• Journal of the Korean Academy of Esthetic Dentistry
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• v.27 no.1
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• pp.41-50
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• 2018

Guided implant surgery is useful in anterior implant case in terms of fixture installation and temporary crown delivery. For the aesthetic prosthetics in anterior implant, the position of the implant fixture is crucial. Guided surgery is the top-down procedure and we designed prosthetics first and then determine the position of the fixture. Guided surgery can reduce the stress of dentist with difficult anterior implant case.

• The Journal of the Korean dental association
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• v.56 no.9
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• pp.492-502
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• 2018

Anterior maxillary teeth play an important role in determining a person's first impression and facial profile. Implant surgery in esthetic area requires more careful diagnosis, treatment planning, surgery, and prosthetic restoration than in posterior area. To avoid complications in surgery and prosthetic restoration for implants in esthetic area, accurate diagnosis and appropriate case selection become very important. If you have decided to restore the area with implant prosthesis, you have to know exactly where to place an implant. I will discuss the ideal implant position in terms of mesio-distally, apico-coronally, labio-palatally, and implant angulation. And I would like to point out the selection of fixture diameter & length for anterior implant. Finally, a clinical implant prosthesis case in maxillary central incisor will be shown. In conclusion, for superior esthetic outcome in anterior implant prostheses, we must understand the patient's anatomic condition and know our ability.

• The korean journal of orthodontics
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• v.33 no.5 s.100
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• pp.339-350
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• 2003

The purpose of this study was to investigate the micro-implant height and anterior hook height to prevent maxillary six anterior teeth from lingual tipping and extruding during space closure. We manufactured maxillary dental arch form, bracket and wire, using the computer aided three-dimensional finite element method. Bracket was $.022'{\times}.028'$ slot size and attached to tooth surface. Wire was $.019'{\times}.025'$ stainless steel and $.032'{\times}.032'$ stainless steel hook was attached to wire between lateral incisor and canine. Length of hook was 8mm and force application points were marked at intervals of In. Four micro-implants were implanted on alveolar bone between second premolar and first molar. The heights of them were 4, 6, 8, 10mm starting from wire. We analyzed initial displacement of teeth by various force application point applying force of 150gm to each micro-implant and anterior hook. The conclusions of 4his study are as the following : 1. When the micro-implant height was 4m and the anterior hook height was 5mm and below, anterior teeth were tipped lingually. When the anterior hook height was 6mm and above, anterior teeth were tipped labially. 2. When the micro-implant height was 6mm and the anterior hook height was 6mm and below, the anterior teeth were tipped lingually. When the anterior hook height was 6m and above, the anterior teeth were tipped labially. But lingual tipping of anterior teeth decreased and labial tipping Increased when the micro-implant height was 6mm, compared with 4mm micro-implant height. 3. When the micro-implant height was 8mm and the anterior hook height was 2mm, the anterior teeth were tipped lingually. When the anterior hook height was 3mm and above, labial tipping movement of the anterior teeth increased proportionally. 4. When the micro-implant height was 10mm and the anterior hook height was 2mm and above, labial tipping of the anterior teeth increased proportionally. 5. As the anterior hook height increased, aterior teeth were tipped more labially. But extrusion occurred on canine and premolar area because of the increase of wire distortion. 6. Movement of the posterior teeth was tipped distally during maxillary six anterior teeth retraction using micro-im plant because of the friction between bracket and were Based on the results of this study, we could predict the pattern of the tooth movement according to position of micro-implant and height of anterior hook. It seems that we can find the force application point for proper tooth movement in consideration of inclination of anterior anterior teeth, periodontal condition, overjet and overbite

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.6
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• pp.575-579
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• 2006

Purpose : The purpose of this study was to evaluate peri-implant bone loss and implant success on anterior maxillary alveolar ridges and Compare Class III and Class IV ridges in the aspect of peri-implant bone loss. Material and Methods : 14 patients (aged 21 to 68, 6males and 8females), who lacked maxillary anterior teeth and were installed from January 2000 to April 2003 at Samsung Medical Center, were selected. The type of implant used included 30 $Br\ddot{a}nemark$ implant. They were taken with digital tomographic and conventional intraoral radiographic examinmation, and were treated with implant installaion without bone augmentation. The peri-implant bone resorption was measured at the mesial and distal aspect of implant on the conventional intraoral radiographs. Results : The study classified the anterior maxillary alveolar ridge and measured peri-implant bone resorption from the period of implant installation to the 2nd year after functional loading radiographically. The study revealed no statistically significant difference between two groups, which was classified by its morphology. The average bone resorption on healing period before loading was 0.18mm and 0.18mm, the 1st year of loading period, 0.77 mm and 0.84mm, and on the 2nd year of loading period, 0.07mm and 0.06mm, respectively on both Class III and class IV. Conclusion : In the knife edge form of anterior maxillary residual ridges(Class IV), implant placement without ridge augmentation does not have significant difference with that of Class III alveolar ridge in the concern of Implant success after 2 year functional loading period in the aspect of peri-implant bone resorption radiographically.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.27 no.2
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• pp.97-104
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• 2018

