ISSN : 0376-4672
Various maxillary sinus floor augmentation techniques were common performed and in the most cases, many kinds of bone graft materials were used. The graft materials are autogenous bone or other biomaterials of human, animal or synthetic origin. But these cases report describes a new surgical technique by which dental implants are inserted in a void space created by elevating the sinus membrane without additional graft material in atrophic posterior maxilla. We created lateral bony window using piezoelectric device and elevated the schneiderian membrane in ten patients. Dental implants were simultaneously placed and lateral window prepared was covered with non-resorbable membrane in five patients and was repositioned with bony window in five patients, without any bone graft. From the clinical and histological results, it is found there is potential capacity for bone formation and placement of implants in the maxillary sinus without the use of bone grafts or bone substitutes.
관절잡음의 발생은 측두하악 관절의 구조적, 기능적 이상의 징후로 여겨져왔다. 이러한 관절잡음을 평가하는데 electrovibratography가 비침습적이고 신뢰할만한 방법으로 제시되어 왔으며 이를 통해 관절잡음의 진동수와 진폭 및 전체 에너지 양상을 숫자화하고 도식화 하는 것이 가능하게 되었다. 기존의 연구에서 여러 가지 관절잡음의 양적, 질적 분석이 시도되어 왔다. 이번 연구의 목적은 관절 잡음이 도식화되어 나타나는 frequency spectrum pattern을 integral >300Hz/<300Hz ratio와 함께 분석하는 것이다. 본 실험에서는 Joint Vibration AnalysisTM를 사용하여 측두하악 관절 장애의 증상이 없는 10명의 대조군과 관절잡음과 동통이 있으나 개구제한을 보이지 않는 정복성 관절원판 변위의 범주에 있는 20명의 실험군에서 관절진동을 분석하였으며 관절진동 기록 시에 Jaw tracker를 함께 사용하여 개폐구시 관절잡음 발생의 위치를 감별하고 치아접촉음을 배제하여 관절잡음을 분석하였다. 그 후 실험군을 frequency spectrum pattern에 따라 4가지 하위 그룹으로 나누어 분석하였다. 실험 결과 실험군과 대조군의 하위 그룹 1에서 유사한 frequency spectrum pattern과 ratio범위를 보였으며 실험군의 하위 그룹 2,3,4 에서는 더 불규칙한 에너지 양상을 보이는 frequency spectrum pattern과 더 큰 ratio가 관찰되었다. 이번 연구를 통해 Joint Vibration AnalysisTM가 악관절 진동의 특성을 감별하는데 유용함을 알 수 있었고 Joint Vibration AnalysisTM를 이용한 지속적인 진동 분석이 환자 교육뿐 아니라 성공적인 턱관절 기능이상의 진단과 치료에 유용할 것으로 사료된다.
Purpose : Ridge expansion osteotomy (REO) has been introduced when it is necessary to expand narrow crestal ridge with simultaneous implant placement. This study has been designed to evaluate the clinical availability of REO. Materials and methods : Subjects were patients who had visited Seoul National University Bundang Hospital from July, 2003 to December, 2005 for implant placement using REO by one surgeon. Intraoperative and postoperative complication, failure of initial osseointegration and marginal bone resorption were estimated using electronic medical record and periapical radiography. Twenty-three patients, 8 males and 15 females, mean age 51, ranged 18 to 72, were treated for mean 26 months, ranged from 16 months to 46 months. Results : Mean diameter and length of implants placed at upper anterior, were 3.72mm and 13.32mm each other. Guided bone regeneration and ridge splitting were accompanied in this study. Five cases of cortical bone fracture, three cases of crestal bone loss more than 2mm, 2 cases of gingival recession, and 2 cases of infection were noted, but there were no implants removed because of disintegration. Success rate of implant was 91.7%, even if survival rate of implant was 100%. In addition, there were no statistical significance between the success rate of REO and bone graft (p>0.05). Conclusion : Based on the results of the present study, it can be concluded that REO technique is reliable for implant placement at atrophic ridge with adequate height compared to bone graft and other osteotomies for ridge expansion, but care should be taken of esthetic problem such as gingival recession because of crestal bone resorption from trauma by osteotome.
