• 대한관절경학회지
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• 제1권1호
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• pp.47-51
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• 1997

A torn anterior cruciate ligament(ACL) is the most common serious ligamentous injury to the knee joint. The incidence of ACL tears seems to be increasing, at least partly as a result of the increasing participation of individuals of all ages in high-risk sports. The most commonly used graft source for ACL reconstruction is the autogenous bone-patellar tendon-bone graft unit. Despite a good success record. postoperative complications, such as infection, patellar contracture/patellar baja, patellar fracture, rupture of the patellar tendon, graft failure without reinjury, can occur following ACL surgery. The purpose of this paper is to provide guidelines regarding the key points of the reconstructive procedure in a sequence and how to prevent or minimize the complications that can follow ACL reconstructive surgery. We want this knowledge can help orthopaedic surgeons to understand the reasons for previous and current successes and failures of reconstruction of the ACL, and it can help them to plan the care of patients who have an injury of the ligament.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.462-465
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• 2012

Horizontal and vertical ridge augmentation with implant placement was performed, using a block type of autogenous tooth bone graft in a 37-year old male patient. This material was very useful for the case of severe alveolar bone resorption of a single tooth. After 13 months, excellent bony healing was obtained and final restoration was performed successfully.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.483-489
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• 2011

Introduction: This study examined the cumulative resorption of implants placed in a severely atrophic mandible and analyzed the radiologic bone resorption in the marginal bone, after an autogenous bone graft including both block and particulates that had been harvested from the ramus and iliac crest. Materials and Methods: A retrospective study was performed on patients who had bone grafts for augmentation followed by implant installation in the mandible area from 2003 to 2008. Twelve patients (6 men and 6 women) who received 34 implants in the augmented sites were evaluated. Cumulative radiologic resorption around the implants was measured immediately, 3 months, 6 months and 12 months after implant installation surgery. Results: The installed implant in grafted bone showed 0.84 mm marginal bone resorption after 3 months and 50% total cumulative resorption after 1 year. The mean marginal bone resorption around the implant installed in the grafted bone was 0.44 mm after 3 months, 0.52 mm after 1 year, after which it stabilized. The implant survival rate was 97% (failed implant was 1/34). Marginal bone resorption of the installed implant in the autogenous onlay block bone grafts was 0.98 mm after 3 months, which was significantly higher than that of a particulated bone graft (0.74 mm) (P <0.05). Conclusion: An autogenous graft including block type and particulate type is a predictable procedure for the use of dental implants in a severely atrophic mandible. Implant placement in augmented areas show a relatively high survival and minimal bone loss, as revealed by a radiologic evaluation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권3호
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• pp.254-261
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• 2009

저자들은 상악골 구치부에서 잔존 치조골의 흡수 및 상악동의 함기화로 인하여 통상적인 임플란트 시술이 어려운 증례에서 하악골의 하악지에서 자가골을 채취하여 이를 분쇄한 후 이종골과 부피비로 약1:1로 혼합하여 상악동 골이식술을 시행하고 동시에 임플란트를 식립하여 비교적 만족할만한 결과를 얻었기에 이를 문헌고찰과 함께 보고하며, 향후 이러한 증례들과 다른 골이식재를 사용한 증례들에 대하여 보다 장기적인 추적조사와 골이식된 부위의 골조직의 재형성, 식립된 임프란트의 보철적인 기능과 장기적인 예후에 대한 보다 체계적인 연구가 필요하리라 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.46-52
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• 2009

The maxillary posterior edentulous region presents unique and challenging conditions in implant dentistry. The height of the posterior maxilla is reduced greatly as a result of dual resorption from the crest of the ridge and pneumatization of the maxillary sinus after the loss of teeth. Materials previously used for sinus floor grafting include autogenous bone, allogeneic bone, xenogenic bone and alloplastic materials. Autogenous bone is the material of choice, but its use is limited by donor-site morbidity, complications, sparse availability, uncontrolled resorption and marked volume loss. One way to overcome this problem would be to use bone substitutes alone as a osteoconductive scaffold for bone regeneration from the residual bone or in combination with allogeneic bone, which also has osteoinductive properties. The purpose of this article is to describe a double layers technique of demineralized and mineralized bone graft materials instead of autogenous bone in sinus floor augmentation of deficient posterior maxillary alveolar process and to report our experience with this technique. Our results show that maxillary sinus augmentation using mineralized and demineralized bone materials, when installed simultaneously with the implant or not, is good results for bone healing.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권1호
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• pp.28-39
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• 2007

The purpose of this study is to evaluate the regenerative capacity of reconstruction in the atrophied posterior maxilla by comparing bone graft procedures and alveolar distraction osteogenesis (ADO) techniques. We performed the autogenous iliac bone graft (AGB group, 5 specimens in 3 patients), and the combination (Mixed group, 3 specimens in 3 patients) of the autogenous and deproteinized bovine bone ($Bio-Oss^{(R)}$, Geistlich Co., Switzerland) as the ratio of 2:1 in the sinus floor elevation procedures. ADO procedures using $TRACK^{(R)}$ (KLS Martin Co., Germany) were also performed to augment vertical alveolar height in atrophied posterior maxilla (ADO group, 5 specimens in 4 patients). Newly generated bone tissues were obtained with the 2.0mm diameter trephine bur (3i Co., USA) during implant fixture installation after 5-7 months. Routine histolomorphological observation, immunodot blot assay for quantitative evaluation, and immunohistochemical staining with antibodies to MMP-1, -9, -10, TIMP-1, -2, and BMP-2, -4 were all carried out. Lamellar bone formation was well shown in all specimens and new bone formations of ADO group increased than those of other procedures. In immunohistochemical staining, the strong expression of BMP-2 was shown in all specimens, and immunodot blot assay showed that bone formation is accompanied by the good induction of factors associated with angiogenesis and appeared more increased amount of osteogenic and angiogenic factors in ADO group. ADO is the most effective technique for new bone formation compared to sinus floor elevation with autogenous or mixed bone graft in the atrophied posterior maxilla. In the quantitative immunodot blot assay, the regenerated bone after ADO showed more increased products of VEGF, BMP-2, PCNA and MMP-1 than those after the other procedures, and these findings were able to be confirmed by immunohistochemical stainings.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권5호
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• pp.284-289
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• 2015

