• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.64-68
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• 2002

The cleft alveolus is one of three parts in cleft deformity. The purpose of cleft alveolus bone grafting is the recovery of normal esthetics, occlusion and speech. If a bony defect is extended to the nasal floor, especially wide bony defect at the ala base, it is difficult to condense the cancellous bone during bone transplantation and to reconstruct the normal anatomy at the alar base. We treated with above mentioned cleft alveolus patients using the autogenous cortical bone effectively. We report this technique with two cases and the literatures review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.565-580
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• 2000

This study was designed to evaluate the influence of cultured epidermal tissue graft and the administration of transforming growth factor(TGF)-${\beta}_3$ on maxillary growth in surgically created palatal defects. A total of 155 rats were divided into 2 groups according to surgical timing : postnatal 2 weeks(n=95), 4 weeks(n=40) and control(unoperated) group(n=20). The postnatal 2-week surgical group was subdivided into 3 groups according to repair methods: conventional surgery(Von Langenbeck technique)group(n=23); cultured tissue graft group(n=25); and full thickness skin graft group(n=25). Additionally, recombinant human TGF-${\beta}_3$ was administered(30ng or 150ng) on collagen matrix in surgically created palatal defects during surgery(9 conventional surgeries, 9 cultured tissue grafts) in 2-week-old rats. The results showed that all types of surgical treatment decreased maxillary growth compared with the control(unoperated) group(p<0.0001). On the other hand, the tissue graft group, whether cultured tissue or grafted skin, contributed to increased maxillary growth(p<0.0001).And exogenous TGF-${\beta}_3$ might play a role in connective tissue proliferation and new bone generation during wound healing on palatal defects. Our results suggest that grafting cultured epidermis with collagen matrix decreases the scar tension on maxillary growth more than conventional palatal surgery does. Therefore, exogenous TGF-${\beta}_3$ may contribute to accelerate wound healing on palatal defects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.325-336
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• 2000

Bone morphogenetic protein-2/4 are members of Transforming Growth Factor-$\beta$(TGF-$\beta$) superfamily and they may induce formation of cartilage and bone in vivo. This study was performed to investigate the cellular target and period of action of BMP-2/4 and understanding of actions of BMP-2/4 at cellular level. The appearance of BMP-2/4 during healing of mandibular and periodontal defect in rat was evaluated immunohistochemically. 40 Sprague-Dawley strain white male rats, each weighing about 300gm were used. Bony defect was performed in the mandible and they were sacrificed at the day of 3rd, 10th, 20th, 30th after operation. The specimens were harvested and examined histologically and immunohistochemically by localization of anti-BMP-2/4. The results were as follows: 1. Woven bone was observed at 10th day and perfect healing of defect with compact bone and periodontal ligment space at 30th day. 2. Osteoprogenitor cells, osteoblastic cells and periosteum were positive reaction to immunohistochemical stain at 10th day. 3. Cells of bone marrow space and surface cells of osteocytes and cementoblasts were positive reaction to immunohistochemical stain at 20th day. 4. Newly formed osteocytes and cementocytes were positive reaction to immunohistochemical stain at 30th day. From the above findings, we could conclude that BMP-2/4 acted significant roles as factors of induction, proliferation and differentiation during bone healing process.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.85-92
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• 2005

