• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.154-165
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• 2006

Objectives : It is difficult to place implants at a severely atrophied edentulous mandible because of vertical and horizontal alveolar defect. The autogenous and allogenic bone graft and guided bone regeneration are useful, but there are some limitations such as the resorption and infection of the grafted bone, and insufficiency of soft tissue. Distraction osteogenesis has recently evolved a challenging technique to overcome major draws of conventional augmentation procedures, we, therefore, report the four applications of implant placement after vertical alveolar distraction osteogenesis. Patients and Methods : Four patients(all female, mean age: $60{\pm}6$ years) with severe alveolar ridge deficiencies at their anterior mandible were treated with vertical alveolar distraction osteogenesis by intraoral device(Track 1.5, 15 mm model, KLS Martin, Tuttlingen, Germany) and placement of implants (Branemark MK III, TiUnite). After the latency periods of 5, 7, 8 days, distraction rhythm and rate were $0.5\;mm{\times}2\;times/day$ in the case of good bone quality, and $0.25\;mm{\times}3\;times/day$ in the case of poor bone quality. After consolidation periods of mean fifteen weeks, five implants for each patients were placed at the interforaminal area. Results : On average, a vertical gain of $11.38{\pm}1.38\;mm$ was obtained by distraction. And all distraction zone showed complete ossification by panoramic radiography. There were no postoperative complications other than numbness of lower lip in one case. Total twenty implants in four patients were placed and their outcomes were satisfactory. Conclusion : It is a useful method to place five implants after vertical distraction osteogenesis of the severely atrophied mandible for the implant-supported fixed prosthesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.225-231
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• 2008

This study evaluated whether there is a difference between a conventional titanium distraction device and a TiN-coated device in terms of implant osseointegration after horizontal distraction osteogenesis in narrow alveolar bone. Four adult mongrel dogs, each weighing $9{\sim}10kg$, were used in this study. The lower premolars were extracted and horizontal distraction was performed with conventional titanium distraction devices (group 1) or TiN-coated devices (group 2). After an 8-week consolidation period, the implants were installed, and the dogs were sacrificed after another 8 weeks. The osseointegration around the implants was evaluated histomorphologically. There was one failure in experimental group 1 because of fracture of the device. Direct bone contact was achieved and there were no significant differences between the control group and experimental groups 1 and 2 in terms of osseointegration around the implants at 8 weeks. In summary, intraoral distraction osteogenesis is a good option for augmenting severely atrophied alveolar ridges, and the TiN-coated device may be useful because of its advantages, which include surface hardness, corrosion resistance, and reduced bacteria.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.312-321
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• 2007

Purpose: Distraction osteogenesis has been applied to the maxillofacial implantology and good experimental and clinical results have been reported. However, histologic studies of implants placement on distraction osteogenesis of atrophic alveolar ridges are scarce. In this study, we compare the bone formation between in the transport part and in the distraction part by histomorphometric analysis. Materials & methods: Three adult beagle dogs were served as experimental subjects. The 2 premolars and 1st molar were extracted on the Lt. side of mandible in each beagle dog. After one month later, osteotomy was performed and distraction device was adapted. Distraction was performed with gradual incremental separation of two bone pieces at a rate of 1.0mm per day for 5 days. During consolidation phase, new bone was formed in the distraction zone between the separated bone pieces. 5 weeks after distraction phase, 3 implants were placed in each beagle dog. The implants were inserted through transport part and distraction part and inferior basal bone. The animals were sacrificed at 2 weeks, 4 weeks, and 12 weeks after implant placement. BIC and BA of implants on distraction part and transport part were measured histomorphometrically. Results: BIC, BA increased after implant placement as time goes by passes and new bone formation was slightly higher in transport part than in distraction part at 2 weeks, 4 weeks after implant placement. At 12 weeks after implant placement, BIC, BA of were 74%, 61% in transport part and 77%, 59% in distraction part, therefore there were no difference in BIC and BA between transport part and distraction part at 12 weeks after implant placement.

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 2005년도 제9회 종합학술대회 및 정기총회
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• pp.19-21
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• 2005

• 구강회복응용과학지
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• 제33권2호
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• pp.143-153
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• 2017

치아 외상에 따른 흔한 합병증 중 하나는 치아 유착이다. 성인과 달리 성장기 아동에서 유착이 나타날 경우 유착치가 인접 치조골의 성장을 방해하여 치조골의 발육 부전과 이에 따른 개방 교합을 야기한다. 그러나 저위된 유착치를 단순 발치할 경우, 성장 완료 시까지 치조제의 상당한 소실을 유발하여 향후 심미적인 보철물을 수복하기가 어려워진다. 본 증례에서는 성장기에 상악 전치의 유착이 발생한 환자에서 단일 치아 골절단술 후 치조골 신장술과 치관 절제술을 시행하여 상악 전치부의 유착치를 심미적으로 결과를 얻었으므로 소개하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권5호
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• pp.419-424
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• 2009