In cases of severe alveolar bone atrophy in the posterior maxillary area, which has only a thin sinus floor, the autogenous tooth bone graft block (ABTB) was used to wrap the implant to enhance its primary stability and osseointegration in the sinus. These cases with four years of clinical follow-up demonstrate the applicability of the ABTB in maxillary sinus membrane elevation to improve the outcomes of implant placement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.142-147
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• 2011

The authors installed implants combined with guided bony regeneration (GBR) using autogenous tooth bone graft material in the patients. In one patient, GBR and simultaneous implant placement were performed. In two patients, GBR was performed and the implants were placed after 6 months. All patients achieved favorable clinical outcomes. Excellent osteoconductive bony healing was observed in the 6 month histology examination after the bone graft.

• 대한골관절종양학회지
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• 제20권2호
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• pp.74-79
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• 2014

목적: 섬유성 골 이형성증은 신호전달 G 단백의 alpha 소단위체 유전자 변이에 따른 양성 골격계 질환으로 다양한 임상적 양상을 보인다. 기능적 장애, 구조적 변형를 방지하기 위해 제한적으로 수술을 시행하게 되는데 종양소파술 후 발생한 공동을 메우는 골 이식술이 시행된다. 이 연구에서는 본원에서 시행한 섬유성 골 이형성증 치료로서 자가 해면골 이식술을 시행한 경우와 자가 해면골과 동종골, 동종골만을 사용한 경우를 비교 분석하고자 한다. 대상 및 방법: 1997년4월부터 2013년 10월까지 본원에서 섬유성 골이형성증으로 진단된 58 명 중 수술 후 1년이상 추시 관찰이 가능했던 34명을 대상으로 하였다. 수술 시 평균 연령은 26.7세(범위, 2-57세)이었고, 남자는 13명, 여자는 21명이었다. 자가 골이식은 모두 장골에서 채취한 망상골을 이식하였고, 동종골은 골은행에서 기증받은 뼈를 이식용으로 재처리하여 이용하였다. 자가 해면골만 이식한 경우(I군)는 5예, 자가 해면골과 동종 골, 혹은 동종골만 이식한 경우(II군)가 29예였다. 재발, 이차적 변성 같은 합병증을 확인하기 위해, 주기적인 단순 방사선 촬영으로 관찰하였으며 각 군을 비교하였다. 결과: 섬유성 골이형성의 재발이 4예(11.4%)있었으며, 자가 해면골 이식술 시행한 군(I군; 1예 20%)과 자가해면골과 동종골, 혹은 동종골만을 이식한 경우(II군; 3예, 10.3%) 간의 재발율을 Kaplan-Meier 방법으로 분석한 결과 두군간의 차이가 없었다(p=0.554). 재발한 경우는 모두 소파술 및 자가골이식술을 다시 시행하였으며 재수술 후 재발은 없었다. 낭종 같은 이차적 변성이 확인된 경우가 1예, 병적 골절을 보인 경우 1예가 있었으나, 악성변화를 일으킨 경우는 없었다. 결론: 섬유성 골 이형성증 환자들에게 골이식을 시행한 경우, 자가 해면골 또는 동종 골 이식술을 시행한 양 군에서 재발,병적 골절 같은 합병증의 결과가 의미 있는 차이를 보이지 않았다. 따라서 종양의 부피가 작고 병변의 위치가 체중이 가하지는 부위가 아닐 경우에는 자가 해면골 이식 또한 좋은 방법으로 사료되며 이에 대한 연구가 필요하다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권3호
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• pp.103-110
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• 2014

Purpose: The current gold standard for clinical jawbone formation involves autogenous bone as a graft material. In addition, demineralized dentin can be an effective graft material. Although demineralized dentin readily induces heterotopic bone formation, conventional decalcification takes three to five days, so, immediate bone grafting after extraction is impossible. This study evaluated the effect of vacuum ultrasonic power on the demineralization and processing of autogenous tooth material and documented the clinical results of rapidly processed autogenous demineralized dentin (ADD) in an alveolar defects patient. Methods: The method involves the demineralization of extracted teeth with detached soft tissues and pulp in 0.6 N HCl for 90 minutes using a heat controlled vacuum-ultrasonic accelerator. The characteristics of processed teeth were evaluated by scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Bone grafting using ADD was performed for narrow ridges augmentation in the mandibular area. Results: The new processing method was completed within two hours regardless of form (powder or block). EDS and SEM uniformly demineralized autotooth biomaterial. After six months, bone remodeling was observed in augmented sites and histological examination showed that ADD particles were well united with new bone. No unusual complications were encountered. Conclusion: This study demonstrates the possibility of preparing autogenous tooth graft materials within two hours, allowing immediate one-day grafting after extraction.