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1.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 278-286, 2023.
Article in English | WPRIM | ID: wpr-1001644

ABSTRACT

Objectives@#This review assessed the performance of implant-supported fixed hybrid prostheses in 21 patients who received a total of 137 implants between 2003 and 2010. The implants were evaluated for marginal bone resorption, complications, success rate, and survival rate based on their vertical angularity, type of bone graft, and measured implant stability. @*Materials and Methods@#One-way ANOVA and chi-square tests were used to analyze the relationships among long-term evaluation factors and these variables. The mean initial bone resorption in the implant group with a vertical angle of more than 20° was 0.33 mm and mean final bone resorption was 0.76 mm. In contrast, the mean initial bone resorption in the implant group with a vertical angle of less than 10° was 1.19 mm and mean final bone resorption was 2.17 mm. @*Results@#The results showed that mean bone resorption decreased with an increase in the vertical placement angle of the implants used in fixed hybrid prostheses, as well as in the group without additional bone grafts and those with high implant stability. The success rate of implants placed after bone grafting was found to be higher than those placed simultaneously. @*Conclusion@#These results suggest that implant-supported fixed hybrid prostheses may be an effective treatment option for edentulous patients, and intentionally placing implants with high angularity may improve outcomes.

2.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 13-20, 2023.
Article in English | WPRIM | ID: wpr-967750

ABSTRACT

Objectives@#Ultra-wide implants may be used as a replacement if existing implants fail. This study was conducted to evaluate the factors influencing the prognosis and failure of ultra-wide implants. @*Patients and Methods@#This study evaluated whether sex, age, site, diameter, length, additional surgery, implant stability (primary and secondary), and reason for ultra-wide implant placement affect the 5-year survival and success rates and marginal bone loss (MBL) of ultra-wide implants. Seventy-eight ultra-wide implants that were placed in 71 patients (39 males and 32 females) from 2008 to 2010 were studied. One-way ANOVA analysis was conducted to evaluate the statistical significance of MBL according to the patient’s sex, implant site, and diameter. Independent sample t-tests were used to determine the statistical significance of MBL analysis which was used to determine the significance of the 5-year success and survival rates related to the variables. One-way ANOVA was conducted to evaluate the statistical significance of sex, implantation site, diameter, and MBL. Independent sample t-tests were used to evaluate the correlation between implantability and MBL for implantation reasons, while additional surgery, length, and Kaplan–Meier analysis were used to evaluate 5-year survival and success rates. @*Results@#The mean age of patients was 54.2 years with a survival rate of 92.3% and a success rate of 83.3% over a mean 97.8-month period of observation. MBL averaged 0.2 mm after one year of prosthetic function loading and 0.54 mm at the time of final observation. Success rates correlated with primary stability (P=0.045), survival rates correlated with secondary stability (P=0.036), and MBL did not correlate with any variables. @*Conclusion@#Ultra-wide implants can be used to achieve secure initial fixation in the maxillary and mandibular molar regions with poor bone quality or for alternative purposes in cases of previous implant failure.

3.
Gut and Liver ; : 216-227, 2022.
Article in English | WPRIM | ID: wpr-925011

ABSTRACT

Background/Aims@#The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort. @*Methods@#Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015. @*Results@#During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p<0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68). @*Conclusions@#The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades.

4.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 175-182, 2021.
Article in English | WPRIM | ID: wpr-893061

