• Title/Summary/Keyword: 조직 결손

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On the osseointegration of zirconia and titanium implants installed at defect site filled with xenograft material (이종골 이식을 동반한 지르코니아와 타이타늄 임플란트의 골유착에 관한 연구)

  • Kim, Sung-Won;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.1
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    • pp.9-17
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    • 2014
  • Purpose: The purpose of this study was to compare zirconia implants with titanium implants from the view point of biomechanical stability and histologic response on osseointegration when those were placed with xenograft materials. Materials and methods: Specimens were divided into two groups; the control group was experimented with eighteen titanium implants which had anodized surface and the experimental group was experimented with eighteen sandblasted zirconia (Y-TZP) implants. At the tibias of six pigs, implants were installed into bone defect sites prepared surgically and treated with resorbable membranes and bovine bone. Two pigs were sacrificed after 1, 4 and 12 weeks respectively. Each implant site was sampled and processed for histologic and histomorphometric analysis. The stability of implants was evaluated with a $Periotest^{(R)}$. And the interfaces between bone and the implant were observed with a scanning electron microscope. Results: In stability analysis there was no significant difference between Periotest values of the control group and the experimental group. In histologic analysis with a light microscope after 4 weeks, there was new bone formation with the resorption of bovine bone and the active synthesis of osteoblasts in both groups. In bone-implant contact percentage there was significant difference between both groups (P<.05). In bone area percentage there was no significant difference between both groups. In analysis of both groups with a scanning electron microscope there was a gap between bone and a surface at 4 weeks and it was filled up with bone formed newly at 12 weeks. Conclusion: When accompanied by xenograft using membrane, bone to implant contact percentage of zirconia implants used in this experiment was significantly less than that of the titanium implants by surface treatment of anodic oxidation. So, it is considered that the improvement of zirconia implant is needed through ongoing research on surface treatment methods for its practical use.

Tissue Engineered Bone Formation Using Porous Chitosan and Chitosan/Tricalcium Phosphate Matrices (Chitosan 및 Chitosan/Tricalcium Phosphate 다공성 기질을 이용한 조직공학적 골형성에 관한 연구)

  • Lee, Yong-Moo;Choi, Sang-Mook;Park, Yoon-Jeong;Lee, Seung-Jin;Ku, Young;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.28 no.4
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    • pp.577-604
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    • 1998
  • chitosan은 골치유증진 및 골세포의 분화를 촉진하는 것으로 알려진 천연의 생분해성 고분자이다. 이연구에서는 chitosan 및 chitosan/tricalcium phosphate(TCP) 다공성 기질을 제조하여 골이식재 및 조직공학적 골형성을 위한 3차원적 세포배양 지지체로서의 가능성을 평가하고자 하였다. chitosan 용액 및 TCP가 포함된 chitosan 용액을 동결건조함으로써 소공의 크기가 $100-200{\mu}m$인 스폰지형태의 chitosan 및 chitosan/TCP 다공성 기질을 제작하였다. 골이식재로서의 효과를 평가하기 위하여 백서의 두개골 결손부에 제작된 chiosan 및 chitosan/TCP 다공성 기질을 각각 이식하고 2주 및 4주 후에 동물을 희생하여 조직학적으로 치유양상을 관찰하였다. 조직공학적 골형성을 위한 세포배양 지지체로서의 가능성을 평가하기 위하여 백서 태자의 두개골에서 분리된 골아세포를 chitosan 및 chitosan/TCP 다공성 기질에 각각 접종하고 56일간 배양하면서 각 기간 별로 세포수, 염기성 인산효소 활성, 축적된 calcium의 양을 측정하였고 배양된 세포-기질 혼합체를 광학현미경 및 주사전자현 미경하에서 조직학적 관찰을 시행하였다. 백서 두개골결손부에 이식된 chitosan 및 chiosan/TCP 다공성 기질은 별다른 이물반응 없이 자연 분해되면서 신생골조직 내에 매립되었으며 이식하지 않은 대조군에 비해 유의하게 높은 신생골형성 효과를 나타내어 우수한 골전도성이 있음이 확인되었다. 신생골형성 양상이나 형성된 양에 있어서 두 가지 기질간의 유의한 차이는 없었다. 골아세포-기질 혼합체의 배양결과, 접종후 배양 28일 경과 시까지 골아세포수는 지속적으로 증가하다가 이후에는 5 8일까지 성장정도가 둔화되었다. 염기성 인산효소의 활성 및 calcium 축적량은 접종후 배양시간경과에 따라 56일까지 지속적으로 증가하였다. 세포수 및 염기성 인산효소의 활성에서 두 기질간의 유의한 차이는 없었고, calcium 축적량에 있어서는 chitosan/TCP 기질에서 유의하게 높았고 증가속도도 컸다. 배양된 골아세포가 접종된 다공성 기질의 조직학적 관찰결과, 골아세포는 다공성 기질에 잘 부착하여 중층의 형태로 성장하면서 광화된 골기질을 형성함이 관찰되었다. 배양 14일부터 작은 골편형태의 골형성이 기질 표면에 부착되어 관찰되었고, 배양기간이 길어짐에 따라 성장하여 배양 56일째에는 상당한 양의 광화된 골질이 형성됨이 관찰되었다. 배양 56일 경과후의 광화된 골질의 양은 chitosan/TCP 기질에서 더 많았다. 이 연구의 결과, chitosan 및 chitosan/TCP 다공성 기질이 골이식재로서 뿐만 아니라, 조직공학적 골형성에 적용되는 골아세포의 배양을 위한 3차원구조의 세포지지체로 이용되어 골재생술식에 유용한 생체재료로 활용될 수 있음이 확인되었다.

