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A Case of Surgical Technique to Overcome Vertical Bone Loss using a Resorbable Membrane with Fixation Screw and Sinus Crestal Approach: An 8-year Follow-up

Jun-Hyeong KONG ; Dae-Young KANG

Journal of implantology and applied sciences.2024;28(2):114-122. doi:10.32542/implantology.2024012

A 42-year-old male patient presented with severe periodontal disease requiring extensive vertical bone augmentation (VBA) prior to implant placement. Following tooth extraction and periodontal treatment, VBA was achieved using a xenogeneic graft and stabilized with a native bilayer collagen membrane and fixation screw. Owing to the limited volume maintenance of the resorbable membrane, the implant was installed with reinforcement using a sinus crestal approach. Over an 8-year follow-up period, the implant exhibited stable alveolar bone without signs of peri-implantitis or significant bone resorption, suggesting the efficacy and longevity of this technique.

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One-step Approach for Radicular Cyst Removal in the Maxillary Sinus and Implant Placement in the Posterior Maxilla: A Case Report with a 3-Year Follow-Up

Won-Bae PARK ; Hyun-Chang LIM

Journal of implantology and applied sciences.2024;28(2):96-104. doi:10.32542/implantology.2024010

A 39-year-old woman with a large radicular cyst in their left maxillary sinus desired implant treatment in the area of tooth #25 and #26. The cyst was carefully removed using a lateral window approach. During the removal, the sinus membrane next to the cyst also partially removed. Two implants were then placed, measuring Ø4.3 × 8 mm at #25 and Ø4.8 × 8 mm at #26. Due to insufficient bone height in those areas, the implants extended into the sinus floor. The implant protrusion into the sinus measured 3.0 mm at #25 and 0.5 mm at #26. No bone substitute material was used in the sinus. The healing after the surgery went smoothly. After a three-year follow-up, the protruding part of the implant was completely covered by newly formed bone, and there was no evidence of the cyst returning. This case report demonstrates that removing a radicular cyst and placing an implant simultaneously is possible with careful patient selection.

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Full-arch Reconstruction using a Mixture of Xenograft and Octacalcium Phosphate-based Alloplast: A Case Report

Kyeong-Ok LIM ; Won-Pyo LEE ; Jooseong KIM ; Robum LEE

Journal of implantology and applied sciences.2024;28(2):105-113. doi:10.32542/implantology.2024011

In cases of severely atrophic edentulous maxilla, reconstruction, including lateral sinus floor elevation (LSFE) and alveolar ridge augmentation is performed using anorganic bovine bone matrix (ABBM) and/or autogenous bone. In this case, a 1:1 mixture of ABBM and octacalcium phosphate (OCP) was used for bilateral LSFE and vertical ridge augmentation. After a 7-month healing period, seven implants were successfully placed in the regenerated bone without the need for additional bone grafting. Core biopsy revealed a new bone formation rate of 43.8%. Among the residual graft materials, OCP and ABBM accounted for 2.9% and 7.1%, respectively and connective tissue comprised 46.2%. Within the limitations of this case, the combination of ABBM and OCP appeared to be a reliable choice for bone regeneration.

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Digital Guided Implant Placement using Sinus Lift with Iliac Bone Graft: A Case Report

Euntae JOO ; Yootaek SHIN ; Sang Min HAM ; Jee Hwan KIM ; Jun-Young KIM

Journal of implantology and applied sciences.2024;28(2):88-95. doi:10.32542/implantology.2024009

To restore masticatory function, dental implants require adequate bone support. For extensive maxillary bone loss, sinus lift surgery with bone grafting is often employed, favoring the autogenous iliac crest bone for better implant integration. Guides aid in the precise placement of implants and can reduce surgery time. In this context, an approach that combines of sinus lifting, bone grafting, and implant placement can be beneficial. In April 2020, a 58-year-old male presented with severe left maxillary alveolar bone atrophy and peri-implantitis of the right maxilla. Implants #15i, # 16i, and # 17i were removed, followed by bilateral sinus lift, bone grafting, and implant placement. During the 2-year follow-up after prosthesis placement, both the graft material and implants remained stable without complications. Iliac bone grafts exhibit greater resorption than other graft materials. In this case, implant positioning based on virtual planning and modifications guided by experience was performed without complications.