Mandibular anterior region has high implant survival rates and better accessibility compared with any other region. Even if there are possibilities for perforation on lingual cortical bone due to improper drilling and bleeding caused by lingual artery damage, mandibular anterior region is a safe region because less amount of major anatomical structures exist compared with other regions. However, because of narrow bucco-lingual width of alveolar ridge, it is challengeable to obtain esthetic implant prosthesis. Although patients are less sensitive subjectively, mandibular anterior region is as difficult as maxillary anterior region in that implant placement location plays a critical role on the prognosis of implant prosthesis. One-piece implant is a very useful option for mandibular anterior region. Considering the narrow roots and thin alveolar bone of mandible, it is clinically difficult for implant diameter to be greater than 3mm In this case, we could approach the esthetic restoration in mandibular anterior region with one-piece implant and immediate loading.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.639-651
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• 2006

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 Journal of the Korean dental association
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• v.51 no.11
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• pp.586-594
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• 2013

The critical factors affecting the esthetics of anterior implants can be summarized as following: 1) Correct positioning of implant fixture 2) Enough amount of alveolar bone 3) Optimum volume of soft tissue. The position of implant is probably the most important factor in obtaining esthetic treatment outcome. The 3-dimensional orientation of implant is determined by the position on the alveolar ridge and its direction. Clinicians often try to mimic natural teeth when fabricating restorations. During the course of esthetic diagnosis and treatment, however, one should not forget to consider the correlation between facial pattern, lips, gingiva, alveolar ridge, as well as remaining dentition. Since anterior region is biologically unfavorable when compared with posterior region, one minor discrepancy in positioning of implant can cause esthetically undesirable treatment outcome. If one understands the biological and prosthetic meaning of implant's 3-dimensional position, he or she can achieve superior esthetic outcome in anterior region.

• The Journal of the Korean dental association
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• v.57 no.3
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• pp.149-160
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• 2019

Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.16 no.2
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• pp.7-18
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• 2007

There is now an increased demand for harmony between the peri-implant gingiva and adjacent dentition. In the event of a pending loss of a single tooth in the aesthetic zone with healthy periodontium, expectation for optimal gingival and prosthodontic aesthetics are often very high. Unfortunately, bone resorption is common following the removal of an anterior tooth, compromising the gingival tissue levels for the eventual implant restoration. Also, improper implant placement and inadequate osseous-gingival support potentially deleterious aesthetic result. The creation of an esthetic implant restoration with gingival architecture that harmonizes with the adjacent dentitionis formidable challenge. The predictability of the peri-implant esthetic outcome may ultimately be determined by the patient's own presenting anatomy rather than the clinician's ability to manage state-of-the-art procedures. To more accurately predict the peri-implant esthetic outcome before removing a failing tooth, a considering of diagnostic keys is essential. This presentation addresses the useful diagnostic keys that affect the predictability of peri-implant gingival aesthetics and the overcoming of the risk factors in anterior single-tooth replacement; it also describes a surgical and prosthodontic technique in achieving a long term successful esthetic outcome. Proper diagnosis and understanding of the biological and periodontal variables of failing dentition and their response to surgical and prosthodontic procedures are the essence of predictability. Using a smart protocol that alters the periodontium toward less risk and more favorable assessment of the diagnostic keys before implant placement will provide the most predictable esthetic outcome. Simple diagnostic keys suggested this presentation are useful method to evaluate the overcoming of the risk factors in anterior single implant restoration.

• Imaging Science in Dentistry
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• v.52 no.4
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• pp.343-350
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• 2022

Purpose: This study evaluated the prevalence of dental implant positioning errors and the most frequently affected oral regions. Materials and Methods: A sample was obtained of CBCT images of 590 dental implants from 230 individuals who underwent diagnosis at a radiology center using cone-beam computed tomography from 2017 to 2020. The following variables were considered: thread exposure, violation of the minimum distance between 2 adjacent implants and between the implant and tooth, and implant contact with anatomical structures. Descriptive data analysis and the Pearson chi-square test(P<0.05) were performed to compare findings according to mouth regions. Results: Most (74.4%) of the 590 implants were poorly positioned, with the posterior region of the maxilla being the region most frequently affected by errors. Among the variables analyzed, the most prevalent was thread exposure (54.7%), followed by implant contact with anatomical structures, violation of the recommended distance between 2 implants and violation of the recommended distance between the implant and teeth. Thread exposure was significantly associated with the anterior region of the mandible (P<0.05). The anterior region of the maxilla was associated with violation of the recommended tooth-implant distance (P<0.05) and the recommended distance between 2 adjacent implants(P<0.05). Implant contact with anatomical structures was significantly more likely to occur in the posterior region of the maxilla (P<0.05). Conclusion: Many implants were poorly positioned in the posterior region of the maxilla. Thread exposure was particularly frequent and was significantly associated with the anterior region of the mandible.