• The Journal of the Korean dental association
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• v.53 no.5
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• pp.298-306
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• 2015

Bacterial infection after implant installation or bone graft is a serious complication. Bone grafts represent a temporary foreign body lacking vascularisation and are therefore of increased susceptibility to infection, which may be introduced either intraoperatively or postoperatively. Bone graft-associated infections are due to biofilm formation on the surface of the bone graft and often require removal of the infected bone graft with substantial graft failure. In this review, the implant and graft related infection, the role of biofilm and the management will be discussed.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.745-752
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• 2002

Osteomyelitis is an exhaustive disease whose main feature is an inflammation of inner part of bone, bone marrow. In oral and maxillofacial area, we have maxillary and mandibular osteomyelitis and the latter is dominant because of its impaired blood supply. The main cause of osteomyelitis is a bacterial infection and the ways of infections are by periapical odontogenic infection, fracture, post-operative complication, and periodontal disease. The predominant etiologic factor is periapical odontogenic infection mostly caused by advanced dental caries. It is generally believed that periodontal disease could be a cause of osteomyelitis. But periodontal disease is usually confined to the alveolar bone area and not extends to the underlying bone marrow. Accordingly periodontal infection per se rarely cause produce oseomyelitis. Even though osteomyeltis could be occurred by periodontal disease, its virulence of infection is milder than periapical odontogenic infection. So it usually provokes sclerosing or hyperplastic osteomyelitis rather than suppurative type. We had a case of suppurative osteomyelitis caused by periodontal disease and treated it with periodontal and oral and maxillofacial surgical method.

• Archives of Craniofacial Surgery
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• v.20 no.5
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• pp.324-328
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• 2019

Intraorbital infection shows a low incidence, but it might cause blindness or even death. This case is unusual in that its origin from a craniofacial bone fracture prior to infection of the maxillary sinus. A 33-year-old female patient was referred for right cheek swelling. When she visited the emergency room, we removed right cheek hematoma and bacterial examination was done. In the past, she had craniofacial bone surgical history due to a traffic accident 6 years ago. Next day, the swelling had remained with proptosis and pus was recognized in the conjunctiva. We planned an emergency operation and removed the pus which was already spread inside the orbit. And the evaluation for sinusitis was consulted to the otorhinolaryngology department simultaneously. There were Prevotella oralis and methicillin-resistant Staphylococcus epidermidis bacterial infection in the intraorbital and sinus respectively. Afterwards, the vigorous dressing was done for over a month with intravenous antibiotics. Though the intraorbital infection was resolved, blindness and extraocular movement limitation were inevitable. In conclusion, close follow up of the maxillary sinus in facial bone fracture patients is important and aggressive treatment is needed when an infection is diagnosed.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.216-220
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• 2001

Objective : Cranioplasty is required to protect underlying brain, to correct major aesthetic deformities, or both. The ideal material for this purpose is autogenous bone. When this is not available, alloplastic or artificial materials may be used. In this study authors compared the infection rate according to the cranioplasty materials(the frozen autologous bone vs. bone cement), and duration of the skull defect. Materials : Between May 1994 and December 1999, 111 patients with skull defect treated with cranioplasty(82 cases of frozen autologous bone and 29 cases of artificial bone material) were included in this study. There were 77 males and 34 females with a mean age of 41.4 years(range 1-85 years). 57 patients had head trauma and 54 had non-traumatic insults. According to the duration of skull defect, there were 28 cases under 1 month, 33 cases of 1-2 months, 15 cases of 2-3 months, 20 cases of 3-6 months and 15 cases over 6 months of duration. Results : Overall infection rate was 9.9%. In cases with frozen autologous bone and artificial bone material, the infection rate was 8.5% and 13.7%, respectively. The infection rate according to the duration of skull defect was 3.6%(among 28 cases) under 1 month of age, while those were 12%(4 among 33 cases) at 1-2 months, 20%(3 among 15 cases) at 2-3 months, 5%(1 among 20 cases) at 3-6 months and 13%(2 among 15 cases) over 6 months. Accoring to the underlying disease, the infection rate in traumatic cases was 12%(7 among 57 cases) and that in non-traumatic one was 3.7%(2 among 54 cases). Conclusion : From this study, it appears that skull defect should be repaired as soon as possible, because early cranioplasty can lower the infection rate. And surgeons could save the patients' cranial bone as possible as they can because autologous bone is not only cost effective in cosmatic purpose but lower the infection rate.

