After periodontal surgery, the potential healing responses were occurred by interaction among junctional epithelium, gingival connective tissue, alveolar bone and periodontal ligament. The only cell that created periodontal regeneration was derived from periodontal ligament. The aim of the study was to evaluate the regenerative effects of the collagen membrane($collacote^{\circ}C$) and autogenous connective tissure graft with periosteum. Experimental periodontitis were created in furcation area of 4 adult dogs with bone removal and gutta percha packing. After 6 weeks later, the gutta percha was removed and experiment was performed divided by 3 groups. 1) Flap operation(control group). 2) Flap operation with collage membrane(Experimental group I). 3) Flap operation with autogenous connective tissue graft with periosteum (Experimental group II). After dogs were sacrificed after two and three weeks, specimens were prepared and stained with hematoxylin-eosin and masson-trichrome stain for light microscopic study. The results were as follows : 1. In all gruoups, connective tissue compartments were increased from two to three weeks especially in experimental group I. 2. Collagen membrane and connective tissue were increased collagen deposits of periodontal ligament. Therefore collagen fiber attached to tooth surface was seen. 3. In al experimental groups, newly forming alveolar bone was seen. 4. Collagen membrane and connective tissue were which prevented proliferation of epithelium, aided connective tissue new attachment and influenced periodontal regeneration.
The use of autogenous tooth bone graft material has been commercialized since 2008. Autogenous tooth bone grafts always require that the tooth of the patient be extracted, and thus, the use of graft material are limited in many cases. For solution of limitation in quantity and concurrent use of autogenous tooth bone graft material, the grafting of familial teeth has been suggested. It has the following advantages: the teeth of family members are used as bone graft materials, the genetic composition is identical, and potential genetic and infectious risks can be minimized. Because the teeth of family members are used, a good tissue affinity is obtained, and thus, superior bone generation rates compared to those observed for allogenic or xenogenic bones can be anticipated. We used familial tooth bone-graft materials for alveolar ridge augmentation, socket preservation, and maxillary sinus graft in some cases. In most cases, the impacted third molars of their children were prepared as bone graft material and were used for surgery. In one case, the impacted third molar from the patient's brother was used as bone graft material. We obtained satisfactory result and these cases are reported herein.
Kim, Eun-Suk;Lee, In-Kyung;Kang, Ji-Yeon;Lee, Eun-Young
Maxillofacial Plastic and Reconstructive Surgery
/
v.37
/
pp.27.1-27.7
/
2015
The aim of this study was to evaluate the clinical relevance of autogenous fresh demineralized tooth (Auto-FDT) prepared at chairside immediately after extraction for socket preservation. Teeth were processed to graft materials in block, chip, or powder types immediately after extraction. Extraction sockets were filled with these materials and dental implants were installed immediately or after a delay. A panoramic radiograph and a conebeam CT were taken. In two cases, tissue samples were taken for histologic examination. Vertical and horizontal maintenance of alveolar sockets showed some variance depending on the Auto-FDT and barrier membrane types used. Radiographs showed good bony healing. Histologic sections showed that it guided good new bone formation and resorption pattern of the Auto-FDT. This case series shows that Auto-FDT prepared at chairside could be a good material for the preservation of extraction sockets. This study will suggest the possibility of recycling autogenous tooth after immediate extraction.
