• Title/Summary/Keyword: Cancellous bone graft

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The Reharvesting of Iliac Crest Cancellous Bone for the Repair of the Alveolar Cleft (치조열 교정을 위한 장골 능선 해면골 재이식술)

  • Kim, Suk-Wha;Kim, Byung-Jun;Choi, Tae-Hyun
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.15-18
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    • 2011
  • Purpose: The anterior iliac crest is a common source for autologous cancellous bone graft. For patients who have previously received cancellous bone grafts from bilateral anterior iliac crests, there may be concerns of whether a sufficient quantity of autologous cancellous bone remains for additional grafts without harvesting it from other sites, such as the posterior iliac crest. Methods: We experienced 3 cases of reharvesting in 2 patients. The diagnosis of the first patient was bilateral facial cleft number 3. This patient received bilateral side cleft alveoloplasty with corticocancellous bone graft from the both anterior iliac crest respectively by a previous surgeon. This patient then needed reharvesting of the anterior iliac crest cancellous bone to correct an ongoing skeletal problem for the bilateral cleft. The other patient had bilateral incomplete cleft of the primary palate. This patient received left side cleft alveoloplasty with cancellous bone graft from the right anterior iliac crest. Before the patient could receive the alveoloplasty on the other side, a radial head osteotomy and cancellous bone graft was performed by orthopedic surgeons who then used the remaining left iliac crest in order to treat a pulled elbow. For the completion of the right side cleft alveoplasty, the anterior iliac crest cancellous bone needed to be reharvested. Prior to the reharvesting, a preoperative computed tomography scan of the pelvis was obtained to assess the maturity of the donor site regeneration. The grafts were then taken from site where a greater amount of regeneration was evident. Results: Long term follow ups showed that the grafts were successfully taken. This sufficient volume was obtainable 14 months after the first harvest. Conclusion: Satisfactory results were achieved after the reharvesting of iliac cancellous bone. Thus, it appears that the reharvesting of the iliac bone is a possible alternative to multiple site grafting, use of allograft or bone substitute materials.

A CASE REPORT OF GREATER TROCHANTAL BONE GRAFT (대전자골을 이용한 골이식증례)

  • Kim, Eun-Cheol;Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.86-91
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    • 2000
  • Autogenous bone graft is the useful technique for management of various bone defect in oral and maxillofacial surgery. The most common site for bone graft harvest is the anterior iliac crest. There is usually considerable cancellous bone graft available and it can be obtained with minimal morbidity. However, complications noted in iliac crest grafts include prolonged postoperative pain, hematoma and fracture, gluteal muscle weakness. Occasionally, when large amounts of bone graft are needed and previous harvest procedure had used, iliac bone harvest may be not adequate. Like the iliac crest, the greater trochanter has abundant cancellous bone and is readily accessible with acceptable morbidity. The purpose of this study was to assess the availability of cancellous bone graft from the greater trochanter, compare the quantity with that available from the anterior iliac crest, investigate anatomical hazards, and make recommendations for consistent harvest.

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RECONSTRUCTION OF ALVEOLAR CLEFTS WITH ILIAC CANCELLOUS PARTICULATE OR BLOCK BONE GRAFTS : A COMPARATIVE STUDY (장골의 해면 입자골 또는 블럭골을 이용한 치조열의 재건에 관한 비교 연구)

  • Choi, Byung-Ho;Yi, Choong-Kook;Min, Yon-Sook;Hong, Soon-Xae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.189-191
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    • 2001
  • Objective : The objective of this study was to determine which forms of iliac cancellous bone grafts better restore alveolar clefts. Study design : Forty consecutive patients who required a unilateral alveolar cleft graft were studied. Group I (20 patients) had reconstruction with iliac cancellous particulate bone grafts and group II (20 patients) had reconstruction with iliac cancellous block bone grafts. The two groups were evaluated radiographically and clinically. Results : The group with the block bone grafts showed less postoperative problems and better incorporation of the bone graft than the group with the particulate grafts. Conclusion : Surgical reconstruction of alveolar process defects in patients with alveolar cleft using iliac cancellous block bone is a more reliable method than particulate bone grafts both for closing the oronasal fistula and for building interalveolar septal height.

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A CLINICAL COMPARATIVE STUDY BETWEEN ANTERIOR ILIAC AND PROXIMAL TIBIAL METAPHYSIS PARTICULATED CANCELLOUS BONE GRAFTS (장골과 경골의 자가입자망상골 이식에 관한 임상적 비교연구)

  • Oh, Sung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.228-231
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    • 1998
  • This is a clinical and retrospective study of 36 patients received the autogenous particulated cancellous bone grafts from anterior iliac and proximal tibial metaphysis and we compared the clinical postoperative complications in operation sites and donor site morbidity. The results of this study indicate that, in all our patients, the proximal tibia provided an adquate volume of cancellous bone and there were no special contraindications, in choosing and using the proximal tibia as a donor site in most oral and maxillofacial cancellous bone graft surgeries. Furthermore, the proximal tibial metaphysis would appear a more easily obtainable cancellous bone source and offer a superior clinical results than anterior iliac crest in donor site morbidity.

