• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.138-141
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• 2006

Introduction : In recent years, vascularized, i.e., living bone grafts, have been widely applied in the field of oral and maxillofacial surgery, as a method of treatment of congenital or acquired non-unions, and a large defects in mandible. The vascularized fibular graft has been especially used for this purpose because of its shape and mechanical strength. The postoperative hypertrophy of grafted fibula is of particular interest to us. Material and methods : This study was undertaken to determine the volume change(indirect methods) and radiographic appearance of a free vascularized fibular graft as it responds to the mechanical and physiologic features of its new environment. In order to elucidate the long term effect on fibular mass after mandibular reconstruction, change in various method of volume change was utilized as indirect measure of change in long-term. Results : The younger the patient, the more prominent and rapid the hypertrophy of the graft. the hypertrophy of the graft never exceeded the diameter of the recipient bone, except for callus enlargement after stress fracture of the grafted bone. Conclusion : Etiologic explanations for this phenomenon have not been clarified in the previeous literature. some of the factors implicated include a periosteal reaction or new bone formation, as seen at the onset of bone union after a fracture in a child, a reaction to the mechanical loading on the graft and a reaction to the circulatory changes resulting from the grafting procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.263-268
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• 2013

Objectives: The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure. Materials and Methods: We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012. Results: From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen. Conclusion: When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent these complications and progress with a safe surgical procedure, a thorough radiographic examination before the surgery is indispensable. Further, clinicians should retract lingual flap definitely to confirm the shape of the lingual bone and existence of the lingual foramina.

• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.737-747
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• 2001

Regeneration of Periodontium with PRP does not only improve regeneration rate and density of bone but have a possibility to estimate faster healing process for soft tissue. And also, synthetic bone and xenogenic bone graft are effective on regeneration of periodontium. The purpose of this study is to evaluate the effectiveness of synthetic bone ($Biogran^{(R)}$) and xenogenic bone ($BBP^{(R)}$) grafts with the PRP technique on regeneration of periodontium. 52 Generally healthy Pt. who had pocket depth 5mm at any of 6 surfaces of the teeth were in the study at Dept. of Perio. in Dankook Dental Hospital. Open Flap was treated for 18 infra-bony pockets as control group, $Biogran^{(R)}$ with PRP was inserted for 25 infrabony pockets as first test group, and $BBP^{(R)}$ with PRP was inserted for 22 infrabony pockets as 2nd test group. Then evaluation was made after 3 and 6 months 1. 6 months after surgery, each difference of average probing pocket depth was $2.61{\pm}0.23$ for control, $3.40{\pm}0.30$ for 1st test, and $3.45{\pm}0.37$ for 2nd test group. 2. 6 months after surgery, each difference of clinical probing attachment level was $1.39{\pm}0.12$ for control, $2.88{\pm}0,24$ for 1st, and $2.86{\pm}0,27$ for 2nd test group. 3. 6 months after surgery, each difference of Maximal probing attachment level was $1.11{\pm}0.16$ for control, $3.28{\pm}0.30$ for 1st, and $3.27{\pm}0.35$ for 2nd test group. 4. There were significant differences for clinical change of each three group which were between average probing pocket depth and clinical attachment level of 3,6 months and minimal and maximal attachment level after 6 months 5. There were significant differences for average probing pocket depth which were only at control group and 2nd test group between 1 and 6months. For clinical attachment level and minimal and maximal proving attachment level, there was a significant difference after 6month of surgery. 6. There was no significant difference between two test groups for average probing depth, clinical attachment level, and minima1 and maximal probing attachment level. As the result, PRP with bone graft is very effective for regeneration of periodontium and there is no difference between xenogenic bone and synthetic bone.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.653-659
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• 2006