ABSTRACT

Objectives@#In this prospective randomized controlled trial, we measured the primary and secondary stability of two surface-treated implants placed in the posterior maxilla, applied 3-month loading protocols, and compared and analyzed the short-term outcomes of the implants. @*Patients and Methods@#From June 2018 to June 2019, patients with a residual bone height of 4 mm in the posterior maxilla were enrolled and randomly divided into two groups to place SA implants (Osstem Implants, Korea) in Group A and NH implants (Hiossen, USA) in Group B. Finally, 14 implants placed in 13 patients in Group A and 17 implants placed in 14 patients in Group B were analyzed. The measured primary and secondary stability of each implant was represented by implant stability quotient (ISQ), and treatment outcomes were evaluated. @*Results@#Group A consisted of patients with an average age of 62.2 years (range, 48-80 years), and Group B consisted of patients with an average age of 58.1 years (range, 35-82 years). Primary stability was 73.86±6.40 and 71.24±5.32 in Groups A and B, respectively (P=0.222). Secondary stability was 79.07±5.21 in Group A and 78.29±4.74 in Group B (P=0.667). A steep increase in ISQ during the healing period was observed in Group B, though it was not significant (P=0.265). The mean follow-up period was 378.5±164.6 days in Group A and 385.3±167.9 days in Group B. All implants in each group met the success criteria, and the success rate was 100%. @*Conclusion@#Two surface-treated implants placed in the posterior maxilla with greater than 4 mm alveolar bone height exhibited successful one-year treatment outcomes if a primary stability of 65 or higher ISQ was obtained and a 3-month early loading protocol was applied.

5.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 91-98, 2021.
Article in English | WPRIM | ID: wpr-893036

ABSTRACT

Objectives@#Hyaluronoglucosaminidase (hyaluronidase) increases the local intercellular permeability of the peripheral lymphatic channel and capillaries, which may help reduce edema. In the present study, the effects of hyaluronidase on postoperative edema and pain reduction were evaluated. @*Materials and Methods@#The study included 38 patients who underwent guided bone regeneration (GBR) surgery before implantation. Patients were randomly assigned to either the control group (n=20) or the test group (n=18). Hyaluronidase was injected into the GBR site of subjects in the test group. Postoperative edema was evaluated by measuring the distance between specific facial landmarks immediately after surgery (T1) and 2-4 days after surgery (T2). The degree of pain at T2 and at 10-14 days after surgery (T3) was assessed. @*Results@#In the test group, the degree of swelling was lower than in the control group, however, only two measurements, from the tragus to the mouth corner and from the outer canthus to the mouth corner, showed statistically significant differences (P=0.012 and P=0.001, respectively). The antiedema effect of hyaluronidase was more effective in the maxilla than in the mandible. In the maxilla, the percentage of facial swelling was significant for three measurements. However, in the mandible, the percentage of facial swelling was significant for only one measurement. Low levels of pain that were similar at T2 and T3 were reported in both groups. @*Conclusion@#The results indicate the degree of swelling was lower in the test group and hyaluronidase appeared to be more effective in the maxilla. The degree of pain reduction was similar between groups. Further in vivo and randomized controlled trials with larger sample sizes are warranted.

6.
Gut and Liver ; : 742-751, 2021.
Article in English | WPRIM | ID: wpr-890773

ABSTRACT

Background/Aims@#We aimed to evaluate the clinical characteristics and long-term prognosis of elderly-onset ulcerative colitis (EOUC) in Korean patients over a 30-year period using a wellestablished population-based cohort in the Songpa-Kangdong district of Seoul, Korea. @*Methods@#Clinical characteristics and prognosis were compared between two groups: EOUC,defined as UC diagnosed in individuals aged ≥60 years and non-EOUC (N-EOUC), defined asUC diagnosed in individuals aged 18 to 59 years. @*Results@#We identified 99 patients with EOUC (10.3%) and 866 patients with N-EOUC (89.7%) between 1986 and 2015. During the median follow-up of 104.5 months, the overall exposure tomedications was comparable between patients with EOUC and N-EOUC (p=0.091 for corticosteroids, p=0.794 for thiopurines, and p=0.095 for anti-tumor necrosis factor agents). The cumula-tive risks of disease outcomes were also comparable between patients with EOUC and N-EOUC (22.4% vs 30.4% for proximal disease extension [p=0.351], 11.9% vs 18.1% for hospitalization [p=0.240], and 2.3% vs 1.8% for colectomy [p=0.977]) at 10 years after diagnosis. Multivariate Cox regression analysis revealed that corticosteroid use at diagnosis was an independent predic-tor of proximal disease extension (hazard ratio [HR], 6.216; 95% confidence interval [CI], 1.314 to 28.826) and hospitalization (HR, 11.241; 95% CI, 3.027 to 41.742) in patients with EOUC. @*Conclusions@#In this population-based study from Korea, the pattern of medication use seemed comparable between the EOUC and N-EOUC groups. Moreover, patients with EOUC and those with N-EOUC have a similar disease course in terms of proximal disease extension, hospitaliza-tion, and colectomy.

