• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.5
• /
• pp.380-383
• /
• 2009

Osteoma is a slow growing benign osteogenic lesion characterized by proliferation of compact or cancellous bone. Osteomas may be classified as peripheral, central, or extraskeletal. Central osteoma arise from the endosteum, pheripheral osteoma from the periosteum, and extraskeletal soft tissue osteoma within a muscle. Peripheral osteoma of the mandible is uncommon. They manifest as asymptomatic, fixed tumors of bony-hard consistency that may be sessile or pedunculated. Radiographically, a well circumscribed round or oval radiopaque mass is seen. Here, we report a case of a huge solitary peripheral osteoma of the buccal posterior mandible in a 40-year-old woman who was otherwise in good health. The patient visited at the dental clinic because the lesion makes esthetic problem. Treatment was performed by surgical esthetic recontouring and histological examination. The patient remains free of recurrence after surgical esthetic recontouring operation.

• Journal of Periodontal and Implant Science
• /
• v.43 no.1
• /
• pp.30-36
• /
• 2013

Purpose: Implant stability at the time of surgery is crucial for the long-term success of dental implants. Primary stability is considered of paramount importance to achieve osseointegration. The purpose of the present study was to investigate the correlation between the insertion torque and primary stability of dental implants using artificial bone blocks with different bone densities and compositions to mimic different circumstances that are encountered in routine daily clinical settings. Methods: In order to validate the objectives, various sized holes were made in bone blocks with different bone densities (#10, #20, #30, #40, and #50) using a surgical drill and insertion torque together with implant stability quotient (ISQ) values that were measured using the Osstell Mentor. The experimental groups under evaluation were subdivided into 5 subgroups according to the circumstances. Results: In group 1, the mean insertion torque and ISQ values increased as the density of the bone blocks increased. For group 2, the mean insertion torque values decreased as the final drill size expanded, but this was not the case for the ISQ values. The mean insertion torque values in group 3 increased with the thickness of the cortical bone, and the same was true for the ISQ values. For group 4, the mean insertion torque values increased as the cancellous bone density increased, but the correlation with the ISQ values was weak. Finally, in group 5, the mean insertion torque decreased as the final drill size increased, but the correlation with the ISQ value was weak. Conclusions: Within the limitations of the study, it was concluded that primary stability does not simply depend on the insertion torque, but also on the bone quality.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.2
• /
• pp.108-118
• /
• 2010

Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.1
• /
• pp.47-57
• /
• 2010

An undisturbed healing process without micromotion at the implant-bone interface is essential for achievement of osseointegration of dental implant. Therefore, initial stability was advocated as prerequisite for successful clinical outcome. Adequate bone quality and quantity were important to achieve initial stability and to prevent early failures. However there were few published data available regarding the effect of design change in implant geometry on initial stability of the implants. The purpose of the current study was to assess the initial stability of various designs of implants when placed into artificial bone materials of varying qualities and shapes of insertion holes. Within the scope of this study, the following results were drawn. Bone quality was major importance to achieve initial stability. Initial stability was higher on GS II which had additional design feature of double thread. With a tapered design of implant such as GS III showed a higher initial stability than straight one. An insertion hole with the similar shape of implant would lead to reduce a compression force on cortical bone and enhance a bone anchorage on cancellous bone.

• International Journal of Oral Biology
• /
• v.40 no.1
• /
• pp.1-9
• /
• 2015

Osteocalcin (OC) is the most abundant noncollagenous protein of extracellular matrix in the bone. In an OC deficient mouse, bone formation rates are increased in cancellous and cortical bones. OC is known as a negative regulator of mineral apposition. OC is also expressed in the tooth of the rat, bovine, and human. However, little is known about OC during tooth development in Xenopus. The purpose of this study is to compare the expression of OC with mineralization in the developing tooth of Xenopus, by using von Kossa staining and in situ hybridization. At stage 56, the developmental stage of tooth germ corresponds to the cap stage, and an acellular zone was apparent between the dental papilla and the enamel organ. From stage 57, calcium deposition was revealed by von Kossa staining prior to OC expression, and the differentiated odontoblasts forming predentin were located at adjoining predentin. At stage 58, OC transcripts were detected in the differentiated odontoblasts. At stage 66, OC mRNA was expressed in the odontoblasts, which was aligned in a single layer at the periphery of the pulp. These findings suggest that OC may play a role in mineralization and odontogenesis of tooth development in Xenopus.