Oral malodor may cause a significant social or psychological handicap to those suffering from it. Oral malodor has been correlated with the concentration of volatile sulfur compounds (VSC) produced in the oral cavity. Specific bacteria identified in the production of VSC have been reported and many of these bacteria are commonly suspected periodontal pathogens. The aim of this study was to estimate the change of the VSC concentration after periodontal treatment, Twenty subjects with probing depth $(PD)\;{\geq}5mm$ (experimental group) and 20 subjects with PD<5mm (control group) participated. VSC concentration measurement was made with gas chromatography. VSC concentration was measured at pre-treatment, 2 weeks after scaling and 1 month after periodontal treatment(root planning and flap operation). Maximum probing depth and bleeding on probing(BOP) were also examed at pretreatment and 1 month after periodontal treatment, The conclusions were as follow: 1. In the experimental group VSC concentration and CH3SH/H2S ratio were higher than control group. (p<0.05) 2. Both VSC concentration and CH3SH/H2S ratio showed decrease after periodontal treatment, But only CH3SH/H2S ratio after 1 month periodontal treatment was statistically significantly different from pre-treatment. (p<0.05) 3. CH3SH/H2S ratio tended to be on increase according to maximum probing depth and bleeding on probing. Periodontal disease could be a factor that caused oral malodor and oral malodor could be decreased after periodontal treatment.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.117-128
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• 1997

Using barrier membrane, guided bone regeneration(GBR) and guided tissue regeneration(GTR) of periodontal tissue are now widely studied and good results were reported. In bone regeneration, not all cases gained good results and in some cases using GTR, bone were less regenerated than that of control. The purpose of this study is to search for the method to improve the success rate of GBR and GTR by examination of the cause of the failure. For these study, rats and beagle dogs were used. In rat study, 5mm diameter round hole was made on parietal bone of the rat and 10mm diameter of bioresorbable membrane was placed on the bone defects and sutured. In 1 ,2, 4 weeks later, the rats were sacrificed and Masson-Trichrome staining was done and inspected under light microscope for guided bone regeneration. In dog study, $3{\times}4mm^2$ Grade III furcation defect was made at the 3rd and 1th premolar on mandible of 6 beagle dogs. The defects were covered by bioresorbable membrane extending 2-3mm from the defect margin. The membrane was sutured and buccal flap was covered the defect perfectly. In 2, 4. 8 weeks later. the animals were sacrificed and undecalcified specimens were made and stained by multiple staining method. In rats. there was much amount of new bone formation at 2 weeks. and in 4 weeks specimen, bony defect was perfectly dosed and plenty amount of new bone marrow was developed. In some cases, there were failures of guided bone regeneration. In beagle dogs, guided tissue regeneration was incomplete when the defect was collapsed by the membrane itself and when the rate of resorption was so rapid than expected. The cause of the failure in GBR and GTR procedure is that 1) the membrane was not tightly seal the bony defects. If the sealing was not perfect, fibrous connective tissue infiltrate into the defect and inhibit the new bone formation and regeneration. 2) the membrane was too tightly attached to the tissue and then there was no space to be regenerated. In conclusion, the requirements of the membrane for periodontal tissue and bone regeneration are the biocompatibility, degree of sealingness, malleability. space making and manipulation. In this animal study. space making for new bone and periodontal ligament, and sealing the space might be the most important point for successful accomplishment of GBR and GTR.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.26-38
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• 1994

The purpose of this study was to evaluate the effects of citric acid and fibrin on the regeneration of periodontal tissues using 4 normal canines of five dogs. Mucoperiosteal flap was raised and experimental defects were made at the buccal root surfaces about $4{\times}6mm$ in length. The denuded root surfaces were covered using coronally repositioning technique after root planing alone at left lower canine, root planing plus fibrin at rigth lower canine, root planing plus citric acid at left upper canine or root planning plus citric acid and fibrin at right upper canine. All of the specimens were tangentially cut(about $3-5{\mu}m$)and available for histologic analysis 1, 3, 7, 14 and 21 days after operations. The results were as follows : At one' day after operations, the amounts of fibrin were similarly higher in the group I, II and III than control group and at 3 days after operations, the apical migrations of the long junctional epithelium were prominent in the control group and group I. At 7 days after operations, the fibrin meshworks of each group were partly changed to the collagen fibers and characteristics of the fibers were almost collagenous rather than fibrinous at 14 days after operations and at 21 days after operations, the orientation of collagen fibers were partly normal in group II and group III, but not in control group and group I. Root resorptions were visible in group II and group III at 14 days after operations and more significant in group II than group III at 21 days.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.425-429
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• 2014

