• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.1
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• pp.49-61
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• 1993

The transplantation of cartilage, especially auricular cartilage, has assumed a role of importance in the field of plastic and reconstructive surgery. From long years ago, many reports have appeared in the literature describing the experimental and clinical results of the use of cartilage. At present, the evidence for survival of autograft of cartilage is admitted, But, the results for interrelationship between the bone and cartilage grafts with or without perichondrium is not so conclusive. The purpose of this study were observed as to whether autogenous cartilage grafts were fixed by means of tie with 4-0 vicryl and fibrin adhesive on the femur or microscopic findings of union state in 16 rabbits. We sacrified the experimental animals after 1, 2, 4, 6 weeks postoperatively and made the specimens as a routine laboratory procedures and stained with Hematoxylin-Eosin stain, Verhoeff-van Gieson elastic fiber stain, and alcian blue periodic acid-Schiff(AB-PAS) for mucopolysaccharide. Histologic evaluation was performed under microscope. The obtaind results were as follows : 1. Fibrous union was formed between the grafting cartilage and the femur, nor any findings of calcification and formation of new bone. 2. Partial fibrous adhesion was observed in fibrin adhesive groups on 6 weeks postoperatively. 3. Appositional growth has performed more in fibrin adhesive groups than tie groups. 4. There are little difference in both for new copillary proliferation and fibroblast activations. 5. Degenerative changes have apperared more in tie groups than adhesive groups, but not related to the healing periods.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.87-93
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• 2012

Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.528-532
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• 2010

Introduction: There are few reports on tooth eruption through Bio-Oss grafts. To our knowledge, there are no reports on whether teeth can erupt normally through the grafts. The aim of this study was to examine the effect of Bio-Oss grafts on tooth eruption in a canine model. Materials and Methods: In five 10-week-old dogs, the deciduous third mandibular molars in one jaw quadrant of each animal were extracted and the fresh extraction sockets were then filled with Bio-Oss particles (experimental side). No such treatments were performed on the contralateral side (control side). A clinical and radiological evaluation was carried out every other week to evaluate the eruption level of the permanent third mandibular premolars and compare the eruption levels between the two sides. Results: At week 4 after the experiment, the permanent third premolars began to erupt on both sides. At week 12, the crown of the permanent third premolar emerged from the gingiva on both sides. At week 20, the permanent third premolars on both sides erupted enough to occlude the opposing teeth. No significant differences were found between the control and experimental sides in terms of the eruption speed of the permanent third molars. Conclusion: These findings demonstrate that the grafting of Bio-Oss particles into the alveolar bone defects does not affect tooth eruption.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.2
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• pp.68-75
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• 2014

Objectives: This study was performed to analyze the cumulative survival rate of Osstem implants (Osstem Implant Co., Ltd.) over a seven-year period. Materials and Methods: A total of 105 patients who had 467 Osstem implants that were placed at the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from June 2003 through December 2005 were analyzed. The life table method and a cross-tubulation analysis, log rank test were used to evaluate the survival curve and the influence that the prognostic factors. The prognostic factors, i.e., age and gender of patients, diameter and length, type of implants, bone graft history and loading time were determined with a Cox proportional hazard model based on logistic regression analysis. Results: The seven-year cumulative survival rate of Osstem implants was 95.37%. The Cox proportional hazard model revealed that the following factors had a significant influence on survival rate; increased diameter, reduced prosthetic loading period and performance of bone grafting. Conclusion: The osstem implants showed satisfactory results over the seven-year study period.

• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.705-715
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• 2003

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.605-610
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• 2001

Objective : The authors investigated the efficacy of the calcium sulfate(OsteoSet$^{(R)}$ pellets) as an autograft extender when used to perform posterolateral lumbar fusions. Patients and Methods : Twenty patients who underwent lumbar posterolateral arthrodesis for various spinal diseases between October 1999 and March 2000 were evaluated. Arthrodesis was performed by transpedicular screw fixation and bone grafting with a mixture of autograft + calcium sulfate in a 1 : 1 ratio. At time intervals of 1, 2, 3, and 6 months, postoperative radiographs were obtained to review the resorption of calcium sulfate and the evidence of fusion. A modified Lenke scale was used to assess the status of the fusion. Results : At 2 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 3.8. However at 6 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 1.8. Resorption of calcium sulfate pellets was revealed in all cases at 6 months after surgery. Conclusion : It is presumed that a combination of calcium sulfate and autograft can play a role as an effective autograft extender in the posterolateral spinal fusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.428-436
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• 2008

