• Title/Summary/Keyword: 이식술

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MEASUREMENT OF MAXILLARY SINUS VOLUME FOR THE PLACEMENT OF GRAFT MATERIAL - A CASE CONTROL STUDY USING CT IMAGE (상악동 골이식술을 위한 이식재의 부피 측정 - CT를 이용한 환자 대조군 연구)

  • Kim, Hyung-Wook;Lee, Seul-Ki;Chung, Jae-An;Shin, Jin-Eob;Um, Yun-Sub;Kim, Ki-Young;Kim, Jong-Sik;Song, Yun-Jung;Hong, Soon-Min;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.511-517
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    • 2007
  • Purpose: The aim of this study is to determine whether a difference in the amount of bone graft material is needed between edentulous patients and dentulous patients and to calculate the amount of augmentation for a sinus lift procedure. Methods: 19 patients(20 sinuses) were included to measure maxillary sinus volume. Facial CT scanning was performed using MX 8000 IDT CT devices(Philips, USA). And it was used for IDLvm(The IDL Virtual Machine) 6.0, CT Volume Analyzer Ver 2.3 program to measure maxillary sinus volumes Results: At edentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.56{\pm}0.13cm^3$(5mm height), $2.35{\pm}0.57cm^3$(10mm height), $4.85{\pm}1.10cm^3$(15mm height). At dentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.41{\pm}0.18cm^3$(5mm height), $1.76{\pm}0.42cm^3$(10mm height), $3.80{\pm}0.84cm^3$ (15mm height). A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume.(p=0.027, p=0.018, p=0.044) Conclusions: A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume. Detailed preoperative knowledge of sinus lift augmentation volume is helpful in determining the appropriate amount of the bone graft material.

The Effects of Bone Grafts using Platelet Rich Plasma on Infrabony Defects (혈소판 농축 혈장을 이용한 골 이식술이 골연하낭의 치료에 미치는 효과)

  • Hur, Yoon-Jun;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.31 no.2
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    • pp.489-499
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    • 2001
  • Bone graft and guided tissue regeneration have been used for the regeneration of periodontal tissue which is the ultimate goal of periodontal treatment. Recently, it was reported that some kind of growth factors were used for regeneration. Platelet rich plasma was researched that it could increase the density of bone and the rate of bone regeneration. For that, 25 patients which have pocket depth more than 5mm at any of 6 surfaces, of healthy patient without any systemic disease were treated. $Biogran^{?}$ Were grafted into 14 infrabony pockets as controls, and $Biogran^{(R)}$ with PRP were inserted into 31 infrabony pockets. And then, follwing evaluations were made at the end of 1, 3 and 6 months. 1. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level at preoperation(p>0.05). 2. Decrease in probing pocket depth were reduced to 3.32mm for experimental group and 2.71mm for control group. The decrease was evident at the end of 1 month, they were 2.97mm and 2.29mm,and it was statistically difference(p<0.05). 3. Gingival recession was increased by 0.55mm in experimental group and 0.50mm in control group, it was evident at the end of 1 month. And it was statistically difference(p<0.05). 4. Minimum probing attachment level was increased by 0.35mm in experimental group and 0.36mm in control group, it was statistically difference(p<0.05). 5. Maximum probing attachment level was decreased by 3.19mm in experimental group and 2.93mm in control group, it was statistically difference(p<0.05). 6. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level(p>0.05). There was statistical difference in decrease of pocket depth between pre-operation and 1 month after post-operation(p<0.05). In conclusion, bone graft using $Biogran^{?}$ and bone graft using $Biogran^{?}$ With platelet rich plasma were both effective in treatment of infrabony pocket, bone graft using $Biogran^{?}$ With platelet rich plasma was more effective in early soft tissue healing.

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Anti-Ionizing Radiation Effect of Selenium on Osteoporosis Model during Bone Repair Process (골다공증 모델의 뼈 재생기에 있어 셀레늄(Selenium)의 방사선 보호작용)

