• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제35권5호
• /
• pp.340-345
• /
• 2009

Purpose: The purpose of this study was to evaluate the surgical success of bone reconstruction of the severely atrophic maxilla using autogenous block bone onlay graft from the ramus and ilium prior to dental implantation. And we measured the amount of vertical height change Material and Methods: 26 partially edentulous patients(32 case) who needed block onlay bone graft before implant placement in posterior maxillary area from 2002 to 2009 were selected for this study. Patients consisted of 20 males & 6 females and the average of their age was 54.2. Patients who were treated with ramal bone were 19 case and patients who were treated with iliac bone were 11 case. Digital panoramic X-ray was taken at the day of surgery, 3 months and 6 months later after the surgery. Vertical height change & resorption rate of grafted bone were measured with the same X-rays and compared Results: Two out of 32 bone grafts had to be removed because of inflamation at the grafts area(97.3%). The mean of radiographic vertical height change(change rate) of post-op. 3 month was 0.54mm(8.5%)and 6 month was 0.99mm(15.9%). Compairing to intraoral donor site(ramus), iliac bone had more vertical height change(1.18mm) at 6 month after surgery. Conclusions: Within the limit of this study, autogenous block onlay grafts can be considered a promising treatment for severely atrophic maxilla.

• 대한치과의사협회지
• /
• 제50권6호
• /
• pp.329-338
• /
• 2012

Introduction: The purpose of this study is to evaluate the clinical results of vertical alveolar ridge augmentation using autogenous block bone graft, especially resorption rate, and outcomes of dental implants placed in the grafted site. Patients and Methods: Medical records and radiographs were reviewed. Twenty-seven patients who have been received the autogenous block bone graft which harvested from chin, ramus, and ilium, and the implant installation on 31 areas(22 maxillas and 9 mandibles) were included. Eight implants were installed simultaneously at the time of bone graft in 4 patients, and 65 implants were installed after 4.9 months(range 2~18 months) of autogenous block bone graft in 23 patients. The resorption amount and rate of augmented bone, and the success and survival rates implants were evaluated. Results: Mean height of the augmented block bone was $5.9{\pm}2.3mm$(range from 2.5 to 13.0 mm). Mean follow-up period after block bone graft was 30.4 months(range from 16 to 55 months). Mean resorption of the augmented block bone was $2.0{\pm}1.5mm$ (range from 0.5 to 7.24 mm). The success and survival rates of the implants were 78.1 % and 98.6%, respectively. Conclusion: This study indicates that the autogenous block bone graft is a useful and stable method for alveolar ridge augmentation for dental implant. And more augmentation is needed to compensate the resorption of the grafted bone.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제28권6호
• /
• pp.570-578
• /
• 2006

A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권6호
• /
• pp.469-477
• /
• 2009

육안적 검사결과 실험군과 대조군 모두에서 특별한 염증 소견이나 창상 이개 없이 반원 모양의 골형성이 관찰되었다. 조직학적으로 3주째에 대조군, 실험 1군, 실험2군, 실험 3군 모두 이식골 주위 및 티타늄 반구 내면을 따라 신생 골형성이 관찰되었다. 조직학적으로 6주째에 모든 군에서 3주째에 비하여 신생골 면적의 증가 및 성숙 소견이 관찰되었고, 실험2군에서는 부분적으로 이식골이 흡수되면서 신생골이 형성되는 것이 관찰된 반면, 실험 3군에서는 이식골의 흡수 소견이 관찰되지 않았다. 조직형태계측학적으로 3주, 6주 모두 자가골에서 가장 많은 신생골 형성이 나타났고, 신생골 면적 비교시 자가골, 이종골, 합성골 순으로 크게 나타났고, 각 군간의 통계학적으로 유의한 차이는 없었다(p>0.05). 본 연구결과 골유도 재생술시 골형성 능력은 자가골이 가장 좋지만, 자가골 채취가 불가능할 경우, 적절한 차폐막을 사용한 합성골과 이종골 복합 이식방식도 좋은 대체제가 될 것으로 생각된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제37권6호
• /
• pp.483-489
• /
• 2011

Introduction: This study examined the cumulative resorption of implants placed in a severely atrophic mandible and analyzed the radiologic bone resorption in the marginal bone, after an autogenous bone graft including both block and particulates that had been harvested from the ramus and iliac crest. Materials and Methods: A retrospective study was performed on patients who had bone grafts for augmentation followed by implant installation in the mandible area from 2003 to 2008. Twelve patients (6 men and 6 women) who received 34 implants in the augmented sites were evaluated. Cumulative radiologic resorption around the implants was measured immediately, 3 months, 6 months and 12 months after implant installation surgery. Results: The installed implant in grafted bone showed 0.84 mm marginal bone resorption after 3 months and 50% total cumulative resorption after 1 year. The mean marginal bone resorption around the implant installed in the grafted bone was 0.44 mm after 3 months, 0.52 mm after 1 year, after which it stabilized. The implant survival rate was 97% (failed implant was 1/34). Marginal bone resorption of the installed implant in the autogenous onlay block bone grafts was 0.98 mm after 3 months, which was significantly higher than that of a particulated bone graft (0.74 mm) (P <0.05). Conclusion: An autogenous graft including block type and particulate type is a predictable procedure for the use of dental implants in a severely atrophic mandible. Implant placement in augmented areas show a relatively high survival and minimal bone loss, as revealed by a radiologic evaluation.

