• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.339-347
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• 1996

Prior to the advent of microvascular surgery, conventional prosthetic rehabilitation offered limited success to re-establish the physiological function in oromaxillofacial reconstruction. Microvascular surgery provided a new frontier and there are multitude of flaps. Each flap has the benefits and limitation for the application to various defects. Advantage of the scapular flaps over other reconstructive methods include the ability to design multiple cutaneous panels on a separate vascular pedicle allowing improvement in three-dimensional relationship and osseointegrated implants can be palced to restore occlusal and masticatory function. Here I present the detailed description of the important surgical anatomy as well as graft dissection and clinical application of free vascularized scapular flap.

• Journal of Periodontal and Implant Science
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• v.40 no.3
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• pp.144-149
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• 2010

Purpose: The aim of this case report is to present the successful clinical treatment of two cases of postoperative infection following maxillary sinus augmentation. Methods: In the two cases of postoperative infection, immediate total removal of the grafted material from the sinus was conducted to stop the spread of the infection, after which a high dose of antibiotics was administrated. Re-augmentation procedures were then conducted after the infection subsided. Results: No further complications occurred after sinus re-augmentation. The dental implants placed in the re-augmented sinus were clinically osseointegrated, and the implant-supported restorations in the two cases of postoperative infection have been functioning very well for over 2 years. Conclusions: In the case of infection of the grafted sinuses, it is necessary to completely remove the graft materials and then administer a high dose of antibiotics to treat the acute infection, after which sinus re-augmentation is suggested.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.1
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• pp.57-70
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• 2004

The significance of occlusion has regained its popularity in dentistry with the introduction of implant therapy. Literature has reported that the clinical success and longevity of dental implants can be achieved by biomechanically controlled occlusion. Occlusal overload is known to be one of the main causes for implant failure. Evidences have suggested that occlusal overload contribute to early implant bone loss as well as deosseointegration of successfully integrated implants. Unlike natural teeth, osseointegrated implants are ankylosed to surrounding bone without the periodontal ligament (PDL) which provides mechanoreceptors as well as shock-absorbing function. Moreover, the crestal bone around dental implants may act as a fulcrum point for lever action when a force (bending moment) is applied, indicating that implants/implant prosthesis could be more susceptible to crestal bone loss by applying force. Hence, it is essential for clinicians to understand inherent differences between teeth and implants and how force, either normal or excessive force, may influence on implants under occlusal loading. The purposes of this paper are to review the importance of implant occlusion, to establish the optimum implant occlusion with biomechanical rationale, to provide clinical guidelines of implant occlusion and to discuss how to manage complications related to implant occlusion.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.341-348
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• 2006

Accurate fit of the implant prosthesis is important in ensuring long term success of osseointegrated implant. Inaccurate fit of the implant prosthesis may give rise to complications and mechanical failure. To evaluate fite of the implant prosthesis, the development of the methods of analyzing the degree of misfit is important in clinical practice. To analyze the degree of the misfit of implant prosthesis, modal testing was used. A 2-dimensional finite element modal testing was accomplished. Four 2-dimensional finite element models with various levels of misfit of implant prostheses were constructed. Thickness gauges were simulated to make misfit in the implant prostheses. With eigenvalue analysis, the natural frequencies of the models were found in the frequency domain representation of vibration. According to the difference of degree of misfit, natural frequencies of the models were changed.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.3-9
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• 2016

The reconstruction of the mandible is a complex procedure because various cosmetic as well as functional challenges must be addressed, including mastication and oral competence. Many surgical techniques have been described to address these challenges, including non-vascularized bone grafts, vascularized bone grafts, and approaches related to tissue engineering. This review summarizes different modifications of the free vascularized fibula graft, which, since its introduction by Hidalgo in 1989, has become the first option for mandibular reconstruction. The fibula free flap can undergo various modifications according to the individual requirements of a particular reconstruction. Osteocutaneous flaps can be harvested for reconstruction of composite defects. 'Double-barreling' of the fibula can, for instance, enable enhanced aesthetic and functional results, as well as immediate one-stage osseointegrated dental implantation. Recently described preoperative virtual surgery planning to facilitate neomandible remodeling could guarantee good results. To conclude, the free fibula bone graft can currently be regarded as the "gold standard" for mandibular reconstruction in case of composite (inside and outside) oral cavity defects as well as a way of enabling the performance of one-stage dental implantation.

