Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.40
no.1
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pp.11-16
/
2014
Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true "Hunsuck" line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was $5.55{\pm}1.07$ mm (deviated) and $5.66{\pm}1.34$ mm (contralateral) (P =0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.
Journal of the korean academy of Pediatric Dentistry
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v.38
no.4
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pp.421-426
/
2011
Most of the intraoral infections origin in odontogenic infection. Odontogenic infection spreads out along the least resistant path. In maxilla, the thickness between periapical area and cortical bone is narrower on the buccal side than the palatal side. So infection usually spreads out along the buccal side rather than the palatal side. The failure of root canal treatment more frequently occurs on the buccal root compared to the palatal root. So the palatal abscess is rarer than the buccal abscess. It is difficult to differential diagnosis palatal abscess from salivary gland tumors, benign neural tumors and cysts on the palate. Therefore, when the palatal swelling is observed in children, you need to prevent the systemic spread of infection by early diagnosis of the odontogenic palatal abscess. In these cases, the patient who complained of the pain in deciduous teeth and the palatal swelling was diagnosed with odontogenic palatal abscess. The patient was treated with extraction and antibiotic medication. The palatal abscess was resolved, and we report after treatments.
Objective: The aim of this study was to validate the Periotest values for the prediction of orthodontic mini-implants' stability. Methods: Sixty orthodontic mini-implants (7.0 mm $\times$$\emptyset1.45$ mm; ACR, Biomaterials Korea, Seoul, Korea) were inserted into the buccal alveolar bone of 5 twelve month-old beagle dogs. Insertion torque (IT) and Periotest values (PTV) were measured at the installation procedure, and removal torque (RT) and PTV were recorded after 12 weeks of orthodontic loading. To correlate PTV with variables, the cortical bone thickness (mm) and bone mineral density (BMD) within the cortical bone and total bone area were calculated with the help of CT scanning. Results: The BMD and cortical bone thickness in mandibular alveolus were significantly higher than those of the maxilla (p < 0.05). The PTV values ranged from -3.2 to 4.8 for 12 weeks of loading showing clinically stable mini-implants. PTV at insertion was significantly correlated with IT (-0.51), bone density (-0.48), cortical bone thickness (-0.42) (p < 0.05) in the mandible, but showed no correlation in the maxilla. PTV before removal was significantly correlated with RT (-0.66) (p < 0.01) in the mandible. Conclusions: These results show that the periotest is a useful method for the evaluation of mini-implant stability, but it can only be applied to limited areas with thick cortical and high density bone such as the mandible.
Park, Jung Jin;Park, Young-Chel;Lee, Kee-Joon;Cha, Jung-Yul;Tahk, Ji Hyun;Choi, Yoon Jeong
The korean journal of orthodontics
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v.47
no.2
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pp.77-86
/
2017
Objective: The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT). Methods: This retrospective study included 14 patients (mean age, 20.1 years; range, 16-26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data. Results: The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6-1.1 mm and 1.7-2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of $1.1^{\circ}-2.9^{\circ}$. Conclusions: Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.
Purpose: To investigate the effects of simultaneous soft and hard tissue augmentation and the addition of polydeoxyribonucleotide (PDRN) on regenerative outcomes. Materials and Methods: In five mongrel dogs, chronic ridge defects were established in both mandibles. Six implants were placed in the mandible, producing buccal dehiscence defects. The implants were randomly allocated to one of the following groups: 1) control: no treatment; 2) GBR: guided bone regeneration (GBR) only; 3) GBR/PDRN: GBR+PDRN application to bone substitute particles; 4) GBR/CTG: GBR+connective tissue grafting (CTG); 5) GBR/VCMX: GBR+soft tissue augmentation using volume stable collagen matrix (VCMX); and 6) group GBR/VCMX/PDRN: GBR+VCMX soaked with PDRN. The healing abutments were connected to the implants to provide additional room for tissue regeneration. Submerged healing was achieved. The animals were euthanized after four months. Histological and histomorphometric analyses were then performed. Results: Healing abutments were gradually exposed during the healing period. Histologically, minimal new bone formation was observed in the dehiscence defects. No specific differences were found between the groups regarding collagen fiber orientation and density in the augmented area. No traces of CTG or VCMX were detected. Histomorphometrically, the mean tissue thickness was greater in the control group than in the other groups above the implant shoulder (IS). Below the IS level, the CTG and PDRN groups exhibited more favorable tissue thickness than the other groups. Conclusion: Failure of submerged healing after tissue augmentation deteriorated the tissue contour. PDRN appears to have a positive effect on soft tissues.
Purpose: The aim of the present study is to evaluate the long term bone healing after horizontal ridge augmentation using auto block bone graft for implant installation timing. Materials and Methods: Five Beagle dogs(which were 14 months old and weighted approximately 10kg). In surgery 1(extraction & bone defect), premolars(P2, P3,P4) were extracted and the buccal bone plate was removed to create a horizontally defected ridge. After three months healing, in surgery 2(ridge augmentation). Auto block bone grafts from the mandibular ramus were used in filling the bone defects were fixed with stabilizing screws. The following fluorochrome labels were given intravenously to the beagle dogs: oxytetracycline 1week after the surgery, alizarin red 4 weeks after the surgery, calcein blue 8 weeks after the surgery. The tissue samples were obtained from the sacrificed dogs of 1, 4, 8, 12, 16 weeks after the surgery. Non-decalcified sections were prepared by resin embedding and microsection to find thickness of $10{\mu}m$ for the histologic examination and analysis. Results: 1. We could achieve the successful reconstruction of the horizontal bone defect by auto block bone graft. The grafted bone block remained stable morohologically after 16 weeks of the surgery. 2. In the histologic view. We observed osteoid tissue from the sample $4^{th}$ week sample and active capillary reconstruction in the grafted bone from the $12^{th}$ week sample. Healing procedures of auto bone grafts were compared to that of the host bone. 3. Bone mineralization could be detected from the $8^{th}$ week sample. 4. Fluorochrome labeling showed active bony changes and formation at the interface of the host bone and the block graft mainly. Bony activation in the grafted bone could be seen from the $4^{th}$ week samples. Conclusions: Active bone formation and remodeling between the grafted bone and host bone can be seen through the revascularization. After the perfect adhesion to host bone, Timing of successful implant installation can be detected through the ideal ridge formation by horizontal ridge augmentation.