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Three key factors for successful esthetic anterior implant restoration (성공적인 전치부 심미 임플란트를 위한 3가지 요소)

  • Lim, Pil
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.25 no.1
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    • pp.35-49
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    • 2016
  • With the increasing demand for aesthetic implant dentistry, the importance of implant restoration is emphasized not only in the functional aspect but also in the aesthetic aspect. The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. The soft tissue aesthetics are dependent upon the condition of the supporting hard tissue because the osseous structure provides a framework for the development of a healthy and aesthetic soft tissue interface. Therefore, the augmentation of hard tissue is a first step and especially, optimal 3-dimensional position of implant is the most important factor in aesthetic implant restoration. The management of soft tissue is a second step, and the final step is a restoration of harmonic prosthesis using provisional restoration with proper emergence profile. This clinical report describes the procedure of bone augmentation in labial dehiscence defect, Vascularized Interpositional Periosteal-Connective Tissue (VIP-CT) flap for aesthetic anterior soft tissue, and the importance of provisional restoration and impression taking stage with customized impression coping.

Inguinal Soft Tissue Reconstruction Using Pedicled Anterolateral Thigh Flap- A Case Report - (혈관경 전외측대퇴피판을 이용한 서혜부 연부 조직 결손의 재건례)

  • Koo, Youn Taek;Eun, Seok Chan;Baek, Rong Min
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.113-115
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    • 2011
  • We present our experience of reconstruction of inguinal soft tissue defect following inguinal lymphadenectomy, because of penile squamous cell carcinoma. Malignant infiltration required wide resection, producing a defect requiring complex soft tissue reconstruction. We have used a pedicled anterolateral thigh flap as our first choice flap for this case. Patient achieved reasonable esthetic coverage. Complications were few and patient achieved durable long term coverage. We found this flap to be technically easy, reliable and effective.

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Reconstruction of Soft Tissue Defect of Knee Joint Area Using Anterolateral Thigh Perforator Flap (전외측 대퇴부 천공지 피판을 이용한 슬관절부의 연부조직 결손의 재건)

  • Oh, Seung Il;Eun, Seok Chan;Baek, Rong Min
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.96-101
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    • 2011
  • Reconstruction of soft tissue defect of knee joint area has been remained a challenging task for plastic surgeons. The earlier the normal tissue saved and the necrotic tissue removed, the less the patients had complications and functional disability. But such defects are difficult to manage for its poor vascularity, rigid tissue distensibility, easy infectability and a relatively long healing period. The goal of flap coverage in the knee joint should not only be satisfactory wound coverage, but also acceptable appearance and minimal donor site morbidity. We have treated five cases using the anterolateral thigh perforator flaps for reconstruction successfully. In conclusion, we believe that in cases of knee joint area soft tissue defects, flaps like anterolateral thigh perforator flap should be considered as the first line of treatment.

