• 대한치과의사협회지
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• 제52권7호
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• pp.396-401
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• 2014

Peri-implantitis is an inflammatory disease of the peri-implant tissue by bacterial infection or other factors, which results in peri-implant bone loss. Many nonsurgical treatments were tried on initial to moderate peri-implantitis lesion to reduce the inflammation. Some of these treatments made effective results, however, they were not definitively predictable. To prevent peri-implantitis and further peri-implant bone loss, early intervention is the most important. Early detection of peri-implant infection through the regular maintenance care can make it possible to do early nonsurgical intervention. Nonsurgical intervention is effective on peri-implant mucositis and can also be effective on initial peri-implantitis lesion. If the peri-implantitis is not resolves by nonsurgical treatment, surgical approach should be considered.

• 대한치과의사협회지
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• 제47권4호
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• pp.184-190
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• 2009

OBJECTIVE The purpose of clinical study was to evaluate the survival of dental implants used in restoring patients with implant supported removable partial dentures (ISRPDs) of different configurations. MATERIALS AND METHODS The sample consisted of 20 consecutively treated partially edentulous patients, who, between 2003 and 2008, had a total of 84implants placed in different arch sites and who were treated with ISRPDs. The mean age was 57 years. Mean follow up time from delivery of ISRPDs was 3 years 2 months (range, 1 to 6 years). Osseointegration failure, postoperative complication of dental prosthesis, and the success rate of ISRPDs were retrospectively evaluated using clinical and radiographic examination. RESULT The overall implant survival rate was 100%. During follow up, the one clasp of removable partial denture was broken in 1 year11 months after prosthesis delivery. All patients were satisfied with their prosthesis. CONCLUSIONS Implant supported removable partial dentures could serve as favorable prognosis. Careful patient selection, with an appropriate maintenance and recall system, is recommended to obtain satisfactory results.

• 대한치과보철학회지
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• 제56권4호
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• pp.384-390
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• 2018

치주적으로 지지가 불리한 소수의 잔존치가 남은 환자에게 있어 하이브리드 텔레스코픽형 이중관의치는 장기적으로 안정적인 예후를 보이는 치료가 된다. 편측 악궁에 소수 잔존치가 남고 반대측 악궁에 다수의 자연치가 존재 하는 경우 임플란트를 식립하여 자연치와 혼재된 형태의 이중관 의치를 제작 할 시 의치의 지지 및 안정요소의 향상과 더불어 저작력의 균형을 맞추어 줄 수 있게 된다. 본 증례는 55세 여자 환자로 만성 치주염으로 인해 치주 지지가 감소한 소수 잔존치 상태에서 자연치만으로 하이브리드 텔레스코픽형 이중관 의치 치료를 통해 9.5년간 의치를 사용하였다. 9.5년 후 지대치 파절로 내원 하여 임플란트의 식립을 통해 자연치와 임플란트가 혼재된 하이브리드 텔레스코픽형 이중관 의치로 재수 복 하였으며, 이를 통해 재 치료에서도 장기적 예후의 안정성을 기대 할 수 있다.

• 대한치과보철학회지
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• 제62권2호
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• pp.146-156
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• 2024

임플란트 보조 국소의치의 치료는 오래전부터 여러 형태로 시도되어 왔으며, 이 중 임플란트 서베이드 크라운 국소의치의 경우 점차 예지성을 얻고 있으며, 특히 경제적, 해부학적으로 불리한 부분 무치악 환자에게 한 가지 치료 방법이 될 수 있다. 이때 임플란트의 식립 위치는 치료 목적에 따라 전방 식립과 후방 식립으로 분류될 수 있는데, 이는 환자의 치조제, 잔존치 예후, 대합치 등 여러 상황을 고려하여 결정되어야 한다. 본 증례에서는 하악 Kennedy 1급 부분 무치악 환자에게 두 개의 임플란트 서베이드 크라운을 활용한 하악 임플란트 보조 국소의치를 통해 수복하였다. 본 환자에게 후방 식립이 어렵다는 점과 잔존치의 예후를 고려하여 임플란트를 잔존치에 근접한 부위에 두 개를 식립하는 것이 계획되었으며, 가이드 수술을 통해 계획한 위치, 각도, 깊이에 식립되었다. 고정성 보철물 제작 과정은 상악 무치악 치아 배열 과정과 병행하여 예지성을 높였고, 국소의치를 제작 시에는 임플란트가 최후방 지대치로서 과도한 하중이 가하지 않도록 기능 운동을 허용하는 형태로 디자인되고, 이차 인상 과정을 거쳐 제작되었다. 각 치료 과정을 계획한대로 진행하여 환자와 술자 모두 심미적, 기능적으로 만족스러운 결과를 얻었기에 이를 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.41.1-41.6
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• 2016