  • Kim, Hyun;Cho, Sang-Rae;Choe, Changyong;Seong, Hwan-Hoo
    • Journal of Embryo Transfer
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    • v.30 no.3
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    • pp.201-206
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    • 2015
  • Selenium (Se) is an essential trace element for humans and animals, and several findings suggest that dietary Se intake may be necessary for bone health. Accumulating evidence indicates that Se compounds possess anticancer properties. Se is specifically incorporated into proteins in the form of selenocysteine and non-specifically incorporated as selenomethionine in place of methionine. This study evaluated protection by Se in the bone repair process in ovariectomized rats after irradiation. For such purpose, 80 ovariectomized female Sprague-Dawley rats were randomly divided into 4 experimental groups: ovariectomized (Ov), Ov/Se, Ov/irradiated (Irr) and Ov/ Se/Irr. A bone defect was created on the tibia of all animals 40 days after ovariectomy. Two days after surgery, only the Ov/Se and Ov/Se/Irr rats received 0.8 mg Se/kg. Three days after surgery, only the Ov/Irr and Ov/Se/Irr rats received 10 Gy of X-rays on the lower limb region. The animals were euthanized at 7, 15, 22 and 29 days after surgery to assess the repair process, which was evaluated by analysis of trabecular bone number (Masson Trichrome) and birefringence analysis (Picrosirius). It was possible to observe a delay in the bone repair process in the ovariectomized/irradiated group and similarity between the ovariectomized, Ov/ Se and Ov/Se/Irr groups. Our findings suggest that sodium selenite may influence a radioprotective effect in the bone repair of tibia of ovariectomized rats without toxicity.

Effect of Bone Marrow Aspirate with Autogenous Bone graft for Alveolar Cleft in a new Rabbit Model (가토의 치조열 모델에서 골수 흡인물이 자가뼈 이식술에 미치는 효과)

  • Bae, Sung Gun;Chung, Ho Yun;Lee, Sang Yun;Cho, Byoung Chae;Yang, Jung Dug;Park, Mee Young
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.531-537
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    • 2009
  • Purpose: Alveolar bone grafting has become an essential process in the treatmemt of alveolar cleft patient for stabilization of the maxillary arch, elimination of oronasal fistula, the reconstruction of the soft tissue nasal base support, and creation of bony support for tooth eruption for implant. The use of Autologous iliac cancellous bone is preferable because of the adequate quantity and high osteoinductive potential. However, even with iliac bone, insufficient osteoregeneration and absorption occur due to several factors such as the patient's age, cleft width, functional stress, and others. In order to increase osteoregeneration where the iliac bone is placed, the present study is associated with bone marrow aspirate (BMA). The experimental study evaluated the efficacy of osteoregeneration in normal cleft rabbits when alveolar bone grafting was performed with autologous iliac corticocancellous bone. Methods: Twenty - four New Zealand White rabbits were divided randomly into 2 groups (BMA, control). All animals underwent harvesting of corticocancellous bone graft from the right posterior iliac crest via standard surgical technique. $1m{\ell}$ of BMA were obtained by scraping the needle and aspirate with $10m{\ell}$ syringe from the contralateral iliac bone wall. The muco - periosteal flap on the palate was elevated. A mixture of Equal bone's volumes with BMA and saline as its control was inserted into the cleft. Animals were sacrificed at 2, 4, and 8 weeks and maxilla was harvested for dental peri - apical X-ray, bone matrix density (BMD),and histologic analysis. Result: BMD of regenerated bone to the cleft in the rabbits was higher than that of the control rabbits. X-ray, histologic analysis showed that increased osteoregeneration and low absorption rate were observed in the BMA group. Conclusion: Our experimental study showed BMA enhanced the osteoregeneration and survival rate of alveolar bone grafting. BMA is easy to extract & cost - time effective. So it can be an effective enhancers for bone grafting mixtures.

Surgical Treatment of Anomalous Origin of Coronary Artery from the Pulmonary Artery: Postoperative Changes of Ventricular Dimensions and Mitral Regurgitation (관상동맥-폐동맥 이상기시증(Anomalous Origin of Coronary Artery from Pulmonary Artery)의 수술적 치료: 중기 성적과 좌심실 및 승모판 기능의 변화 양상에 대한 연구)

  • Kang, Chang-Hyun;Kim, Woong-Han;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Back, Man-Jong;Oh, Sam-Se;Na, Chan-Young;Han, Jae-Jin;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.19-26
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    • 2004
  • Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

Dual Grafting of Left Internal Thoracic Artery and Saphenous Vein to Left Anterior Descending Artery (좌내흉동맥편과 복재정맥편을 좌전하행지에 동시에 문합한 관상동맥 우회로술의 임상적 결과)

  • 최종범;양현웅;한재오;최순호
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.709-714
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    • 1999
  • Background: When internal thoracic artery (ITA) and saphenous vein graft are anastomosed to the same coronary artery, the patency rate of the internal thoracic artery graft with relatively narrow diameter may be decreased owing to competition of pressure and flow rate. We evaluate the clinical outcome and the patency of the ITA graft in patients undergoing dual grafting to the same coronary artery. Material and Method: In 14 patients with the ITA graft having relatively low flow, the ITA and saphenous vein graft were anastomosed to the same coronary artery. During the mean follow-up period of 33.5 months, coronary angiography was performed in 6 patients who complained of recurrent angina, needed confirmation of graft flow, or showed postoperative Q wave. Result: In all 6 patients, the ITA and saphenous vein grafts were patent without stenosis or obstruction. Two patients showed good flow in both grafts, 2 showed competitive flow in the ITA graft, and the remaining 2 showed poor flow in the ITA graft. Conclusion: Early operative closure When saphenous vein grafting was added to the same coronary artery that the internal thoracic artery was anastomosed to, the perfusion to the coronary artery was satisfied and the dual grafting did not affect the short-term and mid-term patency rate of the ITA.

