• 제목/요약/키워드: Craniofacial bone defects

검색결과 24건 처리시간 0.022초

두개안면골 결손부 재건에 있어서 티타늄 그물판의 임상적 유용성 (Clinical Usefulness of Titanium Mesh in Reconstruction of the Craniofacial Bone Defects)

  • 서영민;정승문
    • Archives of Plastic Surgery
    • /
    • 제33권6호
    • /
    • pp.688-694
    • /
    • 2006
  • Purpose: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load-bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. Methods: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from $1.0{\times}1.5cm$ to $12{\times}10cm$. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. Results: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. Conclusion: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.

rhBMP-2를 이용한 조직공학;치과 임프란트에서의 골 재건 (Tissue Engineering with rhBMP-2;Bone Reconstruction in Implant Dentistry)

  • 울프비케쇼;올리버하니쉬;마이클데니쉬마이어;조규성;김종관
    • Journal of Periodontal and Implant Science
    • /
    • 제29권3호
    • /
    • pp.447-472
    • /
    • 1999
  • The preclinical and clinical studies reviewed herein show that rhBMP-2 induces normal physiologic bone in relevant defects in the craniofacial skeleton. The newly formed bone assumes characteristics of the adjacent resident bone, and allows placement and osseointegration of dental implants. Clearly, the bone inducing capacity of rhBMP-2 is carrier and site dependent. rhBMP-2 in an absorbable collagen sponge carrier induces relevant bone formation in space providing defects. Space providing carries extends this possibility to non-space providing sites. Notably, some ceramic and polymeric biomaterials may substantially interfere with rhBMP-2 induced osteogenesis.

  • PDF

두개안면골 결손 환자의 치료에서 Bonesource®의 유용성 (Utility of the BoneSource® in the Treatment of Craniofacial Bone Defect)

  • 변준희;송진경;유결
    • Archives of Plastic Surgery
    • /
    • 제32권1호
    • /
    • pp.24-28
    • /
    • 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.

Antimicrobial surfaces for craniofacial implants: state of the art

  • Actis, Lisa;Gaviria, Laura;Guda, Teja;Ong, Joo L.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제39권2호
    • /
    • pp.43-54
    • /
    • 2013
  • In an attempt to regain function and aesthetics in the craniofacial region, different biomaterials, including titanium, hydroxyapatite, biodegradable polymers and composites, have been widely used as a result of the loss of craniofacial bone. Although these materials presented favorable success rates, osseointegration and antibacterial properties are often hard to achieve. Although bone-implant interactions are highly dependent on the implant's surface characteristics, infections following traumatic craniofacial injuries are common. As such, poor osseointegration and infections are two of the many causes of implant failure. Further, as increasingly complex dental repairs are attempted, the likelihood of infection in these implants has also been on the rise. For these reasons, the treatment of craniofacial bone defects and dental repairs for long-term success remains a challenge. Various approaches to reduce the rate of infection and improve osseointegration have been investigated. Furthermore, recent and planned tissue engineering developments are aimed at improving the implants' physical and biological properties by improving their surfaces in order to develop craniofacial bone substitutes that will restore, maintain and improve tissue function. In this review, the commonly used biomaterials for craniofacial bone restoration and dental repair, as well as surface modification techniques, antibacterial surfaces and coatings are discussed.

두개골 조기 유합증 수술 시 두개골막 피판의 역할 (The Role of Pericranial Flap in Surgery of Craniosynostosis)

  • 변준희;임영민;유결
    • Archives of Plastic Surgery
    • /
    • 제32권2호
    • /
    • pp.189-193
    • /
    • 2005
  • Reconstruction of calvarial bone defects from congenital anomaly or from bone loss due to traumatic or neoplastic processes remains a significant problem in craniofacial surgery and neurosurgery. To facilitate bone regeneration, there have been many trials such as autologous bone graft or allograft, and the addition of demineralized bone matrix and matrix-derived growth factor. Guided bone regeneration is one of the methods to accelerate bone healing for calvarial bone defects especially in children. Pericranium is one of the most usable structure in bone regeneration. It protects the dura and sinus, and provides mechanical connection between bone fragments. It supplies blood to bone cortex and osteoprogenitor cells and enhances bone regeneration. For maximal effect of pericranium in bone regeneration, authors used pericranium as a flap for covering calvarial defects in surgeries of 11 craniosynostosis patients and achieved satisfactory results: The bone regeneration of original cranial defect in one year after operation was 74.6%(${\pm}8.5%$). This pericranial flap would be made more effectively by individual dissection after subgaleal dissection rather than subperiosteal dissection. In this article, we reviewed the role of pericranium and reported its usefulness as a flap in surgery of craniosynostosis to maximize bone regeneration.

혈관화 두개골 외층골피판을 이용한 두개안면부 재건 (CRANIOFACIAL RECONSTRUCTION USING VASCULARIZED OUTER TABLE CALVARIAL BONE FLAP : REPORT OF TWO CASES)

  • 김기영;정숭룡;정주성;김창룡;이승호;박문성;유선열
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제18권4호
    • /
    • pp.546-554
    • /
    • 1996
  • 전두골 결손과 다발성 안면골 골절의 비유합 및 부정유합으로 인해 심한 안모변형이 초래된 62세의 남자 환자와, 좌측 상악골에 발생한 점액종의 치료를 위해 상악골 전척출술후 안모변형이 예상되는 66세 남자환자에서 동측의 혈관화 두개골 외층골피판으로 재건해 주었다. 이 골피판은 수술부위와 가깝고 막성골이며 흡수가 적어 두개 안면골의 결손이나 변형시에 유용하게 사용될 수 있을 것으로 생각된다.

