• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.434-444
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• 2006

This study was performed to evaluate the effects of three different implant surface treatments to the bone formation during osseous healing period under unloading conditions. Machined, double-acid etched and anodic oxidized implants were inserted into tibia of 3.0 - 3.5 kg NZ white male rabbits and 2 animals of each group were sacrificed at 2, 4 and 8 weeks. The specimens containing implant was dehydrated and embedded into hard methylmethacrylate plastic. After grinding to $50{\mu}m$, the specimens were stained with Villanueva bone stain. From each specimen, histomorphometric evaluation and the bone implant contact rate were analysed with optical microscope. The results were as follows; 1. In the scanning electronic microscopic examination, machined surface implant had several shallow and paralleled scratches on plain surface, double acid-etched implant had lots of minute wrinkles, rough valley and also irregularly located craters that looked like waves, anodic oxidized surface implant had porosity that minute holes were wholly distributed on the surface. 2. After 2 weeks of implantation, the percentages of bone-to-implant contact in the machined implant, double acid-etched implant and anodic oxidized implant were 26.85%, 62.64% and 59.82%, after 4 weeks of implantation they were 64.29%, 77.85% and 75.23%, and after 8 weeks they were 82.66%, 85.34% and 86.39%. 3. After 2 weeks of implantation, the percentages of bone area between threads in the machined implant, double acid-etched implant and anodic oxidized implant were 21.55%, 42.81%, and 40.33%, after 4 weeks of implantation they were 49.32%, 62.60% and 75.56%, and after 8 weeks they were 71.62%, 87.73% and 83.94%. In summary, percentages of implant surface contacted to bone trabeculae and bone formation area inside threads in double acid-etched implants and anodic oxidized implants were greater than machined implants in early healing stage. These results suggest that double acid-etched and anodic oxidized surface implants could reduce the healing period for osseointegration and may enable to do early function.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권2호
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• pp.131-139
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• 2005

The therapeutic goal of implant dentistry is not merely tooth replacement but total oral rehabilitation. Considering dental implants as a treatment option can be provided patients with positive, long-term results. Implant dentistry has gone through many phases over the years. Modern technology and design allows us to predictably place our dental implants often load the implants at the time of placement. The purpose of this study is to evaluate the implant stability after immediate loading in dogs. The control group was performed delay loading and experimental group was immediate loading. Each group was measured periotest value(PTV) to evaluate clinical mobility and performed radiographic examination to evaluate marginal bone loss. Statistically significant difference was not founded in control group between experimental group in PTV(P>0.05) and marginal bone loss(P>0.05). Finally, implant stability after immediate loading was similar to delay loading implant.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.580-586
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• 2022

Background Appropriate position of the nipple-areolar complex (NAC) is crucial following nipple-sparing mastectomy (NSM). The prevention of NAC malposition in two-stage implant-based breast reconstruction has not been well described, and the efficacy of the techniques has not been evaluated. This study aimed to evaluate the efficacy of our technique to prevent NAC malposition in patients who underwent implant-based breast reconstruction after NSM. Methods Patients who underwent two-stage implant-based breast reconstruction with NSM between January 2012 and December 2019 were included. We used a surgical technique to fix the NAC to the rigid base, assuming a pocket-like appearance, with pectoralis major muscle and lateral adipofascial flap at the time of tissue expander (TE) insertion. Patients were classified into two groups based on the performance of the technique for the prevention of NAC malposition. Results In 35 patients who underwent implant-based breast reconstruction after NSM, the clavicle-to-nipple distance ratio was 96.0±5.0% in those who underwent NAC fixation and 86.1±11.5% in those who did not undergo NAC fixation. Conclusions Using our technique, NAC malposition could be prevented in two-stage implant-based breast reconstruction. NAC fixation during TE insertion was found to be extremely effective. This procedure successfully prevented NAC malposition without the formation of extra scars.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권4호
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• pp.307-314
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• 2005