• The Journal of Korean Academy of Prosthodontics
• /
• v.41 no.5
• /
• pp.674-688
• /
• 2003

Statement of Problem : With increasing demand of the implant-supported prosthesis, it is advantageous to use the different platform width of the fixture according to bone quantity and quality of the patients. Purpose : The purpose of this study was to assess the loading distributing characteristics of two implant designs according to each platform width of fixture, under vertical and inclined loading using finite element analysis. Material and method : The two kinds of finite element models were designed according to each platform width of future (4.1mm restorative component x 11.5mm length, 5.0mm wide-diameter restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction, 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction and 200N at the buccal cusp in a 300 transverse direction individually Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. Results : The stresses were concentrated mainly at the cortex in both vertical and oblique load ing but the stresses in the cancellous bone were low in both vertical and oblique loading. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading. Increasing the platform width of the implant fixture decreased the stress in the supporting bone, future and abutment screw. Increased the platform width of fixture decreased the stress in the crown and platform. Conclusion : Conclusively, this investigation provides evidence that the platform width of the implant fixture directly affects periimplant stress. By increasing the platform width of the implant fixture, it showed tendency to decreased the supporting bone, future and screw. But, further clinical studies are necessary to determine the ideal protocol for the successful placement of wide platform implants.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.6
• /
• pp.611-619
• /
• 2017

Objective : In addition to bone bridging inside a cage or graft (intragraft bone bridging, InGBB), extragraft bone bridging (ExGBB) is commonly observed after anterior cervical discectomy and fusion (ACDF) with a stand-alone cage. However, solid bony fusion without the formation of ExGBB might be a desirable condition. We hypothesized that an insufficient contact area for InGBB might be a causative factor for ExGBB. The objective was to determine the minimal area of InGBB by finite element analysis. Methods : A validated 3-dimensional, nonlinear ligamentous cervical segment (C3-7) finite element model was used. This study simulated a single-level ACDF at C5-6 with a cylindroid interbody graft. The variables were the properties of the incorporated interbody graft (cancellous bone [Young's modulus of 100 or 300 MPa] to cortical bone [10000 MPa]) and the contact area between the vertebra and interbody graft (Graft-area, from 10 to $200mm^2$). Interspinous motion between the flexion and extension models of less than 2 mm was considered solid fusion. Results : The minimal Graft-areas for solid fusion were $190mm^2$, $140mm^2$, and $100mm^2$ with graft properties of 100, 300, and 10000 MPa, respectively. The minimal Graft-areas were generally unobtainable with only the formation of InGBB after the use of a commercial stand-alone cage. Conclusion : ExGBB may be formed to compensate for insufficient InGBB. Although various factors may be involved, solid fusion with less formation of ExGBB may be achieved with refinements in biomaterials, such as the use of osteoinductive cage materials; changes in cage design, such as increasing the area of polyetheretherketone or the inside cage area for bone grafts; or surgical techniques, such as the use of plate/screw systems.

• The Journal of Korean Academy of Prosthodontics
• /
• v.29 no.2
• /
• pp.225-243
• /
• 1991

In recent years immediate implantation has been tried by a few clinicians. This study placed IMZ implants in the rabbit femur with and without bony defects around the implant for simulating fresh extraction site. And one group with bony defects used porous hydroxyapatite ganules(HA) to fill if and the other group left the bony defects around the implant. The purpose of this study was to compare the shear bond strength and the bony contact and formation around the implant. Fifteen rabbits were divided into three groups and placed 10 IMZ implants to each group. Implant sites were surgically prepared with IMZ drills kit and implants were placed(Control), artificial bony defect was created with Apaceram drills kit around the implant sites and implants were placed(Experimental I), bony defect was filled with porous hydroxyapatite granules(Experimental II). Thereafter, rabbits were sacrificed at 8th week and specimens were prepared and pushout tested for shear bond strength of bone-implant interface immediately. Undecalcified and decalcified specimens were prepared with Vilanueva and hematoxylin-eosin stain for light microscopic finding. The results of this study were as follows. 1. In the control group, mean shear strength of bone-implant interface was $2.614{\pm}0.680$ MPa, experimental I was $0.664{\pm}0.322$ MPa, and experimental II was $2.281{\pm}0.606$ MPa. There was significant difference between control and experimental I, between experimental I and experimental II, but did not show significant difference between control and experimental II statistically. 2. In the bony formation surrounding IMZ implant of the three groups, that of cortical bone is more advanced than cancellous bone area. 3. In the histological findings of undecalcified specimens, control and experimental II showed more than 50% of bony or osteoid formation at the bony-implant interface. 4. In the histological findings of undecalcified specimens, experimental I showed less than 50% of bony or osteoid formation at the interface, and observed partial bony defect in the coronal zone. 5. In the experimental II group, were observed direct bony contact to hydroxyapatite granules, and infiltration of a few giant cells. 6. No inflammatory responses were seen around the titanium implants and the hydroxyapatite granules.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.28 no.2
• /
• pp.111-117
• /
• 2006

