• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제13권1호
• /
• pp.9-15
• /
• 1991

치조골 파열은 전체 구개파열 환자의 약 75% 정도 발생하며 발생원인은 유전적 요인이 강하며 환경적 요인으로 모체의 영양장애, 방사선조사, 스테로이드투여, 저산소증, 양수변화 바이러스에 의한 질환등을 들 수 있다. 치조골 파열시 상악골의 전후방관계의 전방골결손 및 수평관계의 후방골결손, 인접치아에 대한 골지지력 결여, 측절치의 조기결손, 그리고 안모의 외형에도 많은 변화를 줄 수 있다. 치조골 파열에 대한 골이식은 치조골을 안정시키고, 치조골의 연속성 도모 및 인접치아에 대한 골지지와 치아상실 예방 및 비익저부를 제공하는데 그 목적이 있다. 골이식은 시기에 따라 2세미만에 실시하는 일차 골이식술, 2세에서 5세사이에 시술하는 조기 이차 골 이식술, 5세에서 16세 사이에 실시하는 이차 골 이식술, 그리고 16세 이후에 실시하는 말기 이차골 이식술 등이 있으며 이중 혼합치열기인 5세에서 16세 사이에 실시하는 이차골 이식술이 가장 성공률이 높은 것으로 알려져 있다. 본 교실에서는 치조골 파열환자에 자가망상골을 이용한 골이식술을 시행하여 비교적 양호한 결과를 얻었기에 이에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권6호
• /
• pp.529-536
• /
• 2010

Purpose: The Purpose of this study is to show the total survival rate of implants with maxillary sinus grafting and the effects that reach the survival rate by classifying types of graft materials, implant type, operation method, residual bone height and evaluate graft material resorption rate after sinus grafting Patients and Methods: 61 dental implants placed with sinus bone grafting in 24 patients at Wonkwang University Sanbon Dental Hospital were installed simultaneously or after regular healing. Various bone grafts (autograft, xenograft, allograft, alloplast) and fourth implant type (GSII, Xive, Implantium, Novel biocare) were used. All implants were investigated clinically and radiographically, being with average 20 months follow-up period after installation. Results: 3 fixtures were lost, resulting in 95.1% cumulative survival rate of 61 osseointegrated dental implant. Survival rate according to bone material type, Implant type, operation method, residual bone height, have no statistically significant differencies. The mean preoperative residual alveolar bone height was 4.75 mm, average postoperative height of graft materials 10.8 mm, vertical bone resorption rate was 10% after 2 years. Resorption rate according to operation method was 7% (simultaneous) and 5% (delayed) after 1 year. Conclusion: It can be suggested that maxillary sinus grafting may have predictable result with various bone graft materials and implant type, residual bone height, operation method

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권2호
• /
• pp.163-168
• /
• 2001

Purpose : This study is conducted to evaluate the clinical success of secondary alveolar bone grafting using autogenous iliac particulate cancellous bone marrow in cleft maxilla. Materials and methods : We evaluated 107 cleft patients who had been admitted to the Dept. of Oral and Maxillofacial Surgery of Pusan National University Hospital from January 1, 1991 to January 31, 1999 and had been performed secondary alveolar bone grafting with autogenous particulated cancellous bone marrow from iliac crest. Results : 1. Men were 70 and women were 37, which shows 65.4% and 34.6% and the proportion of males to females was 1.9:1. Unilateral cases were 89(83.2%) and bilateral cases were 18(16.8%). 2. Age of bone grafting is widely distributed from 7 to 29, and the average was 13.2. 3. Success rate was 97.8% in unilateral cases, 94.4% in bilateral cases. Overall success rate was 96.7%. 4. We evaluated the bone graft contour by the percentage of bone attachment level adjacent to the alveolar cleft and the menial side showed 82.4% and the distal 87.7%. 5. The amount of notching the alveolar ridge at the grafted site through the ratio of notching length up to the most apical base to the length of proximal segment anatomic root was 0.19.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제17권4호
• /
• pp.365-378
• /
• 1995

