• Title/Summary/Keyword: Posterior bone loss

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Periimplant bone change after alveolar ridge preservation: radiographic retrospective study (발치와 치조제 보존술 후 식립한 임플란트 주위 골 변화: 후향적 방사선학적 분석)

  • Shim, Da-Eun;Pang, Eun-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.281-290
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    • 2021
  • Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

A 10-year follow-up study on clinical outcomes of dental implant rehabilitation using surgical guide

  • Haoyun Li;Mi Young Eo;Kezia Rachellea Mustakim;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.2
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    • pp.70-79
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    • 2024
  • Objectives: The surgical guide is a static computer-assisted device used for implant surgery planning and guidance. By taking an impression and referring to the patients' three-dimensional computed tomography scan of the desired implant site, a surgical guide can be created. During surgery, the surgical guide aids in achieving the designed implant placement position and direction. We examined and evaluated the long-term clinical outcomes of implant surgery using surgical guides. Materials and Methods: This study investigated a total of 15 patients with 32 implants that were placed using surgical guides from 2009 to 2011 with a mean follow-up period extended beyond 10 years. Patient demographics and implant survival rates were recorded. We analyzed marginal bone loss (MBL) by assessing the radiographs acquired at installation, three months after installation, and one month, one, two, and five years after prosthesis delivery. Results: The mean patient age was 57.33 years at implant placement. Of the 32 implants, five implants were placed in the anterior region and 27 implants were in the posterior region. Six implants failed and three of them were replaced, resulting in an 81.25% survival rate. The mean follow-up period was 10 years and nine months. Mean MBL compared to post-installation was significantly higher than at three months after installation, and one month, one, two, and five years after prosthesis delivery. Mean MBL at three months after installation, and one month, one year, and two years were significantly higher compared to the previous visit (P<0.05). However, MBL at five years after prosthesis delivery did not differ significantly compared to at two years. Conclusion: In this study, implant rehabilitation assisted by surgical guides exhibited favorable survival rates. With the limitation of the sample amount in this study, further research and more samples are required to evaluate the long-term clinical effectiveness of surgical guides.

Is It Appropriate to Insert Pedicle Screws at an Infected Vertebral Body in the Treatment of Lumbar Pyogenic Spondylodiscitis? (요추부 화농성 척추염의 수술적 치료: 이환된 추체에 척추경 나사 고정이 타당한가?)

  • Na, Hwa-Yeop;Jung, Yu-Hun;Lee, Joo-Young;Kim, Hyung-Do
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.419-426
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    • 2021
  • Purpose: In the surgical treatment of pyogenic lumbar spondylodiscitis, screw insertion at the affected vertebra has been avoided because of biofilm formation, and the risk of infection recurrence. The authors analyzed the success rate of infection treatment while minimizing the number of instrumented segments by inserting pedicle screws into the affected vertebrae. Therefore, this study examined the usefulness of this technique. Materials and Methods: From January 2000 to June 2018, among patients with pyogenic lumbar spondylodiscitis treated surgically, group A consisted of patients with pedicle screws inserted directly at the affected vertebrae (28 cases), and group B underwent fusion by inserting screws at the adjacent normal vertebrae due to bone destruction of the affected vertebral pedicle (20 cases). The classified clinical results were analyzed retrospectively. All patients were treated via the posterior-only approach, so the affected disc and sequestrum were removed. Posterior interbody fusion was performed with an autogenous strut bone graft, and the segments were then stabilized with pedicle screw systems. The hospitalization period, operation time, amount of blood loss, EQ-5D index, duration of intravenous antibiotics, and the clinical and radiological results were analyzed. Results: In group A, the number of instrumented segments, operation time, blood loss, and EQ-5D index at one month postoperatively showed significant improvement compared to group B. There were no significant differences in the duration of antibiotic use, hospitalization, radiological bone union time, sagittal angle correction rate, and recurrence rate. Conclusion: Minimal segmental fixation, in which pedicle screws were inserted directly into the affected vertebrae through the posterior approach, reduced the surgery time and blood loss, preserved the lumbar motion by minimizing fixed segments and showed rapid recovery without spreading or recurrence of infection. Therefore, this procedure recommended for the surgical treatment of lumbar pyogenic spondyodiscitis.