7.
Gut and Liver ; : 742-751, 2021.
Article in English | WPRIM | ID: wpr-898477

ABSTRACT

Background/Aims@#We aimed to evaluate the clinical characteristics and long-term prognosis of elderly-onset ulcerative colitis (EOUC) in Korean patients over a 30-year period using a wellestablished population-based cohort in the Songpa-Kangdong district of Seoul, Korea. @*Methods@#Clinical characteristics and prognosis were compared between two groups: EOUC,defined as UC diagnosed in individuals aged ≥60 years and non-EOUC (N-EOUC), defined asUC diagnosed in individuals aged 18 to 59 years. @*Results@#We identified 99 patients with EOUC (10.3%) and 866 patients with N-EOUC (89.7%) between 1986 and 2015. During the median follow-up of 104.5 months, the overall exposure tomedications was comparable between patients with EOUC and N-EOUC (p=0.091 for corticosteroids, p=0.794 for thiopurines, and p=0.095 for anti-tumor necrosis factor agents). The cumula-tive risks of disease outcomes were also comparable between patients with EOUC and N-EOUC (22.4% vs 30.4% for proximal disease extension [p=0.351], 11.9% vs 18.1% for hospitalization [p=0.240], and 2.3% vs 1.8% for colectomy [p=0.977]) at 10 years after diagnosis. Multivariate Cox regression analysis revealed that corticosteroid use at diagnosis was an independent predic-tor of proximal disease extension (hazard ratio [HR], 6.216; 95% confidence interval [CI], 1.314 to 28.826) and hospitalization (HR, 11.241; 95% CI, 3.027 to 41.742) in patients with EOUC. @*Conclusions@#In this population-based study from Korea, the pattern of medication use seemed comparable between the EOUC and N-EOUC groups. Moreover, patients with EOUC and those with N-EOUC have a similar disease course in terms of proximal disease extension, hospitaliza-tion, and colectomy.

8.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 175-182, 2021.
Article in English | WPRIM | ID: wpr-900765

ABSTRACT

Objectives@#In this prospective randomized controlled trial, we measured the primary and secondary stability of two surface-treated implants placed in the posterior maxilla, applied 3-month loading protocols, and compared and analyzed the short-term outcomes of the implants. @*Patients and Methods@#From June 2018 to June 2019, patients with a residual bone height of 4 mm in the posterior maxilla were enrolled and randomly divided into two groups to place SA implants (Osstem Implants, Korea) in Group A and NH implants (Hiossen, USA) in Group B. Finally, 14 implants placed in 13 patients in Group A and 17 implants placed in 14 patients in Group B were analyzed. The measured primary and secondary stability of each implant was represented by implant stability quotient (ISQ), and treatment outcomes were evaluated. @*Results@#Group A consisted of patients with an average age of 62.2 years (range, 48-80 years), and Group B consisted of patients with an average age of 58.1 years (range, 35-82 years). Primary stability was 73.86±6.40 and 71.24±5.32 in Groups A and B, respectively (P=0.222). Secondary stability was 79.07±5.21 in Group A and 78.29±4.74 in Group B (P=0.667). A steep increase in ISQ during the healing period was observed in Group B, though it was not significant (P=0.265). The mean follow-up period was 378.5±164.6 days in Group A and 385.3±167.9 days in Group B. All implants in each group met the success criteria, and the success rate was 100%. @*Conclusion@#Two surface-treated implants placed in the posterior maxilla with greater than 4 mm alveolar bone height exhibited successful one-year treatment outcomes if a primary stability of 65 or higher ISQ was obtained and a 3-month early loading protocol was applied.

