• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.45 no.5
• /
• pp.260-266
• /
• 2019

Objectives: Dental implants shorter than 8 mm, called short dental implants (SDIs), have been considered to have a lower success rate than standard length implants. But recent studies have shown that SDIs have a comparable success rate, and implant diameter was more important for implant survival than implant length. Also, SDIs have many advantages, such as no need for sinus lifting or vertical bone grafting, which may limit use in medically compromised patients. Materials and Methods: In this study, 33 patients with 47 implants 7-mm long were examined over the last four years. All patients had special medical history and were categorized into 3 groups: systemic disorders, such as diabetes mellitus (controlled or uncontrolled), mental disability, and uncontrolled hypertension; oral cancer ablation with reconstruction, with or without radiotherapy; diverse osteomyelitis, such as osteoradionecrosis and bisphosphonate-related osteonecrosis of the jaw. Most of these patients have insufficient residual bone quality due to mandible atrophy or sinus pneumatization. Results: The implant diameters were 4.0 (n=38), 4.5 (n=8), and 5.0 mm (n=1). Among the 47 implants placed, 2 implants failed before the last followup. The survival rate of 7-mm SDIs was 95.74% from stage I surgery to the last follow-up. Survival rates did not differ according to implant diameter. The mean marginal bone loss (MBL) at 3 months, 1 and 2 years was significantly higher than at implant installation, and the MBL at 1 year was also significantly higher than at 3 months. MBL at 1 and 2 years did not differ significantly. Conclusion: Within the limitations of the present study, the results indicate that SDIs provide a reliable treatment, especially for medically compromised patients, to avoid sinus lifting or vertical bone grafting. Further, long-term follow-up is needed.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.33 no.1
• /
• pp.47-54
• /
• 2017

The atrophy of edentulous ridge and pneumatization of the maxillary sinus often limit the volume of bone available for implant placement on maxillary posterior teeth. Most clinicians suffer difficulties from poor bone quality and quantity on maxillary posterior site. Thus, the success of maxillary posterior implant surgery depends on the increase of the available bone and obtaining a good initial stability of the implant after maxillary sinus reconstruction. The maxillary sinus augmentation methods include a crestal approach and a lateral approach. Less morbidity and complications after operation is major advantage to sinus augmentation using crestal approach than lateral approach. However, when the residual ridge height is ${\geq}6mm$, it is known that crestal approach is appropriate. Also delayed implantation after sinus augmentation is recommended in severely atrophic ridge. We present the three cases of implant placement simultaneously sinus augmentation using crestal approach in posterior maxilla site with ${\leq}3mm$ of residual alveolar bone.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.28 no.1
• /
• pp.171-191
• /
• 1998

The present study was designed to elucidate the effects of the Co-60 γ irradiation and/or calcium-deficient diet on the periodontal tissue formation in rat pups. The pregnant three-week old Sprague-Dawley rats were used for the study. The experimental group was divided into two groups, irradiation/normal diet group (Group 2) and irradiation/calcium-deficient diet group (Group 3). The control group was non-irradiation/normal diet group (Group 1). The abdomen of the rats at the 19th day of pregnancy were irradiated with single absorbed dose of 350 cGy. The rat pups were sacrificed on the 14th day after delivery, and the maxillae including molar tooth germ were taken. The specimens including the 1st molar tooth germ were prepared to make tissue sections for light and transmission electron microscopy. Some of tissue sections for light microscopy were stained immunohistochemically with anti-fibronectin and anti-osteonectin antibodies. The results were as follows; 1. In the periodontal ligament forming area, the fibroblasts of Group Z showed irregular arrangement and low activity. The immunoreactivity between the fibroblasts and collagen fibers was decreased, compared with Group 1. The fibroblasts of Group 3 showed atrophic change and clumped nucleus. The collagen fibers showed cystic change and low immunoreactivity to the fibronectin. 2. In the cementum forming area, the cementoblasts of Group 2 showed decrease of number and atrophic change. The cementoblasts of Group 3 showed edematous change, atrophy of cytoplasm, and clumping of nucleus. 3. In the alveolar bone forming area, the bone of Group 2 was thin and various degree of immunoreactivity to the osteonectin. Group 3 showed edematous osteoblasts, fibrous degeneration of bone marrow, and weak immunoreactivity to the osteonectin.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.2
• /
• pp.171-175
• /
• 2019

