• Title/Summary/Keyword: Gap healing

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Evaluation of the feasibility of bony window repositioning without using a barrier membrane in sinus lateral approach (상악동측방접근법시 차폐막을 사용하지 않는 골창재위치술의 유용성 평가)

  • Jeon, Seung-Hwan;Cho, Yong-Seok;Lee, Byung-Ha;Im, Tae-Yun;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.2
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    • pp.122-126
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    • 2011
  • Introduction: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. Materials and Methods: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. Results: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. Conclusion: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.

Clinical Application of Recombinant Human Bone Morphogenetic Protein-2 for Delayed Fractures in Dogs (개에서 골절의 지연유합에 대한 rhBMP-2의 임상적 적용 2례)

  • Kim, Jae-Kyong;Kim, Se-Eun;Go, A-Ra;Kim, Seung-Hyun;Shim, Kyung-Mi;Bae, Chun-Sik;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.412-415
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    • 2012
  • A 1-year-old, castrated male Yorkshire terrier (case 1) and a 7-year-old female Poodle (case 2) presented with delayed union fractures. In case 1, the dog had a fractured right distal radius and ulna. In case 2, the dog had a fractured left distal tibia and fibula. A physical examination and radiographs performed in both dogs revealed delayed union fractures with large gaps. The fracture sites were fixed by bone plate and screws. Autogenous cancellous bone graft was applied into the fracture gap. To encourage rapid bone union, we used matrigel containing $20{\mu}g$ of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the fracture site. Radiographs were taken postoperatively to monitor healing. Rapid bone union was noted in both dogs in long-term radiographs. In case 1, the radiographs revealed that the fracture gaps of the radius and ulna were bridged at 2 weeks. Fracture lines were not observed and normal appearance was restored at 20 weeks. In case 2, the radiographs showed that fracture repair had progressed at 11 weeks. The fractures healed faster than expected in these two cases. The results indicate that rhBMP-2 and matrigel may be effective and useful materials to enhance healing of delayed fractures.

The sequential management of recurrent temporomandibular joint ankylosis in a growing child: a case report

  • Cho, Jung-Won;Park, Jung-Hyun;Kim, Jin-Woo;Kim, Sun-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.39.1-39.6
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    • 2016
  • Background: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. Case report: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood. The multiple surgeries including a costochondral graft and gap arthroplasty using interpositional silicone block were performed, but re-ankylosis of the TMJ occurred after surgery. Alloplastic TMJ prosthesis was conducted to prevent another ankylosis, and signs or symptoms of re-ankylosis were not found. Additional reconstruction surgery was performed to compensate mandibular growth after confirming growth completion. During the first 3 years of long-term follow-up, satisfactory functional and esthetic results were observed. Conclusions: This is to review the sequential management for the recurrent TMJ ankylosis in a growing child. Even though proper healing was expected after reconstruction of the left TMJ with costal cartilage graft, additional surgical interventions, including interpositional arthroplasty, were performed due to re-ankylosis of the affected site. In this case, alloplastic prosthesis could be an option to prevent TMJ re-ankylosis for growing pediatric patients with TMJ ankylosis in the beginning.

AN IMMUNOHISTOCHEMICAL STUDY OF THE DISTRIBUTION OF FIBRONECTIN, LAMININ AND TENASCIN IN THE REGENERATING PERIODONTAL TISSUE (재생중인 치주조직내 Fibronectin, Laminin 및 Tensacin의 분포에 관한 면역조직화학적 연구)

  • Chung, Gap-Hwan;Kim, Byung-Ok;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • v.25 no.2
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    • pp.321-340
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    • 1995
  • The regeneration of destructed periodontal tissues is one of the ultimate objectives of periodontal therapy. Guided tissue regeneration technique was developed for the ideal regeneration of periodontal tissues. In order to investigate the role of fibronectin, laminin and tenascin in the regenerating process of periodontal tissues, the expanded PTFE barrier membranes(Gore Associates, USA) removed from the patients who had been treated by guided tissue regeneration(GTR) and guided bone regeneration(GBR) techniques were fixed in neutral formalin for 6-24 hours, embedded with paraffin, sectioned at $4-6{\mu}m$ in thickness, and immunohistochemically processed by Avidin-Biotin peroxidase complex method for detecting fibronectin, laminin and tenascin. Monoclonal mouse anti-human fibronectin antibody(Oncogene Science, USA., 1:100), monoclonal mouse anti-human laminin antibody(Oncogene Science, USA., 1:50) and mouse anti-human tenascin antibody(Oncogene Science, USA, 1:10) were used as primary antibodies. The light microscopic findings were as follows: (1) The distribution of fibronectin, laminin and tenascin was various according to the area of barrier membranes. (2) The distribution of fibronectin in case of GBR was extensive in the tissue on the outer surface of barrier membranes, and rare in the intervening space and on the inner surface. In case of GTR it was extensive on the outer surface and in the intervening space, and rare on the inner surface. (3) The distribution of laminin was rare in the tissue on the outer, the inner surface and intervening space of barrier membranes, regardless of GBR or GTR. (4) In case 'of GBR rare distribution of tenascin was observed on the outer surface only, except the inner surface and the intervening space of barrier membranes. In case of GTR the distribution of tenascin was extensive in the tissue on the outer surface, rare in intervening space and the inner surface. The results suggest that fibronectin, laminin and tenascin may play a important role in the regenerating process of periodontal tissue, and they may affect the outcome of healing.