• The Journal of Advanced Prosthodontics
• /
• 제3권2호
• /
• pp.96-100
• /
• 2011

An 18-year-old male presented severe hypodontia due to hypohidrotic ectodermal dysplasia was treated with Le Fort I maxillary osteotomy with simultaneous sinus floor augmentation using the mixture of cortical autogenous bone graft harvested from iliac crest and organic Bio-Oss to position the maxilla in a right occlusal plane with respect to the mandible, and to construct adequate bone volume at posterior maxilla allowing proper implant placement. Due to the poor bone quality at other sites, ridge augmentation with onlay graft was done to construct adequate bone volume allowing proper implant placement, using tissue harvested from the iliac bone. Seven implants were placed in the maxilla and 7 implants were inserted in the mandible and screw-retained metal ceramic FPDs were fabricated. The two year follow up data showed that dental implants should be considered as a good treatment modality for patients with ectodermal dysplasia.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제41권5호
• /
• pp.232-239
• /
• 2015

Objectives: The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods: Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results: No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was $74.6%{\pm}8.4%$. Conclusion: Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.

• 대한치과의사협회지
• /
• 제50권12호
• /
• pp.743-754
• /
• 2012

urpose : The purpose of this study was to evaluate the US II plus/GS II Osstem$^{(R)}$ implants through the study for the clinical success rate during the installation of the Osstem¢Á implants after bone graft. Materials and Methods : This study was researched in the 4 medical institutions: Chonnam National University, Chosun University, Bundang Seoul National University Hospital, and FM dental clinic from May, 2002 to September, 2009. Based on the total number of 60 patients whose treatment was the installation of the US II plus/GS II Osstem¢Á implants after bone graft, we evaluated success rate of implants. We analysis the distribution of patient's age and gender, edentulous area, bone type, fixture length and diameter, installation and loading time, donor site, bone graft material and method, antagonistic teeth, and survival and success rate. From these analyses we got the following results. Results : 1. In this study, the total number of patients who have been installed with US II plus implant was 27, and total of 52 implants were installed. The average age was 38.9, with 16 male, and 11 female patients. 2. The total number of patients who have been installed with GS II implant was 33, and total of 54 implants were installed. The average age was 49.7, with 24 male, and 9 female patients. 3. As for bone graft method, either autogenous bone or a mix of autogenous and heterogenous bone was used(88.4%) for US II plus. Chin, iliac, and Maxillary tuberosity were the donor sites for autogenous bone graft, and onlay method of bone graft was performed. 4. Allogenic bone or a mix of autogenous and heterogenous bone was used(77.8%) for GS II. Chin, ramus, and tibia were the donor sites for autogenous bone graft, and GBR method of bone graft was performed. 5. The duration from the installation of implants to setting of final prosthesis was average of 16 months and 10 months for US II plus and GS II respectively. Also, the final follow up period was average of 31 months and 28 months respectively. During this period, one GS II implant was removed from 1 patient due to failure of early osteointegration. 6. The survival rates were 100% and 98.1%, and success rates were 94.2% and 94.4% for US II plus and GS II implant respectively. Conclusion : On the evaluation of our clinical study, both US II plus and GS II Osstem¢Á implants showed the excellent clinical results after bone graft.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권6호
• /
• pp.644-651
• /
• 2000

In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre- and postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제21권4호
• /
• pp.376-381
• /
• 1999

A variety of materials and procedures such as sinus floor elevation, sinus-lift graft, inlay bone graft using Le Fort I osteotomy, and onlay graft have been used to create adequate bone volume in the maxillary sinus for placement of endosseous implants in the posterior atrophic maxilla. Because of the frequent lack of bone in the posterior maxilla, sinus lift procedure has become a commonly practiced treatment modality. The 138 endosseous implants of 36 patients with sinus augmentation procedures performed in Korea University Hospital from January 1991 to December 1998 were summarized and analysed. The result of this study were as follows: 1. Age ranged from 39 to 57, with a mean of 50.7. 2. The mean survival rate for 138 implants with maxillary sinus lift procedure was 80.4%. 3. There was no corelationship between the fixture length, width and the survival rate. 4. The result showed that the healing period for 8-12 months was necessary if the residual alveolar bone height was less than 5mm. 5. Autogenous iliac corticocancellous block graft showed the most favorable survival rate(95%).