• Title/Summary/Keyword: Bone block surgery

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SUBANTRAL AUGMENTATION WITH AUTOGENOUS BONE GRAFT FOR SIMULTANEOUS IMPLANT INSTALLATION (상악동저 점막 거상술을 이용한 인공치아 임프란트 동시 식립술 후 예후에 관한 임상적 연구)

  • Kim, Myung-Jin;Kim, Tae-Young;Hwang, Kyung-Gyun;Yu, Sang-Jin;Myoung, Hoon;Kim, Soo-Kyung;Kim, Jong-Won;Kim, Kyoo-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.644-651
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    • 2000
  • In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre- and postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

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Vertical and Horizontal Ridge Augmentation Using Autogenous Tooth Bone Graft Materials: Case Report (자가치아골이식재를 이용한 치조능 수직 및 수평증대술: 증례보고)

  • Kim, Young-Kyun;Kim, Su-Gwan;Um, In-Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.166-170
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    • 2011
  • Horizontal and vertical ridge augmentation was performed using autogenous tooth bone graft block and powder in 44-year old male patient. Excellent bony healing was obtained 2~4 months after ridge augmentation. Implant treatment was performed successfully.

Operative Treatment of Chronic Recurrent Dislocation of Peroneal Tendon (A Case Report) (외상성 만성 비골건 탈구의 수술적 치료 (1예 보고))

  • Lee, Do-Young;Kang, Jae-Do;Lim, Moon-Sup;Yoon, Hyeong-Jo
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.120-122
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    • 2007
  • Traumatic dislocation of the peroneal tendon is an infrequent injury. This injury is caused by forceful dorsiflexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior peroneal retinaculum and allows the tendons to snap anteriorly. We experienced a case of chronic recurrent dislocation of the peroneal tendon, which was treated by bone block surgery using autograft of lateral fibula and reattachment of the superior peroneal retinaculum. The clinical result was satisfactory.

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AN EXPERIMENTAL STUDY OF THE EFFECTS OF BONE WAX ON THE MOUSE FEMORAL BONE DEFECTS (백서 대퇴골 결손부에 매식된 밀랍지혈제의 조직반응에 관한 실험적 연구)

  • kim, Jang-Yun;Han, Kyung-Su;Um, In-Woong;Chung, Ho-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.3
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    • pp.228-236
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    • 1992
  • This study was to designed to evaluate the reactions of mouse femoral bone to bone wax. In sixteen mice with a strain of I. C. R. mouse weighed approximately 300 to 850g 2.0~2.0mm sized bone defects were created by drilling. Half of mice were inserted by bone wax and the remainder serving as control without bone wax application. The mice were sacrificed 1, 2, 6, 8 weeks after operation and block specimens were prepared for light microscopy examination. The results obtained were as follows. 1. Histologic features of tissue reaction to bone wax were the presence of inflammatory cell infiltration and multinucleated giant cell. 2. Bone ear healing from the created margin were markedly impaired by the application of bone wax 3. New bone formation was markedly decreased in bone wax application.

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Implant Placement Using Various Surgical Techniques: Case Report

  • Lee, Ji-Young;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.3 no.2
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    • pp.50-59
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    • 2010
  • Implant placement is frequently complicated and challenging because of the poor quality and inadequate height of bone. Clinicians should consider various surgical procedures to overcome the problems. We report a case with various surgical procedures used such as inferior alveolar nerve repositioning, sinus bone graft, and autogenous block bone graft using the coronoid process and ramus to overcome severe vertical and horizontal alveolar bone atrophy.

