• Title/Summary/Keyword: 연조직 이식

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HISTOLOGICAL AND CLINICAL STUDY OF ARTIFICIAL DERMIS IMPLANTATION FOR RESTORATION OF SOFT TISSUE DEFECTS (연조직 결손부 회복을 위한 인공진피 이식의 조직학적 및 임상적 연구)

  • Ryu, Sun-Youl;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.410-417
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    • 2006
  • The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

TISSUE REACTION IN RESPONSE TO AUGMENTATION OF SOFT TISSUE DEFECTS ACCORDING TO THE DERMIS GRAFT MATERIALS IN RABBITS (연조직 결손을 일으킨 가토에서 진피 이식재에 따른 조직반응 비교)

  • Ha, Hyun;Kim, Sun-Kook;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.114-120
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    • 2007
  • The augmentation of soft tissue defects is one of the critical problems in the oral and maxillofacial surgery. Various types of graft materials, both autologous and non-autologous, have been used for the augmentation of soft tissue in the facial region. However, it is not easy to choose an ideal material for soft tissue augmentation because each has its advantages and disadvantages. An ideal graft material should meet the following criteria : it should not leave a scar at the area from which it was taken; should have less likelihood of causing infection; should feel natural after implanted; and should be not absorbed. Among the materials meeting these criteria, human dermis and artificial dermis are commonly used for clinical purposes. The present study was aimed to investigate and compare the resorption rate and the histological change following the use of the autologous dermis, the human homogenous dermis $Alloderm^{(R)}$, and the artificial dermis $Terudermis^{(R)}$ to reconstruct the soft tissue defect. Twenty mature rabbits of either sex, weighing about 2 ㎏, were used. Each rabbit was transplanted with the autologous dermis, $Alloderm^{(R)}$, and $Terudermis^{(R)}$ size $1{\times}1-cm$ at the space between the external abdominal oblique muscle and the external abdominal oblique fascia. They were then divided into 4 groups (n=5 each) according to the time elapsed after the surgery: 1, 2, 4, and 8 weeks. The resorption rate was calculated by measuring the volume change before and after the transplantation, and H-E stain was preformed to observe the histological changes. The resorption rate after 8 weeks was 21.5% for the autologous dermis, 16.0% $Alloderm^{(R)}$, and 36.4% $Terudermis^{(R)}$, suggesting that $Alloderm^{(R)}$ is the most stable while $Terudermis^{(R)}$ is the most unstable. In microscopic examinations, the autologous dermis graft was surrounded by inflammatory cells and showed foreign body reactions. The epidermal inclusion cyst was observed in the autologous dermis graft. $Terudermis^{(R)}$ and $Alloderm^{(R)}$ demonstrated neovascularization and the progressive growth of new fibroblast. The results suggest that $Terudermis^{(R)}$ and $Alloderm^{(R)}$ can be availably for substituting the autologous dermis.

Implant esthetic restoration with bone graft in the extended maxillary anterior area: A case report (확장된 상악전치부 결손부위에 골이식을 동반한 임플란트 심미수복 증례)

  • Jeong, Ji-Won;Park, Sang-Yong;Kim, Yoon-Young;Park, Won-Hee;Lee, Young-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.298-305
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    • 2016
  • The maxillary anteriors play an important role in esthetics. Therefore after extraction, it is crucial to preserve the hard tissue and soft tissue in order to promote esthetics of restoration. There are several challenges when restoring the maxillary anteriors via implant. Some of the challenges are be maintaining consistency with neighboring teeth in terms of shade, form, and texture : as well as having harmonious emergency with the gingival margin. In this case, a traumatized patient with crown-root fracture of the maxillary central and lateral incisors is presented. The cracked teeth were extracted, and implants were inserted with bone grafts to compensate the volume of damaged area of the maxillary anterior. Cantilever implant prosthetics were planned while precise adjustments to the gingival area were made using customized impression coping to perform the esthetic restorations. The final outcome of the treatment was satisfying in both esthetic and utilitarian perspective.

Inflammatory Responses to Hydroxyapatite/Poly(lactic-co-glycolic acid) Scaffolds with Variation of Compositions (하이드록시아파타이트/락타이드 글리콜라이드 공중합체 지지체 조성에 따른 염증 완화 효과)

  • Jang, Ji Eun;Kim, Hye Min;Kim, Hyeongseok;Jeon, Dae Yeon;Park, Chan Hum;Kwon, Soon Yong;Chung, Jin Wha;Khang, Gilson
    • Polymer(Korea)
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    • v.38 no.2
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    • pp.156-163
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    • 2014
  • Hydroxyapatite has osteoconductivity, biocompatibility and noninflammatory, and it has been used clinically as artificial bone. In this study, we prepared hydroxyapatite/poly(lactic-co-glycolic acid) (PLGA) scaffolds using 0, 10, 20, 40 and 60 wt% of hydroxyapatite. We analyzed compressive strength, SEM analysis and FTIR for mechanical property of 3D hydroxyapatite/PLGA scaffolds. For biocompatibility tests, cell proliferation and viability were measured via MTT assay and SEM. We analyzed RT-PCR, FACS, histology (H&E, ED-1) for anti-inflammatory effect. This study showed that hydroxyapatite hybrid scaffolds have low inflammatory reaction compared with the PLGA. This result has a potential for the application of artificial bone graft material.

