• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.169-176
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• 2003

Background: Although dental implantation has become widespread and acceptable treatment for dental prosthodontics, maxillary posterior jaw region is often complicated by the pneumatization of the maxillary sinus and physiological resorption of the alveolar bone. When this occurs, the residual bone between the floor of the sinus and the crestal ridge is inadequate for the placement of implants. The sinus elevation procedure provides a way to increase the amount of available bone and to allow the placement of longer implants. Materials & methods: We studied 11 patients requiring the implant placements and the maxillary sinus elevation simultaneously from 1996 to 2003 in our clinic. Nine patients were males and two patients were females, aged from 39 to 72(mean=51.6). Four patients had medical compromised states; angina pectoris, diabetes, hypertension, hepatitis. Patients didn't show any pathologic findings clinically or radiographically. We studied the success and survival rate of implants, factors increasing the osseointegrating capacity of implants. Results: The success rate of osseointegration of implants was 93%. At least 6 months after loading on implants, the survival rate of implants was 78.5%. Autogenous bone graft and adequate residual bone height(>6mm) increased survival rate of implants. Conclusion: Successful implant placement with maxillary sinus elevation mainly depends on sufficient residual bone height, healthy maxillary sinus, autogenous bone graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.249-257
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• 2008

The authors performed the clinical and radiographic evaluation in the 29 patients with sinus bone graft and $Osstem^{(R)}$ implant placement between Sep 2003 and Jan 2006 and got the following results. 1. Fifteen complications developed in the 13 patients. Intraoperative sinus membrane perforation and postoperative maxillary sinusitis developed frequently. 2. The mean preoperative residual alveolar bone height was 4.5 mm, postoperative height 18.5 mm, height 1 year after operation 16.9 mm. 3. Three primary osseointegration failures(3.7%) developed in 3 patients. 4. The survival rate of prosthodontics was 100% at the final follow up. The mean marginal bone resorption around the implants was 0.69 mm 1 year after prosthodontic loading. Marginal bone resorption more than 1.5 mm developed in nine implants and the success rate was 88%.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.241-248
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• 2011

Purpose: The aim of this study was to present the clinical results of maxillary sinus augmentation implants and to evaluate the effects of various factors on the implant survival rate. Methods: In a total of 112 patients, 293 implants after sinus augmentation were performed. The total survival rate and the influence of the following factors on implant survival were evaluated; patient characteristics (sex, age, smoking, general disease), graft material, implant surface, implant installation stage, site of implant placement, length and width of implant, closure method for osseous window, residual alveolar bone height. Results: 1. Age ranged from 16 to 70 yr, with a mean of 45.7 yr. 2. Cumulative survival rate for the 293 implants with the maxillary sinus augmentation procedure was 94.9%. 3. Simultaneous implant installation was performed in 122 patients and delayed implant installation was performed in 117 implants. The average healing period after sinus elevation was 7.3 months for delayed implant installation and this procedure had a significantly higher survival rate. 4. There were no significant differences in sex, age, smoking, general disease, site of implant placement, length and width of implant, residual alveolar bone height and the survival rate. 5. RBM (Resorbable Blasting Media) implant surface and allograft groups had significantly lower survival rates. Conclusion: These data suggest that maxillary sinus augmentation may give more predictable results for autogenous bone grafts and delayed implant placement.

