• Archives of Plastic Surgery
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• v.48 no.6
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• pp.630-634
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• 2021

To date, there have been no reports of patients showing a Tessier number 7 cleft with unilateral complete cleft lip and palate. Furthermore, no studies have established the sequence, plan, or timing of surgical methods for treating patients presenting the above anomalies simultaneously. We report a case of a Tessier number 7 cleft with unilateral complete cleft lip and palate. Two months after birth, lip adhesion was performed on the unilateral complete cleft lip and total excision was performed on the skin tag. At 4 months of age, Tessier number 7 cleft was corrected. At 6 months of age, surgery involving two small triangular flaps was performed on the unilateral incomplete cleft lip after performing lip adhesion. At 13 months of age, two-flap palatoplasty with a vomer flap was performed on the complete cleft palate. At 6 years of age, open rhinoplasty was performed on the unilateral cleft lip nose deformity. At 9 years of age, bone grafting was performed for the alveolar cleft. At follow-up appointments up to 13 years of age, there were no major complications. Here, we present this patient, surgical procedures and timelines, and show our results demonstrating good postoperative outcomes.

• Korean Journal of Veterinary Research
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• v.60 no.4
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• pp.187-194
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• 2020

Two small-breed dogs and two cats, with an average body weight of 4.88 kg (range: 4.3-5.5 kg), suffered hindlimb lameness due to luxation with or without fractures of the tarsocrural joint. These patients underwent tarsocrural arthrodesis with epoxy putty external skeletal fixator. The animals' skins were incised minimally, and the articular cartilage of the tarsocrural joint was removed, followed by autogenous cancellous bone grafting. Epoxy putty and positive Centerface®, pins with diameters 1.2 mm and 2.0 mm, were used for connecting bar and as a full pin fixation, respectively. All the patients regained the ability to bear weight on the affected limb within 3-7 days and resumed a normal gait within 9-15 weeks. The external skeletal fixator frame was removed within 13-17 weeks without major complications. Tarsocrural arthrodesis using epoxy putty external skeletal fixator resulted in excellent outcomes without severe postoperative complications in this study. Epoxy putty external skeletal fixator can be a valuable surgical option for tarsocrural arthrodesis in patients weighing less than 5.5 kg.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.29 no.1
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• pp.54-61
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• 2020

Forced orthodontic eruption(FOE) is a non-surgical treatment approach that allows augmenting both soft- and hard-tissue profiles of potential implant sites, by forced orthodontic extrusion of "hopeless" teeth and their periodontal apparatus. By stretching the gingival and periodontal ligament fibers during extrusion, tension is imparted to the entire alveolar socket, stimulating osseous apposition at the alveolar crest. FOE increases the width of the attached gingiva, and the mucogingival junction remains stable when the gingival margin migrates coronally. Based on these effects, FOE of non-restorable teeth prior to implant placement is a viable alternative to conventional surgical augmentative procedures in implant site development. The aim of this case report is to describes coronal soft-tissue augmentation around fractured teeth, which was achieved by FOE before implant placement.

• Archives of Plastic Surgery
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• v.51 no.2
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• pp.187-195
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• 2024

Primary tuberculous osteomyelitis involving the mandible represents less than 2% of skeletal locations. In this paper, we report a case of mandibular tuberculosis (TB) detected after histopathological analysis of the surgically resected specimen during surgical management of a suspected case of ameloblastoma. A 14-year-old male patient presented to us with history of right-sided chin swelling. The clinical examination revealed a swelling, involving right body and parasymphysis of mandible, measuring approximately 6 cm in length and 2 cm in width, extending from right lateral incisor till the first molar. Radiological scans revealed a large multiloculated osteolytic expansive lesion measuring 52 × 20 × 18 mm. Excision of the lesion was performed and reconstruction was done with iliac bone grafting. The histopathological findings revealed a granulomatous lesion, suggestive of tuberculous osteomyelitis. The patient was successfully treated with standard multidrug therapy. One year after completion of therapy, there were no signs of recurrence. Primary mandibular TB is an extremely rare entity. Its clinical presentation is not specific. Radiologically, TB has no characteristic appearance. The positive diagnosis is based on histology. Primary mandibular TB is rare and should be kept among differential diagnoses in susceptible population and in endemic areas.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.429-455
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• 2002