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THE PHYSICAL PROPERTIES AND HEALING EFFECT OF CALCIUM SULFATE-HYDROXYAPATITE COMPOUND ON ROOT PERFORATION (Calcium sulfate-Hydroxyapatite 혼합재의 물성 및 치근천공 치유효과에 관한 연구)

  • Lee, Seung-Jong;Kim, Kyoung-Nam
    • Restorative Dentistry and Endodontics
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    • v.22 no.2
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    • pp.739-750
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    • 1997
  • Treatment of root perforation elicits special considerations due to its blood-contaminated circumstances. It is known that conventional dental restorative materials are all leaking. Calcium sulfate is the material which react with water to become chemically set. This study, therefore, was performed to develop a new compound containing calcium sulfate and to evaluate its physical and biological characteristics. Three materials were used, IRM, calcium sulfate, calcium sulfate-hydroxyapatite compound. The composition of the calcium sulfate-hydroxyapatite compound was basically 50 % of calcium sulfate and 50 % of hydroxyapatite mixed with guajacol. The materials were mixed in conventional way and underwent four physical test procedures, setting time, solubility test, compressive strength, and marginal leakage test. All materials were evaluated under the scanning electron microscope to examine the marginal sealing ability. Animal experiment was also performed to test the materials' tissue response. Twenty-four dog's premolars were tested with either furcation perforations or apical retro-fillings. From the results, we found that calcium sulfate possess the good marginal sealing ability. However, calcium sulfate creates many voids which is caused by crystal thrusting action when it reacts with water. It seemed that the voids caused disintegration of the material which eventually lead to tissue reaction. By compounding calcium sulfate and hydroxyapatite, we were able to obtain the better physical properties but it showed larger marginal gap between the material and the root surface. Within the six weeks observation period, both IRM and calcium sulfate-hydroxyapatite compound showed good tissue responses in animal experiment. It is concluded that calcium sulfate would be the material of choice in root perforation repair, but the physical property needs to be further improved.

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Arthroscopic Rotator Cuff Repair: Single Row Technique (관절경적 회전근 개 봉합술: 일열 봉합 수기)

  • Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.155-159
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    • 2007
  • Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.

Contribution of the Free Learning Semester Programs of Public Library to Local Development: Focused on Cases of Busan City (공공도서관 자유학기제 프로그램의 지역발전 기여 - 부산지역 사례를 중심으로 -)

  • Yoon, Hee-Yoon;Kim, Gyoung Hee
    • Journal of the Korean Society for Library and Information Science
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    • v.53 no.2
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    • pp.29-48
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    • 2019
  • The free learning semester system focuses on the activation of career education of middle school students as an educational policy that links career recognition in elementary school, career search in middle school, and career planning in high school. This system was fully implemented in 2016 and public libraries also provided various programs. This study analyzed the free learning semester system programs of public libraries in Busan city and demonstrated the contribution of local development. As a result, career and job search, career exploration and experience, and information literacy enhancement programs contributed to local knowledge culture, reading culture, learning culture, living culture and leisure culture. However, contribution of reading exhibitions, job experience, information literacy enhancement to the leisure culture and local economy were limited. Therefore, it is desirable that all libraries should add programs related to knowledge ecosystem structure, digital information gap, human healing, social environment issues, future job prospects, and provide information literacy programs.

