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양해민(Hae-Min Yang),유선경(Sun-Kyoung Yu),이명화(Myoung-Hwa Lee),김성훈(Seong-Hoon Kim),김승희(Seung-Hee Kim),김흥중(Heung-Joong Kim) 대한체질인류학회 2010 해부·생물인류학 (Anat Biol Anthropol) Vol.23 No.3
임플란트 식립과 위턱굴 거상술 시 위턱굴바닥의 형태와 이틀돌기의 높이에 대한 이해는 성공적인 시술을 위해 매우 중요한 요소이다. 본 연구에서는 한국인의 위턱굴바닥의 형태와 이틀돌기와의 관계를 계측, 분석하여 유용한 자료를 제공하고자 한다. 정상 치아를 가지고 있는 해부학 연구실습용 시신 29구(남 18구, 여 11구)의 위턱을 이용하였다. 사망 시 연령은 40~90세였으며 평균연령은 59.9세였다. 위턱뼈 절편을 코안 바닥의 높이와 평행하게 절단한 후, 치아장축에 평행하게 첫째작은어금니, 둘째작은어금니, 첫째큰어금니, 둘째큰어금니의 가운데 부위를 절단하였다. 각 절편의 절단면을 스캐너(HP Scanjet G4050)로 스캔한 다음, 얻어진 영상을 Adobe Photoshop CS3에서 0.01 ㎜ 수준까지 계측하였다. SPSS를 이용하여 평균, 표준편차 및 상관계수(r)를 구하였다. 위턱굴바닥의 너비는 첫째작은어금니, 둘째작은어금니, 첫째큰어금니, 둘째큰어금니 순으로 7.87±3.04 ㎜, 11.05±4.40 ㎜, 13.21±4.78 ㎜, 12.47±4.32 ㎜였다. 위턱굴바닥의 깊이는 첫째작은어금니, 둘째작은어금니, 첫째큰어금니, 둘째큰어금니 순으로 -3.74±4.57 ㎜, -4.77±4.80 ㎜, -4.84±4.69 ㎜, -4.19±6.24㎜였다. 이틀돌기의 높이는 첫째작은어금니, 둘째작은어금니, 첫째큰어금니, 둘째큰어금니 순으로 19.02±3.36 ㎜, 15.71±4.44 ㎜, 13.59±3.22 ㎜, 12.50±2.99㎜였다. 위턱굴바닥의 너비와 이틀돌기의 높이 사이의 상관계수(r)는 치아순으로 각각 0.342, 0.631, 0.602, 0.543으로 상관관계가 낮았다. 위턱굴바닥의 깊이와 이틀돌기의 높이 사이의 상관계수(r)는 치아순으로 각각 0.808, 0.899, 0.789, 0.805로, 위턱굴바닥의 깊이가 깊을수록 이틀돌기의 높이도 낮아지는 결과를 보여 높은 상관관계를 보였다. 이를 종합하여 보면, 한국인의 위턱굴바닥은 첫째큰어금니에서 가장 깊고 넓었으며, 이틀돌기의 높이는 둘째 큰어금니에서 가장 낮았다. 이러한 계측 결과는 임플란트 식립과 위턱굴 거상술 시 위턱굴바닥에 대한 중요한 해부학적 자료를 제공해 줄 것이다. The implant placement and sinus floor elevation on maxillae have required the accurate understanding of maxillary sinus floor and alveolar process. Therefore, the purpose of this study was to investigate the maxillary sinus floor morphology and the correlation between maxillary sinus floor and alveolar process in Korean. Twenty-nine cadaveric maxillae with normal teeth were used, with age at death ranging from 40 to 90 years (mean: 59.9 years). After the maxilla was cut above the nasal cavity floor, it was sectioned at midline of the tooth from 1st premolar to 2nd molar by parallel to long axis of the tooth. The specimens were scanned using the Scanner (HP Scanjet G4050). The scan image was measured using Adobe Photoshop CS3 at the 0.01 mm. Mean, SD, and correlation coefficient (r) were took using SPSS. The width of maxillary sinus floor at nasal cavity floor level was 7.87±3.04 ㎜ at 1st premolar (P1), 11.05±4.40 ㎜ at 2nd premolar (P2), 13.21±4.78 ㎜ at 1st molar (M1), and 12.47±4.32 ㎜ at 2nd molar (M2). The depth of maxillary sinus floor at nasal cavity floor level was -3.74±4.57 ㎜, -4.77±4.80 ㎜, -4.84±4.69 ㎜, and -4.19±6.24 ㎜ at P1, P2, M1, and M2, respectively. The height of alveolar process bone was 19.02±3.36 ㎜, 15.71±4.44 ㎜, 13.59±3.22 ㎜, and 12.50±2.99 ㎜ at P1, P2, M1, and M2, respectively. The correlation coefficient (r) between the width of maxillary sinus floor and the height of alveolar process was 0.342, 0.631, 0.602, and 0.543 at P1, P2, M1, and M2, respectively, which were lack of correlations. The correlation coefficient (r) between the depth of maxillary sinus floor and the height of alveolar process was 0.808, 0.899, 0.789, and 0.805 at P1, P2, M1, and M2, respectively. It represented that the deeper the depth of maxillary sinus floor, the lower the height of alveolar process was. In conclusion, the maxillary sinus floor in Korean was the deepest and the widest at M1, and the height of alveolar process was the lowest at M2. This result provided useful anatomic information about maxillary sinus floor for the implant placement and sinus floor elevation.