There are numerous kind of materials and techniques to regenerate the periodontal tissue which has been lost due to destructive periodontal disease, including bone graft material. Many bone graft materials have been reported and among these materials, synthetic material has been developed fin the long time because of its sufficient supply economically. Calcium sulfate which was evaluated as including much calcium, has been used in the clinical field. In the dental field calcium sulfate has been used as bone graft material and Kim reported that improved bone formation and more amount of new attachment after grafting calcium sulfate. but, because calcium sulfate has the problem that it generates the heat in setting period and resolves fast, we need to evaluate the effect of the improved calcium sulfate on periodontal tissue. The present study evaluates the effect of paste type calcium sulfate on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony defect in dogs. Four millimeter deep and four millimeter wide 3-wall defects were surgically created in the mesial or distal aspects of premolars or molars. the test group received paste-type calcium sulfate with a flap procedure and the control group underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results : 1. The length of epithelial growth(the distance from CEJ to the apical end of JE) was 0.52${\pm}$0.26mm in the control and 0.56${\pm}$0.25mm in the test group. there was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was 1.74${\pm}$1.06mm in the control and 1.28${\pm}$0.57mm in the test group. there was no statistically significant difference between the two groups. 3. The length of new bone was 2.01${\pm}$0.95mm in the control and 2.62${\pm}$0.81mm in the test group. there was no statistically significant difference between the two groups. 4. The length of new cementum was 1.86${\pm}$0.80mm in the control and 2.77${\pm}$ 0.86mm in the test group. there was a statistically significant difference between the two groups.(P<0.01) These results suggest that the use of paste type calcium sulfate in 3-wall intrabony defects has significant effect on new cementum formation , but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation. Finally, the paste type calcium sulfate that is used in this study is suggested to be the material that can have a significant effect on the periodontal healing, if its biocompatibility is improved.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.405-412
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• 1999

Purpose: It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. Materials and Methods: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. Results: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). Conclusion: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.209-219
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• 1997

Objectives: Anterior approach to achieve arthrodesis of the cervical spine has become a widely accepted and often-used approach since its earliest reports by Bailey and Badgley, Smith and Robinson and Cloward. However, anterior interbody fusion in the presence of the posterior instability may be complicated by the bone graft dislodgement, kyphotic defomity or nonunion. As an attemp to prevent this undesirable complication, additional methods such as skeletal traction, halo appratus or even posterior fusion has been utilized. Therefore, The cervical spine locking plate(CSLP) with the anterior intervertebral body bone grafting provide immediate cervical stabilization and widely successful in achieving fusion. Material and methods: This study analysed 14 patients who underwent a single anterior procedure and application of CSLP for the treatment of the cervical spinal disorder. Eleven patients were disc herniations and three patients were traumatic lesion. The average age of the patient was 47 years and the mean follow up periods was 20 months ranging from 13 to 27 months. Results: Ambulation was started 2nd day after the operation with the aid of the Philadelpia orthoses. Bone union was observed 13 cases on average 12 weeks after operation. The one case was nonunion with plate breakage without clinical symptom. Conclusion: Anterior fusion with CSLP are thought to be a safe and valuable method for treating cervical spine disorder.

• Journal of dental hygiene science
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• v.13 no.2
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• pp.158-164
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• 2013

The most frequently encountered problems at fixture-implantation sites are lack of adequate bone and proximity to anatomic structures. It is generally accepted that growth factors play an essential role in the healing process and tissue formation, and they have become the focus of grafting materials research. The granules in platelets contain high concentrations of various growth factors. In particular, platelet-rich fibrin (PRF) is a second-generation platelet concentrate that allows the production of fibrin membranes enriched with platelets and growth factors from an anticoagulant-free blood harvest. This study investigated the in vitro effects of PRF on osteoblasts, in terms of the key cellular functions, and especially the effects on two growth factors, the homodimer of platelet-derived growth factor subunit B (BPDGF-BB) and transforming growth factor (TGF)-${\beta}1$, which are associated with wound healing and regeneration (i.e., proliferation and differentiation). The following parameters were investigated: PDGF-BB and TGF-${\beta}1$ levels in PRF, cell viability, alkaline phosphatase (ALP) activity, type 1 collagen synthesis, and the expressions of osteoblast differentiation markers (ALP and runt-related transcription factor 2) and bone matrix proteins (type 1 collagen). The release of autologous growth factors from PRF was maintained for a reasonable period of time, and exerted positive effects on the proliferation and differentiation of osteoblasts. The use of PRF thus appears to be a promising method for enhancing bone healing and remodeling.

