• Journal of Korean Dental Science
• /
• 제3권2호
• /
• pp.50-59
• /
• 2010

Implant placement is frequently complicated and challenging because of the poor quality and inadequate height of bone. Clinicians should consider various surgical procedures to overcome the problems. We report a case with various surgical procedures used such as inferior alveolar nerve repositioning, sinus bone graft, and autogenous block bone graft using the coronoid process and ramus to overcome severe vertical and horizontal alveolar bone atrophy.

• 대한치과의사협회지
• /
• 제53권5호
• /
• pp.298-306
• /
• 2015

Bacterial infection after implant installation or bone graft is a serious complication. Bone grafts represent a temporary foreign body lacking vascularisation and are therefore of increased susceptibility to infection, which may be introduced either intraoperatively or postoperatively. Bone graft-associated infections are due to biofilm formation on the surface of the bone graft and often require removal of the infected bone graft with substantial graft failure. In this review, the implant and graft related infection, the role of biofilm and the management will be discussed.

• 대한치과의사협회지
• /
• 제54권10호
• /
• pp.771-779
• /
• 2016

Purpose: Antral pseudocyst is a common benign lesion that exists in the maxillary sinus. Because of this possible complication, controversy remains with respect to sinus floor elevation operations. The purpose of this study was to analyze the antral pseudocyst related to maxillary sinus augmentation. Patients and Methods: The radiographs of 268 patients who visited Chosun University Dental Hospital from 2008 to 2010 and underwent the maxillary bone grafting procedure were examined. Results: Of the 268 patients who underwent the maxillary bone grafting procedure, 5 patients (1.86%) were diagnosed with antral pseudocysts. In all cases, maxillary sinus floor elevation was performed without aspiration, biopsy or extraction of the antral pseudocyst. Conclusion: Antral pseudocysts are not considered a contraindication for maxillary sinus bone grafting procedure.

• Journal of Periodontal and Implant Science
• /
• 제27권1호
• /
• pp.45-59
• /
• 1997

Platelet-derived growth factor(PDGF) has been shown to play an important role in periodontal regeneration. The purpose of the present study was to examine the distribution of PDGF in experimentally created periodontal intrabony defects after flap surgery with various bone graft materials. Six healthy mongrel dogs were used in this study. Three-wall bony defects were created in maxillary and mandibular premolars, inflammation induced by wire ligation and injection of impression material into the defects. Eight weeks later, the experimental lesions thus obtained were treated by plain flap surgery(control group), flap surgery plus autogenous bone graft(autogenous bone group), flap surgery plus Biocoral graft(Biocoral group), or flap surgery plus bioglass graft(bioglass group), which were randomly assigned to the defects. After 4, H, and 12 weeks postoperatively, 2 dogs were sacrificed at each time and 1he specimens were taken for histological examinations and immunohistochemical examinations for PDGF. In the control defects the amount of new bone formation was minimal. In the autogenous bone and Biocoral group new bone was deposited around implanted particles and the amount of new bone was increased with time. A large number of bioglass particles exibited a central excabation and bone formation could be observed in the central excabation as well as around the particles. The expression of PDGF was low in the control group. The expression of PDGF in Biocoral group was increased at 1, H week, but decreased at 12 week. The increased PDGF expression in autogenous bone and bioglass group was maintained to the end of the experiment.

• Journal of Korean Dental Science
• /
• 제13권2호
• /
• pp.73-80
• /
• 2020

Purpose: The purpose of this case study series was to introduce successful implant cases that used the palatal bone in patients with severe maxillary alveolar bone atrophy or defects. Case Presentation: In this case series study, a total of four patients underwent implant placement in the palatal bone of the maxilla. A total of 6 implants were installed using the palatine bone. The patients' ages ranged from 40 to 73 years with an average age of 63.5 years. The patients had maxillary sinus-related diseases, such as maxillary sinusitis, oroantral fistula, and dentigerous cysts, prior to implantation. To achieve initial stability, the implants were placed on the palatal side, and buccally tilted. The average postoperative recovery period was 8 months. No postoperative complications occurred in any of the cases, and the approach was used without reported issues. Conclusion: Implant treatment by securing the initial fixation in the palatal bone is a good alternative when an implant must be installed in a patient who requires extensive and invasive bone graft.

• Journal of Korean Dental Science
• /
• 제16권2호
• /
• pp.211-217
• /
• 2023

Fibrous dysplasia (FD) accompanying osteomyelitis (OM) has been reported to result in recurrent, refractory pain and swelling. Although radical resection of the lesions has been suggested, effective surgical treatment strategies have not yet been established due to the limited number of studies on this pathological condition. In this report, we present the conservative surgical management of FD accompanying OM in two patients who exhibited recurrent signs and symptoms. The present report suggests that OM occurring in patients with FD can be successfully managed with conservative surgical treatment and following removal of the odontogenic origin although bone defect in which inflammatory fibro-osseous lesions is removed through decompression surgery may exhibit regeneration of dysplastic bone. In addition, for the prevention of OM in patients with FD, careful clinical examination and thorough management of dental-related pathologies are necessary with regular follow-up examinations to screen for the possibility of malignant changes.

