Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.29
no.5
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pp.282-292
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2003
Several agents are in use to promote new bone formation during bone graft procedures in maxillofacial region. Among them, we have used crude BMP, PRP, and P-15 for experimentally created defects with accompanying graft materials in the rabbit model. The aim of this study is to analyze the effect of above mentioned agents on bone formation using histologic and histomorphometrical methods, thus to provide experimental support for clinical application of these agents. Six rabbits were used as experimental animals. Four surgical defects were created on the distal femoral heads of each animal using trephine drill. The defects were filled with each agents with accompaning graft materials as experimental groups and particulate corti-co-cancellous autogenous graft as control. For histomorphometric analysis, fluorescent dye was injected at 2week and 1week before sacrifice. Then, the animals were sacrificed at 2, 4 and 8weeks after surgery and histologic and histomorphometric examinations were achieved. At two weeks after bone graft, bone formation and active remodeling process were examined in all experimental groups and the control. But the intensity of such activities of the experiments were somewhat weaker than that of the control. In BMP group, the amount of newly formed osteoid was increased constantly and the amount was preserved constantly in PRP group. But in P-15 group, the amount of newly formed osteoid was decreased with time to 8week after surgery. Histologic findings showed superior bony quantity and quality in PRP group than that of P-15 group. MAR(Mineralization Apposition Rate) of all experimental groups were slower than that of control group. In P-15 group, constant foreign body reaction was observed at all periods and the graft material showed inwardly destroyed characteristics rather to mature. The data from this study provide the basis for future studies for evaluating the long-term remodeling process and foreign body reactions observed in P-15 group and clinical study for predictable use of these agents.
Between 1997 May and 2007 May, One hundred and seventeen patients were treated. There were 129 cases of sinus elevation using a lateral window opening procedure and 258 implants placed simultaneously or delayed. The cumulative survival rate of the implants calculated. The implants were evaluated according to surgical site, quality and quantity of bone, graft material, membrane used, the length and diameter of the implant and complications. 1. The 10-year cumulative survival rate of the implants by sinus augmentation using lateral window approach was 96.90%. 2. There was no difference in the survival rate between the implant placed simultaneously with sinus elevation (one stage) and the procedure performed in the delayed procedure (two stage). 3. There was no difference in the survival rate according to the type and amount of graft materials. 4. There was no difference in the survival rate according to the implant site, bone quality and quantity. 5. There was no difference in the survival rate when the $CollaTape^{(R)}$ or Gore-Tex was placed in the window of the lateral wall. 6. There was no difference in the survival rate of the implant length and diameter. 7. The survival rate was as low as 75.00% when there were more than two complications. Implant placement with sinus augmentation using the lateral window approach is a predictable treatment method. Although the vertical height of residual ridge is insufficient and the quality of bone is poor, the normal survival rate of the implants would be expected if an appropriate graft material and membrane is used with greater effort to prevent complications.
Park, Hyun-Soo;Lim, Sung-Bin;Chung, Chin-Hyung;Hong, Ki-Seok
Journal of Periodontal and Implant Science
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v.36
no.2
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pp.531-554
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2006
Oral implants must fulfill certain criteria arising from special demands of function, which include biocompatibility, adequate mechanical strength, optimum soft and hard tissue integration, and transmission of functional forces to bone within physiological limits. And one of the critical elements influencing the long-term uncompromise functioning of oral implants is load distribution at the implant- bone interface, Factors that affect the load transfer at the bone-implant interface include the type of loading, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface. To understand the biomechanical behavior of dental implants, validation of stress and strain measurements is required. The finite element analysis (FEA) has been applied to the dental implant field to predict stress distribution patterns in the implant-bone interface by comparison of various implant designs. This method offers the advantage of solving complex structural problems by dividing them into smaller and simpler interrelated sections by using mathematical techniques. The purpose of this study was to evaluate the stresses induced around the implants in bone using FEA, A 3D FEA computer software (SOLIDWORKS 2004, DASSO SYSTEM, France) was used for the analysis of clinical simulations. Two types (external and internal) of implants of 4.1 mm diameter, 12.0 mm length were buried in 4 types of bone modeled. Vertical and oblique forces of lOON were applied on the center of the abutment, and the values of von Mises equivalent stress at the implant-bone interface were computed. The results showed that von Mises stresses at the marginal. bone were higher under oblique load than under vertical load, and the stresses were higher at the lingual marginal bone than at the buccal marginal bone under oblique load. Under vertical and oblique load, the stress in type I, II, III bone was found to be the highest at the marginal bone and the lowest at the bone around apical portions of implant. Higher stresses occurred at the top of the crestal region and lower stresses occurred near the tip of the implant with greater thickness of the cortical shell while high stresses surrounded the fixture apex for type N. The stresses in the crestal region were higher in Model 2 than in Model 1, the stresses near the tip of the implant were higher in Model 1 than Model 2, and Model 2 showed more effective stress distribution than Model.
