• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.27-31
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• 2010

Purpose of study: The purpose of this study was to provide adequate diagnostic guideline for the maxillary sinuses prior to dental implant treatment for edentulous posterior maxillary areas. For this purpose, our procedure involves the estimation of the remaining alveolar bone height, the examination of the anatomical variation in the maxillary sinuses (e.g. sinus septum), and the evaluation of the incidence of preoperative pathological conditions in the maxillary sinuses. Materials and Methods: We selected 189 patients to undergo computerized tomography (CT) in order to account for the posterior maxillary anatomy found in patients of Korean ethnicity. We evaluated the following using Dentascan software: Remaining alveolar bone height, incidence of sinus septum, and rate of preoperative pathologic conditions in the maxillary sinus. The average amount of remaining alveolar bone height was analyzed using the student's t-test for differences according to anatomical site, and the ANOVA was used for the differences according to age group with the level of significance set at 0.05. Results: Alveolar bone heights of upper first premolar, second premolar, first molar, and second molar was 12.24 mm, 10.37 mm, 7.16 mm, and 7.15 mm, respectively with statistical significance (P < 0.05). Incidence of sinus septum as an anatomic variation was 17 out of 189 cases (9.0%). Incidence of mucosal thickening as a pathologic variation was 82 out of 189 cases (43.4%). Conclusion: In treatment planning of posterior maxillary edentulous area of Koreans, the consideration of augmentation surgery for maxillary sinus is required in maxillary molar area before dental implant installation, and preoperative screening of the asymptomatic maxillary sinuses can be regarded as a reasonable preoperative procedure in the planning of dental implant treatment on the posterior maxillary edentulous area.

• 대한치과보철학회지
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• 제60권2호
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• pp.211-221
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• 2022

완전 무치악 악궁을 수복함에 있어 해부학적인 한계 또는 경제적인 제한이 있거나 환자가 광범위한 수술을 원하지 않을 경우에 임플란트 식립이 제한될 수 있다. 이러한 경우 전악 임플란트 고정성 보철물의 대안으로 임플란트 보조 국소의치를 이용할 수 있다. 본 증례는 치주질환으로 다수 치아를 발거하여 상악 완전 무치악과 하악 부분 무치악이 된 56세 여성 환자에서 상악 전방부에 4개의 임플란트를 식립하여 8본 서베이드 보철물과 임플란트 보조 국소의치로 수복하였고, 하악은 전치부 8본 고정성 가공 의치 및 구치부 임플란트 고정성 보철물로 수복하였다. 9년 간의 경과 관찰 시 심미적, 기능적으로 적절한 결과를 얻었기에 이를 보고하고자 한다.

• 대한구순구개열학회지
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• 제15권1호
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• pp.29-38
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• 2012

A 20 year-old cleft lip and palate patient came for occlusal rehabilitation, but the constricted maxilla and early loss of posterior teeth called for an unusual treatment modalities. Distraction osteogenesis in the edentulous areas followed by artificial bone graft, dental implant along with orthodontic tooth movement were planed. Multidisciplinary treatment enabled both esthetic and functional oral rehabilitation of this patient.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.481-485
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• 2009

Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissues and involve, essentially, the same pathological process. They are usually classified, depending on their extent and radiographic appearances, into three main groups. Periapical cemental dysplasia predominantly involves the periapical region of the anterior mandible. Florid cemento-osseous dysplasia presents with multifocal lesions in the tooth bearing or edentulous areas of the maxilla and mandible, often occurring bilaterally with symmetric involvement. Focal cemento-osseous dysplasia exhibits a single site of involvement in any tooth bearing or edentulous area of the mandible or maxilla, with the posterior mandible representing the most common site. We report the clinical, radiographic and histological findings of 3 types of cemento-osseous dysplasia with a review of literatures.

• Imaging Science in Dentistry
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• 제38권1호
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• pp.1-5
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• 2008

Purpose: The primary aims of this retrospective study were to compare subjective bone quality and bone quality based on the Hounsfield scale in different segments of the edentulous jaw, and to establish quantitative and objective assessment of the bone quality. Materials and Methods: Twenty eight randomly selected cone-beam computed tomographic (CBCT) scans were analyzed. For evaluation one hundred and twelve edentulous areas were selected. Implant recipient sites were evaluated visually for Lekholm and Zarb classification. The same sites were subsequently evaluated digitally using the Hounsfield scale with Vimplant$2.0^{TM}$, and the results were correlated with visual classification. Data was subject for statistical analysis in order to determine correlation between recorded HU and the regions of the mouth with the Kruskal-Wallis test. Results: The highest unit/mean density value (311 HU) was found in the anterior mandible, followed by 259 HU for the posterior mandible, 216 HU for the anterior maxilla, and 127 HU for the posterior maxilla. These results demonstrate a strong correlation for HU depending on the region of the mouth (p<0.001). The relationship between HU and type 4 bone was found to be significant (r=0.74). Conclusion: Knowledge of the Hounsfield value as a quantitative measurement of bone density can be helpful as a diagnostic tool by using $CBMercuRa6^{TM}$ with $Vimplant^{TM}$ software.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.340-345
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• 2009