AN EXPERIMENTAL STUDY AND CASE ANALYSIS OF ACELLULAR DERMAL MATRIX IMPLANTATION FOR RESTORATION OF SOFT TISSUE DEFECTS (연조직 결손부 회복을 위한 무세포성 진피 기질 이식에 대한 실험연구 및 증례분석)

  • Ryu, Sun-Youl;Ryu, Jae-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.1
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    • pp.1-10
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    • 2008
  • Purpose: This study was aimed to examine the resorption rate, the healing pattern, and the response of the surrounding tissue after the graft of the acellular dermal matrix ($AlloDerm^{(R)}$) and the autogenous dermis, and to report the clinical result of the use of $AlloDerm^{(R)}$ in order to restore the soft tissue defects. Methods: Twenty mature rabbits, weighing about 3 ㎏, were used for the experimental study. The $10\times10$ mm-size autogenous dermis and the $AlloDerm^{(R)}$ were grafted to the space between the external abdominal oblique muscle and the fascia of the rabbits. And the $AlloDerm^{(R)}$ was grafted to the pocket between the skin and the underlying perichondrium of rabbit ear. The resorption rate of the grafted sites was calculated, and the tissue specimens were histologically examined at 1, 2, 4, and 8 weeks after the graft. The five patients with the cleft-lip nasal deformity and the one patient with the saddle nose deformity, who received the $AlloDerm^{(R)}$ graft to restore the facial soft tissue defects, were reviewed for the clinical study. Results: The resorption rate at 8 weeks after the graft was 21.5% for the autogenous dermis, and 16.0% $AlloDerm^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. However, the neovascularization and the progressive growth of the new fibroblasts were shown in the $AlloDerm^{(R)}$ graft. And the six patients, who received the $AlloDerm^{(R)}$ graft, demonstrated the good stability of the grafts and improved appearance. There were no remarkable complications such as inflammation, rejection, dislocation, and severe absorption in the clinical cases. Conclusion: These results suggest that $AlloDerm^{(R)}$ can be an useful graft material for restoration of soft tissue defects because of the good stability and the tissue response without the remarkable clinical complications.

WISKOTT-ALDRICH SYNDROME WITH DENTAL PROBLEMS : CASE REPORT (Wiskott-Aldrich 증후군 환아의 증례보고)

  • Lee, Yeon-Joo;Hyun, Hong-Keun;Jang, Chul-Ho;Kim, Yeong-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.468-472
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    • 2007
  • The Wiskott-Aldrich Syndrome (WAS) is an inherited immunodeficiency caused by a variety of mutations in the gene encoding the WAS protein (WASp). First described in 1937 by Wiskott, the incidence of WAS has so far been estimated at 4 in 106 live births. The Wiskott-Aldrich Syndrome is an X-linked condition characterized by 1) an increased tendency to bleed caused by a reduced number of platelets, 2) recurrent bacterial, viral and fungal infections, and 3) eczema of the skin. The purpose of this report is to present cases highlighting the clinical features of the syndrome and the required considerations in the treatment of patients. The report consists of two particular cases: a 2-year-11-month-old boy seen for a routine oral examination prior to his bone marrow transplantation and a 2-year-6-month-old boy with herpes gingivostomatitis and teeth discoloration.

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Treatment of Squamous Cell Carcinoma in Extremity (사지에 발생한 편평세포 상피암의 치료)

  • Lee, Doo-Hyung;Shin, Kyoo-Ho;Lee, Soo-Hyun;Hahn, Soo-Bong
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.126-133
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    • 2005
  • Purpose: to know the treatment result of squamous cell carcinoma in extremity had poor prognosis with risk factor including burn scar and chronic osteomyelitis. Material and Methods: Between Octorber 1993 and September 2002, 20 patients with squamous cell carcinoma in extremity had no distant metastasis was got operation and followed over 36 months. Amputation was done when it was hard to get enough wide margin or neurovascular structure was involved instead of wide excision. Mean age of patients was 57.2 years old and male to female was 16 to 4. TMN staging and histologic grading were performed. Results: There were 6 metastasis (30%) in 20 cases for mean 48.3 months (36-84 months). 3 metastasis to local lymph node and 3 distant metastasis were happened at lung (in 3 cases) and thorasic vertebra (in 1 case). Survival was 18 cases at last look. 5-year survival rate was 50%. 3 local recurrence was developed at average 11 months (4-18 months). Complication was focal skin defect after wide excision and skin graft in 2 cases. The patients by wide excision got average 1.9 time operation and by amputation got average 1.3 time. Conclusion: Squamous cell carcinoma at extremity in Korea had high metastasis rate due to burn scar and chronic osteomyelitis, and it showed equal treatment result which treated by wide excision compared with amputation.