• Archives of Reconstructive Microsurgery
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• v.22 no.2
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• pp.57-62
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• 2013

Purpose: The aim of this study is to report on the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of large bone and soft tissue defect combined with infection by open tibia fracture. Materials and Methods: During the research period, lasting from December 2002 to June 2008 (Kyung Hee University Medical Center), data were collected from three patients who underwent IVFT after free flap. We analyzed the successiveness and persistency of the infection using free flapping, bone union, and hypertrophy between transposed fibula and tibia. Results: Regarding free flap, successive results were observed in all examples. In the final follow-up results, transposed fibulas all survived, having hypertrophy similar to that of adjacent tibia. Conclusion: Reconstruction of tibia defect with free flap followed by IVTF is a useful and safe method for avoidance of the potential risk of infection for patients with a large tibial bone defect and soft tissue defect associated with infection.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.1-4
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• 2016

Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits. They are not palpable after plate absorption, which obviates the need for plate removal. Absorbable plate-related infections are relatively uncommon at less than 5% of patients undergoing fixation of facial bone fractures. The plates are made from a mixture of poly-L-lactic acid and poly-DL-lactic acid or poly-DL-lactic acid and polyglycolic acid, and the ratio of these biodegradable polymers is used to control the longevity of the plates. Degradation rate of absorbable plate is closely related to the chance of infection. Low degradation is associated with increased accumulation of plate debris, which in turn can increase the chance of infection. Predisposing factors for absorbable plate-related infection include the presence of maxillary sinusitis, plate proximity to incision site, and use of tobacco and significant amount of alcohol. Using short screws in fixating maxillary fracture accompanied maxillary sinusitis will increase the rate of infection. Avoiding fixating plates near the incision site will also minimize infection. Close observation until complete absorption of the plate is crucial, especially those who are smokers or heavy alcoholics. The management of plate infection is varied depending on the clinical situation. Severe infections require plate removal. Wound culture and radiologic exam are essential in treatment planning.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.4
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• pp.193-199
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• 2006

Infectious and inflammatory bone diseases include a wide range of disease process, depending on the patient's age, location of infection, various causative organisms, duration from symtom onset, accompanied fracture or prior surgery, prosthesis insertion, and underlying systemic disease such as diabetes, etc. Bone infection may induce massive destruction of bones and joints, results in functional reduction and disability. The key to successful management is early diagnosis and proper treatment. Various radionuclide imaging methods including three phase bone scan, Ga-67 scan, WBC scan, and combined imaging techniques such as bone/Ga-67 scan, WBC/bone marrow scan add complementary role to the radiologic imaging modalities including plain radiography, CT and MRI. F-18 FDG PET imaging also has recently been introduced in diagnosis of infected prosthesis and chronic active osteomyelitis. Selection of proper nuclear medicine imaging method will improve the diagnostic accuracy of infections and inflammatory bone diseases, based on understading of pathogenesis and radiologic imaging findings.

• Archives of Craniofacial Surgery
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• v.22 no.6
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• pp.319-323
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• 2021

Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures. Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon's specialty, and operation time. Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of "surgical site infection." Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon's specialty did not show any difference in infection-related complication rates. Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.425-429
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• 2011

Bone grafts are becoming increasingly common in oral and maxillofacial surgery to improve bone healing procedures. Bovine bone as a xenograft is a representative osteoconductor and space filler; however, sometimes complications, such as infection and wound dehiscence are encountered with its use. We report the result of an eight-year follow-up of a xenograft case and processing methods of inorganic bovine bone along with a review of the literature. Xenograft ($LUBBOC^{(R)}$) was used in a cyst enucleation site of the maxilla, as a bone substitute and space filler. Inflammation and infection were defined several times as lack of osseous contact between the graft and host bone, caused by remodeling failure over an eight-year period. Pathologic findings of the xenograft revealed dead bony trabeculae with inflamed fibrous tissue and actinomycosis.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.10
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• pp.117-122
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• 2007

The novel implant system was developed using osseo-integration technology which enable amputee to overcome skin troubles in use of previous socket system and was evaluated in view of biomechanics, radiology, histology, and pathology. The osseo-integrated implants were designed and manufactured using CT image of canine's tibia and were applied to laboratory animals (canines). The follow-up studies were performed for 24 months with 10 canines. In radiology examination, we found that the relative low strain distribution caused medial and posterior bone resorption and then we verified them by biomechanical testing. In histological approach, the complete osseo-integration was observed through the activity of osteoblast cells around bone-implant interface and the radial outer region of bone due to peristeum reaction. Lastly in pathological aspect, the evidence of superficial infection was detected but that of deep infection was not. Therefore it is thought that infection problem will be overcome by immunity of body and good hygiene.