• Title/Summary/Keyword: Grafting, Bone

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The use of the buccal fat pad flap for oral reconstruction

  • Kim, Min-Keun;Han, Wonil;Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.5.1-5.9
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    • 2017
  • Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects. The control of etiologic factors, size of defect, anatomical location of defect, and general condition of patient could influence the prognosis after grafting. In conclusion, BFP is a reliable flap that can be applied to various clinical situations.

Therapeutic effect of marine bioactive substances against periodontitis based on in vitro, in vivo, and clinical studies

  • Tae-Hee Kim;Se-Chang Kim;Won-Kyo Jung
    • Fisheries and Aquatic Sciences
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    • v.26 no.1
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    • pp.1-23
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    • 2023
  • Marine bioactive substances (MBS), such as phlorotannins, collagens, peptides, sterols, and polysaccharides, are increasing attention as therapeutic agents for several diseases due to their pharmacological effects. Previous studies have demonstrated the biological activities of MBS including antibacterial, anticoagulant, antidiabetic, antimicrobial, anti-inflammatory activities. Among numerous human diseases, periodontitis is one of the high-prevalence inflammatory diseases in the world. To treat periodontitis, several surgeries (bone grafting, flap surgery, and soft tissue graft) are usually used. However, the surgery for patients with chronic periodontitis induces several side effects, including additional inflammatory responses at the operated site, chronic wound healing, and secondary surgery. Therefore, this review assessed the most recent trends in MBS using Google Scholar, PubMed, and Web of Science search engines to develop marine-derived therapeutic agents for periodontitis. Further, we summarized the current applications and therapeutic potential of MBS to serve as a reference for developing novel technologies applied to MBS against periodontitis treatment.

Full mouth rehabilitation of fully edentulous patient with implant-supported fixed prosthesis preceding bone graft: A case report (전악 무치악 환자에서 골이식술을 선행한 임플란트 고정성 보철 수복 증례)

  • An, Ju-Nam;Lee, Jung-Jin;Seo, Jae-Min;Kim, Kyoung-A
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.77-87
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    • 2018
  • Prosthetic treatment using implants in fully edentulous patients includes implant-supported fixed prosthesis, implant hybrid prosthesis, implant retained- or supported-over-denture and implant supported fixed prosthesis has advantages such as psychological stability, pronunciation. If an implant supported fixed prosthesis is planned, the implants should be placed in consideration of pronunciation, esthetics, and oral hygiene. For this, clinical and radiological diagnosis is indispensable. When placing the prosthetic driven implant at the site determined from the diagnosis, a sufficient amount of alveolar bone and soft tissue support are required. If these requirements found to be insufficient, a wide range of bone grafting should be performed in advance. In this case, a fully edentulous patient with severe alveolar bone resorption due to periodontal disease was treated with a full mouth rehabilitation using implant-supported fixed prosthesis preceding maxillary sinus graft and alveolar bone augmentation. We report this patient were satisfied with esthetic and function.

Evaluation of the course of the inferior alveolar canal in the mandibular ramus using cone beam computed tomography

  • Kwon, Kyung-Hwan;Sim, Kyu-Bong;Lee, Jae-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.4
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    • pp.231-239
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    • 2012
  • Objectives: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. Materials and Methods: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. Results: The distance medially from the R point to the IAC along the axial plane was $6.19{\pm}1.21mm$. The HD from the R point, posteriorly to IAC, in the lateral view was $13.07{\pm}2.45mm$, the VD from the R point was $14.24{\pm}2.41mm$, and the ND from the R point was $10.12{\pm}1.76mm$. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within $0.56{\pm}0.70mm$. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. Conclusion: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.

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.

The effects of bioactive glass on the periodontal healing of 1-wall intrabony defects in dogs (성견 1면 골결손부에서 Bioactive Glass가 치주조직 치유에 미치는 영향)

  • Park, Weon-Yeong;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.145-160
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    • 1998
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease, and numerous kinds of materials and techniques have been developed to achieve this goal. Bone grafts include autografts, allografts, xenografts and synthetic grafts. Among the synthetic grafts, bioactive glass has been used in dentistry for more than ten years and Fetner reported improved new bone formation and more amount of new attachment after grafting PerioGlas, a kind of bioactive glass, in 2-wall defects of monkeys in 1994. It Is well known that 1-wall defects have less osteogenic potential and more epithelial migration, so we need to study the erect of bioactive glass in 1-wall dejects in dogs. The present study evaluates the effect of bioactive glass on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony detects of dogs. Four millimeter deep and four millimeter wide 1-wall defects were surgically cheated in the mesial aspects of premolars. The test group received bioactive glass with a flap procedure and the control underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results: 1. The height of gingival margin was 1.30{\pm}0.73mm$ above CEJ in the control and $1.40{\pm}0.78mm$ in the test group. There was no statistically significant difference between the two group. 2. The length of epithelial growth (the distance from CEJ to the apical end of JE) was $1.74{\pm}0.47mm$ in the control and $1.12{\pm}0.36mm$ in the test group. These was a statistically significant difference between the two groups (P<0.01). 3. The length of new cementum was $2.06{\pm}0.73mm$ in the control and $2.62{\pm}0.37mm$ in the test group. There was no statistically significant difference between the two groups. 4. The length of new bone was $1.83{\pm}0.74mm$ in the control and $2.39{\pm}0.59mm$ in the test group. There was no statistically significant difference between the two groups. These results suggest that the use of bioactive glass 1-wall intrabony defects has significant effect on the prevention of junctional epithelium migration, but doesn't have any significant effect on new bone and new cementum formation.