Angulation between Long Axis of Anterior Teeth and Alveolar Process, and Thickness of Alveolar Bone
Sun-Kyoung Yu(유선경),HeeJu Kim(김희주),Myoung-Hwa Lee(이명화),Seog Kim(김석),Heung-Joong Kim(김흥중) 대한체질인류학회 2012 해부·생물인류학 (Anat Biol Anthropol) Vol.25 No.1
앞니부위의 임플란트 시술 시 기능과 심미성의 회복은 중요한 요소이다. 본 연구의 목적은 한국인 앞 니부위의 치아와 이틀돌기의 장축 사이의 각도 및 이틀뼈의 두께를 계측하여 임플란트 시술 시 유용한 해부학 적 자료를 제공하는데 있다. 본 연구에서는 한국인 시신 25구에서 (남자 16구, 여자 9구) 얻어진 위턱뼈 18쪽과 아래턱뼈 23쪽을 사용하였 다. 치아와 이틀돌기의 장축을 설정하여 두축 사이의 각도를 계측하였고, 엽술쪽과 혀쪽의 이틀능선, 뿌리중간, 그리고 뿌리끝 부위에서 이틀뼈의 두께를 Adobe Photoshop을 이용하여 측정하였다. 이틀돌기와 치아장축 사이의 각도는 위턱 앞니들이 아래턱보다 2-3배 정도 더 혀쪽 경사를 보였다. 위턱에 서 입술쪽과 혀쪽 이틀뼈의 두께는 유의적 차이를 보였으며,특히 뿌리끝부위에서 큰 차이를 보였다 아래턱에 서 엽술쪽 이틀뼈의 두께와 혀쪽 이툴뼈의 두께를 비교한 결과 뿌리끝부위에서만 유의적 차이가 나타났다. 이를 종합하면,앞니부위의 이틀돌기의 두께가 앓고 특히 위턱에서 치아의 장축이 이틀돌기에 대하여 싱당한 혀쪽 경사를 보이기 때문에, 임상의들은 임플란트 시술 시 입술쪽 이틀뼈에 대한 주의가 요구된다. The main aim of dental implant placement on the anterior region is to recover the function and esthetics. Therefore, this study examined the angulation between the long axis of the anterior teeth and the alveolar process, and thickness of the alveolar bone on the anterior region. Twenty-five cadaver heads (18 maxillae and 23 mandibles) were examined (16 male and 9 female, mean: 56.7 years). The angulation between the long axis of the anterior teeth and the alveolar process was measured, and the alveolar bone thickness was measured in the three levels (crest; C, middle; M, apex; A) on the labial and lingual sides. All data was analyzed statistically using one-way ANOVA. The maxillary anterior teeth showed two to three times more lingual inclination than the mandibular teeth. The difference in maxillary alveolar bone thickness on the labial and lingual sides was significant in all levels, particularly in the apex. The mandibular alveolar bone thickness on the labial and lingual side was significantly different only in the apex. In conclusion, the alveolar bone thickness on the anterior region was too thin, and the long axis of the maxillary anterior teeth showed more lingual inclination than the alveolar process. Therefore, clinicians need to be a detailed assessment of the labial alveolar bone for dental implant placement.