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Effect of Porcine Cancellous Bones on Regeneration in Rats with Calvarial Defect (랫드의 두개골 결손부에서 돼지 해면질골이 골재생에 미치는 영향)

  • Yoo, Kyeong-Hoon;Kim, Se-Eun;Shim, Kyung-Mi;Park, Hyun-Jeong;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Life Science
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    • v.20 no.8
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    • pp.1207-1213
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    • 2010
  • The purpose of this study was to evaluate the effect of porcine cancellous bone as a scaffold in a rat calvarial defect model. Critical-sized defects were created in 30 male Sprague-Dawley rats. The animals were divided into critical defect (CD, n=10), $\beta$-tricalcium phosphate (TCP) graft (BT, n=10) and porcine cancellous bone graft (PCB, n=10) groups. Each defect was filled with $\beta$-TCP mixed with fibrin glue or porcine cancellous bone powder mixed with fibrin glue. In the CD group, the defect was left empty. All rats were sacrificed at 8 weeks after bone graft surgery, and bone formation was evaluated by gross observation, plain radiography, micro-computed tomography scanning and histological evaluation. Repair of bone defect was the least in the CD group, and significant new bone formation was observed in the PCB group. Grafting of porcine cancellous bone was more efficient for regenerating new bone than grafting $\beta$-TCP.

CLINICAL STUDY ON TIBIAL BONE GRAFT (경골이식에 관한 임상 연구)

  • Kim, Sik;Kim, Su-Gwan;Kim, So-Young;Kim, Soo-Min;Park, In-Soon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.540-543
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    • 2000
  • The purpose of this retrospective study was to evaluate the treatment outcome of proximal tibial graft. Thirty-nine patients were grafted with proximal tibia for the repair of maxillofacial defect. Complications can be considered incidental and neglectable clinical significance. It is concluded that the proximal tibial metaphysis offers a promising alternative sources of cancellous bone for the repair of maxillofacial defect.

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The Use of a Porcine Cancellous Bone Graft for Arthrodesis of Bilateral Antebrachiocarpal Luxation in a Dog (양측 전완앞발목관절 탈구의 관절고정술을 위한 돼지뼈 해면골이식의 적용)

  • Heo, Su-Young;Lee, Ki-Chang;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.259-262
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    • 2012
  • A seven-year-old Yorkshire terrier 2.1 kg was admitted with a 2 months history of sever bilateral forelimb lameness and joint instability. Examination and radiographs revealed caudal luxation of bilateral antebrachiocarpal joint. Luxation of bilateral antebrachiocarpal (ABC) joint in a toy breed dog was treated with pancarpal arthrodesis. Modified external skeletal fixator (ESF) (type IIb) with polymethylmethacrylate (PMMA) was utilized in this case. Porcine cancellous bone graft (PCBG) was inserted to fill the joint space in carpus. The clinical and radiographic assessments of joint after the surgical procedure proved that PCBG can be used a promising alternative to Autogenous cancellous bone graft (ACBG).

Current Methods for the Treatment of Alveolar Cleft

  • Kang, Nak Heon
    • Archives of Plastic Surgery
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    • v.44 no.3
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    • pp.188-193
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    • 2017
  • Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

  • Bari, Roberto Di;Coronelli, Roberto;Cicconetti, Andrea
    • Imaging Science in Dentistry
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    • v.43 no.3
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    • pp.135-143
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    • 2013
  • Purpose: This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness. Materials and Methods: This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L). Results: The cortical volume was $0.71{\pm}0.23mL$ (0.27-1.96 mL) and the cancellous volume was $2.16{\pm}0.76mL$ (0.86-6.28 mL). The minimal cortical vestibular thickness was $1.54{\pm}0.41mm$ (0.61-3.25 mm), and the maximal cortical vestibular thickness was $3.14{\pm}0.75mm$ (1.01-5.83 mm). Conclusion: The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site.

A RETROSPECTIVE ANALYSIS OF THE MEDIOPROXIMAL TIBIAL BONE GRAFT FOR ORAL AND MAXILLOFACIAL RECONSTRUCTION (구강악안면 영역의 재건을 위한 경골 근위부 내측 골이식술의 후향적 분석)

  • Baek, Min-Kyu;Kim, Il-Kyu;Cho, Hyun-Young;Chang, Keum-Soo;Park, Seung-Hoon;Park, Jong-Won;So, Kyung-Mo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.241-248
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    • 2008
  • Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.