• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.3
• /
• pp.277-290
• /
• 2012

Dental implants are universal restorative method on edentulous site in oral cavity and generally recognized by patients as well as clinicians. Rapid bone resorption of labial portion of maxillary anterior area is performed due to dental trauma, chronic periodontitis, and so on. Accordingly, Implants on maxillary anterior alveolar ridge with narrow labiopalatal width would lead to bony defects of dehiscence or fenestration. In this case, guided bone regeneration procedure is used to augment maxillary anterior alveolar ridge. It can have mechanical and biological advantages to mix tissue adhesive with bone graft materials in guided bone regeneration procedure. In these cases, when the dehiscence or fenestration defects was occurred by dental implants on maxillary anterior alveolar ridge with narrow labiopalatal width, guided bone regeneration procedures were performed with various combination of particle bone graft materials(allograft, xenograft, and alloplast) mixed with fibrin glue, excepting autogerous bone. We reported that all of 4 cases showed favorable alveolar ridge augmentations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.46 no.3
• /
• pp.162-173
• /
• 2020

Dental implants are the first option for replacement of missing teeth. Failure usually involves additional cost and procedures. As a result, the physician should limit the risk factors associated with implant failures. Implant site is one of many factors that can influence the success or failure of dental implants. The association between early implant failure (EIF) and implant site has yet to be documented. This review aims to estimate the impact of insertion site on the percentage of EIFs. An electronic and manual search of studies that reported early failure of dental implants based on collection site. A total of 21 studies were included in the review and examined for the association between EIF and alveolar site. Subgroup analysis, including a comparison between implants inserted in four alveolar ridge regions of both jaws was performed. The early failure rate was higher for maxillary implants (3.14%) compared to mandibular implants (1.96%). Applying a random effect, risk ratio (RR), and confidence interval (CI) of 95% revealed higher failure in the maxilla compared to the mandible (RR 1.41; 95% CI [1.19, 1.67]; P<0.0001; I²=58%). The anterior maxilla is more critical for early implant loss than other alveolar bone sites. Implants in the anterior mandible exhibited the best success rate compared of the sites.

• Journal of Periodontal and Implant Science
• /
• v.35 no.2
• /
• pp.449-460
• /
• 2005

Objectives Aim of this study was to evaluate the clinical use and the efficacy of Frialit-2 implant system. Experimental Methods Fifty nine patients received placement of Frilalit-2 implants(137 implants) in their maxillary anterior and posterior sites(40 and 97 implants). Intraoral & clinical examination, chart review and radiographs were taken from each patient. Results 1. The total implant survival rate was 92.7% after a mean follow-up period of 19.9 months. 2. The implant survival rate placed in anterior region was 97.5%. 3. The implant survival rate placed in posterior region was 90.7%. 4. The implant survival rate placed in atrophic posterior maxilla with advanced technique (GBR, Sinus elevation) was 87.2%. 5. The implant survival rate placed in type N(D4) bone was 82%, while 95.7% in type III (D3), and 100% in type II(D2) bone. 6. Most of the failed implants(7 of 10) were removed during the maintenance stage after prosthodontic treatment. Conclusion It was concluded that Frialit-2 implant could be used satisfactorily in the esthetic anterior region, but the use in the posterior region, especially with poor bone quality and quantity, further studies are needed.

• The Journal of Korean Academy of Prosthodontics
• /
• v.39 no.3
• /
• pp.306-312
• /
• 2001

Achieving an aesthetic implant-supported restoration in the single tooth missing case can be challenging when the implant site is in e anterior region. The objective of this report is to focus on presurgical evaluation of implant site and systematic development of related prosthetic modalities. An accurate diagnostic evaluation, a systematically developed pesurgical plan, and knowledge and clinical skill of the various related therapeutic modalities are indispensible. Collection of patient's information, appropriate abutment selection, soft tissue contour, implant axis, and occlusion need to be discussed for aesthetic clinical outcome. For aesthetic restoration, such as surgical guide stent for precise implant positioning customized provisional restoration for development of optimal periimplant soft tissue contours, and fabrication customized abutment (mesiostructure) for veriable emergence profile, are recommended.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.2
• /
• pp.168-174
• /
• 2022

In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.5
• /
• pp.459-466
• /
• 2010

Alveolar distraction osteogenesis (ADO) has been regarded as an acceptable treatment for the alveolar bone deficiency. For ADO at anterior maxillary area, the vector should be oriented to forward and down-ward direction to get an adequate occlusion with mandibular teeth and to increase bone length and width for implant placement. However, the conventional commercial distraction devices for ADO are designed to allow mainly downward movement of alveolar segment, even though a forward movement can be obtained a little by controlling of inclination of device. To make ADO with controllable bidirectional vector possible, we used customized devices using self-manufactured ABDUL (Alveolar Bone Distractor Using Lag screw principle) and commercial orthodontic palatal expansion device ($Hyrex^{(R)}$). In all cases (n = 4), ADO could be performed successfully and dental implants were able to placed with adequate occlusion. We report the procedures, advantages and disadvantages of these methods.