임플랜트 시술을 위한 치조돌기와 상악동 주변 구조물의 형태계측적 연구
박주진,이영수,백두진,박원희,유동엽,Park, Ju-Jin,Lee, Young-Soo,Paik, Doo-Jin,Park, Won-Hee,Yoo, Dong-Yeob 대한치과보철학회 2007 대한치과보철학회지 Vol.45 No.2
Statement of problem: Following tooth loss, the edentulous alveolar process of maxilla is affected by irreversible reabsorption process, with progressive sinus pneumatization leads to leaving inadquate bone height for placement of endosseous implants. Grafting the floor of maxillary sinus by sinus lifting surgery and augmentation of autologous bone or alternative bone material is a method of attaining sufficient bone height for maxillary implants placement and has proven to be a highty successful. Purpose: This study was undertaken to clarify the morphometric characteristics of inferior maxillary sinus and alveolar process for installation of implants. Material and method: Nineteen skulls (37 sinuses, 10M / 9F) obtained from the collection of the department of anatomy and cell biology of Hanyang medical school were studied. The mean age of the deceased was 69.9 years (range 44 to 88 years). The distance between alveolar border and inferior sinus margin at each tooth, the height of alveolar process and the thickness of cortical bone of the outer and inner table of alveolar process and the inferior wall of maxillary sinus were measured. Results and Conclusion: 1. The septum of inferior maxillary sinus were observe 28 sides (76.%) and located at the third molar (52.6%) and the second molar (26.3%). The deepest points of inferior border of maxillary sinus were located the first or second molar. The distance between alveolar margin and the deepest point of inferior maxillary sinus is $9.7{\pm}4.9mm$. 2. The length of the outer table of alveolar process were $4.9\sim28.2mm$ and the shortest point was between the first and the second molors. The thickness of them were $0.9\sim3.2mm$. The length of the inner table of alveolar process were $7.4\sim25.8mm$ and the shortest point was between the first and the second molars. The thickness of the were $0.9\sim4.6mm$. The results of this study are useful anatomical data for installing of maxillary implants.
Nostril Base Augmentation Effect of Alveolar Bone Graft
Lee, Woojin,Park, Hyung Joon,Choi, Hyun Gon,Shin, Dong Hyeok,Uhm, Ki Il Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.5
Background The aims of alveolar bone grafting are closure of the fistula, stabilization of the maxillary arch, support for the roots of the teeth adjacent to the cleft on each side. We observed nostril base augmentation in patients with alveolar clefts after alveolar bone grafting. The purpose of this study was to evaluate the nostril base augmentation effect of secondary alveolar bone grafting in patients with unilateral alveolar cleft. Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bone grafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 were reviewed. Preoperative and postoperative worm's-eye view photographs and reconstructed three-dimensional computed tomography (CT) scans were used for photogrammetry. The depression of the nostril base and thickness of the philtrum on the cleft side were measured in comparison to the normal side. The depression of the cleft side pyriform aperture was measured in comparison to the normal side on reconstructed three-dimensional CT. Results Significant changes were seen in the nostril base (P=0.005), the philtrum length (P=0.013), and the angle (P=0.006). The CT measurements showed significant changes in the pyriform aperture (P<0.001) and the angle (P<0.001). Conclusions An alveolar bone graft not only fills the gap in the alveolar process but also augments the nostril base after surgery. In this study, only an alveolar bone graft was performed to prevent bias from other procedures. Nostril base augmentation can be achieved by performing alveolar bone grafts in children, in whom invasive methods are not advised.
Nostril Base Augmentation Effect of Alveolar Bone Graft
Woojin Lee,Hyung Joon Park,Dong Hyeok Shin,엄기일 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.5
Background The aims of alveolar bone grafting are closure of the fistula, stabilization of the maxillary arch, support for the roots of the teeth adjacent to the cleft on each side. We observed nostril base augmentation in patients with alveolar clefts after alveolar bone grafting. The purpose of this study was to evaluate the nostril base augmentation effect of secondary alveolar bone grafting in patients with unilateral alveolar cleft. Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bone grafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 were reviewed. Preoperative and postoperative worm’s-eye view photographs and reconstructed three-dimensional computed tomography (CT) scans were used for photogrammetry. The depression of the nostril base and thickness of the philtrum on the cleft side were measured in comparison to the normal side. The depression of the cleft side pyriform aperture was measured in comparison to the normal side on reconstructed three-dimensional CT. Results Significant changes were seen in the nostril base (P=0.005), the philtrum length (P=0.013), and the angle (P=0.006). The CT measurements showed significant changes in the pyriform aperture (P<0.001) and the angle (P<0.001). Conclusions An alveolar bone graft not only fills the gap in the alveolar process but also augments the nostril base after surgery. In this study, only an alveolar bone graft was performed to prevent bias from other procedures. Nostril base augmentation can be achieved by performing alveolar bone grafts in children, in whom invasive methods are not advised.
