• Title/Summary/Keyword: osteotome technique

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Benign paroxysmal positional vertigo as a complication of sinus floor elevation

  • Kim, Moon-Sun;Lee, Jae-Kwan;Chang, Beom-Seok;Um, Heung-Sik
    • Journal of Periodontal and Implant Science
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    • v.40 no.2
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    • pp.86-89
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    • 2010
  • Purpose: Osteotome sinus floor elevation (OSFE) is an often-used technique of great utility in certain implant patients with resorbed posterior maxilla. Recently benign paroxysmal positional vertigo (BPPV) has been reported as an early postoperative complication following OSFE. Although OSFE-induced BPPV commonly resolves itself within a month without treatment, this complication can be a cause of trouble between the implant surgeon and patient. This report presents a case of BPPV following OSFE. Methods: A 27-year-old man without any significant medical problems and missing his maxillary right first molar, was scheduled for OSFE and simultaneous implant placement. Results: The patient suffered dizziness accompanied by nausea immediately after implant placement using OSFE. Following referral to the ear nose throat clinic, "right posterior canal BPPV" was diagnosed. Despite anti vertigo medication and a single episode of the Epley maneuver, the condition did not improve completely. The Epley maneuver was then applied 7 and 8 days later and the symptoms of BPPV disappeared. One year later, the patient remained symptom-free. Conclusions: Before sinus elevation with an osteotome, implant surgeons should screen out patients with a history of vertigo, to diminish the possibility of BPPV. Operators should be aware of BPPV symptoms. As the symptoms may be very incapacitating, immediate referral to an otorhinolaryngologist is recommended.

Novel approach to the maxillary sinusitis after sinus graft

  • Hong, Sung ok;Shim, Gyu-Jo;Kwon, Yong-Dae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.18.1-18.4
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    • 2017
  • Background: Postoperative infection occurs when bone graft material is dislodged into the maxillary sinus cavity and most of the patients are often uncomfortable with the drainage and irrigation procedures to eradicate the infection. In this case report, we share a technique in treating patients with such condition. Material and methods: A 47-year-old patient was referred after sinus elevation using the crestal socket osteotome, bone graft, and implant insertion at a local clinic. Clinical and radiographic findings confirmed the diagnosis of right maxillary sinusitis. A surgical and medical treatment regimen was applied. Results: By using this technique for irrigation, we were able to achieve successful results, and the patient was satisfied due to less discomfort during the irrigation process. Conclusion: This method is a patient-friendly technique for sinus irrigation. It is not only limited to sinus grafted patients, but also maxillary sinusitis patients in any other type of odontogenic infection.

A change of sinus floor level related to the amount of grafted material after bone added osteotome sinus floor elevation (BAOSFE) technique: A radiographic retrospective study (상악동저 거상술에서 이식재 양에 따른 이식골 높이 변화에 대한 방사선학적 평가)

  • Lee, Ji-Eun;Park, So-Min;Lee, Jong-Bin;Pang, Eun-Kyoung
    • The Journal of the Korean dental association
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    • v.55 no.11
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    • pp.756-765
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    • 2017
  • Purpose: The purpose of this article is to evaluate a change o bone level on the sinus floor by a bone added osteotome sinus floor elevation (BAOSFE) technique, according to the amount of deproteinized bovine bone mineral (DBBM). And Changes in augmented bone height after BAOSFE procedure were also assessed for 6 months after the implant procedure. Materials and Methods: Forty eight single implants were placed in the posterior maxilla using BAOSFE technique. The implantation sites were classified into two groups according to the amount of grafted DBBM, 0.25 group (0.25g) and 0.5 group (0.5 g). Panoramic views or cone-beam computed tomography (CBCT) were taken at the time of implant placement with BAOSFE and after at least 6 months to assess the bone level changes in the elevated sites with DBBM. Results: Alveolar bone level around all implants was stable clinically and radiographically during the follow-up. Mean augmented bone height was $5.21{\pm}0.94mm$ in 0.25 group and $6.92{\pm}1.19mm$ in 0.5 group. Statistically significant difference in augmented bone height was found in the comparison between the 0.25 group and 0.5 group at the time of surgery. There was a positive correlation between the length of the implant protruding into the maxillary sinus and the augmented bone height. After 6 months, mean reduction of augmented bone height was $0.50{\pm}0.34mm$ in 0.25 group and $0.41{\pm}0.30mm$ in 0.5group. There was no specific correlation between the reduction of augmented bone height and amount of grafted DBBM. Conclusion: Within the limit of this study, the amount of grafting materials and the protrusion length of implant into the maxillary sinus affect the amount of the augmented bone height.