Allogeneic bone grafting has recently been used in oral and maxillofacial regions to restore the cosmetic and functional problem. There are several types of allogeneic bone grafts ; bone powder, bone chips, bone blocks. Empirically, it is thought to be better to combine the allogeneic bone chips to any type of tissue adhesive not to displace during packing and condensing. But, there are no reports about using tissue adhesive in allogeneic bone grafting. This experimental study is designed to investigate the effect of the fibrin adhesive on bone healing process after demineralized allogeneic bone grafting in 60 rats. In control groups (30 rats), routine demineralized allogeneic bone grafting were done in 7 ${\times}$ 7mm calvarial bone defects which were drilled intentioally. And we used the fibrin adhesive for holding the bone particle in experimental groups (30 rats). Each experimental specimen was sacrified at 1, 2, 4, 6, 8 weeks postoperatively The results were as follows : 1. The degree of inflammatory cell infiltrations were more prominent in experimental than in control groups till 2 weeks. 2. Early fibroblast proliferation and new capillary proliferation were uncorporated around graft sites in the experimental groups later than in control groups at early stages. 3. Osteoblastic activity in control group was more prominent at 2 weeks. 4. Osteoblastic activity in experimental groups was more prominent than in control group till 4 weeks. 5. New bone formation was more in control group than experimental group till 3 weeks, but similar appearance after that time. As above results, initial bone healing within 2 weeks were more processed in without adhesive group than with adhesive group. But above 4 weeks; similar bone healing were observed.

• Archives of Plastic Surgery
• /
• 제35권3호
• /
• pp.273-278
• /
• 2008

Purpose: The most widely accepted protocol for alveolar cleft reconstruction is to repair it during the mixed dentition stage. There were lower resorption rate (about 88%) at this stage. However we found some cases that need repeated bone grafting. Therefore we sought to analyze the cause of repeated alveolar bone grafting in connection with other factors. Methods: From January 2000 to January 2006, thirty-nine secondary alveolar bone grafts with iliac crest spongiosa were carried out. In 39 patients, 5 patients who had significant bone graft resorption received repeated alveolar bone graft. In all the cases, the causes of repeated bone grafts were dental root exposure(angulation), and the deficiency of the bony support for lateral incisor or canine eruption. In 3 cases, there was deficiency of the alveolar bone at the cleft side. There was the need of repeated bone grafts for orthodontic treatment in 2 cases and for application of dental implants in 1 case. Results: During the follow-up period, the clinical and radiologic examinations showed that repeated alveolar bone grafts were maintained successfully without any complications. The volume of the repeated bone graft was sufficient for orthodontic treatment and implantation. Conclusion: The essential conditions for successful alveolar bone grafting includes the status of cleft sided teeth, further treatment and planed schedule, as well as canine eruption. Alveolar bone grafting has to be performed with difference of each case in mind.

• 대한골관절종양학회지
• /
• 제14권2호
• /
• pp.182-186
• /
• 2008

비교적 흔한 골의 양성 질환으로 소파술 및 골 이식술, 절제술, 스테로이드 또는 골수 주입법 등이 일반적으로 시행되는 단순 골낭종은 비교적 낮은 빈도로 종골에 발생하게 되며, 종골에 발생 시, 기존의 스테로이드 주입술보다는 관혈적 소파술 및 골 이식술이 주로 시행된다. 저자들은 9세 남아에서 발생한 종골의 단순 골낭종에 대해 최소 침습적 술기를 통한 내시경적 소파술 및 골 이식술을 통해 좋은 결과를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

• Archives of Plastic Surgery
• /
• 제50권5호
• /
• pp.478-487
• /
• 2023

Background The outcome of alveolar grafting with synthetic bone substitute (Osteon III) in various bone defect volumes is highlighted. Methods A prospective study was accomplished on 55 patients (6-13 years of age) with unilateral alveolar bone cleft. Osteon III, consisting of hydroxyapatite and tricalcium phosphate, is used to reconstruct the defect. Alveolus defect diameter was calculated before surgery (V1), after 3 months (V2), and finally after 6 months (V3) postsurgery. In the t-test, a significant difference and correlation between V1, V2, and V3 are stated. A p-value of 0.01 is considered a significant difference between parameters. Results The degree of cleft is divided into three categories: small (9 cases), medium (20 patients), and large (26 cases).The bone volume of the clefted site is divided into three steps: volume 1: (mean 18.1091 mm³); step 2: after 3 months, volume 2 resembles the amount of unhealed defect (mean 0.5109 mm³); and the final bone volume assessment is made after 6 months (22.5455 mm³). Both show statistically significant differences in bone volume formation. Conclusion An alloplastic bone substitute can also be used as a graft material because of its unlimited bone retrieval. Osteon III can be used to reconstruct the alveolar cleft smoothly and effectively.

