• 대한치과의사협회지
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• 제47권9호
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• pp.596-606
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• 2009

Aim : The ultimate goal of periodontal treatment is regeneration of periodontium that have been lost due to inflammatory periodontal disease. Recently, Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate bone substitute have been introduced to achieve periodontal regeneration. The purpose of this study is to evaluate the effect of the Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate(BoneMedik-$DM^{(R)}$, Meta Biomed Co., Ltd. Oksan, Korea) on periodontal intrabony defects. Methods and materials : Clinical effects of Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate implantation in intrabony defects were evaluated 6 months after surgery in Sixty-one intrabony defects from Fourty-six patients with chronic periodontitis. Twenty-nine experimental defects in twenty-five patients received the Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate(test group), while Thirty-Three defects in twenty-one patients were treated with flap procedure only( control group). Comparative observation were done for preoperative and postoperative differences between control and experimental clinical parameters,-clinical attachment 10ss(CAL), probing depth(PD), bone probing depth(BPD), gingi val recession. Results : Postoperative improvements in CAL, PD, BPD were observed in both test and control groups(P<0.0l). However, the improvements in CAL, PD, BPD of the test group were significantly greater than control group. Conclusion : Healing of the both groups were uneventful during experimental periods. Use of Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate in a flap operation resulted in significantly greater improvements in CAL, PD, and BPD over flap operation alone. Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate will be good bone substitute materials for treatment of intrabony defects.

• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.363-372
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• 2008

Purpose: This study compared the effects of coating implants with hydroxyapatite (HA) using an ion beam-assisted deposition (IBAD) method prepared with machined, anodized, sandblasted and large-grit acid etched (SLA) surfaces in minipigs, and verified the excellency of coating method with HA using IBAD. Material and Methods: 4 male Minipigs(Prestige World Genetics, Korea), 18 to 24 months old and weighing approximately 35 to 40 kg, were chosen. All premolars and first molars of the maxilla were carefully extracted on each side. The implants were placed on the right side after an 8 week healing period. The implant stability was assessed by resonance frequency analysis (RFA) at the time of placement. 40 implants were divided into 5 groups; machined, anodized, anodized plus IBAD, SLA, and SLA plus IBAD surface implants. 4 weeks after implantation on the right side, the same surface implants were placed on the left side. After 4 weeks of healing, the minipigs were sacrificed and the implants were analyzed by RFA, histology and histometric. Results: RFA showed a mean implant stability quotient (ISQ) of $75.625{\pm}5.021$, $76.125{\pm}3.739$ ISQ and $77.941{\pm}2.947$ at placement, after 4 weeks healing and after 8 weeks, respectively. Histological analysis of the implants demonstrated newly formed, compact, mature cortical bone with a nearby marrow spaces. HA coating was not separated from the HA coated implant surfaces using IBAD. In particular, the SLA implants coated with HA using IBAD showed better contact osteogenesis. Statistical and histometric analysis showed no significant differences in the bone to implant contact and bone density among 5 tested surfaces. Conclusion: We can conclude that rough surface implants coated with HA by IBAD are more biocompatible, and clinical, histological, and histometric analysis showed no differences when compared with the other established implant surfaces in normal bone.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.839-848
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• 2007