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Comparative Analysis of Three Modalities for Maxillary Sinus Perforation Repair: A Retrospective Study

Jong-Hoon LEE ; Jeoung-A YU ; Seong-Ho CHOI ; Dong-Woon LEE

Journal of implantology and applied sciences.2024;28(2):63-76. doi:10.32542/implantology.2024007

Purpose: This study aimed to analyze the prognosis of implant placement after maxillary sinus perforation repair using a collagen membrane during sinus elevation surgery.Materials and Methods: The radiographic and clinical data of 27 patients who underwent simultaneous or delayed implant placement with perforation repair (using collagen membranes) were retrospectively analyzed. The patients were divided into the following three groups: group 1: perforation repair, bone grafting, and simultaneous implant placement (nine patients, 19 implants); group 2: perforation repair, no bone grafting, and simultaneous implant placement (11 patients, 19 implants); group 3: perforation repair, bone grafting, and delayed implant placement (seven patients, 15 implants). The follow-up period was at least 2 years for all patients. Results: No significant differences in implant survival rates were observed between groups. Marginal bone loss was minimal in all groups with some exceptions. The thickness of the maxillary sinus measured on the day of surgery differed significantly between the groups, potentially attributed to the variations in the surgical materials employed. However, the thickness normalized in all groups at 1-year follow-up. Conclusion This study suggests that simultaneous and delayed implant placement in cases of perforated maxillary sinus membranes repaired with collagen membranes during sinus elevation surgery can achieve favorable long-term outcomes. In certain cases, simultaneous implant placement without bone grafting is a viable option.

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Evaluation of Factors Influencing Maxillary Sinus Floor Augmentation for Implant Placement: A Retrospective Study

Jihun CHA ; Jaeyoung RYU ; Seunggon JUNG ; Hong-Ju PARK ; Hee-Kyun OH ; Min-Suk KOOK

Journal of implantology and applied sciences.2024;28(2):77-87. doi:10.32542/implantology.2024008

Purpose: This retrospective study compared the maxillary sinus floor augmentation techniques (lateral and transcrestal approaches) to assess the impact of bone grafting, graft materials, and initial residual bone height (RBH). Materials and Methods: Fifty patients who underwent maxillary sinus floor augmentation for posterior maxillary implant placement were included. Panoramic radiographs were obtained before surgery (T0), immediately after surgery (T1), and 6-10 months post-surgery (T2). Length measurements on panoramic radiographs were performed using a digital caliper at T1 and T2. Statistical validation included one-way ANOVA, t-tests, Mann-Whitney U tests, and correlation analyses. Multivariate linear regression was used to assess associations after adjusting for confounding factors. Results: Of the 50 patients, 35 underwent a transcrestal approach and 15 underwent a lateral approach. The results showed significant endosinus bone gain (ESBG) differences between allogeneic and xenogeneic grafts and no grafts (p < .001). Osteotomy sinus floor elevation without grafting yielded 3.24 ± 1.42 of ESBG. When divided into three groups based on initial RBH, RBH 1 had 27 patients, RBH 2 had 12 patients, and RBH 3 had 11 patients. Within the RBH group 1 (RBH under 4), the lateral approach had significantly greater ESBG than the transcrestal approach (p < .001). Multivariate linear regression analysis confirmed statistically significant associations between the studied variables after adjusting for confounding factors. Conclusion When the RBH is < 4 mm, lateral-approach sinus augmentation and bone grafting should be performed to attain significant ESBG. The RBH, bone graft materials, and sinus elevation techniques vary considerably in ESBG.

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Esthetic Rehabilitation of A Single-implant Prosthesis Using Software-based Virtual Trial Procedures Encompassing Visual Inspection and Quantitative Evaluation: A Case Report

Hyeon Chae KIM ; Kyung Chul OH

Journal of implantology and applied sciences.2024;28(1):54-61. doi:10.32542/implantology.2024006

Shade selection is essential to achieving good esthetic outcomes of prosthodontic treatment. Visual inspection methods are easily performed but may feature inconsistent outcomes. Digital shade- measuring devices require expert result interpretation and are expensive. In this case report, a practical clinical approach for shade selection was applied. After an impression was obtained, a single implant-supported crown was fabricated on a cast model. Intraoral photograph and the photograph of the cast model with the prosthesis placed upon it were uploaded into the software. The prosthesis part of the cast model photograph was cropped and superimposed over the intraoral photograph, enabling a virtual trial of the prosthesis to predict the expected esthetic outcomes.