  • PDF

장기간 방치된 경막하 농양을 동반한 복합 두피 및 두개골 결손 환자에서 광배근 유리 근피부피판을 이용한 치험례 (Reconstruction of Long Term Neglected, Complicated Scalp and Calvarial Defects with Subdural Abscess Using Latissimus Dorsi Myocutaneous Free Flap: A Case Report)

  • 노용준;이상형;정의철;박지웅
    • 대한두개안면성형외과학회지
    • /
    • 제12권2호
    • /
    • pp.107-110
    • /
    • 2011
  • Purpose: There have been few case reports regarding treatment plans for long-term, neglected scalp defects and calvarial defects with subdural abscess. The purpose of this case report is to present our experience with a free latissimus dorsi musculocutaneous flap for scalp and calvarial defects and to discuss flap options in comparison with a literature review. Methods: A 60-year-old man who fell down from a four-story-height that resulted in a craniotomy in 1979; he visited our outpatient clinic for a chronic, purulent scalp and calvarial defects with unidentified artificial bone. The artificial bone was removed by a neurosurgeon and reconstructed with a free latissimus dorsi musculocutaneous flap. The deep temporal artery was used as a recipient artery. The postoperative flap status was excellent until the 6th day post-operation when the patient experienced a seizure, and an arterial insufficiency occurred at the flap probably due to an arterial spasm. Emergency exploration with arterial re-anastomosis was performed and the flap status was stabilized. Results: Complete wound healing was achieved after 3 weeks without infectious and systemic postoperative complications. During the 6 month follow-up period, there were no complications. Conclusion: We suggest the latissimus dorsi myocutaneous free flap as a good treatment option for a chronic, purulent, complicated scalp with calvarial defect, as a well as treatment for an acute traumatic defect.

간세포성장인자가 골결손부의 치유에 미치는 영향 (THE EFFECT OF HEPATOCYTE GROWTH FACTOR FOR REPAIR OF THE BONE DEFECT)

  • 신상훈;김창주;김철훈;김용덕;정인교
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제30권5호
    • /
    • pp.380-390
    • /
    • 2004
  • Bone healing plays an important role in orthognathic and craniofacial surgery. Bone tissue repair and regeneration are regulated by an array of growth and morphogenetic factors. Bone formation and remodeling require continuous generation of osteoprogenitor cells from bone marrow stromal cells, which generate and respond to a variety of growth factors with putative roles in hematopoiesis and mesenchymal differentiation. In this study, the efficacy of a single application of hepatocyte growth factor to promote bone regeneration in 5-mm experimental calvarial defects of adult male rats was assessed histologically and immunohistochemically. The result of the experimental site were compared with those of the contralateral contral side. None of the control and experimental bone defects demonstrated complete bone closure. Bone regeneration was found close th the margine and central part of the defects. At 1, 2 weeks, there were found much significant cellural mitotic activity and many inflammatory cells and osteoblasts on the experimental site than control site. At 4, 6 weeks, new bone apposition was founded in both site but, more apposition was seen at experimental site. At 8, 12 weeks, also, some differences was found that more apposition of new bone and collagen fiber was seen on experimental site. Our results have some possibility that HGF do a early positive role to repair the bone defect. More study will be needed.

Skeletal cavernous hemangiomas of the frontal bone with orbital roof and rim involvement

  • Seo, Bommie Florence;Kang, Kyo Joon;Jung, Sung-No;Byeon, Jun Hee
    • 대한두개안면성형외과학회지
    • /
    • 제19권3호
    • /
    • pp.214-217
    • /
    • 2018
  • Skeletal cavernous hemangiomas are rare, benign tumors that may involve the supraorbital rim and orbital roof. However, such involvement is extremely rare. We report a case of skeletal cavernous hemangioma of the frontal bone involving the orbital roof and rim. En bloc excision and reconstruction, using a calvarial bone graft for the orbital roof and rim defect, was performed. It is important not only to perform total excision of skeletal cavernous hemangiomas, but to properly reconstruct the defects after the total excision since several complications can arise from an orbital roof and rim defect.

Surgical management of severe cherubism persisting into early adulthood: a case report and literature review

  • Youngwoong Choi;Jeong Min Ji;Choong Hyeon Kim;Ki Pyo Sung
    • 대한두개안면성형외과학회지
    • /
    • 제25권1호
    • /
    • pp.38-43
    • /
    • 2024
  • Cherubism is a rare fibro-osseous condition characterized by bilateral expansion of the mandible and maxilla. Due to its rarity, treatment guidelines for cherubism have not been clearly established. Observation without surgical intervention is typically recommended, as cherubism often regresses spontaneously after puberty. However, a surgical intervention may be necessary if aggressive lesions lead to severe complications. In this report, we present a case involving surgical management of cherubism that did not spontaneously regress until early adulthood. An 18-year-old man was diagnosed with cherubism, presenting characteristic upward-looking eyes and a swollen face. He strongly desired surgical management. Gross contouring of the mandible was performed using an osteotome. Subsequently, delicate contouring was performed by bone burring and curettage. The remaining multiple locular bony defects were filled with demineralized bone matrix. No major complications, including infection and hematoma, occurred during the 8-month follow-up period. The facial contour remained stable without the aggravation of cherubism. The patient was satisfied with the cosmetic results. Considering that cherubism is a rare disease globally, with few reported cases in Korea, and that treatment guidelines are not clearly established, we anticipate that the results of this case will contribute to the development of future protocols for treating cherubism.