After dental implant are planted into their bony site among the various growth factors associated with bone formation. BMP is expressed in the bone surrounding the implant fixture. By taking a close look at BMP2, BMP4 which are growth factors that take put in bone formation, its histologic features and radiographic bone healing patterns we would like to examine the mechanism of osseointegration. We randomly used 8 male and female house rabbit amd used diameter 5 mm height spiral shaped implants(Ostem, Korea) for animal use handled as a resorbable blast machined(RBM) surface and machined surface. 2group were formed and each group had RBM surface and machined surface implant or a simple bone cavity. After 3, 7, 14 and 28 days post surgery 2 objects were sacrificed from each group and histologic specimens were acquired. RT-PCR analysis was conducted and after H&E staining the extent of osseointegration was measured applying a histologic feature and histomorphometric analysis program. Quanitity one -4.41(Bio-Rad, USA) was used after scanning the PCR product image of the growth factors manifested in each group. According to the histomorphometric features the RBM, Machined surface group showed increased contact between bone and implant surface at 3, 7, 14 and 28 days after surgery. The BMP2 level increased in both experiment groups but remained unchanged in the contrast group. BMP4 levels stayed steady after the early post implantation period for RBM but showed decreased in the machined surface group and contrast group. The amount of contact between bone and implant surface increased with the passage of time. BMP2, BMP4 were expressed in both experimental group and contrast group. These growth factors play a role in osseointegration of implant.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권3호
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• pp.186-199
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• 2012

Purpose: Single implants, of which screw loosening has been observed frequently, presents problems such as fixtures fractures, marginal bone loss, and inflammation of the soft tissue around the implant. However, the single implant is more conservative, cost effective, and predictable compared to the 3 unit bridge with respect to the long-term outcome. This study evaluated the survival rate as well as future methods aimed at increasing the survival rate in single implants in posterior teeth. Methods: Among the implants placed in the Dankook University Dental Hospital department of Oral & Maxillofacial surgery from January 2001 to June 2008, 599 implants placed in the maxillar and mandibular posterior were evaluated retrospectively. Survival rates were investigated according to implant location, cause of tooth loss, gender, age, general disease, fixture diameter and length, surface texture, implant type and shape, presence of bone graft, surgery stage, surgeons, bone quality and opposite teeth. Results: Out of 599 single implants in posterior teeth, 580 implants survived and the survival rate was 96.8%. The difference in survival rate was statistically significant according to the implant location. The survival rate was low (84.2%) in implants exhibiting a wide diameter (${\geq}5.1mm$) and the surface treated by the acid etching group demonstrated a significantly lower survival rate (91.1%). One stage surgical procedure, which implemented a relatively better bone quality survival rate (100%), was higher than the two stage surgical procedure (96.1%). The survival rate of type IV bone quality (75%) was significantly lower than the other bone quality. Conclusion: Single posterior teeth implant treatments should use an improved surface finishing fixture as well as careful and safe procedures when performing implant surgery in the maxilla premolar and molar regions since bone quality is poor.

• 대한치과보철학회지
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• 제39권3호
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• pp.273-281
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• 2001

Digital subtraction radiography may be one of the most precise and noninvasive methods for assessing subtle density changes in peri-implant bone, providing additional diagnostic information on implant tissue integration in overall maintenance. The aims of this study were to evaluate density changes after first, second surgery of dental implant and to measure the amount of marginal bone loss 9 months after second surgery using digital subtraction radiography. Bone change around 30 screw-shaped implants in 16 patients were assessed on radiographs. 17 Branemark implants of 3.75mm in diameter(Nobel Biocare, Goteborg, Sweden), 2 Branemark implants of 5.0mm in diameter, 11 $Replace^{TM}$ implants of 4.3mm in diameter(Nobel Biocare, Goteborg, Sweden) were used. To standardize the projection geometry of serial radiographs of implants, customized bite block was fabricated using XCP film holder(Rinn Corporation, Elgin, IL.) with polyether impression material of Impregum(ESPE, Germany) and direct digital image was obtained. Qualitative and quantitative changes on radiographs were measured with Emago software(The Oral Diagnostic System, Amsterdam, Netherlands). The results were as follows: 1. The peri-implant bone density of 69.2% implants did not change and the peri-implant bone density of 30.8% implants decreased after 3 months following first surgery. 2. The crestal bone density of 53.9% implants decreased first 3 months after second surgery. The crestal bone density of 58.8% implants increased 9 months after second surgery. No density change was observed around the midportion of the implants after second surgery, 3. The amount of marginal bone loss between different kinds of implants showed no statistically significant differences (p>0.05). 4. More than 90% of total marginal bone loss recorded in a 9-month period occurred during the first 3 months.