Background: The goal of this study was to retrospectively evaluate the prognosis of minimal invasive horizontal ridge augmentation (MIHRA) technique using small incision and subperiosteal tunneling technique. Methods: This study targeted 25 partially edentulous patients (10 males and 15 females, mean age $48.8{\pm19.7years$) who needed bone graft for installation of the implants due to alveolar bone deficiency. The patients took the radiographic exam, panoramic and periapical view at first visit, and had implant fixture installation surgery. All patients received immediate or delayed implant surgery with bone graft using U-shaped incision and tunneling technique. After an average of 2.8 months, the prosthesis was connected and functioned. The clinical prognosis was recorded by observation of the peri-implant tissue at every visit. A year after restoration, the crestal bone loss around the implant was measured by taking the follow-up radiographs. One patient took 3D-CT before bone graft, after bone graft, and 2 years after restoration to compare and analyze change of alveolar bone width. Results: This study included 25 patients and 39 implants. Thirty eight implants (97.4 %) survived. As for postoperative complications, five patients showed minor infection symptoms, like swelling and tenderness after bone graft. The other one had buccal fenestration, and secondary bone graft was done by the same technique. No complications related with bone graft were found except in these patients. The mean crestal bone loss around the implants was 0.03 mm 1 year after restoration, and this was an adequate clinical prognosis. A patient took 3D-CT after bone graft, and the width of alveolar bone increased 4.32 mm added to 4.6 mm of former alveolar bone width. Two years after bone graft, the width of alveolar bone was 8.13 mm, and this suggested that the resorption rate of bone graft material was 18.29 % during 2 years. Conclusions: The bone graft material retained within a pouch formed using U-shaped incision and tunneling technique resulted with a few complications, and the prognosis of the implants placed above the alveolar bone was adequate.

• 구강회복응용과학지
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• 제23권2호
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• pp.145-155
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• 2007

The advent of osseointegration and advances in biomaterials and techniques have contributed to increased application of dental implants in the restoration of maxillary partial edentulous patients. Often, in these patients, soft and hard tissue defects result from a variety of causes, such as infection, trauma, and tooth loss. These create an anatomically less favorable foundation for ideal implant placement. Reconstruction of the atrophic maxillary alveolar bone through a variety of regenerative surgical procedures has become predictable; it may be necessary prior to implant placement or simultaneously at the time of implant surgery to provide a restoration with a good long-term prognosis. Regenerative procedures are used for horizontal and vertical ridge augmentation. Many different techniques exist for effective bone augmentation. The approach is largely dependent on the extent of the defect and specific procedures to be performed for the implant reconstruction. It is most appropriate to use an evidenced-based approach when a treatment plan is being developed for bone augmentation cases. The cases presented in this article clinically demonstrate the efficacy of using a autogenous block graft, guided bone regeneration, ridge split, immediated implant placement technique on the atrophic maxillary area.

• 대한치과의사협회지
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• 제57권12호
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• pp.758-767
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• 2019

The classification of periodontal disease in 1999 has been widely used for determining a diagnosis, establishing a treatment plan, and evaluating the prognosis of the patient with periodontal disease. However, scientific evidence from many studies indicates the need for a new classification system for periodontal and peri-implant disease. Summary at 2017 world workshop as follows: 1) Periodontal health and peri-implant health was defined; 2) Chronic periodontitis and aggressive periodontitis were unified as periodontitis; 3) Periodontitis was further classified by staging and grading to reflect disease severity and management complexity, rate of disease progression, respectively; 4) Periodontal disease as manifestation of systemic disease is based on the International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) code; 5) Periodontal biotype and biologic width was replaced to periodontal phenotype and supracrestal tissue attachment, respectively; 6) The excessive occlusal force was replaced by a traumatic occlusal force; 7) ≥3 mm of radiographic bone loss, ≥6 mm of pocket probing depth and bleeding on probing indicates peri-implantitis in the absence of radiograph at final prosthesis delivery.