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Implants Removal Due to Abutment or Screw Fracture: Report of 13 Cases

Tae-Wook KWAK ; Kang-Min AHN

Journal of implantology and applied sciences.2024;28(1):10-17. doi:10.32542/implantology.2024002

Purpose: This study aimed to report dental implant removal due to various instances of implant abutment and screw fractures. In this study, the indications for implant removal due to mechanical failure were documented.Materials and Methods: This study investigated patients referred to the Department of Oral and Maxillofacial Surgery of our hospital for implant removal surgery due to abutment screw fractures between 2010 and 2024. The study included 13 patients with 15 implants. Patient age, sex, implant location, fracture site, and implant system type were investigated. Results: Fifteen implants were removed in 13 patients with abutment and screw fractures. The mean age of the patients was 63.4 years. Moreover, a total of 11 men and two women were included in the analysis. The implants were most commonly placed in the molar region, with a maxilla-to-mandible ratio of 9:6. The screw fracture locations were categorized into the cervical, middle, or apical thirds. Their corresponding numbers were two, eight, and four, respectively. The implant system and manufacturer demonstrated no significant correlation with screw fractures. Conclusion When a screw fracture occurs in the lower third of a dental implant, removal is often difficult. Regular check-ups and periodic screw tightening are mandatory to prevent severe complications such as screw or abutment fractures. Failed implants should be removed and replaced with new dental implants.

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Dental Implant Fractures: A Report of 43 Implant Fixtures in 33 Patients

Sangjun PARK ; Kang-Min AHN

Journal of implantology and applied sciences.2024;28(1):1-9. doi:10.32542/implantology.2024001

Purpose: Implant-supported restorations have become the standard treatment for edentulous patients. However, several complications have been reported, including implant-fixture fracture. This study aimed to determine the risk factors for dental implant-fixture fracture by evaluating 43 fractured implant fixtures in 33 patients. Materials and Methods: This study included patients referred from local clinics owing to implant fracture between 2006 and 2023. The implant type and location, method for removal, and risk factors for implant fracture were investigated. Results: This study included 22 men and 11 women (mean age, 60.8 years; range, 33–82 years). Implant fracture was twice as common in men than in women. Fractures were more common in fixtures with internal connections rather than in those with external connections. More implant fractures were observed in patients with single implants than in those with multiple implants. Conclusion Since the only solution to implant fracture is removal, regular follow-up and biomechanical and biological considerations to reduce dental implant fracture are necessary.

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Endosinus Bone Gain after Osteotome Sinus Floor Elevation Without Bone Grafting: A Retrospective Study

Hye In KEUM ; Hun Jun LIM

Journal of implantology and applied sciences.2024;28(1):42-53. doi:10.32542/implantology.2024005

Purpose: This retrospective study evaluated the radiographic and clinical outcomes of osteotome sinus floor elevation (OSFE) without bone grafts, and analyzed the factors influencing endosinus bone remodeling.Materials and Methods: Radiographic and clinical data from 44 implants in 36 patients were collected after a follow-up period of 6 months to 6.5 years (mean, 2.04 years). Mean residual bone height (RBH) was 5.0 ± 1.3 mm. The length of the implant protruding into the sinus and endosinus bone gain (ESBG) on radiographs were measured. Results: All the 44 implants survived until the final follow-up period. Groups were divided according to an RBH of 5 mm at the time of implant placement, with 22 implants per group. Mean ESBG was 2.40 ± 1.48 mm in an RBH < 5 mm group and 2.01 ± 0.87 mm in an RBH ≥5 mm group. Endosinus bone gain was significantly higher in the RBH < 5 mm group for up to one year after the implant placement; however, there was no significant difference between the two groups at the final follow-up period. Conclusion Osteotome sinus floor elevation without bone grafting is a predictable procedure for achieving endosinus bone remodeling when RBH is < 5 mm.

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