Two dogs were presented with a history of anorexia, respiratory distress, or epistaxis. On physical examination, the dogs showed difficulty breathing and open-mouth breathing and large masses were found on the hard palate and soft palate. Cardiac arrest happened in case 2 and the dog was stabilized with cardiopulmonary resuscitation and oxygen therapy. Computed tomography demonstrated that the mass occupied the oropharynx, intrapharyngeal ostium, and laryngopharynx including the hard palate and soft palate in case 1. Palliative surgery was decided to improve swallowing and breathing with owner's consent in two dogs. Buccal mucosal flaps were performed for reconstruction of defects using rotational and single-pedicle advancement flaps and bilateral 90 degree transposition flaps in cases 1 and 2, respectively. Histopathology results described the oral masses as amelanotic melanoma in two dogs. The owners reported that there was normal swallowing and breathing at 7 days postoperatively in two dogs. In case 1, recurrent tumor was identified caudal to the hard palate 4 weeks after surgery. The owner did not allow further treatment and the dog became lost to follow-up at 2 months postoperatively. In case 2, there was no clinical or radiographic evidence of a local recurrence or distant metastasis at 3 weeks after surgery. The owner informed that the dog died suddenly with no signs of anything particularly wrong at 7 weeks after surgery.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.1
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• pp.1-6
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• 2009

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.249-264
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• 1998

The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was $1.05{\pm}0.48mm$ in the control, $1.30{\pm}0.67mm$ in the test group I, $0.97{\pm}0.22mm$ in the test group II and $0.93{\pm}0.15mm$ in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was $0.97{\pm}0.27mm$ in the control group, $1.45{\pm}0.42mm$ in the test group I, $2.00{\pm}0.33mm$ in the test group II, $1.88{\pm}0.34mm$ in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was $1.13{\pm}0.17mm$ in the control, $1.78{\pm}0.31mm$ in the test group I, $2.17{\pm}0.38mm$ in the test group II, $2.15{\pm}0.47mm$ in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.475-492
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• 1993

The effect of synthetic bone materials was assessed in the patients with pure periodontal class II and III furcation defects. The buccal aspects of the maxillary and mandilular first and second molars were surgically exposed, and synthetic bone materials were interposed between the gingival flap and the furcation defects in the experimental group. The control group were treated without the use of synthetic bone materials by same operator. Probing pocket depth, gingival recession, and loss of attachment, were measured by Michigan O-probe and tooth mobility was evaluated by an electronic mobility tester(Periotest(R), Siemens co. Germany) at preoperation and 3-, 6-, and 12-month postoperation. Standardized radiogrphs were taken at preoperation and 6-month and 12-month postoperation. The postoperative change of clinical parameters and the difference between experimental group and control group were statistically analyzed by Student, t-test. The results were as follows: 1. The probing pocket depth at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at preoperative examination in both experimental group and control group(P<0.005), but there was no significantly difference between experimental group and control group. 2. The amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was increased, compared to that at the preoperative examination in both experimental and control group(P<0.005). In the case of the class III furcation involvement, the amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was more significantly increased in control group than experimental group(P<0.05). 3. The amount of loss of attachment at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group in the case of class II furcation involvement, and in experimental group only in the case of furcation III involvement(P<0.005). The amount of loss of attachment at, the 3-, 6-, and 12-month postoperative examination was more significantly decreased in experimental group than control group in the case of the class III furcation involvement(P<0.05), but in the case of class II furcation involvement there was no significant difference between experimental group and control group. 4. The tooth mobility at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group(P<0.005), but there was no significant difference between experimental group and control group. 5. Radiopacity of furcation area was greatly increased in the experiment group, but there was no radiographic change in the control group.