• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.269-273
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• 1998

To clarify the clinical utility of the calvarial bone graft in the maxillofacial reconstruction, we performed on anatomical study by measuring the regional thickness of the parietal bone on 17 Korean adult dry skulls. Before the sectioning the calvarium, the anatomical landmarks were marked on each specimens. And then we measured the total thickness of the parietal bone, the thickness of the outer and inner cortical plates on various points in each sections of parietal bones using a digital caliper under the stereomicroscope. The total thickness of the parietal bone was ranged from 5.17mm to 7.50mm, and there were no statistical difference in the total thickness of the parietal bone on the same points bilaterally. But there was a tendency that the thickness of the parietal bone was thicker toward to the lambda point than the coronal suture area. At the other hand, the thickness of the outer and inner plate of the parietal bone was the thickest at the first point of the right aspect on the line 1, the first point of the left aspect on the line 5, respectively. In conclusion, this study showed that the donor site of the parietal bone for the maxillofacial reconstruction should be located at more posterior and medial area of the parietal bone than the prevalent known donor site.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.186-190
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• 2007

Purpose: Plate systems have been used for osteosynthesis of cranial and oromaxillofacial fracture. However, there is no consensus on the need for routine removal of plate and the question about indications of removal. Therefore, we present the retrospective study to clarify the indications and consensus of removal. Methods: The medical records of patients who were treated with rigid internal fixation using plates after craniofacial trauma were reviewed. Study variables included age, gender, type of fracture, type of plate, seniority of the operator, causes of removal, and time between insertion and removal. All results amendable to statistics were analyzed using SPSS 10.0 to determine which set of variables might affect the fate of the plates. Results: For a period of 10 years (March 1, 1994 through July 31, 2004), total of 41 plates(6.7%) were removed among 609 plates inserted into 419 patients; 27 plates were removed from 15 patients for infection, which is the most common cause of removal accounting for 65.8%. Mean time between insertion and removal is 35.2 months and mean age is 41.4 years. Most plates were removed from combined fracture(14.92%) and facial fracture(8.47%) and these were statistically significant. The age, gender, seniority of the operator and other variables were not statistically associated with plate removal. Conclusion: This retrospective study shows that routine removal does not appear to be clinically indicated due to respectively low removal rate and that the commonest indications for removal were infection.

• The korean journal of orthodontics
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• v.24 no.4 s.47
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• pp.933-943
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• 1994

The present study was undertaken to determine the effect of tensile force on DNA and protein biosynthesis in bone cells, and to identify the cell type(s) which primarily respond to external physical force among the heterogenous bone cell populations. As a prerequisite for this study, two bone cell populations which retain fibroblastic and osteoblastic feature were isolated from fetal rat calvaria with sequential enzyme digestion scheme. Tensile force was delivered to each bone cell population by two acrylic resin plates connected with a orthodontic expansion screw during culture period. Rate of DNA and protein synthesis in each bone cell population were assessed by the incorporated radioactivity of $[^3H]-thymidine$ into DNA and $[^3H]-proline$ into fraction of collagenase-digestible protein and noncollagenous protein, respectively. DNA synthesis of osteoblast-like calvarial cell populations was increased significantly by the application of tensile force for 24 hours. In contrast, no alteration in DNA synthesis of fibroblast-like populations could be observed in response to applied force. Tensile force induced the change in protein synthesis of bone cell populations with the same pattern. Total protein and collagen synthesis were increased whithin 24 hours in osteoblast-like populations, but not in fibroblast-like populations by tensile force application. These findings indicate that physical force can affect cellullar activity of the particular cell population, not all cell Populations residing in bone and osteoblasts respond more sensitively than fibroblasts. So osteoblasts can modulate the behavior of other bone cells including osteoclasts by producing several local regulating factors of bone metabolism. In this context, preferential responsiveness of osteoblasts to applied tensile force observed in this study suggests that osteoblasts may play an important role in regulation of physical force-induced remodelling process.

• Archives of Plastic Surgery
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• v.50 no.3
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• pp.248-253
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• 2023

Metal fixation systems for cranial bone flaps cut by a drill are convenient devices for cranioplasty, but cause several complications. We use modified craniotomy using a fine diamond-coated threadwire saw (diamond T-saw) to reduce the bone defect, and osteoplasty calcium phosphate cement without metal fixation. We report our outcomes and tips of this method. A total of 78 consecutive patients underwent elective frontotemporal craniotomy for clipping of unruptured intracranial aneurysms between 2015 and 2019. The follow-up periods ranged from 13 to 66 months. The bone fixation state was evaluated by bone computed tomography (CT) and three-dimensional CT (3D-CT). The diamond T-saw could minimize the bone defect. Only one wound infection occurred within 1 week postoperatively, and no late infection. No pain, palpable/cosmetically noticeable displacement of the bone flap, fluid accumulations, or other complications were observed. The condition of bone fixation and the cosmetic efficacy were thoroughly satisfactory for all patients, and bone CT and 3D-CT demonstrated that good bone fusion. No complication typical of metal fixation occurred. Our method is technically easy and safety, and achieved good mid-term bone flap fixation in the mid-term course, so has potential for bone fixation without the use of metal plates.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.21-27
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• 2015

Background: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. Methods: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. Results: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. Conclusions: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.114-119
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• 2018