Statement of problem. Cortical bone plays an important role in the primary implant stability, which is essential to immediate/early loading. However, immediate load-bearing capacity and primary implant stability according to the change of the cortical bone thickness have not been reported. Purpose. The objectives of this study were (1) to measure the immediate load-bearing capacity of implant and primary implant stability according to the change of cortical bone thickness, and (2) to evaluate the correlation between them. Material and methods.48, screw-shaped implants (3.75 mm$\times$7 mm) were placed into bovine rib bone blocks with different upper cortical bone thickness (0-2.5 mm) and resonance frequency (RF) values were measured subsequently. After fastening of healing abutment. implants were subjected to a compressive load until tolerated micromotion threshold known for the osseointegration and load values at threshold were recorded. Thereafter, RF measurement after loading, CT taking and image analysis were performed serially to evaluate the cortical bone quality and quantity. Immediate load-bearing capacity and RF values were analyzed statistically with ANOVA and post-hoc method at 95% confidence level (P<0.05). Regression analysis and correlation test were also performed. Results. Existence and increase of cortical bone thickness increased the immediate load-bearing capacity and RF value (P<0.05) With the result of regression analysis, all parameter's of cortical bone thickness to immediate load-bearing capacity and resonance frequency showed significant positive values (P<0.0001). A significant high correlation was observed between the cortical bone thickness and immediate load-beating capacity (r=0.706, P<0.0001), between the cortical bone thickness and resonance frequency (r=0.753, P<0.0001) and between the immediate load-bearing capacity and resonance frequency (r=0.755, P<0.0001). Conclusion. In summary, cortical bone thickness change affected the immediate load-baring capacity and the RF value. Although RF analysis (RFA) is based on the measurement of implant/bone interfacial stiffness, when the implant is inserted stably, RFA is also considered to reflect implant/bone interfacial strength of immediately after placement from high correlation with the immediate load-baring capacity. RFA and measuring the cortical bone thickness with X-ray before and during surgery could be an effective diagnosis tool for the success of immediate loading of implant.
The success and failure of dental implants depends on various factors such as patient's systemic status, quantity and quality of surrounding bone, presence or absence of marginal infection and mechanical loading condition. The measurement of crestal bone changes around the implants is implemental to evaluate the success and long-term prognosis of the implant. This study was to evaluate the cumulative survival rate of the implants which had been placed in the Department of Periodontics, Chonnam National University Hospital between 1992 and 2003, and to observe the crestal bone loss around the implants which had at least 2 consecutive periapical radiographs after connecting the transmucosal abutment. The radiographs were scanned and digitalized, and the crestal bone levels on the mesial and distal surface of implants were measured using Image analyzer (Image Pro Plus, Media Cybernetics, USA), immediately after implant placement, at 2nd surgery, and 3 months, 6 months, 1 year, and every year thereafter. Any bone loss was not observed during the period between the 1stand 2nd surgery, and the bone loss was 0.86 ${\pm}$ 0.92 mm for the first year of loading after connecting the transmucosal abutment. After 1 year of loading, annual bone loss was 0.1 ${\pm}$ 0.27 mm, and total bone loss was 0.90 ${\pm}$ 0.80 mm (during the average follow-up periods of 22.5 ${\pm}$ 25.6 Mos), The implant, with smooth surface, in the mandible, and with the fixed bridge prosthesis showed greater bone loss, compared to those, with the rough surface, in the maxilla and with single crown. In systemically diseased patients (including DM or osteoporosis), the greater bone loss was observed. The cumulative survival rate among 432 implants was 94.10% for 7 years. Among 15 failed implants, 9 implants were removed due to mobility from disintegration of bone-implant interface. From this results, crestal bone loss around the implants were greatest during 1 year after transmucosal abutment connection, and various factors could affect peri-implant bone loss. To prevent and predict the bone loss around the implants and improve the prognosis, further comprehensive maintenance and follow-up schedules are required.