• The Journal of Advanced Prosthodontics
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• v.7 no.1
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• pp.62-68
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• 2015

PURPOSE. The purpose of this research was to evaluate the amount of reosseointegration after counter torquing (reverse torque) and transposing the installed implants at different times. MATERIALS AND METHODS. This study was done on ten tibiae of five cross-bred dogs. At the first day one implant was installed in each tibia. After one week half of the implants were randomly counter torqued (1WCT) and the other half were explanted and reimplanted in a new juxtaposition site (transposed)(1WT). At the same time three new implants were installed in each dog, one of them was considered as one week control (1WC) and remaining two as 8 week groups (8WCT&8WT). After eight weeks the 1WCT and 1WT implants were loosened by counter torque and the quantity of needed force for liberation was measured with the digital device (BGI). At the same time one implant was installed in each dog as eight week control (8WC) and the same protocol was repeated for 8 week groups after another 8 weeks. RESULTS. All implants were osseointegrated. Mean quantities of osseointegration in case groups indicated better amounts rather than control groups. CONCLUSION. Counter torque or transposition of the installed implants one week or eight weeks after the implantation did lead to osseointegration.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.1
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• pp.43-48
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• 2003

During the past several years, significant advances have occurred in the utilization of osseointegrated implants for the treatment of partially edentulous patients. One of the biggest purposes for treating of these patients is the high demand for improved esthetics, especially in the anterior region. For this esthetics, the new trend in dental implants is the immediate placement and immediate superstructure fabrication. The refined surgical technique, the skillful soft tissue management, and the proper prosthetic coordination are the main factors to achieve natural looking of implant supported prosthesis. The customized provisional restoration and the customized impression coping are recommended for the optimal peri-implant soft tissue contour. The basic concept of Frialit 2 system was the immediate replacement of a tooth with root-analog fixture after extraction. This system guarantees an ideal result in function and esthetics. The ceramic abutment system offers improved quality in the respect of esthetics, fitness, translucency, and biocompatibility. In this clinical report, the final restoration made with IPS Empress 2 crown on the CeraBase abutmen of Frialit 2 system allowed the reproduction of the natural vitality of tooth and adjacent gingiva.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.125-137
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• 2003

The use of screw-retaind prosthesis on an osseointegrated implant is a popular treatment modality offering relative ease in the removal of the restoration. One of the complications associated with this modality is the loosening of the abutment and coping screws. Loosening of the screws results in patient dissatisfaction, frustration to the dentist and, if left untreated, component fracture. There are several factors which contribute to the loosening of implant components which can be controlled by the restorative dentist and lab technician. This article offers pratical solutions to minimize this clinical problem and describes the factors involved in maintaining a stable screw joint assembly. To avoid joint failure, adherence to specific clinical, as well as mechanical, parameters is critical. With respect to hardware, optimal tolerance and fit, minimal rotational play, best physical properties, a predictable interface, and optimal torque application are mandatory. In the clinical arena, optimal implant distribution; load in line with implant axis; optimal number, diameter, and length of implants; elimination of cantilevers; optimal prosthesis fit; and occlusal load control are equally important.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.11-14
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• 2011

Individuals with cognitive disabilities face many barriers to oral care, often suffering from partial or complete edentulism. While the use of implant reconstruction is becoming more common in general population, such care is still being used infrequently in individuals with intellectual impairment. Because of the patients'oral hygiene practice is poor, special need is required for prosthetic design. These two cases were restored by prostheses using implants. Prosthetic modalities were different but the implants were fully osseointegrated, presenting satisfactory functional and esthetic conditions without clinical or radiographic signs of alterations or pathologies. We report that it is good for cognitive disabilities to give prosthetic treatment using implants.

• The Journal of the Korean dental association
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• v.38 no.6 s.373
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• pp.558-566
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• 2000

Osseointegrated dental implants have now become and accepted form of treatment for patients with a fully or partially missing dentition. The purpose of this study was to evaluate the performance of AVANA implant-Korea. A total of 323 AVANA implants were placed at 9 centers in the edentulous and partially edentulous jaws of 88 consecutive patients ranging in age form 18 to 79 years. So we get the clinical results. 1. Both patients (94.4%) & doctors (94%) were satisfied with the results, in patient's aspect 'most satisfaction' case were more common(52%) 2. The length of fixture which was frequently used was 13mm (168/319,44.5%) followed by 15mm and 10mm, and 3.75mm width implant (239/319,74.9%) was the most popularly used. 3. Mandibutar posterior was the most common installation site (140/317.43%) 4. A mean implant survival rate was 96.2%. That showed little difference which reported other paper. Cause of failure consisted of inflammation $ infection-36%, fall of osseointegration-18%, paln during masticatory function-9%. improper prosthetic function $ procedure-9%. 5. The most popularly used types of abutment was the UCLA abutment(168/305,55.5%)