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Clinical application of auto-tooth bone graft material

  • Park, Sung-Min;Um, In-Woong;Kim, Young-Kyun;Kim, Kyung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.2-8
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    • 2012
  • Introduction: Auto-tooth bone graft material consists of 55% inorganic hydroxyapatite (HA) and 45% organic substances. Inorganic HA possesses properties of bone in terms of the combining and dissociating of calcium and phosphate. The organic substances include bone morphogenetic protein and proteins which have osteoinduction capacity, as well as the type I collagen identical to that found in alveolar bone. Auto-tooth bone graft material is useful as it supports excellent bone regeneration capacity and minimizes the possibility of foreign body reaction,genetic diseases and disease transmission. Materials and Methods: Implant placement combined with osteoinductive regeneration,preservation of extraction socket, maxillary sinus augmentation, and ridge augmentation using block type,powder type, and block+powder type autobone graft materialwere performed for 250 patients with alveolar bone defect and who visited the Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University from September 2009 to August 2011. Results: Clinical assessment: Among the 250 patients of auto-tooth bone graft, clinical assessment was performed for 133 cases of implant placement. The average initial stabilization of placed implants was 74 implant stability quotient (ISQ). Radiological assessment: The average loss of crestal bone in the mandible as measured 6 months on the average after the application of prosthesis load was 0.29 mm, ranging from 0 mm to 3.0 mm. Histological assessment: In the histological assessment, formation of new bone, densified lamellated bone, trabecular bones, osteoblast, and planting fixtures were investigated. Conclusion: Based on these results, we concluded that auto-tooth bone graft material should be researched further as a good bone graft material with osteoconduction and osteoinduction capacities to replace autogenous bone, which has many limitations.

A COMPARATIVE STUDY OF VARIOUS TYPE OF AUTOGENEOUS BONE GRAFT ON THE RABBIT-SKULL DEFECT HEALING (가토 두개골에 이식한 다양한 형태의 자가골에 의한 골성 회복 양상 비교 평가)

  • Choi, So-Young;Lee, Su-Youn;Kim, Jin-Wook;Kim, Chin-Soo;Lee, Sang-Han;Shin, Hong-In;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.428-434
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    • 2008
  • Introduction: Piezosurgery device is one of the most commonly used instrument on the intraoral surgery such as maxillary sinus lift and autogeneous bone graft. Piezosurgery instrument also contains the tips that are manufactured especially for the convenient bone graft, which now many surgeons apply them for collecting bone graft materials in the curettage method for the restoration of skull defects. However, objective data has not been shown concerning the effects about bone graft with using Piezosurgery. Therefore we investigated the effects of Piezosurgery on the rabbit-skull defect healing. Materials & Methods: To investigate the regeneration of the bony defect with various bone graft, 10 adult New Zealand white rabbits (average weight : $2.8{\pm}0.3kg$, about 12weeks) were used. The four circular bony defects measuring 6mm in diameter were made with Piezosurgery device on each rabbit cranial bone. The harvested bone tissues during defect formation were also used for autogeneous bone graft. They were grafted into the defects in a various type; block type (Group 1), particulated type by the bone mill (Group 2), chopped type by curette shaped Piezosurgery tip (Group 3), the defect without any graft was served as control (control group). The animals were sacrificed after 6 weeks and bone regeneration capacity was evaluated histomorphometrically. Result & Conclusion: Autogeneous bone graft harvested using a Piezosurgery instrument showed satisfactory bone regeneration. There was no conspicuous difference bone prepared among by bone mill or Piezosurgery and block bone graft. Therefore, the bone harvested from the intraoral site near the operation field using the piezosurgery device can be a feasible and reliable graft for intraoral bony defects.

Extraction Socket Preservation and Reconstruction Using Autogenous Tooth Bone Graft: Case Report (자가치아골이식재를 이용한 발치창 보존 및 재건술)

  • Kim, Young-Kyun;Kim, Su-Gwan;Kim, Kyung-Wook;Um, In-Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.264-269
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    • 2011
  • An extraction socket was preserved and reconstructed using an autogenous tooth bone graft powder and block in two patients. The grafted site was healed 3 to 3.5 months after surgery. Implant treatment was successfully completed.

