• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.56-66
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• 2020

Purpose: A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device. Methods: Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured. Results: The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was -6.76 (-25.05 to 11.53, P<0.05). Conclusions: Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.535-543
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• 2019

Background A high incidence of breast animation deformity (BAD) has been reported following immediate breast reconstruction with subpectorally placed implants. The aim of this study was to assess and compare the incidence of BAD in women who underwent either subpectoral or prepectoral immediate breast reconstruction. Therefore, we developed a grading tool and tested its reproducibility in a clinical setting. Methods Video recordings of 37 women who had undergone unilateral or bilateral immediate breast reconstruction were evaluated by two consultant plastic surgeons. The degree of BAD was assessed by our grading tool, named the Nipple, Surrounding Skin, Entire Breast (NSE) grading scale, which evaluates the degree of tissue distortion in three areas of the breast. Blinded assessments were performed twice by each observer. Results Eighteen patients were reconstructed with subpectoral implant placement and 19 with prepectoral implant placement. Using the NSE grading scale, we found a significant difference in the degree of BAD between the groups, in favor of patients who underwent prepectoral immediate breast reconstruction (0.2 vs. 4, P=0.000). Inter- and intraobserver agreement was moderate (74%) to strong (88%). Conclusions The incidence and severity of BAD was significantly lower in women reconstructed with a prepectorally placed implant than in those who underwent subpectoral immediate breast reconstruction. All patients reconstructed using the subpectoral technique had some degree of BAD. The inter- and intraobserver agreements were high when using the NSE grading scale, suggesting it is an easy-to-use, reproducible scale for assessing BAD in women who undergo immediate breast reconstruction.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.1
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• pp.33-44
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• 2015

Purpose: This study is to evaluate the clinical significance of the platform switching concept by comparing the marginal bone loss around platform-matched and platform-switched implants. Materials and Methods: Date of implant placement, diameter, length, implant-abutment connection type and absence of splinting prosthesis were investigated on patients who performed treatment with implant placement at Wonkwang University Dental Hospital Implant Center. To measure the marginal bone loss around implants, periapical radiographs of patient were used when implant was placed and when visited the center most recently by using the program, Emago advanced v5.6. Results: As a result of observing on 150 implants of 82 patients for 6 - 63 months, platform-matched implants showed $1.16{\pm}0.54mm$, platform-switched implants showed $0.68{\pm}0.27mm$ of marginal bone loss. Conclusion: It was considered that there is the positive effect to reduce marginal bone loss around platform-switched implants.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.499-501
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• 2009

Because sublingual region is well-vascularized and sublingual artery is passed throughout this region, it should be careful not to perforate lingual cortex when placing dental implant on mandible. A 83-years-old male complained severe sublingual hematoma, hemorrhage and dyspnea came our outpatient department. He had received dental implant placement in the same day. He needed hemostasis and airway control. If soft tissue of sublingual region and the artery are injured, it may result in life-threatening excessive hemorrhage. In dental implant surgery, especially mandible, we should recognize the accurate shape of mandible and anatomy of sublingual region. It is important to stop anticoagulant agent before surgery. When a patient has airway obstruction, the operator should manage airway quickly.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.221-226
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• 2013

Purpose: This study is to evaluate the efficacy of the autogenous tooth bone graft material, clinically and radiologically, as related to implant installation. Methods: In oral and maxillofacial surgery department of Ajou University Hospital, guided bone regeneration (GBR), implant placement combined with GBR, sinus graft, implant placement combined with sinus graft, and defect filling were performed in 46 patients, using autogenous tooth bone. Among these, 66 implants were inserted with autogenous tooth bone. Implant stability quotient (ISQ) was measured by Osstell Mentor (Integration Diagnostics, Goteborg, Sweden) on 39 implants on the operation date and 4 months later, and on 21 implants 9months on the average at the final setting of restoration. Twenty-eight implants with GBR and sinus graft (GBR group: n=14, sinus graft group: n=14) were evaluated radiologically to measure the resorption of grafted autogenous tooth bone after loading. Results: The average initial stabilization of the installed implants was 67 ISQ, and the average secondary stabilization at 4 months later was 76. The average bone loss of GBR group as measured 8.0 months after application of prosthesis loading was 0.29 mm and the average bone loss of the sinus graft group as measured 7.6 months after application of prosthesis loading was 0.66 mm, respectively. In the histological assessment, formation of the new bone and continuous trabecular bone pattern was identified around autogenous tooth bone. Conclusion: Based on these results, we concluded that autogenous tooth bone is an excellent bone graft material that can substitute the autogenous bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.590-594
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• 2006

Dental implant has become one of the important option for completely or partially edentulous patients, But it is challenging to reconstruct the severely atrophic ridge. Insufficient bone volume could restrict to place the wide and long implant and because of excessive interocclusal clearance, improper prosthetics could be produced. In this case bone augmentation for implant dentistry is necessary procedure to improve the insufficient bone volume. Therefore, bone augmentation or GBR is the most important procedure for successful implant placement and for ideal crown- root ratio. There are various bone augmentation techniques have been introduced recently; like block bone graft, distraction osteogenesis, inlay graft, onlay graft, etc.... In severe bucco-lingual resorption area, ridge splitting is the first choice of the treatment, because it provides a place for implantation and also has compaction effect. This technique may be indicated for sharp mandible and maxillary ridges in patients whose bone quantity is inadequate for primary stabilization. We report that the clinical experience of bone augmentation using ridge splitting technique in bucco-lingual bone resorption area.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.246-252
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• 2014

$Br{\aa}nemark^{\prime}s$ original protocol required 4 to 6 months for implant osseointegration before placement of the definitive prosthesis. Although this approach gave very predictable results, it had certain drawbacks. The main disadvantages of this approach were prolonged treatment time, two surgical procedures, placement of a removable prosthesis that required modifications during the course of treatment, and a greater number of appointments. Immediate implant loading is a viable treatment method for selected cases. One of the greatest advantages of this method is the virtual surgery, which precedes the actual clinical treatment and eliminates any need for last minute decisions. The actual surgery time is decreased, since all steps are predetermined. These advantages aren't only more useful for normal patients but also for the mental retardation patients whose cooperation is difficult. This article presents a clinical approach made possible due to the guided implant surgery and CAD/CAM technique.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.244-249
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• 2015

With the recent progress of digital technology, the computer guided surgery utilizing a guide template in the placement of implant has been actively performed, and the method employing the intraoral scanner at the implant prosthesis introduced. Fabrication method of the guide template can be largely classified into design-related rapid prototyping (RP) system and vector milling system, and each of the method has its own weakness in the clinical application despite of excellent accuracy. Thus, in this case study, a working model was fabricated by the wax RP technology using images acquired by CBCT and an intraoral scanner, and the metal bushing was picked up with orthodontic resin cast upon the wax model. Using this method, a surgical guide template was fabricated and used in surgery. From this, we could obtain a satisfactory outcome clinically in the implant placement and the fabrication of the final prostheses and thus report this case herein.

• 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.45 no.3
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• pp.82-93
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• 2015

Purpose: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.