• Title/Summary/Keyword: 장골이식

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Assessment of the permanent canine bone support after secondary bone graft In UCLP patients (편측성 순구개열 환자에서 이차 골이식후 맹출된 영구 견치의 치조골 지지도에 관한 연구)

  • Park, Ki-Tae
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.601-610
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    • 2001
  • The purpose of this retrospective study was to evaluate the level oi alveolar bone support of the erupted Permanent canine through the reconstructed cleft region compared to the contralateral canine on the non-cleft side. This study was limited to children with complete unilateral cleft lip and palate who underwent secondary alveolar iliac bone gvaft and the apices of the erupted canine roots were closed at the time of evaluation. With these criteria the study included 21 children whose average age at the time of bone graft reconstruction was 9.8 years, with a minimum of 12.4 years of age at the time of the evaluation. The study was limited to the use of iliac cancellous bone as the autograft material for reconstruction of the alveolar cleft. Cranial bone graft and other autogenous bone sources were excluded. The periapical radiographs were used to evaluate alveolar bone level of each canine. The percentages of root supported by the bone were established by dividing the amount of root covered with the bone by the anatomic root length. The canine oi the non-cleft side was used as an internal control and the canine on the cleft side was used as an experimental. There was a statistically significant difference in the alveolar bone support ratio between the control ($92.9\%$) and experimental canines ($8.7\%$). An average of $95\%$ level of alveolar bone support was achieved for the experimental canine in comparison to the control canine. Neither the presence of lateral incisor, nor the stage of root development of the canine at the time of the bone graft appeared to have affected the alveolar bone support ratio of the canine after the secondary bone graft.

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Percutaneous Autologous Marrow and Heterograft Bone Grafting in a Treatment for Simple Bone Cyst (경피적 자가 골수 및 이종골 이식을 이용한 고립성 골낭종의 치료)

  • Lee, Keun-Bae;Rowe, Sung-Man;Yoon, Taek-Rim;Son, Il-Jin;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.24-30
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    • 2003
  • Purpose: To clarify the results of simple bone cyst (SBC) treatment in children by percutaneous autologous bone marrow grafting and xenografting. Materials and Methods: We studied seven cases (4 males, 3 females) of SBC, which were treated by percutaneous autologous marrow and heterograft bone grafting from January 1996 to February 1999. Their mean age at surgery was 10 years (6 to 15), and the mean follow-up period was 35.6 months (20 to 52). Three cases were located in the proximal and middle humerus; three cases were in the proximal femur; and one case occurred in the ilium. Mean volume was 14.7 $cm^2$ (10 to 23). Six cases were active, and one was inactive. Five patients had a history of receiving a mean of 3.2 steroid injections. The mean quantity of bone marrow used in treatment was 14.3 ml (10 to 20), and the mean amount of $Lubboc^{(R)}$ heterograft bone (Transphyto S.A. Clermont Ferrand, France) used was 6.4 blocks (5 to 10). Results were analyzed using the modified Neer classification. Results: Five cases completely healed with obliteration of the cyst cavity (Grade IV). Two cases demonstrated sclerosis around a partially visible cyst (Grade III). All treatment results were satisfactory and without intraoperative or postoperative complications. Conclusione: Percutaneous autologous marrow and heterograft bone grafting is recommended as an effective treatment method for simple bone cyst. It offers ease of operative technique, a high rate of healing, a low recurrence rate, low morbidity, a low incidence of postoperative complications, and free from bone graft donor site problems.

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Giant Cell Tumor of Proximal Phalanx of the Hand - A case report - (수부 근위지골에 발생한 거대세포종 - 1례 보고-)

  • Park, Yong-Koo;Lim, Sung-Jig;Kim, Youn-Wha;Han, Chung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.30-34
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    • 2000
  • Giant cell tumor of the small bones of the hands and feet is rare. Giant cell tumors in these locations develop at young age, are more commonly multifocal, and show the higher risk of recurrence than those at the end of the long bone. It should be differentiated from the other lesions of the hands, such as giant cell reparative granuloma, aneurysmal bone cyst and enchondroma. We experienced a case of giant cell tumor in the proximal phalanx of the left hand with swelling and pain. Curettage and bone graft were performed. Histologically large number of giant cells were distributed diffusely in the highly cellular stroma containing sheets of mononuclear cells. Secondary aneurysmal bone cyst and hemorrhage were associated.

