• 구강회복응용과학지
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• 제39권4호
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• pp.260-266
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• 2023

'Implant Supracrestal Complex (ISC)'의 개념은 임플란트 보철물의 디자인 형태가 단기 임상 결과와 임플란트 주변 경·연조직의 장기 예후에 미치는 영향을 확인하는 방법으로 도입되었다. 임플란트-지대주 디자인과 접합부(junction) 및 위치와 같은 임플란트-보철물-지대주 복합 디자인 형태는 임플란트 주변 조직의 장기적인 유지에 중요한 영향을 미칠 수 있다. 본 증례에서는 임플란트 보철물 수복 후 만성적인 연조직 염증이 발생한 환자에게 오목한 맞춤형 지대주와 출현각이 30도를 이루는 보철물을 수복하였다. 새로운 보철물은 충분한 경·연조직 공간을 확보하고 적절한 연조직 폐쇄를 이룸에 따라 합병증이 개선되고 임플란트의 장기적인 안정성을 유지하는 것을 확인하였다.

• Imaging Science in Dentistry
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• 제46권3호
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• pp.173-178
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• 2016

Purpose: Optical coherence tomography (OCT) has been investigated as a novel diagnostic imaging tool. The utilisation of this equipment has been evaluated through several studies in the field of dentistry. The aim of this preliminary study was to determine through basic experiments the effectiveness of OCT in implant dentistry. Materials and Methods: To assess detection ability, we captured OCT images of implants in each of the following situations: (1) implants covered with mucosae of various thicknesses that were harvested from the mandibles of pigs; (2) implants installed in the mandibles of pigs; and (3) implants with abutments and crowns fixed with temporary cement. The OCT images were captured before cementation, after cementation, and after removing the excess submucosal cement. Results: If the thickness of the mucosa covering the implant body was less than 1 mm, the images of the implants were clearly detected by OCT. In the implants were installed in pigs' mandibles, it was difficult to capture clear images of the implant and alveolar bone in most of the samples. Remnants of excess cement around the implants were visible in most samples that had a mucosa thickness of less than 3 mm. Conclusion: Currently, OCT imaging of implants is limited. Cement remnants at the submucosal area can be detected in some cases, which can be helpful in preventing peri-implant diseases. Still, though there are some restrictions to its application, OCT could have potential as an effective diagnostic instrument in the field of implant dentistry as well.

• Journal of Periodontal and Implant Science
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• 제45권6호
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• pp.229-237
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• 2015

Purpose: The aim of this study was to determine the clinical feasibility of using dehydrothermally cross-linked collagen membrane (DCM) for bone regeneration around peri-implant dehiscence defects, and compare it with non-cross-linked native collagen membrane (NCM). Methods: Dehiscence defects were investigated in twenty-eight patients. Defect width and height were measured by periodontal probe immediately following implant placement (baseline) and 16 weeks afterward. Membrane manipulation and maintenance were clinically assessed by means of the visual analogue scale score at baseline. Changes in horizontal thickness at 1 mm, 2 mm, and 3 mm below the top of the implant platform and the average bone density were assessed by cone-beam computed tomography at 16 weeks. Degradation of membrane was histologically observed in the soft tissue around the implant prior to re-entry surgery. Results: Five defect sites (two sites in the NCM group and three sites in the DCM group) showed soft-tissue dehiscence defects and membrane exposure during the early healing period, but there were no symptoms or signs of severe complications during the experimental postoperative period. Significant clinical and radiological improvements were found in all parameters with both types of collagen membrane. Partially resorbed membrane leaflets were only observed histologically in the DCM group. Conclusions: These findings suggest that, compared with NCM, DCM has a similar clinical expediency and possesses more stable maintenance properties. Therefore, it could be used effectively in guided bone regeneration around dehiscence-type defects.

• 구강회복응용과학지
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• 제37권4호
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• pp.186-198
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• 2021

임플란트 치료에 대한 기능적 성공률이 높아짐에 따라 심미성에 대한 새로운 성공 기준이 제시되고 있다. 이에 따라 치과의사 및 환자가 가지는 심미적 기준도 높아졌으며, 임플란트 심미 수복 결과에 대한 만족도 또한 높아지고 있다. 임플란트 식립하기 전 치료계획 수립 과정, 임플란트 수술 과정, 수술 후 보철수복 과정이 모두 심미적 결과에 영향을 미칠 수 있으며, 임플란트의 심미적 실패를 예방하기 위해서는 치조골, 연조직, 그리고 임플란트의 세 가지 요소를 고려하여 각 단계마다 적절한 처치를 통해 이루어질 수 있다. 성공적인 전치부 임플란트의 연조직 심미를 얻기 위해서는 외상과 자극을 최소화하는 수술, 골이식을 통한 골조직 증강, 임플란트 식립 시 임플란트의 3차원적 위치, 필요한 경우 연조직 이식술의 시행, 임시보철물의 충분한 경과관찰과 적절한 수정을 고려해야 한다.

• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.561-573
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• 1997

The keratinized mucosa around the implant is an important key in health of soft tissue and hard tissue. The purpose of this study is showed that the keratinized mucosa is associated with the keratinized mucosa index, plaque index, gingival index, probing depth. which is investigated to observing the peri-implant mucosa of mandibular partial edentulous patuent using periodontal parameter by previously published paper. It was estimated 6 site with regard to 80 fixture for 28 person, and the average age is 46.8. Each estimation is the order of less trauma, that is, plaque index, keratinized mucosa index, gingival index and probing depth. In this study, statstically analyzed treatment is used for Spss V 7.0 for Windows(Spss Inc, USA). The Kruskal Walis Test is used to compare the amount of the keratinized mucosa is into the $0{\sim}3$ index, with plaque index, gingival index and probing depth. Mann-whitney Test is used to interpreate the relation of plaque index and probing depth, which is showed significant difference. The Result are as follows 1. The kertinized mucosa index 3 amounts to 47.7%, which is much higher than the other indices and the index order is followed 3, 1, 2 and O. 2. The plaque index 1 amounts to 61.7%, which is much higher than the other indices and the index order is followed 1, 2, 3 and O. The plaque index 0 is significant to each of index(P<0.05). The plaque index is decrease as the keratinized mucosa index is increased. 3. The probing depth for 2mm, 1mm, 3mm is 48.9%, 23.5%, 16.8% respectively, which is most occupied. The probing depth 2mm and 3mm for the keratinized mucosa index is significant(P<0.05). The probing index is decreased as the keratinized mucosa index is increased. 4. The gingival index 0 amounts to 58.0%, which is much higher than the other indices and the index order is followed 0, 1, 2 and 3.

• 대한치과보철학회지
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• 제34권3호
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• pp.489-500
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• 1996

Pulsed Nd : YAG LASER has been applied to various fields in clinical dentistry including the treatment of peri-implantitis. However, LASER can affect properties of matter of dental implants which are important to maintaining the health of peri-implant tissue and can raise its temperature during lasing. So there have been warings of using LASER to treat peri-implantitis. But, the effects of laser on dental implants itself are not certain yet. So we measured the temperature rising, examined matter of properties by SEM and EDX before and after pulsed Nd : YAG lasing various intensity. 7 TPS implants and 7 HPS implants were used and pulsed Nd : YAG LASER was used in 0.3W, 1.0W, and 2.0W. 1. 2.0W LASER made polished neck portion of HPS implants reach $39.2^{\circ}C$ after 5 seconds lasing. 2. LASER made crater-like defects on plasma sprayed surface and surfaces were melted and divided by fragments after lasing. 3. There was no specific evidence of element change after lasing.

• 구강회복응용과학지
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• 제31권2호
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• pp.126-133
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• 2015

염증에 의해 파괴된 치주조직은 외과적 방법만으로 조직의 완전한 재생과 심미수복을 이루는 것이 어렵다. 특히, 임플란트와 관련된 문제라면 심미성의 향상을 얻기가 더욱 어렵다. 23세 여자 환자가 비심미적인 전치부 임플란트 보철물을 개선하고자 내원하였다. 개인 치과의원에서 수차례 치조골 이식술과 연조직 이식술을 받았으나 실패한 상태였다. 염증을 제거하고 심미성을 향상시키기 위해 유리치은이식술 시행 후 골유도재생술과 혈관개재 골막결합조직 이식술(vascularized interpositional periosteal connective tissue graft)을 이용한 치조제증대술을 시행하였다. 심미적 보철물 제작을 위해 임플란트 지지형 보철물 대신 인접 자연치를 이용한 전통적인 고정성 보철물을 선택하였다. 상악 전치부 치열에서 비심미적인 임플란트 보철물을 외과적 그리고 보철적 접근을 통한 다각적 방법을 병용함으로써 더 우수한 심미성을 회복한 증례를 소개하고자 한다.

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.687-702
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• 2005

The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied $Gore-Tex^{(R)}$ to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively(0.05). 4. The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

• Journal of Periodontal and Implant Science
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• 제34권1호
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• pp.71-81
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• 2004

Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.

• Archives of Plastic Surgery
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• 제45권3호
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• pp.280-283
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• 2018

Knee revision arthroplasty following peri-prosthetic joint infections is a formidable challenge. Patients are at a high risk of recurrent infection, and the soft tissue over the revised implant is often of questionable quality. Flap reconstruction has improved the salvage rates of infected arthroplasties, and should be considered in all cases of revision arthroplasty. We present a challenging case requiring staged reconstruction with two free latissimus dorsi flaps after the initial use of a medial gastrocnemius flap.