• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권2호
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• pp.83-86
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• 2014

There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

• Archives of Plastic Surgery
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• 제43권2호
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• pp.204-209
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• 2016

Temporal hollowing occurs to varying degrees after pterional craniotomy. The most common cause of temporal hollowing is a bony defect of the pterional and temporal regions due to the resection of the sphenoid ridge and temporal squama for adequate exposure without overhang. The augmentation of such bony defects is important in preventing craniofacial deformities and postoperative hollowness. Temporal cranioplasty has been performed using a range of materials, such as acrylics, porous polyethylene, bone cement, titanium, muscle flaps, and prosthetic dermis. These methods are limited by the risk of damage to adjacent tissue and infection, a prolonged preparation phase, the possibility of reabsorption, and cost inefficiency. We have developed a method of temporal augmentation using a calvarial onlay graft as a single-stage neurosurgical reconstructive operation in patients requiring craniotomy. In this report, we describe the surgical details and review our institutional outcomes. The patients were divided into pterional craniotomy and onlay graft groups. Clinical temporal hollowing was assessed using a visual analog scale (VAS). Temporal soft tissue thickness was measured on preoperative and postoperative computed tomography (CT) studies. Both the VAS and CT-based assessments were compared between the groups. Our review indicated that the use of an onlay graft was associated with a lower VAS score and left-right discrepancy in the temporal contour than were observed in patients undergoing pterional craniotomy without an onlay graft.

• Journal of Periodontal and Implant Science
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• 제39권3호
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• pp.321-329
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• 2009

Purpose: The purpose of this study was to evaluate the bone regeneration of particulated hydroxyapatite(HA) and block type of hydroxyapatite graft in rabbit calvarial defects. Methods: An 8 mm calvarial circular defects were created in sixteen young adult New Zealand white male rabbits (weight $3.0{\sim}3.5kg$). Each defects were filled with Bio-Oss, particulated HA and block type HA. Sham surgery control defects were filled with blood clots. The specimens were harvested at 4 weeks and 8 weeks for histologic and histomorphometric evaluation. Results: Histomorphometric analysis demonstrated statistical differences in defect closure, new bone formation, and bone density of the four groups. Block type of HA group showed increased bone formation and bone density at 4 weeks and 8 weeks compared with Bio-Oss group or sham surgery control group(p<0.05). Conclusions: Block type of HA is an effective material for osteoconduction in rabbit calvarial defects, which may acts as a guide in use of these products in human application.

• 한국임상수의학회지
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• 제39권6호
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• pp.302-310
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• 2022

Recently, in human medicine and veterinary medicine, interest in synthetic bone graft is increasing. Among them, bone morphogenic protein (BMP) is currently being actively researched and applied to clinical trials. However, BMP has the disadvantage of being expensive and easily absorbed into surrounding tissues. Therefore, BMP requires the use of small amounts and rhBMP (recombinant human bone morphogenetic protein)-2 carriers that can be released slowly. Hydrogel has the property of swelling a large amount of water inside when it is aqueous solution, and when it is, it consists of more than 90 percent water. Using these properties, hydrogels are often used as rhBMP-2 carrier. The scaffold used in this study is a hydrogel made from which keratin is extracted using human hair and based on it. In this study, we wanted to see the effect of bone formation in the calvarial defect model by using keratin-based hydrogel made with human hair as a scaffold. The experiment was conducted by dividing 3 groups a total of 12 mice. Calvarial bone defect is set to all 4 mm diameters. Bone formation was evaluated by using gross evaluation, micro-computed tomography (micro-CT), immunohistochemistry. Groups using keratin-based hydrogel were significantly observed compared to Group 1s, and the most bone formations were found when rhBMP-2 and hydrogel were used. This represents the superiority of the functions of the rhBMP-2 carrier by a new material, keratin-based hydrogel. Through gross evaluation, micro-CT, and immunohistochemistry, we can confirm that keratin-based hydrogel is a useful rhBMP-2 carrier.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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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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• 제32권1호
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• pp.24-28
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• 2005

Skull or facial bone defect causes cosmetic and functional problems. On going efforts were taken to reconstruct the craniofacial bone defect with autogenous bone or alloplastic materials. Between 2001 and 2003, we reconstructed 15 cases with small to large craniofacial bone defect using Hydroxyapatite paste($BoneSource^{(R)}$, Leibinger Corp., Dallas, TX, U.S.A) and calvarial bone graft. All patients were followed up by clinical examination and periodic radiographic studies for an average of 1.6 years (range, 6 months to 2 years and 6 months). One complication case was noted with $BoneSource^{(R)}$ exposure. Otherwise, there was no evidence of adverse healing, wound infection, foreign body reaction and seroma collection in other patients. Adequate 3-dimensional aesthetic restoration of calvarial contour was noted in each case. In conclusion, $Bonesource^{(R)}$ is relatively safe and rigid material for craniofacial bone defect and reasonable method for the reconstruction of craniofacial bone defects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.290-301
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• 2002