Reconstruction of defect in the anterior part of the maxilla to enable implant placement or prothesis is a complicated treatment due to the anatomical position and lack of soft tissues. Two cases are presented in which autogenous iliac PMCB(particulate marrow and cancellous bone) with titanium mesh were used for premaxilla reconstruction and alveolar bone repair of the anterior maxillas prior to denture and implants fixation respectively. Cancellous bone from the anterior iliac crest was compressed and placed against a titanium mesh fixed to the bone of palate in a patient with severe defect of the anterior maxilla. There were no problem in the healing, and the anterior maxillas of two patients had increased height and width during the initial healing and remodeling. The clinical reports describe the use of titanium mesh for reconstruction of premaxilla. Autogenous bone grafts were harvested from the iliac crest and were loaded on a titanium mesh that were left in the patient's maxilla for 6 months before they were removed respectively. The radiographic analysis demonstrated that a 10mm vertical ridge augmentation had been achieved. In guided bone regeneration, the quantity of bone regenerated under the barrier has been demonstrated to be directly related to the amount of the space under the membrane. This space can diminish as a result of membrane collapse. To avoid this problem which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, were used in association with autologous bone in 2 cases. The aim of this study was to evaluate the capability of a configured titanium mesh to serve as a mechanical and biologic device for restoring a vertically defected premaxilla.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.299-310
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• 2012

Purpose: The purpose of this study was to evaluate the histological healing process of 3 different types of xenogenic tooth bone graft material and xenogenic bone graft material. Methods: Three types of human tooth bone graft material (chips, crowns, and roots) and BioOss (Geistlich Pharma AG, Wolhausen, Switzerland) was filled at the preformed 4 round-shaped calvarial bone defects of beagle dogs. The beagles were sacrificed at 2, 4, 8, and 12 weeks, respectively, for radiological and histological evaluation. Results: Increased strength and radiopacity were detected in all graft material groups in time-dependent manner. New bone was formed and matured surrounding the graft material histologically. Also, a new bone was directly integrated with graft material. Conclusion: It was expected that newly developed tooth bone graft material would show good bone healing capacity if it was used as a graft material for the restoration of bony defect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.293-298
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• 2012

Purpose: The aim of this study was to evaluate the bone regeneration ability of 1% tetracycline (TC)-loaded silk fibroin membrane (SFM), in a rabbit calvarial defect model. Methods: Twenty New Zealand white rabbits were used for this study. Bilateral round defects were made on the rabbit parietal bone, using trephine bur with an 8 mm diameter. TC-loaded SFM or SFM was covered on the right parietal bone defect, and the left parietal bone defects were uncovered for the control. The animals were humanely sacrificed at 4 or 8 weeks postoperatively. A micro-computerized tomography (${\mu}$-CT) of each specimen was taken for analysis of bone regeneration. Hematoxylin and Eosin stain were done to observe histological findings. Results: From the ${\mu}$-CT results, regenerated bone volume ($mm^3$) of 1% TC-loaded SFM, SFM, and control were $7.80{\pm}5.87$, $8.79{\pm}3.44$, and $10.61{\pm}5.3$ at 4 weeks postoperatively, respectively (P>0.05). Regenerated bone volume ($mm^3$) of 1% TC-loaded SFM, SFM, and control were $36.56{\pm}8.50$, $25.86{\pm}8.17$, and $19.09{\pm}5.07$ at 8 weeks postoperatively, respectively (P<0.05). Conclusion: The 1% TC-loaded SFM showed more bone regeneration than the SFM and the uncovered control, in guided bone regeneration.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.1
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• pp.13-17
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• 2013

Purpose: This study evaluated the capability of bone formation of silk fibroin particles coated with hydroxyapatites (HA/SF), as bone graft material when put into the calvarial defect of rats. Methods: Twenty Sprague Dawley rats were used for this study and round shaped defects were formed in the center of parietal bones (diameter: 8.0 mm). The defect was filled with (1) HA/SF (experimental group), or (2) left as a vacant space (control group). The animals were sacrificed at 4 or 8 weeks, postoperatively. The specimens were decalcified and stained with Masson's trichrome for histomorphometric analysis. Results: The average of new bone formation was $33.18{\pm}3.10%$ in the experimental group and $20.49{\pm}5.79%$ in the control group at 4 weeks postoperatively. That was $42.52{\pm}7.74%$ in the experimental group and $25.50{\pm}7.31%$ in the control group at 8 weeks postoperatively. The difference between the groups was significantly higher at both 4 weeks and 8 weeks postoperatively (P<0.05). Conclusion: The rat calvarial defect was successfully repaired by HA/SF graft. The HA/SF graft showed more new bone formation compared with the unfilled control.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.33-38
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• 2010

