• The Journal of Korean Academy of Prosthodontics
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• v.58 no.1
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• pp.23-29
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• 2020

Purpose: The purpose of this retrospective study was to evaluate the method using the S-reamer and gel-type graft material by the success rate and survival rate. Materials and methods: Implantation period was from 2008 to 2014, Follow check up year is 2019. There were 59 patients and 117 implants. All implants were placed in the posterior maxilla with the sinus lift. The patients population consisted of 34 men and 25 women, ranging from 19 to 75 years. The residual bone heights were from 1 mm to 6 mm. Sinus was perforated with S-reamer without membrane tearing and gel type bone graft material was used for membrane lifting and filling the space. all implants were placed simultaneously. Panoramic X-ray was taken. After 5 - 6 months healing period, final prostheses were restored. After more 5-years implant surgery, Panoramic X-ray was obtained and X-ray analysis and clinical examination were performed. Success criteria was referred to a Buser's success critera. All implants were classified to success implant, survival implant, failed implant. A success implant was satisfying success criteria, a survival implant was a implant that was acute infection with suppuration and bone loss, a failed implant was a implant that was mobile, removed. Results: Five implants were removed, and 4 implants had infected with bone loss. Survival rate was 95.7% and success rate was 92.3%. Conclusion: This retrospective study presented that this method with S-reamer and gel-type graft material was a successful treatment without membrane tear in the condition of 1-6 mm residual bone height.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.154-161
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• 2010

Many edentulous posterior maxilla are found to be compromised by alveolar resorption and increased pneumatization of the sinus. One of the surgical procedures to overcome this anatomical limitation is sinus floor elevation with bone graft, which is reported as more appropriate and more successful procedure. Commonly, if the residual bone height is over 5mm, sinus floor elevation is operated through transcrestal approach using osteotome technique. But, it is possible for patients to feel discomfort during operation and dizziness after operation while malleting, sinus floor elevation, using osteotome technique. Some instruments and methods has been used to overcome these problems and use more easily. The aim of this study is to compare between the surgical procedure of sinus floor elevation using Hatch reamer technique and that of sinus floor elevation using osteotome technique. From 2004 Feb to 2007 Oct, we investigate patients (osteotome group: 72, Hatch reamer group: 70) who were given implant surgery with sinus floor elevation (osteotome group: 92, Hatch reamer group: 98). We analysed gender, age, residual bone height, amount of sinus floor elevation, used graft material, total success rate, failure rate by residual bone height and implant type and discomfort during operation, etc. The results obtained were as follows. 1. In the amount of sinus elevation was osteotome group was $3.85{\pm}1.02\;mm$ and Hatch reamer group was $3.93{\pm}1.38\;mm$. There was no statistically significant difference between the two groups (P > 0.05). 2. At the total success rate, osteotome group was 92.4% and Hatch reamer group was 94.9%. There was no statistically significant difference between the two groups (P > 0.05). 3. On the discomfort during the operation by using numerical rating scale, osteotome group was $2.87{\pm}0.83$ and Hatch reamer group was $1.12{\pm}0.64$. There was statistically significant difference between the two groups (P < 0.05). The Hatch reamer group clinical results was similar to osteotome group and we thought that Hatch reamer technique can overcome the faults of osteotome technique.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.96-99
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• 2009

We report here on a case of a ruptured sinus of a valsalva aneurysm into the left ventricle with the rupture site communicating with both the left coronary sinus and the noncoronary sinus in a 37-year-old male who presented with symptoms of congestive heart failure. Echocardiography showed a sac-like structure around the sinus of valsalva, an enlarged left ventricle (LV) and severe aortic regurgitation, which all suggested a ruptured sinus of a valsalva aneurysm or an aortic-left ventricular tunnel. The operative findings revealed that both the left coronary sinus and the noncoronary sinus had an opening into the left ventricle. The proximal opening into the LV was closed with bovine pericardium and the aortic root was replaced with a composite graft (a 21 mm St. Jude Epic Supra tissue valve and a 24 mm Hemashild graft) by the modified Bentall procedure. The patient was discharged on the 15th postoperative day, and he was regularly followed up for 2 months. We report on this case due to its rarity and to describe the surgical repair techniques.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.533-539
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• 2000

Recent development of dental implantology has taken an interest in the bone graft procedure. This is a review of literature, published from 1994 to November 1999. This study is provided by MEDLINE search. In this study, 718 patients received 829 graft with placing 2,677 endosseous implants. In mandible, nonvascularized or vascularized block bone grafts provided better results(success rate 95.2%) than particulate grafts(83.6%). But in maxilla, particulate grafts provided better results(93.7%, 86.2%) and more cases especially in sinus elevation. There were many cases using autogenous bone graft and revealed good results, but allogenic or alloplastic bone graft materials also were used by many surgeons.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.281-285
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• 2011

Sinus floor elevation is a predictable and standard procedure for the treatment of the posterior maxilla before insertion of dental implants. Although overall complication rates are low, complications can occur including sinus membrane perforation, infection of sinus, swelling and hemorrhage. The most common complication is membrane perforation. Recently, various techniques and materials for repair of perforation to the sinus membrane have been proposed. The purpose of this article is to report on various techniques and materials that can be used for repair of perforations to the sinus membrane. The search protocol used was the following electronic database: Pubmed, with a time limit from 1998 to 2009. The key words such as 'sinus lift', 'sinus augmentation', 'sinus floor elevation', 'sinus graft', 'sinus perforation', 'repair of sinus perforation' and 'repair of sinus membrane' were used, alone and in combination, when searching the database. Various techniques have been proposed to manage of perforation of sinus membranes. These include that the use of collagen membranes, demineralized freeze-dried human lamellar bone sheets, processed human allografts, lamella bone, buccal fat pads and suturing. Implant success rate ranges from 69.9% to 98.9%.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.467-473
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• 2007

