• The Journal of Korean Academy of Prosthodontics
• /
• v.51 no.1
• /
• pp.11-19
• /
• 2013

Purpose: The aim of this study was to evaluate the heat generation in bone in vitro during the guided flapless drilling procedure and the effect of drilling methods on the heat generation. Materials and methods: A model that has missing the first and second mandibular molars bilaterally was used. In group A, classical flap implant surgery was performed. In group B, flapless implant surgery using surgical guide was performed. In group C, flapless implant surgery using surgical guide without up-and-down pumping motion was performed. Temperature was measured with k-type thermocouple and a real-time digital thermometer. The thermocouples were placed at 0.5 mm away from the osteotomy area at the depths of 3 mm and 6 mm. The measured values were evaluated with independent t-test. Results: The mean temperature generated was $27.2^{\circ}C$ ($SD{\pm}2.1^{\circ}C$) and $27.5^{\circ}C$ ($SD{\pm}2.3^{\circ}C$) for groups A and B, respectively. These differences were not statistically significant. In group C, the mean temperature was $37.0^{\circ}C$ ($SD{\pm}3.4^{\circ}C$). There were statistically significant differences between groups B and C with respect to the mean temperature. Conclusion: These findings suggest that guided flapless drilling with up-and-down pumping motion may not significantly increase the bone temperature.

• Journal of International Society for Simulation Surgery
• /
• v.2 no.2
• /
• pp.83-86
• /
• 2015

Recently, computer-assisted surgery is popular for performing well-planned operations. Computer-aided navigation system is helpful in maxillofacial surgery with real time instrument positioning and clear anatomic identification. Generally, segmental mandibulectomy and reconstruction flap surgery have done by extra-oral approach such as, submandibular approach. This case report describes performing intra-oral segmental mandibulectomy and reconstruction with monocortical deep circumflex iliac artery (DCIA) flap and CT guided implant surgery by using computer-aided surgical guide and navigation for managing ameloblastoma in a 31 years old female patient.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.40
• /
• pp.2.1-2.7
• /
• 2018

With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.

• Journal of Audiology & Otology
• /
• v.25 no.4
• /
• pp.217-223
• /
• 2021

Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.

• Korean Journal of Audiology
• /
• v.25 no.4
• /
• pp.217-223
• /
• 2021

Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.

• Journal of Periodontal and Implant Science
• /
• v.42 no.1
• /
• pp.25-29
• /
• 2012

Purpose: There has been no attempt to establish an objective implant surgical evaluation protocol to assess residents' surgical competence and improve their surgical outcomes. The present study presents a newly developed assessment and rating system and simulation model that can assist the teaching staffs to evaluate the surgical events and surgical skills of residents objectively. Methods: Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed regarding surgical competence and assessment tools. Particularly, medical journals reporting rating and evaluation protocols for various types of medical surgeries were thoroughly analyzed. Based on these studies, an implant surgical technique assessment and rating system (iSTAR) has been developed. Also, a specialized dental typodont was developed for the valid and reliable assessment of surgery. Results: The iSTAR consists of two parts including surgical information and task-specific checklists. Specialized simulation model was subsequently produced and can be used in combination with iSTAR. Conclusions: The assessment and rating system provided may serve as a reference guide for teaching staffs to evaluate the residents' implant surgical techniques.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.29 no.2
• /
• pp.66-74
• /
• 2020

Communication and cooperation between dentists and dental technicians are two essential elements for the fabrication of high quality 'custom' prosthesis. For successful communication and cooperation between the two groups, however, dentists and dental technicians must share common understanding about clinical dentistry. Ironically, it is often noticed that they are not really sharing the same clinical knowledge. Although there is a strong association between 'Emergence Profile' of implant prostheses and periodontal health or esthetics, no definite guideline has ever been provided for ideal emergence profile of implant prosthesis in literature. Problems resulted from inherent differences between implants and natural teeth must be acknowledged and shared between dentists and dental technicians so that they can come up with desirable clinical results with implant prostheses.

