The rate and stability of mandibular block bone graft in recent 5 years / 대한악안면성형재건외과학회지

BACKGROUND: The purposes of the present study were to compare implant stabilities of mandibular block bone graft and bovine bone graft and to evaluate influencing factors for implant stability in mandibular block bone (MBB) graft. METHODS: This retrospective study investigated 1224 cases and 389 patients treated by one surgeon in the Department of Oral and Maxillofacial Surgery of Pusan National University Dental Hospital (Yangsan, Korea) between January 2010 and December 2014. Proportions that MBB graft cases constitute in all implant restoration cases and in all bone graft cases were measured. Implant stability quotient (ISQ) values were achieved by the same surgeon before loading. The average ISQ values of the experimental groups were compared. In addition, ISQ values of influencing factors, such as age, sex, implant size, and implant placement site, were compared within the MBB group using OsstellTM Mentor (Osstell®, Göteborg, Sweden). Paired t test and ANOVA were conducted for statistical analysis with a significance level of 0.05. RESULTS: Fifty-five percent of all implant restoration cases performed bone graft while MBB cases constituted 34% of all implant restoration cases and 61% of all bone graft cases. Comparing ISQ values according to bone graft materials, the MBB group manifested sufficient implant stability by presenting comparable ISQ value to that of the experimental group without bone graft. Among the reviewed factors, females, mandibular molar regions, and implants in larger diameter displayed greater implant stabilities. CONCLUSIONS: Satisfactory implant stability was accomplished upon administration of MBB graft. Within the limitation of this study, gender, implant site, and implant diameter were speculated to influence on implant stability in MBB graft.

Clinical application of anterior alveolar bone reconstruction achieved through onlay grafting technique with autogenous block bone from the wisdom teeth extraction zone / 口腔疾病防治

Objective@#To explore the effect of anterior alveolar bone reconstruction achieved through autogenous block bone from the wisdom teeth extraction zone in onlay grafting technique. @*Methods@#The 20 patients with bone defect of anterior teeth area were selected. They all had impacted teeth with no infection factors of pericoronitis to be removed. They were treated with autogenous block bone grafts from wisdom teeth extraction zone in onlay grafting technique respectively. The changes of thickness and the height of the bone measured from CBCT before and after 6 months of the surgery were carefully compared. Questionnaire from the patients opinion of acceptance was also be collected. @*Results@# Acceptance questionnaire showed an average score of 55 points (60 full score). Among them, 75% of paitients showed totally supportion and 25% showed basically supportion. The thickness was 6.73 ± 0.28 mm after the surgery compared with 2.26 ± 0.57 mm before the surgery which illustrated a significant difference (F = 6.32, P<0.001). The height didn't change obviously before 14.32 ± 0.31 mm and after 14.56 ± 0.35 mm the surgery. The technique of using autogenous block bone from the wisdom teeth extraction zone improved the compliance of patients with surgery. It can provide good osteogenesis effect and solve other oral diseases at the same time. @*Conclusion@#The Onlay grafting technique which using autogenous block bone from the wisdom teeth extraction zone was a simple and effective techniques for anterior alveolar bone augmentation.

Frequency of bone graft in implant surgery / 대한악안면성형재건외과학회지

BACKGROUND: Implant surgery has become popular with the advance of surgical techniques such as sinus lifting, guided bone regeneration, and block bone graft. However, there were no data about the frequency of bone graft during implant surgery. The purpose of this study was to report the frequency and types of bone graft depending on dental implant patients' profile to complement the database regarding implant surgery. METHODS: The implant operations had been performed from January 2006 to October 2014. The upper and lower jaws were divided into six sextants. A total of 792 sextants were included in this study. Patient information including sex, age, sites, bone graft, and types of bone were investigated. RESULTS: A total of 1512 implants had been placed. Male and female sextants were 421 and 371, respectively (M:F = 1:0.88). Average age was 54.3 (ranging from 20 to 88 years old). Implants were placed in the posterior maxilla (322 sextants, 40.7 %), posterior mandible (286 sextants, 36.1 %), anterior maxilla (127 sextants, 16.1 %), and anterior mandible (57 sextants, 7.2 %). Bone graft was performed in 50.3 % of the sextants. Among the bone grafted sites, sinus lifting with lateral approach (22.1 %) and guided bone regeneration (22.7 %) were performed most frequently. CONCLUSIONS: Bone graft in implant surgery was necessary to augment defects. More than half of the sextants needed bone graft for implant installation.