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Floating septum technique: easy and safe method maxillary sinus septa in sinus lifting procedure

  • Jung, Junho;Hwang, Bo-Yeon;Kim, Byung-Soo;Lee, Jung-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.54.1-54.3
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    • 2019
  • Background: The presence of septa increases the risk of Schneiderian membrane perforation during sinus lift procedure, and therefore, the chance of graft failure increases. We present a safe method of managing septa and, in particular, overcoming small and palatally located septa. Methods: After the elevation of the flap and the creation of a small bony window positioned anterior to the septum, the Schneiderian membrane is lifted carefully. A thin and narrow osteotome is then placed at the indentation created at the base of the septum, and mobilization of the septum is achieved by gentle malleting. The membrane is again carefully lifted up behind the septum. Results: There was one small membrane perforation case in all 16 cases, and none of these patients showed postoperative complications such as implant failure, infection, or maxillary sinusitis. Conclusions: This technique is useful for overcoming the problem of maxillary sinus septa hindering the sinus floor elevation procedure, leading to fewer complications.

Unilateral Biportal Endoscopic Spinal Surgery Using a 30° Arthroscope for L5-S1 Foraminal Decompression

  • Kim, Ju-Eun;Choi, Dae-Jung
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.508-512
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    • 2018
  • Foraminal decompression using a minimally invasive technique to preserve facet joint stability and function without fusion reportedly improves the radicular symptoms in approximately 80% of patients and is considered one of the good surgical treatment choices for lumbar foraminal or extraforaminal stenosis. However, proper decompression was not possible because of the inability to access the foramen at the L5-S1 level due to prominence of the iliac crest. To overcome this challenge, endoscopy-based minimally invasive spine surgery has recently gained attention. Here, we report the technical skills required in unilateral extraforaminal biportal endoscopic spinal surgery using a $30^{\circ}$ arthroscope to enable foraminal decompression at the L5-S1 level. Two 0.8-cm portals were created 2 cm lateral from the lateral border of the pedicles at the L5-S1 level. After sufficient working space was made, half of the superior articular process (SAP) in the hypertrophied facet joint was removed using a high-speed burr and a 5-mm wide osteotome, whereas the remaining inside part of the SAP was removed using a Kerrison punch and pituitary punch. The foraminal ligamentum flavum should be removed to inspect the conditions of the L5 exiting root and disc. Removing of the extruded disc could decompress the L5 root. The extraforaminal approach using a $30^{\circ}$ arthroscope is considered a minimally invasive alternative technique for decompressing foraminal stenosis at the L5-S1 level that preserves facet stability and provides symptomatic relief.

Switching Genioplasty- a New Genioplasty Technique in Order to Resolve Asymmetry of Chin Area: Case Report (이부 비대칭 치료를 위한 새로운 이부 성형술의 소개 - 전환 이부성형술: 증례보고)

  • Seo, Hyun-Soo;Lee, Young-Joo;Byeon, Kwang-Seob;Hong, Soon-Min;Park, Jun-Woo;Hong, Ji-Sook;Park, Yang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.55-61
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    • 2011
  • Conventional slinding genioplsty has the risk of mental nerve injury after operation and difficult to correct vertical asymmetry of chin. So, authors propose a new genioplasty to correct asymmetry of chin. Switching genioplasty is a modification method of conventional genioplasty. Between mandibular right and left canine, osteotomy line of triangular shape make until mandibular lower border. In large side, osteotome line of wedge shape is added to reduction. After osteotomy, segment of wedge shape was separated from chin. Distal segment was rotated to reduction side. Because of rotation of distal segment, space is made in opposite side. Seperated segement of wedge shape from large side is switched this space to fill. So, stability of distal segment is achieved. Authors applied to swiching genioplasty the patients who was remained the chin asymmetry after both sagittal split ramus osteotome was done because mandible asymmetry. After operation, patient and operator were satisfied with excellent esthetic results without any other complication. The switching genioplasty is effective surgical technique for chin asymmetry because it has more advantages than conventional sliding genioplasty. First, other donor side does not need for bone graft. Second, the switching genioplasty can reduce infection, bone resroption, dehiscence, capsular contraction after allograft. Third, have little mental nerve damage. Forth, anteroposterior correction is possible. Fifth, operation time is less than other genioplasty for chin asymmetry.