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Free gingival graft in combination with apically positioned flap for establishment of keratinized gingiva around the implants: Report of two cases (근단변위판막술과 함께 유리치은이식술을 사용하여 임플란트 주변 각화치은을 증대시킨 2건의 증례 보고)

  • Baek, Won-Sun;Cha, Jae Kook;Lee, Jae-Hong;Lee, Jung-Seok;Jung, Ui-Won
    • The Journal of the Korean dental association
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    • v.54 no.4
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    • pp.296-305
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    • 2016
  • Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.

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The Clinical Analysis of 100 cases of Coronary artery Bypass Grafting with the Right Gastroepiploic artery (우위대망동맥을 이용한 관상동맥 우회술 100례의 임상적 고찰)

  • Song, Hyun;Lim, Han-Jung;Lee, Hyun-Woo;Jung, Jong-Pil;Shin, Je-Kyoun;Kim, Jong-Ook;Park, Jong-Bin;Lee, Jae-Won;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.638-642
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    • 2000
  • Background: In an effort t enhance long term patency of coronary bypass grafts, utilization of arterial conduits have been on an icrease. With the same objective, we have been using the right gastroepiploic artery(RGEA)in coronary artery bypass procedures since 1998. The current paper has been undertaken with the aim of assessing the apropriateness, problems, and short term results of using the RGEA as an arterial graft conduit by studying the postoperative clinical results of 100 patients than received coronary artery bypass grafting (CARG) with this artery. Material and Method: Between May of 1998 and May of 1999, an analysis of the mortality, postoperative myocardial infarction, and the need for IABP insertion as a result of low cardiac output were made between 100 consecutive patients undergoing CABG with the RGEA. Result: There was one postoperative death due to cerebral infarction. Postoperative complications/morbidity comprised myocardial infarction in 2, cerebral infarct in 3, reoperation due to bleeding in 1, mediastinitis in 1, and low cardiac output syndrome necessitating IABP in 3 patients. Complicatons related to harvesting of the arterial grafts were not experienced in any of the patients. Conclusion: The results of the current data show that utilization of the RGEA in CABG is not associated with increased mortality/morbidity and demonstrates satisfactory short term results suggesting the usefulnessof this conduit as an arterial graft.

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THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES (치료법을 달리한 상악골절후 부정유합 2예)

  • Yoo, Jae-Ha;Lee, Won-Yoo;Rew, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.117-127
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    • 1991
  • When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

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Factors associated with the survival and marginal bone loss of dental implants: a 5-year retrospective study (임플란트의 생존과 변연골 소실에 영향을 미치는 인자들)

  • Song, Eul-Rak;Lee, Jae-Kwan;Um, Heung-Sik;Park, Se-Hwan;Chang, Beom-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.4
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    • pp.280-292
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    • 2016
  • Purpose: The purpose of this study was to compare the long-term survival rate and peri-implant marginal bone loss related to multiple risk factors including the clinician's experience. Materials and Methods: Four hundred twenty implants in 146 patients, who had involved a supportive periodontal therapy program every 3 to 6 months and had follow up data for at least 5 years, were selected as the study group. Peri-implant marginal bone loss, data of demographic, implant and surgical characteristics were collected from peri-apical radiographs and chart review. Implant survival was regarded as the remaining with radiographic marginal bone level in excess of 50% of the fixture length for any reason. Results: The cumulative survival rate after 5 years of loading was 94.9%. In binary logistic regression analysis, smoking status (P = 0.033) and presence of spontaneous cover screw exposure (P < 0.001) were significantly related to 5-year survival of implants. In stepwise multiple regression analysis, smoking status (P < 0.001), type of abutment connection (P < 0.001) and implant surface (P = 0.033) were significantly related to peri-implant marginal bone level. And the year of resident was not statistically related to 5-year implant survival in simple logistic regression analysis (P = 0.171). Conclusion: Smoking status, spontaneous cover screw exposure, type of abutment connection and implant surface might influence the implant success. There was no significant correlation between the year of resident and implant failure.