9.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 91-98, 2021.
Article in English | WPRIM | ID: wpr-900740

ABSTRACT

Objectives@#Hyaluronoglucosaminidase (hyaluronidase) increases the local intercellular permeability of the peripheral lymphatic channel and capillaries, which may help reduce edema. In the present study, the effects of hyaluronidase on postoperative edema and pain reduction were evaluated. @*Materials and Methods@#The study included 38 patients who underwent guided bone regeneration (GBR) surgery before implantation. Patients were randomly assigned to either the control group (n=20) or the test group (n=18). Hyaluronidase was injected into the GBR site of subjects in the test group. Postoperative edema was evaluated by measuring the distance between specific facial landmarks immediately after surgery (T1) and 2-4 days after surgery (T2). The degree of pain at T2 and at 10-14 days after surgery (T3) was assessed. @*Results@#In the test group, the degree of swelling was lower than in the control group, however, only two measurements, from the tragus to the mouth corner and from the outer canthus to the mouth corner, showed statistically significant differences (P=0.012 and P=0.001, respectively). The antiedema effect of hyaluronidase was more effective in the maxilla than in the mandible. In the maxilla, the percentage of facial swelling was significant for three measurements. However, in the mandible, the percentage of facial swelling was significant for only one measurement. Low levels of pain that were similar at T2 and T3 were reported in both groups. @*Conclusion@#The results indicate the degree of swelling was lower in the test group and hyaluronidase appeared to be more effective in the maxilla. The degree of pain reduction was similar between groups. Further in vivo and randomized controlled trials with larger sample sizes are warranted.

10.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 84-84, 2020.
Article in English | WPRIM | ID: wpr-811264

ABSTRACT

This correction is being published to correct authorship list. The fourth author listed in the above article, who did not meet authorship criteria of Journal of the Korean Association of Oral and Maxillofacial Surgeons, should be removed.

11.
Maxillofacial Plastic and Reconstructive Surgery ; : 10-2020.
Article | WPRIM | ID: wpr-836934

ABSTRACT

Background@#The aim of this study was to evaluate the long-term clinical stability of implants with acid-etched surfaces sandblasted with alumina using retrospective analyses of the survival rate, success rate, primary and secondary stability, complications, and marginal bone loss of the implants. @*Methods@#Patients who had implants placed (TS III SA, SS II SA, SS III SA, and U III SA) with SA surfaces from Osstem (Osstem Implant Co., Busan, Korea) at the Seoul National University Bundang Hospital, from January 2008 to December 2010 were selected for the study. Patients’ medical records and radiographs (panorama, periapical view) were retrospectively analyzed to investigate sex, age, location of implantation, diameter, and length of the implants, initial and secondary stability, presence of bone grafting, types of bone grafting and membranes, early and delayed complications, marginal bone loss, and implant survival rate. @*Results@#Ninety-six implants were placed in 45 patients. Five implants were removed during the follow-up period for a total survival rate of 94.8%. There were 14 cases of complications, including 6 cases of early complications and 8 cases of delayed complications. All five implants that failed to survive were included in the early complications. The survival of implants was significantly associated with the occurrence of complications and the absorption of bone greater than 1mm within 1 year after prosthetic completion. In addition, the absorption of bone greater than 1mm within 1 year after prosthetic completion was significantly associated with the occurrence of complications, primary stability, and implant placement method. Five cases that failed to survive were all included in the early complications criteria such as infection, failure of initial osseointegration, and early exposure of the fixture. @*Conclusions@#Of the 96 cases, 5 implants failed resulting in a 94.8% survival rate. The failed implants were all cases of early complications such as infection, failure of initial osseointegration, and early exposure of the fixtures. Periimplantitis was mostly addressed through conservative and/or surgical treatment and resulted in very low prosthetic complicat