Background: The ideal absorbable plating system should provide sufficient rigidity and then be absorbed within a timely manner. The Resorb-X has been recently developed as a plating system with a mixture ratio of 50:50 poly(D, L-lactide). Methods: We present seven of 121 patients who experienced delayed degradation with this absorbable plate. One hundred twenty-one patients with facial bone fracture underwent surgical treatment from March 2011 to March 2015, and rigid fixation was achieved with the Resorb-X. Results: Of 121 patients, seven (5.8%) developed complications at the surgical sites. Six of 102 cases underwent fixation of the infraorbital rim and one of 73 underwent fixation of the frontozygomatic buttress; the other sites of fixation did not develop delayed degradation. Foreign body granuloma developed at the earliest by postoperative 20 months and at the latest by postoperative 28 months (average, 23.5 months). Conclusion: We observed that the use of absorbable plates in incision sites or areas with thin skin can increase the possibility of delayed degradation. When performing surgery in these areas, the normal skin above the fixed location should be covered sufficiently.

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.143-147
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• 2018

We present a patient who showed a sterile abscess after facial bone fixation with bioabsorbable plates and screws. He had zygomaticomaxillary complex and periorbital fracture due to falling down. The displaced bones were treated by open reduction and internal fixation successfully using bioabsorbable plate system. However, at postoperative 11 months, abrupt painless swelling was noted on the previous operation sites, left lateral eyebrow and lower eyelid. By surgical exploration, pus-like discharge and degraded materials were observed and debrided. The pathologic analysis revealed foreign body reaction with sterile abscess. This complication followed by bioabsorbable device implantation on maxillofacial bone surgery has been rarely reported in which we call attention to the maxillofacial plastic surgeons.

• Imaging Science in Dentistry
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• v.38 no.4
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• pp.229-231
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• 2008

Brown tumor is a histologically benign lesion that is a serious complication of renal osteodystrophy because it may result in severe deformity and discomfort. We report a case of brown tumor, which occurred in a 35-year-old woman with chronic renal failure, who had been treated with hemodialysis for 14 years. The lesion was found on the lingual side of the mandible. Standard panoramic radiograph showed generally decreased bone mineral density, loss of lamina dura, and thin cortical plates. Computed tomography (CT) revealed multilocular expansile lesions with heterogeneous attenuation in the anterior mandible, as well as generalized trabecular alteration with homogeneous sclerosis, and thinning or obliteration of cortical plates. Excision of the mandibular lesion and curettage of the affected bone were performed. (Korean J Oral Maxillofac Radiol 2008; 38: 229-31)

• The korean journal of orthodontics
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• v.54 no.2
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• pp.108-116
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• 2024

Objective: A three-dimensional-printed individual titanium plate was applied for maxillary protraction to eliminate side effects and obtain the maximum skeletal effect. This study aimed to explore the stress distribution characteristics of sutures during maxillary protraction using individual titanium plates in various directions and locations. Methods: A protraction force of 500 g per side was applied at forward and downward angles between 0° and 60° with respect to the Frankfort horizontal plane, after which the titanium plate was moved 2 and 4 mm upward and downward, respectively. Changes in sutures with multiple protraction directions and various miniplate heights were quantified to analyze their impact on the maxillofacial bone. Results: Protraction angle of 0-30° with respect to the Frankfort horizontal plane exhibited a tendency for counterclockwise rotation in the maxilla. At a 40° protraction angle, translational motion was observed in the maxilla, whereas protraction angles of 50-60° tended to induce clockwise rotation in the maxilla. Enhanced protraction efficiency at the lower edge of the pyriform aperture was associated with increased height of individual titanium plates. Conclusions: Various protraction directions are suitable for patients with different types of vertical bone surfaces. Furthermore, when the titanium plate was positioned lower, the protraction force exhibited an increase.

• Proceedings of the Korean Institute of Surface Engineering Conference
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• 2017.05a
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• pp.79-79
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• 2017

Metallic biomaterials have been mainly used for the fabrication of medical devices for the replacement of hard tissue such as artificial hip joints, bone plates, and dental implants. Because they are very reliable on the viewpoint of mechanical performance. This trend is expected to continue. Especially, Ti and Ti alloys are bioinert. So, they do not chemically bond to the bone, whereas they physically bond with bone tissue. For their poor surface biocompatibility, the surface of Ti alloys has to be modified to improve the surface osteoinductivity. Recently, ceramic-like coatings on titanium, produced by plasma electrolytic oxidation (PEO), have been developed with calciumand phosphorus-enriched surfaces. A lso included the influences of coatings, which can accelerate healing and cell integration, as well as improve tribological properties. However, the adhesions of these coatings to the Ti surface need to be improved for clinical use. Particularly Silicon (Si) has been found to be essential for normal bone, cartilage growth and development. This hydroxyapatite, modified with the inclusion of small concentrations of silicon has been demonstrating to improve the osteoblast proliferation and the bone extracellular matrix production. Strontium-containing hydroxyapatite (Sr-HA) was designed as a filling material to improve the biocompatibility of bone cement. In vitro, the presence of strontium in the coating enhances osteoblast activity and differentiation, whereas it inhibits osteoclast production and proliferation. The objective of this work was to study Morphology of bone-like apatite formation on Sr and Si-doped hydroxyapatite surface of Ti-6Al-4V alloy after plasma electrolytic oxidation. Anodized alloys was prepared at 270V~300V voltages with various concentrations of Si and Sr ions. Bone-like apatite formation was carried out in SBF solution. The morphology of PEO, phase and composition of oxide surface of Ti-6Al-4V alloys were examined by FE-SEM, EDS, and XRD.