Purpose: Various kinds of biodegradable membranes are currently used in dental clinics. And the frequency and the necessity of their usage are increasing due to their numerous advantages. Therefore it is important to understand the difference of various membranes and histological reaction against implanted membranes. Materials and Methods: Biodegradable membranes of $Biogide^{(R)}$, $Resolute^{(R)}$, and $Tutodent^{(R)}$ were cut into small pieces by $1.0{\times}0.5cm$. The membranes were implanted 1.5cm apart from each other under the epithelium on the skull of 18 Sprague Dawley rats. The animals were sacrificed at 3, 7, and 14 days after surgical procedure. The specimens were examined by histological analysis. Results: 1. Early period after implantation of the membranes showed connective tissues surrounding membranes and there were a few inflammatory cells present. 2. In $Biogide^{(R)}$ and $Tutodent^{(R)}$ specimens, inflammatory cells and surrounding tissues were shown to infiltrate from outside with slight density difference inside. In $Resolute^{(R)}$ specimens, membranes were fragmented. Inflammatory cells and connective tissues were also observed inside. 3. In $Resolute^{(R)}$ specimen, giant cells were present which implicates that foreign body reaction has occurred. 4. $Biogide^{(R)}$ had lower integrity than other membranes and is not enough to be used alone in defect area. However, $Resolute^{(R)}$ had superior firmness than others. $Tutodent^{(R)}$ had middle level of integrity. Conclusion: This experimental model enabled to observe early inflammatory reactions and morphological changes of materials and can be used to develop and evaluate the efficacy of biodegradable membranes. Duplication of standardized human oral environment will be required in future experiments.

• 대한치과의사협회지
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• 제47권11호
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• pp.758-768
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• 2009

Purpose : Schulte introduced immediate implant cases in 1970s, since then many patients have been treated by immediate implants. The aim of this study was to evaluate the cumulative survival rate of immediate implant and to analyze various factors associated with survival of immediate implant in a 8-year period retrospectively. Materials and methods : From May, 2000 to October, 2007, 77 implants were placed in 63 patients immediately after tooth extraction at Department of Periodontology, Yonsei University Hospital. The implant survival rate was analyzed using a life-table analysis. After delivery of prosthesis, along 1 year of observation period, all implants were evaluated clinically and radiographically. Results : Among 77 implants, 59 were placed in maxilla and 18 in mandible. The most common site of the implantation was Mx anterior (65%). The overall survival rate was 94.8% over a mean follow-up period of $44.2{\pm}21$ months and the 8-year cumulative survival rate was 94.6%. Failure occurred in 4 implants, all of which were due to early failures. None of the following factors were significantly associated with the survival of immediate implants: advanced surgical technique including bone graft and guided bone regeneration, the types of implants, causes of tooth loss, and types of prosthesis. Conclusion : On the basis of 8-year life time analysis, immediate implant placement can be considered a safe and predictable treatment mordality.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권3호
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• pp.175-182
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• 2021

Objectives: In this prospective randomized controlled trial, we measured the primary and secondary stability of two surface-treated implants placed in the posterior maxilla, applied 3-month loading protocols, and compared and analyzed the short-term outcomes of the implants. Patients and Methods: From June 2018 to June 2019, patients with a residual bone height of 4 mm in the posterior maxilla were enrolled and randomly divided into two groups to place SA implants (Osstem Implants, Korea) in Group A and NH implants (Hiossen, USA) in Group B. Finally, 14 implants placed in 13 patients in Group A and 17 implants placed in 14 patients in Group B were analyzed. The measured primary and secondary stability of each implant was represented by implant stability quotient (ISQ), and treatment outcomes were evaluated. Results: Group A consisted of patients with an average age of 62.2 years (range, 48-80 years), and Group B consisted of patients with an average age of 58.1 years (range, 35-82 years). Primary stability was 73.86±6.40 and 71.24±5.32 in Groups A and B, respectively (P=0.222). Secondary stability was 79.07±5.21 in Group A and 78.29±4.74 in Group B (P=0.667). A steep increase in ISQ during the healing period was observed in Group B, though it was not significant (P=0.265). The mean follow-up period was 378.5±164.6 days in Group A and 385.3±167.9 days in Group B. All implants in each group met the success criteria, and the success rate was 100%. Conclusion: Two surface-treated implants placed in the posterior maxilla with greater than 4 mm alveolar bone height exhibited successful one-year treatment outcomes if a primary stability of 65 or higher ISQ was obtained and a 3-month early loading protocol was applied.

