• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.5
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• pp.232-239
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• 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.

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.23-29
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• 2015

Purpose: This study aimed to assess the reliability of measurements performed on three-dimensional (3D) virtual models of maxillary defects obtained using cone-beam computed tomography (CBCT) and 3D optical scanning. Materials and Methods: Mechanical cavities simulating maxillary defects were prepared on the hard palate of nine cadavers. Images were obtained using a CBCT unit at three different fields-of-views (FOVs) and voxel sizes: 1) $60{\times}60mm$ FOV, $0.125mm^3$ ($FOV_{60}$); 2) $80{\times}80mm$ FOV, $0.160mm^3$ ($FOV_{80}$); and 3) $100{\times}100mm$ FOV, $0.250mm^3$ ($FOV_{100}$). Superimposition of the images was performed using software called VRMesh Design. Automated volume measurements were conducted, and differences between surfaces were demonstrated. Silicon impressions obtained from the defects were also scanned with a 3D optical scanner. Virtual models obtained using VRMesh Design were compared with impressions obtained by scanning silicon models. Gold standard volumes of the impression models were then compared with CBCT and 3D scanner measurements. Further, the general linear model was used, and the significance was set to p=0.05. Results: A comparison of the results obtained by the observers and methods revealed the p values to be smaller than 0.05, suggesting that the measurement variations were caused by both methods and observers along with the different cadaver specimens used. Further, the 3D scanner measurements were closer to the gold standard measurements when compared to the CBCT measurements. Conclusion: In the assessment of artificially created maxillary defects, the 3D scanner measurements were more accurate than the CBCT measurements.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.2
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• pp.126-133
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• 2018

The development of cone beam computerized tomography (CBCT) allows three-dimensional analysis of the patient's anatomy. The surgical guide is a combination of CBCT, computer-aided design/computer-aided manufacturing (CAD/CAM) and implant diagnostics software, which allows well planned prostheses design and ideal implant placement. Guided surgery minimizes possible anatomical damage and allows for more reproducible treatment planning. In this case, the operation time was shortened by using a surgical guide for multiple implants placement in a fully edentulous patient. Immediate loading were performed more easily using preliminary preparation of provisional prosthesis. The patient was satisfied with improved esthetics and chewing function.

• Journal of Periodontal and Implant Science
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• v.47 no.3
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• pp.165-173
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• 2017

Purpose: The aim of this study was to radiographically and clinically compare the effect of extracellular matrix (ECM) membranes on dimensional alterations following a ridge preservation procedure. Methods: One of 2 different ECM membranes was applied during a ridge preservation procedure. A widely used ECM membrane (WEM; Bio-Gide, Geistlich Biomaterials, Wolhusen, Switzerland) was applied in the treatment group and a newly developed ECM membrane (NEM; Lyso-Gide, Oscotec Inc., Seongnam, Korea) was applied in the control group. Cone-beam computed tomography (CBCT) scans and alginate impressions were obtained 1 week and 6 months after the ridge preservation procedure. Results were analyzed using the independent t-test and the nonparametric Mann-Whitney U test. Results: There were no significant differences between the ECM membranes in the changes in the dimension, width, and height of the extraction socket or the quantity of bone tissue. Conclusions: The NEM showed comparable clinical and radiographic results to the WEM following the ridge preservation procedure.

• Journal of Periodontal and Implant Science
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• v.47 no.3
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• pp.154-164
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• 2017

Purpose: Measurement of the root surface area (RSA) is important in periodontal treatment and for the evaluation of periodontal disease as a risk factor for systemic disease. The aim of this study was to measure the RSA at 6 mm below the cementoenamel junction (CEJ) using the Mimics software (Materialise, Leuven, Belgium). Methods: We obtained cone-beam computed tomography (CBCT) data from 33 patients who had visited the Department of Oral and Maxillofacial Radiology of Dankook University Dental Hospital. The patients comprised 17 men and 16 women aged from 20 to 35 years, with a mean age of 24.4 years. Only morphologically intact teeth were included in our data. Because the third molars of the maxilla and mandible have a high deformation rate and were absent in some participants, they were not included in our research material. Results: The CBCT data were reconstructed into 3-dimensional (3D) teeth models using the Mimics software, and the RSA at 6 mm below the CEJ was separated and measured using 3-Matic (Materialise). In total, 924 3D teeth models were created, and the area at 6 mm below the CEJ could be isolated in all the models. The area at 6 mm below the CEJ was measured in all teeth from the 33 patients and compared based on sex and position (maxilla vs. mandible). Conclusions: In this study, we demonstrated that it was feasible to generate 3D data and to evaluate RSA values using CBCT and the Mimics software. These results provide deeper insights into the relationship between periodontal inflammatory burden and systemic diseases.