12.
Maxillofacial Plastic and Reconstructive Surgery ; : 13-2020.
Article | WPRIM | ID: wpr-836931

ABSTRACT

Background@#The aim of this study was to evaluate the factors that may affect implant fixture fractures. @*Methods@#Patients who experienced implant fixture removal at Seoul National University Bundang Hospital from 2007 to 2015 due to implant fixture fracture were included. Implant/crown ratio, time of implant fracture, clinical symptoms before implant fracture, treatment of fractured implants, and the success and survival rate of the replaced implants were evaluated retrospectively. @*Results@#Thirteen implants were fractured in 12 patients. Patient mean age at the time of fracture was 59.3 years. Of the 13 implants, 7 implants were placed at our hospital, and 6 were placed at a local clinic. The mean crown/ implant ratio was 0.83:1. The clinical symptoms before fracture were screw loosening in five implants, marginal bone loss in five implants, and the presence of peri-implant diseases in five implants. All the fractured implants were removed, and 12 out of the 13 sites were re-implanted. Parafunctions were observed in two patients: one with bruxism and one with attrition due to a strong chewing habit. @*Conclusions@#Several clinical symptoms before the fracture of an implant can predict implant fixture failure. Therefore, if these clinical symptoms are observed, appropriate treatments can be taken before more serious complications result.

13.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 361-366, 2020.
Article | WPRIM | ID: wpr-834720

ABSTRACT

Guided bone regeneration (GBR) is a surgical procedure that utilizes bone grafts with barrier membranes to reconstruct small defects around dentalimplants. This procedure is commonly deployed on dehiscence or fenestration defects ≥2 mm, and mixing with autogenous bone is recommended onlarger defects. Tension-free primary closure is a critical factor to prevent wound dehiscence, which is critical cause of GBR failure. A barrier membrane should be rigidly fixed without mobility. If the barrier is exposed, closed monitoring should be utilized to prevent secondary infection.

14.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 211-217, 2020.
Article | WPRIM | ID: wpr-834709

ABSTRACT

In patients with insufficient bone height and width, the successful placement of dental implants is difficult with regards to maintaining an ideal pathway and avoiding important anatomical structures. Vertical and/or horizontal ridge augmentation may be necessary using various bone substitute materials and bone graft procedures. However, effective one-wall reconstruction has been challenging due to its poor blood supply and insufficient graft stability. In this paper, the authors summarize current evidence-based literature based on the author’s clinical experience. Regarding bone substitutes, it is advantageous for clinicians to select the types of bone substitutes including autogenous bone. The most important consideration is to minimize complications through principle-based ridge augmentation surgery. Ridge augmentation should be decided with complete consent of the patients due to the possible disadvantages of surgery, complications, and unpredictable prognosis.

15.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 292-298, 2020.
Article | WPRIM | ID: wpr-834697

ABSTRACT

Sinus Schneiderian membrane elevation surgery is widely performed for dental implant placement in the maxillary posterior region. With regard to sinus elevation surgery, various complications can occur and lead to implant failure. For successful implants in the maxillary posterior region, the clinician must be well acquainted with sinus anatomy and pathology, a variety of bone graft materials, the principles of sinus elevation surgery, and prevention and management of complications.

