• Journal of Periodontal and Implant Science
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• 제51권2호
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• pp.100-113
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• 2021

Purpose: Previous studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their remaining soft and hard tissues following tooth extraction. The aim of this study was to classify infected alveolar sockets and to provide the appropriate treatment approaches. Methods: A proposed classification of extraction sockets with chronic inflammation was developed based upon the morphology of the bone defect and soft tissue at the time of tooth extraction. The prevalence of each type of the suggested classification was determined retrospectively in a cohort of patients who underwent, between 2011 and 2015, immediate bone grafting procedures (ridge preservation/augmentation) after tooth extractions at Seoul National University Dental Hospital. Results: The extraction sockets were classified into 5 types: type I, type II, type III, type IV (A & B), and type V. In this system, the severity of bone and soft tissue breakdown increases from type I to type V, while the reconstruction potential and treatment predictability decrease according to the same sequence of socket types. The retrospective screening of the included extraction sites revealed that most of the sockets assigned to ridge preservation displayed features of type IV (86.87%). Conclusions: The present article classified different types of commonly observed infected sockets based on diverse levels of ridge destruction. Type IV sockets, featuring an advanced breakdown of alveolar bone, appear to be more frequent than the other socket types.

• 대한치과의사협회지
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• 제54권7호
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• pp.501-512
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• 2016

We evaluated a self-inflatable osmotic tissue expander for its utility in creating sufficient soft tissue elongation for primary closure after bone grafting. Six patients with alveolar defects who required vertical augmentation of >6 mm before implant placement were enrolled. All had more than three prior surgeries, and flap advancement for primary coverage was restricted by severely fibrosed scars. Expanders were inserted beneath the flap and fixed with a screw. After 4 weeks, expander removal and bone grafting were performed simultaneously. A vertical block autograft and guided bone regeneration and distraction osteogenesis were performed. Expansion was sufficient to cover the grafted area without additional periosteal incision. Complications included mucosal perforation and displacement of the expander. All augmentation procedures healed uneventfully and the osseous implants were successfully placed. The tissue expander may facilitate primary closure by increasing soft tissue volume. In our experience, this device is effective, rapid, and minimally invasive, especially in fibrous scar tissue.

• 대한의용생체공학회:의공학회지
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• 제26권1호
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• pp.55-63
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• 2005

A novel imaging system for High-resolution Ultrasonic Transmission Tomography (HUTT) and soft tissue differentiation methodology for the HUTT system are presented. The critical innovation of the HUTT system includes the use of sub-millimeter transducer elements for both transmitter and receiver arrays and multi-band analysis of the first-arrival pulse. The first-arrival pulse is detected and extracted from the received signal (i.e., snippet) at each azimuthal and angular location of a mechanical tomographic scanner in transmission mode. Each extracted snippet is processed to yield a multi-spectral vector of attenuation values at multiple frequency bands. These vectors form a 3-D sinogram representing a multi-spectral augmentation of the conventional 2-D sinogram. A filtered backprojection algorithm is used to reconstruct a stack of multi-spectral images for each 2-D tomographic slice that allow tissue characterization. A novel methodology for soft tissue differentiation using spectral target detection is presented. The representative 2-D and 3-D HUTT images formed at various frequency bands demonstrate the high-resolution capability of the system. It is shown that spherical objects with diameter down to 0.3㎜ can be detected. In addition, the results of soft tissue differentiation and characterization demonstrate the feasibility of quantitative soft tissue analysis for possible detection of lesions or cancerous tissue.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.155-160
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• 2006