• Journal of Periodontal and Implant Science
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• v.47 no.6
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• pp.363-371
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• 2017

Purpose: The purpose of this study was to investigate the feasibility of regenerative therapy with a collagenated bone graft and resorbable membrane in intrabony defects, and to evaluate the effects of the novel extracellular matrix (ECM)-based membrane clinically and radiologically. Methods: Periodontal tissue regeneration procedure was performed using an ECM-based resorbable membrane in combination with a collagenated bovine bone graft in intrabony defects around the teeth and implants. A novel extracellular matrix membrane (NEM) and a widely-used membrane (WEM) were randomly applied to the test group and the control group, respectively. Cone-beam computed tomography images were obtained on the day of surgery and 6 months after the procedure. Alginate impressions were taken and plaster models were made 1 week and 6 months postoperatively. Results: The quantity of bone tissue, the dimensional changes of the surgically treated intrabony defects, and the changes in width and height below the grafted bone substitutes showed no significant difference between the test and control groups at the 6-month examination. Conclusions: The use of NEM for periodontal regeneration with a collagenated bovine bone graft showed similar clinical and radiologic results to those obtained using WEM.

• The korean journal of orthodontics
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• v.45 no.2
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• pp.59-65
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• 2015

Objective: To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods: A retrospective study of 34 patients (23 men, 11 women; mean age, $26.2{\pm}6.6years$) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms. Results: The significant T0 to T1 mandibular changes occurred $-9.24{\pm}3.97mm$ horizontally. From T1 to T2, the mandible tended to move forward $1.22{\pm}2.02mm$, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011). Conclusions: Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment.

• The korean journal of orthodontics
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• v.50 no.2
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• pp.86-97
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• 2020

Objective: To propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment. Methods: Seventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption. Results: Significant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG. Conclusions: We successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.

• The korean journal of orthodontics
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• v.50 no.2
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• pp.98-107
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• 2020

Objective: The aim of this study was to compare posterior tooth inclinations, occlusal force, and contact area of adults with different sagittal malocclusions. Methods: Transverse skeletal parameters and posterior tooth inclinations were evaluated using cone beam computed tomography images, and occlusal force as well as contact area were assessed using pressure-sensitive films in 124 normodivergent adults. A linear mixed model was used to cluster posterior teeth into maxillary premolar, maxillary molar, mandibular premolar, and mandibular molar groups. Differences among Class I, II, and III groups were compared using an analysis of variance test and least significant difference post-hoc test. Correlations of posterior dental inclinations to occlusal function were analyzed using Pearson's correlation analysis. Results: In male subjects, maxillary premolars and molars had the smallest inclinations in the Class II group while maxillary molars had the greatest inclinations in the Class III group. In female subjects, maxillary molars had the smallest inclinations in the Class II group, while maxillary premolars and molars had the greatest inclinations in the Class III group. Occlusal force and contact area were not significantly different among Class I, II, and III groups. Conclusions: Premolar and molar inclinations showed compensatory inclinations to overcome anteroposterior skeletal discrepancy in the Class II and III groups; however, their occlusal force and contact area were similar to those of Class I group. In subjects with normodivergent facial patterns, although posterior tooth inclinations may vary, difference in occlusal function may be clinically insignificant in adults with Class I, II, and III malocclusions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.66-73
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• 2015

Objectives: To assess the validity of the vertical tube-shift method using intraoral periapical radiography (IOPAR) for determining the relationship between the mandibular third molar roots and the inferior alveolar nerve (IAN) canal in comparison with cone-beam computed tomography (CBCT). Materials and Methods: Fifty impacted mandibular third molars were analyzed using the IOPAR vertical tube-shift method and CBCT. The relationship of the IAN canal to the impacted mandibular third molar was recorded as buccal, lingual or in line with the apex and was compared with CBCT findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the vertical tube-shift method in depicting the relationship (buccal/lingual/in line with the apex) of the IAN canal to the third molar root apex was calculated. Results: The sensitivity and specificity PPV and NPV of the IOPAR vertical tube-shift technique was found to be highest for a lingual relationship (100%) followed by buccal (94.4%, 92.3%, 97.1%, and 85.7%) and in line with the apex relationship (88.9%, 95.0%, 80.0%, and 97.4%) of the IAN canal with the third molar root apex, respectively. A statistically significant association was observed between the IOPAR vertical tube-shift method and the CBCT with a P-value <0.01. Conclusion: The vertical tube-shift method can be used as an effective diagnostic tool in assessing the relationship of the IAN canal to the third molar root apex with high sensitivity, specificity, PPV, and NPV.