• Archives of Plastic Surgery
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• v.33 no.2
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• pp.255-258
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• 2006

Nasions are flat and located more caudally in Asian than in Caucasian. Implant insertions in rhinoplasties are apt to move nasions more cephallic, which can cause unsatisfactory results in Asian. The purpose of this study is introducing a simple technique in rhinoplasty avoiding unnatural nasion in augmentation rhinoplasty in Asian patients. Multiple radiating incisions were made at nasion level on inner side of silicone implant to fit it into the curvature around the nasion. Between October 2001 and October 2003, 27 patients underwent augmentation rhinoplasties using this technique and results were evaluated. Preoperative and postoperative photographs of patients were used to measure the levels of nasion from medial canthus. The mean nasion level from medial canthus of preopertive patients were $3.46{\pm}0.87mm$ and postoprative patient was $4.98{\pm}0.96mm$. The mean difference between preoperative nasion level and postoperative nasion level was 1.52 mm. There was no complication such as extrusion, displacement or infection. This technique of radiating incisions on inner side of the silicon implant can minimize cephalic migration of the nasion level in augmentation rhinoplasty in Asian.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.239-244
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• 2019

The effectiveness of dental implants in patients with disability, who are non-compliant during treatment, is controversial because of their poor oral health. Thus, oral health-care and management in such patients is concerning. Moreover, limited information is available on prognosis after implant placement. Herein, we describe a patient with schizophrenia who underwent dental implantation under multiple inductions of general anesthesia (5 times) and required conservative treatment and tooth extraction for multiple dental caries and retained roots because of inadequate oral health-care. Postoperatively, fracture of the prosthodontics and progression of dental caries were observed, and with 3 additional inductions of general anesthesia, conservative treatment, implant surgery, and prosthesis implantation were conducted. Postoperative 12-month follow-up since the last prosthesis implantation showed successful results. For patients with schizophrenia, multiple implantation can reduce horizontal bone loss and achieve aesthetic results compared to treatment with removable prosthodontics and could serve as an alternative treatment modality.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.67-70
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• 2009

Purpose: This study presents the use of mini implants for fixed restoration and implant supported overdenture to enable the practitioner to overcome the anatomic obstacles of ridge width and narrow interdental space. Patients and methods: This study consisted of 9 patients who required single implants for one or two teeth replacement and 1 patient who required implant supported overdenture after mandiblectomy, iliac bone graft due to ghost cell tumor. The ages ranged from 29 to 70 years (mean 51). All patients were in good health. Clinical and radiographs were taken pretreatment, postoperatively, during rehabilitation, and at follow ups. Results: Total implant survival rate was 94.7%. One implant was removed due to its mobility as a result of bad bone quality (Type IV) and patient's carelessness (Heavy smoker). All patients except one reported complete satisfaction regarding to function, aesthetics, and phonetics. Radiographic follow up every 3months postoperatively showed success in achieving function and maintaining marginal bone level. Conclusion: Clinician can overcome both severe ridge deficiency and small interdental space with mini implant.

• The Journal of Advanced Prosthodontics
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• v.7 no.6
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• pp.423-430
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• 2015

PURPOSE. To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth $Ankylos^{(R)}$ implants. MATERIALS AND METHODS. This was a retrospective clinical study that analyzed 450 single $Ankylos^{(R)}$ implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. RESULTS. The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). CONCLUSION. The $Ankylos^{(R)}$ implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.

• Archives of Plastic Surgery
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• v.45 no.2
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• pp.158-164
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• 2018

Background During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20-38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. Results The mean follow-up period was 14 months (range, 6-24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160-300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. Conclusions Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.

• Journal of Periodontal and Implant Science
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• v.47 no.4
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• pp.240-250
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• 2017

Purpose: The aim of this study was to analyze the prevalence and risk indicators of peri-implantitis in Korean patients with history of periodontal disease. Methods: A total of 444 patients with 1,485 implants were selected from patients who had been treated at the Department of Periodontology, Chonbuk National University Dental Hospital between July 2014 and June 2015. A group with a history of peri-implantitis (HP) (370 patients with 1,189 implants) and a group with a current peri-implantitis (CP) (318 patients with 1,004 implants) were created based on the radiographic and clinical assessments of implants. The prevalence of peri-implantitis was calculated at both the patient and implant levels. The influence of risk variables on the occurrence of peri-implantitis was analyzed using generalized estimating equations analysis. Results: The prevalence of peri-implantitis in the HP and CP groups ranged from 6.7% to 19.7%. The cumulative peri-implantitis rate in the HP group estimated with the Kaplan-Meier method was higher than that in the CP group over the follow-up period. Among the patient-related risk variables, supportive periodontal therapy (SPT) was the only significant risk indicator for the occurrence of peri-implantitis in both groups. In the analysis of implant-related variables, implants supporting fixed dental prosthesis (FDP) and implants with subjective discomfort was associated with a higher prevalence of peri-implantitis than single implants and implants without subjective discomfort in the HP group. The presence of subjective discomfort was the only significant implant-related variable predictive of peri-implantitis in the CP group. Conclusions: Within the limitations of this study, the prevalence of peri-implantitis in Korean patients with a history of periodontal disease was similar to that reported in other population samples. Regular SPT was important for preventing peri-implantitis. Single implants were found to be less susceptible to peri-implantitis than those supporting FDP. Patients' subjective discomfort was found to be a strong risk indicator for peri-implantitis.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.133-139
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• 2014