Nur Hafizah Kamar Affendi,Jumanah Babiker,Mohd Yusmiaidil Putera Mohd Yusof 대한치주과학회 2023 Journal of Periodontal & Implant Science Vol.53 No.6
Purpose: This study aimed to quantify alveolar bone morphology, demonstrate the relationship between tooth angulation and alveolar bone thickness, and introduce a new classification for anterior mandibular teeth related to immediate implant placement (IIP). Methods: Cone-beam computed tomography (CBCT) images of 211 anterior mandibular teeth were analyzed in sagittal slices to measure the thickness of the facial alveolar bone crest (FAB1) and apex (FAB2), and the lingual alveolar bone crest (LAB1) and apex (LAB2). Tooth angulation was classified as 1°–10°, 11°–20°, and >20° according to the tooth’s long axis and alveolar bone wall. Spearman correlation coefficients were used to evaluate correlations between the variables. Results: FAB1 and LAB1 were predominantly thin (<1 mm) (84.4% and 73.4%, respectively), with the lateral incisors being thinnest. At the apical level, FAB2 and LAB2 were thick in 99.5% and 99.1% of cases, respectively. Significant differences were documented in FAB2 (P=0.004), LAB1 (P=0.001), and LAB2 (P=0.001) of all mandibular teeth. At all apical levels of the inspected teeth, a significant negative correlation existed between TA and FAB2. Meanwhile, TA showed a significant positive correlation with LAB2 of the lateral incisors and canines. These patterns were then divided into class I (thick facial and lingual alveolar bone), class II (facially inclined teeth) with subtype A (1°–10°) and subtype B (11°–20°), and class III (lingually inclined teeth) with subtype A (1°–10°) and subtype B (11°–20°). Conclusions: Mandibular anterior teeth have predominantly thin facial and lingual crests, making the lingual bone apical thickness crucial for IIP. Although anchorage can be obtained from lingual bone, tooth angulation and tooth types had an impact on IIP planning. Hence, the new classification based on TA and alveolar bone wall may enable rational clinical planning for IIP treatment.
Nattida Khumsarn,Virush Patanaporn,Apirum Janhom,Dhirawat Jotikasthira 대한영상치의학회 2016 Imaging Science in Dentistry Vol.46 No.2
Purpose: This study evaluated and compared interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns, using cone-beam computed tomography (CBCT). Materials and Methods: Pretreatment CBCT images of 24 Thai orthodontic patients with Class I and Class II skeletal patterns were included in the study. Three measurements were chosen for investigation: the mesiodistal distance between the roots, the width of the buccolingual alveolar process, and buccal cortical bone thickness. All distances were recorded at five different levels from the cementoenamel junction (CEJ). Descriptive statistical analysis and t-tests were performed, with the significance level for all tests set at p<0.05. Results: Patients with a Class II skeletal pattern showed significantly greater maxillary mesiodistal distances (between the first and second premolars) and widths of the buccolingual alveolar process (between the first and second molars) than Class I skeletal pattern patients at 10 mm above the CEJ. The maxillary buccal cortical bone thicknesses between the second premolar and first molar at 8 mm above the CEJ in Class II patients were likewise significantly greater than in Class I patients. Patients with a Class I skeletal pattern showed significantly wider mandibular buccolingual alveolar processes than did Class II patients (between the first and second molars) at 4, 6, and 8 mm below the CEJ. Conclusion: In both the maxilla and mandible, the mesiodistal distances, the width of the buccolingual alveolar process, and buccal cortical bone thickness tended to increase from the CEJ to the apex in both Class I and Class II skeletal patterns.