• Journal of Periodontal and Implant Science
• /
• v.45 no.4
• /
• pp.152-155
• /
• 2015

Purpose: This case report discusses the effect of a root submergence technique on preserving the periodontal tissue at the pontic site of fixed dental prostheses in the maxillary anterior aesthetic zone. Methods: Teeth with less than ideal structural support for fixed retainer abutments were decoronated at the crestal bone level. After soft tissue closure, the final fixed dental prostheses were placed with the pontics over the submerged root area. Radiographic and clinical observations at the pontic sites were documented. Results: The submerged roots at the pontic sites preserved the surrounding periodontium without any periapical pathology. The gingival contour at the pontic site was maintained in harmony with those of the adjacent teeth, as well as the overall form of the arch. Conclusions: The results of this clinical report indicate that a root submergence technique can be successfully applied in pontic site development with fixed dental prostheses, especially in the maxillary anterior esthetic zone.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.17 no.1
• /
• pp.50-54
• /
• 2008

• The Journal of Korean Academy of Prosthodontics
• /
• v.38 no.4
• /
• pp.552-560
• /
• 2000

Purpose : The purpose of this study was to determine proper position and angulation of an implant for immediate implantation. Materials and Method : From the years 1997 to 2000. 52 Denta $scan^R$ views, 22 upper and 32 lower jaw with an average age of 43 and 40 respectively, were investigated, which comprise intact upper and lower 6 anterior teeth and premolars. On the Denta $scan^R$, the optimal placement for the immediated implantation was simulated. The measuring methods included 1) Angulation difference between tooth long axis and alveolar bone process. 2) Angulation difference of long axis between tooth and installing fixture 3) Distance between center of tooth at cervical area and center of fixture. 4) Distance from root apex to the bone limit of vital structure. One sample t-test was used for statistical analysis. Result : The results were as follows. 1) At the maxillary central incisor and lateral incisor, angulation difference of long axis between tooth and installing fixture was respectively 0.5 and 3.2 degrees with the fixture center's palatally positioned 2mm apart from tooth center. 2) At the lower anterior 6 teeth, that was about $-2.8^{\circ}\;to\;-4.6^{\circ}$ with the fixture center's lingually positioned 1mm apart from tooth center. 3) At the maxillary canine and premolar, that was respectively $11.8^{\circ}\;and \;7.2^{\circ}$ with the fixture center palatally positioned $2\sim2.4mm$ apart from tooth center. 4) At the lower premolar area, that was about $0^{\circ}\;to\;2^{\circ}$ with the fixture center's lingually positioned $0.5{\sim}1mm$ apart from tooth center. 5) Distance from root apex to the bone limit of vital structure, at the maxillary anterior and premolars. was the range of 10 to 12mm, and at the mandibular anterior teeth and the 1st premolar, that was the range of 18 to 20mm. Conclusion : The proper implant position of maxillary anterior and premolar teeth is as paralleled as or more buccally angulated than long axis of tooth with the fixture center's palatally positioned. In mandiblular anterior region, long axis of implants is lingully angulated compared with long axis of tooth and in premolar, almost parelleled with long axis of tooth and alveolar process.

• The Journal of Korean Academy of Prosthodontics
• /
• v.42 no.4
• /
• pp.397-411
• /
• 2004

Purpose: The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-supported overdenture. Material and methods: Maxillary implant -supported overdentures in which 4 implants were placed in the anterior region of edentulous maxilla were fabricated, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional photoelastic stress analysis. Two photoelastic overdenture models were fabricated in each anchorage system to compare with the palatal coverage extent of denture base, as a result we got eight models : Hader bar using clips(type 1), cantilevered Hader bar using clips(type 2), Hader bar using clip and ERA attachments(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4). Result: 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. In every experimental models with or without palatal coverage of denture base, maximum fringe orders on the distal ipsilateral implant supporting bone in an ascending order is as follows; type 3, type 1, type 4, and type 2. 3. Each implants showed compressive stresses in all experimental models with palatal coverage of denture base, but in the case of those without palatal coverage of denture base, tensile stresses were observed in the distal contralateral implant supporting bone. 4. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant supporting bone on loaded side. 5. The type of anchorage system affected in load transfer more than palatal coverage extent of the denture base. Conclusion: To the results mentioned above, in the case of patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant, and poor bone quality, selecting a resilient type attachment or minimizing the distal cantilevered bar is considered to be an appropriate method to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.