Purpose: There have been reports regarding the various factors associated with the level of discomfort and recovery from neurosensory symptoms in patients with trigeminal nerve injury. However, the contributing factors remain uncertain and poorly understood. The purpose of this paper was to investigate the possible association between various factors expected to affect neurosensory discomfort and recovery in patients with mandibular nerve injury after dental implant surgery. Methods: Eighty-nine post-dental implant surgery patients with mandibular nerve injury were enrolled in this retrospective analysis. A medical records review of the patients was done to determine if the patients' improvement was related to pain intensity, the length of time between the injury and removal of the implant or the depth of penetration of the implant into the mandibular canal as determined by cone-beam computed tomography. Results: There was no significant linear relationship between pain intensity and symptomatic improvement (p=0.319). There was no significant linear relationship between the level of mandibular canal penetration and either pain intensity (p=0.588) or symptomatic improvement (p=0.760). There was a statistically significant linear relationship between length of time before the injury was treated, both with pain intensity (p=0.004), and symptomatic improvement (p=0.024). Conclusions: Our findings indicate that the length of time between nerve injury and initiation of conservative treatment is more closely related to the pain intensity and symptomatic improvement than other factors, including the level of mandibular canal invasion. Additionally, increased pain intensity and decreased symptomatic improvement can be expected over time, because of this linear trend. Therefore, although direct injury to the nerve is the most important factor contributing to a neurosensory disturbances, early neurosensory assessment and initiation of conservative treatment should be done to optimize recovery.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.59-64
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• 2017

Background Silicone implants are frequently used in augmentation rhinoplasty in Asians. A common complication of silicone augmentation rhinoplasty is capsular contracture. This is similar to the capsular contracture after augmentation mammoplasty, but a classification for secondary contracture after augmentation rhinoplasty with silicone implants has not yet been established, and treatment algorithms by grade or severity have yet to be developed. Methods Photographs of 695 patients who underwent augmentation rhinoplasty with a silicone implant from May 2001 to May 2015 were analyzed. The mean observation period was 11.4 months. Of the patients, 81 were male and 614 were female, with a mean age of 35.9 years. Grades were assigned according to postoperative appearance. Grade I was a natural appearance, as if an implant had not been inserted. Grade II was an unnatural lateral margin of the implant. Clearly identifiable implant deviation was classified as grade III, and short nose deformation was grade IV. Results Grade I outcomes were found in 498 patients (71.7%), grade II outcomes in 101 (14.5%), grade III outcomes in 75 (10.8%), and grade IV outcomes in 21 patients (3.0%). Revision surgery was indicated for the 13.8% of all patients who had grade III or IV outcomes. Conclusions It is important to clinically classify the deformations due to secondary contracture after surgery and to establish treatment algorithms to improve scientific communication among rhinoplasty surgeons. In this study, we suggest guidelines for the clinical classification of secondary capsular contracture after augmentation rhinoplasty, and also propose a treatment algorithm.

• Archives of Plastic Surgery
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• v.38 no.2
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• pp.182-188
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• 2011

Purpose: The buttocks region has been associated with allure and sex appeal for centuries. Gluteal implants enable buttocks remodeling in a way that is not possible in other methods. One of the reasons that render gluteal implant surgeries unpopular is the fear of complications, the main problems being seroma, wound dehiscence, extrusion, and a visible or palpable implant. The authors present the XYZ technique, which provides anatomical reference points to guide the intramuscular dissection procedure in a feasible and safe way, resulting in a lower complication rate. Methods: The XYZ procedure was done for buttock augmentation on 8 patients from December 2009 to June 2010. Patient's ages ranged from 27 to 44 with a mean age of 36. Seven patients were applied the 250cc sized Elastomer implants with one patient 290cc sized implant. Preoperative marking was done with the patients in the standing position. Bisection of the gluteus maximus muscle was done at the midpoint thickness to create a plane for implant insertion, which is called the sandwich plane. Results: The 8 cases were performed safely without major complications. However one patient had minor wound dehiscence, and was managed with conservative treatment. Another patient had a discomfort on the buttocks for a long time. The patients were followed up for average 6 months. All patients were satisfied with the aesthetic results. Conclusion: In performing the XYZ technique for gluteal augmentation, the surgeon must split the muscle into two equal halves with anatomical reference points to guide the muscle detachment in a symmetrical way at an adequate depth. This method provides a guideline for the surgeon in determining the ideal plane during intramuscular dissection and gives predictable results with low complication rates. Intramuscular gluteoplasty with gluteal implants offers predictable, aesthetically pleasing results without contour irregularities and only a low incidence of major complications.

• Archives of Plastic Surgery
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• v.49 no.2
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• pp.158-165
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• 2022

Background Implant-based breast reconstruction has evolved tremendously in the last decades, mainly due to the development of new products and techniques that make the procedure safer and more reliable. The purpose of this study was to compare the outcomes in immediate one-stage breast reconstruction between acellular dermal matrix (ADM) and inferior dermal flap (IDF). Methods We conducted a retrospective comparative study of patients submitted to immediate breast reconstructions with an anatomical implant and ADM or IDF in a single center between 2016 and 2018. Outcomes evaluated included major complications, early complications, reinterventions, readmissions, and reconstruction failure. Simple descriptive statistics and univariate analysis were performed. Results A total of 118 breast reconstructions (85 patients) were included in the analysis. Patients in the IDF group had a higher body mass index (median = 27.0) than patients in the ADM group (median = 24). There were no statistically significant differences among both groups regarding immediate major complication, early complications, readmissions, and reinterventions. Conclusion There are no significant differences in complications between the ADM and IDF approach to immediate implant breast reconstruction. In patients with higher body mass index and large, ptotic breasts, we recommend an immediate implant reconstruction with IDF.