Although several reports have been introduced about dual plane augmentation mammaplasty, the description of periareolar approach dual plane augmentation mammaplasty was few. This article describes specific characteristics, and different classification and techniques for the periareolar dual plane breast augmentation while postoperative scars resulted from inframammary crease approach caused complaints. A total of 124 patients(248 breasts) had periareolar dual plane augmentation surgery from 1998 to 2004. Anatomic implants were used in 43 cases. Most of the patients were satisfied with the outcomes of periareolar dual plane augmentation. Periareolar dual plane augmentation mammaplasty adjusts implant and tissue relationships to ensure adequate soft-tissue coverage while optimizing implant-breast parenchymal dynamics to offer increased benefits and fewer faults compared to a single pocket location in a wide range of breast types with minimal scars. Two types of dual plane classifications are discussed in this study for the periareolar approach exclusively. The boundaries of retroglandular dissection remain constant, as the costal origin of pectoralis major are divided. Type A dual plane implies that the inferior edge of pectoralis muscle lies below the inferior areolar border, and type B dual plane implies that the inferior edge lies above the superior areolar border.

• 대한심미치과학회지
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• 제29권1호
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• pp.54-61
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• 2020

교정적 정출술(Forced orthodontic eruption, FOE)은 각화 치은과 치조골량을 증가시키는 비침습적인 치료 방법이다. 정출력에 의해 치아가 정출되면 치은 섬유와 치주 인대가 신장되고 조골 세포의 유도가 촉진되어 새로운 골형성이 일어나게 된다. 또한 치은 변연이 치관 방향으로 이동되면서 부착 치은의 폭경이 증가된다. 반면, 점막 치은 경계는 일정하게 유지가 된다. 이러한 치료 효과들로 인해 교정적 정출술은 implant site development를 위해 사용될 수 있다. 본 증례 보고에서는 외상으로 인한 치관 파절로 수복이 불가능한 상악 전치부를 교정적 정출술로 연조직 증대를 이룬 후 치조골 이식술(block bone grafting)과 임플란트 식립을 통해 심미적으로 수복한 증례를 통해 교정적 정출술의 효과를 기술하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권2호
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• pp.177-183
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• 1996

With the increasing esthetic requirement in orthognathic surgeries, midfacial corrective surgeries were developed to improve the paranasal depression. Augmentation with autogenous bones has long been the standard in facial reconstruction, however limited graft availability, donor site morbidity, and difficulties in 3-dimensional shaping were led to limited use. Porous high density polyethylene$(Medpor{(R)})$ was introduced in the 1970s as an alloplastic implants. It can be used in various size and shapes, and shortend operation time. The purpose of this study is to determine, by means of cephalometrics, the degree of long term stability and gaining of the overlying soft tissue thickness. The results were as followings : 1. There was no evidence of foreign body reaction, infection, and tissue necrosis. 2. $(Medpor{(R)})$ implants had an advantage of clinical use ; easy to contour and adapt to obtain a precise 3-dimensional construction. 3. Cephalometric study of 16 cases of paranasal augmentation revealed an overall increase of soft tissue thickness of approximately 82.1% in 6-months following. 4. The successful results could be obtained under the aseptic handling.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.127-132
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• 1998

$Medpor^{(R)}$(porous polyethylene) Surgical Implants are used for the augmentation or restoration of bony contour in craniofacial defects. The purpose of this study is to evaluate the ingrowth of soft tissue and bone after application in calvaria of rats. The experiment was carried out in 60 rats. The reflected periosteum was resutured after implantation of $Medpor^{(R)}$ as a experimental site, while in the calvarial bone the reflected periosteum resutured without implantation as a control site. The histologic examination was performed after 1-, 2-, 4-, 8-, 12-, 24-weeks implantation in calvaria of rats. I concluded that there was abundant ingrowth of soft tissue and bone without any adverse tissue response and that it shows good stability.