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Reversed Adipofascial Flap for Hindfoot Soft Tissue Defect combined with Open Calcaneal Fracture: A Case Report (개방성 종골 골절과 동반된 후족부 연부조직 결손에서의 역행성 지방근막 피판술: 1예 보고)

  • Ahn, Jae-Hoon;Kang, Jong-Won;Lee, Young-Geun;Choy, Won-Sik
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.105-108
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    • 2006
  • Open calcaneal fractures are potentially devastating hindfoot injuries, in which the status of soft tissue envelope is very important. The reversed adipofascial flap has a merit of simplicity and minimal complication compared to free tissue transfer. We report of a case of open calcaneal fracture with soft tissue defect of hindfoot, which was successfully treated with reversed adipofascial flap.

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Upside-down Adipofascial Flap for the Medial Foot Soft Tissue Defect after Trauma: Case Report (지방 근막 피판을 이용한 외상성 족부 내측면의 연부 조직 결손의 치료: 증례보고)

  • Kim, Min Bom;Lee, Young Ho;Seo, Gil Joon;Baek, Goo Hyun
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.27-30
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    • 2015
  • A child sustained a car tire friction injury and had multiple soft tissue wounds. She had a severe soft tissue defect in the medial foot and ankle aspect which requiring flap coverage. We performed an adipoafscial flap with upside-down pattern for the treatment of the medial foot and ankle soft tissue posttraumatic defect. The flap is based on the perforator artery from the posterior tibial artery. Because it gave a thin coverage for the foot, the patient could walk with normal foot wear.

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DENTAL MANAGEMENT OF A CHILD WITH WILLIAMS SYNDROME (윌리엄스 증후군 환아의 치과적 치험례)

  • Shun, Ye-Kyung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.4
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    • pp.666-671
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    • 2007
  • Williams syndrome is a rare congenital disorder characterized by multiple anomalies involving the cardiovascular system, connective tissue, and the central nervous system resulting in mental retardation, distinctive facial features, and cardiovascular disease. It is also known to present typical oral manifestation including dental malformations, agenesis of teeth, and malocclusion. Impaction of a permanent tooth due to its deviant eruption path was observed in this case. The aim of this article is to report oral manifestation of a girl with Williams syndrome and the following dental treatment procedure.

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Reconstrution with Nasolabial Flap Following Excision of Epidermoid Carcinoma of Mouth Floor (비순 피부편을 이용한 구강저 재건 치험 1례)

  • Kim Kwang-Moon;Chung Young-Suk;Jang Mi-Sook
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.2
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    • pp.99-103
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    • 1991
  • The nasolabial flap is a well-known one for regional repairs. When the inferior-based nasolabial flap was used, the beard area was avoided, and subcutaneous flap pedicle versatility was increased. The inferiorly-based nasolabial flap with a subcutaneous pedicle was useful in the primary repair of surgical defects of the floor of mouth. maxillary alveolus, palate. and tonsillar area in selected patients.

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Reconstruction for the Soft Tissue Defect of Heel and Sole using Free Flaps (생유리 피부편을 이용한 종부 및 족저부 연부조직 결손의 재건)

  • Lee, Kwang-Suk;Kang, Ki-Hoon;Kwon, Kyu-Ho;Lim, Dang-Jae
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.81-87
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    • 1998
  • We have investigated the clinical results of 33 cases of free flap transfer performed for the soft tissue defects of heel and sole. In donor sites, tensor fascia lata flaps were 4, dorsalis pedis flaps were 10, forearm flaps were 9, and latissimus dorsi flaps were 10. The recipient sites were heel in 22 cases, sole in 7 cases, and heel and sole in 4 cases. In these cases, the postoperative complications, morbidity of donor sites, recovery of sensation, and cosmetic results were evaluated in each flap. All the flaps survived successfully. The free flaps provided excellent functional and cosmetic results. The tensor fascia lata flap was more reliable free flap for the reconstruction of heel and sole defects.

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