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Role of the periosteum on bone regeneration in rabbit calvarial defects (가토의 두개골 결손부에서 골재생에 끼치는 골막의 역할)

  • Jang, Hyun-Seon;Kim, Sang-Mok;Park, Joo-Cheol;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.939-948
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    • 2005
  • The role of the periosteum on osteointegration of $Bio-Oss^{(R)}$(Geistlich, Wolhusen/Switzerland) was studied in rabbit calvarial defect. 12 New Zealand white male rabbits between 2.8 and 4 kg were included in this randomized, blinded, prospective study. Each rabbit was anesthetized with Ketamine HCl(5 mg/kg) and Xylazine HCl(1.5 ml/kg). An incision was made to the bony cranium and the periosteum was reflected. Using a 6-mm trephine bur(3i. USA), four 8-mm defects were created with copious irrigation. The defects were classified into barrier membrane($Tefgen^{(R)}$, Lifecore Biomedical. Inc, U.S.A.) only group as a control, $Bio-Oss^{(R)}$ with barrier membrane group, $Bio-Oss^{(R)}$ with periosteum covering group, and $Bio-Oss^{(R)}$ without periosteum covering group. There were 2 rabbits in each group. The wound was closed with resorbable suture materials. Rabbits were sacrificed using phentobarbital(100 mg/kg) intravenously at 1, 2, and 4 weeks after surgery. The samples were fixed in 4% paraformaldehyde, and decalcified in hydrochloric acid decalcifying solution(Fisher Scientific, Tustin, CA) at $4^{\circ}C$ for 2-4 weeks. It was embedded in paraffin and cut into 6 ${\mu}m$ thickness. The sections were stained with H & E and observed by optical microscope. The results were as follows; 1. The periosteum played an important role in osteointegration of $Bio-Oss^{(R)}$ in bone defects. 2. When the periosteum remained intact and $Bio-Oss^{(R)}$ was placed on the defect, $Bio-Oss^{(R)}$ with periosteum covering has been incorporated into the newly formed bone from 2-week postoperatively. 3. When the periosteum was removed at the surgical procedure, invasion of connective tissue took place among the granules, and new bone formation was delayed compared to periosteum covering group. Therefore, when the bone grafting was performed with periosteal incision procedure to achieve tension-free suture, the integrity of the overlying periosteum should be maintained to avoid fibrous tissue ingrowth.

THE STUDY ON COURSE OF THE INFERIOR ALVEOLAR CANAL IN THE MANDIBULAR RAMUS USING CONEBEAM CT (하악지에서의 하치조신경관 주행에 대한 Conebeam CT를 이용한 연구)

  • Kim, Hyong-Woo;Kwon, Kyung-Hwan;Min, Seung-Ki;Oh, Seung-Hwan;Chee, Young-Deok;Koh, Se-Wook;Lee, Jae-Hwan;Ohn, Byung-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.386-393
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    • 2009
  • Objectives: This study was performed to evaluate course of the inferior alveolar canal in the mandibular ramus and to find safety zone when ramal bone is harvested. Patients and Methods: From January, 2009 to February, 2009, the 20 patients who visited in the Department of Oral and Maxillofacial Surgery, Sanbon Dental Hospital. Wonkwang University and the Conebeam CT was taken of various chief complaints, were selected. The patients who had left and right mandibular first molar and incisor missing, jaw fracture and bone pathology were excluded. The R point was defined as the point which occlusal plane was crossed to the mandibular anterior ramus(external oblique ridge). In the cross-sectional coronal and axial views, the inferior alveolar canal position to the R point, buccal bone width(BW), alveolar crest distance(ACD), distance from alveolar crest to occlusal plane(COD) and inferior alveolar canal to sagittal plane(CS) were measured and horizontal distance(HD), vertical distance(VD) and nearest distance(ND) were measured. Results: The inferior alveolar canal is located $6.19{\pm}1.21\;mm$ from the R point. Horizontal distance from the R point were $13.07{\pm}2.45\;mm$, vertical distance from the R point were $14.24{\pm}2.41\;mm$ and nearest distance from the R point were $10.12{\pm}1.76\;mm$. The course of the inferior alveolar canal was positioned within $0.61{\pm}0.68\;mm$. The distance from external buccal bone to the inferior alveolar canal was increased from the R point anteriorly. Conclusions: It is considered that the mandibular ramus from the R point to 10 mm anteriorly can be harvested safely at ramal bone grafting.

Analysis of the Disposal Rate of Fresh Frozen Femoral Head in the Bone Bank of a Single Hospital (단일 병원 인체조직은행에서 채취한 신선 동결 대퇴골두의 폐기율 분석)

  • Lee, Jaeyoung;Lee, Donghun;Jeon, Jinhwa;Lee, Kee Haeng
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.305-309
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    • 2021
  • Purpose: This study analyzed the increase in disposal rate of femoral heads in the bone bank of a single hospital from medical disease and drug history, as assessed by the Korean health insurance review and assessment service. Materials and Methods: The disposal rate and cause of 340 femoral heads were analyzed according to the regulations of the bone bank based on the standard model of the Ministry of food and drug safety. Results: One hundred and seven (33%) of 323 femoral heads collected from 2009 to 2018, and 65 (46%) of 142 femoral heads collected from 2015 to 2018 were discarded. The most common causes were related to the history of dementia and the administration of radioisotope for nuclear medicine. Conclusion: The current methods and screening tools can lead to errors in disposing of the available tissues in a bone bank. Thus, improved standards and screening methods are needed.