Kim, Min-Jeong;Chung, Hyun-Ju;Kim, Ok-Su;Kim, Young-Joon
Journal of Periodontal and Implant Science
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v.33
no.2
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pp.289-299
/
2003
The autogenous free gingival graft is the most predictable procedure currently used to increase the width of the attached gingiva in periodontics. But the major disadvantage of the procedure is to create the multiple surgical wounds at both a donor site and a recipient site. The other problem is the limited amount of available graft material in oral cavity. Therefore, recent researches have been focused to develop the biomaterial to substitute the autogenous gingival tissue. The purpose of this study was to evaluate the histologic healing after grafting of bilayer artificial dermis, compared to the free gingival graft. Four non-smoking subjects (mean age, 32.5 years) in systemically healthy state and good oral hygiene were selected according to their particular needs for correction of mucogingival problems as suggested by Nabers(1966). The recipient sites were prepared through the procedure for the free gingival graft and were grouped according to the graft materials: Experimental group(n=5) - bilayer artifcia1 dermis ($Terudermis^{(R)}$; Terumo Co. Japan) and Control group(n=6) - free gingival graft with autogenous palatal mucosa. Biopsies were harvested at 1,2,3 and 6 weeks postsurgery to evaluate histologically. At the third week in the experimental group and at the second week of in the control group, the grafts has been clinically stabilized on the recipient bed and the graft border has been blended into the surrounding tissue. In the experimental group after 1 week of grafting, the epithelial migration from the adjacent tissue to graft material was seen and after 3 weeks of grafting, the : nflmmation decreased, collagen layer of the artificial dermis was lost and the basement membrane of epithelium was formed. After 6 weeks of grafting, both groups demonstrated orthokeratinized epithelium and increased thickness of epithelial tissue and the rete peg formation, similar to the adjacent tissue, Histologic evaluation revealed a biologic acceptance and incorporation of the collagen layers of the graft tissue to the host tissue, without foreign body reaction. In conclusion, a bilayer artificial dermis is essentially similar to autogeneous free gingival graft in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.
Kim, Dong-Gi;Lim, Sung-Bin;Chung, Chin-Hyung;Hong, Ki-Seok
Journal of Periodontal and Implant Science
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v.34
no.3
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pp.499-508
/
2004
Regeneration of Periodontium with PRP does not only improve regeneration rate and density of bone but have a possibility to estimate faster healing process for soft tissue. And also, autogenous bone and xenogenic bone graft are effective on regeneration of periodontium. The purpose of this study is to evaluate the effectiveness of autogenous bone and xenogenic bone $(BBP^{(R)})$ grafts with the PRP technique on regeneration of periodontium. 52 Generally healthy Pt. who had pocket depth 5mm at any of 6 surfaces of the teeth were in the study at Dept. of Perio. in Dankook Dental Hospital. Open Flap was treated for 18 infra-bony pockets as control group, autogenous bone with PRP was inserted for 25 infrabony pockets as first test group, and $(BBP^{(R)})$ with PRP was inserted for 22 infrabony pockets as 2nd test group. Then evaluation was made after 3 and 6 months 1. There were significant differences between average probing pocket depth and clinical attachment level of 3, 6 months and minimal and maximal attachment level after 6 months each other. 2. There were significant differences in average probing pocket depth of control group and 2nd experimental group between 1 and 6 months. For clinical attachment level and minimal and maximal proving attachment level, there was a significant difference after 6 month of surgery. 3. There was no significant difference between two test groups for average probing depth, clinical attachment level, and minimal and maximal probing attachment level. As the result, PRP with bone graft could be very effective for regeneration of periodontium and there was no difference between xenogenic bone and autogenous bone.
Purpose: Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage. Methods: Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients' perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months. Results: All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months. Conclusions: The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.