HISTOLOGICAL TISSUE RESPONSES OF DEMINERALIZED ALLOGENEIC BONE BLOCK GRAFT IN RABBITS (가토 탈회 동종골편 이식시 조직반응에 관한 연구)

  • Jun, Young-Hwan;Kim, Young-Jo;Min, Seung-Ki;Um, In-Woong;Lee, Dong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.1
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    • pp.63-79
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    • 1993
  • To repair bony defects with tansplanted bone in the body, fresh autogenous bone is undoubtly, the most effective bone graft for clinical applications. But the demineralized bone has the matrix-induced bone formation which was suggested by Urist in 1965. Many authors assisted that demineralized bone powder induces phenotypic conversion of mesenchymal cells into osteoblasts, with high-density bone formation. The process of inducing differentiated cells becomes osteogenic properties. The purpose of this study was to evaluate the osteoinductive capacity of allogenic freeze-dried demineralized bone block (FDD, $7{\times}7mm$) and to compare FDD with the same sue of deep-frozen allogenic bone(DF), fresh autogenous bone (A) after implantation. The histological and ultrastructural features of tissue responses were examined after 1, 2, 4, 6, 8 weeks implantation of each experimental groups in the operative site of the New Zealand white rabbits. The results were as follows : 1. Inflammatory cell infiltration generally has appeared at 1 week, but reduced at 4 weeks in each group, but most severe in DF group. 2. Osteoblastic activity has increased for 4 weeks, but decreased at 6 weeks in each group and there was no significant difference among experimental groups. 3. New bone formation has begun at 1week, least activations in A groups, and showed the revesal line of bone formation among each group at 6 to 8 weeks. 4. Bone resorption has appeared at 1 week, but disappeared at 4 weeks in both A and DF groups, but more severe in DF than A groups. 5. In ultrastructural changs, the DF group have showed the most remarkable osteoclastic activities among experimental groups. 6. Osteoid or tangled collagen fibrils near the implanted sites were replaced by more mature, lamellated bony trabeculae during bone remodeling. There was little difference among each experimental groups. 7. During the convertion osteoblasts to osteocytes which embedded within the bone matrix, there was organ-less-poor cytoplasm, increased nuclear chromatin, abundant rough endothelial reticulum (RER) in each groups. From the above the findings, the DF group shored more bone resorption and foreign body reaction than FDD and A groups, and FDD group showed more new bone formation or osteoblastic activity than DF and A groups in early stage. There was no significant difference of cellular activities among the FDD DF, and A groups according to the time.

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SUTURE TECHNIQUE FOR SUCCESSFUL GUIDED BONE REGENERATION ; PRELIMINARY REPORT OF DOUBLE LAYERED SUTURE TECHNIQUE WITH SUBGINGIVAL SUTURE (성공적인 골유도재생술을 위한 봉합술 : 점막하 봉합법을 이용한 이중 봉합술의 예비 보고)

  • Kim, Young-Bin;Cho, Sung-Dae;Leem, Dae-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.86-91
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    • 2009
  • The success of implants essentially depends on a sufficient volume of healthy bone at the recipient site during implant placement. In patients who have the severe alveolar bone resorption or pneumatized maxillary sinus, it should be performed that bone regeneration procedure before implant placement. Development of barrier membrane makes it possible that predictable result of alveolar bone reconstruction. Many kind of materials used for barrier membrane technique are introduced, non-absorbable or absorbable membranes. But, when operation site was ruptured with membrane exposure, bacterias can be grow up at the bone graft site. Then morphology and migration of fibroblast will be changed. It works as a negative factor on healing process of bone graft site. In oral and maxillofacial department of Chonbuk national university dental hospital, we use variable suture technique like as subgingival suture, vertical mattress suture, simple interrupted suture, if need, tenting suture after GBR or block bone graft. Within these suture technique, wound healing was excellent without complication, so now we take a report of suture technique in reconstruction of alveolar bone surgery.