SINUS GRAFT AND VERTICAL AUGMENTATION OF MAXILLARY POSTERIOR ALVEOLAR RIDGE USING MANDIBULAR RAMAL BLOCK BONE GRAFT

The histologic study of bone healing after horizontal ridge augmentation using auto block bone graft

Comparison the Cortical Perforation of both the Recipient Beds and Grafts with the Cortical Perforation of Only the Recipient Beds

PURPOSE: The aim of this study is to compare volume and revascularization of autogenous block bone grafts in simultaneously cortical perforation of recipient beds and grafts, and only cortical perforation of recipient beds. MATERIALS AND METHODS: Two block bone in 8mm diameter was harvested in both skull using trephine bur on 20 New Zealand white rabbits. Harvested block bone was grafted on both inferior border of mandible. On the left side(experimental side), cortical bone of recipient beds and graftwere perforated, and on the right side(control side), the only recipient bed was perforated. The rabbits had been sacrificed and infused the India ink for the observation of revascularization at 20 day and 40 day after surgery. The specimens were processed for H-E staining and quantitative analysis(independent t-test, p<0.01) was made under an optical microscope. In additional, specimens were processed for the observation of revascularization. RESULTS: After 20 days, more bone volume was observed in experimental group, but no significant difference between two groups(p=0.106). There were significantly more bone volume in the experimental group at 40 days after surgery(p<0.01). After 20 days, more discrete vascular sprouts were observed in experimental side, but no difference at 40 days after surgery. CONCLUSION: We conclude that the cortical perforation of both the recipient beds and grafts improve revascularization at early stage and overall graft persistence.

Horizontal augmentation with autogenous block bone and implant placement

Reconstruction of Acetabular Defect Using Block Bone Graft in Primary Cementless THA / 대한정형외과학회잡지

PURPOSE: To evaluate the results of acetabular reconstruction using block bone graft in primary cementless total hip arthroplasty (THA). MATERIALS AND METHODS: Twenty-four primary THA, in which a block bone graft was used for the reconstruction of the acetabular bone defect, were performed between May 1989 and July 1999, and followed for more than 2 years. Clinical results were assessed using the Harriship score. Radiologically, we observed the graft coverage of the acetabular component, union, resorption of the graft, change in the positionof the hip center, linear wear rate of the polyethylene insert, osteolysis around the acetabulum and evidence of loosening of the acetabularcomponent. RESULTS: The mean Harris hip score improved from 65 points preoperatively to 86 points postoperatively. The coverage of the acetabular components by graft was less than 50% in all hips. Union of the grafted bone took 8 months (5-15 months) on average. During the follow-up period, revisions were required in 3 hips (12%). The causes of the revision were osteolysis. CONCLUSION: Non-structural block bone grafting seems to be a reliable method for restoring acetabular bone stock in primary THA usinga cementless acetabular component.

Subantral Augmentation with Autogenous Bone Graft for Simultaneous Implant Installation

In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre fand postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

Revision Arthroplasty in Acetabular Defect / 대한정형외과학회잡지

It has been established that total hip replacement arthoplasty is one of the most excellent treatment modalities of adult hip joint disease. But aseptic loosening of the acetabular component is a main cause of revision and acetabular defects must be supported to engage the acetabular cup. Many authors have been managed this problem with the various methods of using acetabular ring, bone cement, autogenous or allogeoous bone graft and bipolar endoprosthesis. As the time goes on, it is inevitable that the numbers of revision arthroplasty cases will increase. We observed 36 patients, 39 cases of revision arthroplasty from 1981 and analysed the cases. 27 cases were treated by autogenous lilac block bone to support the acetabular defects. Complete or incomplete iliac block bone was grafted to superior, medial and posterior aspect of acetabulum. Some screws were inserted when they are needed for bone graft fixation. Hip spica casts were applied in 24 cases for 2 or 3 months and crutches were used for about 3 months. Pre-and postoperative hip joint functions by Harris score was increased form average 58.2 to 81.3(23.1 points increment). Sixteen cases were followed up for more than one year and all the bone grafts were united well without bone resorption. We found that autogenous iliac block bone can support the acetabular defects satisfactorily in revision arthroplasty cases.