• Archives of Plastic Surgery
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• 제50권5호
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• pp.478-487
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• 2023

Background The outcome of alveolar grafting with synthetic bone substitute (Osteon III) in various bone defect volumes is highlighted. Methods A prospective study was accomplished on 55 patients (6-13 years of age) with unilateral alveolar bone cleft. Osteon III, consisting of hydroxyapatite and tricalcium phosphate, is used to reconstruct the defect. Alveolus defect diameter was calculated before surgery (V1), after 3 months (V2), and finally after 6 months (V3) postsurgery. In the t-test, a significant difference and correlation between V1, V2, and V3 are stated. A p-value of 0.01 is considered a significant difference between parameters. Results The degree of cleft is divided into three categories: small (9 cases), medium (20 patients), and large (26 cases).The bone volume of the clefted site is divided into three steps: volume 1: (mean 18.1091 mm³); step 2: after 3 months, volume 2 resembles the amount of unhealed defect (mean 0.5109 mm³); and the final bone volume assessment is made after 6 months (22.5455 mm³). Both show statistically significant differences in bone volume formation. Conclusion An alloplastic bone substitute can also be used as a graft material because of its unlimited bone retrieval. Osteon III can be used to reconstruct the alveolar cleft smoothly and effectively.

• 대한구순구개열학회지
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• 제7권1호
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• pp.47-61
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• 2004

The closure of a wide alveolar cleft and fistula in cleft patients and the reconstruction of a maxillary dentoalveolar defect in bilateral cleft lip and palate (BCLP) patients are challenging for both orthodontists and oromaxillofacial surgeons. It is due to the difficulty in achieving complete closure by using local attached gingiva (palatal flap) and the great volume of bone required for the graft. In this article, the authors used bifocal distraction-compression osteosynthesis(BDCO) to create a segment of new alveolar bone and attached gingiva for the complete approximation of a wide alveolar cleft/fistula and the reconstruction of a maxillary dentoalveolar defect. Since the alveoli and gingivae on both ends of the cleft were approximated after BDCO, the need for extensive alveolar bone grafting was eliminated. It also could create new alveolar bone and gingiva for orthodontic tooth movement and implant.

• 대한장애인치과학회지
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• 제6권2호
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• pp.105-111
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• 2010

이종골의 치아맹출에 대한 기존 문헌 및 동물실험 연구를 바탕으로, 자가골 및 동종골 이식이 어려운 구순구개열 환자에서 이종골(Bio-$Oss^{(R)}$)을 이식하여 성공적으로 매복된치아의 맹출을 유도하였고, 치근의 형성 및 치아의 골내 이동도 정상적으로 이루어졌다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.325-329
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• 2009

Objective : This is to report the effectiveness of intraoral distraction osteogenesis, iliac bone graft for alveolar augmentation in the extremely atrophied alveolar defects after infected allobone grafted area. Subjects and Methods : Anterior segmental osteotomy was performed and the trans-oral alveolar distractors (Martin, Germany) were applied in patient with the severe acquired anterior mandibular and mandibular defect after ameloblastoma enucleation. Iliac bone grafts were performed in defect sites and distraction osteogenesis were treated. After latent period for 1 week, the osteomized alveolar segments were distracted by 0.75 mm a day (0.25 mm/1 turn) for 10 days The consolidation period was about 12 weeks. Thereafter, 2 titanium threaded implants were simultaneously installed with removal of distractor. For oral rehabilitiation, The implants were installed in maxilla, mandible. It was tested with clinically and radiographically. Results : Amounts of acquired alveolar bone were 10 mm with the increased width of the ridge crests and soft tissue expansion. Dental implants installated on the augmented alveolar ridges in 12 weeks after distraction were confirmed as in good osseointegration and in good function without any complications. Conclusion : Intraoral distraction osteogenesis can be a good option for alveolar ridge augmentation of the severely atrophied ridges and soft-tissue defects.

• 대한치과의사협회지
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• 제57권3호
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• pp.149-160
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• 2019

Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권4호
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• pp.181-187
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• 2014

Objectives: The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration. Materials and Methods: Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed. Results: Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications. Conclusion: The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.326-329
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• 2002

저자들은 위축된 치조골과 외상 또는 종양으로 상실된 치조골의 재건을 위하여 수직적 치조골 신장술을 이용하여 104명의 환자에서 평균 10.2 mm의 치조골을 신장시킬 수 있었으며, 양호하게 재건된 치조골에 치과 임플란트를 식립함으로서 기능적, 심미적으로 좋은 결과를 얻을 수 있었다. 치조골 신장술은 기존의 치조골 수복술들을 대체할 수 있는 안전하고 효과적인 방법으로 생각된다.

• 대한치과의사협회지
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• 제53권1호
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• pp.6-13
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• 2015

A new field in dental implantology is developing with the goal of finding new ways to improve the osteoconductivity of bone substitutes and to study new molecules able to dictate cellular differentiation and improve bone regeneration. The real future in bone regeneration seems to be in connection with the rhBMP-2s, currently obtained by synthesis using recombinant DNA. Since the first rhBMP-2 studies in humans by Boyne, There are many studies for bone regeneration at oral and maxillofacial area. The rhBMP-2 is widely used at sinus augmentation, alveolar bone defect, and socket preservation.

• Journal of Periodontal and Implant Science
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• 제35권1호
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• pp.251-261
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• 2005

Alveolar ridge defects may limit or restrict placement of implants. The purpose of this study was to evaluate clinical and histopathologic results which occur following guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane in the localized alveolar bone defects. Ten patients who required guided bone regeneration in implant placemnet, were slelected. Alveolar crest height and width were measured at baseline and, afer 2nd surgery 5 months later At 5 months , we obtained histopathological results as follows: 1. Alveolar crest height was an average of $8.20{\pm}3.74$ mm preoperatively and decreased to an average of $7.40{\pm}1.84$ mm postoperatively. There was no significant difference. 2. Alveolar crest width was an average of $4.25{\pm}2.03$ mm preoperatively and significantly increased to an average of $7.20{\pm}2.44$ mm postoperatively (P<0.01) 3. The change of Alveolar crest height and width were $0.80{\pm}1.40$ mm, $2.95{\pm}1.09$ mm 4. Histopathological evaluations revealed new bone formation with graft material and laminated bone containing the presence of osteocyte-like cell In conclusion, guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane would provide a viable therapeutic alternative for implant placement in the localized alveolar defect or implant failure

• Archives of Plastic Surgery
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• 제44권3호
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• pp.188-193
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• 2017

Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.