• Archives of Plastic Surgery
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• v.35 no.6
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• pp.716-722
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• 2008

Purpose: Split or full thickness skin graft is generally used to reconstruct the palmar skin and soft tissue defect after release of burn scar flexion contracture of hand. As a way to overcome and improve aesthetic and functional problems, the authors used the preserved superficial fat skin(PSFS) composite graft for correction of burn scar contracture of hand. Methods: From December of 2001 to July of 2007, thirty patients with burn scar contracture of hand were corrected. The palmar skin and soft tissue defect after release of burn scar contracture was reconstructed with the PSFS composite graft harvested from medial foot or below lateral and medial malleolus, with a preserved superficial fat layer. To promote take of the PSFS composite graft, a foam and polyurethane film dressing was used to maintain the moisture environment and Kirschner wire was inserted for immobilization. Before and after the surgery, a range of motion was measured by graduator. Using a chromameter, skin color difference between the PSFS composite graft and surrounding normal skin was measured and compared with full thickness skin graft from groin. Results: In all cases, the PSFS composite graft was well taken without necrosis, although the graft was as big as $330mm^2$(mean $150mm^2$). Contracture of hand was completely corrected without recurrence. The PSFS composite graft showed more correlations and harmonies with surrounding normal skin and less pigmentation than full thickness skin graft. Donor site scar was also obscure. Conclusion: The PSFS composite graft should be considered as a useful option for correction of burn scar flexion contracture of hand.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.475-480
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• 2009

Purpose: To correct the facial asymmetry and to achieve symmetry and balance, not only the soft tissue restoration of deficits but also creation and facial contour line such as mandible border and angle is important. Micro fat graft has limitation such as high resorption rate and somewhat limited ability to emphasize the rigid bony characteristics of the mandible angle due to its innate soft consistency. We have investigated the advantages of dermal fat graft over micro fat graft to correct asymmetry of the lower face in patients who had undergone mandibular reconstruction or distraction, using comparative analysis. Methods: Total of 12 patients were enrolled in our study: 6 micro fat graft and 6 dermal fat graft. Postoperative results were compared and analyzed at immediate postoperative period and more than 1 year later in each group with photographs, and analysised with image J program. Result: No complications were noted both in the micro fat type and the dermal fat type of procedures such as fat necrosis or micro calcifications. All of the patients who received micro fat graft, however had considerable amount of fat resorption after the procedure which led to two additional fat graft procedures. Although minor contour obliteration due to contracture was seen in patients who had undergone dermal fat graft procedure, no definite resorption was found even after more than one year follow-up. Results of dermal fat graft patients were satisfactory in terms of mandible angle symmetry. Secondary revision was necessary in one case due to overcorrection using dermal fat graft. Conclusion: The dermal fat graft has many advantages over the conventionally more popular micro fat graft to correct asymmetry of the lower face following mandible reconstruction owing to its lower resoption rate, more effective in emphasizing the natural curvilinear anatomical contours of the mandible angle and body and lower complication rates such as fat necrosis or micro calcifications.

• The Journal of the Korean dental association
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• v.48 no.4
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• pp.256-262
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• 2010

bone grafting is indicated in the case of bony defects and is classified into autograft, allograft, and xenograft. Synthetic bone graft is contrasted with these three categories in that it has a different donor source. Autograft is most prominent as it is known as a gold standard of all grafting procedures. Its principles and practices are well established via accumulated informations and clinical experiences, which imposes no regulations or restrictions in its clinical use. On the other hand, other bone graft procedures are under tight control for the safety and effectiveness of each product. Food and Drug Administration of the United States has a system in which the information on the approvals and clearances of bone graft materials on their internet homepage. All the bone graft materials that are under the regulations of the United States are classified into the category of medical devices, which includes allogenic bone, xenogenic bone, and synthetic bone graft materials. Each bone graft material has its own indication and the FDA approvals and clearances of medical devices contain the item of "intended use" to specify the indications of each bone graft materials. US dentists, as users of the specific bone graft materials, are provided with adequate information on the approved materials they are to utilize. As an user of these materials, Korean dentists are less provided with the information on the bone graft materials they want to use. Medical providers of the bone graft materials have to be able to provide their users with the essential information such as the intended use of the regulatory approval. Dentists must also be active in gathering informations on the material of their interest, and the system must be built in which both of the medical providers and users of bone graft materials can be satisfied in providing and getting the information, respectively.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.21.1-21.6
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• 2017