• 대한치과보철학회지
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• 제47권2호
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• pp.215-221
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• 2009

연구목적: 임플란트 시술을 받는 환자가 크게 증가하는 시점에 임플란트 시술환자를 시술 전후로 추적 조사하여 시술 전후의 저작능력을 평가하고, 시술 전후의 환자 만족도와 삶의 질의 변화를 비교하기 위하여 연구를 수행하였다. 연구 재료 및 방법: 대구광역시와 울산광역시에 있는 6개의 치과 의원에서 2006년 12월부터 2007년 10월까지 임플란트 시술을 받은 20세 이상의 성인 환자 109명을 대상으로 임플란트 시술 전후에 설문조사를 실시하여 임플란트 치료선택동기, 저작능력, 환자만족도, 권유의향, 삶의 질을 비교분석하였다. 결과: 임플란트 선택 동기는 '치아기능의 회복을 위하여'가 45.9%로 가장 많았고, 치료 시 가장 걱정되는 것은 '치료실패와 부작용'이 38.5%로 가장 많았다. 임플란트 시술에 대한 만족도는 시술 전 30.37점에서 시술 후 45.01점으로 시술 전후의 만족도 점수가 유의한 차이가 있었으며(P<.001), 치료에 대한 만족도는 '만족한다'라고 답한 사람이 91.8%였으며, 연구대상자의 89%가 가족이나 주위에 임플란트를 '권유할 의향이 있다'라고 응답했다. 섭취가능 식품에 대한 설문을 이용하여 측정한 저작능력 점수는 임플란트 시술 전 15.24점에서 임플란트 시술 후 19.11점으로 시술 전후의 저작능력 점수가 유의한 차이가 있었으며(P<.001), 삶의 질 점수도 임플란트 시술 전 9.99점에서 시술 후 11.17점으로 시술 전후 유의한 차이가 있었다(P<.001). 결론: 이 연구 결과를 통해 치아 질환, 치아상실로 인하여 저하된 저작 능력이 임플란트를 통하여 유의하게 개선됨을 확인할 수 있었다. 향후 임플란트를 시술한 상실치아 수나 상실 부위에 따른 임플란트 시술환자의 만족도에 대한 연구가 필요하며, 시술 후 장기간의 경과 후 평가 및 연구대상자 확대를 통한 연구를 시행할 필요가 있다고 생각한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권3호
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• pp.243-248
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• 2009

Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.467-473
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• 2007

이 실험은 이식재로 Deproteinated Bovine Bone Powder (DBBP)를 사용하였을 때와 골 이식재를 사용하지 않고 단순히 Absorbable Gelatin Sponge(AGS)만을 사용하였을 때의 BMP4와 BMP6의 상대적인 발현량을 real-time RT-PCR을 이용하여 비교해 보기 위한 것으로 다음과 같은 결과를 얻었다. 1. BMP4의 경우 처음 1일째와 3일째의 경우 DBBP군과 AGS군 모두 일정하게 증가하였으나 5일째 AGS군에서 감소하다가 7일째 다시 증가하였으며 9일째 다시 감소하였다. DBBP군에서는 7일까지 계속하여 증가하다가 9일째 감소하였다. DBBP군이 AGS군에 비해 발현의 양이 많은 경우가 많았지만 유의성은 없었다 (p>0.05). 2 BMP6의 경우 처음 1일째와 3일째의 경우 DBBP군과 AGS군 모두 일정하게 증가하였으나 5일째 AGS군에서 감소하다가 7일째 다시 증가하였으며 9일째 다시 감소하였다. DBBP군에서는 7일까지 계속하여 증가하다가 9일째 감소하였다. AGS군이 DBBP군에 비해 발현의 양이 많은 경우가 많았지만 유의성은 없었다 (p>0.05). 3. 두 군간에 동일시기에 BMP발현이 유의할 만한 차이를 보이지 않는 것은 DBBP와 AGS 모두 space retainer로서 작용을 하여 혈병중의 BMP발현의 양상이 비슷하기 때문으로 여겨진다. 4. 따라서 DBBP가 AGS에 비해 초기 골재생에 크게 유리한 점은 없는 것으로 여겨지며 초기 골 형성에서 BMP의 발현은 이식재의 종류가 아니라 물리적인 carrier로서의 작용이 더 중요한 것으로 여겨진다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권3호
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• pp.285-292
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• 2008