The most important factor for successful implantation is osseointegration between the implant and bone. The expression of bone morphogenetic proteins (BMPs) inducing bone formation would differ after maxillary sinus elevation. And within the same graft material. the expression of BMPs would change with time after graft. The aim of this study was to compare the relative expressions of BMP4 and BMP6 using real-time RT-PCR when maxillary sinus elevation was performed using deproteinated bovine bone powder (DBBP) as the graft material or absorbable gelatin sponge (AGS) as the filler without any graft material. Fifteen rabbits, each weighing between 3.0 to 3.5 Kg, were divided randomly into 5 groups of 3 animals each based on their time of sacrifice 0, 3, 5, 7 and 9 days). After exposure of the maxillary sinus bilaterally, bone graft was performed in the right maxillary sinus using DBBP ($BBP^{(R)}$ Oct Inc., Cheonan, Korea) and only AGS ($Gelfoam^{(R)}$ Pharmacia & Upjohn Company, Kalamazoo, MI, U.S.A) was placed into the left without any graft material. Each group of rabbits was sacrificed at 1, 3, 5, 7, or 9 days after operation and all specimens were harvested. And the following results were obtained using real-time RT-PCR from isolated total RNA of the samples. 1. The expression of BMP4 increased at postoperative 1 and 3 days in both DBBP group and AGS group. In AGS group. it decreased at postoperative 5 days. increased again at postoperative 7 days, and decreased at postoperative 9 days. In DBBP group, it increased until postoperative 7 days and decreased at postoperative 9 days. Although the expression of BMP4 was higher in DBBP group compared with AGS group, it was not statistically significant (p>0.05). 2. The expression of BMP6 increased at postoperative 1 and 3 days in both DBBP group and AGS group. In AGS group, it decreased at postoperative 5 days, increased again at postoperative 7 days, and decreased at postoperative 9 days. In DBBP group, it increased until postoperative 7 days and decreased at postoperative 9 days. Although the expression of BMP6 was higher in AGS group compared with DBBP group, it was not statistically significant (p>0.05). 3. There was no statistically significant difference in BMP expression in both groups during same period of time. It' s probably because DBBP and AGS both functioned as a space retainer so that the BMP expression in blood clot seemed to be similar. 4. Thus, DBBP would not offer many benefits for early bone regeneration compared with AGS. The expression of BMP in early bone formation seems to be more influenced by physical carrier rather than the graft type.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.6
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• pp.654-659
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• 2007

We performed sinus bone graft using some amount of autogenous bone and $BioOss^{(R)}$ and covered the sinus window with $Ossix^{(R)}$ membrane in these case series. After 4 to 6 months after operation, histopathologic examinations of trephine core biopsy showed following results. 1. There were bone density of 39.2% to 41.2% four months after operation, and we could observe the favorable early new bone formation. 2. Active bony remodeling of woven and lamellar bone was observed during 4 to 6 months healing period. 3. There were no significant differences between two groups. And also there were no significant differences between 4 months and 6 months.

• Journal of Periodontal and Implant Science
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• v.49 no.2
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• pp.114-126
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• 2019

Purpose: The aim of this study was to evaluate the enhancement of osteogenic potential of biphasic calcium phosphate (BCP) bone substitute coated with Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2) and epigallocatechin-3-gallate (EGCG). Methods: The cell viability, differentiation, and mineralization of osteoblasts was tested with ErhBMP-2-/EGCG solution. Coated BCP surfaces were also investigated. Standardized, 6-mm diameter defects were created bilaterally on the maxillary sinus of 10 male New Zealand white rabbits. After removal of the bony windows and elevation of sinus membranes, ErhBMP-2-/EGCG-coated BCP was applied on one defect in the test group. BCP was applied on the other defect to form the control group. The animals were sacrificed at 4 or 8 weeks after surgery. Histologic and histometric analyses of the augmented graft and surrounding tissue were performed. Results: The 4-week and 8-week test groups showed more new bone (%) than the corresponding control groups (P<0.05). The 8-week test group showed more new bone (%) than the 4-week test group (P<0.05). Conclusions: ErhBMP-2-/EGCG-coated BCP was effective as a bone graft material, showing enhanced osteogenic potential and minimal side effects in a rabbit sinus augmentation model.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.36.1-36.8
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• 2019

Background: This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods: From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results: The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of periimplantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions: When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.

• Journal of Periodontal and Implant Science
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• v.40 no.3
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• pp.144-149
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• 2010

Purpose: The aim of this case report is to present the successful clinical treatment of two cases of postoperative infection following maxillary sinus augmentation. Methods: In the two cases of postoperative infection, immediate total removal of the grafted material from the sinus was conducted to stop the spread of the infection, after which a high dose of antibiotics was administrated. Re-augmentation procedures were then conducted after the infection subsided. Results: No further complications occurred after sinus re-augmentation. The dental implants placed in the re-augmented sinus were clinically osseointegrated, and the implant-supported restorations in the two cases of postoperative infection have been functioning very well for over 2 years. Conclusions: In the case of infection of the grafted sinuses, it is necessary to completely remove the graft materials and then administer a high dose of antibiotics to treat the acute infection, after which sinus re-augmentation is suggested.