• Journal of Periodontal and Implant Science
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• 제47권4호
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• pp.194-210
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• 2017

Purpose: The aim of the present study was to evaluate the healing of post-extraction sockets following alveolar ridge preservation clinically, radiologically, and histologically. Methods: Overall, 7 extraction sockets in 7 patients were grafted with demineralised bovine bone mineral and covered with a porcine-derived non-crosslinked collagen matrix (CM). Soft tissue healing was clinically evaluated on the basis of a specific healing index. Horizontal and vertical ridge dimensional changes were assessed clinically and radiographically at baseline and 6 months after implant placement. For histological and histomorphometric analysis, bone biopsies were harvested from the augmented sites during implant surgery 6 months after the socket preservation procedure. Results: Clinically, healing proceeded uneventfully in all the sockets. A trend towards reduced horizontal and vertical socket dimensions was observed from baseline to the final examination. The mean width and height of resorption were 1.21 mm (P=0.005) and 0.46 mm (P=0.004), respectively. Histologically, residual xenograft particles ($31.97%{\pm}3.52%$) were surrounded by either newly formed bone ($16.02%{\pm}7.06%$) or connective tissue ($50.67%{\pm}8.42%$) without fibrous encapsulation. The CM underwent a physiological substitution process in favour of well-vascularised collagen-rich connective tissue. Conclusions: Socket preservation using demineralised bovine bone mineral in combination with CM provided stable dimensional changes of the alveolar ridge associated with good reepithelialisation of the soft tissues during a 6-month healing period.

• 대한구강악안면임플란트학회지
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• 제22권4호
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• pp.220-235
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• 2018

Sinus lift procedure is frequently required for the maxillary molar implant placement. Previous studies have demonstrated alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. However, there is a lack of studies which evaluated the effect of ARP to avoid sinus lift procedure. Purpose of this study is to describe a method reducing the need of sinus lift surgery by ARP in maxillary molar areas and to assess the feasibility clinically, radiologically and histologically. Ten maxillary molars in ten patients had severe vertical bone resorption with minimal residual bone height. They were considered having the high possibility of the necessity of sinus lift procedure for dental implant after the extraction. After extraction, open healing ARP with deproteinized bovine bone mineral mixed with 10% collagen and resorbable collagen membranes was performed. After sufficient healing, dental implants were placed, and evaluated clinically and radiologically. Histological observation was conducted just before the implantation in one patient. Implants were successfully placed without sinus lift in all ten cases. All the implants were restored with no sign of complications, and patients are now in a close follow-up up to 20 months post-loading. Histological observation showed minimal inflammatory reaction and newly formed bone was substantially noted. The ARP technique has successfully avoided the sinus lift surgeries. It appears that this procedure may improve the simplicity of the clinical process for the clinicians and reduce the discomfort of patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.46-52
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• 2009

The maxillary posterior edentulous region presents unique and challenging conditions in implant dentistry. The height of the posterior maxilla is reduced greatly as a result of dual resorption from the crest of the ridge and pneumatization of the maxillary sinus after the loss of teeth. Materials previously used for sinus floor grafting include autogenous bone, allogeneic bone, xenogenic bone and alloplastic materials. Autogenous bone is the material of choice, but its use is limited by donor-site morbidity, complications, sparse availability, uncontrolled resorption and marked volume loss. One way to overcome this problem would be to use bone substitutes alone as a osteoconductive scaffold for bone regeneration from the residual bone or in combination with allogeneic bone, which also has osteoinductive properties. The purpose of this article is to describe a double layers technique of demineralized and mineralized bone graft materials instead of autogenous bone in sinus floor augmentation of deficient posterior maxillary alveolar process and to report our experience with this technique. Our results show that maxillary sinus augmentation using mineralized and demineralized bone materials, when installed simultaneously with the implant or not, is good results for bone healing.

• Journal of Periodontal and Implant Science
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• 제41권1호
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• pp.23-29
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• 2011