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ESTHETIC RECONSTRUCTION OF ILIAC CREST DONOR DEFECT WITH TWO TITANIUM PLATES AFTER HARVESTING A DCIA COMPOSITE FREE FLAP (장골의 복합유리피판 이식 후 두 개의 타이타늄 금속판을 이용한 공여부의 심미적 재건)

  • Kim, Soung-Min;In, Yeon-Soo;Kim, Ji-Hyuck;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.586-589
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    • 2006
  • Deep circumflex iliac artery (DCIA) flap can be harvested as a composite free flap and is often used to adequately reconstruct wide mandibular defects. However, the harvesting of this DCIA flap can result in severe osseous defect of the donor site causing a morphologic defect in the iliac crest. To reconstruct this defect of the iliac donor site, several innovative techniques using bioactive ceramic spacers, autogenous rib bone, polylactic acid mesh, or titanium plates have been introduced. Nonetheless, these methods have not been widely used due to high cost, secondary donor site morbidity, difficulty of use, and postoperative dissatisfaction. We used two titanium plates to reconstruct the donor iliac site defect at the harvesting time of primary DCIA flap surgery in the 30-year old female with an ameloblastoma in the left mandible. Postoperatively, both iliac sites were relatively balanced and there were few complications. At the 2 years follow-up, there were no specific abnormal radiographic findings and the patient was very satisfied with her esthetic iliac contouring. In our report, we evaluate the effect of two titanium plates on the reconstruction of the iliac donor site in the aspects of esthetics and usefulness. This technique has many advantages, such as reduced cost, simplicity, decreased postoperative pain or discomfort, and improved bilateral balance of both anterior iliac crest contours, especially in young female patients.

STABILITY OF SIMULTANEOUS IMPLANTATION WITH AUTOGENOUS ILIAC BONE GRAFT IN THE SEVERELY ATROPHIC MAXILLA (심하게 흡수된 상악골에서 자가 장골 이식술과 동시에 시행한 임프란트 치료의 안정성에 대한 연구)

  • Byun, June-Ho;Park, Bong-Wook;Jeong, Hee-Chan;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.570-578
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    • 2006
  • A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.

The Reharvesting of Iliac Crest Cancellous Bone for the Repair of the Alveolar Cleft (치조열 교정을 위한 장골 능선 해면골 재이식술)

  • Kim, Suk-Wha;Kim, Byung-Jun;Choi, Tae-Hyun
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.15-18
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    • 2011
  • Purpose: The anterior iliac crest is a common source for autologous cancellous bone graft. For patients who have previously received cancellous bone grafts from bilateral anterior iliac crests, there may be concerns of whether a sufficient quantity of autologous cancellous bone remains for additional grafts without harvesting it from other sites, such as the posterior iliac crest. Methods: We experienced 3 cases of reharvesting in 2 patients. The diagnosis of the first patient was bilateral facial cleft number 3. This patient received bilateral side cleft alveoloplasty with corticocancellous bone graft from the both anterior iliac crest respectively by a previous surgeon. This patient then needed reharvesting of the anterior iliac crest cancellous bone to correct an ongoing skeletal problem for the bilateral cleft. The other patient had bilateral incomplete cleft of the primary palate. This patient received left side cleft alveoloplasty with cancellous bone graft from the right anterior iliac crest. Before the patient could receive the alveoloplasty on the other side, a radial head osteotomy and cancellous bone graft was performed by orthopedic surgeons who then used the remaining left iliac crest in order to treat a pulled elbow. For the completion of the right side cleft alveoplasty, the anterior iliac crest cancellous bone needed to be reharvested. Prior to the reharvesting, a preoperative computed tomography scan of the pelvis was obtained to assess the maturity of the donor site regeneration. The grafts were then taken from site where a greater amount of regeneration was evident. Results: Long term follow ups showed that the grafts were successfully taken. This sufficient volume was obtainable 14 months after the first harvest. Conclusion: Satisfactory results were achieved after the reharvesting of iliac cancellous bone. Thus, it appears that the reharvesting of the iliac bone is a possible alternative to multiple site grafting, use of allograft or bone substitute materials.