Background: The purposes of the present study were to compare implant stabilities of mandibular block bone graft and bovine bone graft and to evaluate influencing factors for implant stability in mandibular block bone (MBB) graft. Methods: This retrospective study investigated 1224 cases and 389 patients treated by one surgeon in the Department of Oral and Maxillofacial Surgery of Pusan National University Dental Hospital (Yangsan, Korea) between January 2010 and December 2014. Proportions that MBB graft cases constitute in all implant restoration cases and in all bone graft cases were measured. Implant stability quotient (ISQ) values were achieved by the same surgeon before loading. The average ISQ values of the experimental groups were compared. In addition, ISQ values of influencing factors, such as age, sex, implant size, and implant placement site, were compared within the MBB group using $Osstell^{TM}$ Mentor ($Osstell^{(R)}$, $G{\ddot{o}}teborg$, Sweden). Paired t test and ANOVA were conducted for statistical analysis with a significance level of 0.05. Results: Fifty-five percent of all implant restoration cases performed bone graft while MBB cases constituted 34% of all implant restoration cases and 61% of all bone graft cases. Comparing ISQ values according to bone graft materials, the MBB group manifested sufficient implant stability by presenting comparable ISQ value to that of the experimental group without bone graft. Among the reviewed factors, females, mandibular molar regions, and implants in larger diameter displayed greater implant stabilities. Conclusions: Satisfactory implant stability was accomplished upon administration of MBB graft. Within the limitation of this study, gender, implant site, and implant diameter were speculated to influence on implant stability in MBB graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.276-281
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• 2010

The maxillary posterior area is the most challenging site for the dental implant. After missing of teeth on maxillary posterior area due to periodontal problems, the remaining alveolar ridge is usually very thin because of not only pneumatization of maxillary sinus but also destruction of alveolar bone. The maxillary sinus bone graft procedure is one of the most predictable and successful treatments for the rehabilitation of atrophic and pneumatized endentulous posterior maxilla. But, in case of severe destruction of alveolar bone due to periodontal problems, very long crown length is still remaining problem after successful sinus graft procedures. We performed vertical augmentation of maxillary posterior alveolar ridge using mandibular ramal block bone graft with simultaneous sinus graft. After this procedures, we could get more favorable crown-implant ratio of final prosthodontic appliance and more satisfactory results on biomechanics. This is a preliminary report of the vertical augmentation of maxillary posterior alveolar ridge using mandibular ramal block bone graft with simultaneous sinus graft, so requires more long-term follow up and further studies.

• Journal of Chest Surgery
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• v.33 no.1
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• pp.99-102
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• 2000

The usual treatment for aortic aneurysms is surgical replacement with a prosthetic graft; however the associated morbidity and mortality rates must be considered. Endovascular placement of self-expandable stent-graft is a safe noninvasive treatment that can be an alternative to the surgical repair, the postoperative course of the 2 cases of thoracoabdominal aortic aneurysms was uneventful and no complication has been associated with the stent-graft during the 17 months and 5 months follow-up studies,.