Park, Jinyoung;Chun, Byung-do;Kim, Uk-Kyu;Choi, Na-Rae;Choi, Hong-Seok;Hwang, Dae-Seok
Maxillofacial Plastic and Reconstructive Surgery
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v.41
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pp.50.1-50.6
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2019
Purpose: Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. Materials and methods: We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. Results: A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19: 6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. Conclusions: The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.
Seo, Dong-Hyun;Ko, Chang-Yong;Kang, Sun-Young;Lim, Do-Hyung;Kim, Han-Sung
Journal of the Korean Society for Precision Engineering
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v.26
no.10
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pp.122-128
/
2009
The aim of this study was to investigate, through a longitudinal tracking, whether gender influences morphological characteristics on trabeucular bone of tibia during unloading. 12 male and 15 female ICR mice at 6 week of age were used and randomly allocated into two groups in each gender; unloading and normal group, respectively Mice in unloading group were operated on denervation (sciatic neurectomy). The tibiae were scanned by using in vivo micro-computed tomography (micro-CT) at 0 day (before denervation) and after 14 days. Structural parameters and BMD on tibia were measured. In female, BV/TV (65%), Tb. Th (5%), Tb.N (61%) and BMD (62%) were significantly decreased and BS/BV (17%), Tb.Sp (54%), SMI (19%) and Tb.Pf (75%) were significantly increased after unloading (p<0.05). In male, BV/TV (1%) and Tb.N (10%) were significantly decreased and SMI (5%) was significantly increased after unloading (p<0.05). In addition, trabeuclar bone loss of female was significantly bigger than that of male (p<0.05). These results indicated that effects of unloading on trabecular bone in growing mice might have difference between female and male, although unloading result in loss of quantity and quality on trabecular bone both female and male.
This study is an analysis of distribution of patients who installed Xive implant in Yonsei University Hospital and types of implant site for about 2 years recall check and cumulative survival rate. 41 implant were used in this study. It shows the conclusion below. 1. Patients at the age of 40s and 50s were 60% of all implant cases and average number of implant was 2.4(man), and 1.9(woman). All cases were operated on mandible, 3 implants on anterior region and 38 implants on posterior region. 2. The major cause of tooth loss is dental caries(48.8%), followed by periodontal disease. 3. Most distribution of bone qaulity for mandibular implant site was type II(65.8%) and bone quantity was type B(75.6%). 4. The majority of implants were those of 11, 13mm in length(95%) and regular diameter in width (64%). 5. The 41(19 persons) Xive implants that were placed in the mandibular anterior and posterior region were all survival and showed a 100% 2 year cumulative survival rate. The results provided us with basic data on patient type, implant distribution, bone condition, and survival rate. We wish that our results coupled with other research data helps assist in the further study for better implant success rates, etc.
This study was performed to investigate the survival rate of single implant used in maxillary anterior region during follow up periods. 231 patients whose single missing tooth in maxillary region had been replaced with 237 implant at the periodontal dept. of Yonsei University Hospital between February 1993 and December 2004. The following results are compiled from 231 patients who received single implant surgery. 1. The major cause of single tooth loss in maxillary anterior region is trauma, followed by periodontal disease and congenital missing. 2. The total survival rate of single implant placed in maxillary anterior region is 94.5%. 3. The survival rate of single implant placed in type II and type IV was 100% and in type III was 92.7%. As for the bone quantity, the survival rate in type A(100%) was most, followed by type B(97.3%) and type C, D (93.5%). 4. The survival rate of implant placement combined with advanced surgery was 94.4%. The results showed that the placement of single implant is considered as a reliable treatment option for a single missing tooth in maxillary anterior region except in certain extreme conditions especially with poor bone quality and quantity.
The sauce is very important to western dishes and also to value and relish of dishes because taste, appearance and the degree of water content are determined by sauce. Also, the taste derived from major sauce like a demi-glace and the basic sauce that affects cooking quality are highly recognized, but preference analyses of source and researches on each ingredients have not been performed up to now. Until today, sauces act as lubricants which add relish to dishes and aid digestion, so the importance of source is more emphasized to raise the taste, appearance, water content and specially healthy function of main ingredients. In this research, some problems of sauce itself and possibilities of improvement was grasped and then some remedies were suggested through the preference, variety and quantity analyses of demi-glace sauce practically used in hotels and restaurants around Gwang-Ju City and South Jeolla(Chon-Nam) Province. Finally, the volume of demi-glace sauce with various ingredients was suggested for various kinds of application. Through the actual proof analysis, preference of each sauce made from various kinds of ingredients was investigated. The result shows that the sauce made from beef bone is highly preferred, followed by pork bone and lamb bone. The least preferred is chicken bone.
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