Immediate implant placement in conjunction with guided bone regeneration and/or connective tissue grafts: an experimental study in canines

  • Lim, Hyun-Chang;Paeng, Kyeong-Won;Kim, Myong Ji;Jung, Ronald E.;Hammerle, Christoph HF.;Jung, Ui-Won;Thoma, Daniel S.
    • Journal of Periodontal and Implant Science
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    • v.52 no.2
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    • pp.170-180
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    • 2022
  • Purpose: This study was conducted to assess the effect of hard and/or soft tissue grafting on immediate implants in a preclinical model. Methods: In 5 mongrel dogs, the distal roots of P2 and P3 were extracted from the maxilla (4 sites in each animal), and immediate implant placement was performed. Each site was randomly assigned to 1 of the following 4 groups: i) gap filling with guided bone regeneration (the GBR group), ii) subepithelial connective tissue grafting (the SCTG group), iii) GBR and SCTG (the GBR/SCTG group), and iv) no further treatment (control). Non-submerged healing was provided for 4 months. Histological and histomorphometric analyses were performed. Results: Peri-implant tissue height and thickness favored the SCTG group (height of periimplant mucosa: 1.14 mm; tissue thickness at the implant shoulder and ±1 mm from the shoulder: 1.14 mm, 0.78 mm, and 1.57 mm, respectively; median value) over the other groups. Bone grafting was not effective at the level of the implant shoulder and on the coronal level of the shoulder. In addition, simultaneous soft and hard tissue augmentation (the GBR/SCTG group) led to a less favorable tissue contour compared to GBR or SCTG alone (height of periimplant mucosa: 3.06 mm; thickness of peri-implant mucosa at the implant shoulder and ±1 mm from the shoulder: 0.72 mm, 0.3 mm, and 1.09 mm, respectively). Conclusion: SCTG tended to have positive effects on the thickness and height of the periimplant mucosa in immediate implant placement. However, simultaneous soft and hard tissue augmentation might not allow a satisfactory tissue contour in cases where the relationship between implant position and neighboring bone housing is unfavorable.

The Physical Environment and Behavioral·Psychological Health and Quality of Life for the Elderly People with Dementia - A Follow-up Study of Empirical Research, conducted on the Context of Long-term Care Facilities for the Elderly People with Dementia, to Identify Healing Environmental Factors and to Expand the Understanding of Related Clinical Outcomes (물리적 환경과 치매거주노인의 행동·심리적 건강과 삶의 질 - 노인요양시설 치유환경 디자인 요소 도출과 연계된 중재적 의료성과의 이해확장을 위한 후속연구)

  • Choi, Young-Seon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.29 no.4
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    • pp.7-20
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    • 2023
  • Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of physical and environmental factors on behavioral·psychological health and quality of life for the elderly people with dementia who reside in long-term care facilities. This follow-up study of the previous literature review aims to further identify physical and environmental factors, that improve health and quality of life for the elderly people with dementia, published in recent five years and to expand the understanding of clinical outcomes as mechanism that mediate the effect of physical environmental factors on improving behavioral·psychological health and quality of life for the elderly people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies that link the design of dementia care facilities to health- and quality of care(QOL)-related outcomes and this follow-up review scrutinized peer-reviewed articles published in recent five years (from January 2018 to December 2022), filling the gap between the previous literature review and the current state of research. Results: The review identified a growing body of literature that articulates environment-related factors that improve behavioral·psychological health and quality of life for the elderly people with dementia living long-term care facilities. Implications: The findings of the review can be translated to design implications and design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

Effect of Nandrolone Decanoate on Disuse Muscle Atrophy and Bone Beating in Dogs (개에서 불용성 근위축과 골절 치유에 대한 Nandrolone decanoate의 효과)

  • Yun Seong-jin;Lim Ji-hey;Rahman Md. Mizanur;Byeon Ye-eun;Kim Wan-hee;Kweon Oh-kyeong
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.336-341
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    • 2005
  • Anabolic steroid compounds are widely used for the increase of muscle mass, density of bone and athletic ability. The present study conducted to evaluate the effects of nandrolone decanoate (ND), one of the anabolic steroid compounds, on disuse muscle atrophy and healing process of bone in dogs. Twenty physically healthy dogs of both sexes were used in this experiment and divided into three groups: group A (control), group B (low dose M-1.5 mg/kg) and group C (high dose ND-7.5 mg/kg). One-mm strip of full thickness bone was excised from the radius below the pronator teres muscle for the artificial fracture and then the fractured ends were fixed in apposition with bone plate leaving 1mm gap, and finally immobilized externally by Robert John's bandage for 4 weeks. ND was administered intramuscularly once a week far 8 weeks. Body weight, muscle mass change and fracture gap of the bone were evaluated immediately after surgery, and 2, 4, and 8 weeks after surgery. The rates of muscle mass change 8 weeks after surgery were $-2.75\pm0.16\%,\;1.68\pm0.11\%\;and\;1.74\pm0.48\%$ in groups A, B and C, respectively. The significant increase (p<0.05) of muscle mass increments were found in the treated groups. The fibrous connective tissue layer in the fracture gaps of the treated groups increased more than the control, especially in the group C at 4th week. More dense fibrous connective tissue were found in the treated groups at 8th week. Collectively, our results suggested that ND was an effective anabolic agent for the immobilized disuse muscle and bone healing.