Predictability of simultaneous implant placement with sinus floor elevation in the severely atrophic posterior maxillae ; Comparison of lateral and trans-crestal approaches (지상보수교육강좌 1 - 상악동저 거상술을 동반한 임프란트 동시 식립의 예지성 평가; 측방접근술과 치조정접근술의 비교)

  • Kim, Yeong-Wook;Keum, Yoon-Seon;Son, Hyo-Jeong;Lee, Jang-Yeol;Kim, Hyoun-Chull;Lee, Sang-Chull
    • The Journal of the Korean dental association
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    • v.48 no.3
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    • pp.205-217
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    • 2010
  • Purpose The aim of this study is to evaluate the survival rates and analyze the stability of lateral approach and trans-crestal approach for maxillary sinus floor elevation of simultaneous implant placement. Materials and method 407 patients who have been treated in LivingWell dental hospital between 2003 to 2009 were selected. Lateral window technique, osteotome technique and sinus drill technique were used for sinus floor elevation procedure. A total of 714 implants-MP-1 HA coated implant(Tapered Screw $Vent^{TM}$, $Spline^{TM}$, Zimmer, USA), FBR surfaced implant(Pitt-$Easy^{TM}$, Oraltronics, Germany)-were placed in grafted maxillary sinus simultaneously. The autogenous bone or a combination with the allograft or alloplast was grafted into sinus. Sinus floor elevation was combined with vertical/horizontal onlay bone grafts to reconstruct the defect of alveolar ridge. Results The average preoperative height of the maxillary alveolar bone was 5.78mm(range: 0.4mm~12.5mm). 14 implants failed during the healing period(lateral approach: 4, trans-crestal approach: 10) and 3 implant failed after prosthetic loading(lateral approach: 2, trans-crestal approach: 1). The cumulative survival rate of implants after 6 years was 97.6%. Trans-crestal approach(97.4%) and lateral approach(97.9%) had similar survival rates. Conclusion The results indicate that the trans-crestal approach and lateral approach for maxillary sinus elevation is a acceptable method at atrophic maxillary posterior area.

Retrospective Study of OSFE and Simultaneous Sintered Porous Surface Implant Placement (OSFE법을 이용하여 식립된 Sintered Porous Surface 임플란트에 대한 후향적 연구)

  • Moon, Kyung-Nam;Kim, Hak-Kyun;Park, Gwang-Bum;Kim, Dong-Ju;Sun, Ju-Rim;You, Jae-Seek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.381-388
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    • 2008
  • Various techniques and diversely designed implants have been developed to overcome anatomic limitations of the maxillary posterior alveolar bone. The OSFE (osteotome sinus floor elevation) technique has been used for maxillary sinus augmentation. Also, $Endopore^{(R)}$ implant was designed to increase the surface area by its sintered porous surface. The purpose of this study was to evaluate the survival rate of $Endopore^{(R)}$ implants placed in the posterior maxilla in association with the elevation of the sinus membrane using OSFE technique, and examine the new bone formation in the sinus. One hundred fifteen $Endopore^{(R)}$ implants in 66 patients were placed in the posterior maxilla by OSFE technique. The implants were clinically and radiographically followed up for an average of 26.3 months. Most implants were stable and radiographs showed that the bone regenerated in contact with the implants. But, 5 implants in 4 patients were removed after the prosthetic restoration and the survival rate was 95.6% during the follow-up period. The height of new bone formed in the sinus was $3.26{\pm}1.04mm$.