Purpose: In Korean rhinoplasty, alloplasts such as silicone rubber have been used for dorsal and tip augmentations. However, alloplasts have produced complications such as deviation, exposure, and infection. Although autogenous tissue is an ideal material, the amount of the cartilage in Korean is not sufficient. Therefore, the authors developed a method to harvest the maximum amount of the septal and conchal cartilage. The authors first performed a complete septal extension graft for short and retruded columella and then performed nasal augmentation using various autogenous tissues. Methods: These surgical techniques were performed on 11 patients. Their average age was 27 years. An open approach with a V-shaped columellar labial incision was performed. At first, the complete septal extension graft was fixed on the entire caudal margin of the septum, and the alar cartilage was suspended to the septal extension graft to make the tip projected and the columella advanced caudally. A temporal fascial ball was used for radix augmentation. For dorsal augmentation, a batten-shaped septal cartilage graft wrapped with or without the temporal fascia or a diced cartilage graft wrapped with the temporal fascia was performed. For nasal tip augmentation, a shield graft and a cap graft or a folded conchal cartilage graft was performed.Results: The mean follow-up period was 11.2 months. The overall results were natural and satisfactory. Two patients underwent slight absorption and caudal displacement. With the exception of these cases, no complications were observed. Conclusion: Korean rhinoplastic surgeons are accustomed to using the alloplasts despite of serious complications. When rhinoplasty using autogenous tissue was performed, some complications occurred such as the displacement of the diced cartilage graft wrapped with the fascia, but many of the complications of alloplastic rhinoplasty were avoided. Therefore, we propose that by this time Korean rhinoplastic surgeons need to change their preference from alloplastic rhinoplasty to autogenous rhinoplasty.
A progressive hemifacial atrophy is characterized by progressive atrophy of subcutaneous fat and rarely muscle and bone. Its contour follows the underlying muscle. Unilateral involvement is common. The treatment goal has been focused on the augmentation of the soft tissue. Many materials such as implants, collagen, fat graft, fat injection, dermal fat graft, filler and vascualized autogenous graft have been used. Although these materials have been used, the best treatment hasn't been achived. In severe cases underlying soft tissue, muscle and bone may be atrophied and massive soft tissue graft, implant and orthognathic surgery must be used. The author used the dermal-fat tissue for the pupose of soft tissue augmentation. We can get the massive soft tissue by the dermolipectomy procedure through the mini-abdominoplsty. The facial augmentation was done by augmentation of the dermal-fat tissue. The progressive hemifacial atrophy is hard to treat by only one procedure and many modalites must be considered.
Kim, Soo-Young;Lee, Soo-Hyang;Hwang, Eun-A;Choi, Hyun-Gon;Kim, Soon-Heum;Shin, Dong-Hyeok;Uhm, Ki-Il
Archives of Plastic Surgery
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v.37
no.3
/
pp.259-264
/
2010
Purpose: Most surgeons have used autogenous cartilage for columella strut graft. But the supply of autogenous cartilage is often limited. So, this study is to investigate the usefulness of biodegradable plate as columella strut material. Methods: We studied 19 patients who have secondary cleft nasal deformity. Patients were divided into two groups. Group A patients who were not closed their growth plate underwent columella strut graft only with biodegradable plate through endonasal approach. The biodegradable plate was inserted between nasal tip and anterior nasal spine. Group B patients were closed their growth plate. They had an operation for columella strut graft with biodegradable plate fixed with autogenous conchal cartilage. If nasal tip projection was insufficient, we performed additionally onlay graft on nasal tip with autogenous soft tissue or remnant cartilage. Results: As a result of mean 14 months follow-up, we achieved a good nasal tip projection, narrowing of interalar distance and symmetrical nostril shape. No specific complications were reported except 2 cases, which were the extrusion of biodegradable plate into the nasal cavity and Staphylococcus aureus infection. Conclusion: The columella strut graft using biodegradable plate is simple and effective method. Biodegradable plate can be a good substitute for columella strut in patients who can not use autogenous cartilages.
The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there has been many attempts to develop a method to achieve this goal, but none of them was completely successful. This study was designed to compare the effects of treatment using resorbable barrier membrane($Biomesh^{?}$) in combination with autogenous bone graft material with control treated by only modified Widman flap. 22 infrabony defecs from 10 patients with chronic periodontitis were used for this study, 10 sites of them were treated with resorbable barrier membrane and autogenous bone graft material as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6-8 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of the two group was reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(P<0.05), but not in experimental group, and initial values of the two group were in statistically significant difference(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using resorbable barrier membrane in combination with autogenous bone graft material improve the probing depth, bone probing depth and loss of attachment in infrabony defects.
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