• The Journal of Advanced Prosthodontics
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• 제10권2호
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• pp.85-92
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• 2018

PURPOSE. This research evaluated clinical outcomes of two types of hydroxyapatite (HA)-coated implants: OT (Osstem TS III-HA, Osstem implant Co., Busan, Korea) and ZM (Zimmer TSV-HA, Zimmer dental, Carlsbad, USA). MATERIALS AND METHODS. The research was conducted on 303 implants (89 of OT, 214 of ZM), which were placed from January 16, 2010 to December 20, 2012. The prognosis was evaluated in terms of success rates, survival rates, annual marginal bone loss, and implant stability quotients (ISQ). The samples were classified into immediate, early, conventional, and delayed groups according to the loading time. RESULTS. Overall, there were no significant differences between OT and ZM in success rates, survival rates, and annual marginal bone loss, except for the result of secondary stability. OT showed $77.83{\pm}8.23ISQ$, which was marginally higher than $76.09{\pm}6.90ISQ$ of ZM (P<.05). In terms of healing periods, only immediate loading showed statistically significant differences (P<.05). Differences between OT and ZM were observed in terms of two indices, the annual marginal bone loss ($0.17{\pm}0.58mm/year$ < $0.45{\pm}0.80mm/year$) and secondary stability ($84.36{\pm}3.80ISQ$ > $82.48{\pm}3.69ISQ$) (P<.05). OT and ZM did not have any statistically significant differences in early, conventional, and delayed loading (P>.05). CONCLUSION. OT (97.75%) and ZM (98.50%) showed relatively good outcomes in terms of survival rates. In general, OT and ZM did not show statistically significant differences in most indices (P>.05), although OT performed marginally better than ZM in the immediate loading and 1-stage surgery (P<.05).

• The Journal of Advanced Prosthodontics
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• 제8권5호
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• pp.396-403
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• 2016

PURPOSE. Early loading of implant can be determined by excellent primary stability and characteristic of implant surface. The implant system with recently improved surface can have load application 4-6 weeks after installing in maxilla and mandible. This study evaluated the effect of healing period to the stability of hydrophilic tapered-type implant at maxillary posterior area. MATERIALS AND METHODS. This study included 30 patients treated by hydrophilic tapered-type implants (total 41 implants at maxilla) and classified by two groups depending on healing period. Group 1 (11 patients, 15 implants) was a control group and the healing period was 12 weeks, and Group 2 (19 patients, 26 implants) was test group and the healing period was 6 weeks. Immediately after implant placement, at the first impression taking, implant stability was measured using Osstell Mentor. The patients also took periapical radiographs after restoration delivery, 12 months after restoration and final followup period. The marginal bone loss around the implants was measured using the periapical radiographs. RESULTS. All implants were survived and success rate was 97.56%. The marginal bone loss was less than 1mm after 1 year postoperatively except the one implant. The stabilities of the implants were not correlated with age, healing period until loading, insertion torque (IT), the diameter of fixture and the location of implant. Only the quality of bone in group 2 (6 week) was correlated with the stability of implant. CONCLUSION. Healing period of 6 weeks can make the similar clinical prognosis of implants to that of healing period of 12 weeks if bone quality is carefully considered in case of early loading.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.428-436
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• 2008

For Longevity of implant, considerations of biomechanical and microbiological aspects must be done. Recently, due to the remarkable development of bone grafting procedure. Implant has been implanted into the more favorable sites but peri-implantitis resulted from periodontal bacteria may obscure the long-term prognosis. Although many different modalities have been introduced to treat the failed implant. Implant's surface and irreversible bony destruction around the implant prevents good result. After Er,Cr:YSGG (waterlase) laser using the wave-length of 2780nm has been introduced to dental field, good results have been reported. Because waterlase uses the hydrokinetic force of water. It is excellent device to detoxify the implant surface mechanically without the heat generation and damage to the implant surface. We designed to evaluate waterlase effect on the peri-implantitis has been occurred after implantation. Four beagle dogs were involved. We have made four premolar extraction in each right and left side of the lower jaw and placed two implants in the anterior of the jaw as a control and six implant were placed posterior in each socket after extraction immediately as an experimental group. We tied floss-silk in each implant to make peri-implantitis intentionally. After three months, we explored peri-implant sites on each experimental fixtures. Using waterlase laser irradiation was performed on that implantitis sites under 3W, air 30% and water 20% intensity for 2 minutes. In control group, we repositioned the flap to cover the exposed fixture without any supportive care. Three months later, we sacrificed experimental animals and extracted and preparated bone blocks with Donath and Breuner (982), Donath (988)'s methods and examined under microscope. We have obtained good re-osseointegration around fixtures after treating with waterlaser irradiation. But it was shown fibroosseointegration in the control group.