• Journal of Periodontal and Implant Science
• /
• v.31 no.2
• /
• pp.451-463
• /
• 2001

Following the extensive use of implant, the incidence of peri-implantitis increases. Guided bone regeneration has been used for the optimal treatment of this disease. Because implant surface was contaminated with plaque and calculus, cleaning and detoxification were needed for the reosseointegration when guided bone regeneration was performed. Various mechanical and chemical methods have been used for cleaning and detoxification of implant surface, air-powder abrasive and oversaturated citrate were known to be most effective among these methods. However, these methods were incomplete because these could not thoroughly remove bacteria of implant surface, moreover deformed implant surface. Recent studies for detoxification of the implant surface using laser were going on, $CO_2$ laser and Soft Diode laser were known to be effective among these methods. The purpose of this study was to obtain clinical guide by application these laser to implant surface. 15 experimental machined pure titanium cylinder models were fabricated. The $CO_2$ laser treatment under dry, wet and hydrogen peroxide condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of models. Each groups were examined with SPM and SEM to know whether their surface was changed. The results were as follows : 1. Surface roughness and surface form weren't changed when $CO_2$ laser was usedunder dry condition(P>0.05). 2. Surface roughness and surface form weren't changed when $CO_2$ laser was used under wet condition(P>0.05). 3. Surface roughness and surface form weren't changed when $CO_2$ laser was used under hydrogen peroxide condition(P>0.05). 4. Surface roughness and surface form weren't changed when Soft Diode laser was used under toluidine blue O solution condition(P>0.05). From the result of this study, it may be concluded that the $CO_2$ laser having relatively safe pulse mode and the Soft Diode laser used with photosensitizer can be used safely to treat peri-implantitis.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.37 no.3
• /
• pp.147-156
• /
• 2021

There are various treatment options such as conventional complete denture, hybrid prosthesis and implant-supported fixed prosthesis for fully edentulous patients. In case of implant-supported fixed prosthesis, compared to removable prosthesis, it is difficult to place the implant in the correct position considering the anatomical contours of the final prosthesis. In this case, a full mouth rehabilitation with implant-supported fixed prosthesis was performed for a patient who required extraction of all remaining teeth due to dental caries and chronic periodontitis. In the implant placement stage, the implant was placed in the desired position using a surgical guide fabricated considering the anatomical contours of the final prosthesis, and the function and esthetics were evaluated through correction and re-fabrication of the fixed provisional restoration. A final restoration of porcelain fused to gold prosthesis was delivered to the patient based on the provisional restoration. To cope with complications such as loosening of screws and fracture of porcelain, a screw-retained type prosthesis was fabricated for the posterior part and a screw-cement-retained type prosthesis for the anterior part. As a result, the patient showed an improved prognosis in terms of functional and esthetics after the final prosthesis was delivered.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.3
• /
• pp.288-295
• /
• 2019

Passive fit of prosthesis is an essential property of implant supported prosthesis for long term success and minimization of complications. And the property is determined mostly by fabrication procedure. There were limitations of extensive implant prosthesis because conventional casting method generate contraction error of long span prosthesis. However, Computer-aided design/Computer-aided manufacturing (CAD/CAM) technology of 3D printing and milling metal framework can overcome those limitations. This case is a full mouth rehabilitation using extensive implant fixed prosthesis. Removable interim prosthesis was made for esthetic, functional evaluation and a guide for implant insertion. After the insertion, implant fixed interim prosthesis was delivered. After additional evaluation and adjustment, final prosthesis was designed with CAD, the fabricated with CAM. Milling technique was used for anterior screw type implant superstructure and 3D printing technique was used for the anterior and posterior implant copings. Fit of the final restoration was favorable. The practitioner and patient were both esthetically and functionally satisfied with the final result.