• Journal of Korean Dental Science
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• v.4 no.2
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• pp.79-84
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• 2011

The extracted right mandibular third molar of a 37-year-old man was transplanted into the first molar area, and a bone graft procedure using autogenous tooth-bone graft material was performed for the space between the root and the alveolar socket. Reattachment was achieved after 10 months. Therefore, autogenous tooth-bone graft material is considered reasonable for bone induction and healing in the autotransplantation of teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.37-42
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• 2014

Recently, clinical application of autogenous tooth bone-graft materials has been reported. Autogenous tooth bone graft has been used in implant surgery. Familial tooth bone graft is a more advanced procedure than autogenous teeth bone graft in that extracted teeth can be used for bone graft materials of implant and teeth donation between siblings is possible. We used autogenous tooth and familial tooth bone-graft materials for ridge augmentation and sinus bone graft and obtained satisfactory results. The cases are presented herein.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.557-564
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• 2000

The bone graft materials can be grossly divided into autogenous bone, allogenic bone, xenogenic bone, and alloplastic material. Much care was given to other bone graft materials away from autogenous bone due to its additional operation for harvesting, delayed resorption and limitation of quantity. Demineralized freeze-dried bone(DFDB) and hydroxyapatite are the representatives of bone graft materials. As resorbable hydroxyapatite is developed in these days, the disadvantage of nonresorbability can be overcome. So we planned to study on the strength and the bone formation at the rats calvarial defects of DFDB graft and those of the composite graft with DFDB and resorbable hydroxyapatite. We used the 16 male rats weighting range from 250 to 300 gram bred under the same environment during same period. After we made the 6mm diameter calvarial defect, we filled the DFDB in 8 rats and DFDB and resorbable hydroxyapatite in another 8 rats. We sacrificed them at the postoperative 1 month and 2 months with the periostium observed. As soon as the specimens were delivered, we measured the compressive forces to break the normal calvarial area and the newly formed bone in calvarial defect area using Instron(Model Autograph $S-2000^{(R)}$, Shimadzu, Japan). The rest of the specimens were stained with H&E(Hematoxylin & Eosin) and evaluated with the light microscope. So we got the following results. 1. In every rats, there was no significant difference between the measured forces of normal bone area and those of the bone graft area. 2. In 1 month, the measured forces at DFDB graft group were higher than those of the DFDB and resorbable hydroxyapatite composite graft group(P<0.05). 3. In 2 months, there was no significant differences between the measured forces of DFDB graft group and those of the DFDB and resorbable hydroxyapatite composite graft group. 4. In lightmicroscopic examination, most of the grafted DFDB were transformed into bone in 1 month and a large numbers of hydroxyapatite crystal were observed in DFDB and resorbable hydroxyapatite composite graft group in 1 month. 5. Both group showed no inflammatory reaction in 1 month. And hydroxyapatite crystals had a tight junction without soft tissue invagination when consolidated with newly formed bone. 6. In both groups, newly formed bone showed the partial bone remodeling and the lamellar bone structures and some of reversal lines were observed in 2 months. From the above results, it is suggested that DFDB and resorbable hydroxyapatite composite graft group had a better resistance to compressive force in early stage than DFDB graft group, but there would be no significant difference between two groups after some period. And it is suggested that the early stage of bone formation procedure of DFDB and resorbable hydroxyapatite composite graft group was slight slower than that of DFDB graft group, but there would be no significant difference between two groups after some period.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.341-346
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• 2006

The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. A new skin graft(dermis graft; deepithelialized split thickness skin graft), was used to minimize these problems. The important aspects of this method involve immediate return of epidermis to the donor site and restoration of the recipient site's epidermis by inducing epithelialization from adjacent skin. From April of 2001 to March of 2004, dermis graft and a conventional split thickness skin graft(STSG) were performed in 53 and 33 patients, respectively. The healing time, the scar condition, and the patients' satisfaction were compared. Regarding the recipient sites, the wounds of the dermis graft(n=53) and STSG(n=33) had reepithelialized after $15.5{\pm}1.9$ and $11.8{\pm}1.6$ days, respectively. The scarring were less severe on the dermis graft in terms of pigmentation, height, and vascularity(p<0.05). No significant difference in pliability was detected. The patients' satisfaction with the dermis graft was also better. Concerning the donor sites, the wounds healed within $7.5{\pm}0.8$ and $12.8{\pm}1.1$ days, respectively. In terms of scar quality and patients' satisfaction, the dermis graft(n=26) showed better results. The dermis graft is superior to conventional STSG both aesthetically and functionally in both the recipient and donor sites.