• Archives of Plastic Surgery
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• v.50 no.5
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• pp.488-491
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• 2023

Silicone breast implant insertion is a commonly performed surgical procedure for breast augmentation or reconstruction. Among various postoperative complications, infection is one of the main causes of patient readmission and may ultimately require explantation. We report a case of infective costochondritis after augmentation mammoplasty, which has rarely been reported and is therefore difficult to diagnose. A 36-year-old female visited the clinic for persistent redness, pain, and purulent discharge around the left anteromedial chest, even after breast implant explantation. Magnetic resonance imaging showed abscess formation encircling the left fourth rib and intracartilaginous and bone marrow signal alteration at the left body of the sternum and left fourth rib. En bloc resection of partial rib and adjacent sternum were done and biopsy results confirmed infective costochondritis. Ten months postoperatively, the patient underwent chest wall reconstruction with an artificial bone graft and acellular dermal matrix. As shown in this case, early and aggressive surgical debridement of the infected costal cartilage and sternum should be performed for infective costochondritis. Furthermore, delayed chest wall reconstruction could significantly contribute to the quality of life.

• Journal of Periodontal and Implant Science
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• v.53 no.6
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• pp.429-443
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• 2023

Purpose: The aim of this study was to determine 1) the bone-regenerative effect of porcine bone block materials with or without collagen matrix incorporation, 2) the effect of a collagen barrier, and 3) the effect of adding recombinant human bone morphogenetic protein-2 (rhBMP-2) to the experimental groups. Methods: Four treatment modalities were applied to rabbit calvaria: 1) deproteinized bovine bone mineral blocks (DBBM), 2) porcine bone blocks with collagen matrix incorporation (PBC), 3) porcine bone blocks alone without collagen matrix incorporation (PB), and 4) PBC blocks covered by a collagen membrane (PBC+M). The experiments were repeated with the addition of rhBMP-2. The animals were sacrificed after either 2 or 12 weeks of healing. Micro-computed tomography (micro-CT), histologic, and histomorphometric analyses were performed. Results: Micro-CT indicated adequate volume stability in all block materials. Histologically, the addition of rhBMP-2 increased the amount of newly formed bone (NB) in all the blocks. At 2 weeks, minimal differences were noted among the NB of groups with or without rhBMP-2. At 12 weeks, the PBC+M group with rhBMP-2 presented the greatest NB (P<0.05 vs. the DBBM group with rhBMP-2), and the PBC and PB groups had greater NB than the DBBM group (P>0.05 without rhBMP-2, P<0.05 with rhBMP-2). Conclusions: The addition of rhBMP-2 enhanced NB formation in vertical augmentation using bone blocks, and a collagen barrier may augment the effect of rhBMP-2.

• Journal of Periodontal and Implant Science
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• v.46 no.1
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• pp.57-69
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• 2016

Purpose: The aim of this pilot study was to determine the osteoconductivity and dimensional stability of augmented sinuses using different ratios of biphasic calcium phosphate (BCP) in a rabbit sinus model. Methods: Each sinus of New Zealand white rabbits (2.5-3.5 kg) was assigned to one of two groups: BCP with a hydroxyapatite to ${\beta}$-tricalcium phosphate (HA:${\beta}$-TCP) ratio of 70:30 (group TCP30) and BCP with an HA:${\beta}$-TCP ratio of 30:70 (group TCP70). After preparing a window in the antral wall of a sinus, the Schneiderian membrane was elevated, and the applicable material was grafted. A fluorochrome calcein green was injected five days before euthanizing the animals at four months post-surgery. The specimens were analyzed histologically, histomorphometrically, and by using micro-computed tomography (micro-CT). Results: Micro-CT analysis revealed that the total augmented volume and the new bone volume did not differ significantly between the two groups whereas the resorption of materials was greater in the TCP70 group. The trabecular thickness, number, and separation also did not differ significantly between the two groups. Histomorphometrically, the areas of total augmentation, new bone, and residual material, as well as the ratio of new-bone-material contact did not differ significantly between the groups. Histologically, the residual particles were more scattered in the TCP70 group than in the TCP30 group. The fluorescence of the calcein green did not differ notably between the two groups. Conclusions: The osteoconductivity and dimensional stability of the two BCPs with different ratios tested in this study were comparable after four months of healing. Therefore, we conclude that both BCPs show promise as a bone substitute for sinus augmentation.

• Journal of Korean Dental Science
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• v.12 no.1
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• pp.5-12
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• 2019

Purpose: To determine the benefits of autogenous tooth bone (ATB) graft in combination with platelet-rich plasma (PRP) in the rates of success and survival of dental implants placed simultaneously with maxillary sinus floor augmentation (MSFA). Materials and Methods: Patients who visited the Department of Oral and Maxillofacial Surgery at Ulsan University Hospital from 2012 to 2014 and underwent simultaneous placement of implants with MSFA using ATB plus PRP were included in the study. Success and survival rates of the implants were evaluated based on the parameters of age and sex of the patient, site, follow-up period, residual bone height before surgery, diameter, and length of implant, sinus mucosa impairment, and postoperative complications. Result: A total of 23 patients and 67 implants were included in this study. The average age of the patients was $53.78{\pm}10.00$ years. The average follow-up period after installation of the prosthesis was $53{\pm}5$ months. The success and survival rates of the implants after placement of prosthesis were 95.52% and 97.01%, respectively. Conclusion: Combination of ATB and PRP showed high overall success rate, and it can be concluded that this combination is a predictable bone graft procedure for MSFA.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.47-54
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• 2017

