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.
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.
Purpose: Deproteinized bovine bone or synthetic hydroxyapatite are 2 prevalent bone grafting materials used in the clinical treatment of peri-implant bone defects. However, the differences in bone formation among these materials remain unclear. This study evaluated osteogenesis kinetics in peri-implant defects using 2 types of deproteinized bovine bone (Bio-Oss® and Bio-Oss/Collagen®) and 2 types of synthetic hydroxyapatite (Apaceram-AX® and Refit®). We considered factors including newly generated bone volume; bone, osteoid, and material occupancy; and bone-to-implant contact. Methods: A beagle model with a mandibular defect was created by extracting the bilateral mandibular third and fourth premolars. Simultaneously, an implant was inserted into the defect, and the space between the implant and the surrounding bone walls was filled with Bio-Oss, Bio-Oss/Collagen, Apaceram-AX, Refit, or autologous bone. Micro-computed tomography and histological analyses were conducted at 3 and 6 months postoperatively (Refit and autologous bone were not included at the 6-month time point due to their rapid absorption). Results: All materials demonstrated excellent biocompatibility and osteoconductivity. At 3 months, Bio-Oss and Apaceram-AX exhibited significantly greater volumes of formation than the other materials, with Bio-Oss having a marginally higher amount. However, this outcome was reversed at 6 months, with no significant difference between the 2 materials at either time point. Apaceram-AX displayed notably slower bioresorption and the largest quantity of residual material at both time points. In contrast, Refit had significantly greater bioresorption, with complete resorption and rapid maturation involving cortical bone formation at the crest at 3 months, Refit demonstrated the highest mineralized tissue and osteoid occupancy after 3 months, albeit without statistical significance. Conclusions: Overall, the materials demonstrated varying post-implantation behaviors in vivo. Thus, in a clinical setting, both the properties of these materials and the specific conditions of the defects needing reinforcement should be considered to identify the most suitable material.
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.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.29
no.5
/
pp.282-292
/
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.
Vascularized iliac crest flap include bone tissue of good quality and quantity for mandible segmental defect. Even if fibular flap can contain longer bone tissue, iliac crest has esthetic shape for mandible body reconstruction and large height for implant. Conventional vascularized iliac crest osteomyocutaneous flap is too bulky for reconstruction of intraoral soft tissue defect. But modified flap can reduce soft tissue volume, so is good for functional reconstruction of oral mucosa. It takes only one month for completely replace oral mucosa. The final mucosal texture is much better than other skin paddle flap, especially for implant prosthesis. Donor site morbidity of this method looks same level or less with other modalities functionally and socially. In case of oral mucosa-mandible combined defect, vascularized iliac crest with internal oblique muscle flap shows good outcomes for hard and soft tissue.
The bone mineral density built in adolescence and college term is formed to the highest level between 25 years old and 35 years old and the formed bone mineral density is decreasing in the middle years and senescence. Decrease of the bone mineral density causes Osteopenia and an increase of dangerousness of a bone fracture which become social health problems. This research is to give guidance for the right living style by surveying the relation between the bone mineral density and college students' life. The result is like below. First of all, most objects of the research were insufficient of quantity of motion and the diet they have was consisted of instant food. It was far from the right living habit and exercise and the bone mineral density was also low. Second of all, male students showed more osteopenia than female students in this research and the smokers' bone mineral density was lower than nonsmokers, which proved that smoking in adolescence was related to the bone mineral density. Finally, the opportunistic eating and living style and the excessive diet and unequal caloric intake caused by the notion of preference for a slim person are considered to be the main reasons for the decrease of the bone mineral density.
Purpose: The purpose of this study was to use cone-beam computed tomography (CBCT) images to determine the prevalence of calcifications in the temporomandibular joint (TMJ) and to evaluate any associations between the presence of such calcifications and degenerative bone alterations of the TMJ, sex, or age. Materials and Methods: In this retrospective study, 1,058 CBCT exams were analyzed, and data regarding the presence and quantity of calcifications, the affected side, any degenerative alterations of the condyle, sex, and age were collected. To evaluate associations between the presence of calcifications and sex or age, the Fisher exact test or the Spearman correlation coefficient, respectively, was used. To assess the association between the presence of calcifications and joint bone alterations, the chi-square and Fisher exact tests were used. The significance level adopted was 5% (P<0.05). Results: Twenty-eight patients (2.7%) presented with TMJ calcifications, including 23 women (82.1%) and 5 men (17.9%). Significant correlations were found between the presence of calcifications and age (P<0.05) and between the presence of calcifications and the presence of condylar alterations (P<0.05), with 73.2% of patients with bone alterations having TMJ calcifications. Conclusion: It may be concluded that, although rare (with a prevalence of only 2.7%), intra-articular calcifications are associated with both degenerative bone alterations and age.
Kim, Jung-Soo;Sohn, Joo-Yeon;Park, Jung-Chul;Jung, Ui-Won;Kim, Chang-Sung;Lee, Jae-Hoon;Shim, June-Sung;Lee, Keun-Woo;Choi, Seong-Ho
Journal of Periodontal and Implant Science
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v.41
no.2
/
pp.86-91
/
2011
Purpose: The aim of this study was to analyze the short-term predictability and reliability of Astra Tech implants according to the demographical distribution of patients and condition of implant sites and location of implants. Methods: Among patients treated with Astra Tech implant (Astra Tech AB) in the Department of Periodontology at the Dental Hospital of Yonsei University of College of Dentisry and K Dental Clinic from May 2004 to March 2009, 195 implants in 98 patients which had been restored more than 6 months ago were reviewed in this study. Following data were reviewed from patient charts and implants success rate was examined: 1) patient type and implant location, 2) bone status at the implant site, 3) diameter and length of the placed implants, 4) presence or absence of bone augmentation and types of the augmentation. Results: The results from this study are as follows: 1) most implants were placed in the molar area, especially 1st molar area of maxilla, 2) most implants were placed at $D_2$ and $D_3$ bone type, 3) most implants were placed in areas of B and C bone quantity, 4) autogenous and alloplastic bone graft and artificial membrane were used for placement of 74 implants. Conclusions: Short-term survival rate of Astra Tech implants was 100%.
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