• Journal of Korean Dental Science
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• 제17권2호
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• pp.84-91
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• 2024

Achieving both esthetic and functional implant rehabilitation is crucial for the successful treatment of the anterior maxilla. Adequate peri-implant alveolar bone and soft tissue are essential for optimal rehabilitation of the esthetic area, and there is a direct association between the implant position and prosthetic outcomes. Immediate provisionalization may also be advantageous when combined with augmentation. This case report described the implant placement in a 25-year-old female patient who had lost her right maxillary lateral incisor (#12) due to trauma-induced avulsion. The treatment involved simultaneous grafting and collagenated, deproteinized bovine bone mineral, along with subepithelial connective tissue taken from the right maxillary tuberosity. A polyetheretherketone abutment and non-functional immediate provisionalization were performed by removing both the proximal and occlusal contacts on the composite resin crown. Clinical and radiographic evaluations revealed maintenance of stable ridge contour aspects for six months following surgical treatment. In summary, implant rehabilitation in the esthetic zone can be successful using simultaneous soft and hard tissue grafts. Moreover, soft tissue stabilization post-subepithelial connective tissue grafting can be achieved through early or immediate visualization, along with immediate implant placement.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.172-181
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• 2023

Purpose: To investigate the effect of epidermal growth factor (EGF) with collagen matrix (CM) for increasing gingival thickness. Materials and Methods: In five mongrel dogs, bilateral gingival defects were surgically made on the maxillary canines. After two months, either a subepithelial connective tissue graft (group SCTG) or CM with EGF (0.1 ug/ml, group EGF) was grafted, and the flap was coronally positioned to cover the graft materials. The animals were sacrificed after three months. Intraoral scanning was performed for soft tissue analysis. Histologic and histomorphometric analyses were performed. Result: Two animals exhibited wound dehiscence during the healing phase, leaving three for analysis. No statistically significant difference was found in soft tissue changes (P>0.05). The level of gingival margin (GM) increased in both groups (1.02±0.74 mm in group SCTG vs. 1.24±0.83 mm in group EGF). Linear increases at the GM pre-augmentation in the soft tissue profile were 1.08±0.58 mm in group SCTG and 0.96±0.73 mm in group EGF. Histomorphometric parameters (keratinized tissue height, tissue thickness, and rete peg density) were not significantly different between the groups (P>0.05). Conclusion: EGF loaded onto CM led to comparable gingival phenotype enhancement to SCTG.

• Journal of Periodontal and Implant Science
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• 제48권3호
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• pp.152-163
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• 2018

Purpose: To determine whether the swelling and mechanical properties of osmotic self-inflating expanders allow or not the induction of intraoral soft tissue expansion in dogs. Methods: Three different volumes (0.15, 0.25, and 0.42 mL; referred to respectively as the S, M, and L groups) of soft tissue expanders (STEs) consisting of a hydrogel core coated with a silicone-perforated membrane were investigated in vitro to assess their swelling behavior (volume swelling ratio) and mechanical properties (tensile strength, tensile strain). For in vivo investigations, the STEs were subperiosteally inserted for 4 weeks in dogs (n=5). Soft tissue expansion was clinically monitored. Histological analyses included the examination of alveolar bone underneath the expanders and thickness measurements of the surrounding fibrous capsule. Results: The volume swelling ratio of all STEs did not exceed 5.2. In tensile mode, the highest mean strain was registered for the L group ($98.03{\pm}0.3g/cm$), whereas the lowest mean value was obtained in the S group ($81.3{\pm}0.1g/cm$), which was a statistically significant difference (P<0.05). In addition, the S and L groups were significantly different in terms of tensile strength ($1.5{\pm}0.1g/cm$ for the S group and $2.2{\pm}0.1g/cm$ for the L group, P<0.05). Clinical monitoring showed successful dilatation of the soft tissues without signs of inflammation up to 28 days. The STEs remained volumetrically stable, with a mean diameter in vivo of 6.98 mm, close to the in vitro post-expansion findings (6.69 mm). Significant histological effects included highly vascularized collagen-rich fibrous encapsulation of the STEs, with a mean thickness of $0.67{\pm}0.12mm$. The bone reaction consisted of resorption underneath the STEs, while apposition was observed at their edges. Conclusions: The swelling and mechanical properties of the STEs enabled clinically successful soft tissue expansion. A tissue reaction consisting of fibrous capsule formation and bone loss were the main histological events.