Maxillectomy is a treatment option for maxillary cancer, which leaves the patient with a palatal defect. It may cause problems with facial deformation, swallowing, mastication, and speech. These functional problems and changes in appearance may result in psychological problems. To control these deficits after maxillectomy, surgical reconstruction or prosthodontic treatment can be chosen as a treatment option. Obturator prosthesis has been used as a preferred method of rehabilitation for most maxillectomy patients. This case is a patient who was classified Aramany classification II hemi-maxillectomy patient with residual teeth from #11-25, whose teeth had substantial labioversion and clinically lengthened from alveolar bone involution, thus making it hard to select proper framework design and resist to the rotational dislodging force of the obturator. Therefore we selected swing-lock attachment design to remain pre-existing crown and bridges and obtain retention and stability of obturator. The swing-lock RPD is economical than the conventional RPD because we can remain pre-existing crown and bridges. And residual teeth which have mobility and poor prognosis can be successfully retained through properly designed swing-lock RPD as it is functioning as a removable splint on the teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.290-301
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• 2002

The purpose of this study was to evaluate new bone formation and healing process in rat calvarial bone defects using $BioMesh^{(R)}$. membrane and DFDB. Forty eight rats divided equally into 4 groups of 1 control group and 3 experimental groups. Standardized transosseous circular calvarial defects (8 mm in diameter) were made midparietally. In the control group, the defect was only covered with the soft tissue flap. In the experimental group 1, it was filled with DFDB only, in the experimental group 2, it was covered $BioMesh^{(R)}$. membrane only, and in the experimental group 3, it was filled DFDB and covered with membrane. At the postoperative 1, 2, 4, 8 weeks, rats were sacrificed and histologic and histomorphometric analysis were performed. These results were as follows. In histomorphometric analysis, It showed the greatest amount of new bone formation through experimental in the experimental group 3 (P<0.001). The amount of new bone formation at the central portion of the defect was greater in the experimental group 3 than experimental group 2. $BioMesh^{(R)}$. membrane began to resorb at 1 week and resorbed almost completely at 8 weeks after operation. The collapse of membrane into the defect was observed through the experimental periods in the experimental group 2. In the area of collapsed membrane, new bone formation was restricted. These results suggest that maintenance of some space for new bone to grow is required in the use of $BioMesh^{(R)}$. membrane alone in the defect. It is also thought that use of the membrane may promote new bone growth in DFDB graft.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.264-273
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• 2002

Pulsed electromagnetic field (PEMF) was used first to induce osteogenesis in 1974. The appliance which was consisted of the Helmholtz coil configuration have used to osteogensis. The objective of this study was to determine whether PEMF, a frequency of 100 Hz and magnetic field strength of 38 gauss applied to the calvarial defect in rabbit, could affect the induction of osteogenesis and the healing of the graft bone. This field should not produce excitation of nerve or muscle and heating the tissue. To evaluate the effect of PEMF on osteogenesis, 16 rabbit under the same condition was divided into 8 experimental groups and 8 control groups. 10 mm calvarial bone defects were formed around sagittal suture. The defect of left side was left without graft while the defect of right side was grafted by bone harvested from left side. A pulsed electromagnetic field was applied for 8 hours per day. Each group was sacrificed after 1 week, 2 weeks, 4 weeks, 8 weeks. Microscopic specimens were obtained from the calvarial bone defects and surrounding tissue using Hematoxylin-Eosin staining method. The results were as follows. 1. In the group which pulsed electromagnetic field was applied, new bone formation filled up the defect was observed after 4 and 8 weeks effectively. 2. There are no difference in the healing period for the fusion between the bone and graft bone. According to the result, the PEMF with 38 Gauss, 100 Hz was very effective in the healing of bone defect and new bone formation. So The PEMF will be useful in clinical aspect for oseteogenesis.