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IMMEDIATE IMPLANT PLACEMENT AFTER EXTRACTION OF RETAINED DECIDUOUS TEETH AND IMPACTED CANINES: REPORT OF A CASE (상악 전치부 잔존 유치와 매복 견치 발치 후 즉시 임플란트 식립: 증례 보고)

  • Yoo, Ji-Yeon;Kim, Yeo-Gab;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Young-Ran;Baek, Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.4
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    • pp.330-333
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    • 2009
  • Alveolar bone resorption after extraction impairs the necessary bone volume and complicates the case for implant surgery and aesthetic implant prosthesis. Immediate implant surgery after extraction decreases the number of surgical procedures and the duration of treatment, while allowing minimum alveolar bone resorption and preserving the residual bone volume. Although immediate implant holds many advantages such as preservation of hard and soft tissue around the extraction socket, greater implant survival rate and higher patient satisfaction, various complications and high failure rate are discouraging factors for the clinicians. In this case report, severe alveolar bone resorption with soft tissue changes were predicted after the extraction of prolonged retained deciduous incisors and impacted maxillary canines and thus decided on immediate implant procedure. Immediate implant surgery after extraction was carried out with minimal bone reduction and tapered wide-neck implant to establish initial stability. Simultaneous bone graft was done by filling the defect area with iliac cancellous bone with additional onlay-type bone graft and absorbable membrane on the labial bone for upper lip support. A stable and esthetic result was obtained with shortened treatment period.

Esthetic Full Zirconia Fixed Detachable Implant-Retained Restorations Manufactured from Monolithic Zirconia : Clinical Report (Monolithic zirconia framework으로 제작된 fixed detachable prostheses를 이용한 심미적인 임플란트 전악 수복 증례)

  • Hong, Jun-Tae;Choi, Yu-Sung;Han, Se-Jin;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.253-268
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    • 2012
  • Full-mouth reconstruction of a patient using dental implants is a challenge if there is vertical and horizontal bone resorption, since this includes the gingival area and restricts the position of the implants. however, hard- and soft-tissue grafting may allow the implants to be placed into the desired position. Although it is possible to regenerate lost tissues, an alternative is to use fixed detachable prostheses that restore the function and the esthetics of the gingiva and teeth. Various material combinations including metal/acrylic, metal/ceramic, and zirconia/ceramic have been used for constructing this type of restoration. Other problems include wear, separation or fracture of the resin teeth from the metal/acrylic prosthesis, chipping or fracture of porcelain from the metal/ceramic or zirconia/ceramic prosthesis, and fracture of the framework in some free-end prostheses. With virtually unbreakable, chip-proof, life-like nature, monolithic zirconia frameworks can prospectively replace other framework materials. This clinical report describes the restoration of a patient with complete fixed detachable maxillary and mandibular prostheses made of monolithic zirconia with dental implants. The occluding surfaces were made of monolithic zirconia, to decrease the risk of chipping or fracture. The prostheses were esthetically pleasing, and no clinical complications have been reported after two years.

Histopathological Changes in Cold-Stored Dog Lungs to the Preservation Solutions (냉한에서 보관된 황견의 폐에서 장기 보존액에 따른 조직 세포의 변화)

  • 김해균;이두연
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.816-821
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    • 1996
  • Lung transplantation is the established treatment for the end stage lung disedse find preservation of the organ is a major obstacle In performing lung transplantation. For solving this problem, we evaluated the histopathologic changes for various preservation solutions. Male mongrel dogs of similar size and weight (15∼20 kg) were used. The dog lungs were flushed with 4fl normal saline(group 1 'n:5): Modified Euro-Collins solution(group 2 n:5) and University of Wisconsin solution (group 3 : n=6), 60m11kg through a catheter placed in the main pulmonary artery aft r flushing of PGE 1 (20ng1kg). The lungs were preserved for 60 hours and measured dry and wet weights. Histologic specimens were taken every 6 hours and %toed for light microscopic evaluation. The edema ratio of the lungs peaked in 12 hours although there was no difference between the groups. Histologically, alveolar septal changes developed in one case (20%) after 1 hour preservation with normal saline. In case of the University of Wisconsin solution, the alveolar septal distortions and swellings were seen in 1 cases (20%) after 6 hours preservation compared with 3 cases (60%) after 6 hours preservation with Modified Euro-Collins solution. Changes of the pneumocytes were observed after 24 hours preser- vation in group 1, after 48 hours preservation in group 2 and after 60 hours preservation in group 3. We conclude that University of Wisconsin solution might have a superior preservation effect compare to normal saline and Modified Euro-Collins solutions.

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