Mandible with severe alveolar bone atrophy poses a significant challenge in terms of reproducing clinically acceptable anatomy for a removable prosthesis. To overcome this potential complication, altered cast impression technique is often recommended to capture accurate and functional gingiva tissues. It becomes possible to get proper anchors functional impression by placing 2 implants crowns which were impossible in previous implant overdenture impression technique. In this case, an 80-year old female patient with severe mandibular ridge atrophy was treated with an implant-assisted removable partial denture with two implant crowns on the canine area. An altered cast impression was taken with an individual tray on a metal framework of removable partial denture on both posterior edentulous areas. The patient was satisfied with the final prosthesis after failure of 2 previous prostheses. Clinician had a difficult time to manage disabled patient and patient were suffered with ill-fitting denture due to inaccurate impression in conventional overdenture condition. The oral rehabilitation was completed with placing 2 implants as proper anchor.

• The Journal of Advanced Prosthodontics
• /
• v.7 no.3
• /
• pp.264-270
• /
• 2015

This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene.

• The Journal of Advanced Prosthodontics
• /
• v.7 no.5
• /
• pp.380-385
• /
• 2015

PURPOSE. The aim of this study was to determine the frequency of significant panoramic radiographic findings and eventual treatment requirements before conventional or implant supported prosthetic treatment in asymptomatic edentulous patients. MATERIALS AND METHODS. A total of 743 asymptomatic edentulous patients were retrospectively evaluated using a digital panoramic system. We analyzed the radiographic findings, including impacted teeth, retained root fragments, foreign bodies, severe atrophy of the posterior maxillary alveolar bone, mucous retention cysts, soft tissue calcifications and radiopaque-radiolucent conditions. RESULTS. Four-hundred-eighty-seven (65.6%) patients had no radiographic finding. A total of 331 radiographic findings were detected in 256 (34%) patients. In 52.9% (n=175) of these conditions, surgical treatment was required before application of implant-supported fixed prosthesis. However, before application of conventional removable prosthesis surgical treatment was required for 6% (n=20) of these conditions. CONCLUSION. The edentulous patients who will have implant placement for implant-supported fixed prosthesis can frequently require additional surgical procedures to eliminate pathological conditions.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.29 no.2
• /
• pp.123-131
• /
• 2007

Introduction: Distraction osteogenesis is widely used as for bone lengthening in patients with maxillofacial deformity and alveolar bone atrophy. One of the major problems in distraction osteogenesis is long consolidation period for 2-3 months, in which the devices have to be fixed on the bone to prevent relapse. It results in scar formation on the face, disturbance of mastication and speech. This study was performed to evaluate the stimulating effect of pulsed electromagnetic field on the early bone consolidation in distraction osteogenesis. Materials and methods: Total 10 rabbit were used (5 for control group, 5 for experimental group). A vertical osteotomy in the mandibular body was performed and the distraction device was fixed. After 5 days distraction was done 1mm per a day for 7 days. A pulsed electromagnetic field (38 Gauss, 60 Hz) was applied for 8 hours per day and it continued for 5 days immediately after distraction in the experimental group. Both groups were sacrificed after 2 weeks. Histological specimens with H&E and Masson Trichrome staining were made and histomorphometrically analysed with image analyser. Results: The device for distraction osteogenesis was displaced in one animal for each group, therefore, only four animals in both groups were evaluated. In both groups, a new bone formation was observed in the distracted area after 2 weeks. The bone formation was enhanced in the experimental groups ($31.76{\pm}8.68%$) compared with control group ($9.94{\pm}3.23%$), its difference was statistically significant (p<0.001). Conclusion: This study suggests that electrical stimulation with electromagnectic field may be effective in the early bone formation after distraction osteogenesis. Further studies with large number of animals are needed before clinical application.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.16 no.1
• /
• pp.41-48
• /
• 1986