Purpose: To investigate the healing pattern of the mucous membrane after tooth extraction necessitated by periodontal disease in the maxillary sinus. Methods: One hundred and three patients with 119 maxillary sinuses were investigated. Before implant placement, cone-beam computed tomography (CT) scanning was performed. The causes of extraction, the time elapsed since extraction, smoking, periodontal disease in adjacent teeth, and gender were recorded. In addition, the thickness of the mucous membrane of the maxillary sinus and the height of residual alveolar bone at the extracted area were calculated from CT images. Results: The thickness of the mucous membrane in the periodontal disease group ($3.05{\pm}2.71\;mm$) was greater than that of the pulp disease group ($1.92{\pm}1.78\;mm$) and the tooth fracture group ($1.35{\pm}0.55\;mm$; P<0.05). The causes of extraction, the time elapsed since extraction, and gender had relationships with a thickening of the mucous membrane of the maxillary sinus (P<0.05). In contrast, the height of the residual alveolar bone at the extracted area, periodontal disease in adjacent teeth, and smoking did not show any relation to the thickening of the mucous membrane of the maxillary sinus. Conclusions: The present study revealed distinct differences in healing patterns according to the causes of extraction in the maxillary sinus, especially periodontal disease, which resulted in more severe thickening of the mucous membrane.

• 대한치과의사협회지
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• 제22권11호통권186호
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• pp.953-960
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• 1984

The author applied the attachment fixation overdenture on the patient whose residual alveolar ridge height was poor to increase mechanical denture retention, and observed the periodontal condition of the abutment roots after insertion of attachment fixation overdenture. The author obtained the conclusions as follows; 1. Attachment fixation overdenture showed better mechanical retention than conventional overdenture did, but it resulted unfavorable crown-root ratio. 2. Within one year after insertion, there were not significant changes in periodontal health, which was indicated by plaque index, gingival index, pocket depth, tooth mobility gingival hyperplasia and alveolar bone change. 3. Mild periodontal thickening was observed. 4. This study emphasized the importance of adequate follow-up care and home care instructions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.108-118
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• 2010

Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.791-803
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• 2007

The purpose of this study was to evaluate exophytically vertical bone formation in residual ridge of the beagle dog by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with irradiated cancellous human bone. Twelve male beagle dogs(mean age 1.5 years and mean weight 12kg) were used for this study. The alveolar ridges after extraction of all mandibular premolars were surgically and horizontally removed. At 8 weeks after extractions, full-thickness flap was reflected and cortical bone was removed with round bur and copious irrigation. Rectangular parallelepiped(10mm in length, 5mm in width, and 4mm in height) bended with titanium-reinforced e-PTFE(TR e-PTFE) membrane was placed on the decorticated alveolar ridge, fixed with metal pins and covered with full-thickness flap and assigned as a control group. Test groups ere treated with TR e-PTFE membrane filled with irradiated cancellous human bone. Of twelve beagle dogs, four control dogs and four test dogs without membrane exposure to oral cavity were sacrificed at 8 and 16 weeks respectively. The surgical sites were dissected out, fixed in 4% buffered formaldehyde, dyed using a Villanueva staining technique, and processed for embedding in plastic resin. The cutting and grinding methods were routinely processed for histologic and histomophometric analyis of exophytic bone formation as well as statistical analysis. The results of this study were as follows: 1. Exophytic bone formation in the both of experimental groups was increased respectively after surgery from 23.40% at 8 weeks to 46.26% at 16 weeks in the control groups, from 40.23% at 8 weeks to 47.11% at 16 weeks in the test groups(p<0.05). 2. At 8 weeks after surgery, exophytic bone formation was made 40.23% in the test groups and 33.40% in the control groups. Exophytic bone formation was significantly made in the test group more than in the control group. At 16 weeks after surgery, exophytic bone formation was made 44.11% in the test groups and 46.26% in the control groups. Exophytic bone formation was made in the test groups more than in the control groups, but there was no statistically significant differences. 3. The membrane was fixed with metal pins to closely contact it to the bone surface. So, collapse and deviation of the membrane could be prevented and in growth of connective tissue also could be blocked from the periphery of the membrane. On the basis of these findings, wee suggest that intraoral experimental model for exophytic bone formation may be effective to evaluate the effect of bone graft material. And it indicates that combined use of membrane and ICB graft material is more effective than use of membrane only for exophytic bone formation.