resorption of the installed implant in the autogenous onlay block bone grafts was 0.98 mm after 3 months, which was significantly higher than that of a particulated bone graft (0.74 mm) (P <0.05). Conclusion: An autogenous graft including block type and particulate type is a predictable procedure for the use of dental implants in a severely atrophic mandible. Implant placement in augmented areas show a relatively high survival and minimal bone loss, as revealed by a radiologic evaluation.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.943-953
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• 1999

Severe alveolar ridge deficiency can prevent ideal implant placement. Ridge augmentation procedures are necessary to regain lost alveolar structures. The corticocancellous block bone graft was harvested from the mandibular symphysis. This block bone was fixed to the lateral aspect of the ridge with titanium screws. Seven months later, the autogenous bone graft was reentered and sufficient bone volume was gained to allow implant placement. The fixation screws were removed and 3I implants were inserted. No complication and postoperative alteration in chin contour were observed. This report demonstrates that chin graft offers a predictable alternative in the reconstruction of ridge deficiency for implant placement.