Bonetti, Giulio Alessandri;Parenti, Serena Incerti;Ciocci, Maurizio;Checchi, Luigi
The korean journal of orthodontics
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v.44
no.4
/
pp.217-225
/
2014
Single-tooth implantation has become a common treatment solution for replacement of a root-fractured maxillary incisor in adults, but the long-term esthetic results can be unfavorable due to progressive marginal bone loss, resulting in gingival recession. In this case report, a maxillary central incisor with a root fracture in its apical one-third was orthodontically extruded and extracted in a 21-year-old female. Implant surgery was performed after a 3-month healing period, and the final crown was placed about 12 months after extraction. After 12 years, favorable osseous and gingival architectures were visible with adequate bone height and thickness at the buccal cortical plate, and no gingival recession was seen around the implant-supported crown. Although modern dentistry has been shifting toward simplified, clinical procedures and shorter treatment times, both general dentists and orthodontists should be aware of the possible long-term esthetic advantages of orthodontic extrusion of hopelessly fractured teeth for highly esthetically demanding areas and should educate and motivate patients regarding the choice of this treatment solution, if necessary.
The glandular odontogenic cyst is a rare lesion described in 1987. It generally occurs at anterior region of mandible in adults over the age of 40 and has a slight tendency to recur. Histopathologically, a cystic cavity lined by a nonkeratinized, stratified squamous, or cuboidal epithelium varying in thickness is found including a superficial layer with glandular or pseudoglandular structures. A 21-year-old male visited Dankook University Dental Hospital with a chief complaint of swelling of the left posterior mandible. Radiographically, a huge multilocular radiolucent lesion involving impacted 3rd molar at the posterior mandible was observed. Buccolingual cortical expansion with partial perforation of buccal cortical bone was also shown. Histopathologically, this lesion was lined by stratified squamous epithelium with glandular structures in areas of plaque-like thickening. The final diagnosis was made as a glandular odontogenic cyst.
Park, Hyun-Soo;Lim, Sung-Bin;Chung, Chin-Hyung;Hong, Ki-Seok
Journal of Periodontal and Implant Science
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v.36
no.2
/
pp.531-554
/
2006
Oral implants must fulfill certain criteria arising from special demands of function, which include biocompatibility, adequate mechanical strength, optimum soft and hard tissue integration, and transmission of functional forces to bone within physiological limits. And one of the critical elements influencing the long-term uncompromise functioning of oral implants is load distribution at the implant- bone interface, Factors that affect the load transfer at the bone-implant interface include the type of loading, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface. To understand the biomechanical behavior of dental implants, validation of stress and strain measurements is required. The finite element analysis (FEA) has been applied to the dental implant field to predict stress distribution patterns in the implant-bone interface by comparison of various implant designs. This method offers the advantage of solving complex structural problems by dividing them into smaller and simpler interrelated sections by using mathematical techniques. The purpose of this study was to evaluate the stresses induced around the implants in bone using FEA, A 3D FEA computer software (SOLIDWORKS 2004, DASSO SYSTEM, France) was used for the analysis of clinical simulations. Two types (external and internal) of implants of 4.1 mm diameter, 12.0 mm length were buried in 4 types of bone modeled. Vertical and oblique forces of lOON were applied on the center of the abutment, and the values of von Mises equivalent stress at the implant-bone interface were computed. The results showed that von Mises stresses at the marginal. bone were higher under oblique load than under vertical load, and the stresses were higher at the lingual marginal bone than at the buccal marginal bone under oblique load. Under vertical and oblique load, the stress in type I, II, III bone was found to be the highest at the marginal bone and the lowest at the bone around apical portions of implant. Higher stresses occurred at the top of the crestal region and lower stresses occurred near the tip of the implant with greater thickness of the cortical shell while high stresses surrounded the fixture apex for type N. The stresses in the crestal region were higher in Model 2 than in Model 1, the stresses near the tip of the implant were higher in Model 1 than Model 2, and Model 2 showed more effective stress distribution than Model.
Objective: The purpose of this study was to provide clinical guidelines to indicate the best location for mini-implants as it relates to the cortical bone thickness and root proximity. Methods: CT images from 14 men and 14 women were used to evaluate the buccal interradicular cortical bone thickness and root proximity from mesial to the central incisor to the 2nd molar. Cortical bone thickness was measured at 4 different angles including $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, and $45^{\circ}$. Results: There was a statistically significant difference in cortical bone thickness between the second premolar/first permanent molar site, central incisor/central incisor site, between the first/second permanent molar site and in the anterior region. A statistically significant difference in cortical bone thickness was also found when the angulation of placement was increased except for the 2 mm level from the alveolar crest. Interradicular spaces at the 1st/2nd premolar, 2nd premolar/1st permanent molar and 1st/2nd permanent molar sites are considered to be wide enough for mini-implant placement without root damage. Conclusions: Given the limits of this study, mini-implants for orthodontic anchorage may be well placed at the 4 and 6 mm level from the alveolar crest in the posterior region with a $30^{\circ}$ and $45^{\circ}$ angulation upon placement.
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