An area of current research is investigating the app1ication of human mesenchymal stem cells or hMSCs as a cell-based regenerative therapy. In order to achieve effective bone regeneration, appropriate matrices functioning as cell-carriers must be identified and optimized in terms of function, efficacy and biocompatibility. Two methods of approaching optimization of matrices are to facilitate adhesion of the donor hMSCs and furthermore to facilitate recruitment of host progenitor cells to osteoblastic differentiation. Pleiotrophin is an extracellular matrix protein that was first identified in developing rat brains and believed to be associated with developing neuronal pathways. A recent publication by Imai and colleagues demonstrated that transgenic mice with upregulated pleiotrophin expression developed a greater volume of cortical as well as cancellous bone. The proposed mechanism of action of pleiotrophin is demonstrated here. Through either environmental stresses and/or intracellular regulation, there is an increase in pleiotrophin production. The pleiotrophin is released extracellularly into areas requiring bone deposition. A receptor-mediated process recruits host osteoprogenitor cells into these areas. Therefore, the aim of our study was to investigate the osteoconductive properties of pleiotrophin. We wanted to determine if pleiotrophin coating facilitates cellular adhesion and furthermore if this has any effect on hMSCs derived bone formation in an animal model. The results showed a dose dependent response of cellular adhesion in fibronectin samples, and cellular adhesion was facilitated with increasing pleiotrophin concentrations. Histologic findings taken after 5 weeks implantation in SCID mouse showed no presence of bone formation with only a dense fibrous connective tissue. Possible explanations for the results of the osteogenesis assay include inappropriate cell loading.

• The Journal of Korean Academy of Prosthodontics
• /
• v.49 no.2
• /
• pp.168-176
• /
• 2011

Purpose: This study aims at investigating the influence of various insertion torques on thermal changes of bone. A proper insertion torque is derived based on the thermal analysis with two different implant designs. Materials and methods: For implant materials, bovine scapula bone of 15 - 20 mm thickness was cut into 35 mm by 40 - 50 mm pieces. Of these, the pieces having 2 - 3 mm thickness cortical bone were used as samples. Then, the half of the sample was immersed in a bath of $36.5^{\circ}C$ and the other half was exposed to ambient temperature of $25^{\circ}C$, so that the inner and surface temperatures reached $36.5^{\circ}C$ and $28^{\circ}C$, respectively. Two types of implants ($4.5{\times}10\;mm$ Br${\aa}$nemark type, $4.8{\times}10\;mm$ Microthread type) were inserted into bovine scapula bone and the temperature was measured by a thermocouple at 0.2 mm from the measuring point. Finite element method (FEM) was used to analyze the thermal changes at contacting surface assuming that the sample is a cube of $4\;cm{\times}4\;cm{\times}2\;cm$ and a layer up to 2 mm from the top is cortical bone and below is a cancellous bone. Boundary conditions were set on the basis of the shape of cavity after implants. SolidWorks was used as a CAD program with the help of Abaqus 6.9-1. Results: In the in-vitro experiment, the Microhead type implant gives a higher maximum temperature than that of the Br${\aa}$nemark type, which is attributed to high frictional heat that is associated with the implant shape. In both types, an Eriksson threshold was observed at torques of 50 Ncm (Br${\aa}$nemark) and 35 Ncm (Microthread type), respectively. Based on these findings, the Microthread type implant is more affected by insertion torques. Conclusion: This study demonstrate that a proper choice of insertion torque is important when using a specific type of implant. In particular, for the Microthread type implant, possible bone damage may be expected as a result of frictional heat, which compensates for initial high success rate of fixation. Therefore, the insertion torque should be adjusted for each implant design. Furthermore, the operation skills should be carefully chosen for each implant type and insertion torque.