Simultaneous Aortobifemoral and Bilateral Femoropopliteal Artery Bypass Graft for Multilevel Lower Extremity Occlusive Disease - 2 cases report - (다단계 폐쇄성 하지동맥경화증에서 복부대동맥-양측 대퇴동맥 및 양측 대퇴동맥-슬와동맥간 우회술의 동시 시행 - 2예 보고 -)

  • 박진홍;김응중;지현근;신윤철
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.371-374
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    • 2003
  • Atherosclerosis has more than 60% of the causes of arterial occlusive diseases. The abdominal aorta and lower extremity arteries are the most common sites of occlusion. We have treated surgically 2 cases who had intermittent claudication and were diagnosed as simultaneous aortobifemoral and bilateral femoropopliteal obstruction by angiography, but had ineffective results from medical treatment or angioplasty. Simultaneously aortobifemoral bypass using Hemashield Y graft and bilateral femoropopliteal bypass using autologous greater saphenous vein were done. After operations, the symptom disappeared and there were no specific post-operative complications except abdominal wound dehiscence. In postoperative angiography, we had obtained good patency of bypass graft. We are following up patients through the out patient department without recurrence up to 16 months.

RECONSTRUCTION WITH A VASCULARIZED FREE ILIAC OSTEOMUSCULAR FLAP AFTER HEMIMANDIBULECTOMY FOR OSTEOSARCOMA OF THE MANDIBULAR CONDYLE REGION : A CASE REPORT (하악과두에서 발생한 악성 골육종 환자에서 외과적 절제 후 유리장골이식을 이용한 재건)

  • Park, Hong-Ju;Yu, Min-Gi;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.386-394
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    • 2008
  • Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.

DISTRACTION OSTEOGENESIS FOLLOWED BY IMPLANT INSTALLATION ON THE RECONSTRUCTED MANDIBLE WITH A FREE ILIAC BONE GRAFT IN A ODONTOGENIC MANDIBULAR MYXOMA PATIENT : CASE REPORT (하악 치성점액종 환자에서 유리장골이식으로 재건된 하악골의 골신장술 후 임플란트식립 : 증례보고)

  • Lim, Hun-Jun;Kim, Moon-Seob;Lee, Dae-Jung;Lee, Jong-Bok;Min, Seung-Ki;Paeng, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.419-424
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    • 2009
  • Odontogenic myxoma, a rare tumour that occurs in the jaws, locally invasive, destructive tumors that do not metastasize to lymph nodes. Large odontogenic myxoma on mandible is treated by mandibulectomy, defected mandible is reconstructed by bone graft. Reconstructed mandible is difficult to reconstruct dentition using implant because of deficiency of bone amount. So it is necessary to additional bone graft. But a poor aspect of soft tissue lead to unsatisfactory result. Because of distraction osteogenesis is possible to reconstruction of an amount of bone and soft tissue, that is advantage to reconstruction of alveolar bone on reconstructed mandible. We report with review of literatures the 25 years old male patient who had odontogenic myxoma in left mandible, was undergone mandibulectomy and successfully implant installation and prosthetic restoration after distraction osteogenesis(Track $Plus^{(R)}$, KLS Martin, Germany) on the reconstructed mandible with a free iliac bone graft, and we have conservative and successful result.

LONG-TERM RESULTS OF VERTICAL HEIGHT AUGMENTATION GENIOPLASTY USING AUTOGENOUS ILIAC BONE GRAFT (장골 이식을 이용한 수직 증강 이부 성형술 후의 장기간 결과)

  • Kim, Gi-Jung;Park, Hyung-Sik;Yoon, Kyu-Sik;Lee, Eui-Wung;Jung, Young-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.6
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    • pp.509-514
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    • 2005
  • Purpose: In order to clarify the clinical utility of the vertical height augmentation (VHA) genioplasty using autogenous iliac bone graft (IBG), this study examined the postsurgical changes in hard and soft tissues of the chin and the stability of the grafted bone. Patients and Methods: Twenty-three patients who had undergone VHA genioplasty using autogenous IBG were evaluated radiographically and clinically. A comparison study of the changes in hard to soft tissues after surgery in all 23 patients was performed with preoperative, 1-month, 3-months, 6-months, and/or 1-year postoperative lateral cephalograms by tracing. Stability, bone healing, and complication of the grafted bone was evaluated by follow-up roentgenograms and clinical observation. Results: Between the preoperative and 6-month postoperative tracings, an average vertical augmentation of the osseous segment was 4.2 mm at menton and that of the soft tissue menton was 4.0 mm. There was a high predictability of 1: 0.94 between the amounts of hard versus soft tissue changes with surgery in the vertical plane. The position of the genial bone segment was stable immediately after surgery and soft tissue was not changed significantly from 1 month to 1 year after operation. Clinical and radiological follow-up results of the iliac bone graft showed normal bony union and were generally stable. Conclusions: VHA genioplasty using IBG is a reliable method for predicting hard and soft tissue changes and for maintaining postoperative soft tissue of the chin after surgery.