The Efficacy of Titanium Mesh Cage in Tuberculous Spondylitis Treated with Anterior Intervertebral Fusion (척추 결핵의 전방유합술시 Titanium Mesh Cage의 효과)

  • Jeong, Ju-Ho;Lee, Sang-Gu;Yoo, Chan-Jong;Han, Ki-Soo;Kim, Woo-Kyung;Kim, Young-Bo;Park, Cheol-Wan;Lee, Uhn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.998-1003
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    • 2001
  • Objective : The maintenance of the correction of kyphotic deformity is one of the difficult problem in tuberculous spondylitis after anterior debriment and fusion with tricortical bone graft. The goal of this study is to find out the efficacy of titanium mesh cage impacted with autogenous bone chip in tuberculous spondylitis treated with anterior intervertebral fusion. Materials and Method : Twelve patients were treated with anterior intervertebral fusion using titanium mesh cage for tuberculous spondylitis from January 1996 to June 1999. We analized the changes in the correction of kyphotic deformity, changes of ESR and CRP, fusion state and recurrence after anterior intervertebral fusion with titanium mesh cage. Results : Clinical symptoms were improved in all twelve patients without any neurologic complications. The mean kyphotic angle corrected was 7.3 degrees immediately after operation, but the loss of correction of kyphotic angle was 2.2 degrees after 3 months and 2.6 degrees after 6 months. We found that the loss of correction of kyphotic deformity occurred mainly within the first 3 months after surgery. Only one patient, suffered from acute hepatic failure after first operation and had an insufficient anti-tuberculous medication therapy, showed recurrence of tuberculous spondylitis after 6 months. The patient underwent a second operation with posterior fixation procedure with good outcome. The changes of ESR and CRP were not specifically important factor to reveal recurrence of tuberculosis of the spine in our series. Conclusion : The surgical procedure of tuberculous spondylitis using titanium mesh cage with bone chip seems to be an effective procedure to minimize loss of the correction of kyphotic deformity without any aggravating inflammatory change and recurrence with titanium mesh cage, when sufficient debridement and anti-tuberculous chemotherapy are achieved.

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Three dimensional finite element analysis of the stress distribution around the mandibular posterior implant during non-working movement according to the amount of cantilever

  • Park, Ji-Man;Kim, Hyun-Joo;Park, Eun-Jin;Kim, Myung-Rae;Kim, Sun-Jong
    • The Journal of Advanced Prosthodontics
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    • v.6 no.5
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    • pp.361-371
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    • 2014
  • PURPOSE. In case of large horizontal discrepancy of alveolar ridge due to severe resorption, cantilevered crown is usually an unavoidable treatment modality. The purpose of this study was to evaluate the clinical criteria for the placement of the aforementioned implant crown. MATERIALS AND METHODS. The mandible model with 2 mm thick cortical bone and cancellous bone was fabricated from CT cross-section image. An external connection type implant was installed and cantilevered crowns with increasing offset of 3, 4, 5, 6, and 7 mm were connected. Vertical load and $30^{\circ}$ oblique load of 300 N was applied and stress around bone and implant component was analyzed. A total of 14 cases were modeled and finite element analysis was performed using COSMOS Works (Solid works Inc, USA). RESULTS. As for the location of the vertical load, the maximum stress generated on the lingual side of the implant became larger according to the increase of offset distance. When the oblique load was applied at $30^{\circ}$, the maximum stress was generated on the buccal side and its magnitude gradually decreased as the distance of the offset load increased to 5 mm. After that point, the magnitude of implant component's stress increased gradually. CONCLUSION. The results of this study suggest that for the patient with atrophied alveolar ridge following the loss of molar teeth, von-Mises stress on implant components was the lowest under the $30^{\circ}$ oblique load at the 5 mm offset point. Further studies for the various crown height and numbers of occusal points are needed to generalize the conclusion of present study.

Use of corticotomy for canine and molar retraction (피질골 절제술을 응용한 견치 및 대구치의 후방 견인)

  • Kim, Sang-Cheol;Kim, Sun-Young;Kim, Hyun-Sook;Jung, Hye-Seung;Kim, Hyun-Tae;Jo, Jin-Woo
    • The korean journal of orthodontics
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    • v.35 no.2 s.109
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    • pp.153-161
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    • 2005
  • Tooth movement facilitated by corticotomy and distraction osteoseresis was discussed. In this study, a portion of cortical bone which can provide resistance to tooth movement in alveolar bone was removed Active bone deposition was thor Possible in the tension side. Teeth moved at such a speedy rate as we could not imagine from conventional orthodontic treatment. which lead to the reduction of the total treatment Period Posterior movement of the canine or molar teeth was possible without any side effects such as anchorage loss, root resorption or Periodontal breakdown.

Implant overdenture of mandible with severe unilateral atrophy: Report of two cases (심한 편측 하악 치조골 흡수를 보이는 환자에서의 임플란트 피개의치 수복 증례)

  • Kim, So-Yeun;Kwon, Eun-Young;Jung, Kyoung-Hwa;Jeon, Hye-Mi;Baek, Young-Jae;Yun, Mi-Jung;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.271-279
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    • 2019
  • There are several unfavorable conditions regarding alveolar bone condition that may compromise the denture patient's satisfaction. Chewing efficiency may not be satisfactory when alveolar bone is deficient, and the denture stability could hardly be achieved when alveolar bone shape is irregular. Implant overdenture can be useful to provide satisfactory denture experience compared to conventional denture. The attachment for implant overdenture can be classified into bar attachment and solitary attachment. When the positions of the implants are in the mandibular anterior region, bar attachment may be favorable to obtain a rigid support of the entire denture. When implants are distributed both on anterior and posterior region, a solitary attachment could be considered for ease of removal and maintenance. This report presents implant overdenture cases with the patients that had unilateral mandibular alveolar bone atrophy conditions. Different abutments were chosen based on the individual patient's mandibular alveolar bone condition and the treatments were successful in terms of patient satisfaction.