Khumsarn, Nattida,Patanaporn, Virush,Janhom, Apirum,Jotikasthira, Dhirawat Korean Academy of Oral and Maxillofacial Radiology 2016 Imaging Science in Dentistry Vol.46 No.2
Purpose: This study evaluated and compared interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns, using cone-beam computed tomography (CBCT). Materials and Methods: Pretreatment CBCT images of 24 Thai orthodontic patients with Class I and Class II skeletal patterns were included in the study. Three measurements were chosen for investigation: the mesiodistal distance between the roots, the width of the buccolingual alveolar process, and buccal cortical bone thickness. All distances were recorded at five different levels from the cementoenamel junction (CEJ). Descriptive statistical analysis and t-tests were performed, with the significance level for all tests set at p<0.05. Results: Patients with a Class II skeletal pattern showed significantly greater maxillary mesiodistal distances (between the first and second premolars) and widths of the buccolingual alveolar process (between the first and second molars) than Class I skeletal pattern patients at 10 mm above the CEJ. The maxillary buccal cortical bone thicknesses between the second premolar and first molar at 8 mm above the CEJ in Class II patients were likewise significantly greater than in Class I patients. Patients with a Class I skeletal pattern showed significantly wider mandibular buccolingual alveolar processes than did Class II patients (between the first and second molars) at 4, 6, and 8 mm below the CEJ. Conclusion: In both the maxilla and mandible, the mesiodistal distances, the width of the buccolingual alveolar process, and buccal cortical bone thickness tended to increase from the CEJ to the apex in both Class I and Class II skeletal patterns.
Suweera Petaibunlue,Pravej Serichetaphongse,Atiphan Pimkhaokham 대한영상치의학회 2019 Imaging Science in Dentistry Vol.49 No.2
Purpose: This study was conducted to characterize the relationship of the angulation between the tooth root axis and alveolar bone axis with anterior alveolar (AA) arch forms and sagittal root position (SRP) in the anterior esthetic region using cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT images that met the inclusion and exclusion criteria were categorized using a recent classification of AA arch forms and a SRP classification. Then, the angulation of the root axis and the alveolar bone axis was measured using mid-sagittal CBCT images of each tooth. The relationships of the angulation with each AA arch form and SRP classification were evaluated using 1-way analysis of variance and a linear regression model. Results: Ninety-eight CBCT images were included in this study. SRP had a greater influence than the AA arch form on the angulation of the root axis and the alveolar bone axis (P<0.05). However, the combination of AA arch form and SRP was more predictive of the angulation of the root axis and the alveolar bone axis than either parameter individually. Conclusion: The angulation of the root axis and alveolar bone axis demonstrated a relationship with the AA arch form and SRP in teeth in the anterior esthetic region. The influence of SRP was greater, but the combination of both parameters was more predictive of root-to-bone angulation than either parameter individually, implying that clinicians should account for both the AA arch form and SRP when planning implant placement procedures in this region.
Valerio, Claudia Scigliano,Alves, Claudia Assuncao e,Manzi, Flavio Ricardo Korean Academy of Oral and Maxillofacial Radiology 2019 Imaging Science in Dentistry Vol.49 No.1
Purpose: This study aimed to introduce a novel method to evaluate the alveolar bone and interdental septum in the anterior mandible using cone-beam computed tomography (CBCT). Materials and Methods: Fifty-six CBCT scans from adult patients were selected. The CBCT scans were obtained before and after orthodontic treatment. The following measurements were taken: width of the alveolar bone and the interdental septum, height of the interdental septum, height of the bone plates, distance between the cementoenamel junction and marginal bone crests, and vertical positioning of the mandibular incisor, using the lingual plane as a reference. To test the reproducibility and the stability of the lingual plane, a triangle was traced in the anterior mandible. The intra-class correlation coefficient(ICC) was used to determine intra- and inter-examiner agreement. The paired Student t-test was used to evaluate the area of the triangle and the reproducibility of all measurements. Results: The ICC was excellent for the alveolar bone and dental measurements (0.9989 and 0.9977, respectively), as well as for the interdental septum (0.9987 and 0.9961, respectively). The area of the triangles showed stability in the lingual plane (P>0.05). For the alveolar bone, mandibular incisor, and interdental septum measurements, no statistically significant differences were found between the 2 examiners(P>0.05), confirming the technical reliability of the measurements. Conclusion: The method used in this study provides a valid and reproducible assessment of alveolar bone dimensions in the anterior mandible measured on CBCT images.