• 대한치과교정학회지
• /
• 제50권3호
• /
• pp.157-169
• /
• 2020

Objective: The aim of this retrospective study was to evaluate the pre- and postsurgical bone densities at alveolar and extra-alveolar sites following two-jaw orthognathic surgery. Methods: The sample consisted of 10 patients (mean age, 23.2 years; range, 18.0-27.8 years; 8 males, 2 females) who underwent two-jaw orthognathic surgery. A three-dimensional imaging program (Invivo 5) was used with multidetector computed tomography images taken pre- and postoperatively (obtained 32.3 ± 6.0 days before surgery and 5.8 ± 2.6 days after surgery, respectively) for the measurement of bone densities at the following sites: (1) alveolar bone in the maxilla and mandible, (2) extra-alveolar sites, such as the top of the head, menton (Me), condyle, and the fourth cervical vertebrae (C4). Results: When pre- and postsurgical bone densities were compared, an overall tendency of decrease in bone density was noted. Statistically significant reductions were observed in the densities of cancellous bone at several areas of the maxillary alveolar bone; cortical and cancellous bone in most areas of the mandibular alveolar bone; cortical bone in Me; and cancellous bone in C4. There was no statistically significant difference in bone density in relation to the depth of the alveolar bone. In a comparison of the bone densities between groups with and without genioplasty, there was almost no statistically significant difference. Conclusions: Accelerated tooth movement following orthognathic surgery may be confirmed with reduced bone density. In addition, this study could offer insights into bone metabolism changes following orthognathic surgery, providing direction for further investigations in this field.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제38권
• /
• pp.16.1-16.9
• /
• 2016

Background: The association of biomaterial combined with repair factor-like platelet-rich plasma (PRP) has prospective values. Bovine-derived xenograft has been identified as an osteoconductive and biocompatible grafting material that provides osseointegration ability. PRP has become a valuable adjunctive agent to promote healing in a lot of dental and oral surgery procedures. However, there are controversies with respect to the regenerative capacity of PRP and the real benefits of its use in bone grafts. The purpose of this study was to assess the influence of PRP combined with xenograft for the repair of peri-implant bone defects. Methods: Twelve rabbits were used in this study, and the experimental surgery with implant installation was performed simultaneously. Autologous PRP was prepared before the surgical procedure. An intrabony defect (7.0 mm in diameter and 3.0 mm deep) was created in the tibia of each rabbit; then, 24 titanium dental implants (3.0 mm in diameter and 8.5 mm long) were inserted into these osteotomy sites. Thus, a standardized gap (4.0 mm) was established between the surrounding bony walls and the implant surface. The gaps were treated with either xenograft alone (control group) or xenograft combined with PRP (experimental group). After healing for 1, 2, 3, 4, 5, and 6 weeks, the rabbits were sacrificed with an overdose of KCl solution. Two rabbits were killed at each time, and the samples including dental implants and surrounding bone were collected and processed for histological analysis. Results: More newly formed bone and a better bone healing process were observed in control group. The histomorphometric analysis revealed that the mean percentage of bone-to-implant contact in the control group was significantly higher than that of the experimental group (25.23 vs. 8.16 %; P < 0.05, independent-simple t test, analysis of variance [ANOVA]). Conclusions: The results indicate that in the addition of PRP to bovine-derived xenograft in the repair of bone defects around the implant, PRP may delay peri-implant bone healing.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제41권
• /
• pp.4.1-4.10
• /
• 2019

Background: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. Methods: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software^® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson's difficulty index (DI) and RID. Results: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. Conclusions: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.

• Journal of Korean Dental Science
• /
• 제6권2호
• /
• pp.50-57
• /
• 2013

Purpose: Autogenous tooth bone graft is proven to be efficient. We evaluated the bone healing effect and clinical capabilities of autogenous tooth bone materials as a scaffold when growth factor is used together with this material. Materials and Methods: Subjects were those who needed implant placement and bone graft because of missing tooth or alveolar bone defect and who kept their autogenous tooth or needed extraction of other tooth. Group I included autogenous tooth bone graft with growth factor, whereas Group II had only autogenous tooth bone graft. We investigated the bone healing state through computed tomography taken just before surgery and 3 to 4 months after surgery to evaluate the effectiveness of bone graft. Group I had 9 patients, whereas Group II had 5 patients. We compared the pre- and post-operative increase of the Hounsfield unit and bone height by analyzing the computed tomography images. Result: Sinus bone grafts numbered 8 cases, and vertical ridge augmentation was performed together with 3 cases of these. Vertical ridge augmentation was performed in 2 cases, and horizontal ridge augmentation in 1 case alone. Socket graft was done in 3 cases. The post-operative mean value of the Hounsfield unit was 960 in Group I and 836.7 in Group II, but the increase was almost similar, i.e., 636.9 in Group I and 634.7 in Group II on the average. Increase of bone height was 7.6 mm in Group I and 11.1 mm in Group II on the average. This difference was attributable to the fact that most of the cases were sinus bone graft in Group II. Conclusion: In this study, we suggest the possibility of autogenous tooth bone graft materials as a scaffold besides their bone healing ability.