The purpose of this study was to evaluate new bone formation and healing process in rat calvarial bone defects using $BioMesh^{(R)}$. membrane and DFDB. Forty eight rats divided equally into 4 groups of 1 control group and 3 experimental groups. Standardized transosseous circular calvarial defects (8 mm in diameter) were made midparietally. In the control group, the defect was only covered with the soft tissue flap. In the experimental group 1, it was filled with DFDB only, in the experimental group 2, it was covered $BioMesh^{(R)}$. membrane only, and in the experimental group 3, it was filled DFDB and covered with membrane. At the postoperative 1, 2, 4, 8 weeks, rats were sacrificed and histologic and histomorphometric analysis were performed. These results were as follows. In histomorphometric analysis, It showed the greatest amount of new bone formation through experimental in the experimental group 3 (P<0.001). The amount of new bone formation at the central portion of the defect was greater in the experimental group 3 than experimental group 2. $BioMesh^{(R)}$. membrane began to resorb at 1 week and resorbed almost completely at 8 weeks after operation. The collapse of membrane into the defect was observed through the experimental periods in the experimental group 2. In the area of collapsed membrane, new bone formation was restricted. These results suggest that maintenance of some space for new bone to grow is required in the use of $BioMesh^{(R)}$. membrane alone in the defect. It is also thought that use of the membrane may promote new bone growth in DFDB graft.

• Journal of Periodontal and Implant Science
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• 제30권4호
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• pp.747-757
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• 2000

Cyclosporin A(CsA) is an immunosuppressive agent widely used for preventing graft rejecting response in organ transplantation. The basic properties of CsA to osteoblast has not been well known yet. A better understanding of the mechanisms of CsA function on bone could provide valuable information regarding basic properties of bone remodeling, pharmacotherapeutic intervention in metabolic bone disease, and the consequences of immunosuppression in bone physiology. The purpose of this study was to investigate the effect of CsA on osteoblast by evaluating parameters of proliferation, collagen synthetic activity, alkaline phosphatase activity, and ALP mRNA expression in mouse calvarial cell. 1. CsA ($3{\mu}g/m{\ell}$) treated mouse calvarial cell showed statistically significant increase in cell proliferation.(P<0.05) 2. CsA($1,\; 3{\mu}g/m{\ell}$) treated MC3T3 cell line showed statistically significant increase in cell proliferation. 3. The amount of collagen of CsA($3{\mu}g/m{\ell}$) treated mouse calvarial cell was decreased statistically significantly. 4. Alkaline phosphatase activity was increased statistically significantly in CsA treated group($1{\mu}g/m{\ell}$). 5. mRNA expression of ALP was increased in CsA treated group These results suggest that CsA could affect bone remodeling by modulating proliferation & differentiation of osteoblast.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.289-303
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• 2006

This study was performed to evaluate the effect of bone graft materials including demineralized freeze-dried bone, freeze-dried bone, deproteinized bovine bone on space-making capacity and bone formation in guided bone regeneration with titanium reinforced ePTFE membrane(TR-ePTFE). Adult male rabbits(mean BW 2kg) were used in this study. Intramarrow penetration defects were surgically created with round bur on calvaria of rabbits. TR-ePTFE membrane was adapted to calvarial defect and bone graft materials were placed. Animals were sacrificed at 2, 8, 12 weeks after surgery. Non-decalcified specimens were processed for histologic analysis and prepared with Villaneuva bone stain. The results of this study were as follows: 1. TR-ePTFE membrane was biocompatible and capable of maintaining the space-making. 2. Tissue integration was not good at TR-ePTFE membrane. Fixation was not enough. so, wound stabilization was not good. 3. In animals using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was little. 4. In animals using freeze-dried bone, bone formation was better. Within the above results, bone formation may be inhibited when wound stabilizafion was not good.

• 대한수의학회지
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• 제50권3호
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• pp.171-177
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• 2010

The purpose of this study was to evaluate the osteogenic capacity of water extract of danshen (Salvia miltiorrhiza Bunge). We have established in rat critical-sized calvarial defect model using the combination with collagen scaffold and danshen hydrophilic extract. All rats were extinguished at 8 weeks after bone graft surgery, and the bone regeneration ability of bone grafting sides was evaluated by plain radiography and micro-CT. These results revealed water extract of danshen had the potential to promote osteogenesis especially continuous oral administration with local treatment compared to one-shot local treatment. This compound may provide a new alternative agent for growth factors to promote bone healing and bone regeneration. In conclusion, these results suggest that danshen hydrophilic extract have the potential to promote osteogenesis in bone defects. Further studies about fusion technology with salvianolic acid B, peptides, growth factors, and scaffolds using of the combination of tissue engineering, cell engineering and mechanical engineering are needed.