The atrophy of edentulous ridge and pneumatization of the maxillary sinus often limit the volume of bone available for implant placement on maxillary posterior teeth. Most clinicians suffer difficulties from poor bone quality and quantity on maxillary posterior site. Thus, the success of maxillary posterior implant surgery depends on the increase of the available bone and obtaining a good initial stability of the implant after maxillary sinus reconstruction. The maxillary sinus augmentation methods include a crestal approach and a lateral approach. Less morbidity and complications after operation is major advantage to sinus augmentation using crestal approach than lateral approach. However, when the residual ridge height is ${\geq}6mm$, it is known that crestal approach is appropriate. Also delayed implantation after sinus augmentation is recommended in severely atrophic ridge. We present the three cases of implant placement simultaneously sinus augmentation using crestal approach in posterior maxilla site with ${\leq}3mm$ of residual alveolar bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.256-263
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• 2011

Purpose: The purpose of this study was to evaluate the effectiveness of autogenous tooth graft materials after maxillary sinus bone grafts. Methods: The study involved 23 implants in 22 patients who visited the Department of Oral and Maxillofacial Surgery and the Department of Periodontics, Chosun University Dental Hospital, in 2008 and received autogenous tooth graft materials for maxillary sinus bone grafts. Results: For eight patients with maxillary bone graft materials prior to implant placement, the healing period averaged five months. For eleven patients with simultaneous maxillary bone graft and implant placement, eight patients received a second surgery, with an average healing time of six months. Three patients had a longer observation period with only a fixture implanted. Three patients who received only a bone graft required more time to implant placement because of the lack of residual bone and also for personal reasons. Only 5 patients had biopsies performed and complications such as infection and dehiscence healed well. The application of autogenous graft materials to the maxillary bone graft sites did not exert any significant effects on the success rates. When a mixture of graft materials was used, the post-surgical bone resorption rate was reduced. Histological analysis showed that new bone formation and remodeling were initiated during the three-to-six month healing period. Bone formation capacity increased continuously up to six months after the maxillary bone graft. Conclusion: According to this analysis, excellent stability and bone-forming capacity were seen in cases where autogenous materials were used alone or mixed with other materials. Autogenous tooth graft materials may be substituted instead of autogenous bones.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.109-115
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• 2011

Implants were placed after performing ridge expansion by inserting screws of gradually increasing thickness. Favorable clinical outcome was obtained. During surgery, buccal cortical plate fracture did not occur. Autogenous tooth bone graft material was grafted around the implant dehiscence defects and over the buccal cortical plate. The method involving the insertion of screws for ridge expansion is a successful and predictable technique for implant placement in narrow alveolar bone. Autogenous tooth bone graft material can be used for ridge augmentation and GBR.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.1
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• pp.33-39
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• 2021

When maxillary anterior tooth is extracted due to alveolar bone loss, the augmentation of alveolar ridge is very important for esthetic implant restoration. Because alveolar bone loss increases after extraction, the ridge preservation performed right after tooth extraction is meaningful for esthetic implant restoration. However, no achievement of primary closure during ridge preservation can negatively affect bone regeneration. To overcome this problem, we can use granulation tissue in the extraction socket for primary closure. This case report confirmed that primary closure using granulation tissue resulted in not only ridge preservation but also ridge augmentation by providing an environment more advantageous of bone regeneration than the open wound.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.125-128
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• 2010

Objective : The purpose of this study was to determine the optimal volume of injected cement and its distribution when used to treat vertebral compression fractures, and to identify factors related to subsequent vertebral fractures. Methods : A retrospective analysis of newly developing vertebral fractures after percutaneous vertebroplasty was done. The inclusion criteria were that the fracture was a single first onset fracture with exclusion of pathologic fractures. Forty-three patients were included in the study with a minimum follow up period of six months. Patients were dichotomized for the analysis by volume of cement, initial vertebral height loss, bone marrow density, and endplate-to-endplate cement augmentation. Results : None of the four study variables was found to be significantly associated with the occurrence of a subsequent vertebral compression fracture. In particular, and injected cement volume of more or less that 3.5 cc was not associated with occurrence (p = 0.2523). No relation was observed between initial vertebral height loss and bone marrow density (p = 0.1652, 0.2064). Furthermore, endplate-to-endplate cement augmentation was also not found to be significantly associated with a subsequent fracture (p = 0.2860) by Fisher's exact test. Conclusion : Neither volume of cement, initial vertebral height loss, bone marrow density, or endplate-to-endplate cement augmentation was found to be significantly related to the occurrence of a subsequent vertebral compression fracture. Our findings suggest that as much cement as possible without causing leakage should be used.

• Journal of Periodontal and Implant Science
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• v.41 no.2
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate 3.5 years-cumulative survival rate of implants placed on augmentedsinus using Osteon, a bone graft material, and to assess the height of the grafted material through radiographic evaluation. Methods: Twenty patients were treated with maxillary sinus augmentation and 45 implant fixtures were installed simultaneously or after 6 months healing period. The height of the augmented sinus and the loss of marginal bone were measured by panoramic and intraoral radiographs immediately after augmentation and up to 42 months (mean, 19.4 months) subsequently. Changes in the height of the sinus graft material were calculated radiographically. Results: The cumulative survival rate was 95.56% in all 45 implants. Additionall, normal healing process without any complication was observed in all patients. The original sinus height was mean 4.3 mm and the augmented sinus height was mean 13.4 mm after the surgery. The mean marginal bone loss till 42 months was $0.52{\pm}0.56\;mm$. The reduced height of Osteon was $0.83{\pm}0.38\;mm$ and it did not show significant correlation with the follow up periods (P=0.102). There were no statistically significant differences in reduced height of Osteon according to the simultaneous/delayed implantation (P=0.299) and particle size of Osteon (P=0.644). Conclusions: It can be suggested that Osteon may have predictable result when it was used as a grafting material for sinus floor augmentation.