For Longevity of implant, considerations of biomechanical and microbiological aspects must be done. Recently, due to the remarkable development of bone grafting procedure. Implant has been implanted into the more favorable sites but peri-implantitis resulted from periodontal bacteria may obscure the long-term prognosis. Although many different modalities have been introduced to treat the failed implant. Implant's surface and irreversible bony destruction around the implant prevents good result. After Er,Cr:YSGG (waterlase) laser using the wave-length of 2780nm has been introduced to dental field, good results have been reported. Because waterlase uses the hydrokinetic force of water. It is excellent device to detoxify the implant surface mechanically without the heat generation and damage to the implant surface. We designed to evaluate waterlase effect on the peri-implantitis has been occurred after implantation. Four beagle dogs were involved. We have made four premolar extraction in each right and left side of the lower jaw and placed two implants in the anterior of the jaw as a control and six implant were placed posterior in each socket after extraction immediately as an experimental group. We tied floss-silk in each implant to make peri-implantitis intentionally. After three months, we explored peri-implant sites on each experimental fixtures. Using waterlase laser irradiation was performed on that implantitis sites under 3W, air 30% and water 20% intensity for 2 minutes. In control group, we repositioned the flap to cover the exposed fixture without any supportive care. Three months later, we sacrificed experimental animals and extracted and preparated bone blocks with Donath and Breuner (982), Donath (988)'s methods and examined under microscope. We have obtained good re-osseointegration around fixtures after treating with waterlaser irradiation. But it was shown fibroosseointegration in the control group.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.140-145
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• 2010

Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

• Archives of Reconstructive Microsurgery
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• v.17 no.2
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• pp.68-74
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• 2008

Segmental defects of the tibia after open fractures, sepsis and a tumor surgery are among the most difficult and challenging clinical problems. Tibia defects in these situations are complicated with infection and are resistant to conventional bone grafting techniques. The aim of this study is to report the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of tibia defects. Ten patients had free flap followed by IVFT in the period 1989~2007. Mean age was 25.3 years. The patients were followed for an average of 3.4 years. All flaps were survived including 1 case with venous thrombosis requiring additional surgery. The average time to union of proximal and distal end was 5.2 months, 8.2 months, each other. All transposed fibula were viable at last follow-up. IVFT offers the advantages of a vascularized graft. In patients with large bone and soft tissue defects combined with infection, free flap followed by IVFT is an useful and reliable method without microvascular anastomosis.

• Journal of Periodontal and Implant Science
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• v.38 no.sup2
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• pp.309-316
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• 2008

Purpose: The aim of this study was to determine the survival rates of implants placed in grafted maxillary sinuses and compare the results obtained with graft materials, implant surfaces and timing of implant placement. Materials and Methods: Between January 1996 and December 2005, 391 implants were placed in 161 patients who underwent sinus grafting treatment simultaneously or separately at Ewha Womans University Hospital. According to inclusion criteria, 272 implants were placed in 102 patients with 112 sinus grafts (30 females, 72 males), aged 26 to 88 years (mean age $49.0{\pm}9.7$). The follow-up period ranged from 12 to 134 months (mean F/U $47{\pm}32$). Survival rates were evaluated according to graft material, implant surface and timing of implant placement. The Kaplan-Meier procedure and the log rank (Mantel-Cox) test were used to estimate survival rates and test for equality of survival rates between different groups of patients. Results: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. The survival rates for autogenous bone, combination and bone substitutes were 94.6%, 85.9% and 100%, respectively (p > 0.05). According to implant surface, survival rates were 84.8% in machined group and 97.5% in rough group (p < 0.05). The survival rates were 92.9% in delayed group and 86.0% in simultaneous group (p > 0.05). Conclusion: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. Rough-surfaced implants have a higher survival rate than machined-surfaced implants when placed in grafted sinuses (p < 0.05).