Odontogenic myxoma, a rare tumour that occurs in the jaws, locally invasive, destructive tumors that do not metastasize to lymph nodes. Large odontogenic myxoma on mandible is treated by mandibulectomy, defected mandible is reconstructed by bone graft. Reconstructed mandible is difficult to reconstruct dentition using implant because of deficiency of bone amount. So it is necessary to additional bone graft. But a poor aspect of soft tissue lead to unsatisfactory result. Because of distraction osteogenesis is possible to reconstruction of an amount of bone and soft tissue, that is advantage to reconstruction of alveolar bone on reconstructed mandible. We report with review of literatures the 25 years old male patient who had odontogenic myxoma in left mandible, was undergone mandibulectomy and successfully implant installation and prosthetic restoration after distraction osteogenesis(Track $Plus^{(R)}$, KLS Martin, Germany) on the reconstructed mandible with a free iliac bone graft, and we have conservative and successful result.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.250-255
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• 1998

The purpose of this study was to evaluate the histologic change of the inferior alveolar nerve according to distraction amount following mandibular lengthening. Seven rabbits weighing about 2 kg were used. Corticotomy was performed on the mandibular body anterior to the right first premolar region and unilateral external fixation device was placed. Every effort was made to preserve the inferior alveolar nerve during the corticotomy. The rabbits were then allowed to heal for 7 days without distraction of the device. The mandible was lengthened 0.36 mm/day, 0.76 mm/day, or 1.0 mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 14-day-consolidation period was allowed. After consolidation, rabbits were sacrificed, and histologic examination of the inferior alveolar nerve was performed. The results obtained were as follows : 1. In the control group, normal trifascicular pattern of inferior alveolar nerve was observed. Epineurium, perineurium, endoneurium, and axon with myelin sheath were observed in normal appearance. 2. In 0.36 mm/day distraction group, the trifascicular pattern was normally shown, and there was no destruction in epineurium, perineurium, and endoneurium. The mild changes including myelin attenuation, axoplasmic swelling and darkening were observed. 3. In 0.72 mm/day distraction group, it was possible to differentiate the epineurium from the perineurium. Two normal fascicles and one injuried fascicle were observed with a partially destructed perineurium. Most of the axons had axoplasmic swelling and darkening. 4. In 1 mm/day distraction group, it was difficult to differentiate the nerve structures such as fascicles, epineurium, perineurium, and endoneurium. The axons were severely destroyed, except few which showed decreases in size and changes in shape. Some collagen matrices were observed around the axons. These results suggest that the higher the distraction amount, the more severe the injury to the inferior alveolar nerve, fascicles, axons. Although distraction osteogenesis may be useful, the amount of distraction should be carefully selected.

• 대한구순구개열학회지
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• 제14권1_2호
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• pp.19-28
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• 2011

Maxillary anterior segmental distraction osteogenesis (DO) has been the alternative treatment option for patients with midfacial retrusion. The patient showed unilateral cleft lip and palate, and premaxillary distraction with rigid external device (RED) was planned to solve midface deficiency and to create alveolar space. Significant advancement of A point was observed, but relapse of A point was detected during consolidation period. The vertical position of the ANS was found to have moved downward. Axis of upper incisor decreased after DO. Maxillary anterior segmental DO is effective for treatment of patient with cleft lip and palate. The alveolar space is regained successfully, and the facial profile is improved without velopharyngeal problems.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.123-131
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• 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.

• 대한치과교정학회지
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• 제39권3호
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• pp.185-198
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• 2009

치아 유착은 손상에 의해서 치조골과 상아질 또는 백악질이 유합된 상태로, 외상, 내분비 질환, 쇄골 두개 이형성증등의 선천성 기형 또는 원인 불명의 맹출 장애 등이 원인으로 알려져 있다. 유착 치아로 인해 인접치의 경사, 공간 상실 및 대합치의 정출이 나타날 수 있고, 성장기 아동에서 유착이 발생한 경우 치조골의 발육 부전을 야기할 수 있으며, 특히 상악 전치부에 이환되면 심각한 심미적 문제를 초래하게 된다. 따라서 유착이 의심되면, 병력 청취와 타진 및 방사선 사진 상의 치근막 공간 평가, 또는 가장 직접적이고 확실한 방법인 교정력을 직접 적용해 보는 방법을 통해 정확한 진단을 내려야 한다. 통상적으로 치료는 유착된 치아의 발거, 자가 치아이식, 외과적 탈구, 수술적 방법을 통한 재위치술 등을 선택하게 된다. 그 중, 수술적 방법을 통한 재위치술은 유착치의 발거 시 상당한 골소실이 예상될 때 시행할 수 있으며, 단일치아 골절단술과 치조골 신장술이 대표적이다. 본 보고에서는 이러한 수술적 방법으로 상악 전치부의 유착치를 심미적으로 치료한 증례를 소개하고자 한다.