• 한국CDE학회논문집
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• 제16권3호
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• pp.216-226
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• 2011

Surgeon dentists usually rely on their experiential judgments from patients' oral plaster casts and medical images to determine the positional and directional information of implant fixtures and to perform drilling tasks during dental implant surgical operations. This approach, however, may cause some errors and deteriorate the quality of dental implants. Computer-aided methods have been introduced as supportive tools to alleviate the shortcomings of the conventional approach. In this paper, we present an approach of 3D dental implant simulation which can provide the realistic and immersive experience of dental implant information. The dental implant information is primarily composed of several kinds of 3D mesh models obtained as follows. Firstly, we construct 3D mesh models of jawbones, teeth and nerve curves from the patient's dental images using software $Mimics^{TM}$. Secondly, we construct 3D mesh models of gingival regions from the patient's oral impression using a reverse engineering technique. Thirdly, we select suitable types of implant fixtures from fixture database and determine the positions and directions of the fixtures by using the 3D mesh models and the dental images with software $Simplant^{TM}$. Fourthly, from the geometric and/or directional information of the jawbones, the gingival regions, the teeth and the fixtures, we construct the 3D models of surgical guide stents which are crucial to perform the drilling operations with ease and accuracy. In the application phase, the dental implant information is combined with the tangible interface device to accomplish 3D dental implant simulation. The user can see and touch the 3D models related with dental implant surgery. Furthermore, the user can experience drilling paths to make holes where fixtures are implanted. A preliminary user study shows that the presented approach can be used to provide dental students with good educational contents. With future work, we expect that it can be utilized for clinical studies of dental implant surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권6호
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• pp.529-536
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• 2010

Purpose: The Purpose of this study is to show the total survival rate of implants with maxillary sinus grafting and the effects that reach the survival rate by classifying types of graft materials, implant type, operation method, residual bone height and evaluate graft material resorption rate after sinus grafting Patients and Methods: 61 dental implants placed with sinus bone grafting in 24 patients at Wonkwang University Sanbon Dental Hospital were installed simultaneously or after regular healing. Various bone grafts (autograft, xenograft, allograft, alloplast) and fourth implant type (GSII, Xive, Implantium, Novel biocare) were used. All implants were investigated clinically and radiographically, being with average 20 months follow-up period after installation. Results: 3 fixtures were lost, resulting in 95.1% cumulative survival rate of 61 osseointegrated dental implant. Survival rate according to bone material type, Implant type, operation method, residual bone height, have no statistically significant differencies. The mean preoperative residual alveolar bone height was 4.75 mm, average postoperative height of graft materials 10.8 mm, vertical bone resorption rate was 10% after 2 years. Resorption rate according to operation method was 7% (simultaneous) and 5% (delayed) after 1 year. Conclusion: It can be suggested that maxillary sinus grafting may have predictable result with various bone graft materials and implant type, residual bone height, operation method

• Archives of Plastic Surgery
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• 제37권3호
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• pp.256-258
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• 2010

Purpose: Predicting the change in breast size for a specific patient's need is a challenging problem in breast augmentation. We intended to investigate the postaugmentation degree of breast size according to the size of cohesive silicone gel implant. Methods: To predict post-augmentation breast size, we measured 100 patients' pre-and postoperative 3 month's bust circumference. All patients were performed by total subfascial breast augmentation with moderate profile cohesive silicone gel implant through areolar omega (transareolar-perinipple) incision. Results: According to this study, each additional one pair of 100 mL in implant size yielded an approximate 1.5 cm increase in bust circumference (p=0.006). Conclusion: From this result, we conclude that each additional one pair of 100 mL in implant volume yielded about 1.5 cm increase in bust circumference. Although this result may not be applied to every patient, we believe that it yields a practical chart that can help to predict the amount of increase in breast size with the use of cohesive silicone gel implant of a specific size preoperatively.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권4호
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• pp.316-322
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• 2004

A low molecular weight component named bone morphogenetic protein(BMP) chemically isolated from the organic matrix of bone, induce postfetal connective tissue cells surrounding small blood vessels to differentiate into cartilage and bone. The end product of BMP is a spherical ossicle of lamella bone filled with red bone marrow for the functional loading. This is a important point that the graft material is embedded the defect site during the implant surgery. Because present knowledge of the relationship between BMP and bone regeneration arises mainly from studies of induced bone formation in heterotopic sites, it would be helpful to determine whether BMP plays any part in the process of bone healing. The BMPs have been shown to play crucial roles in normal skeletal development as well as bone healing and are able to activate transcription of genes involved in cellular migration, proliferation, and differentiation. The delivery of BMP on matrices has been efficacious in the treatment of defect bone in implant surgery. The purpose of the histologic study was to evaluate the effect of DLB(demineralized lyophilized bone) coated with purified human BMP(hBMP-I) in immediate implant surgery with bony defect to obtain the functional structure of implant asap. The ability of a graft of hBMP-I to accelerate bony defect repair provides a rationale for its use in immediate implant surgery that have large bone defect in edentulous area.