• Journal of Periodontal and Implant Science
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• v.33 no.3
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• pp.439-455
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• 2003

연구목적 : SLA surface dental implant 주위의 3면 골내낭에서 xenogeneic demineralized bone matric putty, porous ${\beta}$-tri-calcium phosphate, 새로이 개발된 non-crystalline calcium phosphate glass를 사용한 치료를 조직학적으로 비교 평가하기 위한 것이다. 연구방법 : 실험동물로는 15개월에서 18개월 사이의 12kg에서 15kg 정도되는 성견을 사용하였다. 20개의 SLA surface implant가 사용되었으며, 성견 하악의 양측에 각각 2개씩 사용되었다. 임플란트 식립전에, 각각의 임플란트 근심면에 straight fissure bur를 이용하여 표준화된 3면 골내앙(근원심 5mm ${\times}$협설 3mm ${\times}$깊이 3mm)을 형성하였다. 형성된 골 결손부에는 demineralized bone matrix putty, porous ${\beta}$-tri-calcium phosphate, non-crystalline calcium phosphate glass를 넣은 것을 각각 실험군으로, 이식재를 넣지 않은 것을 대조군으로 사용하였다. 8주 후에 실험 동물을 희생시키고 조직학적 관찰을 하였다. 결과 : 조직학적 소견상 임플란트 주위에 급성 염증 소견은 보이지 않았으며, non-crystalline calcium phosphate glass은 매우 적은량의 신생골을, ${\beta}$-TCP을 이용한 골내낭에서는 약간의 기저부에서 유래된 신생골이 관찰된다. ${\beta}$-TCP granules 가운데로 상당량의 측면의 골에서 유래된 신생골 형성이 보인다. xenogeneic DBM putty에서는 많은 량의 신생골이 기저부에 형성된 것을 볼수 있으나 대조군과의 차이는 크지 않다. 이식재의 종류와 상관없이 흡수되지 않은 이식재를 임플란트 주위에서 관찰할 수 있었다. 골내낭 안의 이식재들은 모두 connective tissue로 둘러 싸여 있었다. 모든 실험군에서 이식재에서 기인한 신생골 형성과 임플란트 표면에 신생 골유착의 조직학적 증거는 발견되지 않았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.197-205
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• 2007

Angiogenesis is a essential part for bone formation and bone fracture healing. Vascular endothelial growth factor (VEGF), one of the most important molecules among many angiogenic factors, is a specific mitogen for vascular endothelial cells. VEGF-mediated angiogenesis is required for bone formation and repair. However, the effect of VEGF on osteoblastic cells during osteogenesis is still controversial. In recent days, substantial progress have been made toward developing tissue-engineered alternatives to autologous bone grafting for maxillofacial bony defects. Periosteum has received considerable interest as a better source of adult stem cells. Periosteum has the advantage of easy harvest and contains various cell types and progenitor cells that are able to differentiate into a several mesenchymal lineages, including bone. Several studies have reported the bone formation potential of periosteal cells, however, the correlation between VEGF signaling and cultured human periosteal cell-derived osteogenesis has not been fully investigated yet. The purpose of this study was to examine the correlation between VEGF signaling and cultured human periosteal-derived cells osteogenesis. Periosteal tissues of $5\;{\times}\;20\;mm$ were obtained from mandible during surgical extraction of lower impacted third molar from 3 patients. Periosteal-derived cells were introduced into the cell culture and were subcultured once they reached confluence. After passage 3, the periosteal-derived cells were further cultured for 42 days in an osteogenic inductive culture medium containing dexamethasone, ascorbic acid, and ${\beta}-glycerophosphate$. We evaluated the alkaline phosphatase (ALP) activity, the expression of Runx2 and VEGF, alizarin red S staining, and the quantification of osteocalcin and VEGF secretion in the periosteal-derived cells. The ALP activity increased rapidly up to day 14, followed by decrease in activity to day 35. Runx2 was expressed strongly at day 7, followed by decreased expression at day 14, and its expression was not observed thereafter. Both VEGF 165 and VEGF 121 were expressed strongly at day 35 and 42 of culture, particularly during the later stages of differentiation. Alizarin red S-positive nodules were first observed on day 14 and then increased in number during the entire culture period. Osteocalcin and VEGF were first detected in the culture medium on day 14, and their levels increased thereafter in a time-dependent manner. These results suggest that VEGF secretion from cultured human periosteal-derived cells increases along with mineralization process of the extracellular matrix. The level of VEGF secretion from periosteal-derived cells might depend on the extent of osteoblastic differentiation.