16.
Maxillofacial Plastic and Reconstructive Surgery ; : 34-2020.
Article in English | WPRIM | ID: wpr-894986

ABSTRACT

Purpose@#The purpose of this study was to evaluate the influence of biodegradable polycaprolactone membrane on new bone formation and the biodegradation of biphasic alloplastic bone substitutes using animal models. @*Materials and methods@#In this study, bony defect was formed at the canine mandible of 8 mm in diameter, and the defects were filled with Osteon II. The experimental groups were covered with Osteoguide as barrier membrane, and the control groups were closed without membrane coverage. The proportion of new bone and residual bone graft material was measured histologically and histomorphometrically at postoperative 4 and 8 weeks. @*Results@#At 4 weeks, the new bone proportion was similar between the groups. The proportion of remaining graft volume was 27.58 ± 6.26 and 20.01 ± 4.68% on control and experimental groups, respectively (P < 0.05). There was no significant difference between the two groups in new bone formation and the amount of residual bone graft material at 8 weeks. @*Conclusion@#The biopolymer membrane contributes to early biodegradation of biphasic bone substitutes in the jaw defect but it does not affect the bone formation capacity of the bone graft.

17.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 84-84, 2020.
Article in English | WPRIM | ID: wpr-893015

ABSTRACT

This correction is being published to correct authorship list. The fourth author listed in the above article, who did not meet authorship criteria of Journal of the Korean Association of Oral and Maxillofacial Surgeons, should be removed.

18.
Journal of the Korean Association of Oral and Maxillofacial Surgeons ; : 435-439, 2020.
Article in English | WPRIM | ID: wpr-893003

ABSTRACT

Extraction socket preservation (ESP) is widely performed after tooth extraction for future implant placement. For successful outcome of implants after extractions, clinicians should be acquainted with the principles and indications of ESP. It is recommended that ESP be actively implemented in cases of esthetic areas, severe bone defects, and delayed implant placement. Dental implant placement is recommended at least 4 months after ESP.

19.
Journal of Korean Dental Science ; : 73-80, 2020.
Article in English | WPRIM | ID: wpr-891948

ABSTRACT

Purpose@#The purpose of this case study series was to introduce successful implant cases that used the palatal bone in patients with severe maxillary alveolar bone atrophy or defects.Case Presentation: In this case series study, a total of four patients underwent implant placement in the palatal bone of the maxilla. A total of 6 implants were installed using the palatine bone. The patients’ ages ranged from 40 to 73 years with an average age of 63.5 years. The patients had maxillary sinus-related diseases, such as maxillary sinusitis, oroantral fistula, and dentigerous cysts, prior to implantation. To achieve initial stability, the implants were placed on the palatal side, and buccally tilted. The average postoperative recovery period was 8 months. No postoperative complications occurred in any of the cases, and the approach was used without reported issues. @*Conclusion@#Implant treatment by securing the initial fixation in the palatal bone is a good alternative when an implant must be installed in a patient who requires extensive and invasive bone graft.

20.
Maxillofacial Plastic and Reconstructive Surgery ; : 34-2020.
Article in English | WPRIM | ID: wpr-902690

ABSTRACT

Purpose@#The purpose of this study was to evaluate the influence of biodegradable polycaprolactone membrane on new bone formation and the biodegradation of biphasic alloplastic bone substitutes using animal models. @*Materials and methods@#In this study, bony defect was formed at the canine mandible of 8 mm in diameter, and the defects were filled with Osteon II. The experimental groups were covered with Osteoguide as barrier membrane, and the control groups were closed without membrane coverage. The proportion of new bone and residual bone graft material was measured histologically and histomorphometrically at postoperative 4 and 8 weeks. @*Results@#At 4 weeks, the new bone proportion was similar between the groups. The proportion of remaining graft volume was 27.58 ± 6.26 and 20.01 ± 4.68% on control and experimental groups, respectively (P < 0.05). There was no significant difference between the two groups in new bone formation and the amount of residual bone graft material at 8 weeks. @*Conclusion@#The biopolymer membrane contributes to early biodegradation of biphasic bone substitutes in the jaw defect but it does not affect the bone formation capacity of the bone graft.

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