Influence of crown-to-implant ratio of short vs long implants on implant stability and marginal bone loss in the mandibular single molar implant (하악 구치 단일임플란트 수복에서 임플란트 길이에 따른 치관-임플란트 비율이 임플란트안정성 및 변연골소실에 주는 영향)

  • Baek, Yeon-Wha;Kim, Bongju;Kim, Myung-Joo;Kwon, Ho-Beom;Lim, Young-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.280-289
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    • 2018
  • Purpose: The purpose of this randomized clinical trial is to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and peri-implant marginal bone loss (MBL). Materials and Methods: 46 patients with single tooth missing in the posterior molar region of the mandible were included in this study. 19 implants (CMI IS-III $active^{(R)}$ long implant) of 5.0 mm diameter and 10 mm length were installed for the control group, while 27 implants (CMI IS-III $active^{(R)}$ short implant) of 5.5 mm diameter and 6.6, 7.3 or 8.5 mm length were placed for the experimental group. Each implant was inserted and immediately loaded using the digitally pre-fabricated surgical template and provisional restoration. The CAD-CAM monolithic zirconia crown was fabricated at 3 months after the surgery as a definitive restoration. The ISQ value and the MBL was measured at 48 weeks after the surgery. The correlation between the C/I ratio, MBL, and secondary implant stability was analyzed. Results: Successful results in terms of ISQ and MBL were achieved with both groups. There was no significant difference between the groups in terms of ISQ values and MBL at 48 weeks after the surgery (P > 0.05). No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the MBL (P > 0.05). Conclusion: The influence of C/I ratio in both groups was not shown on the stability nor the marginal bone loss in implants supporting single crown of the mandible. Short implant could be a preferable alternative option in the reduced bone height mandible under the limited condition despite its higher C/I ratio.

AN EXPERIMENTAL STUDY OF PERIODONTAL INJURY HEALING IN STREPTOZOTOCIN INDUCED DIABETIC RAT (Streptozotocin유도 당뇨백서에서 치주조직 손상의 치유에 관한 실험적 연구)

  • Kim, Seung-Jae;Chang, Whan-Shik
    • The Journal of the Korean dental association
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    • v.22 no.9 s.184
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    • pp.771-780
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    • 1984
  • To observe the healing process of the gingival wound in diabetic condition, the author induced diabetes mellitus by intravascular injection of streptozotocin in rat tail vein and made fresh wound in rat mandibular posterior gingiva using scalpel. The healing processes of gingival wound were examined periodically by light microscopy. The results were as follows. 1) The healing was completed at second week in control group, but it delayed until fourth week in experimental group and the organization was persisted for first two weeks. 2) The inflamed gingiva of dibetic rat demonstrated scanty polymorphonuclear lerkocytic infiltration at the early stage of experiment, but it soon became numerous as in cotrol group and the lymphocytic infiltrations were same degree as in control group. 3) The tissue destruction was broader in the experimental group than in the control group. The epithelization was began at the early stage of healing and the epithelial attachment was reformed with the completion of the wound healing. 4) Loss of Sharpey's fibers and destruction of cementum and alveolar bone were observed with the inflammatroy reaction, but these were reformed with the completion of the wound healing.

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AN ANALYSIS AND MANAGEMENT OF FRACTURED IMPLANTS (파절된 임프란트 고정체의 분석과 처치)

  • Han Chang-Hyun;Kim Sung-Hyun;Hee Seong-Joo;Ku Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.1
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    • pp.25-36
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    • 2001
  • Among the numerous factors contributing to implant failure, the most common are infection, failure of proper healing and overload. These factors may occur combined. Implant fractures are one of the complications resulting from overload. Implant fracture is not a common feature, but once it occurs it causes very unpleasant circumstances for the patient as well as for the practitioner. Only few studies have been reported regarding this subject. Thus, little is known about its solutions. It is important that analyzing reasons for implant fracture and finding appropriate solutions. Factors leading to implant fracture are design, material defects, nonpassive fit of prosthetic framework and biomechanical overload. Previous studies have reported that implant fractures ares associated with marginal bone loss and occur mostly in the posterior regions and that most patients showing parafunctional habits also have implant fracture. Abutment and gold screw loosening or fracture were also observed in some of the cases previous to implant fracture. Similar observations were seen in our hospital as well. The following cases will present implant fracture cases which have been successfully treated regarding function and biomechanics. This was achieved by means of using increased number of futures, increasing fixture diameter and establishing proper occlusion.

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