Purpose: The present study was performed to evaluate the effect of surface treatment of the cervical area of implant on bone regeneration in fresh extraction socket following implant installation. Materials and methods: The four minipigs, 18 months old and 30 kg weighted, were used. Four premolars of the left side of both the mandible and maxilla were extracted. ${\phi}$3.3 mm and 11.5 mm long US II plus implants (Osstem Implant co., Korea) with resorbable blasting media (RBM) treated surface and US II implants (Osstem Implant co., Korea) with machined surface at the top and RBM surface at lower portion were installed in the socket. Stability of the implant was measured with $Osstell^{TM}$ (Model 6 Resonance Frequency Analyser: Integration Diagnostics Ltd., Sweden). After 2 months of healing, the procedures and measurement of implant stability were repeated in the right side by same method of left side. At four months after first experiment, the animals were sacrificed after measurement of stability of all implants, and biopsies were obtained. Results: Well healed soft tissue and no mobility of the implants were observed in both groups. Histologically satisfactory osseointegration of implants was observed with RBM surface, and no foreign body reaction as well as inflammatory infiltration around implant were found. Furthermore, substantial bone formation and high degree of osseointegration were exhibited at the marginal defects around the cervical area of US II plus implants. However, healing of US II implants was characterized by the incomplete bone substitution and the presence of the connective tissue zone between the implant and newly formed bone. The distance between the implant platform (P) and the most coronal level of bone-to-implant contact (B) after 2 months of healing was $2.66{\pm}0.11$ mm at US II implants group and $1.80{\pm}0.13$mm at US II plus implant group. The P-B distance after 4 months of healing was $2.29{\pm}0.13$mm at US II implants group and $1.25{\pm}0.10$mm at US II plus implants group. The difference between both groups regarding the length of P-B distance was statistically significant(p<0.05). Concerning the resonance frequency analysis (RFA) value, the stability of US II plus implants group showed relatively higher RFA value than US II implants group. Conclusion: The current results suggest that implants with rough surface at the cervical area have an advantage in process of bone regeneration on defect around implant placed in a fresh extraction socket.

• 구강회복응용과학지
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• 제31권4호
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• pp.364-370
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• 2015

최근 구치부 부분 무치악 환자의 임플란트 보철 수복은 기능적뿐만 아니라 심미적으로도 환자의 만족을 이끌어내야 하는 과제를 안고 있다. 이렇게 환자의 요구가 높아지면서 상실된 자연치아와 유사한 형태의 임플란트 보철을 사용한 구강회복이 보철수복의 중요한 이슈가 되고 있다. 이를 위해서는 기성 지대주 보다는 더 넓은 customized CAD/CAM 지대주를 사용함으로써 자연스러운 출현윤곽을 재현할 수 있다. 넓은 지대주를 지지해주기 위해서는 충분한 폭과 높이를 가지는 각화치은이 존재해야 하는데, 만약 긴 치아상실기간이나 골이식술 등으로 인해 임플란트 주위에 각화치은이 부족한 경우에는 연조직 증대술을 시행하는 것이 추천된다. 이러한 과정을 통해 심미적이고 기능적인 임플란트 보철 제작이 가능하며 구강위생관리를 용이하게 하고 향후 임플란트 주위염의 발생 가능성을 감소시킨다. 본 증례는 구치부 부분 무치악 환자에서 골이식술, 상악동 이식술, 임플란트 식립술 및 연조직 이식술을 사용하여 부족한 치조골과 각화치은 및 협측전정을 회복하였으며, customized CAD/CAM 지대주와 지르코니아 보철물을 이용하여 수복한 증례로 주기적인 내원 및 검사를 통해 기능적, 심미적으로 만족할만한 결과를 얻었기에 이 사례를 보고하고자 한다.