It is known that radiation therapy is a kind of treatment choices of the maxillofacial tumors. This study is designed to investigate the irradiation effects on rat's periodontal tissues as functional tissues which relate to tooth-support, hard tissue formation and destruction. 20 rats (Sprague-Dowley branch, male) were devided into control group of 4 and experimental groupe of 16. Experimental group was singly exposed to Co-60 irradiation with 10 Gy in the head and neck region. Animals were sacrificed on 2 days, 1 week, 2 weeks and 3 weeks after the irradiation. The specimens were observed by histopathological examination employing H-E stain, van-Gieson stain and PA-ACH fluorescent stain. The results were as follows: 1. Cementoblasts and osteoblasts were gradually lost and rearranged along the external surfaces of the cementum and alveolar bone, but osteoclasts were almost not affected. 2. The cell numbers of the periodontal ligament were decreased due to the cellular atrophy and degeneration, but recovered almost normally on the 3rd week after irradiation. 3. The collagen fibers within the periodontal ligament were irregularly oriented, became finer and decreased in number. 4. The vessels of the periodontal ligament were decreased at the initial stage but increased again on the 2nd week after irradiation, and the hemorrhagic appearances, occurred within the tissues, due to the arterial destruction, were lasted until 3 weeks after irradiation. 5. The glycogen within the periodontal ligament was gradually increased and stored in the matrices of the cemental side on the 1st week after irradiation, but recovered almost normally on the 3rd week after irradiation.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.2
• /
• pp.195-202
• /
• 2019

At the department of prosthodontics, the elderly patients with severely atrophied alveolar ridge who have been wearing complete dentures for a long period frequently visit the clinic. In general, the open-mouth impression technique for manufacturing a mandibular complete denture to secure primary support on buccal shelf area has been prevalent. In addition, for securing retention and stability of mandibular denture, we should consider diagnosis, oral function, denture border, occlusal plane, teeth arrangement, and patient training, etc.. But in edentulous patients with severe alveolar bone atrophy, it may hardly secure retention and stability of mandibular complete denture. To promote these, some of clinicians are making an attempt manufacturing the mandibular complete dentures using closed-mouth impression technique based on several reports that compare various impression techniques including open-mouth and closed-mouth impression technique. This case report suggests closed-mouth impression technique may promote retention and stability of mandibular complete denture and compares between the two impression techniques clinically.

• Journal of Periodontal and Implant Science
• /
• v.50 no.4
• /
• pp.238-250
• /
• 2020

Purpose: This study aimed to evaluate the biocompatibility and the mechanical properties of ultraviolet (UV) cross-linked and biphasic calcium phosphate (BCP)-added collagen membranes and to compare the clinical results of ridge preservation to those obtained using chemically cross-linked collagen membranes. Methods: The study comprised an in vitro test and a clinical trial for membrane evaluation. BCP-added collagen membranes with UV cross-linking were prepared. In the in vitro test, scanning electron microscopy, a collagenase assay, and a tensile strength test were performed. The clinical trial involved 14 patients undergoing a ridge preservation procedure. All participants were randomly divided into the test group, which received UV cross-linked membranes (n=7), and the control group, which received chemically cross-linked membranes (n=7). BCP bone substitutes were used for both the test group and the control group. Cone-beam computed tomography (CBCT) scans were performed and alginate impressions were taken 1 week and 3 months after surgery. The casts were scanned via an optical scanner to measure the volumetric changes. The results were analyzed using the nonparametric Mann-Whitney U test. Results: The fastest degradation rate was found in the collagen membranes without the addition of BCP. The highest enzyme resistance and the highest tensile strength were found when the collagen-to-BCP ratio was 1:1. There was no significant difference in dimensional changes in the 3-dimensional modeling or CBCT scans between the test and control groups in the clinical trial (P>0.05). Conclusions: The addition of BCP and UV cross-linking improved the biocompatibility and the mechanical strength of the membranes. Within the limits of the clinical trial, the sites grafted using BCP in combination with UV cross-linked and BCP-added collagen membranes (test group) did not show any statistically significant difference in terms of dimensional change compared with the control group.