• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.2
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• pp.116-126
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• 2018

Purpose: The purpose of this study was to analyze the factors affecting the survival rate and the marginal bone level of dental implants that have functioned over 7-years. Materials and Methods: In 92 patients, 178 dental implants were included. Implant-related factors (diameter, length, prosthetic splint), patient-related factors (gender, smoking, plaque index, compliance to supportive periodontal therapy) and surgery-related factors (proficiency of surgeon, bone graft) were evaluated via clinical and radiographic examination. The marginal bone level was determined by intraoral standard radiography at the mesial and distal aspects of each implant using an image analysis software program. Results: The survival rate of all the implants was 94.94% and the marginal bone level was $0.89{\pm}1.05mm$, these results are consistent with other studies that present long-term good clinical results. Implant length and plaque index among several factors were statistically significant for implant survival rate (P < 0.05). Smoking and the presence of regeneration surgery were statistically significant for the marginal bone level (P < 0.05). Conclusion: Dental implant that have functioned over 7-years showed favorable long-term survival rates and marginal bone level. Implant length and plaque control should be considered for improving the long-term clinical results. It is needed that careful application of bone regeneration technique and smoking control for maintaining of marginal bone level.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.33.1-33.7
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• 2019

Background: The concept of the ideal morphology for the alveolar bone form is an important element to reconstruct or restore the in maximizing esthetic profile and functional alveolar bone restoration. The purpose of this preliminary study is to evaluate the normal alveolar bone structure to provide the standard reference and guide template for use in diagnosing for implant placement, determining the correct amount of bone augmentation in actual clinical practice and producing prostheses based on three-dimensional imaging assessment of alveolar bone. Methods: This study was included 11 men and 11 women (average age, 22.6 and 24.5 years, respectively) selected from among 127 patients. The horizontal widths of alveolar bone of maxilla and mandible were measured at the crestal, mid-root, and root apex level on MDCT (multi-detector computed tomography) images reconstructed by medical imaging software. In addition, tooth dimensions of the central incisors, canines, second premolars, and first molars of maxilla and mandible, including the horizontal width of the interdental alveolar bone crest, were also measured and statistically analyzed. Results: The horizontal alveolar bone width of the palatal side of maxilla showed a distinct increment from the alveolar bone crest to the apical region in both anterior and posterior areas. The average widths of the maxillary alveolar ridge were as follows: central incisor, 7.43 mm; canine, 8.91 mm; second premolar, 9.57 mm; and first molar, 12.38 mm. The average widths of the mandibular alveolar ridge were as follows: central incisor, 6.21 mm; canine, 8.55 mm; second premolar, 8.45 mm; and first molar, 10.02 mm. In the buccal side, the alveolar bone width was not increased from the crest to the apical region. The horizontal alveolar bone width of an apical and mandibular border region was thinner than at the mid-root level. Conclusions: The results of the preliminary study are useful as a clinical guideline when determining dental implant diameter and position. And also, these measurements can also be useful during the production of prefabricated membranes and customized alveolar bone scaffolds.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.1
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• pp.55-59
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• 2013

In the oral and maxillofacial area, bone defects are created by various reasons and demand for bone grafts, while dental implant implantation has been increased consistently. To solve these problems, there has been development of autogenous tooth-bone graft material (AutoBT$^{(R)}$, Korea Tooth Bank Co., Korea), and we have collected ground reasons to substitute free autobone graft with this material in clinical use. This autogenous tooth-bone graft material is produced in powder type and block type. Block type is useful in esthetic reconstruction of the defect site and vertical and horizontal augmentation of alveolar bone because this type has high strength value, well maintained shape and is less absorbed. Therefore, the author of this study gained favorable result by grafting the block type autogenous tooth-bone graft material after dental implant implantation on the bone defects of the mandibular molar extraction site. Moreover, the author represents this case with literature review after confirming bone remodeling on the computed tomography image and by histological analysis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.42.1-42.7
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• 2016

Background: The purpose of this retrospective study was to evaluate the clinical utility of an implant with a sandblasted, large-grit, acid-etched (SLA) surface and internal connection. Methods: Six patients who received dental implants in the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, were analyzed by factors influencing the success rate and marginal bone loss. Factors included patient's age, sex, implant installation site, whether bone graft was done, type of bone graft materials, approaching method if sinus lift was done, and the size of the fixture. In addition, the marginal bone loss was analyzed by using a radiograph. Results: All implants were successful, and the cumulative survival rate was 100 %. Average marginal bone loss of 6 months after the installation was 0.52 mm and 20 months after the functional loading was 1.06 mm. Total marginal bone resorption was 1.58 mm on average. There was no statistically significant difference in mesial and distal marginal bone loss. Conclusions: The short-term clinical success rate of the implant with an SLA surface and internal connection was satisfactory. Moreover, the marginal bone loss was also consistent with the implant success criteria.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.315-323
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• 2005