Purpose: The purpose of this study was to evaluate the surgical success of bone reconstruction of the severely atrophic maxilla using autogenous block bone onlay graft from the ramus and ilium prior to dental implantation. And we measured the amount of vertical height change Material and Methods: 26 partially edentulous patients(32 case) who needed block onlay bone graft before implant placement in posterior maxillary area from 2002 to 2009 were selected for this study. Patients consisted of 20 males & 6 females and the average of their age was 54.2. Patients who were treated with ramal bone were 19 case and patients who were treated with iliac bone were 11 case. Digital panoramic X-ray was taken at the day of surgery, 3 months and 6 months later after the surgery. Vertical height change & resorption rate of grafted bone were measured with the same X-rays and compared Results: Two out of 32 bone grafts had to be removed because of inflamation at the grafts area(97.3%). The mean of radiographic vertical height change(change rate) of post-op. 3 month was 0.54mm(8.5%)and 6 month was 0.99mm(15.9%). Compairing to intraoral donor site(ramus), iliac bone had more vertical height change(1.18mm) at 6 month after surgery. Conclusions: Within the limit of this study, autogenous block onlay grafts can be considered a promising treatment for severely atrophic maxilla.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권6호
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• pp.644-651
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• 2000

In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre- and postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.166-172
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• 1998

Missing of the upper posterior dentition can cause alveolar bone resorption & pneumatization of Maxillary sinus wall, which makes traditional implant placement impossible, The solution includes various methods to the posterior maxilla to provide adequate bone support for implant installation and long-term survival. -- sinus floor elevation, sinus-lift graft, inlay graft using LeFort I osteotomy, onlay graft, This is a clinical Sr. retrospective study on implant surgery & prosthodontic restoration with upper edentulous posterior jaw from Jan. 1990. to Jun. 1997 at implant clinic of Chonbuk National University Hospital. The results obtained were as follows: 1. Six hundred ninety-nine implants were placed on upper posterior jaw of two hundred seventeen patients, among them one hundred sixty-five implants were placed in forty-four patients with sinus lift. 2. The height of the remained alveolar bone was classified on the base of Misch's concept. This included seventy-nine SA-1s, ninety-seven SA-2s, sixty-five SA-3s and sixty SA-4s. 3. Ninety percent of implants were successfully integrated in non-grafted area and eighty-seven percent of implants were successully integrated in sinus lift area.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.381-389
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• 2013

Two patients with partial edentulous maxilla were scheduled to undergo installation of implant fixtures using a tooth-supported surgical template based on computer assisted treatment planning. After 3-dimensional (3D) computed tomographic scanning was transferred to the OnDemand3D (Cybermed Co., Seoul, Korea) software program for virtual planning, fixtures of MK III Groovy RP implant of the Br${\aa}$nemark System (Nobel Biocare AB Co., G$\ddot{o}$teborg, Sweden) was installed using the In2Guide (CyberMed Co., Seoul, Korea) tooth-supported surgical template with a Quick Guide Kit (Osstem Implant Co., Seoul, Korea) system in the posterior maxilla of each patient. Sinus floor elevation with a xenogenic bone graft procedure was also performed simultaneously in one patient. Fixture installations were completed successfully without complications, such as sinus mucosa perforation, bony bleedings, fenestrations, or others. During the last two-year follow-up period after prosthetics delivery, each implant was found to be fine with no other minor complications. The entire procedures are reported and the literatures on use of tooth-supported surgical template was reviewed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.46-52
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• 2009

The maxillary posterior edentulous region presents unique and challenging conditions in implant dentistry. The height of the posterior maxilla is reduced greatly as a result of dual resorption from the crest of the ridge and pneumatization of the maxillary sinus after the loss of teeth. Materials previously used for sinus floor grafting include autogenous bone, allogeneic bone, xenogenic bone and alloplastic materials. Autogenous bone is the material of choice, but its use is limited by donor-site morbidity, complications, sparse availability, uncontrolled resorption and marked volume loss. One way to overcome this problem would be to use bone substitutes alone as a osteoconductive scaffold for bone regeneration from the residual bone or in combination with allogeneic bone, which also has osteoinductive properties. The purpose of this article is to describe a double layers technique of demineralized and mineralized bone graft materials instead of autogenous bone in sinus floor augmentation of deficient posterior maxillary alveolar process and to report our experience with this technique. Our results show that maxillary sinus augmentation using mineralized and demineralized bone materials, when installed simultaneously with the implant or not, is good results for bone healing.