• Journal of Periodontal and Implant Science
• /
• 제45권1호
• /
• pp.30-35
• /
• 2015

Purpose: Implant beds with an insufficient amount of cortical bone or a loss of cortical bone can result in the initial instability of a dental implant. Thus, the objective of this study was to evaluate the effect of bone cement grafting on implant initial stability in areas with insufficient cortical bone. Methods: Two different circumferential defect depths (2.5 mm and 5 mm) and a control (no defect) were prepared in six bovine rib bones. Fourteen implants of the same type and size ($4mm{\pm}10mm$) were placed in each group. The thickness of the cortical bone was measured for each defect. After the implant stability quotient (ISQ) values were measured three times in four different directions, bone cement was grafted to increase the primary stability of the otherwise unstable implant. After grafting, the ISQ values were measured again. Results: As defect depth increased, the ISQ value decreased. In the controls, the ISQ value was $85.45{\pm}3.36$ ($mean{\pm}standard$ deviation). In circumferential 2.5-mm and 5-mm defect groups, the ISQ values were $69.42{\pm}7.06$ and $57.43{\pm}6.87$, respectively, before grafting. These three values were significantly different (P<0.001). After grafting the bone cement, the ISQ values significantly increased to $73.72{\pm}8.00$ and $67.88{\pm}10.09$ in the 2.5-mm and 5.0-mm defect groups, respectively (P<0.05 and P<0.001). The ISQ value increased to more than double that before grafting in the circumferential 5-mm defect group. The ISQ values did not significantly differ when measured in any of the four directions. Conclusions: The use of bone cement remarkably increased the stability of the implant that otherwise had an insufficient level of stability at placement, which was caused by insufficient cortical bone volume.

• Journal of Periodontal and Implant Science
• /
• 제29권3호
• /
• pp.469-484
• /
• 1999

The purpose of this study was to evaluate new bone formation following guided bone regeneration by resorbable and nonresorbable membrane. Six adult mongrel dogs were used. The first, second, third, fourth premolars in the mandible of each dog were extracted. Two months after tooth extraction, a buccal dehiscence defect was surgically created on each edentulous area. The experimental sites were divided into three groups according to the treatment modalities ; Group I-a: surgical treatment only ; Group I -b: allogenic decalcified freezed dried bone grafting ; Group II-a : e- PTFE membrane placement only ; Group II-b : allogenic decalcified freezed dried bone grafting and e-PTFE membrane placement ; Group III-a : Vicryl(R) mesh placement only ; Group III-b : allogenic decalcified freezed dried bone grafting and Vicryl(R) mesh placement . The animals were sacrificed at 8 weeks after operation and the specimens were prepared for histologic and histometric examination. The results were as follows : Clinically, all defect sites were healed without exposure of barrier membrane after the eight weeks. In Group I-a, dense connective tissues were impinged in the bony defect area. Well vascularized and fibrous bone marrow indicated that bone formation was still taking place was found. In Group I-b, in areas closer to the periphery, lamellation of the newly formed bone would found. In Group II-a, beneath the e-PTFE membrane a dense layer of connective tissue covering the most external portions of the regenerated tissue was seen. The new bone surfaces were lined with osteoid and osteoblast. In Group II-b, a dense layer of connective tissue covering the most external portions of the regenerated tissue was observed beneath the e-PTFE membrane. A notable amount of alveolar ridge regeneration was seen with new rigdes with well-contoured form. In Group III-a, the new bone surface were lined with osteoid and osteoblast, indicating active bone formation. A clear demarcation could not be noted between the host bone and new bone. In Group III-b, a notable amount of alveolar ridge regeneration was seen with new ridges assuming wellcontoured form. In areas closer to the periphery, lamellation of the newly formed bone would found. As histometric examination, the amount of bone formation was gained from $12.8mm^2$ to $26.3mm^2$. It was significantly greater in group II-b and group III-b compared to other groups(p<0.05) . These results suggest that Vicryl(R) mesh after DFDB grafting used in guided bone regeneration could create and sustain sufficient space for new bone formation.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권2호
• /
• pp.144-148
• /
• 2011

Purpose: The purpose of this study was to evaluate the effectiveness of a novel bone grafting material using an autogeneous tooth (AutoBT) and provide the basis for its clinical application. The AutoBT contains organic and inorganic mineral components and is prepared from autogenous grafting material, thus eliminating the risk of immune reactions that may lead to its rejection. AutoBT can be used as bone material as is has both osteoinduction and osteoconduction activities at guided bone regeneration for implant placement and maxillary sinus graft. Methods: In a total of 63 patients, guided bone regeneration surgery was performed at the time of implant placement, and tissue samples were harvested at the time of the second surgery with the patient's consent. Results: There were no complications in guided bone regeneration using autogeneous tooth. Conclusion: We concluded that AutoBT underwent gradual resorption and was replaced by new bone of excellent quality via osteoinduction and osteoconduction.