For reconstruction of the bony defect, distraction osteogenesis has many advantages in comparison with bone graft. However, it needs long consolidation period for sufficient bone maturity. This study is performed to evaluate the effect of PRP injection into the distracted mandible on bone formation in rabbits. Twelve house rabbits, weighing 2 kg, were used. All animals underwent bilateral mandibular osteotomy under general anesthesia. A internal distractor divice was positioned along a plane perpendicular to the line of osteotomy. After 5 days of latency period, distraction osteogenesis was started at a rate of 1 mm/day for 9 days which was distracted 9 mm totally. After completion of distraction, 0.5 ml of PRP which collected in rabbit blood was injected into the distracted mandible on experimental group, whereas no injection was done in control group. Macroscopical, radiographical, and histological, and histomorphometric examinations were performed 2, 4 and 8 weeks after distraction. All animals showed distracted mandible and severe anterior cross-bite. In radiographical findings 2 weeks after distraction, more radiopacity in the distracted gap was found in experimental group than that of control group. At 4 weeks after distraction, distracted bone was similar to normal bone in experimental group. In histological findings, 1) At 2 weeks after distraction, number of osteoblasts and angiogenesis in the distracted gap was found in experimental group than that of control group. 2) At 4 weeks after distraction, more active and distinct bone in the distracted gap was found in experimental group than that of control groups. 3) At 8 weeks after distraction, more dense and matured lamellated bone in the distracted gap was found in experimental group than that of control group. In histomorphometrical findings 8 weeks after distraction, more bone formation was observed in experimental group than control group (p<0.01). These results indicate that administration of PRP into the distracted mandible can promote bone formation.

• Journal of Periodontal and Implant Science
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• v.46 no.3
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• pp.176-196
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• 2016

Purpose: We sought to evaluate the effectiveness of bone substitutes in circumferential periimplant defects created in the rabbit tibia. Methods: Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant ($4.1mm{\times}8.5mm$) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss$^{(R)}$ (BI), and Bio-Oss$^{(R)}$ Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results: For biomechanics, BC showed a better biological response ($61.00{\pm}15.28Ncm$) than CO ($31.60{\pm}14.38Ncm$) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions: Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.27.1-27.8
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• 2018

Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

• The Journal of the Korean dental association
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• v.50 no.5
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• pp.262-269
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• 2012

TMJ reconstruction is one of the most challenging surgical treatment, and many methods using autogenous and alloplastic materials have been reported for making neocondyle. Although alloplastic materials which include aclylic, synthetic and total joint system are recently widely used, many surgeons agree that autogenous TMJ reconstruction is gold standard until now. In this article, classification of the TMJ defects and the various TMJ reconstruction methods using autogenous source were introduced with review of literature.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.207-214
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• 2008

Purpose: The aim of augmentation of the alveolar ridge is to restore absorbed alveolar ridges for future implant site or esthetic prosthodontic restoration. The present clinical report describes the anterior maxillary augmentation cases using a soft tissue rotated palatal flap, and considers various problems of before and after surgery. Method: First & second patients were treated by vascularized interpositional periosteal-connective tissue(VIP-CT) flap for horizontal soft tissue augmentation. Especially second patient was progressed with bone grafting at the same time. Third patient was treated by the same flap with bone graft and implant placement in single tooth missing premaxillary area. Result: The obtained horizontal augmentation width measured $0.5{\sim}2.7\;mm$. Conclusion: This technique constitutes a viable approach for augmentation the anterior sector of alveolar ridge with the placement of dental implants. But it needs correct diagnosis preparation and careful surgery skill.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.2
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• pp.71-78
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• 2022

This study was conducted to review the efficacy of different sources of stem cells in bone regeneration of cleft palate patients. The majority of previous studies focused on the transplantation of bone marrow mesenchymal stem cells. However, other sources of stem cells have also gained considerable attention, and dental stem cells have shown especially favorable outcomes. Additionally, approaches that apply the co-culture and co-transplantation of stem cells have shown promising results. The use of different types of stem cells, based on their accessibility and efficacy in bone regeneration, is a promising method in cleft palate bone regeneration. In this regard, dental stem cells may be an ideal choice due to their efficacy and accessibility. In conclusion, stem cells, despite the lengthy procedures required for culture and preparation, are a suitable alternative to conventional bone grafting techniques.